Sound Medicine -- January 11, 2003

Hosts Dianne Willis, Dr. Kathy Miller, & Dr. David Crabb talk to experts about:

Childhood cancers

Postpartum depression

Influenza 101

Childhood cancers

Cancer remains the leading cause of death by disease among children, but advances in treatment have improved the five-year survival rate from 55 percent in the 1970s to over 75 percent today. Here to discuss childhood cancer is Dr. Robert Fallon, Zachary E. Klingler Professor of Pediatrics at the IU School of Medicine and director of pediatric hematology/oncology at Riley Hospital for Children. We also meet Barb Healy, mother of 6-year-old Anna, who is being treated for neuroblastoma, a solid tumor that primarily affects children.

Dr. Fallon lists the most common childhood cancers as leukemia, brain cancer, and neuroblastoma. Thanks to new drugs and high rates of enrollment in clinical trials, the overall survival rate is 75 percent. Dr. Fallon says children respond well because they're physically able to tolerate high doses of chemotherapy. And mentally, they worry less. There can be long-term side-effects to treatment, including infertility, so physicians now try to minimize aggressive therapies such as radiation to limit future problems.

Neuroblastoma is a tumor of the nerve tissue, and it affects very young children, even newborns. It's difficult to treat and tends to recur. It often begins as an abdominal mass, but it can appear anywhere in the body. Dr. Fallon details the general progression of treatment, including genetic analysis of the tumor. Barb Healy talks about her daughter's specific experience with this disease and how she and her family have coped.

Resources

Learn how you can help fund neuroblastoma research from the Anna Needs Neuroblastoma Answers (ANNA) foundation. In Indianapolis, call: 317-823-9829.

The American Cancer Society has excellent factsheets on childhood versus adult cancer and neuroblastoma.

The National Cancer Institute also provides current information on childhood cancers and more on neuroblastoma.

A 1999 book published by the NCI, Cancer Incidence and Survival among Children and Adolescents: United States SEER Program, 1975-1995, is aimed at researchers.

Postpartum depression (PPD)

An estimated 70 percent of women experience some type of emotional letdown following delivery. For most, this feeling lasts only a few days. But for some new mothers, a longer-lasting depression ensues, causing feelings ranging from sluggishness to hopelessness. Serious cases can result in suicide or desire to harm the baby. Jeanne Watson Driscoll, a psychiatric nurse and mental health consultant from Boston, helps us understand more.

Ms. Driscoll emphasizes the difference between "baby blues" and depression. While both may be triggered by hormonal shifts, "the blues" lift by 21 days. Postpartum depression, however, is a major depressive disorder and doesn't go away on its own. Sufferers have serious symptoms, such as inability to sleep or accomplish simple daily tasks. Women with a history of depression are more at risk, and Ms. Driscoll urges doctors to ask women about their psychological history and mood swings. Treatment includes antidepressant medication, talk therapy, and household support after giving birth. Women should ask for help, says Driscoll, because the condition is curable.

Resources:

There are many Web sites dedicated to PPD. Postpartum Support International and Depression After Delivery are just two online resources for depressed new mothers.

Find the latest news, research, and treatment information from MEDLINEplus.

Influenza 101

A new advisory from the Centers for Disease Control is provoking debate. The CDC now advises flu shots for healthy babies aged 6 months to 23 months, a change from the past, when only children with weakened immune systems were advised to get the flu vaccine. Dr. Stephen Wintermeyer, associate professor of clinical medicine at the IU School of Medicine, talks about the flu and the new CDC advisory.

The influenza virus is a serious illness that causes fever, fatigue, a dry cough, and a sore throat. Dr. Wintermeyer says large outbreaks occur every 30 years and warns we're due for one soon. He explains why we need a new shot every year, when we should get one, and who is most susceptible to serious illness. He emphasizes we do not get flu from the shot, which is not a live vaccine. Addressing the CDC recommendation, Dr. Wintermeyer explains that babies aged 6 to 23 months tend to have higher complication rates with influenza.

Dr. Wintermeyer explains the difference between influenza strains A and B, how the virus is transmitted, and talks about new antiviral medications for treatment.

Resources:

Visit the CDC's flu home page and read the 2002-2003 recommendations that advise healthy baby vaccinations.

Interesting, practical, and authoritative flu information from The National Jewish Medical & Research Center.

Get FDA information on the antiviral flu treatment drugs Relenza and Tamiflu.

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A study of 468 Swedish women at the Karolinska Institute in Sweden and at the National Institute of Child Health and Human Development found that pregnant women with low levels of the vitamin folate, also known as folic acid, were more likely to have miscarriages than women with adequate folate levels. (Folic acid also is known to help prevent neural tube defects such as spina bifida and other birth defects.) Obviously, foods high in folic acid should be included in a pregnant woman's diet. Which of the following foods is NOT known to be high in folic acid.

a. Fortified breakfast cereals
b. Carrots
c. Black beans
d. Orange juice

Find out!

Medical mystery — Cold weather asthma?

'Blame it on the weather,' we often say. Indeed, for asthmatics the weather is often to blame for an attack. Although no season or set of weather conditions make for the perfect "asthma-attack climate," air temperature, moisture and wind all play a role in triggering an episode. During winter, cold air is often the culprit. But why?

Find out!

• In 1998, an estimated 12,400 children were diagnosed with cancer.
• Cancer ranks fourth as the cause of death for children between the ages of 1 and 19, coming behind accidents, homicides, and suicides.
• A newborn baby has roughly a 1 in 300 chance of developing cancer by the age of 20.
• Nearly 33,000 different kinds of cancer have been diagnosed in children during the past twenty years.
• Leukemias and cancers of the brain/nervous system are the most prevalent types of cancers found in individuals under the age of 20 years old.
• Childhood cancer mortality has decreased by nearly 40% over the past two decade, while the overall incidence of cancer in children has increased.

Source: The National Cancer Institute