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			Monday, June 22, 2009 News Clipping Archives *Maryland / Regional* Governor O’Malley Declares Calvert County Maryland’s ‘Capital for a Day’ (Inner Charm City) Gastric cancer incidence low, but diagnosis often late (Baltimore Sun) EPA to oversee cleanup of Ft. Meade (Daily Record) *National / International* Why high health care costs hurt economy (Baltimore Sun) Study will test vitamin D, fish oil benefits (Baltimore Sun) New map finds HIV rates are highest in the South (Baltimore Sun) AARP to endorse plan that cuts drug costs (Baltimore Sun) Colorectal cancer rates are rising in younger people (Baltimore Sun) The hidden salt in chicken (Baltimore Sun) Newspapers: Philadelphia VA hospital botched cancer treatments for years (Baltimore Sun) *Opinion* Caregiving Must Be Affordable (Washington Post Letter to the Editor) *Maryland / Regional* Governor O’Malley Declares Calvert County Maryland’s ‘Capital for a Day’ O’Malley release By Stan Moore Inside Charm City Monday, June 22, 2009 CALVERT COUNTY, MD (June 19, 2009) – Today, Governor Martin O’Malley, Lt. Governor Brown and Maryland’s Executive Cabinet joined Senate President Thomas V. Mike Miller, Jr. and local officials in Calvert County, declaring it Maryland’s “Capital for a Day.” The monthly program brings the State Capital to every corner of Maryland through a series of events across a diverse selection of Maryland cities, towns and communities. “I want to thank the Calvert County Commissioners for hosting us today, as I am proud to officially proclaim Calvert County Maryland’s ‘Capital for a Day,’” said Governor O’Malley, making his announcement at the Jefferson Patterson Park and Museum following an official Cabinet Meeting and presentation by local officials. “It’s important for families across Maryland to know that their government is working for them – putting families first and fighting to expand the safety net for working families during these difficult economic times. Strengthening our local partnerships is absolutely critical to the progress of areas like Calvert County.” “I thank President Miller and the men and women of Southern Maryland for hosting us today and serving as a clear reminder that we are indeed One Maryland. During difficult economic times like these, it is refreshing to see strong communities coming together in pursuit of common goals and goals to leave our children a better state than we were left,” Lt. Governor Brown said. “Now more than ever, Maryland’s working families need leaders in Annapolis who are willing to stand up for them and put families first. I’m proud that Governor O’Malley and I, with help from President Miller and the General Assembly, have been able to protect the progress we’ve made even – and especially – during difficult times.” Even in difficult economic times, development and progress continues in many parts of Calvert County, built on the foundation of a strong partnership with the State. The County is budgeted to receive more than $101 million for K-12 education in Fiscal Year 2010, representing an increase of 23 percent since FY2007. Since taking office, over $27 million has been allocated to Calvert County by the O’Malley-Brown Administration for school construction, representing a 38 percent increase over the entire four years of the previous administration. “I am pleased the Governor and his leadership team are coming to Calvert County to meet with local officials, business leaders, and community activists,” said Senate President Thomas V. Mike Miller, Jr. “It is an opportunity for the Governor to hear about the challenges Calvert County residents face, and to talk about how the State is helping all Marylanders weather the economic storm.” Governor O’Malley has also prioritized many capital projects in the County, even during difficult economic times, including the replacement of Calvert Middle School in Prince Frederick, well and arsenic treatment in East Prince Frederick, Expansion of infusion therapy at Calvert Memorial Hospital, and upgrades to Calvert Industrial Park. “We welcome Governor O’Malley and his top leaders to Calvert County as part of his Capital for a Day initiative,” said Commission President Wilson Parran. “His visit provides us a unique opportunity to meet face to face, and to hone in on our challenges and priorities that affect Calvert County and its residents. Calvert County has enjoyed a good working relationship with the State, and we are pleased that Governor O’Malley is working hard to maintain and build the synergy between local and State government for the benefit of our community. It is essential that we sustain this relationship through this economic downturn and beyond.” The Governor began the day with Senate President Miller at a prayer brunch with faith leaders of Calvert County. The Governor was joined at the prayer breakfast by Calvert County’s two mayors, Mayor Bruce Wahl of Chesapeake Beach and Mayor Michael Bojokles of North Beach. The brunch, held at the North Beach Volunteer Fire Hall, included more than 25 faith leaders from throughout the County, where they discussed ways the leaders can serve as ambassadors for their congregation, informing them about state services that assist families during difficult economic times. The Governor discussed the state’s web portal for all such services – problemsolver.maryland.gov – and talked informally with the faith leaders attending the brunch. The Governor then joined Senate President Miller, Lieutenant Governor Brown, and Health and Mental Hygiene Secretary John Colmers for an official ribbon cutting opening the Calvert Medical Arts Center at Calvert Memorial Hospital. The 75,000-square foot facility brings additional services and physician talent to serve the needs Calvert County patients. The three-story structure features an Imaging Center, Physical Therapy and Sports Medicine as well as Pediatrics, Dermatology, and Woman’s Wellness practices. A new information technology data center on the second floor provides critical space for IT infrastructure for the hospital to develop a community health information system. The new technology, when implemented, will allow the hospital and its affiliates along with area providers to share patients’ health records. Governor O’Malley then moved to the Jefferson Patterson Park and Museum, where he was lead on a tour of the grounds by solar vehicle. The 560-acre park, located along 2.5 miles of the Patuxent River waterfront and St. Leonard Creek in Calvert County, includes a state-of-the-art visitor’s center, the Maryland Archaeological Conservation Laboratory where scientists explore the past and protect the State’s rich archaeological heritage, and a recreated Eastern Woodland Indian Village, a representation of the way American Indians along the Chesapeake Bay would have been living in 500 years ago. Later at the park, Governor O’Malley convened an official Executive Cabinet Meeting, where he received a presentation from local officials, including Senate President Miller and County Commission Chair Wilson Parran, on issues that are important to the County and where an ongoing partnership and dialogue with the state can be beneficial. After the Cabinet Meeting, Governor O’Malley officially declared Calvert County Maryland’s “Capital for a Day.” “Capital for a Day,” a program launched by Governor O’Malley in 2007, brings the State Capital to every corner of Maryland through a series of monthly events across a diverse selection of Maryland cities, towns and communities. Previous “Capitals” have included Westminster, Hagerstown, Chestertown, Leonardtown, the Port Towns of Prince George’s County, Cumberland, Pocomoke City, Gaithersburg and Ellicott City. © Copyright 2009 - http://insidecharmcity.com. Gastric cancer incidence low, but diagnosis often late Ask the Expert: Dr. Vadim Gushchin, Institute for Cancer Care at Mercy Medical Center Baltimore Sun Monday, June 22, 2009 Gastric cancer is a difficult malignancy to treat. A combined approach of surgery, chemotherapy and radiation can be challenging for patients to tolerate and the survival rates are poor. Dr. Vadim Gushchin, director of gastrointestinal oncology at the Institute for Cancer Care at Mercy Medical Center, discusses the little-known but dangerous disease. •The incidence of gastric cancer in the United States is relatively low. However, this is not good news for more than 20,000 patients who will be diagnosed with this disease in 2009. Diagnostic studies aimed at early cancer detection or screening studies are not effective in tumors with relatively low incidence. As a result, gastric cancer is often not discovered (via an upper endoscopy and biopsy) until it is advanced. •Genetic predisposition accounts only for a minority of gastric cancer cases. The dramatic decrease in gastric cancers in the U.S. over the past 100 years is attributed to better food refrigeration and preparation techniques (e.g. avoiding nitrates and smoking in food preservation). •New immigrants from Asia, South America and Eastern Europe appear to be at the highest risk for developing gastric cancer. The disease is less prevalent in subsequent generations. •Unfortunately, there are no proven strategies to prevent this disease. At present, research is focused on effective treatments that not only prolong survival, but also preserve the patients' quality of life during and after the treatment. •Surgery for gastric cancer became a "lost art," and studies have shown that surgical treatment of gastric cancer in the U.S. is mostly inadequate. •Treatment results for gastric cancer in Japan and other Asian countries have been better than those in the Western world. In part, this is explained by a superior surgical technique of Asian surgeons. Many Western surgeons who have adopted the Japanese approach in treating gastric cancer have significantly improved their patients' outcomes. Today, the most promising strategy is combining meticulous surgery (followed by thorough pathological testing of the tumor and lymph nodes) and chemotherapy before and after surgery. All treatment decisions should be done by a multidisciplinary team of surgical, medical and radiation oncologists after accurate staging of the tumor and prior to treatment. Copyright © 2009, The Baltimore Sun. EPA to oversee cleanup of Ft. Meade By Andy Rosen Daily Record Monday, June 22, 2009 Four federal agencies have agreed to end a longstanding dispute over the cleanup of environmental contaminants at Fort Meade in Anne Arundel County, a move that could bring conclusion to a state legal challenge to the way the site was being handled. The Environmental Protection Agency will oversee the U.S. Army’s cleanup of the site under the agreement announced Monday, which also includes the Department of Defense, the Architect of the Capitol and the Department of the Interior. A disagreement over who would oversee the cleanup had been brewing for several years. Though the Army says it spent about $84 million to clean up contaminated areas around the base since the site’s decontamination was made a federal priority in 1998, the defense department and the EPA never had an agreement to place the EPA in charge of the cleanup. Harry Lockley, a public affairs officer at Fort Meade, said the agreement allows the Army to follow the letter of the law in cleaning up the site. Without such an agreement, there was no set time frame for the cleanup, said EPA spokesman David Sternberg. “What’s significant about the agreement is that it’s a legitimate [document] that puts the army under an enforceable schedule to proceed with the cleanup,” he said. State officials had grown impatient with the cleanup at Fort Meade, where contaminated sites include parts of the current military installation and other parcels of land that have been transferred to the Department of the Interior and the Architect of the Capitol. According to the EPA, the contaminants include several solvents and heavy metals, explosives, arsenic and PCBs. The state sued the Army in December, after demanding an agreement be put in place last fall. The agreement is a positive development, but Horacio Tablada, director of waste management administration with the Maryland Department of the Environment, said it does not erase the state’s concern. MDE wants to see a finalized agreement after a 45-day public comment period before it considers dropping its case, he said. It’s crucial to have a legally binding contract because that gives the cleanup more structure and does not leave it at the mercy of annual budgets, he said. Sen. Benjamin L. Cardin, D-Md., had made a resolution to the deal one of his top priorities, said spokeswoman Susan Sullam. She said the EPA’s oversight will ensure accountability for the Army under the deal. “I am pleased that after nine years, a formal agreement has been reached regarding the cleanup of contaminated sites at Fort Meade,” Cardin, a Democrat who sits on the Senate Environment and Public Works Committee, said in a statement. “The agreement recognizes EPA’s role as ultimate arbiter of cleanup standards and provides an enforceable framework for the Army to complete all remaining work at the fort.” Some contaminants have been detected in aquifers, the EPA says. All told, there are 14 contaminated sites at the installation, which measures nearly 14,000 acres and is 12 miles from Baltimore. Three other contaminated sites are on land controlled by the other federal agencies. Copyright 2009 Daily Record. *National / International* Why high health care costs hurt economy Associated Press By Linda A. Johnson Baltimore Sun Monday, June 22, 2009 In pushing for health care reform, President Barack Obama has said problems with the current health care system are a big cause of our economic troubles. He's even called the system, with its spiraling costs and inconsistencies in the amount and quality of care people get, a "ticking time bomb" for the federal budget. Just how serious is the problem? How big a role does health care play in the nation's economy? Here are some questions and answers about the economic impact of health care. Q: How big a part of the economy is health care? A: It accounts for about one-sixth of the entire economy -- more than any other industry. Spending on health care totals about $2.5 trillion, 17.5 percent of our gross domestic product -- a measure of the value of all goods and services produced in the United States. That's up from 13.8 percent of GDP in 2000 and 5.2 percent in 1960, when health spending totaled just $27.5 billion -- barely 1 percent of today's level, according to the Kaiser Family Foundation, a nonpartisan health policy group. Q: What's included in that spending? A: It covers money paid to health care providers -- hospitals, outpatient centers, Veterans Affairs and other clinics, doctor and dentist practices, physical therapists, nursing homes, home health services and on-site care at places such as schools and work sites. Also included are retail sales of prescription and nonprescription drugs, premiums paid to health insurers, and revenues of makers of medical devices, surgical equipment and durable medical equipment such as eyeglasses, hearing aids and wheelchairs. It also counts out-of-pocket payments by consumers for health insurance premiums, deductibles and co-payments, along with costs not covered by insurance and "medical sundries" like heating pads. Q: Why does Obama say the health care system must be fixed first to repair the economy, and is it true? A: It's absolutely correct, for a host of reasons, experts say. "Health care is the economy," and fixing it would free up money for other priorities, such as education and industrial innovation, said Meredith Rosenthal, a Harvard University professor of health economics and policy. The health care system is dysfunctional and full of waste -- as much as 30 percent of all spending, she said. Unlike most other markets, consumers rarely know which doctors, drugs or treatments are best for them, don't price shop and, if they're insured, don't know the full cost of care. That all can lead to unnecessary spending. Kaiser's president, Drew Altman, said health care costs have become pocketbook issues for businesses and both insured and uninsured Americans. Kaiser's periodic polls on what consumers worry about find the cost of health care and insurance are equal with job security, gas prices and being able to pay the mortgage. "People make the link, not just the president," he said, adding that they're most concerned with how reform will affect them personally. Q: How do health care costs drag on the economy? A: Growth in overall health care costs, including spending on the huge Medicare and Medicaid programs, is out of control, said Robert Laszewski, president of consultants Health Policy and Strategy Associates. That limits how much money the federal government and businesses have to invest in solving the energy problem, developing products that can be sold to other countries, creating technology that can bring medical breakthroughs, building infrastructure and more. Q: How do rising health costs affect workers and businesses? A: Health insurance premiums have skyrocketed, making it ever-tougher for workers and employers to afford them. From 1999 through 2008, annual health insurance premiums jumped 119 percent, according to Kaiser data. The average family premium paid by workers rose from $1,543 to $3,354 a year, and employer payments per worker jumped from $4,247 to $9,325. During that span, worker earnings rose only 34 percent and overall inflation was just 29 percent. So worker income has barely kept pace with inflation, more of the paycheck is going to health costs, and there's less left over for things like vacations, dining out, home improvements or a new car -- especially for low-wage workers and retirees. That represents a huge drag on the economic growth, considering that consumer spending powers about 70 percent of the economy. For employers, particularly small businesses, rising insurance premiums mean there's far less money for new equipment, better facilities, research or expansion. That means fewer new jobs, plus smaller raises and higher health premiums for workers, further limiting consumer spending. Q: What's the impact of 50 million Americans having no insurance? A: Ira S. Loss, senior health care analyst at Washington Analysis, puts it this way: "We're paying to take care of those people." Hospitals, particularly in inner-city and rural areas, charge patients with insurance more to help make up for those who can't pay their bills. And we're all paying more in taxes to cover extra payments by federal and state governments to hospitals that have large shares of uninsured patients. Q: Isn't health care one of the few parts of the economy that's growing? A: Yes. Employment in the huge health care sector has grown by about 427,000 jobs -- nearly 3 percent -- since the recession began in December 2007, and totaled 15.5 million jobs in April, the latest month for which U.S. Bureau of Labor Statistics figures were available. Most of the increases came in ambulatory care services (up 254,400 jobs) and hospitals (up 148,400 jobs). That was partly offset by job declines at pharmaceutical companies, drug wholesalers and pharmacies. However, only 42,900 jobs have been added since January. That's because the steady growth in jobs throughout the recession in ambulatory care, hospitals and, to a lesser extent, health insurers, has slowed dramatically over those months, with hospitals adding only 7,700 jobs and insurers just 1,000. Obama and Congress are trying to reduce the rate at which health care spending is growing, by eliminating waste and fraud, improving efficiency and increasing preventive care, so it's unlikely jobs at health care providers will decline. In fact, more caregivers will be needed for aging baby boomers, plus the millions who could get coverage under health care reform and presumably would seek care more regularly. So despite the system's faults, there's an economic silver lining: As Altman of the Kaiser Family Foundation explains, health care has been "one of the few engines of job growth during the recession." Copyright 2009 Associated Press. All rights reserved. Study will test vitamin D, fish oil benefits Associated Press Baltimore Sun Monday, June 22, 2009 Two of the most popular and promising dietary supplements -- vitamin D and fish oil -- will be tested in a large, government-sponsored study to see whether either nutrient can lower a healthy person's risk of getting cancer, heart disease or having a stroke. It will be one of the first big nutrition studies ever to target a specific racial group -- blacks, who will comprise one quarter of the participants. People with dark skin are unable to make much vitamin D from sunlight, and researchers think this deficiency may help explain why blacks have higher rates of cancer, stroke and heart disease. "If something as simple as taking a vitamin D pill could help lower these risks and eliminate these health disparities, that would be extraordinarily exciting," said Dr. JoAnn Manson. She and Dr. Julie Buring, of Harvard-affiliated Brigham and Women's Hospital in Boston, will co-lead the study. "But we should be cautious before jumping on the bandwagon to take mega-doses of these supplements," Manson warned. "We know from history that many of these nutrients that looked promising in observational studies didn't pan out." Vitamins C, E, folic acid, beta carotene, selenium and even menopause hormone pills once seemed to lower the risk of cancer or heart disease -- until they were tested in big studies that sometimes revealed risks instead of benefits. In October, the government stopped a big study of vitamin E and selenium pills for prostate cancer prevention after seeing no evidence of benefit and hints of harm. Vitamin D is one of the last major nutrients to be put to a rigorous test. For years, evidence has been building that many people are deficient in "the sunshine vitamin." It is tough to get enough from dietary sources like milk and oily fish. Cancer rates are higher in many northern regions where sunlight is weak in the winter, and some studies have found that people with lower blood levels of vitamin D are more likely to develop cancer. Fish oil, or omega-3 fatty acid, is widely recommended for heart health. However, studies of it so far have mostly involved people who already have heart problems or who eat a lot of fish, such as in Japan. Foods also increasingly are fortified with omega-3, so it is important to establish its safety and benefit. "Vitamin D and omega-3s have powerful anti-inflammatory effects that may be key factors in preventing many diseases. They may also work through other pathways that influence cancer and cardiovascular risk," Manson said. However, getting nutrients from a pill is different than getting them from foods, and correcting a deficiency is not the same as healthy people taking large doses from a supplement. The new study, which will start later this year, will enroll 20,000 people with no history of heart attacks, stroke or a major cancer -- women 65 or older and men 60 or older. They will be randomly assigned to take vitamin D, fish oil, both nutrients or dummy pills for five years. The daily dose of vitamin D will be about 2,000 international units of D-3, also known as cholecalciferol, the most active form. For fish oil, the daily dose will be about one gram -- five to 10 times what the average American gets. Participants' health will be monitored through questionnaires, medical records and in some cases, periodic in-person exams. "We're hoping to see a result during the trial, that we won't have to wait five years" to find out if supplements help, Manson said. Researchers also plan to study whether these nutrients help prevent memory loss, depression, diabetes, osteoporosis and other problems, Buring said. The $20 million study will be sponsored by the National Cancer Institute, with the National Heart, Lung and Blood Institute and other federal agencies. Pharmavite LLC of Northridge, Calif., is providing the vitamin D pills, and Ocean Nutrition Canada Ltd. of Dartmouth, Nova Scotia, is providing the omega-3 fish oil capsules. ___ On the Net: Study information: www.vitalstudy.org Copyright 2009 Associated Press. All rights reserved. New map finds HIV rates are highest in the South Associated Press By Mike Stobbe Baltimore Sun Monday, June 22, 2009 ATLANTA - A new Internet data map offers a first-of-its-kind, county-level look at HIV cases in the U.S. and finds the infection rates tend to be highest in the South. The highest numbers of HIV cases are in population centers like New York and California. However, many of the areas with the highest rates of HIV -- that is, the highest proportion of people with the AIDS-causing virus -- are in the South, according to the data map, which has information for about 99 percent of the nation's counties and Washington, D.C. HIV infection rates are higher in African-American communities, and high minority populations in the South help explain the finding. While that's not surprising, the high rates seen throughout states like Georgia and South Carolina were, said Gary Puckrein, president of the National Minority Quality Forum, the nonprofit research organization that put the map together. Of 48 counties with the highest prevalence rates for HIV that had not yet progressed to AIDS, 25 were in Georgia, according to the map. Those were counties in which more than 0.7 percent of the population was infected with HIV. Georgia, Florida, South Carolina and Virginia were heavily represented on another map of counties, which showed the highest prevalence rates for cases that had progressed to AIDS. Both The map depicts reported numbers of people living with HIV and AIDS in 2006. Puckrein said the data came from state health departments and was checked against information from the U.S. Centers for Disease Control and Prevention. Different states report data in different ways, and there may be case duplication that could impact some of the findings, Puckrein said. The CDC's HIV and AIDS prevalence data is reported on a state level, not by county. CDC officials were cautious about the data map, saying they hadn't seen all the organization's information. "But we have long been part of the effort to identify geographic differences in the HIV epidemic, and we do see the need for efforts like these to facilitate better understanding of these differences," said CDC spokeswoman Elizabeth-Ann Chandler. __ On the Net: The HIV data map: http://www.MapHIV.org Copyright 2009 Associated Press. All rights reserved. AARP to endorse plan that cuts drug costs By The Washington Post Baltimore Sun Monday, June 22, 2009 WASHINGTON — AARP, the nation's largest seniors lobby, will give its blessing today to an offer by drug manufacturers to contribute $80 billion over the next decade to reduce the cost of comprehensive health reform, in part by discounting the price of Medicare prescriptions. Barry Rand, chief executive of AARP, will join President Obama at the White House to announce the endorsement of an organization that boasts 40 million highly engaged, politically active members. "This is an early win for reform and a major step forward," Rand said in remarks prepared for delivery at the event. After weeks of secret talks, the pharmaceutical industry trade group voted Friday to dedicate $80 billion to lowering the price of medicines sold to seniors and the government. The unusual offer by the Pharmaceutical Research and Manufacturers of America is part of its effort to convince skeptical lawmakers that it backs major health-care legislation. When Congress added a Medicare prescription drug benefit in 2003, it left a coverage gap that charges seniors the full cost of medications once a patient has received $2,700 worth of drugs, until the total reaches about $6,100. At that point, "catastrophic" coverage kicks in and covers nearly all drug expenses. Copyright © 2009, The Baltimore Sun. Colorectal cancer rates are rising in younger people Incidence of the cancer has gone up 17% over a decade for people under 50. A CLOSER LOOK: COLORECTAL CANCER By Jill U. Adams Baltimore Sun Monday, June 22, 2009 Colorectal cancer rates are rising in adults under age 50 -- people who are not typically screened for such cancers. The finding, gleaned from a cancer surveillance database and published in the June issue of Cancer Epidemiology Biomarkers & Prevention, reported a 17% increase in this age group over a decade. Scientists aren't sure why this is happening, but there are some things they know and suspect. First, some stats: Colorectal cancer (cancer of the colon or rectum) is the third most common cancer in the U.S. in men and women, with nearly 150,000 new cases each year. Close to 50,000 people die of it each year, according to the American Cancer Society. The good news is that overall, rates of colorectal cancer have been declining in the U.S. for more than a decade -- the result of widespread screening, which either prevents the disease or detects it early enough to treat it successfully. The risk in younger adults is still low compared with those over 50: Fully 91% of new cases are in people 50 and older. Still, rates have been creeping up in younger people, by as much as 2% per year in certain groups. The new study found that the rate in white men ages 20 to 49 was 8.4 cases out of every 100,000 people in the period 1992 to 1995. Ten years later (2002-05), the rate had risen to 10.2 -- a 21% increase. For white women ages 20 to 49, the incidence rate was 6.9 in 1992 to 1995 and 8.8 in 2002 to 2005 -- a 28% increase. In Latinos, the increases were 33% for men in this age group and not statistically significant for women. There was no increase for African Americans, but the incidence of colorectal cancer in that group is higher than in whites or Latinos: 12.7 and 10.8 cases per 100,000 in 20- to 49-year-old men and women, respectively. This is not the first report of a rise in colorectal cancer rates among younger groups. A 2004 review of data by UCLA surgeon Dr. Clifford Ko reported a similar increase in U.S. colorectal cancer rates in 20- to 39-year-olds. Ko investigated after a surgical resident said he had recently operated on two patients with colon cancer who were under 40. Researchers speculate that the increases may be caused, at least in part, by changes in the American lifestyle. Diets high in red and processed meat have been linked to colorectal cancer, as have diets low in milk and calcium -- a double whammy for a generation raised on burgers and soda at fast-food restaurants. Obesity and low physical activity also are risk factors for these cancers, and obesity rates have risen significantly over the last two decades. The data for those under 50 could be a harbinger. "We often look at trends in younger adults because they can be an earlier indicator of changes in risk factors and rates overall," says Elizabeth Ward, a senior researcher at the American Cancer Society and an author on the new paper. "As this population ages, their increased risk for colorectal cancer could carry through." A major factor driving down U.S. colorectal cancer and death rates in the over-50s is wider use of screening, Ward says. Colonoscopy, the mainstay test, detects cancer early. It also can prevent its development by removal of precancerous polyps in the bowel. But most people under 50 are not screened for colorectal cancers -- only those with certain risk factors, such as family history, chronic inflammatory bowel disease or a predisposing genetic condition. Lack of routine screening gives benign polyps time to turn cancerous and early cancers time to turn invasive. If the cancer risk increases enough in younger age groups, screening guidelines might be revised to include younger adults, Ko says. "That's not the case yet," he adds. The costs and risks of screening make routine testing of questionable value in a population that is still at low risk. But Ko says physicians need to be aware of the trend so they don't rule out cancer based on age. "If somebody comes in and they're 39 years old and they have bleeding that isn't due to hemorrhoids, they should get a colonoscopy." Diet isn't iron-clad protection against colorectal cancer, but it can help reduce risk. The American Cancer Society recommends plenty of fruits, vegetables and whole grains, as well as exercise for at least 30 minutes five days a week. Copyright © 2009, The Los Angeles Times Copyright 2009 Baltimore Sun. The hidden salt in chicken Those plump breasts often come 'enhanced' with saltwater broth. NUTRITION LAB By Elena Conis Baltimore Sun Monday, June 22, 2009 Most people don't think of uncooked chicken as a significant source of sodium -- but it can be, not just because most cooks use salt as seasoning. Injecting raw chicken with saltwater solutions during processing is a widespread practice in the poultry industry. It's also a practice that has the industry increasingly divided. Major producers who inject their products with saltwater solutions say it makes for tastier, juicier meat. Other producers promote their products as free of the additive and say that the practice is deceptive. Granted, poultry producers on both sides of the issue are probably vying for a market edge. But marketing wars aside, the practice of saltwater plumping has ruffled the feathers of many nutrition experts too. "People believe that when they're getting chicken, they're getting a low-sodium food," says Liz Trondsen, a registered dietitian at Hollywood Presbyterian Medical Center in Los Angeles and a spokeswoman for the American Heart Assn."They need to be aware of this." Raw chicken breast can contain as little as 50 to 75 milligrams of sodium per 4-ounce serving. But much of the chicken on the market in the U.S. is "enhanced" -- injected with a salt solution, or broth, during processing. Sodium levels often reach well over 400 milligrams per serving -- nearly one-third of the maximum daily intake of 1500 milligrams recommended for people at risk of high blood pressure (including African Americans and older adults). High sodium levels can cause and aggravate high blood pressure, which increases the risk of heart disease and stroke. Producers have been injecting chicken (and other meats) with saltwater solutions since the 1970s, says John Marcy, professor and poultry processing specialist at the University of Arkansas at Fayetteville. The practice makes for more flavorful meat, he says, because "a consumer can't put salt into chicken like a processor can." Processors use multiple-needle injectors or vacuum-tumblers, which force the sodium solution into the muscle. Binding agents in the solution prevent the added salt and water from leaching out of the meat during transport, in grocery stores and during cooking, says Kenneth McMillin, professor of meat science at the Louisiana State University Agricultural Center in Baton Rouge. The labels on saltwater-infused meats typically say "enhanced with up to 15% chicken broth." They can also say "all natural" if ingredients in the solution meet the U.S. Department of Agriculture definition of natural, says Bryn M. Burkard, a public affairs specialist with the agency's Food Safety and Inspection Service. The Truthful Labeling Coalition, a Washington, D.C.-based coalition of poultry producers that don't enhance their products, is pressing the USDA to change that policy. "The labels [on raw poultry] are really misleading," says Charles Hansen, executive director of the coalition. "We've got no objections to them adding saltwater to chicken, but why not list it prominently on the label?" The USDA is reviewing comments on the policy, Burkard says. But though clearer labeling may help consumers avoid excess sodium in the chicken they buy at grocery stores, they'll still encounter high sodium levels in chicken dishes in restaurants and cafeterias. "In the food services industry, chicken has always been injected to retain moisture," Marcy says. "It's been standard practice for decades." And despite the high levels of sodium in enhanced chicken, it's still not the top source of hidden dietary sodium, Trondsen says. Consumers should generally be more concerned with the typically high levels of sodium in frozen and canned foods, processed foods, soups and condiments, she says. An 8-ounce serving of canned soup can often contain 700 to 900 milligrams of sodium, and many frozen dinners contain well over 1,000 per meal. Nonetheless, at more than 400 milligrams per serving, the sodium levels in plumped chicken are significant. "Pity the poor person trying to cut down on salt," says Marion Nestle, professor of nutrition, food studies and public health at New York University, and the author of the 2006 book "What to Eat." "It gets put into everything and you don't have any choice about it." Nestle adds that not only does the practice of saltwater plumping add unnecessary salt to people's diets, it also increases the water weight of chicken. Livingston, Calif.-based Foster Farms, a member of the Truthful Labeling Coalition, has estimated that consumers are paying an average of $1.50 for added saltwater per package when they purchase enhanced chicken. "This practice manages to do not one but two bad things," Nestle says. "It increases the water weight of the chicken so you are paying for water, not chicken, and it adds salt that you don't need." Copyright © 2009, The Los Angeles Times Copyright 2009 Baltimore Sun. Newspapers: Philadelphia VA hospital botched cancer treatments for years By Associated Press Baltimore Sun Monday, June 22, 2009 PHILADELPHIA (AP) — Ninety-two veterans were given incorrect radiation doses in a common surgical procedure to treat prostate cancer during a six-year period at the Veterans Affairs Medical Center in Philadelphia, according to newspaper reports Sunday. A hospital team that performed the procedure botched it on 92 of 116 occasions and continued the treatment for a year even though monitoring equipment was broken, The New York Times said. The Philadelphia Inquirer said treatment errors occurred in 92 of 114 cases. The cases involved brachytherapy, in which implanted radioactive seeds are used to kill cancer cells. Most veterans got significantly less than the prescribed dose while others received excessive radiation to nearby tissue and organs. A federal commission announced last fall that an inspection at the hospital was under way partly because of the number of patients given incorrect radiation doses. The medical center suspended its prostate cancer treatment program as a result of the ongoing investigation. Investigators found that 57 implants delivered too little radiation to the prostate and 35 cases involved overdoses to other parts of the body, according to a Nuclear Regulatory Commission report published in the Federal Register this month. An unspecified number of patients had both underdoses to the prostate and overdoses in other areas. All of the affected veterans have received follow-up care, and eight got additional seed implants at a Seattle VA center, according to Dale Warman of the Philadelphia VA Medical Center. Warman said the hospital leadership "takes the ... situation very seriously and has taken every step possible to correct or mitigate the problem." Four of the men have since died, but Warman said none of the deaths was connected to prostate cancer or the treatment. Several staff members, including oncologist Gary Kao, who was under contract to the VA and was involved in nearly all of the cases, are no longer employed at the hospital. Kao's lawyer, Jack L. Gruenstein, told the Times its account of the doctor's role was "false" but declined to elaborate. A team from the commission, which oversees such radiation therapy, is scheduled to be in Philadelphia this week to investigate. "As we have done throughout this process, Philadelphia VA Medical Center staff are prepared to share whatever records and information are necessary to discover what happened, why it happened, and to take steps to prevent it from happening again," Warman said. Copyright 2009 Associated Press. All rights reserved. *Opinion* Caregiving Must Be Affordable Washington Post Letter to the Editor Monday, June 22, 2009 Paula Span's article on her caregiving experience ["Their Parents' Keepers," Health, June 16] raised an important question our country must consider: How can we ensure that the millions of Americans who need long-term services and support receive care at prices they can afford? The current system is fragmented, difficult and expensive. It affects not only families but also government programs, the medical profession and the economy as a whole. Providing care is simply unaffordable. What our country needs is a national insurance trust whose premiums provide cash benefits to pay for these expenses. When we are well, we would pay premiums as we do for car or health insurance. When people like Murray Span need help, they could use the benefit to hire an aide, pay a family member to help them or order groceries to be delivered. This approach would provide more choice and control over our lives. An example is the Community Living Assistance Services and Supports (CLASS) Act, included in health reform legislation proposed by the Senate Health, Education, Labor and Pensions Committee. We must make it affordable to provide care. Larry Minnix Chief Executive American Association of Homes and Services for the Aging Washington Copyright 2009 Washington Post. BACK TO TOP


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