Medical Bulletin 18/August/2023

Here are the top medical news for the day:

Cancer death risk after exposure to low-dose ionizing radiation underestimated

Prolonged exposure to low-dose ionizing radiation is associated with a higher risk of death from cancer than previously thought, suggests research tracking the deaths of workers in the nuclear industry, published in The BMJ recently.

The researchers tracked and analyzed deaths among 309,932 workers in the nuclear industry in the UK, France, and the US (INWORKS) for whom individual monitoring data for external exposure to ionizing radiation were available.

During a monitoring period spanning 1944 to 2016, 103,553 workers died: 28,089 of these deaths were due to solid cancers, which include most cancers other than leukemia.

The researchers then used this information to estimate the risk of death from solid cancers based on workers’ exposure to radiation 10 years previously.

Reference: Cancer mortality after low dose exposure to ionizing radiation in workers in France, the United Kingdom, and the United States (INWORKS): cohort study, The BMJ, DOI 10.1136/bmj-2022-074520 

Levonorgestrel and Anti-Inflammatory Medications Combo for Emergency Contraception

Taking piroxicam, an anti-inflammatory medication commonly used for arthritis pain, at the same time as the levonorgestrel emergency contraceptive pill after unprotected sex prevents significantly more pregnancies compared to taking levonorgestrel alone, according to a randomized controlled trial published in The Lancet.

Two types of emergency contraceptive pills - containing either levonorgestrel or ulipristal acetate - are the most widely used emergency contraception method in most countries. The accepted effectiveness of levonorgestrel is based on the results of a trial from 1998 in which levonorgestrel prevented 95% of expected pregnancies when taken within 24 hours of unprotected sex, 85% if taken within 25–48 hours, and 58% if taken within 49–72 hours. However, more recent research suggests the efficacy of levonorgestrel might be lower.

Reference: Oral emergency contraception with levonorgestrel plus piroxicam: a randomized double-blind placebo-controlled trial, The Lancet, DOI: https://doi.org/10.1016/S0140-6736(23)01240-0

Lorazepam treatment may be linked to poorer outcomes for pancreatic cancer patients

Patients with pancreatic cancer who took the benzodiazepine lorazepam, commonly prescribed to treat anxiety during cancer treatment, had a shorter progression-free survival than patients who did not, according to results published in Clinical Cancer Research,

Feigin and colleagues first evaluated how many patients take benzodiazepines during cancer treatment. The researchers then examined the relationship between benzodiazepine use and survival in patients with pancreatic cancer. When they adjusted for age, race, sex, disease stage and progression, and treatments received, any benzodiazepine use was associated with a 30% lower risk of pancreatic cancer-related death.

Reference: Lorazepam stimulates IL-6 production and is associated with poor survival outcomes in pancreatic cancer, Clinical Cancer Research, DOI 10.1158/1078-0432.CCR-23-0547