TUESDAY, April 29 (HealthDay News) -- Treating elderly cancer patients for five years costs Medicare $21.1 billion, and these costs are expected to increase dramatically as the population ages, a new study says.

The costs for treating patients varies by type of cancer, with expenditures highest for lung, colorectal and prostate tumors, said the researchers, who based their estimates on patients diagnosed with cancer in 2004.

"Because the U.S. population is aging and growing, we think that these costs are going to get higher in the future," said lead researcher Robin Yabroff, an epidemiologist at the U.S. National Cancer Institute. "We think there are going to be a lot more cancer patients in the future."

"The main goal of this study," Yabroff added, "was to provide cost of care estimates that could be useful for policy makers and health planners and researchers that might want to do cost-effectiveness analyses."

The findings are published in the April 29 issue of the Journal of the National Cancer Institute.

For the study, Yabroff's team estimated the cost of cancer care among 718,907 cancer patients and compared that to 1,623,651 people without cancer. The researchers used data from the Surveillance, Epidemiology, and End Results (SEER) and SEER-linked Medicare files to identify these patients.

The researchers then subtracted Medicare costs for people without cancer from costs among those with cancer. The resulting number was the estimated cost of cancer care per person.

Costs varied over five years from about $20,000 for people with breast cancer or melanoma to $40,000 for people with lymphoma, brain or other cancers of the nervous system, as well as malignancies of the esophagus, ovaries or stomach.

The study authors found that costs were highest during the first year of treatment and also during the last year of life. Patients are more likely to be hospitalized during the last year of life, which increases costs, Yabroff said.

"We also found the cost of care is generally higher for patients diagnosed with a later stage disease, compared with patients diagnosed with earlier stage disease," Yabroff said.

To help contain costs, Yabroff suggested that more emphasis be placed on cancer screening and early diagnosis, as well as lifestyle changes, such as not smoking.

Paul Precht, policy director at the Medicare Rights Center, said he thinks Medicare will have to change some of its policies to keep costs down while continuing to offer care to the elderly with cancer.

"Clearly, treatment of cancer is expensive," he said. "When people talk about the sustainability of Medicare, they have to look at findings like this, because we are paying for treatments of very serious diseases, and that's why it's so expensive."

Precht agreed that one way to lower costs is to put more emphasis on early detection and increase Medicare benefits for prevention. Also, federal law needs to be changed to allow Medicare to negotiate drug prices with the pharmaceutical companies, he said.

"The cost of cancer drugs is going through the roof," he said. "Medicare really has to look at ways to deal with that."

People are already paying high co-payments and coinsurance for care under Medicare, and these costs are likely to grow, Precht added. And as those costs increase, it could reach a breaking point. "People will say: 'Yes, I want to live, but I don't have the money, so I guess I'm not going to,' and that's not right," he said.

Increasing costs don't necessarily lead to the rationing of health care, Precht said. "But there needs to be cost-effectiveness analysis, so there is some relationship to the effectiveness of the treatment we are paying for," he said.

More information

To learn about financial assistance and other resources for people with cancer, visit the U.S. National Cancer Institute.

SUNDAY, April 27 (HealthDay News) -- Many older adults don't get enough sleep, which can increase the risk of serious health problems such as obesity, cardiovascular disease and diabetes, says the American Academy of Sleep Medicine.

While sleep patterns do change as people age, disturbed sleep and waking up tired every day aren't a normal part of aging.

"As we get older, the amount of nightly sleep that we need remains the same as that of what we needed when we were younger. However the ability to get the sleep that we need does change. Older people have a hard time getting the sleep they need because of the interference of medical illness, the medications they take for those illnesses, and changes in their biological clock," Sonia Ancoli-Israel, a professor of psychiatry at the University of California, San Diego, School of Medicine and director of the sleep disorders clinic at the Veterans Affairs San Diego Healthcare System, said in a prepared statement.

Ancoli-Israel, who is also co-director of the Laboratory for Sleep and Chronobiology at the UCSD General Clinic Research Center, cited a number of common sleep disorders in the elderly:

• Insomnia affects almost half of adults aged 60 and older.
• Obstructive sleep apnea (OSA) affects almost 40 percent of adults, and is more common among older adults. OSA can increase the risk of high blood pressure, heart disease, stroke and cognitive problems.
• Restless legs syndrome, which affects more than 20 percent of people aged 80 and older, includes uncomfortable feelings in the legs, such as tingling, or pins and needles.
• Periodic limb movements cause people to jerk and kick their legs every 20 to 40 seconds during sleep. One study found that about 40 percent of older adults have a least a mild form of this condition.

Older adults who don't get enough sleep are more likely to feel depressed, have attention and memory problems, excessive daytime sleepiness, more nighttime falls, and to use more over-the-counter or prescription sleep medications.

In order to get a better night's sleep, older adults should:

• Establish a routine sleep schedule.
• Avoid using the bed for activities other than sleep or intimacy.
• Avoid substances that disturb sleep, such as caffeine and alcohol.
• Avoid napping during the day. If you have to nap, limit it to less than one hour and do it no later than 3 p.m.
• Develop pre-sleep rituals that help you relax, such as a warm bath, a light snack or a few minutes of reading.
• Leave worries behind. Bedtime is a time to relax, not replay the stresses of the day.
• Keep your bedroom dark, quiet and a little cool.
• If you can't fall asleep, leave the bedroom and do a quiet activity. Go back to bed only when you're tired.

More information

The U.S. National Institute on Aging has more about sleep and aging.

THURSDAY, April 24 (HealthDay News) -- German researchers are reporting a new approach to the possible prevention of the molecular "debris" that's associated with the development of Alzheimer's disease.

The basic idea -- to block the activity of an enzyme called beta-secretase -- is not new, said study lead author Dr. Kai Simons, a professor of cell biology at the Max Planck Institute of Molecular Cell Biology and Genetics in Dresden.

A number of laboratories, both academic and commercial, are working on methods to prevent the enzyme from slicing a protein into beta amyloid fragments that form the brain plaques found in people with the disease. All work on the same principle. "If we decrease the amount of cleavage, we could in all likelihood reduce the likelihood of the disease," Simons said.

Most experts now agree that formation of the beta amyloid plaques is directly linked to the development of Alzheimer's. The problem with most proposed methods of blocking beta-secretase, Simons said, is that they are designed to work outside of the affected brain cells.

"This process of cleaving takes place inside cells," he said. "We have constructed an inhibitor which binds outside, on the cell membrane, and goes into the cell where the cleavage occurs."

Reporting in the April 25 issue of the journal Science, Simons and his colleagues described both test-tube experiments and animal studies in which the combination of an anchoring molecule and a beta-secretase inhibitor reduced the formation of beta amyloid plaque by more than 50 percent over four hours, while the inhibitor alone was ineffective.

The success is just one small step toward a medically useful preventive therapy for Alzheimer's disease, Simons acknowledged. For one thing, the treatment was given by injection into the brains of the experimental animals (fruit flies and mice), something not likely to be done with people.

"This is proof of principle," Simons said. "The idea would be to get it into the blood in humans and then over the blood-brain barrier into the brain. There are many ways for molecules to get into the brain."

The blood-brain barrier is a network of tightly packed cells that prevents most molecules from entering the brain.

William J. Netzer, an Alzheimer's researcher at the Fisher Center for Alzheimer's Disease Research Foundation at Rockefeller University in New York City, called the new study "a profoundly interesting line of research."

"It is not implausible that one might improve the effectiveness of a drug by coaxing it to go into a region where the enzymes it blocks exist," Netzer said.

But medical use of such a product can raise questions, he said. "When you put an inhibitor into a living being, the chemical you put in can be modified in the body. Where a compound goes into a cell is a complicated issue when you put it into a human being," he added.

Dr. James Galvin, associate professor of neurology and psychiatry at Washington University in St. Louis, called the German research "a novel idea."

If the concept works, it would solve a puzzle about how to best target the enzyme, Galvin said. And it is a concept with broader medical possibilities, he said.

"You can potentially inhibit other enzymes where cleavage occurs within membranes," he said.

More information

Learn more about Alzheimer's disease from the U.S. Library of Medicine.