TUESDAY, March 18 (HealthDay News) -- The use of radiation therapy in fewer, but higher doses appears to be just as effective as conventional doses for women recovering from breast cancer, British researchers report.

Because fewer treatments are needed, the overall amount of radiation the patient receives is actually less, though treatment outcomes remain the same or better, according to two British trials appearing this week in the April edition of the journal Lancet Oncology and an upcoming edition of The Lancet.

The studies, led by researchers at the Institute of Cancer Research, in Sutton, support what other trials have already shown and what doctors have noted in practice settings, experts said.

"These two studies confirm work done in the U.S.," said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, LA. "Today, there are a whole bunch of techniques to give shorter courses of radiation."

According to background information in the studies, the international standard radiation schedule for breast cancer treatment involves a high total dose delivered in 25 small daily doses or fractions. But this approach, which reduces the risk of local cancer relapse by about 70 percent, requires a huge investment of time and effort on the part of the patient.

"One of the biggest problems in radiation therapy is just the sheer amount of time it takes for women to receive treatment," Brooks said. "In the U.S., traditionally, it's about six weeks of treatment. When many women live 50 miles from a radiation center, that's a 100-mile trip each day, five days a week. That's an enormous amount of time and effort to have radiation."

In the first trial, known as START A, 2,236 women with early-stage breast cancer were randomly assigned to receive the conventional dose of radiotherapy or one of two regimens both involving fewer but larger fractions of radiation.

All treatments were given over five weeks, essentially the standard amount of time for conventional radiotherapy.

After a median follow-up of about five years, the rate of tumor recurrence was about equivalent in the two groups. There also seemed to be fewer adverse effects in the groups receiving the lower total dosage.

The second trial, known as START B, involved 2,215 women, again with early breast cancer, who were randomly assigned after surgery to receive the conventional, higher dose of radiation or to receive fewer, larger fractions. The conventional arm received their therapy over five weeks while the second group received theirs over three weeks.

This time, after a median follow-up of six years, the rate of tumor recurrence was 2.2 percent in the group receiving a smaller total dose of radiation, versus 3.3 percent in the conventional-treatment arm.

More information

For more on breast cancer treatment, visit the U.S. National Cancer Institute.

MONDAY, March 17 (HealthDay News) -- While men suffer more heart attacks than women, women have a 20 percent higher prevalence of stable angina, according to a new study that conflicts with conventional medical wisdom.

Angina is a common and serious heart problem. It's caused by inadequate oxygen to the heart, which can lead to chest pain or discomfort on exertion that typically goes away with rest. The condition can result from partially blocked heart arteries or decreased flexibility of the cardiac arteries.

"When one looks at typical symptoms of angina, one finds that they are as common in women as men," said study lead researcher Dr. Harry Hemingway, a professor of clinical epidemiology at University College London Medical School in Great Britain. "In fact, they are slightly more common in women than men right across 31 countries, and we didn't know that before," he added.

Because heart attacks are more common in men than women, Hemingway said doctors "have assumed the same thing to be the case for other forms of coronary heart disease. The main other form of heart disease is angina."

For the new study, Hemingway and his colleagues collected data from 74 studies involving 401,315 people living in 31 countries, including the United States. The prevalence of angina varied from country to country. Among women, the prevalence varied from 0.73 percent to 14.4 percent, with an average of 6.7 percent. Among men, it varied from 0.76 percent to 15.1 percent, for an average of 5.7 percent, the study found.

While risk factors for heart disease, such as smoking, differed from country to country, once the researchers compensated for those risk factors, they found that the prevalence of angina was still higher among women. In fact, the prevalence of angina was 20 percent higher overall among women than men.

The study findings are published in the March 25 issue of the journal Circulation.

"Doctors and the general public should realize that out there in the real world, men and women experience these symptoms with a similar frequency," Hemingway said. "When someone sees their doctor with symptoms of angina, the sex of the patient is not the most important factor."

While the study doesn't show that women with angina are under-diagnosed or under-treated, Hemingway thinks that, overall, women with heart disease are less likely to receive appropriate treatment.

"This is consistent with many observations which suggest that women with suspected or confirmed heart disease are less likely to go for further investigation or treatment," Hemingway said. "This study shows that that general issue may be even more important than we suspected."

One expert on women and heart disease isn't surprised that angina is more common among women.

"This is something we've always believed -- that there was an excess of angina symptoms in women," said Dr. Nieca Goldberg, medical director of the Women's Health Program at New York University Medical Center.

Angina used to be considered a benign symptom in women, added Goldberg, who's the author of Dr. Nieca Goldberg's Complete Guide to Women's Health. "Maybe that's the thing that sent us on the wrong pathway that women didn't have heart disease," she said.

"Just because women don't have as many heart attacks as men, we have to recognize that angina is something that's limiting women from having a good quality of life," she said.

More information

To learn more about angina, visit the American Heart Association  .

FRIDAY, March 14 (HealthDay News) -- Women who have the most severe menopausal symptoms may also be at a higher risk of cardiovascular disease, a new study suggests.

Dutch researchers surveyed 5,648 women, aged 46 to 57, about their menopausal complaints and collected data on other health information such as their cholesterol and blood pressure.

Night sweats were reported by 38 percent of women; flushing by 39 percent.

Those with flushing had higher cholesterol levels than those without the symptom. They also had higher blood pressure, higher body mass index (BMI, a ratio of weight to height) and a slightly higher chance of developing heart disease over the next decade. The women with night sweats had comparable results.

The researchers, from the University Medical Center Utrecht, conclude that the connection between severity of symptoms and heart disease risk may be the result of reduced beneficial effects of estrogen on the functioning of blood vessel walls, as estrogen declines during menopause.

The Dutch researchers were scheduled to present their findings Friday at the American Heart Association's Cardiovascular Disease Epidemiology and Prevention Conference, in Colorado Springs, Colo.

"The implication is the women with the worst symptoms may be at higher risk, clinically, for heart disease," said Dr. Suzanne Steinbaum, director of women & heart disease, at the Heart & Vascular Institute at Lenox Hill Hospital, in New York City.

But the American Heart Association does not advise postmenopausal women to take hormone therapy to reduce heart disease or stroke risk, due to clinical trials that show the hormones, over time, actually increase cardiovascular risks. Hormone therapy is only recommended to relieve very severe symptoms of menopause, and only for the shortest possible period.

The take-home point from this study for the general population, according to Steinbaum, is to pay close attention to improvement in lifestyle habits before menopause and before estrogen levels decline. "One of the things I talk about is lifestyle management to control high blood pressure, high cholesterol," she explained.

If women keep in check the risk factors of heart disease, such as high blood pressure and high cholesterol, by eating healthfully and exercising often before menopause, the transition "doesn't have to be as terrible" as many women fear it will be.

Among her suggestions: Exercise at least 20 to 30 minutes three to five days a week, and eat a diet filled with fiber, vegetables, fruits, multi-grains, legumes and omega-3 fatty acids.

In a second study, also scheduled to be presented Friday at the conference, French researchers found the type of hormone delivery method affects the risk of blood clots in postmenopausal women.

Researchers from Paul Brousse Hospital in Villejuif, France, compared women who did not use hormones with those who used estrogen, taking it either orally or transdermally with a patch. Some women took only estrogen, others took estrogen plus progesterone, pregnane, norpregnane or nortestosterone.

The researchers found that transdermal estrogen alone or in combination with progesterone or pregnane derivatives did not raise the risk for blood clots, while other delivery systems did.

They looked at a population of nearly 86,000 French women -- including 984 with blood clots -- who were followed for more than 10 years.

"This [study] is one more piece of the puzzle," said Dr. Jennifer Wu, an obstetrician-gynecologist at Lenox Hill Hospital in New York City. When women take hormones orally, she said, the metabolism involves much more processing through the liver, for instance.

While the study concluded that the patch delivery is less risky when it comes to blood clots, Wu said "the indications remain the same" for hormone therapy. It should be used only for very severe menopausal symptoms interfering with daily life, for the shortest possible time.

More information

To learn more about menopause and heart disease risks, visit the American Heart Association  .

THURSDAY, March 13 (HealthDay News) -- An American woman's risk of developing the skin cancer called squamous cell carcinoma appears to increase if she lives in areas where UV radiation is high, such as in the South, a new study found.

The risk of developing another type of skin cancer, basal cell carcinoma, appears to be only moderately affected by living in areas with high UV (ultraviolet) radiation. And the chance of developing melanoma, the deadliest form of skin cancer, is not significantly affected by where you live, the researchers said.

"There's an increased risk of skin cancer in general, as you know, from North to South," said lead researcher Dr. Abrar A. Qureshi, of the Department of Dermatology at the Channing Laboratory of Brigham and Women's Hospital and Harvard Medical School. "So for people living in areas where there is more sun around, the risk of skin cancer is higher, as we've known for decades."

"But what we found was that squamous cell carcinoma was very much related to the North-South difference," Qureshi added. "Women living in the South had a twofold increased risk of developing squamous cell carcinoma, compared with women living in the North."

However, there was no statistically significant difference for developing melanoma, whether women lived in the North or the South, Qureshi said. "We're not saying that melanoma risk doesn't increase with sun exposure, but compared to women living in the North, women in the South did not have a significantly increased risk of melanoma," he said.

The findings were published in the March 10 issue of the Archives of Internal Medicine.

Squamous cell carcinoma is the second most common form of skin cancer, with more than 250,000 new cases diagnosed each year in the United States. Most squamous cell cancers aren't serious, particularly if they're diagnosed and treated promptly. But later diagnoses can mean the cancers are harder to treat and can cause disfigurement. A small number of cases can be potentially fatal, according to The Skin Cancer Foundation.

For the new study, Qureshi's team collected data at 84,836 women who took part in the Nurses' Health Study. The women lived in different parts of the United States with different levels of UV exposure.

Over the 18 years of the study, 420 women developed melanoma, 863 developed squamous cell carcinoma, and 8,215 developed basal cell carcinoma.

The researchers found that women living in areas with medium UV exposure had a 47 percent increased risk of developing squamous cell carcinoma. Women living in areas where UV exposure was high had a 90 percent greater risk of developing squamous cell carcinoma.

Qureshi said it's not clear why there are differences in risk for different types of skin cancer. "The question is, is melanoma more a disease of genetics as well as exposure to the sun," he said. "It could be more of a genetic disease than squamous cell carcinoma -- that's really the question."

It's also not clear if the same risk factors affect men, Qureshi said, adding that he and his colleagues are examining that question now. He speculated that they will find the same relationship for the various types of skin cancer among men.

One skin cancer expert advises people to protect themselves from the sun, no matter where they live.

"We have a slogan of the American Cancer Society -- slip, slop, slap," said Dr. Martin A. Weinstock, a professor of dermatology at Brown University and a spokesman for the American Cancer Society. "Slip on a shirt, slop on the sunscreen and slap on a hat. That's the advice when you're out in the sun to protect yourself from the damage that leads to skin cancer, no matter where you live."

More information

To learn more about skin cancer, visit the American Cancer Society  .