Women with breast cancer who carry a high-risk gene can lower their risk of death from the disease 62% by having their ovaries removed, a new study finds. They can reduce their risk even more by not delaying that surgery for more than a year or two, researchers said. The study included 676 women who had early-stage breast cancer. All of them were carriers of a BRCA1 or BRCA2 gene mutation. Women with these genes have a much higher than average risk of breast cancer and ovarian cancer. About half of the women in the study decided to have their ovaries removed. Those with a BRCA1 gene who had their ovaries removed were 62% less likely to die of breast cancer in the next 20 years. Death rates were up to 73% lower for women who had the surgery within 2 years of their breast cancer diagnosis.
Doctors often find it hard to talk with patients about end-of-life care, a new study shows. And differences in culture, ethnic group and language make things even more difficult, they told researchers. The study was based on a survey. In all, 1,040 doctors in training (residents) answered the questions. They were asked if they had difficulty talking about end-of-life care with seriously ill patients and their families. Almost everyone said yes. They also were asked about the top 3 problems that came up when they had these talks with someone from a different ethnic group. They named language differences, the patient's or family's spiritual beliefs about death and dying, and the doctor's ignorance of the patient's cultural values and practices. Other problems listed were the patient's or family's limited understanding of medical information and mistrust of the health-care system.