European Health News from Englemed

Plans for the new European Cancer Patient Coalition were announced today at a major conference on the disease.

The coalition says it hopes to become a sounding board for the European Commission and other continent-wide institutions.

Details of the coalition were revealed by cancer campaigner Lynn Faulds Woods, a well known British television presenter.

Ms Faulds Wood set up a patient group in Britain after being diagnosed with bowel cancer 12 years ago.

She said there were many "inequalities" in treatment and knowledge of best practice across the continent.

Speaking at the European Cancer Conference in Copenhagen, she said: "We hope that this new group will enable us to highlight some of these problems to policy makers, and empower patients - the people who are the most directly affected - to ask questions about them.

"No-one with cancer should have to put up with sub-standard treatment just because they don’t know that there is anything better in another country, or even another region of the same country."

She added: "It is time that all cancer patients had a properly representative forum to help them help themselves. There is much that we can achieve by working together across Europe."

Fewer than a third of adults over the age of 35 suffer from the problem in the USA or Canada - lower than countries such as Italy and Sweden, researchers found.

The findings, reported in the Journal of the American Medical Association, come from a study involving thousands of people in the two continents.

Researchers found that 42 per cent of adults in England suffered from the problem and 55 per cent in Germany.

In Canada this fell to 27 per cent and in the USA 28 per cent.

And in supposedly healthy Italy researchers found a 38 per cent rate of high blood pressure, the same rate as in Sweden.

The researchers, led by Dr Katharina Wolf-Maier, of the Loyola University Stritch School of Medicine, Maywood, Illinois, USA, are unable to provide an explanation for their findings.

The research also showed that high rates of high blood pressure were linked to increased death rates from stroke - and also to rates of heart disease.

The researchers write: "Our study provides no direct information on what the causal explanations might be but rather places this topic on the research agenda. Among the most relevant factors are nutrient intake, obesity, physical activity, alcohol intake, environmental toxins, psychosocial stressors, and genetic susceptibility.

"The potential for both prevention and better pharmacologic control would thus appear to be substantial for Europe. The need to further increase awareness of this common risk factor among both physicians and the public is evident."

The conclusion comes from an analysis of perinatal deaths in ten European countries.

The researchers studied details of more than 1,600 baby deaths - looking for evidence of inadequate care for the research reported in the British Journal of Obstetrics and Gynaecology.

They found the highest proportion of "suboptimal care factors" in England, 53.5 per cent of the total. However the figures may be distorted by the level of care devoted to investigating perinatal deaths compared with other countries.

In Finland, inadequate care contributed to fewer than a third of deaths, some 31.9 per cent, and this rose to 35.7 per cent in Sweden. Other countries studied ranged from Norway to Greece and included Spain, Scotland and Belgium.

The researchers said that the findings were distorted by differences in data between countries. Greece, Holland and Spain needed special studies to identify cases.

But England provided data covering about half the country, produced after full multidisciplinary audit.

But there was, they said, a link between a country's perinatal death rate and the proportion of deaths explained by failures of care.

The most frequent problems was a failure to detect poor growth in the womb - which accounted for ten per cent of cases - and the mother's smoking - a total of 11.7 per cent of cases.

Researcher Dr Jan Hendrik Richardus, of the Erasmus Medical Centre, Rotterdam, Holland, writes: "Differences exist between the regions in the quality of antenatal, intrapartum and neonatal care, and that these differences contribute to the explanation of differences in perinatal mortality between these countries."

European researchers set out to estimate the prevalence of cancer across the continent.

The findings show the number of living cancer patients in each country. This could indicate high rates of cancer - but could also point to other explanations. Differences in survival rates among people diagnosed with cancer would affect prevalence rates as would the effectiveness of diagnosis.

Researchers found that more than three per cent of the population of southern Sweden had cancer - compared with just over one per cent in Poland.

The highest prevalence of cancer was found in Sweden, Switzerland, Germany and Italy, they report in the journal Annals of Oncology.

The lowest rates were found in Poland, Estonia, Slovakia and Slovenia.

Some 61 per cent of cancer patients were women and 57 per cent were over the age of 65. About a third of women patients suffered from breast cancer.

Some 58 cancer registries from 17 countries provided information on three million patients diagnosed between 1970 and 1992 for the project, known as Europreval.

However, writing in the same journal, Professor Graham Giles, of the Anti-Cancer Council, Victoria, Australia, casts doubt on the value of the prevalence figures.

He said: "Total prevalence based on a complete estimation of survivors of all cancer types has a rather limited application. Many long-term survivors will, essentially, be cured of their cancer and may place little additional burden the health services than others of their age."

As a third case of anthrax infection was reported in Florida, USA, a study found "critical" weakenesses in the detection, coordination and reporting between national surveillance networks.

Writing in the British Medical Journal, researchers reported delays in informing other countries about important events and a "lack of clarity" about how cross-border disease investigations should be conducted.

The researchers, led by Julius Weinberg, pro-vice chancellor of City University, London, studied the handling of five outbreaks of disease including flu, legionnaire's disease, and salmonella.

One country failed to identify 60 per cent of cases of legionnaire's disease acquired in the community, the research found.

"Increasing globalisation is likely to lead to further international outbreaks," they write.

"Responding effectively to these requires coordination of national surveillance and response systems within the European Union and support for enhanced surveillance and control activities in developing countries."

Researchers studied urban and rural communities in Spain, UK, Ireland, Finland and Norway for the research, published in the British Journal of Psychiatry.

The project, the European Outcome of Depression International Network, sought to question random samples of people to identify symptoms of disorder.

Rates of depression of men and women reached 17 per cent in Liverpool, UK, and 12.8 per cent in Dublin, Ireland.

But in the city of Santander, Spain, fewer than three per cent of people showed symptoms of depression.

The researchers found more consistent patterns in the countryside - ranging from 6.5 per cent to 9.3 per cent - although they were unable to study rural Spain because of funding difficulties.

The overall depression rate among men was 6.6 per cent.

The researchers said the results of the project should be used as a base for further European studies - looking for causes and trends.

"These results confirm that depressive disorder is a highly prevalent condition among working age adults in Europe, particularly in urban centres," they write.

The 1.7 million pounds sterling "Eurobank" project is to be coordinated at Newcastle University, UK.

Transplant centres in Paris, Germany, London, Holland and the Czech Republic will take part in the project.

Researchers plan to collect cells and DNA from patients and donors and use it to identify genetic risk factors.

Dr Anne Dickinson, senior lecturer in marrow transplant biology at Newcastle University, said: "The survival and cure of patients after the transplant is often hampered by complications that arise from genetic differences between patients and their donors, even if they are completely matched, as in sibling transplants.

"By identifying the genetic differences between patients and donors clinicians will be able to make more accurate decisions about the donor to be used and or the type of transplant to be carried out together with the type of therapy to be given."

Meanwhile a European body published new guidelines for research into human stem cells.

The European Science Foundation said that therapeutic stem cell cloning should be allowed - but reproductive cloning should be banned.

A foundation report said there were major differences in the legal approach to the issue in different countries.

It said: "The ESF urges all European countries to introduce legislation and regulation to oversee and control the laboratories concerned, the scientists involved and the experiments that can be performed."

• A clinical trial of gene therapy for prostate cancer is to be conducted in Birmingham, UK, it was announced at the Global Conference for Cancer Organisations in Brighton, UK.

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The week takes place next week between March 12 and 18.

The Dana Alliance for Brain Initiatives in the USA and the European Dana Alliance for the Brain is to produce jointly a vision and goals statement for the future of research.

It will ask the reader to imagine that brain disease and mental illness can be treated effectively, for example, or that spinal cord injury will not mean a lifetime of paralysis.

The statement represents the future of brain research as seen by more than 300 neuroscientists, including 13 Nobel laureates, from Europe and the USA who are members of the alliances, which advance and promote brain research.

Professor Colin Blakemore, chief executive of the European Dana Alliance for the Brain, said: "To imagine an end to brain diseases may seem far-fetched, but the amazing progress of thousands of basic and clinical neuroscientists around the globe means that we can now allow ourselves to hope for early diagnosis and effective treatments for developmental, genetic and degenerative disorders."

Accompanying the vision statement is a progress report on brain research entitled "Visions of the Brain", charting landmark research in our understanding of the brain since World War II, including brain mapping, genetics and the biological basis of behaviour.

"The public are enormously interested in science and medicine, but it is essential that they have confidence in the aims and achievements of research, and in the mechanisms to avoid risk," said Professor Blakemore.

"This worldwide effort surely demonstrates how firmly neuroscientists believe in sharing their knowledge with the public to ensure that they support us as we increase the pace of progress in brain research in the next decade."

Throughout Brain Awareness Week, hundreds of events will take place around the world to highlight the importance of research into the human being's most complex organ.

The only glimmer of hope for British youth was a slight fall in illicit drug use since an earlier survey in 1995 - with the dance drug ecstasy falling out of fashion, according to the European School Survey Project on Alcohol and other Drugs.

The survey showed that 20 per cent of British teenagers claim to smoke daily compared with 18 per cent in Ireland, 16 per cent in Russia, 15 per cent in Finland and 14 per cent in France. And more girls in the UK are now smoking than boys.

Meanwhile teenagers in Ireland and France, together with the Czech Republic, share the scourge of high drug use with British teenagers - while schools in Finland, Sweden, Malta and Cyprus are relatively free of the problem, the study showed.

More than 35 per cent of British teenagers claimed to have sampled cannabis - but just 3.3 per cent had encountered ecstasy.

High levels of drinking were found in Britain, Ireland, and northern countries such as Denmark, Finland and Iceland.

Meanwhile Mediterranean teenagers are restrained in their drinking, the survey showed, with low levels in France, Italy, Greece, Portugal and the Mediterranean islands.

Researcher Dr Martin Plant, from Edinburgh, Scotland, said: "One of the problems we have is that drug taking has now become so commonplace that it is widely regarded as socially acceptable."

Delegates at the conference of the European Haematology Association heard how French doctors may have cured so-called "bubble babies" - while American researchers have developed a drug for a common form of leukaemia.

In Paris, France, six babies have been treated for severe combined immuno-deficiency syndrome - using gene therapy.

Normally the infants would not be expected to survive their first birthday.

In December doctors told how two babies had successfully been treated. Yesterday they said five out of six children had gained dramatic benefits from the treatment - and appeared to have fully developed immune systems.

Researcher Dr Alain Fischer, of the Hospital Necker, Paris, France, said: "Obviously we should now treat more patients with the X-linked form of SCID.

"We need to see the long term results of the treatment.

"We also need to see if we can extend this strategy to other diseases," he told the conference in Birmingham, UK.

Meanwhile the doctor who discovered a new leukaemia drug, STI 571, said he hoped it could be applied to other forms of cancer, including small cell lung cancer and the brain disease, glioblastoma.

The drug was designed to treat chronic myeloid leukaemia - and has achieved astonishing success in early trials.

The blood disease spends up to four years developing in its victims - and then turns into an acute and deadly form of the disease.

Dr Brian Druker, of the Oregon Health Sciences University, Portland, USA, said the new drug was most effective in the early stages of the disease - and few patients experienced more than mild side effects.

Its effects have been so dramatic that diseased blood cells have returned to their healthy state.

In the initial trial of 33 patients, every patient went into remission, Dr Druker said.

500 patients internationally are taking part in further trials - and early indications are that 90 per cent are in remission, he said.

He said: "It is my hope we can begin to get some other similar therapies in place to use during the crisis phase of the disease. At the moment in acute leukaemia patients we may need to use it in combination with other drugs."