Shedding light

National | Easier breast-cancer screening; taking the edge off jet lag; counterfeit drugs seep into U.S. market

Issue: "Walking the tightrope," Feb. 10, 2001

A lighter touch
It may only indirectly help defeat breast cancer, but a new invention could save a lot of women a lot of grief. A new device, now known as Smart Probe, uses a super-thin needle to inspect suspicious lumps, helping doctors more easily determine whether tissue is benign or needs a closer look. Scientists at Lawrence Livermore Nuclear Laboratory in Livermore, Calif., are still developing the Smart Probe, but they hope their invention can help cut down on unnecessary biopsies. It takes measurements by sending out light that bounces off tissue, providing data about a lump's properties. If the Smart Probe lives up to its promise, it could save hundreds of thousands of women from unnecessary treatment and the pain and trauma that surround it. According to project consultant Neil Gorrin, assistant chief of surgery at Kaiser Permanente Medical Center in South San Francisco, 1.2 million women undergo biopsies annually. Between 75 percent and 80 percent of those tests turn out benign. If successful, Dr. Gorrin says the device could help cut cancer treatment costs and "save women a lot of grief and trouble." The device is supposed to help doctors compare normal and cancerous tissue more easily. As a demonstration, the scientists inserted the Smart Probe into a steak, then compared the different patterns produced by muscle, fat, and gristle on a computer monitor. They hope to start testing on humans this spring and have their probe readily available within three years. The invention is still being tested for precision; the results will determine Smart Probe's fate. "Any tool that could provide complete assurance that an abnormality that we might need to biopsy today was not cancer would be a step forward," said Robert Smith, the American Cancer Society's director of cancer screening. "However, it would need to be nearly 100 percent accurate." Before arriving in Rome, eat as the Romans do
The old adage goes, You are what you eat. But when you eat may be an important weapon in fighting jet lag, according to a study in Science magazine. So a few days before that trans-time zone flight, you might want to start mealtimes a few hours early (or late), depending upon where you're headed. It's a way of resetting the body clock. Michael Menaker, a University of Virginia biologist, and other researchers found by studying rats that human travelers may be able to take the edge off jet lag by slowly altering the body's so-called "circadian rhythms," which involve biological patterns such as sleep and body temperature. Mr. Menaker simulated jet lag in rats; they were exposed to light six hours before their usual wake-up time. Their brains adjusted within a few days, but their livers took up to two weeks to adjust. By changing mealtimes the rats found the time change easier to deal with. The whole issue of circadian rhythms, the human body clock, is a bit mysterious. While meal times can be important, light and darkness are core factors in keeping things calibrated. That's why we tend to sleep at night and wake in the morning. The rhythms can be a real problem for the blind, who can't use light and dark as cues. According to Dr. Robert L. Sack of the Sleep and Mood Disorders Laboratory at Oregon Health Sciences University, about half of the totally blind people in America suffer insomnia and daytime sleepiness due to this issue. Keep out of reach
Here's a scary thought: Patients pick up a prescription and get a potentially dangerous fake instead. This nightmare scenario became reality for about 10 people who received a counterfeit instead of the anti-AIDS drug Serostim. About 6,000 patients use the injected medicine to help fight the disease. Its Swiss manufacturer, Serono, said patients in California accidentally received the bogus version; patients called, complaining of skin irritation and that the drug looked different. Meanwhile, the federal Food and Drug Administration discovered fakes in Ohio, Kentucky, Michigan, New Jersey, Florida, and Missouri. The fake Serostim was sold in boxes that resembled the real thing. Serono issued a statement that "the counterfeit product is of unknown safety and efficacy and may pose a health risk to patients." The fraud is now the subject of a criminal investigation. Many questions remain unanswered: How did a counterfeit get dispensed as a prescription drug? Who pulled off the hoax and why? Can future fakes be prevented? While the counterfeit's origin is not yet known, the Serostim mess comes as concern rises over fake drugs from overseas slipping into U.S. pharmacies, particularly from China. The FDA wants more power to inspect imported drugs. Fakery adds controversy to proposals that would allow importation of drugs from overseas at prices lower than available in the United States. The Serostim fraud may scare some off from wanting to open the market for medications.

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