Removing kidney of elderly patients with localized kidney cancer does not prolong their lives

Washington, May 10 (ANI): If a new study is to be believed, then removal of an entire kidney doesn’t prolong lives of patients aged 75 and above who have confined kidney tumours.

In fact, they suffer from other medical problems, which should be given due cancer-related care, such as observation or treatments that spare the non-cancerous parts of their kidneys.

To investigate if surgical kidney removal, or nephrectomy, improves survival when compared with active monitoring or kidney-sparing surgery, Steve Campbell, of the Cleveland Clinic and his colleagues conducted a study.

The doctors analysed information from 537 patients with localized kidney tumours that were 7cm in diameter and were detected at age 75 years or older.

Twenty percent of these patients were closely observed, 53 percent had kidney-sparing surgery, and 27 percent underwent a nephrectomy.

After following up for 4 years, 28 percent of patients died, the most common cause of death being heart-related (29 percent). Cancer progression was responsible for only four percent of deaths. Older age and additional medical conditions increased patients” risk of dying during the follow-up period, but choice of treatment did not.

Surgical removal of kidney seemed to indicate accelerated dysfunction of the remaining kidney and also appeared to increase patients” risk of dying from cardiovascular causes.

“Current research is indicating over-treatment of localized renal tumors, and our data suggest that active surveillance is a reasonable strategy and one that is greatly under-utilised in the elderly population,” the authors wrote.

They added that the potential benefit of kidney-sparing surgery in elderly patients who have the lowest risk for heart-related deaths and the greatest life expectancy warrants further investigation.

The study is published online in CANCER, a peer-reviewed journal of the American Cancer Society. (ANI)

‘Pain relievers don’t prevent Alzheimer’s disease’

Washington, Apr 23 (ANI): Nonsteroidal anti-inflammatory drugs (NSAIDs), such as the pain relievers ibuprofen and naproxen, do not prevent Alzheimer’s disease or other forms of dementia, a new study has shown.

In fact, researchers found that the risk of developing dementia in the study’s very elderly population was 66 percent higher among heavy NSAID users than among people who used little or no NSAIDs.

For the study, researchers identified 2,736 members of Group Health, an integrated healthcare delivery system, who did not have dementia when they enrolled in the study at an average age of 75.

The researchers then followed these people for 12 years to see if they developed Alzheimer’s or other forms of dementia.

They checked Group Health pharmacy records for NSAIDs (tracking both prescriptions and over-the-counter use) and also asked participants about their use of NSAIDs.

Of the participants, 351 people had a history of using NSAIDs heavily at the study’s start, and another 107 became heavy NSAID users during the follow-up period. Heavy use was defined as having prescriptions for NSAIDs at least 68 percent of the time in two years.

During the study, 476 people developed Alzheimer’s disease or dementia. Researchers found that the risk of developing dementia among heavy NSAID users was 66 percent higher than among people with little or no NSAID use.

“NSAIDs are useful for relieving pain from conditions including arthritis. Although we hoped to find a protective effect, there was none. Thus, for this age group, there’s no basis for taking NSAIDs to prevent Alzheimer’s disease. Our study in this quite elderly population showed more risk of dementia with NSAIDs, especially when used heavily,” said study author Eric B. Larson, MD, MPH, executive director of Group Health Center for Health Studies.

The study is published online in Neurology, the medical journal of the American Academy of Neurology. (ANI)