Vitamin D, Calcium May Lower Risk of Melanoma for Some Women

Women who have a history of skin cancer and take supplements of calcium and vitamin D may lower their risk of developing melanoma, according to a new study published Monday in the Journal of Clinical Oncology.

Researchers at the Stanford University School of Medicine analyzed data collected from 36,000 women for the Women’s Health Initiative and found that women with a history of non-melanoma skin cancer who took a daily dose of 1,000 mg of calcium plus 400IU of vitamin D had a 57 percent lower risk of developing melanoma than women with the same cancer history who didn’t take the supplements.

However, the study’s authors found that the combination of supplements did not have this protective effect in women without a history of non-melanoma skin cancer.

The authors noted that although these results should be interpreted with caution, it may be that vitamin D and calcium could prevent melanoma in high-risk women.

Health researchers try to link up with more Hispanic women

Illinois’ number of Hispanic women reporting that they were in fair or poor health was the highest in the nation, according to a 2009 study, and efforts are growing to figure out why.

Researchers want specifics on why 34.3 percent of Latino women in Illinois said their health was not good, compared with about 8.5 percent of non-Hispanic white women, in the study by the Henry J. Kaiser Family Foundation. Hispanic women in the state also have higher rates than non-Hispanic white women of diabetes, cardiovascular disease and obesity, according to the study.

But enlisting people to be studied can be complicated by a distrust of medical research and an inability to overcome language barriers and other concerns.

Northwestern University’s Feinberg School of Medicine is taking a step toward finding answers through a recently launched Spanish-language version of its Illinois Women’s Health Registry. The idea is to boost the number of Hispanic women who participate in clinical trials and provide data to help researchers understand their health needs and access to care.

“It will really give us the statistical power we need for analysis of ethnic differences,” said Candace Tingen, director of research programs at Northwestern’s Institute of Women’s Health Research. “There’s a strong desire among Illinois women to join research trials, but we knew the language barrier might be a problem for Hispanic women.”

Almost 6,300 women have joined the registry since it began in 2008, but only 4 percent describe themselves as Hispanic. The registry’s Spanish-language website, whr.northwestern.edu/es, went live in May.

Tingen hopes to attract 1,000 Hispanic women to the registry in the next year. Building up the number of Hispanic women involved is crucial to gaining a better understanding of their health across the state, she said.

The disparities between ethnic groups are striking. Hispanic women in Illinois have a 9 percent rate of diabetes compared with the 3 percent rate among non-Hispanic white women, and about 4 percent of Hispanic women have cardiovascular disease while fewer than 2 percent of non-Hispanic white women do, the Kaiser Foundation study says.

In addition, about 30 percent of Hispanic women in Illinois are obese compared with about 21 percent of non-Hispanic white women, the study says.

Contributing factors are inadequate access to and use of health care, a lack of health insurance, lower socioeconomic status and lower levels of education.

“We need to have better planning and coordination,” said Esther Sciammarella, director of the Chicago Hispanic Health Coalition, “to make sure we help people reach the services they need.”

Sciammarella, who advocates for a “good state plan” to tackle health disparities in Illinois, said her coalition will promote Northwestern’s effort to reach Hispanic women. Involving them in clinical trials allows access to the latest treatments and quality care, she said.

Northwestern has matched women already in the registry with about 20 clinical trials, including studies related to hearing, fertility, postpartum depression, osteoarthritis, HIV, menopause and gestational diabetes.

In the past, women were excluded from clinical research, but the National Institutes of Health Revitalization Act of 1993 requires women and minorities to be included unless their involvement is inappropriate for the purpose of the research or the health of the subjects.

On its website, the registry poses these questions: “Why do some diseases affect women more than men? Why do women respond to some drugs and treatment therapies differently than men? What environmental factors and behaviors most influence women’s health? We don’t know. But we want to find out. And we need your help.”

“We make the connection between women and researcher, disallowing any excuse for researchers not to include women,” Tingen said. “We want to do the same for Spanish-speaking women. They’re hard to recruit because they’re often hard to reach.”

The registry intends to focus recruitment efforts on church groups and other small-group gatherings, but Northwestern’s Institute of Women’s Health Research does not have funding to hire a Spanish-speaking community liaison.

Northwestern professors Aida Giachello and Dr. Martha Daviglus plan to help with outreach and to use the data collected from the registry. The two recently submitted a National Institutes of Health grant application for $950,000 over five years to establish something that would be called the Center of Health Disparities for Cardiovascular Health. They are seeking funds for research, research training and community engagement.

“In poor communities, people don’t understand what research is. There is distrust,” said Giachello, former director of the Midwest Latino Health, Research, Training and Policy Center at the University of Illinois at Chicago. “If we receive funding, we can do a comprehensive community campaign, outreach and a media effort to get the word out about research, clinical studies and the importance of studies to improve their own health.”

Giachello and Daviglus are working on a six-year study of Hispanic health by targeting 16,000 participants in Chicago, Miami, New York and San Diego. They have a $65 million National Institutes of Health grant funding the research.

The lack of data on Hispanic health is more apparent among recent immigrants and Hispanics with low income and low levels of education, Giachello said. In Illinois, advocates say they are fighting the perception that Hispanics are clustered in the Southeast, Northeast, Texas and California, and not the Midwest.

About 13 percent of the state’s population — 1.7 million people — is Hispanic, according to U.S. census figures, constituting the 10th-highest Hispanic population in the nation.

“Latinos are all over the place, but that’s something not a lot of policymakers are necessarily aware of,” Giachello said. “That lack of awareness has led to a lack of funding to do research in Illinois. We need the data for better programs, services and public policy.”

Kansas’ Stringent New Licensing Law Shuts Down Abortion Clinic, Others Fear ‘We’re Doomed’

Kansas is now down to just two abortion providers, after one clinic failed to meet the rigorous licensing requirements established by a new state law. Abortion advocates see the new regulations — which require abortion clinics to obtain a state license to continue operating past July 1 — as an effort by opponents to chase abortion providers out of the state. Kansas’ remaining clinics worry they could be next“:

A lawyer for the Aid for Women clinic in Kansas City, Kan., said Friday that it received a notice that its application for a license had been denied by the Kansas Department of Health and Environment without an inspection. Attorney Cheryl Pilate said the clinic was looking at its legal options but would have to close, at least temporarily.

The clinic received its notice on the same day the leader of a regional Planned Parenthood chapter said inspectors who spent two days at its Overland Park clinic found it will comply with all new regulations. An inspection of the third provider is scheduled for Wednesday. All three are in the Kansas City area.

“We’re doomed,” said Dr. Herbert Hodes, who performs abortions for the third provider, the Women’s Health Center, also in Overland Park.

The new requirements are far more specific than anything the state requires for hospitals and ambulatory surgical centers, and are much more detailed “than the rules for most clinics and offices in which doctors perform many surgical procedures.” The abortion providers were informed of the new standards earlier this month and given just weeks to comply with the new licensing requirements. For instance, the room where the abortions occur must maintain a temperate of between 68 and 73 degrees, have at least 150 square feet (excluding ‘fixed’ cabinets), and come with its own janitor’s closet with 50 or more square feet. Women also have to remain in recovery for at least two hours afterward.

No such requirements exist for hospitals or surgical centers and the state doesn’t mandate specific room sizes or temperature standards. Instead, “they’re tied to standards from the American Institute of Architects for medical facilities, which call for at least 360 square feet of unrestricted space for surgery rooms. But those standards apply to new construction.” The health department also doesn’t “set a minimum recovery time.”

If the licensing standards succeed in closing down the two remaining abortion clinics and discourage any new providers from entering the market, it will pose a direct challenge to Roe v. Wade. In Planned Parenthood v. Casey, the Supreme Court held that states may enact some abortion regulations, but they may not “strike at the right itself” to terminate a pregnancy.