Imaging Tests Up Among Advanced Cancer Patients

HealthDay – 1 hr 50 mins ago TUESDAY, July 31 (HealthDay News) -- A new U.S. study finds that the use of diagnostic imaging tests in Medicare patients with advanced cancer has risen faster than among patients with early-stage cancer.

The costs of diagnostic imaging have increased more than the overall costs of cancer care, making diagnostic imaging the fastest-growing part of Medicare-reimbursed services, the researchers noted. Medicare is the U.S. government-funded health insurance program for people over 65 and certain other patients.

They added that cancer care costs are highest during the last year of life, but little is known about the use of high-cost imaging tests in cancer patients during their final year.

In this study, the researchers examined data on the use of CT, MRI, PET and nuclear medicine scans for Medicare patients with late-stage (stage 4) breast, colon, lung or prostate cancer between 1995 and 2006. Stage 4 cancer means the cancer has spread throughout the body.

The analysis revealed that most of the patients underwent imaging procedures during the course of their care, and that the use of imaging in late-stage cancer patients increased between 1995 and 2006.

The study was published July 30 in the Journal of the National Cancer Institute.

The increasing use of imaging in late-stage cancer patients may be due to a lack of guidelines in this area or the use of imaging to help doctors manage symptoms, detect disease progression and assess the effects of treatment, said Dr. Yue-Yung Hu and colleagues at the Dana-Farber Cancer Institute, Brigham and Women's Hospital, and the University of Wisconsin.

While imaging often leads to appropriate measures to ease dying patients' suffering, it can also distract them from focusing on achievable end-of-life goals, cause them to spend more of their remaining time in medical care settings, and provoke anxiety, the researchers said.

Determining the most appropriate care for patients with late-stage cancer is complex, Drs. Robin Yabroff and Joan Warren, of the Health Services and Economics Branch at the U.S. National Cancer Institute, noted in an accompanying editorial.

"Physicians tend to overestimate survival for terminally ill cancer patients, which may influence their treatment and related imaging recommendations," they wrote in a journal news release. "Development of practice guidelines for advanced imaging in patients with stage IV disease, with explicit statements about the state of evidence will be critical, particularly for care outside of the window surrounding patient diagnosis."

More information

The American Cancer Society offers advice for cancer patients nearing the end of life.

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Fighting obesity with thermal imaging

ScienceDaily (July 18, 2012) — Scientists at The University of Nottingham believe they've found a way of fighting obesity -- with a pioneering technique which uses thermal imaging. This heat-seeking technology is being used to trace our reserves of brown fat -- the body's 'good fat' -- which plays a key role in how quickly our body can burn calories as energy.

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This special tissue known as Brown Adipose Tissue, or brown fat, produces 300 times more heat than any other tissue in the body. Potentially the more brown fat we have the less likely we are to lay down excess energy or food as white fat.

Michael Symonds, Professor of Developmental Physiology in the School of Clinical Sciences, led a team of scientists and doctors at The University of Nottingham who have pioneered the thermal imaging process so we can assess how much brown fat we've got and how much heat it is producing. Their research has just been published in the Journal of Pediatrics.

The University of Nottingham's Early Life Nutrition Research Unit is at the forefront of ground-breaking international research into managing brown adipose tissue using nutrition, exercise, and environmental and therapeutic interventions.

Thermogenic index for food labels

Professor Symonds said: "Potentially the more brown fat you have or the more active your brown fat is you produce more heat and as a result you might be less likely to lay down excess energy or food as white fat.

"This completely non-invasive technique could play a crucial role in our fight against obesity. Potentially we could add a thermogenic index to food labels to show whether that product would increase or decrease heat production within brown fat. In other words whether it would speed up or slow down the amount of calories we burn."

The obesity threat

Obesity is one of the biggest challenges we face in Europe and America as our children grow older. It affects 155 million children worldwide. In the UK the number of overweight children doubled in the 1990s.

Dr Helen Budge, Clinical Associate Professor and Reader in Neonatology, said: "Babies have a larger amount of brown fat which they use up to keep warm soon after birth making our study's finding that this healthy fat can also generate heat in childhood and adolescence very exciting."

Professor Symonds and his team say their ground-breaking research could lead to a better understanding of how brown fat balances the energy from the food we eat with the energy our bodies actually use up.

Professor Symonds, together with Dr Budge and their team from the University's School of Clinical Sciences has shown that the neck region in healthy children produces heat. With the help of local school children they found that this region, which is known to contain brown adipose tissue, rapidly switches on to produce heat. This capacity is much greater in young children compared with adolescents and adults. The researchers are now using their findings to explore interventions designed to promote energy use as heat and, thus, prevent excess weight gain in both children and adults.

Non-invasive technology

Professor Symonds said: "Using our imaging technique we can locate brown fat and assess its capacity to produce heat. It avoids harmful techniques which use radiation and enables detailed studies with larger groups of people. This may provide new insights into the role of brown fat in how we balance energy from the food we eat, with the energy our bodies use up.

This research goes to the heart of the University's biggest ever fund raising appeal, Impact: The Nottingham Campaign, which is supporting lifelong health for children. Additional funding will allow more innovative approaches to be researched, developed and introduced across the globe. Find out more about our research and how you can support us at http://tiny.cc/UoNImpact.

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