SNM applauds the U.S. House of Representatives for its passage of H.R. 3276-the American Medical Isotopes Production Act of 2009.

"The worldwide isotope shortage has long been adversely affecting patients in the U.S.," said Michael M. Graham, Ph.D., M.D., president of SNM. "This important legislation will bring us one step closer to solving this chronic problem."

The American Medical Isotopes Production Act of 2009 was introduced by Congressman Edward J. Markey (D-MA) in July.

"Congressman Markey has worked closely with the medical community, members of industry and other stakeholders to ensure that this important legislation comes to fruition," said Robert W. Atcher, Ph.D., M.B.A., chair of SNM's Domestic Isotope Availability Taskforce. "The time is now to make sure that the U.S. has long-term access to medical isotopes-without having to rely on foreign producers."

Molybdenum-99 (Mo-99) is a critical medical isotope. Technetium-99m-the decay product of Mo-99-is used in more than 16 million diagnostic medical tests annually in the U.S. for the early detection and effective management of cancer, heart disease, thyroid disease and other serious conditions.

There are currently only six foreign producers of Mo-99 approved by the U.S. Food and Drug Administration to import the product into the U.S.-and no domestic facilities exist which are dedicated to the production of Mo-99 for medical uses. These aging foreign reactors regularly experience significant ongoing maintenance issues-frequently causing these reactors to go off-line. These continuing problems were exacerbated with reactors shutting down in Canada and the Netherlands earlier this year. Subsequently, the Canadian government announced that it will no longer produce medical isotopes as of 2016.

"To date, it has not been a pretty picture-and that is why SNM is so supportive of the House's approval of this bill," added Graham.

Most reactors in the world that produce Mo-99 utilize highly enriched uranium (HEU), which can also be used in the construction of nuclear weapons. Under this legislation, nuclear reactors that produce Mo-99 would have to stop using HEU and make the transition to low enriched uranium (LEU) as a replacement.

The American Medical Isotopes Production Act of 2009 now heads to the U.S. Senate for approval. If enacted, this legislation would create a stable and reliable supply of medical isotopes in the U.S.

"This is landmark legislation for patients and all Americans," said Graham.

The American Society of Radiologic Technologists (ASRT) is offering eight pointers to patients to ensure that they receive the best and safest imaging possible. The tips come on the eve of National Radiologic Technology Week (NRTW), Nov. 8-14, which recognizes and honors radiologic technology (RT) personnel who provide medical imaging and radiation therapy treatments. NRTW marks the anniversary of Wilhelm Roentgen's discovery of the X-ray on Nov. 8, 1895.

"As radiologic technologists, our ultimate goal is to use our knowledge, skills and education to improve health care and provide patients with outstanding care," says Sal Martino, EdD, RT(R), FASRT, CAE, ASRT CEO. "Radiologic technologists realize that they are the conduit between the patient and the procedure, so they are in a unique position to help patients before, during and after exams."

The ASRT's goal in providing its list of X-ray safety tips is to empower patients with the knowledge they need to understand what to look for during exams, which will help increase safety measures and ultimately improve patient care.

 The ASRT's patient tips include:

1.       Tell your doctor or radiologic technologist if you're pregnant. Many types of X-ray examinations can be performed safely on pregnant women, but the exam's benefits must be weighed against any risk to the developing fetus.

2.       The eyes, thyroid and reproductive organs are more sensitive to radiation than other parts of the body and should be shielded when they're in the path of the X-ray beam, unless the shielding would interfere with the examination. Ask if you think you need shielding.

3.       Remain still during the exposure, which lasts only seconds. Motion makes the images blurry and requires them to be repeated, adding to radiation exposure. For certain exams, you will be asked to hold your breath so your moving lungs won't blur the image. The easiest way to do this is to take a deep breath, exhale and then take another deep breath and hold it.

4.       Remove any metal you may be wearing that could interfere with the X-ray. For example, if you're having a skull radiograph, remove earrings, hairpins and eyeglasses. For radiographs of the hand, remove rings, bracelets and watches. You may need to wear a hospital gown if your clothing has zippers, metal buttons or snaps.

5.       Tell your technologist if you have any medical or electronic devices in your body, including heart valves, pacemakers or metal objects such as those used in orthopedic surgery. Electronic and metal orthopedic devices may interfere with certain types of exams or pose risks.

6.       Don't refuse a radiologic examination if the need for it is clear. On the other hand, don't insist on a radiograph or other type of imaging exam if your physician doesn't recommend one.

7.       If you're referred to a different physician, take all of your prior imaging exams and reports with you so the new physician doesn't reorder the same exam. And remember--the new physician may call it something different, so you may think you haven't had that exam even though you have.

8.       Finally, make sure the person taking the X-ray is a registered RT. RTs must graduate from a formal educational program and pass a national certification exam. They also must earn CE credits throughout their careers.

A pair of studies in Cancer Epidemiology, Biomarkers & Prevention have laid to rest the decades-long concern that lower total cholesterol may lead to cancer--and indicate that lower cholesterol actually may reduce the risk of high-grade prostate cancer.

Early studies suggested that low cholesterol could increase the risk of certain types of cancer, said Demetrius Albanes, MD, a senior investigator at the National Cancer Institute (NCI). "Our study affirms that lower total cholesterol may be caused by undiagnosed cancer," said Dr. Albanes. "In terms of public health message, we found that higher levels of 'good cholesterol' (HDL) seem to be protective for all cancers, which is in line with recommendations for cardiovascular health."

The researchers observed 29,093 men from the Alpha-Tocopheral, Beta-Carotene Cancer Prevention Study cohort for 18 years, making it the largest and longest study of its kind. In that follow-up period, they noted 7,545 cancer cases. Low total cholesterol blood levels were associated with an 18 percent higher risk of cancer overall, similar to increases seen in previous studies. However, this risk disappeared when researchers excluded cases that occurred in the early years after the original blood draw.

This finding suggests that the low total cholesterol levels didn't cause cancer, but rather were the result of underlying cancer, said Dr. Albanes. Higher levels of HDL cholesterol were associated with a 14 percent decreased risk of cancer even after excluding nine years of early cases.

In an accompanying study that specifically examined risk for high-grade prostate cancer, Elizabeth Platz, ScD, MPH, associate professor in the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health and co-director of the Cancer Prevention and Control Program at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, found a link between low cholesterol and decreased risk of high-grade prostate cancer among 5,586 men older than 55 years.

Specifically, if men had total cholesterol of less than 200 mg/dL, they had a 59 percent reduced risk of high-grade prostate cancer, defined as a Gleason score of eight to 10. No association was seen for prostate cancer overall or for prostate cancer with a lower Gleason score. The study supports another benefit of keeping cholesterol low among men in this age group. "High-grade prostate cancer is less common than prostate cancer overall," said Dr. Platz, "but it is a subset of prostate cancer that is more likely to progress."

Discussion of the benefits of lower cholesterol inevitably leads to the discussion of the role of statins. Researchers left open the possibility that industry leaders may seek a new indication for these cholesterol-lowering drugs. "Until there is evidence from randomized trials, men should not take statins to prevent high-grade prostate cancer," said Eric Jacobs, PhD, strategic director of pharmacoepidemiology at the American Cancer Society (ACS). The author of an accompanying editorial in the Cancer Epidemiology, Biomarkers & Prevention issue, Dr. Jacobs said a randomized trial among men without prostate cancer would need to be very large and might not be feasible. "One possibility, however, would be a randomized trial among early-stage prostate cancer patients opting for surveillance rather than immediate treatment, to see if statins could lower risk of prostate cancer progression," he said.

The American College of Radiology (ACR) recently launched a practice leaders' Web site designed to address clinical and administrative issues facing radiology and radiation oncology practice leaders by providing the most recent literature from across the medical landscape as well as an online forum to discuss these issues with peers.

With its library of articles, the site offers insight into practice-related issues regarding clinical and administrative improvement. Until now, information on these topics has been scattered in different locations. The Practice Leaders' Web site offers a one-stop shop for answers to practice leadership-related questions, comments and concerns.

The Practice Leaders' Web site is a place to find customized support. The "about" section includes an area where visitors can provide feedback on topics and articles that they would like to see posted on the site. With the ever-evolving content provided by radiologists and their peers, this tool will continue to add value to the visitor's practice.

"The group practice leaders' site is by practice leaders, for practice leaders," says Philip Cook, MD, chair of the ACR Practice Leaders Web Subcommittee. "It is designed to encourage practice leaders to take an active and informed role in the issues affecting their practices and more effectively manage the day-to-day activities of their practices."

As part of the American Recovery and Reinvestment Act of 2009, the National Cancer Institute (NIC), part of the National Institutes of Health (NIH), recently funded seven research and research infrastructure Grand Opportunities (GO) grants.

The awards were for comparative effectiveness research (CER) in genomic and personalized medicine (GPM). These awards will support two-year efforts that will advance methods for analysis, synthesis, modeling and evaluation of the clinical validity and utility of existing and emerging GPM applications in cancer control and prevention. They will accelerate GPM development by planning CER initiatives as well as enhance clinical and population data infrastructure to support CER initiatives in GPM.

A team from Michigan State University's Breslin Cancer Center is developing a clinic for breast cancer survivors, hoping to reduce mortality and improve quality of life. A $39,591 grant from the Mid-Michigan Affiliate of Susan G. Komen for the Cure will support "Changing Tomorrow's Breast Cancer Survivors," a new multidisciplinary program.

"Some breast cancer survivors don't feel like medical providers are very involved with their care when treatment ends," says Deimante Tamkus, MD, an assistant professor in MSU's Department of Medicine. "However, various areas of life are affected by cancer. We want to help survivors identify potential problems, both physical and emotional, to improve their lives and help prevent recurrence."

The multidisciplinary MSU team will consist of a medical oncologist, oncology social worker and nurse educator. Martha Trout, a nurse at the Breslin Cancer Center, and Heather Spotts, an oncology social worker, also are co-investigators on the grant. Survivors will talk to team members, focusing on healthy lifestyles and recommendations to avoid recurrence.

A treatment summary and long-term recommendation will be given to the patient and sent to the primary care doctor. Follow-up phone consultations will be conducted to help survivors achieve healthy lifestyle goals. The grant also will support three educational seminars for breast cancer survivors focusing on sexuality after breast cancer, healthy exercise and nutrition for survivors, and on how to manage side effects caused by treatment such as lymphedema, a type of tissue swelling caused by fluid retention.

"We hope to raise awareness in the medical community of the many issues that breast cancer survivors struggle with after treatment such as fatigue, cognitive problems, depression and sexuality concerns," says Spotts. "The good news is, there are so many more cancer survivors compared to years ago; now, it is imperative that we address their physical and psycho-social needs."

Susan G. Komen for the Cure is the world's largest breast cancer organization, and the mid-Michigan affiliate is one of 125 affiliates dedicated to ending breast cancer in their communities.

To improve cancer care in underserved regions of the world, the American Society of Clinical Oncology (ASCO), in partnership with Health Volunteers Overseas (HVO), recently launched the International Cancer Corps (ICC), a new humanitarian program that will enable ASCO member oncologists to volunteer their time to teach in medical facilities in developing countries.

ASCO's partnership with HVO, another international medical education organization, will give ASCO's member oncologists an opportunity to spend one to four weeks at medical care centers in developing countries, sharing their medical expertise and building long-term, supportive relationships with physicians who provide cancer care in these countries.

Medical professionals who are trained and credentialed in oncology--including physicians, laboratory professionals and nurses--will be eligible to apply for the ICC program. While ICC volunteers won't treat patients directly, they will share their clinical knowledge and skills. Upon their return to the U.S., ASCO's member volunteers will continue to share ASCO's professional resources with the hospital to help sustain and improve cancer care in the region.

The first International Cancer Corps training program with HVO will open in Tegucigalpa, the capital of Honduras. With a population of nearly 7.3 million people, Honduras has less than 20 trained medical, radiation, and surgical oncologists. Over half of the population lives below the international poverty line, and health care for urban and rural poor Hondurans is extremely limited. More than 20 percent of the population has no access to health care at all.

Each practice setting will have its own unique challenges and needs. In Honduras, the focus will be on developing a training program for adult and pediatric oncology at three centers in Tegucigalpa. ASCO volunteers, depending on individual expertise and skills, will provide teaching and training to staff, residents and students in the following areas: pathology; cancer control; medical, surgical and radiation oncology seminars and workshops; curriculum development; and student and resident education.

Each year, ASCO and HVO plan to expand the program to an additional developing country while remaining committed to multi-year volunteer and educational support of previously established sites.