First Baby Over Age 45? Expect Complications

A study of older new mothers in Israel finds that 8 in 10 experienced health problems during their pregnancies, and nearly half of their babies were smaller than average.

First-time births over age 45 have more than tripled over the last decade in Israel. Though they still represent a small fraction of all births, the researchers note that the study highlights a downside to using assisted reproduction technologies to make first-time motherhood possible later and later in life.

The researchers gathered data on 131 mothers ranging in age from 45 to 65, who gave birth at the same hospital in Israel between 2004 and 2008.

Four of every 10 women developed pregnancy-related diabetes, and two of 10 had preeclampsia, a potentially dangerous condition that includes high blood pressure and protein in the mother's urine.

One third of the babies were born prematurely, and nearly all were delivered by a cesarean section.

"This study shows that pregnancy after the age of 45 is in fact a risky proposition, and this provides a basis upon which women of this age group can be counseled" about those risks, said Dr. Richard Paulson, director of the in vitro fertilization program at the University of Southern California, who was not involved in the study.

In the U.S., first-time births to mothers over 45 still make up a very small percentage of all deliveries.

In 2010, they totaled 2,028, with just 165 of those babies born to new mothers aged 50 and up, according to the Centers for Disease Control and Prevention.

In the Israeli study, the risk of having a baby born early or underweight was higher for women over age 50, than for women in their late 40s.

Two out of every three babies born to the mothers aged 50 to 65 weighed less than 2,500 grams (about 5 and a half pounds), and half were born prematurely. That compared to one out of three babies born either underweight, or prematurely, or both to mothers 45 to 49.

The study, published in the journal Fertility and Sterility, did not compare the women to mothers less than 45 years old, but the authors write that other studies have found much lower rates of pregnancy-related health problems and premature births in younger mothers.

All of the women in this study had experienced fertility problems and more than half had been pregnant before. All but five of the 131 women underwent in vitro fertilization (IVF), in which a fertilized egg is implanted into the mother's uterus.

Nearly a third of the women had a chronic disease like high blood pressure or diabetes before they got pregnant.

Paulson told Reuters Health that there is no policy dictating how old a mother can be to undergo IVF, although his clinic's policy is that women over age 50 who already have health problems are not candidates for the procedure.

Interestingly, the mothers over age 50 were more likely to have a boy than the mothers in their late 40s.

"There's no reason for that," Paulson said. "It just shows you that statistically significant results can sometimes happen by chance."

The health risks for older mothers are well established, however.Paulson said that the way to mitigate those risks is to consider alternative procedures.

Women might consider "gestational surrogacy," in which another woman carries the child, but the father's sperm and sometimes the mother's egg are used to create the embryo.

Paulson also said that starting motherhood at an advanced age may carry risks, "but they're not prohibitive risks. 

People of all ages are interested in having a child and completing their families."The study did not look at the excess cost of having a baby at an advanced age.

Clinic in Jakarta Touts Smoking as Cancer Cure

A clinic staff blowing cigarette smoke into the ear of an Indonesian patient undergoing treatment at the Griya Balur clinic in Jakarta on March 12. The Griya Balur clinic claims it can cure cancer with cigarettes.

An Indonesian woman exhales cigarette smoke into the mouth of a gaunt, naked patient at a Jakarta clinic, where tobacco is openly touted as a cancer cure.

The Western patient is suffering from emphysema, a condition she developed from decades of smoking. Along with cancer and autism, it's just one of the ailments the Griya Balur clinic claims it can cure with cigarettes.

"I missed this," says the woman, a regular customer, with an American accent, as Phil Collins’s "I Can Feel It" blares in the background.

Griya Balur would be shut down in many parts of the world, but not in Indonesia, one of the developing-country new frontiers for big tobacco as it seeks to replace its dwindling profits in the health-conscious West.

Long traditions of tobacco use combined with poor regulation and the billions of dollars that flow into government coffers from the tobacco industry mean places like Griya Balur go unchallenged.

The "treatment" for the emphysema sufferer includes the blowing of smoke from "divine cigarettes" infused with "nanotechnology" to remove their cancer-causing "free radicals", through a tube into her diseased lungs.

Smoke is also blown into her ears and nose, while she holds a cup of aspirin over her right eye. The Phil Collins music, it seems, has no curative properties.

Griya Balur founder Dr. Gretha Zahar told AFP she had treated 60,000 people with tobacco smoke over the past decade.

With a PhD in nanochemistry from Padjadjaran University in Bandung, West Java, Zahar believes that by manipulating the mercury in tobacco smoking can cure all diseases including cancer, and even reverse the ageing process.

"Mercury is the cause of all illnesses. In my cigarettes — we call them Divine Cigarettes — there are scavengers that extract the mercury from the body," she said.

On her Web site she says she does not need to subject her theories to clinical tests or publish them in peer-reviewed journals, nor does she have the money to "fight" with "Western medical scientists".

Zahar’s claims were recently presented to the Constitutional Court where farmers and legislators from the tobacco-growing hub of Central Java are challenging a law that recognises the leaf as addictive.

Aris Widodo, a pharmacology professor at Brawijaya University in Malang, East Java, told the court that he had never heard of anyone dying from smoking. On the contrary, he said, smoking was good for you.

"Smoking can eliminate anxiety, sharpen concentration and calm the nerves. It’s a good cheap alternative to other expensive drugs, like Valium," he said.

Tobacco is addictive and harmful to health, but Indonesians are taking up the habit in ever larger — and younger — numbers, cheered on by the tobacco industry's aggressive marketing.

Cigarettes cost about $1 for a pack of 20, yet they are often the second biggest item of household expenditure after food for the country's poorest families.

According to the World Health Organisation, smoking rates have risen six-fold in Indonesia over the last 40 years. Smoking kills at least 400,000 people every year and another 25,000 die from passive smoking.

Yet Indonesia is the only country in Asia not to have ratified the WHO's Framework Convention on Tobacco Control, which sets policy recommendations and benchmarks for countries concerned about the health impacts of smoking.

Indonesia's biggest cigarette manufacturer, PT HM Sampoerna, is an affiliate of Philip Morris International. British American Tobacco bought Indonesia’s fourth largest cigarette maker, PT Bentoel, for $494 million in 2009.

The government reaps about $7 billion a year in excise taxes from the industry, which employs scores of thousands of people around Temanggung in Central Java.

Anti-smoking activists say industry players are dusting off their old marketing playbook to obscure the science and paint smoking as cool, masculine, glamorous and even healthy, especially to women and children.

During deliberations of smoking regulations in 2009, a clause stating tobacco’s addictiveness went missing from the final draft. The government said the omission was a mere oversight and later reinserted the clause.

Health Ministry official Budi Sampurno was questioned but he maintains that tobacco companies had nothing to do with it.

"Never. Is there any proof? We have never been approached by tobacco companies. That is not legal practice," he said.

Dr. Hakim Sorimuda Pohan, a Democratic Party legislator who helped draft the Health Law, said there was no doubt big tobacco was behind the shenanigans.

"They did the same thing in 1992. Tobacco companies successfully had the same clause omitted from the law," he said.

Study shows Europe's alcohol-linked cancer burden

Many people do not know that drinking alcohol can increase their cancer risk.

Drinking more than a pint of beer a day can substantially increase the risk of some cancers, research suggests.

The Europe-wide study of 363,988 people reported in the British Medical Journal found one in 10 of all cancers in men and one in 33 in women were caused by past or current alcohol intake.

More than 18% of alcohol-related cancers in men and about 4% in women were linked to excessive drinking.

The Department of Health said it was taking action to reduce drinking.

Cancer charities say people should limit their drinking to lower the risk.

The study calculated that in 2008 current and past drinking habits were responsible for about 13,000 cancer cases in the UK, out of a total of 304,000 cases.

Previous research has shown a link between alcohol consumption and cancers of the oesophagus, liver, bowel and female breast.

When alcohol is broken down by the body it produces a chemical which can damage DNA, increasing the chance of developing cancer.

Glass too far

The latest research found that individuals who drank more than two standard drinks a day for men and one drink a day for women were particularly at risk of alcohol-related cancers.

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Dr Kat Arney, Cancer Research UK: "The more you drink, the greater the risk"

A standard drink contains about 12g of alcohol, which is equivalent to a 125ml glass of wine or a half pint of beer.

Yet NHS guidelines are a little more relaxed, saying that men should drink no more than three to four units a day while women should not go above two to three units a day.

Of the cancers known to be linked to alcohol, the researchers suggest that 40% to 98% occurred in people who drank more than the recommended maximum.

The results were gathered as part of a study following 363,988 men and women in eight European countries aged between 35 and 70.

The European Prospective Investigation into Cancer study tracked their levels of drinking and how this affected their risk of cancer.

Researchers then looked at figures on how much people drank in each country, including the UK, taken from the World Health Organization.

The study focused on France, Italy, Spain, the Netherlands, Greece, Germany, Denmark and the UK.

Madlen Schutze, lead researcher and study author, from the German Institute of Human Nutrition, said that many cancer cases could be avoided if alcohol consumption was limited.

"And even more cancer cases would be prevented if people reduced their alcohol intake to below recommended guidelines or stopped drinking alcohol at all," she said.

'Best data'

Cancer Research UK director of health information Sara Hiom said that many people did not know that drinking alcohol could increase their cancer risk.

"In the last 10 years, mouth cancer has become much more common and one reason for this could be because of higher levels of drinking - as this study reflects.

"Along with being a non-smoker and keeping a healthy bodyweight, cutting back on alcohol is one of the most important ways of lowering your cancer risk."

Cancer Partners UK medical director Prof Karol Sikora said the message had to be "drink occasionally, but not regularly".

"This is the best data we've got and we're ever likely to get.

"The take-home message is that the more alcohol you drink, some of the common cancers - the four cancers that have been identified - do increase, and that's worrying. So the message has to be 'look at drinking habits, and reduce.'"

The Department of Health is set to publish an alcohol strategy in the summer.

Professor Sir Ian Gilmore, former president of the Royal College of Physicians and chairman of the UK Alcohol Health Alliance, called for tougher regulation to curb alcohol consumption.

He told the BBC: "It is yet another piece of evidence that really leads us to conclude that sitting back and waiting for people to change their habits, perhaps with voluntary partnerships with the drinks industry included in policies, will not bring about results.

"If we really want to see preventable deaths coming down in the next decade or so, I think there will have to be some form of tougher regulation by government."

It is expected to include plans to stop supermarkets selling cheap alcohol and tighten up licensing laws which were relaxed under the previous government.

More Evidence Painkillers Lower Colon Cancer Risk

A new study adds to growing evidence that regular use of painkillers like aspirin or ibuprofen may reduce a person's risk of developing colon or rectal cancers - sometimes by as much as 50 percent.

This latest report also shows that people with a family history of colon cancer - who are therefore at higher risk for the disease - also benefit from the pain relievers.

"The (risk) reductions that we saw here are not inconsequential," said Dr. Elizabeth Ruder of the National Cancer Institute, the study's lead author.

"But we're not at the point that one could make a public health recommendation" based on the findings, she added.

Colon and rectal cancers are diagnosed in about 48 out of every 100,000 people in the U.S., according to the National Cancer Institute.

Together, these "colorectal" cancers are the third-leading cause of deaths from cancer.

Previous studies have found that aspirin is tied to a smaller risk of colon cancer.

The current study expanded on earlier research by including larger numbers of people and assessing where in the colon cancers occurred.

Using questionnaire data from more than 300,000 adults, Ruder's group analyzed how often people took any of 19 non-steroidal anti-inflammatory (NSAID) pain medications, which include aspirin, ibuprofen (Advil), naproxen sodium (Aleve), sulindil (Clinoril), and others.

The observed drop in cancer risk varied depending on how often people took the painkillers and the type of cancer in question.

Overall, taking any of the NSAID drugs was associated with a 20 percent drop in the risk of colorectal cancer over 10 years.And the more frequently people took a drug, the less likely they were to be diagnosed with colon or rectal cancer.

Daily use of an NSAID was associated with a 28 percent drop in colon cancer risk, for instance, whereas monthly use was associated with only a 14 percent reduction in risk.

A similar pattern was seen among people with immediate family members who had been diagnosed with colon cancer: Daily users of NSAIDs saw a 28 percent drop in their risk of colon or rectal cancer, and weekly users had an 11 percent decline.

When the researchers looked at the site in the colon where cancers appeared, the drugs' effects were more pronounced, but distinctly different for aspirin versus non-aspirin NSAIDs.

Those who took aspirin daily, for example, had a 62 percent drop in rectal cancer risk, but their risk of colon cancer did not change.

In contrast, non-aspirin NSAIDs, taken daily, were linked to a 56 percent drop in risk of colon cancers farthest from the rectum (a region called the proximal colon), whereas the risk of rectal cancer was unaffected.

Ruder said it's unclear why there's a difference between the type of drug and the risk of developing a particular type of colorectal cancer.

One of the limitations of the study, the authors note, is that they didn't monitor how long people took the drugs.

The researchers also caution that they did not weigh the potential benefits of the drugs against their drawbacks.

"There's an elevated risk of gastrointestinal ulcers and bleeds" from taking aspirin, said Amanda Cross, an investigator at the National Cancer Institute and another of the study's authors.

"We're certainly not advocating that people take aspirin to reduce the risk of colon cancer," she told Reuters Health.

The research, funded by the National Institutes of Health, is published in the American Journal of Gastroenterology.

Dr. Andrew Chan, a gastroenterologist at Massachusetts General Hospital who was not involved in the study, said it would be premature to offer any recommendations.

"I think what remains to be addressed," Chan said, "is, 'are there specific types of colon cancer that may be most likely to benefit from aspirin use, and who are the best patients to take aspirin?'"

Fewer studies supporting the use of non-aspirin NSAIDS in reducing colon cancer risk have been done, he added.

"This is an area of a lot of controversy," Chan told Reuters Health.

But the study is useful in backing up what doctors are beginning to realize, he said. "These are compelling data, which support (the idea) that aspirin use reduces the risk of colorectal cancer."