BOSTON -- For reasons that are not clear, women with disabilities who develop breast cancer are less likely to be given optimum treatment.
Advise patients who ask that this study suggests women with disabilities may be treated differently than other women when they develop breast cancer.
BOSTON, Nov. 7 -- For reasons that are not clear, women with disabilities who develop breast cancer are less likely to be given optimum treatment.
A retrospective database analysis found that women on disability insurance and Medicare at the time of a breast cancer diagnosis were twice as likely to die of any cause as other breast cancer patients, according to Ellen McCarthy, Ph.D., of Beth Israel Deaconess Medical Center and Harvard Medical School.
Also, they were 30% more likely to die of their cancer, Dr. McCarthy and colleagues reported in the Nov. 7 issue of Annals of Internal Medicine.
"Because clinical trials typically exclude this population, there is little scientific evidence available to guide doctors in their treatment decisions," Dr. McCarthy said. "Consequently, very little is known about cancer treatment for individuals with disabilities."
One thing that is known, she and colleagues noted, is that "many women with traits that can suggest a social disadvantage -- including older age, race or ethnicity, low socioeconomic status (income or education), rural residence and lack of health insurance -- do not receive breast-conserving surgery."
The same was true among women with disabilities. The researchers found that 43.2% of women with disabilities were offered breast-conserving surgery, compared with 49.2% of other patients.
The findings remerged from an analysis of information from 11 Surveillance, Epidemiology, and End Results (SEER) databases, involving 100,311 women who were diagnosed with breast cancer from 1988 to 1999.
Women who qualified for Social Security disability insurance and Medicare at the time of diagnosis were considered disabled, Dr. McCarthy and colleagues said.
Disabled women were 20% less likely to be offering breast-conserving surgery. The odds ratio was 0.80, with a 95% confidence interval from 0.76 to 0.84.
Those who were offered breast-conserving therapy were less likely to get radiotherapy (the odds ratio was 0.83, with a 95% confidence interval from 0.77 to 0.90) or axillary lymph node dissection (the odds ratio was 0.81, with a 95% confidence interval from 0.74 to 0.90).
Those with disabilities had a hazard ratio for all-cause death of 2.02, with a 95% confidence interval from 1.88 to 2.16.
And the hazard ratio for cancer mortality was 1.31, with a 95% confidence interval from 1.18 to 1.45.
The lack of radiation therapy is particularly worrying, Dr. McCarthy said. "This means that they are at higher risk that their cancer will come back and they could potentially experience greater rates of cancer-related morbidity," she added.
"Because this is such a large study, we hope it will serve as a starting point for understanding what is happening [among disabled populations] when it comes to cancer treatment," Dr. McCarthy said. "These findings tell us that there are indeed differences in treatment decisions, but do not tell us the reasons for these differences."
Indeed, the reasons for the differences are probably "multi-factorial," said co-author Lisa Iezzoni, M.D., also of Harvard Medical School. For instance, for some women, their disabilities may create a greater risk of death, she said.
Physicians may also assume that physical appearance is less important to women with disabilities, and therefore may be less likely to offer breast-conserving therapy, rather than mastectomy, she said.
"And logistical issues could also be playing a role," Dr. Iezzoni said. "The women with disabilities may, for example, be unable to arrange for daily transportation to and from radiation therapy treatments."
As a medical provider, learn how you can use telemedicine to broaden your services, provide better patient care and create a new revenue stream.
Schedule a consultation to learn how we can accelerate your business processes and reduce your costs.
Unbelievably, when it comes to choosing wedding bands, many men today love to design their own bands with engraved personalized messages. A popular choice among the couples that is doing rounds is designing their own bands, selecting a style that is unique and represents the characteristic of the person who wears them.
Wedding bands today are just not available in gold. A number of materials have been giving a tough competition to gold such as tungsten, platinum, silver, steel, titanium etc. They are gaining more attention among the newly engaged. They are some of the hottest wedding bands of today that men love to wear.
You will find that the men’s wedding bands do not differ a lot from the women’s wedding bands and both the sex can wear it anytime. They can exchange it. Therefore, it is important to select the right wedding band and set a wonderful experience it is a great way to set the tone and stay ahead of all competitions.
When someone is looking for a wedding band, then they should consider the following selling points to have a great purchase.
Before you purchase a wedding band, it is important to look into the hottest trends. Titanium is one of the growing trends and it is lightweight and corrosion resistant, so a wedding band made out of it is surely going to be a great deal. This material is fashionable, sleep and extremely strong and it available in a number of colors such as natural, exotic black and hardcore carbide rings.
Gold is next in the line when it comes to the metal of the wedding band. It is not much lighter like the titanium ring and prone to scratches, but the style plays a significant role when it comes to gold.
Once you have chosen the material of the wedding band you need tolearn moreabout the proper size. Many people become nervous while deciding the perfect fit and size of the ring and end up making the wrong choices. If you do it properly, it is not an issue. Choosing a comfortable and snug ring is important. The center of the ring stays closer to the finger and not on the outer edges. This is the ring of the life and will display the strong bonding between the relationships that will be created soon. Therefore, you have to be particular about your choice.
Author Bio – Bill Williams is a gemstone expert and has been making wedding bands with precious stones in his laboratory since 10 years. You can learn more about his innovation through the articles, which he keeps on writing.
Nobody wants to wake up for the day feeling groggy. When your sleep suffers, your health suffers. Whether you struggle with falling asleep, staying asleep, or just feeling awake when morning comes around, you’re not alone. Even the small things in our life like stress and routine changes can negatively affect our night’s sleep.
It’s easy to think that going to bed early will solve all of your sleeping problems, but that’s not always the case. So many different factors contribute to your ability to feel refreshed. If you’re still finding yourself tired when you wake up in the morning, try these health hacks below to see if they help get your sleep cycle back on track.
No matter how much you paid for your mattress, it might not be a good fit for your lifestyle and body type. Tossing and turning throughout the night is a sign that it’s time for a new mattress. Your mattress might be too soft or too firm, and it’s hard to tell at first. Luckily, there are so many options today for purchasing a new mattress.
The best way to choose a mattress is to spend at least 20 minutes trying it out. While it’s not always possible to test a mattress in person, (and who wants to sleep in public?) many online-based mattress companies allow you to try the mattress for a number of days to decide if it’s right for you.
Essential oils have long been used to boost our health for generations. The power of essential oils also can help with sleeping. The most common essential oil for getting a good night sleep is lavender. The aroma of this oil naturally calms your body, and it’s shown to lead to improved sleep quality. You can purchase a lavender mist to spray on your pillow before you sleep, or you can diffuse the oil with a diffuser through your bedroom.
Another common sleep problem that essential oils can help with snoring. Thyme and sage open the airways to ensure you’re able to breathe freely. If you’re snoring, you might wake up others in your home and even yourself throughout the night. Try these essential oils to see if they’re the cure you’ve been waiting for. Like with lavender, you can use a light mist over your pillow or even try sipping a tea before bedtime.
What do you usually do before bedtime? If your current ritual involves sitting in bed and scrolling through social media, that might be to blame for your poor sleep quality. A bedtime ritual is something you do every day before bed. It conditions your brain to recognize that it’s time to prepare for sleep, so your body will have an easier time falling asleep.
Common bedtime rituals include things like drinking tea, taking a bath, meditating, or even just reading your favorite book. Whatever you choose to do, just stick with it again and again so your body learns what to expect.
Bright light before bed is bad news for your sleep schedule. The worst light is the light that emits from electronics like your smartphone and your TV. If possible, turn these devices off at least an hour before bedtime. Many smartphones come with light-blocking technology today to automatically help your body adjust to nighttime. This blue-light filter will keep you from straining your eyes too close to bedtime.
How many times do you lay awake in bed struggling to fall asleep? It makes sense to stay in bed if you’re trying to lure yourself to sleep, but sometimes this can have negative consequences. If you’re unable to fall asleep, you’ll only have increased anxiety and stress. This will condition your mind to feel stressed about falling asleep. Instead, leave the room when you find yourself struggling to fall asleep. If it takes you more than 10 minutes to fall asleep and you feel yourself becoming stressed, go to another room.
A good night’s sleep isn’t something to take lightly. You need to make sure you’re making smart choices about your own health, and that means protecting your time spent asleep each night. These tips will make sure you have a healthy relationship with sleep so you can feel your best.