The Morning Drill: October 11, 2011

A collection of dentistry and health related links/comments for your day.

The trouble with prostate cancer tests

Doctors who treat prostate cancer disagree on the value of the prostate specific antigen, or PSA, test. But they agree on one thing.

Men are often hurt by overdiagnosis and treatment for prostate cancer.

"There are clearly people we harm with therapy," said Dr. Bruce Roth, professor of medicine at Washington University in St. Louis. "I don't think there's doubt about that. We wouldn't be having this conversation if the therapy was nontoxic."

Prostate cancer treatments are known for side effects such as sexual dysfunction, incontinence, difficulty urinating and controlling bowel functions.

At least 20% to 30% of patients who get radiation therapy or surgery will experience incontinence and erectile dysfunction, according to a report released last week by a federal advisory board. At the same time, prostate cancer survivors say their lives have been saved by PSA tests and subsequent treatments.

The PSA test has become increasingly controversial as more doctors and studies question its effectiveness.

To examine that topic, the U.S. Preventive Services Task Force, an independent panel of experts, reviewed the existing evidence and released a draft recommendation against PSA testing.

There is convincing evidence that "PSA-based screening leads to substantial overdiagnosis of prostate tumors," the draft stated. The task force found "small or no reduction" in prostate cancer deaths and that the test was also "associated with harms related to subsequent evaluation and treatments."

The task force will open the recommendation Tuesday for a comment period before issuing a final recommendation.

New Alzheimer's Drug Shows Early Promise

An experimental Alzheimer's disease drug, gantenerumab, may help lower levels of amyloid plaque in the brains of people with the disease, an early clinical trial indicates.

The new study, which appears online Oct. 10 in the Archives of Neurology, is among the first to show the effects of an anti-amyloid drug in humans with Alzheimer's disease, but experts caution that while promising, more research is needed before this drug can be deemed safe or effective.

And, in what may turn out to be an equally important caveat, experts also say that it's by no means certain that reducing levels of amyloid plaque would stave off memory loss and the other mental declines associated with the disease because the role of the plaque in Alzheimer's isn't fully understood.

Alzheimer's disease is the most common form of dementia. Symptoms including serious memory loss, confusion and mood changes develop gradually and worsen with time. Recently, many strides have been made in diagnosing Alzheimer's disease earlier, but doctors have been stymied by a lack of effective treatments to stop or slow the course of the disease.

It's long been known that a protein fragment called beta-amyloid builds up in the spaces between nerve cells in the brains of people with Alzheimer's disease. The new drug, gantenerumab, targets these amyloid proteins by priming the body's immune system to recognize them as invaders.

The need for a drug to delay the onset or slow progression of Alzheimer's disease can't be underestimated, Aggrawal said. In the United States alone, there are 5.4 million people with Alzheimer's disease, and the numbers are expected to increase to 13 million by 2050, when approximately three of every five people over the age of 85 will have Alzheimer's disease, she said.

Dentists offer cash, gifts for kids' Halloween candy

Scott J. Pettinato is not a fan of the harm candy can inflict on children's teeth.

With Halloween creeping ever closer, the Scranton dentist is among those who will look to spare young patients some sugary damage while still preserving their seasonal fun - and sending a little cheer to American troops deployed overseas in the process.

For the third consecutive year, Dr. Pettinato will participate in the Halloween Candy Buyback Program, which allows children across the country to trade 1 pound of their Halloween haul for $1. The candy will be turned over to Operation Gratitude for its holiday care packages that are shipped to troops.

"We love the fact that we're taking the candy out of the hands of the kids so that they're not putting quite so much of it in contact with their teeth," Dr. Pettinato said.

Dr. Pettinato's practice at 821 Oak St. will be accepting the candy on Tuesday, Nov. 1, and Wednesday, Nov. 2, between 8 a.m. and 5 p.m.

Previous years netted between 200 and 250 pounds of candy, he said.

Dr. Joyce Perih, 321 Spruce St., Scranton, offers a unique twist on the program. For every pound of candy donated to her orthodontic practice, she provides patients with four "ortho" dollars, equivalent to $2. The "ortho" dollars can be used to purchase gift cards, T-shirts, backpacks and other items.

"I think it's a win-win situation," Dr. Perih said of the candy buyback program. "It's a more healthy alternative. The less candy dissolving in your month, the better off you are."

Dr. Perih said in years past she also donated dental cleaning supplies such as toothpaste and toothbrushes to troops. This year, she said she will match whatever is received from the program and donate it to the local American Red Cross for local flood victims or to the Flight 93 National Memorial Campaign. Candy will be accepted through Nov. 18.

Enjoy your morning!