Genetic link found between fetal growth, cancer

   (NIH) - 4/16/2013 - Two researchers at the National Institutes of Health discovered a new genetic link between the rapid growth of healthy fetuses and the uncontrolled cell division in cancer. The findings shed light on normal development and on the genetic underpinnings of common cancers.
    The work, conducted using mouse and human tissue, appears in a recent issue of the Proceedings of the National Academy of Sciences. The authors, Julian C. Lui, Ph.D., and Jeffrey Baron, M.D., work at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
    “We’ve long known that some of the genes that promote rapid growth in prenatal and early postnatal life become reactivated in cancer cells,” Baron said. “Now we’ve identified a molecular switch that appears to turn on some of these genes, taking us a step forward in understanding normal body growth and the abnormal growth in some types of cancer.”
  Before birth, a team of more than 200 growth-promoting genes is highly active, fueling the fetus’ explosive growth. After birth, these genes are gradually switched off, apparently to slow body growth as we age and approach adult size. In cancer cells, some of these genes can be switched back on.
    One of the major growth-promoting genes is called IGF2. This gene is critical for normal prenatal body growth and is reactivated in many types of cancer, showing remarkably high activity in bladder and prostate cancer and some childhood cancers.
    For years, scientists did not know what turned IGF2 on and off. Now, using a variety of techniques and tissue types, Drs. Lui and Baron found evidence that a protein known as E2F3 activates the IGF2 gene in normal development and in cancer — in particular, in bladder and metastatic prostate cancers.
    More broadly, E2F3 appears to regulate not just IGF2, but also many other genes on the body-growth team. When E2F3 levels are high, these genes are active. When E2F3 takes a dive, so do these genes. The upshot is that E2F3 may function as one of the master switches that limit body growth. As such, it is of great interest as researchers seek to understand the complex genetic choreography responsible for normal growth and the diseases that result when it goes awry.
   Source: National Institutes of Health

Seniors Save $6 Billion on Prescription Drugs

   (HHS) - 4/10/2013 - As the third anniversary of the Affordable Care Act approaches, Health and Human Services Secretary Kathleen Sebelius announced recently that more than 6.3 million people with Medicare saved over $6.1 billion on prescription drugs because of the health care law.
   “By making prescription drugs more affordable, the Affordable Care Act is improving and promoting the best care for people with Medicare,” Secretary Sebelius said.
   The Affordable Care Act makes Medicare prescription drug coverage (Part D) more affordable by gradually closing the gap in coverage where beneficiaries must pay the full cost of their prescriptions out of pocket. This gap is known as the doughnut hole.
   People with Medicare in the doughnut hole now receive discounts when they purchase prescription drugs at a pharmacy or order them through the mail, until they reach the catastrophic coverage phase. The Affordable Care Act gave those who reached the doughnut hole in 2010 a one-time $250 check, then began phasing in discounts and coverage for brand-name and generic prescription drugs beginning in 2011. The law will provide additional savings each year until the coverage gap is closed in 2020.
   In 2013, the health care law increases the discounts and savings to 52.5 percent of the cost of most brand name drugs and 21 percent of the cost of covered generic drugs.
   Also under the Affordable Care Act, those who choose to enroll in Medicare Advantage and Part D now have access to a wider range of high-quality plan choices, with more four- and five-star plans than were previously available. The Affordable Care Act continues to make Medicare more secure, with new tools and enhanced authority to crack down on criminals who cheat the program.
   For more information on how the Affordable Care Act closes the doughnut hole, please visit:
   For state-by-state information on savings in the donut hole, visit:

Study: Dementia Care Costs Could Rise Sharpely

   (NIH) - 4/3/2013 - The costs of caring for people with dementia in the United States in 2010 were between $159 billion to $215 billion, and those costs could rise dramatically with the increase in the numbers of older people in coming decades, according to estimates by researchers at RAND Corp. and the University of Michigan, Ann Arbor. The researchers found these costs of care comparable to, if not greater than, those for heart disease and cancer.
   The study, supported by the National Institutes of Health and published April 4 in The New England Journal of Medicine, totaled direct medical expenditures and costs attributable to the vast network of informal, unpaid care that supports people with dementia. Depending on how informal care is calculated, national expenditures in 2010 for dementia among people aged 71 and older were found to be $159 billion to $215 billion. Dementia is a loss of brain function that affects memory, thinking, language, judgment, and behavior; the most common form is Alzheimer's.
   The researchers first looked at care purchased in the health care market — formal costs for nursing homes, Medicare, and out-of-pocket expenses. The direct costs of dementia care purchased in the market were estimated to be $109 billion in 2010, exceeding direct health costs for heart disease ($102 billion) and cancer ($77 billion) that same year.
   Adding informal, unpaid care to the equation as much as doubled the estimated total national costs for dementia care. The study estimated full costs per case of dementia in 2010 at $41,000 to $56,000. The lower number accounts for foregone wages among caregivers, while the higher figure valued hours of informal care as the equivalent of formal paid care. The range of national expenditures was tallied based on an estimated prevalence of dementia of 14.7 percent in the U.S. population older than 70.
   The researchers also project skyrocketing costs as the baby boom grows older; the Bureau of the Census estimates that the population age 65 and older will double to about 72 million over the next 20 years. Rates of dementia increase with age, and unless new ways are found to treat and effectively prevent it, national health expenditures for dementia could come close to doubling by 2040, as the aging population increases and assuming the rate of dementia remains the same.
   "These findings reveal that the enormous emotional and physical demands of caring for people with dementia are accompanied by the similarly imposing financial burdens of dementia care," said Richard J. Hodes, M.D., director of the NIH's National Institute on Aging (NIA), which funded the analysis. "The national costs further compel us to do all we can to find effective treatments for Alzheimer's disease and related dementias as soon as possible. "The complex analysis is one of the most comprehensive yet to determine health care costs for dementia. It is based on a nationally representative sample from the Health and Retirement Study (HRS), a survey of people 51 years and older that is funded by the NIA with contributions from the Social Security Administration. Interest in national health expenditures for Alzheimer’s disease and related dementias has intensified with the January 2011 signing of the National Alzheimer's Project Act (NAPA),which calls for stepped up efforts to find new treatments and to improve care and services. Under NAPA, the Administration is leading development and implementation of a National Plan to Address Alzheimer’s Disease, under which new research studies, the new web portal, and new clinical training initiatives have moved forward.
   "We are just entering the second year of our national plan to fight Alzheimer’s disease," said NIH Director Francis Collins, M.D. "It is a dedicated battle on many fronts, including capitalizing on research opportunities now before us. The new BRAIN initiative announced by the President just this week, for example, will use a new generation of tools to help us learn the secrets to many neurological disorders, including Alzheimer’s disease.”
  Identifying costs of dementia has been challenging. People with Alzheimer's and other dementias are typically older and often have multiple medical conditions, such as stroke and depression, diseases commonly co-occurring with dementia. It is also difficult to capture the national costs of family-provided or other informal care. To overcome such barriers, the researchers focused on dementia rates and costs among volunteers aged 71 and older participating in a sub-study of the HRS, the Aging, Demographics, and Memory Study (ADAMS). For this analysis:
   Some 856 ADAMS volunteers received a three– to four-hour in-home clinical assessment for dementia. An expert panel reviewed the test results to determine who was demented, cognitively impaired but not demented, and normal.
   Researchers then used these data to determine the national prevalence rate, and previously collected cognitive and functional measures on 10,903 people in the full HRS sample of people older than 70 to estimate dementia care costs based on the use and costs of health care services reported by this same group.
   "Dementia costs currently rival those of cancer and heart disease. But, within 30 years, dementia may be in a league of its own," said Richard M. Suzman, Ph. D., director of NIA's Division of Social and Behavioral Research. "Unless effective interventions are found to treat Alzheimer's, formal long-term dementia care costs will escalate for the baby boom generation, as they have fewer children available to provide unpaid, informal care."
   The NIA leads the federal government effort in conducting and supporting research on aging and the health and well-being of older people. It provides information on age-related cognitive change and neurodegenerative disease specifically at its Alzheimer’s Disease Education and Referral (ADEAR) Center at For expanded information on Alzheimer’s care and resources, visit the federal government's portal website at Information on health and on aging can be found at