Patients who have had metal-on-metal hip replacements are no more likely to develop cancer in the first seven years after surgery than the general population, although a longer-term study is required, a study led by the University of Bristol claims.
A recent BMJ and BBC Newsnight investigation looked into the potentially high level of toxic metals from failing hip implants which may, in future, affect thousands of people around the world. The investigation also looked at why these hip replacements were allowed despite the risks being known and documented for decades. The BMJ has a large collection of articles about the safety of medical devices which can be found here.
This study, commissioned by the National joint Registry of England and Wales and carried out by authors from the Universities of Bristol and Exeter, looks at whether these concerns are valid. The registry contains records of over one million procedures from at least 97 per cent of orthopaedic units. Every year registry data and hospital episode statistics are linked up to check how patients who have had joint replacements are faring.
Ashley Blom, Professor of Orthopaedic Surgery in the School of Clinical Sciences at the University of Bristol, who led the team that undertook the study, said: ‘This research shows that there is no increased risk of cancer with metal-on-metal hip replacements in the first seven years after surgery. Although this is very reassuring, we do not know what are the long-term risks and thus further studies will be necessary in the future.’
In this study cancer rates in patients with metal-on-metal hip replacements were compared with both a group of patients who had other hip bearing surfaces implanted and the general population. Overall, 14 per cent (40,576) of registered patients had some type of metal-on-metal bearing surface: seven per cent (21,264) had a stemmed metal-on-metal prosthesis and seven per cent (19,312) had a resurfacing procedure. The researchers compared patients’ outcomes using mathematical modelling. The models included the age and sex of the patient as well as three measures of general health at the time of hip surgery (the American Society of Anaesthesiologists grade that scores the patient’s other serious illnesses, the number of distinct diagnostic codes recorded at time of surgery, and the number of NHS funded admissions to hospital in the previous five years). The authors do say, however, that comparison with the general population is not straightforward as hip replacement patients ‘tend to be healthier than others of the same gender and age group’.
Results show that the chance of a 60-year-old man with moderate health and a metal-on-metal stemmed hip replacement being diagnosed with cancer in the five years following surgery is 6.2 per cent, compared to 6.7 per cent chance with hip replacement using other bearing surfaces. For women, these figures were 4.0 per cent for metal-on-metal stemmed hip replacement and 4.4 per cent for other bearing surfaces. Further results show that the incidence of cancer diagnosis is low after hip replacement and lower than that predicted for the age and sex matched general population.
The authors hope that this study will help clinicians reassure patients that the ‘risk of cancer for hip replacement patients is relatively low’ with no evidence of an increase in cancer associated with metal-on-metal hips. They add though that this only shows results for up to seven years following surgery and the analysis of long-term data is required over the next few decades as some cancers take many years to develop. University of Bristol

Heart cells bio-engineered at University of Michigan Center for Arrhythmia Research display activity similar to most people’s resting heart rate

A cutting-edge method developed at the University of Michigan Center for Arrhythmia Research successfully uses stem cells to create heart cells capable of mimicking the heart

Primary care physicians are faced with treating a large proportion of chronic pain patients, but many do not often have specific training in the assessment and management of chronic pain, including the use of opioid medications for chronic pain management. Recognising the significant role prescribers can play in reducing the risk of addiction, unintentional overdose, and death from the misuse and abuse of opioids, the U.S. Food and Drug Administration (FDA) has made prescriber education a central part of its Risk Evaluation and Mitigation Strategy (REMS) requirements for manufacturers of long-acting and extended-release (LA/ER) opioids.
With this in mind, Inflexxion

An injection of banked sperm-producing stem cells can restore fertility to male primates who become sterile due to cancer drug side effects, according to researchers at the University of Pittsburgh School of Medicine and Magee-Womens Research Institute. In their animal study previously frozen stem cells restored production of sperm that successfully fertilised eggs to produce early embryos.
Some cancer drugs work by destroying rapidly dividing cells. As it is not possible to discriminate between cancer cells and other rapidly dividing cells in the body, the precursor cells involved in making sperm can be inadvertently wiped out leaving the patient infertile, said senior investigator Kyle Orwig, Ph.D., associate professor, Department of Obstetrics, Gynecology and Reproductive Medicine, Pitt School of Medicine, and an investigator at Magee-Womens Research Institute.
‘Men can bank sperm before they have cancer treatment if they hope to have biological children later in their lives,’ he said. ‘But that is not an option for young boys who haven

A new study has determined how often people should get screened for gastric or stomach cancer in high-risk regions of the world. The findings could help reduce deaths from gastric cancer, which is the second most common cause of cancer-related mortality.

Although the incidence of gastric cancer has decreased substantially in the western part of the world, the disease is still common in areas such as Eastern Asia, including Korea, Japan, and China.

Gastric cancer patients’ prognosis strongly depends on the stage of the disease, or how advanced it is, at the time of diagnosis. In other words, early detection and treatment can save lives.

Gastric cancer screening is often done by upper endoscopy