theheartwithin.com

Iressa, the lung cancer pill, has shown surprising results for patients with advanced lung cancer where it has been at least as effective as a standard chemotherapy treatment, researchers have reported.

The drug also, known as Gefitinib, works as well as chemotherapy as a second-line treatment for lung cancer, according to an international Phase III clinical trial, led by researchers at the University of Texas’ M D Anderson Cancer Center.

However, in contrast to earlier Iressa findings, the study reported on Thursday showed that there was no additional survival benefit for patients who expressed an elevated level of the epidermal growth factor receptor (EGFR) mutation.

“A pill, with less side effects, taken once a day, has similar activity to traditional chemotherapy given by vein every three weeks,” said lead researcher Dr Edward Kim, an assistant professor at the M D Anderson Cancer Center in Houston. This finding should reassure doctors that they are not compromising effective therapy by using a pill, Kim said.

Iressa is not available in the United States, but a similar drug, Tarceva, is. Iressa was first developed by AstraZeneca, but it failed to meet expectations.

The National Cancer Institute ended clinical trials of the drug in 2005 because it failed to prolong the lives of lung cancer patients.

“Based on our findings, I’m hopeful that Iressa can return as a treatment for lung cancer in the United States, offering this some patients a therapy with far fewer side effects,” said Kim.

The study is expected to offer both physicians and patients some confidence in another biological oral therapy, erlotinib, commercially known as Tarceva, that hits similar targets as Iressa.

The Phase III international study enrolled 1,466 lung cancer patients from 149 centers in 24 countries. Of those enrolled, 1,433 were evaluable. All had either locally advanced or metastatic disease and had been previously treated for their cancer. Patients were randomized to receive either Iressa or Docetaxel every three weeks.

The study had two primary survival endpoints: in all treated patients and in those whose tumors had high EGFR gene copy number, explained Kim.

The results showed, median overall survival for those receiving Iressa was 7.6 months and one-year survival was 32 per cent, compared to 8 months and a 34 per cent one-year survival for those taking chemotherapy.

In an assessment of quality of life, Iressa patients experienced far fewer side effects, with the most common being a rash and diarrhea. In contrast, patients taking Docetaxel experienced low blood count, infection, and hair loss.

In the subgroup of 174 patients with a high EGFR gene copy number, median overall survival in the Iressa arm was 8.4 months and one-year survival was 32 per cent, versus 7.5 months overall survival and a one-year survival rate of 35 per cent for those taking chemotherapy.

“Our study found that patients who received Iressa and whose tumors had EGFR mutations will have an improved response rate and progression-free survival compared to Docetaxel, but overall survival was similar in both treatment groups. In contrast,” said Kim.

Like many other elderly Americans, Edie Stark has been hard hit by the meltdown in U.S. financial markets. She is 84 and has been worried a lot lately about outliving her savings.

A retired nurse, Stark is a prime example of what financial planners coldly call “longevity risk,” a reference to the need for a secure income and lasting savings at a time when growing numbers of Americans can live for 30 years in retirement.

Life expectancy in the United States has already reached a record high of 77.8 years, up from 70.8 in 1970, according to the U.S. National Center for Health Statistics. Fueled by continuing health gains, the U.S. Census Bureau projects life expectancy in the world’s wealthiest country will reach 79.2 years by 2015.

Stark said she and her husband had seen more than 50 percent of their retirement assets wiped out since the stock market started tanking several months ago.

She still plans to see out the end of her days with her 88-year-old husband at the Palace, an upscale retirement complex where they live on the palm-fringed southern outskirts of Miami.

She acknowledges that may not be possible, however, as her life savings vanish.

“I have fixed expenses so I can add it up and tell you how many years we can live unless the market comes up,” said Stark.

“We wanted to have money to leave our children. That’s not possible anymore,” said Stark, whose husband suffers from dementia and is cared for in an assisted living facility at the Palace.

Dorie Ryder, 89, a retired school teacher and neighbor of Stark’s at the Palace, said she had lost about 25 percent of her assets to the recent stock market downturn.

She has fond memories of better times when she and her husband lived just a block away from the home of former President Richard Nixon on nearby Key Biscayne.

But Ryder said she is now contemplating a move into a Miami-area apartment, where she’d live alone but pay less rent than the $3,500 she forks out monthly at the Palace.

“I just do the best I can and I’m worried,” said Ryder, who has a small pension. “I don’t know how long I’ll be able to stay here.”

Coping with financial fears is not unique to the elderly, especially at a time of record home foreclosure filings, crumbling real estate values and rising unemployment.

It can be especially painful for the elderly, however, even for those who are still a long way from being destitute.

“Money anxiety when you’re older is just different than when you are young. You don’t have a chance to recover,” said Teresa Ghilarducci, a retirement expert and professor of economic policy analysis at New York’s New School for Social Research.

DYING OF WORRY

“I predict that this spike in anxiety around the security of money is actually going to lead to more sickness,” she added. “People are going to die of worry.”

Experts say millions of middle- and upper-class retirees across the country face mounting insecurity due to exposure to stocks instead of “safe money” investments like short-term bonds and fixed annuities.

Many were lured into the equities because they offered a chance to double their money from 2003 to 2008. Others face foreclosures because they over-borrowed against their homes before the U.S. housing meltdown.

“Probably half our clients are retired and yes, we have a lot of very worried, concerned clients,” said Peggy Cabaniss, president of HC Financial Advisors in Lafayette, California.

“Their leading concerns are, No. 1, that they’re going to run out of money,” she said.

Like the American Psychological Association, Cabaniss said she tells her clients not to get caught up in blow-by-blow media reports about swooning markets and dour economic news.

“The way things are presented it sort of sounds like and feels like the end of the world,” she said.

But avoiding bad news is tough when it affects life savings and people’s retirement security hangs in the balance.

Ghilarducci and Alicia Munnell, director of the Center for Retirement Research at Boston College, say the erosion of retirement savings due to stock declines is something that should be triggering alarm bells.

The United States is the only developed, industrialized and democratic country in the world where traditional pension plans with a nearly guaranteed stream of income are being replaced by 401k plans, in which retirees bear many risks from volatile market investments, Ghilarducci said.

“It’s disastrous,” she said, referring to the outlook for retiring or soon-to-be retired “baby boomers.”

“Late boomers will fare far worse than their parents and grandparents in terms of replacing their income in retirement, mainly because of the erosion in the employer pension system,” Ghilarducci said.

“It highlights the flaws in our retirement income system,” said Munnell.

“The idea that we have people increasingly and solely dependent on accounts which vary with the ups and downs of the stock market just doesn’t make for a very sensible retirement arrangement,” she added.

“My view is that it was always going to take the real suffering of a whole cohort before anybody was going to be willing to do anything to improve the retirement system. And I think the financial crisis may have accelerated that process.”

In the not-so-distant future, American seniors may turn to helpful, uncomplaining robots to fill the worrisome “care gap” that many face today.

One of these autonomous devices, called the uBOT-5, is already capable of carrying out simple tasks while it monitors the home environment. The robot can even spot trouble — such as a person falling down — and call 911 if necessary.

The freestanding device can also bring a faraway loved one into an aging person’s home via video Internet hook-up.

“So, if I’m at work, and it’s lunch hour and I want to poke in on Dad, I can get on the Internet and basically ’step inside’ the robot,” said uBOT-5 co-inventor Rod Grupen, who directs the Laboratory for Perpetual Robotics at the University of Massachusetts, Amherst. With their face appearing via video on the front of the robot’s head, the virtual visitor can converse with their loved one while moving the robot around, doing some cleaning, for example, or retrieving a dropped TV remote.

Any “authorized user” can jump into and guide the robot, Grupen said. “So, if you can’t get to your doctor, your doctor can now come to you,” he said. In fact, the UMass team hopes that the uBOT-5 will someday be capable of running simple medical tests, such as measuring blood pressure or blood sugar.

And because it’s fully mobile, with Segway-like wheels, virtual visits from others should include much of the house, and beyond. “Your granddaughter on the West Coast can get into the robot and visit with you outside in the garden, you can have a two-way conversation with audio/video, hold hands and go show them the flowers you just planted,” Grupen said.

There’s a huge and growing need for robotic home assistants that might help care for the elderly or disabled and allow them to stay in their homes, Grupen believes. According to U.S. Census figures, the number of Americans age 65 or over will double by 2030, and two-thirds will need some form of long-term care. At the same time, there’s a dearth of nurses and home health-care aides to care for them; experts predict a shortage of 800,000 nurses by 2020.

The uBOT-5’s design was inspired by the human body. Its myriad sensors mimic human eyes and ears, constantly scanning its environment. It is even programmed to detect and respond to worrisome aberrations, including a fallen, unresponsive human. The robot’s arms are each capable of handling 2.2-pound loads, and they can extend to reach high or pick things up off the floor (a dropped pill bottle, a package in a foyer, for example). The robot can lie prone to scoot itself under a bed (and then right itself), and it may even someday help with household cleaning and grocery shopping, Grupen said.

And the cost? Right now, the prototypes at UMass cost $65,000 apiece, but Grupen envisions a day when commercial versions would be sold for $5,000 plus a monthly Internet hook-up fee, much like today’s computers.

And the uBOT-5 isn’t the only such device in the pipeline. Over at Massachusetts Institute of Technology, researcher Nicolas Roy, at the institute’s Computer Science and Artificial Intelligence Laboratory, has developed an “autonomous wheelchair” that only requires a command to whiz users from one spot to another in a hospital or nursing home.

When first delivered to a facility, the wheelchair — rigged out with high-tech scanning software — has no knowledge of the particular layout. But staff will uncrate it, turn it on, and give it a verbal guided tour, walking it past different rooms and nursing stations.

“You talk to it like you’d talk to a new person, a new nurse. And as a side effect of the thing being walked through the facility once or twice, the wheelchair has now been demonstrated a route between all the points,” explained co-developer Seth Teller, who helps lead the lab’s Robotics, Vision and Sensor Networks Group.

After that, a wheelchair-bound stroke patient or quadriplegic need only say, “Take me to Room 451″ for the chair to understand and then do just that. The device will be launched as a prototype ready for testing in a Boston-area nursing home within two years, Teller said.

Finally, at Georgia Tech, researchers led by assistant professor Charlie Kemp are making their own home-care robots, inspired by the agile intelligence of service dogs.

“We’re using service dogs to answer three important questions: What tasks would be good for a [home] robot to perform? How should people interact with the robot, to tell it to do these tasks? And how can the robot actually perform these tasks, given the complexities of the home?” Kemp said.

Service dogs and the disabled people they help are providing the answers. The new robot is being designed to move about and perform tasks such as opening drawers, turning doorknobs and working light switches, Kemp said. Users indicate what they’d like done by using a laser pointer, and homes are modified slightly to help the robot, just as homes are subtly tweaked to aid service dogs. “Things like tying a small towel to a doorknob” to facilitate grasping, Kemp explained.

The robot may not ever replace a great service dog, but Kemp noted that the average disabled American now pays $16,000 for a properly trained canine, and waiting lists now stretch for years.

“I think there’s a real need,” he said. “So, the hope is that people will support this sort of work. Then, we’ll be able to deliver these things when people need them.”