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One of every 10 clinical trials for adults with cancer ends prematurely because researchers can't get enough people to test new treatments, scientists report.
 
The surprisingly high rate reveals not just the scope and cost of wasted opportunities that deprive patients of potential advances, but also the extent of barriers such as money, logistics and even the mistaken fear that people won't get the best care if they join one of these experiments.
 
"Clinical trials are the cornerstone of progress in cancer care," the way that new treatments prove their worth, said Dr. Matthew Galsky of the Icahn School of Medicine at Mount Sinai Hospital in New York.
 
When an experimental drug or other treatment fails to make it to the market, people often think it didn't work or had too many side effects, but the inability to complete studies can doom a drug, too, Galsky said.
 
He helped lead an analysis of 7,776 experiments registered on Clinicaltrials.gov, a government web site for tracking medical experiments, from September 2005 to November 2011. All were mid- or late-stage studies testing treatments for various types of cancer in adults.
 
About 20 percent of the studies were not completed for reasons that had nothing to do with the treatment's safety or effectiveness (legitimate reasons for ending a study early). Poor accrual — the inability to enroll enough patients in enough time to finish the study — led to nearly 40 percent of premature endings.
 
Company-sponsored studies were less likely to be completed than those sponsored by the government or others. Late-stage cancer trials can cost companies "tens to even hundreds of millions of dollars," and that money is wasted if no clear answer on the drug's value is gained, said Dr. Charles J. Ryan, a cancer specialist at the University of California, San Francisco.
 
He heads the program for a conference later this week in San Francisco where Galsky's study will be presented. It was discussed Tuesday in a telebriefing by the American Society of Clinical Oncology, an organization for doctors who treat cancer.
 
Ryan and Galsky said they hoped the study would spur more research on why more patients don't participate. In most cases, the treatment being tested is provided for free, but there can be other costs such as lab tests. Some states require insurers to cover these additional costs, but others do not, so money may be one hurdle for patients.
 
Some doctors do not strongly encourage patients to participate in studies, and sometimes patients fear they'll get a dummy treatment instead of real medicine. However, in cancer clinical trials, ethical standards require that all patients get the current best care, plus a chance at an experimental treatment.
 
"Patients still have concerns about getting a placebo, but they're always going to get at a minimum the standard of care," said Shelley Fuld Nasso, head of the National Coalition for Cancer Survivorship, a patient advocacy and education organization.
 
Doctors need to encourage more patients to participate, and clinical trial designers need to make sure they are testing key questions and treatments to honor the contributions of study participants, she said.
 
___
 
Online:
 
Cancer patient info: http://www.cancer.net
 
Decision-making guide: http://bit.ly/L67zkT
 
Clinical trials: http://www.clinicaltrials.gov
 
Published in Health & Fitness
   Bitterly cold weather and extreme wind chills are creating a dangerous situation for anyone who has to venture outside.  Local hospitals generally see a spike in emergency room visits from patients affected by the cold.
   Barnes-Jewish Hosptial ER Dr. Brian Froelke told Fox 2 News that in this weather, it doesn't take long to get into trouble.  "The risk is the possibility of frostbite," Dr. Froelke says.  "You have somewhere between ten minutes to a half an hour, depending on how cold it is."
   Dr. Froelke says its important to dress in layers and cover up any exposed skin.  
   Parents are especially encouraged to keep an extra eye on kids who will be waiting at the bus stop or walking to school in this weather.
 
Published in Local News
By LAURAN NEERGAARD, AP Medical Writer

WASHINGTON (AP) - We know a lot about how babies learn to talk, and youngsters learn to read. Now scientists are unraveling the earliest building blocks of math - and what children know about numbers as they begin first grade seems to play a big role in how well they do everyday calculations later on.

The findings have specialists considering steps that parents might take to spur math abilities, just like they do to try to raise a good reader.

This isn't only about trying to improve the nation's math scores and attract kids to become engineers. It's far more basic.

Consider: How rapidly can you calculate a tip? Do the fractions to double a recipe? Know how many quarters and dimes the cashier should hand back as your change?

About 1 in 5 adults in the U.S. lacks the math competence expected of a middle-schooler, meaning they have trouble with those ordinary tasks and aren't qualified for many of today's jobs.

"It's not just, can you do well in school? It's how well can you do in your life," says Dr. Kathy Mann Koepke of the National Institutes of Health, which is funding much of this research into math cognition. "We are in the midst of math all the time."

A new study shows trouble can start early. University of Missouri researchers tested 180 seventh-graders. Those who lagged behind their peers in a test of core math skills needed to function as adults were the same kids who'd had the least number sense or fluency way back when they started first grade.

"The gap they started with, they don't close it," says Dr. David Geary, a cognitive psychologist who leads the study that is tracking children from kindergarten to high school in the Columbia, Mo., school system. "They're not catching up" to the kids who started ahead.

If first grade sounds pretty young to be predicting math ability, well, no one expects tots to be scribbling sums. But this number sense, or what Geary more precisely terms "number system knowledge," turns out to be a fundamental skill that students continually build on, much more than the simple ability to count.

What's involved? Understanding that numbers represent different quantities - that three dots is the same as the numeral "3" or the word "three." Grasping magnitude - that 23 is bigger than 17. Getting the concept that numbers can be broken into parts - that 5 is the same as 2 and 3, or 4 and 1. Showing on a number line that the difference between 10 and 12 is the same as the difference between 20 and 22.

Factors such as IQ and attention span didn't explain why some first-graders did better than others. Now Geary is studying if something that youngsters learn in preschool offers an advantage.

There's other evidence that math matters early in life. Numerous studies with young babies and a variety of animals show that a related ability - to estimate numbers without counting - is intuitive, sort of hard-wired in the brain, says Mann Koepke, of NIH's National Institute of Child Health and Human Development. That's the ability that lets you choose the shortest grocery check-out line at a glance, or that guides a bird to the bush with the most berries.

Number system knowledge is more sophisticated, and the Missouri study shows children who start elementary school without those concepts "seem to struggle enormously," says Mann Koepke, who wasn't part of that research.

While schools tend to focus on math problems around third grade, and math learning disabilities often are diagnosed by fifth grade, the new findings suggest "the need to intervene is much earlier than we ever used to think," she adds. Exactly how to intervene still is being studied, sure to be a topic when NIH brings experts together this spring to assess what's known about math cognition.

But Geary sees a strong parallel with reading. Scientists have long known that preschoolers who know the names of letters and can better distinguish what sounds those letters make go on to read more easily. So parents today are advised to read to their children from birth, and many youngsters' books use rhyming to focus on sounds.

Likewise for math, "kids need to know number words" early on, he says.

NIH's Mann Koepke agrees, and offers some tips:

-Don't teach your toddler to count solely by reciting numbers. Attach numbers to a noun - "Here are five crayons: One crayon, two crayons..." or say "I need to buy two yogurts" as you pick them from the store shelf - so they'll absorb the quantity concept.

-Talk about distance: How many steps to your ball? The swing is farther away; it takes more steps.

-Describe shapes: The ellipse is round like a circle but flatter.

-As they grow, show children how math is part of daily life, as you make change, or measure ingredients, or decide how soon to leave for a destination 10 miles away,

"We should be talking to our children about magnitude, numbers, distance, shapes as soon as they're born," she contends. "More than likely, this is a positive influence on their brain function."

--------------

EDITOR'S NOTE - Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Published in Health & Fitness

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