r
O ctober 20, 1993 • T he P ortland O bserver
P age A6
Portland Men To Participate In Prostate Cancer Prevention Trial
M en in the Portland/V ancouvcr
area w ill have an op p o rtu n ity to par­
ticip a te in the firs t large-scale pre­
ve n tio n tria l fo r prostate cancer in the
U n ite d States The Prostate Cancer
P re v e n tio n T r i a l (P C P T ), an
in te rg ro u p study designed to test
w hether ta kin g the drug finasteride
w ill prevent prostate cancer, w ill be
c o o r d in a te d by th e S o u th w e s t
O ncology Group (S W O G )and is spon­
sored by the U S . N ational Cancer
In stitu te (N C I).
E ighteen thousand men age 55
and older w ill participate nationally
A t least 150 men w ill participate lo ­
ca lly. O regon H ealth Sciences U n i­
ve rsity, K aiser Permanente, and five
h o sp ita ls w ho w o rk cooperatively
th ro u g h a consortium know n is the
C o lu m b ia R ;ver Oncology Program
(C R O P ), are am ong the 222 sites
across the country in v o k e d in the
pre ve n tio n tria l CROP hospitals in ­
clude Providence M edical Center, St
V in c e n t H o o ita l and M edical Cen­
ter, Em anu H ospital & Health Cen­
ter, Good Samaritan Hospital & M e d i­
cal C enter and Southwest W ashing-
ton M edical Center
“ The prostate Cancer Prevention
T ria l is a very im portant prevention
e ffo rt,” said Bruce Lowe, M D . A s­
sociate Professor or Urology at O r­
egon H ealth Sciences U n ive rsity.
"T h is y ear in the U nited Slates, there
w ill be about 165,000 new eases o f
prostate cancer, and about 35,000
deaths. Prevention o f cancer is our
highest goal, and the need for effec­
tive prevention strategies is clear."
The U S. Food and D rug A d m in ­
istration approved finasteride in 1992
fo r the treatment o f benign prostatic
hyperplasia (BPH), a non-canccrous
enlargement o f the prostate gland
Because BPH and prostate cancer arc
influenced by s im ila r horm onal fac­
to rs , re s e a rc h e rs b e lie v e th a t
finasteride may also prevent cancer.
M ore than h a lf a m illio n men in
25 countries arc currently ta k in g
finasteride for BPH, the drug has
never been tested for cancer preven­
tion. N C I is prov id in g approxim ately
$60 m illio n to conduct the tria l in the
U nited Stales.
“ We believe finasteride is a very
prom ising agent that could prov e to
be o f great value in heading o il pros­
tate cancer,” said Stephen Lieberman,
M D C h ie f o f Urology at Kaiser
Sunnyside M edical Center. “ But the
theory is s till untested, andon a large-
scale, c o n tro lle d c lin ic a l tr ia l o f
finasteride can show vv hethcr the drug
is truly effective for cancer prevention.”
“ A m in im u m age lim it o f 55 was
selected because older men arc a hig h ­
est ris k o f d e v e lo p in g p ro sta te
cancer,"explained D avid Menashc,
M D , a urologist and investigator
w ith CROP "A b ou t 98 percent o f
prostate cancers arc diagnosed in men
age 55 o r older.”
The men in the tria l w ill be d i­
vided randomly into two groups H a lf
w ill take one five m illig ra m tablet o f
finasteride per day fo r seven years,
and h a lf w ill take a placebo (an inac­
tive p ill that looks like finasteride).
The tw o groups w ill then be com ­
pared to determi ne whether their pros­
tate cancer rates differ. The company
that manufactures finasteride (trade
name Proscar), M erck and Co., Inc.,
w ill provide both the finasteride and
H e a lt h B r i e f s
TEENAGE ATHLETES AND
HEART DISORDERS
A d u lts are not the only ones who
need to be concerned about heart dis­
orders. Teenage athletes also can be
at risk.
H yp e rtro p h ic cardiom yopathy,
lo n g Q -T syn d ro m e and W o lff-
P a rkin so n-W h ite syndrome are ju st
some o f the “ quiet” k ille rs a segment
o f today’ s teenage athletes, said D r
Jeffrey T o w b in , a pediatric ca rdiolo­
g ist at B a ylo r College o f M edicine in
• ?
H ouston
“ W hat is devastating is that most
o f these young people appear per­
fe c tly norm al, but then, d u rin g the
stress o f athletics, they die from heart
fa ilu re ,” T o w b in said
Each o f these three heart disor­
ders can be detected d u rin g infancy
th ro u g h E K G readings and electro­
p h ysio lo g ic a l studies A com m on
sym ptom o f a possible com plication
is sudden fainting.
T o w b in stresses increased aware­
ness o f hear: disorders when consid­
e rin g dem anding activities such as
sports
HORMONE THERAPY FOR
M’ -NOPAUSAL WOMEN
Menopausal women are at in ­
creased risk fo r cardiovascular dis­
ease and should be evaluated fo r hor­
mone therapy.
The key to this therapy is in the
replacem ent o f the estrogen hormone
th a t the body no longer produces after
menopause, since it seems to protect
a w om an fro m heart disease, said Dr.
R o xa n n R okcy, a c a rd io lo g is t at
B a y lo r C o lle g e o f M e d ic in e s ’
DeBakey Heart Center in Houston.
W om en have tw o options fo r
horm one replacement; estrogen alone
o r estrogen combined w ith progestin
W om en receiv in g estrogen are able to
m a in ta in the low er levels o f “ bad"
Cholesterol (L D L ) and higher levels
o f“ good’ cholesterol (H D L ) that they
had before th e ir ovaries stopped pro­
d u cin g the hormone
Research indicates that replac­
ing the estrogen a menopausal woman
lacks can reduce the risk o f heart
disease by 40 to 50 percent, Rokey
said.
CONTRACEPTIVE METHODS
FOR THE 35-PLUS WOMAN
Recent improvements in contra­
ceptive technology have given today's
35-plus woman b irth control options
she d id not have before.
A w om an’ s choice o f contracep­
tion should be based on w h ich method
offers the least risk fo r her health, said
Dr. A lfre d N. Poindexter III, a repro­
ductive e n d o crinologist at B a y lo r
College o f M edicine in Houston.
A lth o u g h not previously pre­
scribed for w omen older than 35, oral
contraceptives arc now a popular
choice. Today’ s lovv-cstrogcnpill has
reduced the risk o f blood clots and
heart attacks associated w it h the hig h -
estrogen p ill introduced in the 1960s.
A lso suggested as contraceptive
methods arc ste riliza tio n ; N orplant,
the im planted contraceptive; b a rrie r
contraceptives; and intrauterine de­
vices.
SEX AFTER 60
It is no m yth; there is sex after 60.
“ Sexual expression can continue
to be a part o f life into our sixties,
seventiesand beyond,” said Dr. Naomi
Nelson, a psychologist at Baylor C o l­
lege o f M edicine in Houston. But to
often people get wrapped up in social
customs and miss the big picture o f
what i t ’ s lik e to be a sexual being all
o f th e ir lives.
A g in g people can learn to over­
come the perception that they w ill
lose th e ir physical a b ility to have an
active sex life. There arc physical
changes that are signs o f norm al ag­
ing, but sex can s till be a part o f a
person’ s life . Nelson said
A no th e r barrier is learning to be
com fortable w ith sexuality. The eld­
erly need to fig h t stereotypes about
sexual attitudes and have open dis­
cussion w ith th e ir mates, she said.
The elderly should th in k o f sexu­
a lity as a part o f life , not a th in g o f the
past, and live it to the fullest. Nelson
said.
NEW TEST DETECTS COMMON
STOMACH ILLNESS
A sim ple new test may q u ickly
explain the cause o f stomach pain in
m illio n s o f people.
The G iardia antigen test checks
for giardiasis, a common water-borne
disease. People w ith giardiasis suffer
from cramps, gas, nausea, diarrhea
and bloating. Symptoms, i f any, usu­
a lly appear one to tw o weeks alter
infections.
In the G iardia antigen lest, by­
products o f the G iardia parasite arc
detected, said D r. C ynthia Chappell
o f B aylor College o f M edicine in
Houston. W ith the old method, the
stool was examined m icroscopically,
and repeated testing .vas sometimes
required.
The bug is present in untreated
water, in water from poorly filtered
supplies o r in food It is spread by
hand-to-m outh contact.
LEARNING OPPORTUNITY FOB
MINORITIES
M in o rity college students and
graduates interested in piu suing medi­
cal degrees may apply for the Honors
Pre-M edical Academy, a six-week
summer program at B aylor Col lege o f
M edicine and Rice U niversity, both
in Houston
The national program , funded in
part by The Robert W ood Johnson
Foundation, is designed to increase
m in o rity representation in medicine
by enhancing p a rticipants’ com peti­
tiveness in the medical-school a p p li­
cation pool
Participants must be A fric a n -
Am erican, M exican-Am erican, main­
land Puerto Rican or Native American
Participants spend mornings in
medical settings paired w ith Baylor
physicians and afternoons in Rice
science and com m unications classes
A d d itio n a l in fo rm a tio n is a va il­
able by c a llin g 1-800-633-6445. The
deadline fo r applications is M arch 4.
1994.
the placebo w ith o u t charge
N either the participants nor the
study physicians w ill know w hich
men arc getting finasteride and w hich
are getting placebo The tria l design,
called "double b lin d in g ,” perm its the
researchers to see the possible ben­
efits and side effects o f finasteride
w ith o u t being influenced by other
factors, such as the expectations o f
participants or researchers.
Finasteride controls BPH by re­
d u c in g le v e ls o f th e h o rm o n e
dihydrtcstostcronc (D H T ) in the pros­
tate. The drug works by b lo ckin g the
activity o f an enzyme that converts
testosterone, the p rim a ry male hor­
mone, to D H T
“ W cb clie ve fin a ste rid c may help
prevent prostate cancer because we
know D H T promotes the grow th o f
prostate cancer, and finasteride de­
creases levels o f D H T ,” explained Dr.
Lieberm an. " W ith low er levels o f
D H T , perhaps prostate cancer w o n ’ t
develop.”
T here’ s no guarantee that a man
w ho enrolls in the tria l w o n ’ t develop
prostate cancer,” Dr. Lieberm an cau-
tioned. "B u t a ll men in the study,
whether they gel finasteride or a p la ­
cebo, w ill have the opportunity for
close fo llo w -u p for the detection o f
prostate cancer.”
One o f the m ain advantages o f
using finasteride in a prev ention tria l
is that the drug w orks only in the
prostate, and its side effects are rela­
tive ly rare and relatively m ild
Prostate cancer among A fric a n -
A m erican men is a pa rticu la r concern
to N C I. The death rate from the dis­
ease among A frica n -A m e rica n men
is tw ice as high as the rate for w hite
men.
The reasons not currently under­
stood, A frica n -A m e rica n men have
the highest prostate cancer m o rta lity
rate in the w o rld The higher death
rate among black men may be p a rtly
due to the fact that blacks tend to be
diagnosed w ith prostate cancer at later
stages than whites.
Because prostate cancer is a seri­
ous problem fo r A frican-A m ericans,
the PCPT researchers stress the im ­
portance o f obtaining a representa­
tive sample o f the entire U S. male
population.
“ Ideally, we’ d lik e to recruit men
from a ll racial and ethnic groups»
A frica n -A m crica n s, whites, Native
Americans, Hispanics, A sia n -A m e ri-
c a n s-ro u g h ly in proportion to their
risk o f developing the disease,” said
d r Lowe. "T h e better the representa­
tio n we have from a ll o f these groups,
the more confident we can be in ap­
p lyin g the results o f the tria l to the
population at large.”
A ll men in the tria l w ill have a
prostate biopsy at the end o f seven
years to determ ine whether they have
developed prostate cancer In a ddi­
tio n , the researchers w ill use p a rtic i­
pants self-reports to assess the effects
o f the drug on m en’ s sexual and u ri­
nary fu n ctio n in g and other q u a lilv-
o f-life measures.
M en w ho are interested in par­
ticip a tin g in the prostate cancer pre­
vention tria l should contact one o f the
sites near them: Oregon Health S ci­
ences U niversity, (503) 494-5601,
Kaiser Permanente, (503) 249-3514;
C olum bia R iver O ncology Program,
(503) 230-6308.
African-Americans Sought
For New Health Plan Jobs
Several dozen Oregon H ealth
Plan positions are being fille d by the
Oregon Department o f Hum an Re­
sources, w h ich is actively seeking to
hire more racial-ethnic group m em ­
bers, particularly A frican-Am ericans.
“ We arev igorously seeking A f r i­
can-Am ericans to apply fo r a v ariety
o f jobs to brin g the Oregon Health
Plan on lin e ," says D onny A dair,
D H R employee development d ire c­
t o r ." The department has an excellent
record fo r em ploying q u a lifie d m i­
norities. women and people w ith dis­
abilities in general, but currently there
is a need for A frica n -A m e rica n em-
ployees.”
A d a ir says no A fric a n -A m e ri­
cans are among the approxim ately
200 employees o f the O ffice o f m edi­
cal Assistance Programs, w h ich w ill
manage the health p la n 's medicaid
expansion, and that few are applying
for the newly created jobs.
A d a ir says h a v in g A fr ic a n -
Am ericans represented in the state
M edicaid office is im portant to pro­
vide perspective on the problems and
needs o f one o f the state’ s largest
ethnic groups.
Anyone interested in positions
may contact any local state D epart-
I
ment o f Employ ment office or call the
State Job lin e 373-1193 (Salem) or
731-3322 (Portland). Persons w ith
questions may call the D H R D irector's
Office: 945-5743 or (T D D 378-8313).
The Health p la n ’ s M edicaid ex­
pansion w ill start February’ 1, when
the firs t o f 120,000 more poor Orego­
nians w ill start becoming elig ib le for
coverage. M any o f the newly insured
are poor, w o rk in g Oregonians who
have no em p'oyer-paid health in su r­
ance By 1998, the health plan calls
fo r all O regonians to be covered by a
sy stem o f p u b lic and private in su r­
ance coverage.
Vision C enters S tress Im portance O f
Screenings & Exams For Children
Eyc doctors at the P acific U n i­
versity College o f O ptom etry rem ind
com m unity members o f the im p o r­
tance o f receiv ing visio n screenings
and exam inations early in the school
year so that v ision disorders h in d er­
ing the le arning process can be de­
tected and corrected P acific's F am ily
V ision Centers offer free vision screen­
ings for infants six months and older,
children, and adults on an ongoing
basis.
V isio n screenings provide im ­
portant info rm a tio n regarding cla rity
o f vision, overall eye health, and how
w e ll the eyes arc coordinating. They
take about 20 minutes to complete
and do not cause discom fort
A ccording to Thomas Samson,
IT JUST
KEEPS ON
HELPING
United Way
of the Columbia-Willamette
228-9131 ‘
O .D ., a sta ff optom etrist w ith the
Infant/P cdiatric Service at the Pacific
Univ ersity C ollcgcofO ptom clry Fam­
ily V isio n Centers. “ A regular pro­
gram o f vision screenings and e xam i­
nations are especially beneficial for
young ch ild re n who are le a rning to
read and w rite .” Dr. Samson em pha­
sizes the im portance o f clear vision
and good visual skills in assuring that
ch ild re n have a fa ir chance at suc­
cessfully developing learning skills
such as reading and w ritin g . He also
stresses that visio n screenings and
exam inations be received p rio r to or
early in the school year in order to
id e n tify and correct visual problems
w hich may hinder the learning p ro ­
cess. New guide! incs set by the A n ic ri-
can O ptom etrie Association ca ll fo r
infants to receive th e ir firs t vision
screening o r exam ination at age six
months and every’ year thcrea fier I bor­
ough the school years.”
In addition to free screenings.
P a cific’ s F a m ily V isio n Centers pro­
vide a s lid in g fee scale, based on
in d iv id u a l o r fa m ily income, w hich is
designed specifically fo r those who
cannot afford to pay fu ll visio n care
fees.
For scheduling and more in fo r­
m ation about free screenings and slid ­
in g fee scales, please contact the Pa­
c ific U niversity Fam ily V isio n Center
near you: D ow ntow n Portland, 224-
2323; Forest Grove, 357-5800; and
N o rth Portland, 240-5319.
»
McMurphy's Appliance Center
Monthly Drawing Groceries or Gift Certificate
Stop in and fill out an entry form.
McMurphy's
Appliance Center
Legal Aid Séries 23: Problems With Medical Organizations
I f yo u ’ re on welfare, you may
have to deal w ith long lines, pages o f
paperw ork and overw orked doctors
ju s t to get medical care B ut you d o n ' t
fr
<7^
ra s
have to deal w ith shoddy treatm ent or
d iscrim in a tio n I f yo u ’ re a welfare
recipient and have problems w ith your
medical care, you have a rig h t to get
these problems corrected o r change
yo u r health care prov ider
Recipients o f A id to Fam ilies
w ith Dependent C h ild re n (A D C ) liv ­
in g in M u ltnom ah, Polk. M a rio n .
C lackam as. W ash in g to n o r Lane
C ounty must obtain medical care from
a Health M aintenance O rganization
(H M O ), such as Kaiser-Permanente.
o r fro m a Physician Care O rg a n iza ­
tio n (PCO), such as Evergreen M e d i­
cal Systems If, however, y o u 're fac­
in g a medical emergency , you can go
anywhere
Y ou may feel the quality o f your
medical care is inadequate, services
are hard to get or the H M O o r PCO is
d iscrim in a tin g against you I f so, you
can do som ething about it. such as file
a grievance, request a hearing o r
change providers
Each H M O and PCO must hav e
a griev ancc procedure When you sign
up fo r either o f these health plans, you
should receive a Handbook w h ich
describes h o w to file a grievance For
example. Evergreen M edical Sy stems
spells out in detail how to do this in its
Subscriber's Handbook I f you have a
problem or com plaint, contact E ver­
green PCO A dm inistrativ c O ffice at
Ev ergreen Medical System. Inc , 9221
S W Barbur B lv d , Suite 310, P ort­
land. OR 97219 or call 245-9523.
You can cither w rite o r call The
C h ie f Executive O ffic e r w ill look in to
all problems, both medical and non-
medical. and get back to you w ith in
five w o rk in g days They 'll help fin d
an interpreter i f you need one I f not
satisfied at this point, you may ask for
a second review w ith in 30 days by
w ritin g the Evergreen Medical Sy s­
tem Inc M edical Director, 9221 S W
Barbur B lvd., Suite 310, Portland.
OR 97219. Someone w ill review your
problem and send a w ritten decision
w ith in 30 days. I f s till unsatisfied,
you can ask A d u lt and Fam ily Ser­
vices (A F S ) fo r a hearing Simply go
the local welfare office branch and
ask fo r help in fillin g out a request for
hearing form
PCOs and H M O s have contracts
w ith the state that impose certain
conditions on these groups I f the
H M O s and PCOs fa il to live up to
th e ir contract requirements, the state
can take measures forcing them to
comply So i f you're unsatisfied vv ith
your H M O or PCO. you can request
an adm inistrative hearing and ask the
Oregon M edical Assistance Program
to do something about the problem
To do this, f ill out the A dm inistrative
Request Form. AFS 443, and turn it in
at your local welfare office branch
Y our problem m ight be solved
simply by sw itching toanothcr health­
care prov ider I f y ou're in an H M O ,
you can get out at any tim e and get
in to a new H M O or PCO. i f they can
f it you in. I f there’ s no room for new
patients, you can stay w ith your cur­
rent H M O o r get a “ fee-for-serv ice
card, w hich allows you to see any
doctor who accepts Medicaid patients
But i f you're in a PCO, you can’ t get
out u ntil your next redetermination,
w hich happens every six months or
less for A D C recipients
As a w e lfa re re c ip ie n t, you
can fin d h e lp in d e a lin g w ith
h e a lth care prov iders I f you liv e
in M u ltn o m a h C ounty w h o have
w e lfa re p ro b le m s A p p o in tm e n ts
may be made by c a llin g o u r N o rth /
N o rth e a s t C o m m u n ity Law O f­
fic e (on the P o rtla n d C o m m u n ity
College Cascade Campus) at 295-
9494 For telephone advice, call the
W elfare Rights H otline at 241-4111
Washer & Dryer *199“
Refrigerators From *129“
Ranges From *129°°
Open Mon. - Fri. 9:00am to 5:00pm
Saturday 10:00am to 2:00pm
. I***
Sunday Closed
‘ J O llM MIK
288-3233 'Sfc
SSS
is
Sales • Service • Parts 5
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