Dental experts fault study linking X-rays to term low birth weight

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San Antonio (June 7, 2004) – A study published April 28 in the Journal of the American Medical Association (JAMA) is causing some pregnant women to question whether they should have X-rays taken in their dentists’ offices. The study raises undue concern about the safety of dental radiography during pregnancy, said William Moore, D.D.S., and John W. Preece, D.D.S., of the Dental School at The University of Texas Health Science Center at San Antonio.

Dr. Moore, assistant professor of dental diagnostic science and head of the division of maxillofacial radiology, and Dr. Preece, professor of dental diagnostic science, have written a response to the study and submitted it to the JAMA. The response also has been accepted for publication in the Journal of the American Dental Association.

“The knee-jerk reflex is to think that radiation used in dentistry is harmful,” Dr. Preece said. “The public should know that the potential radiation risk a patient may experience in the dentist’s office is equivalent to only three to five days of normal ‘background’ radiation in our country (background radiation is radiation we receive from outer space, soil and building materials, and the food we eat). The risk of harmful effects such as cancer and birth defects after dental X-rays is miniscule and certainly does not equal the health benefits of good oral care.”

The study in the JAMA was reported in the May 10 issue of TIME magazine under the headline “Dare you see your dentist again?” The study compared 1,117 women who delivered low birth weight infants at term and 4,468 women who delivered normal birth weight infants. Women were grouped according to the level of dental radiographic exposures they received. The authors estimated that eliminating dental radiographs during the first trimester could reduce the incidence of term low birth weight infants by “up to 5 percent.”

Dr. Preece pointed out that 85 percent of the mothers with term low birth weight babies in the study had no identifiable dental radiographic exposure. “Thus, the benefit of a possible 5 percent decrease in term low birth weight would really affect only three babies out of the study group,” he said.

Drs. Moore and Preece said that in the last century of research, no other authors have been able to demonstrate cancer or other biological effects at the low levels of radiation exposure reported as being significant in the study. The study also did not consider possible non-dental, medical radiation exposure as a contributing factor to term low birth weight infants, “a significant oversight and another potential flaw in the study,” Dr. Preece said.

Dental X-rays are measured in units called milligrays (mGy). The effective dose (the amount of radiation from a full-mouth dental radiographic survey) is less than 0.0003 mGy when the dentist uses the lead apron to shield patients, compared to the 3 mGy in background radiation absorbed annually by everyone in the United States.

“As a point of reference, various localities around the world with large populations have background radiation levels averaging 15 to 40 mGy a year with no known harmful effects, including Ramsar, Iran, where an individual was found to have an annual dose of 132 mGy, or 0.36 mGy per day,” Drs. Moore and Preece wrote.

Health Science Center bestows degrees for 2004

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The five schools of The University of Texas Health Science Center at San Antonio held their commencement exercises in May. Some individuals in the following lists are summer or winter graduates.

The Graduate School of Biomedical Sciences held its commencement ceremony May 21. Ceremonies for the Medical School, Dental School, School of Allied Health Sciences and School of Nursing were May 22.

GRADUATE SCHOOL OF BIOMEDICAL SCIENCES

Doctoral degrees

Biochemistry – Veronica Contreras-Shannon, San Jose, Calif.; Jennifer Elam, Wildwood, Mo.; Natalie Gibson, Belize City; Dong Kang, Pusan, South Korea; Xu Lu, Guangdong Province, China; Satya Panda, Jeypore, India; Xun Yu, Hefei, Anhui Province, China.

Cellular and structural biology – Valerie Adams, Woodlake, Calif.; Ibtissam Echchgadda, Meknes, Morocco; Cara Knight, San Antonio; James Mele, White Plains, N.Y.; Nuttawut Saelim, Suratthami, Thailand.

Microbiology and immunology – Angela Archer, Richardson; Whitney Greene, Canyon Lake; Suzanne Keller, Adel, Iowa; Rita Tamayo, Houston; Robyn Woodbury, Eagan, Minn.

Molecular medicine – Karen Block, Soldotna, Alaska; John Leppard, Houston; Sean Post, Port Colborne, Ontario, Canada; Hui-Min Tseng, Feng-Shaw, Taiwan.

Nursing – Susan Andersen, Toronto, Ontario, Canada; Laura Munoz, San Antonio; Barbara Owens, Bloomington, Ind.

Pharmacy (joint degree with UT Austin) – Myra Beshear, Comfort; Jessica Blanton, Waco; Jerry Byler, Sherman; Marissa Cervera, Crystal City; Jordyn Chapman, Duncanville; James Cox, Muleshoe; Michael Deanda, Andrews; Jesse Esparza, San Antonio; Juan Gonzalez, Brownsville; Waylon Haecker, Cibolo; Doug Haney, Mission; Kimberley Hardy, Georgetown; Elizabeth James, San Antonio; M. Layton Kincaid, Victoria; Kristina Klein-Bradham, Centralia, Ill.; Ronald LaVecchio, Honolulu;

Stephanie Lowrance, Victoria; Melody Melton, Lampasas; Leticia Moczygemba, Karnes City; Vanessa Morales, Laredo; Steven Morgan, San Antonio; Alejandra Ortiz, San Antonio; Amisha Patel, Houston; Rima Patel, Houston; Sherri Pinkston, Sinton; Amy Poore, Karnes City; Vanessa Recio, McAllen; Kelly Red, Los Angeles, Calif.; Kristi Rokyta, Spring; Ingrid Rylander, Leander; Hilary Schmidt, Fredericksburg; Ingrid Svihla, Austin; Griselda Tamez, San Antonio; Cara Trejo, San Antonio; Kristy Warrington, Ruston, La.; Mark Wong, San Antonio.

Pharmacology – Nathaniel Jeske, Cedar Park; Theodore Price, Dallas.

Physiology – Kathleen Goei, Peekskill, N.Y.; Yun Li, Quanzhou, China.

Radiological sciences – Ande Bao, Beijing, China; Ching-Mei Feng, Taipei, Taiwan; Bhujanga Lankipalli, Elk Grove, Calif.; Luis Medina, Mexico City; David Nelson, Charleston, W.Va.; Bahadir Ozus, Istanbul, Turkey; Seonghwan Yee, Cheju, South Korea.

Master of science

Biochemistry – Houyi Wang, Houston; Kerfoot Walker III, Tyler.

Cellular and structural biology – Christine Gear, Hondo; Michael Herrera, San Antonio; Kim Hildreth, San Antonio; Traci Reddick, San Antonio.

Clinical investigation – Inmaculada del Rincon, Madrid, Spain; Jeannae Dergance, San Antonio; Phuong Loan-Ha Mai, Houston; Marcos Restrepo, Medellin, Colombia; Juan Jose Toro, Medellin, Colombia; Joan Zhao, Changsha, China.

Clinical laboratory sciences – Teresa Sanchez, San Antonio.

Dental diagnostic science – Samer Bsoul, Irbid, Jordan; John Guidry, Rayne, La.

Periodontics – Sara Bender, San Antonio; Patricia Berube, Danbury, Conn.; Chol Chong, Vacaville, Calif.; Edithann Graham, Paradise Valley, Ariz.; Todd Keller, San Antonio; Joanna Rogalski, Chicago; Gerald Van Cammack II, San Antonio.

Pharmacology – Shelley Thielen, Noblesville, Ind.

Physiology – John Adams II, San Antonio; Jocelyn Eckerman, San Antonio; Maricela Reyes, Donna; Thomas Rodgers, Monahans.

Prosthodontics – Scott Dyer, Las Vegas, Nev.; Holly Hasegawa, Mercer Island, Wash.; Robert Stover, Olympia, Wash.; Kelley Tomsett, Houston; Francisco Veray, Guaynabo, Puerto Rico.

Radiological sciences – Lindsey Voeltz, San Antonio; Curtis Volgamore, Great Falls, Mont.

SCHOOL OF MEDICINE

Doctor of medicine – Adedotun Adewusi, Pablo Aguayo, Laura Akin, Travis Akin, Francis Ali-Osman, Jennifer Almonte, Ajey Alurkar, Scott Ambruster, Kristy Anderson, Matthew Anderson, Prakash Balan, Thomas Baldwin, Alfonso Ballesteros, Heather Banks, Kathryn Barenberg, LaMonica Barnum, Christopher Beadles, Chandra Beals, Charles Bechert, David Benglis Jr., Samia Benslimane, Sarah Berry, Natalie Biediger, John Birbari Jr., Lori Birbari, Amanda Blair, Adam Blanchette, Karen Blanton,

Christa Blecher, Alice Blount, Mary Bohnenblust, Himabindu Borra, Tiffany Brainerd, David Brooks, Robert Brown, Aaron Buzzard, Lacie Callaway, Pedro Calzada, Andrea Campaigne, Aimee Carswell, Thomas Chambliss, Daniel Chan, Jonathan Chang, Justin Chavez, Jodi Coates, J. Lauren Crawford, Owen Davenport, Melissa DeLario, Damian DeLeon, Korina DeLeon, Rachel DelFavero, Deepali Dubal, Rachel Dunagin, Jessica Edwards, Monica Eisele, Rafael Elenes, Jacqueline Emmons, Ricardo Escamilla,

Stacey Fedder, Dominick Fernandez, Keith Flak, Derrick Flint, Gabriela Freile, Adam Frome, Tara Frost, Erlita Gadin, Aakash Gajjar, Bethany Gallagher, Erica García-Pittman, Jojy George, David Gibson, Paul Goen, Lorelei Gonzalez, Michael Green, Christina Greig, Emily Grigsby, Nilda Guerra-Cavazos, Evelyn Haddad, Joseph Hancock, Clayton Harper, Bradley Hart, Horacio Hau, Patrick Hayes, Joseph Henske, Antonio Hernández, José Hernández Jr., Lethecia Hernandez, Tania Hernandez,

Phillip Hill, Edward Hiltner Jr., Jennifer Horan, Jennis Iruke, Jennifer Isner, Nathaniel Jablecki, Jennifer James, Ralph Johnson, Scott Junkins, Colleen Kelly, Bonnie Kim, Traci Kimball, Amanda Kimbrough, James King, Jennifer Kirkpatrick, Frederick Krause, Sachin Kukreja, Kristen Kulasa, Babin Kurian, Albert LaCasse III, Meredith Lann, Melvin Lau, Mark LeDoux, Olivia Lee, Megan Lenhart, Lillian Liao, Jennifer Lingamfelter, Kristie Liska, Anne Lockman, Sonja Longbotham, Christopher Lowe,

Sarah MacMahon, Matthew Maki, Marisa Mammarappallil, Jenifer McNair, Michelle McNutt, Emily Meyer, Bradley Miller, Kate Miller, Whitney Mitchell, Alka Mittal, Richa Mittal, Kimberly Moore, Matt Moore, Brian Morse, Michael Muhlert, Shalini Mukhi, Matthew Musick, Wendell Neeley II, Derrick Nguyen, Patrick Nguyen, Kelly O’Brien, Scott Orr, Gerardo Ortiz, James Palmer, Julie Sharad Parekh, Aashish Parikh, Mitul Patel, Eric Pearlman, Elizabeth Perkins, Benjamin Perschau, Lindsey Pershern,

Christopher Phelps, Andreea Popovici, Arturo Portillo Jr., John Primomo, Peter Ramirez, Monica Ramos, Hetal Rana, Rebekah Rardin, Hampton Richards, Patrick Robinson, Ramona Rogers, Rebecca Romero, Simone Marie Bridges Roschmann, Rito Sauceda, Joseph Schniederjan, Amber Schrank, Penner Schraudenbach, Barbara Jeanne Schroeder, Heather Sloan, Aspen Smith, Christian Stallworth, Rose Stavinoha, Stephen Stewart, Jennifer Surber, Larissa Szeyko, Doreen Telisak, Scott Thomas, Brandon Tinkler,

Katherine Treviño, Mary Unzueta-Hernández, Benjamin Vacula, E. Swann Van Delden, Cynthia Vega, Cheryl Vera-Burkhalter, Matthew Wallace, Brennan Watkins, Megan Way, Ladelle Weatherby, Vanessa Wellinghoff, Fay West, Tara Winkelmann, Erin Winston, Kim Wong, Lee Woodward, Todd Worley, Randy Wright, Wendell Wu, Margaret Zembala.

SCHOOL OF ALLIED HEALTH SCIENCES

Bachelor of science in clinical laboratory sciences – Randy Cunningham, San Antonio; Tammy Flores, San Antonio; Barbara Gutierrez, San Antonio; Charles Hiller, Poteet; Timothy Hunt, Leon Valley; Coyle Kunz, Boerne; Paula Rendon, Laredo; Jodie Rodriguez, San Antonio.

Bachelor of science in clinical laboratory sciences (cytogenetics) – Jasmin Humpherys, Mexico City; Carrie Jenkins, Wimberley; Erica McDonald, Cibolo.

Post-baccalaureate certificate in clinical laboratory sciences – Epp Goodwin, Paldiski, Estonia; Kandy Hudson, Raymondville; Amy Trotter, Gallatin, Tenn.

Post-baccalaureate certificate in clinical laboratory sciences (cytogenetics) – Amy Chien, Taipei, Taiwan; Vanessa Nevarez, San Antonio; Michael Ortiz, Austin; Olvia Revelo, San Antonio; Yvette Soto, El Paso; Darlene Tarango, Fabens.

Post-baccalaureate certificate in clinical laboratory sciences (molecular diagnostics) – Kenneth Bloodworth, Helotes; Cora Lahey, Mexico City; Cristina Padilla, San Antonio.

Master of science in clinical laboratory sciences – Teresa Sanchez, San Antonio.

Master of deaf education and hearing science – Deborah Alaniz, George West; Judy Bravo, Big Wells; Anthony Jones, Universal City; Cindy Lou Lamb, Tonasket, Wash.; Laurie Marrero, San Antonio; Elayne Rhodes, Levittown, N.Y.; Victoria Wardenburg, Knoxville, Iowa.

Certificate in dental hygiene – Jessica Barrera, Laredo; Kammie Brzozowski, San Antonio; Silvia Buelna, Lima, Peru; Monna Carpenter-Barin, San Antonio; Virginia Carrillo, San Antonio; Kristi Clemmer, Abilene; Sheri Collins, Albuquerque, N.M.; Sara Lee Cox, Jourdanton; Laura Crosser, San Antonio; Marcella Fuentes, Austin; Katrina Grote, Devine; Dana Haney, Bulverde; Pamela Hilbig, San Antonio; Nadine Ishmon, Atlanta, Ga.; Jenny Ivers, Hondo; Lisa Manning, Beech Island, S.C.;

Diana Martinez, San Antonio; Heather Martinez, San Antonio; Leslie Martinez, Taylor; Michelle Matthews, San Antonio; Sandra Mendoza, Hondo; Margaret Moore, Blanco; Michele Moore, San Antonio; Brenda Rauch, Austin; Laura Rodriguez, Laredo; Jamie Smith, Hempstead; Gina Strength, Coleman; Bonita Werner, Hondo.

Bachelor of science in dental hygiene – Brandy Brown, Galveston; Virginia Carrillo, San Antonio; Kristi Clemmer, San Antonio; Kendra Davis, Austin; Dolores Fales, San Antonio; Marcella Fuentes, Austin; Tasha Goswick, Weimar; Rose Gutierrez, San Antonio; Dana Haney, Bulverde; Pamela Hilbig, San Antonio; Emelda Hernandez, San Antonio; Jessica Huizar, San Antonio; Nadine Ishmon, Atlanta, Ga.;

David Landers, Copperas Cove; Jimmie Lawrence, Converse; Heather Martinez, San Antonio; Leslie Martinez, Taylor; Mary-Beth Mayfield, San Antonio; Sandra Mendoza, Hondo; Christine Mosman, San Antonio; Esther Nuñez, San Antonio; Anita Pesina, Hondo; Elmira Ramos, Uvalde; Brenda Rauch, Austin; Laura Rodriguez, Laredo; Misty Smith, Schertz; Monika Stagg, Fredricktown, Ohio; Nicole Steele, Napa Valley, Calif.; Bonita Werner, Hondo.

Master of science in dental hygiene – C. Denise Beitel, San Antonio.

Certificate in dental laboratory technology – Jason Bullis, Amarillo; Michelle Candelario, San Antonio; Helen Carley, Austin; John Clark, Weatherford; Gregory de la Garza, San Antonio; Peter Duong, Houston; Phuong Ho, Pflugerville; Roberto Hurtado, El Paso; Samuel Kai, Kowloon, Hong Kong; Hyo Kim, Seoul, South Korea; Ellery Northrup, Boerne; James O’Neal Jr., San Antonio; Altagracia Perez, San Antonio; Phu Pham, Cedar Park; Lourdes Ruiz, El Paso; Chad Willhite, Amarillo; William Woods, Garden Ridge.

Bachelor of science in emergency health sciences – Kristina Delgado, El Campo; Brian Hadas, Marquette, Mich.; Marc Puglia, South Dayton, N.Y.; Michael Reyes, McAllen; Joe Scheihing, Guthrie, Okla.

Master of occupational therapy – Amanda Acevedo, Portland; Alfredo Aguilera, San Juan; Alejandra Barrera, Mission; Clarisa Castro, McAllen; Paula Degley, San Benito; Christi Dehnel, San Angelo; Leandra Estrada, Roswell, N.M.; Amanda Gonzales, Victoria; Heather Hamilton, San Antonio; Candida Herrera, El Paso; Michelle Lizana, San Antonio; Maria López, Crystal City; Patricia López, Mission; Maria de Jesus Martínez, San Antonio; Yvonne McKinley, San Antonio; Thèrése Navarro, Abilene; Rebecca Root, Farmers Branch; Lindsay Ross, Dickinson; Dana Treviño, Weslaco.

Master of physical therapy – Tiffany Arredondo, Wichita Falls; Jennifer Bales, Deer Park; Rebecca Claycomb, Albuquerque, N.M.; Travis Couey, Dripping Springs; John DeLeon, Dallas; Sonia Flores, Mercedes; Tami Heimer, Pleasanton; Charity Hill, Nixon; Nia Jackson-Lewis, Round Rock; Karrie Johnson, Amarillo; Lauren Leeds, Spring; Norma Lugo, San Antonio; Tanya Moore, D’Hanis; Lisa Murphy, Fort Worth; Michelle Nalepa, Tulsa, Okla.; Pierre Navarrete, Montreal, Quebec, Canada; Jennifer Pehl, Kerrville; James Pittman, Corpus Christi; Christopher Rabágo, San Antonio; Claudia Ramos, San Antonio; Denise Saenz, Brownsville; Rebecca Sansom, Austin; Melissa Simon, Dallas; Denise Williams, Colorado Springs, Colo.

Bachelor of science in physician assistant studies – Gordon Adams, San Antonio; Carry Balthes, San Antonio; Wilson Cochrane, Liberty Hill; Jose Elizondo, San Diego, Texas; Alitza Ford, San Antonio; Kirk Gautier, Tyler; Jennifer Gomez, San Antonio; Vanessa Gomez, San Antonio; Iris Guerra, Rio Grande City; Teresa Hargrove, Tulsa, Okla.; Robert Lawson, San Antonio; Richard Marquez Jr., Marion; Anne Martinez, Austin; John Perez, Uvalde; Sheila Pinkson, San Antonio; Meredith Quinene, Killeen; Susan Ryan, San Antonio; Sharon Slubar, Del Rio; Judith Spanyers, San Antonio.

Certificate as entry-level respiratory therapist awarded by the National Board for Respiratory Care* – Cynthia Anderson, Plano; Arthur Carandang, Killeen; Charnette Darrington, Houston; Myra Garcia, Manila, Philippines; René Guerra Jr., San Antonio; Anna Hernandez-Sanchez, San Antonio; Natania Linton, San Antonio; Brenda Medina, Laredo; Denise Rodriguez, San Antonio; Ricky Smith, Laredo; Eduardo Vasquez, Brownsville; Jana Wallace, San Antonio.
*These students will be candidates for the degree bachelor of science in respiratory care, August 2004.

Bachelor of science in respiratory care – Lizzette Benavidez, Eagle Pass; Brandi Blackburn, La Vernia; Jennifer Boenisch, San Antonio; Claudia Cantu, Alamo; David Chapa, McAllen; Alan DeLeón, Mission; Anna Elizondo, Laredo; Yvette Fernandez, San Antonio; Shaka Ford, San Antonio; Leticia Gutierrez, Weslaco; Carolina Mendez, Laredo; Mando Morales, McAllen; Janna Rodriguez, Alice.

DENTAL SCHOOL

Doctor of dental surgery – Jeffrey Adcock, Reza Arzegar, Michael Bartlett, David Beltran, Val Bingham, Roger Brandon Jr., Amy Brewton, Jennifer Burcin, Hannah Burns, Vicente Canales, Damen Caraway, José Chow, Joshua Cooper, Joseph Creasy Jr., Camie Davis, DeAnna Dean, Chad Drennan, Susan Durgapersad, Joel Edwards, James Ewing, Donnese Fritsche, Scott Furrow, Angelica Garcia, Jennifer Garcia, Pierre Ghattas, Ryan Green, Leonello Grisanti II, Scott Gruwell, Jesus Guerra III, Harry Jackson,

Amy James, Vinita John, Jeffrey Johnston, Ryan Jouett, John Kacher, Travis Kern, Mandana Khani, Charles Larsen, Christopher Long, Marlena Lujan, Sheri McConnell, Michelle Mendoza, Shane Murphy, Debra Nakunz, Anne Newman, Jessica Page, Dan Pham, Risa Poortvliet, Brian Pratt, Kendra Pratt, Jaime Ramírez, Sylvia Ramírez, Jose Reyes, Cory Roach, Ryan Roberson, Susan Robinson, Cristina Rodriguez, Violetta Roller, Alberto Sanchez, Jacqueline Schutt, Lisa Sheldon, Agata Sheppard, James Sierra,

Lyndi Smart, Jaclyn Smith, Stacey Smith, April Sousa, Jason Stamboulieh, Sanda Stamboulieh, Brian Stancoven, Taylor Starr, Jay Thomas, Jess Tucker, Thomas van de Walle, Christopher van Kesteren, Ricardo Vásquez, Steven Vaughan, Deyanira Vela, Kiersten Week, Dallas Woolf, Marshall Wright.

SCHOOL OF NURSING

Doctor of philosophy (conferred at Graduate School of Biomedical Sciences commencement) – Janet Andersen, Toronto, Ontario, Canada; Laura Muñoz, San Antonio; Barbara Owens, Bloomington, Ind.

Master of science in nursing – Sylvia Allen, Del Rio; John Arbour, Oshawa, Ontario, Canada; Natalie Barganski, Corpus Christi; Kathleen Baumbach, San Antonio; Neil Beckstrom, Spokane, Wash.; Clyde Biggs, San Antonio; Dawn Bishop, Cibolo; Dean Blount, Uvalde; Ughanmwan Efeovbokhan, New Haven, Conn.; Paul Fanucchi, Bakersfield, Calif.; Michelle Faulkner, San Antonio; Amanda Flagg, Cirencester, Gloucestershire, U.K.; Modesta García-Atwater, Corpus Christi;

Margit Gerardi, San Antonio; Linda Hill, Midland; Kathryn Jordan, Art; Christiann Ledford, San Antonio; Joyce Littlefield, Floresville; Amy Mallory, San Antonio; Darla Martinelli, San Antonio; Lyndel Mead, Ingram; Sandra Mellor, Tulsa, Okla.; Yolanda Narváez-Edwards, San Antonio; Raynell Odom, Floresville; Wesley Richardson, Houston; Donna Schmidt, San Antonio; Alexandria Smoots, San Antonio; Maria del Consuelo Valle, San Benito.

Bachelor of science in nursing – Joseph Acord III, San Antonio; Kelle Adams, Boerne; Rosanne Aldana, San Antonio; Esteban Aguirre Jr., San Antonio; Sylvia Allen, Del Rio; Tracy-Lee Amoretti, San Antonio; Kelly Arana, El Paso; John Arbour, Oshawa Ontario, Canada; Yvette Arnold, San Antonio; John Arredondo, Uvalde; Melissa Arthur-Hancock, San Antonio; Michelle Baca, El Paso; Christy Bain, San Antonio; Michele Baumann, San Antonio; Kathleen Baumbach, San Antonio; Kristie Benavides, Kenedy; Frances Bietsch, San Antonio; Jennifer Billings, College Station; Heather Billingsley, San Antonio;

Dean Blount, Corvallis, Ore.; Rachel Blum, Fairfax, Va.; Tana Bonner, New Braunfels; Jennifer Boswell, Austin; Shelley Botello, San Antonio; Sarah Bowers, San Antonio; Debra Brannen, Houston; Stacey Breckons, San Antonio; Mark Brewer, El Paso; Jennifer Brooks-Gilliam, Richardson; Cynthia Brown, San Antonio; Mandi Brown, Beavertown, Pa.; Jessica Burden, San Antonio; Mary Burke, Pleasanton; Cynthia Burrage, San Antonio; Juan Bustamante, San Antonio; Kelly Campbell, San Antonio; Jennifer Campos, San Antonio; Zandra Cancino, San Antonio; Amanda Carlisle, Georgetown;

Jared Carter, Spanish Fork, Utah; Armenia Castellon, San Antonio; Amy Cauthen, Spring Branch; Griselda Cavazos, Houston; Deborah Centeno, San Antonio; Michelle Cervantes-Juarez, San Antonio; William Chappell, Colorado Springs, Colo.; Anita Chisnell, San Antonio; Gloria Collier, San Antonio; Connie Cone, Albany, Ga.; Elizabeth Covarrubias, El Paso; Patrick Dandaneau, Flint, Mich.; Rosalinda Daugherty (posthumously), Edgewater, Colo.; Amy Daylong, San Antonio; David DeAbreu, Maracaibo, Venezuela; Shelly DeCock, San Antonio; Martha Delgado, Laredo;

Felipe de los Santos, San Antonio; Liza del Villar, San Antonio; Kelly Denton, San Antonio; Joan DiGeorge, Del Rio; Sachiko Dismukes, Ishinomaki, Miyagi, Japan; Cheri Dolloff, West Covina, Calif.; Evelyn Drzymala, Stockdale; Cleveland Dunlap, Memphis, Tenn.; April B. Esquivel, San Antonio; Dora Estrada, San Antonio; Michelle A. Faulkner, San Antonio; Kimberly Ferguson, Peoria, Ill.; Noel Ferrer, Sugar Land; Gwendolyn Fewell, San Antonio; Angelica Finney, San Antonio; Angelo Fiore Sr., Chicago; Erica Flores, San Antonio; Charles Foulk, Potwin, Kan.;

Amber Galbreath, San Antonio; Amparo Garcia, Mathis; BreaAnn Garcia, San Antonio; Cecilia García, Laredo; Debra Garcia, San Antonio; Donna Garcia, San Antonio; Ellena Garcia, Atascosa; Jonell Garza, San Antonio; Melissa Garza, Rantoul, Ill.; Veronica Garza, San Antonio; Jennifer Geesee, San Marcos; Felicia Gillin, Ceres, Calif.; Alisha Glueck, San Antonio; Peter Goldbeck, San Antonio; Diana Gonzales, San Antonio; Tasha Gonzales, Camp Wood; Cynthia Gonzalez, San Antonio; Elsa Gonzalez, San Antonio; Jessica Gonzalez, Chicago; John Gorostiza, Brownsville; Stephanie Grewe, Ganado;

Veronica Grimes, Pontiac, Mich.; Julia Growney-Campos, San Antonio; Teri Grubbs, Fort Wayne, Ind.; Natalie Guerra, San Antonio; Aundrea Guess, Stevenson, Ala.; NaShawn Guillory, Lake Charles, La.; Shannon Gutierrez, San Antonio; Kara Haley, San Antonio; April Hall, La Vernia; Erika Hanson, Kyle; Lori Henze, New Braunfels; Elizabeth Hernandez-Cardona, Eagle Pass; Guillermo Hernandez, Goliad; Karlinda Hernandez, San Antonio; Rebecca Hernandez, Fredericksburg; Veronica Herrera, San Antonio; Vanessa Herschell, San Antonio; Jennifer Hinahon, Copperas Cove;

Barbara Hobbs, San Antonio; Seth Holloway, Bristol, Fla.; Tamara Houser, San Antonio; Christina Howard, Little Rock, Ark.; Holly Jamison, Mary D, Pa.; Stephen Jansky, Edna; Rebecca Jarvis, Quinlan; Joanna Jimenez, Manila City, Philippines Sonia Jimenez, San Antonio; Donnica Jones, Kansas City, Mo.; Rebecca Jones, Boerne; Kathryn Jordan, Art; Michelle Junsay, Guam; Katherine Kasch, San Antonio; Tuesday Kayongo, Detroit, Mich.; Cynthia Kelly, San Antonio; Sheri Kennick, San Antonio; Melinda Kiefat, West Columbia; Jamie King, Fredericksburg; Kimberlea King, San Antonio;

Kristin Kizer, Kingsbury; Kathleen Koepke, San Antonio; Wendi Konomos, Panama City, Fla.; Christy Kunzeman, Baylis, Ill.; Donna Lamoureux, Canada; Stephanie Land, Kerrville; Jennifer Lange, San Antonio; Sandra Lara, Refugio; Margaret Lawrence, San Antonio; Sara Lawson, Jourdanton; Amber Lea, Santa Fe; Melinda Ledesma, McAllen; Megan Lee, Bandera; Vickiros Legion, San Antonio; Melissa Limon, San Antonio; Michelle Lively, San Antonio; Marie Loera, San Antonio; Stephanie Loera, San Antonio; Mark Lofland, Key West, Fla.; Michelle Lopez, San Antonio;

Kimberly Lucas, San Antonio; Stacy Luera, Converse; Michelle MacMahon, Alice; Lucy Macnak, San Antonio; Rosalinda Maddox, San Antonio; Jessica Marlowe, Boise, Idaho; Gilbert Marquez Jr., San Antonio; Fonshay Martin, San Antonio; Darla Martinelli, San Antonio; Antonio Martinez, Laredo; Catalina Martinez, San Antonio; Célida Martínez, Premont; Marina Martinez, Devine; Rudy Martinez, San Antonio; Michelle Maxwell, Charleston, S.C.; Dana McCale, San Antonio; Shirley McComas, Las Vegas, Nev.;

Charmaine McKnight, Honolulu; Lyndel Mead, Ingram; Jennifer Meadows, Boulder, Colo.; Eva Morales-Edwards, Falfurrias; Christi Moreno, San Antonio; Lizaida Moreno, Pearsall; Pamela Moynihan, Lake City, Fla.; Chrissi Muñoz, San Antonio; Nancy Muñoz, San Antonio; Zita Navarrete, San Antonio; Alicia Newberry-Quiroz, New Braunfels; Marco Nicasio, South Gate, Calif.; Caroline Nims, Fort Worth; Corey O’Brien, San Antonio; Ericka O’Bryant, Griffin, Ga.; Mario Ochoa, San Antonio; María Oliú, Matagalpa, Nicaragua; Marina Olivares, San Antonio; Eugenia Orhii, San Antonio;

Sarah Orozco, San Antonio; Tammy Orta, San Antonio; Sheree Otis-Sullivan, San Antonio; Peggy Pais, Seguin; Wiley Paschal Jr., West Monroe, La.; Lisa Payne, San Antonio; Rebecca Peet, Oneonta, N.Y.; Erin Pehl, Fredericksburg; Mayela Peña, Brownsville; Velinda Perez, Manchaca; Bonnie Peyton, San Antonio; Phylavanh Phanhtharath, San Antonio; Jessíca Pícaso, San Antonio; Carlesa Pierre, Fort Pierce, Fla.; Cynthia Pizzini, San Antonio; Lyndsey Puga, Harlingen; Cheryl Rabe, San Antonio;

Sergio Ramos, El Paso; Michelle Ransdell, San Antonio; Cathy Rasco, San Antonio; Norma Razo, San Antonio; Jill Resendez, San Antonio; Deborah Reyes, Del Rio; Guadalupe Reyes, San Antonio; Johnnie Robbins, Copperas Cove; Miranda Rodriguez, Sinton; Sandra Romo, Laredo; Robin Rosas, San Antonio; Maria Roth, Laredo; Lorraine Rush, Del Rio; Susan Rutkowski, San Antonio; Edith Sanchez, Eagle Pass; Marissa Sanchez, San Antonio; Frederick Scantling Jr., Long Beach, Calif.;

Edee Schultz, San Antonio; Cheryl Scott, Hondo; Yvonne Sendejo, San Antonio; Dianna Sherrill, San Antonio; Elizabeth Sikon, Katy; Keith Simmons, Macon, Ga.; Kellie Skirvin, McKinney; Quentin Smith, Newton, Ala.; Samantha Stavinoha, San Antonio; Michelle Strong, San Antonio; Angela Tann, Colorado Springs, Colo.; Tonie Tenorio-Lytle, San Antonio; Natasha Thompson, Pflugerville; Linda Till, Austin; John Tindall, Schertz; Angelica Torres, Sinton; Iris Torres, Orange, Calif.; Amanda Triplett, Boerne;

Vanessa Valdez, San Antonio; Christel Vasquez, Brownsville; Priscilla Vidales, San Antonio; Nicole Vierus, Fredericksburg; Carol Villareal, Gonzales; Theresa Villarreal, San Antonio; Julie Wallace, Rockford, Ill.; Rebecca Westfall, Tulsa, Okla.; Isamari White, San Antonio; Adriana Williams, Pleasanton; Kristin Williams, San Antonio; Misty Willis, Corpus Christi; Jane Wilson, San Antonio; Lorna Wright, Edinburg; Shantell Wyss, San Antonio; Tiffany Young, San Antonio.

Work published in ‘Nature’ sheds light on key cell division process

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NatureMay27cover_BODY
The cover of the May 27 issue of “Nature.”

San Antonio (June 8, 2004) – There is important news from The University of Texas Health Science Center at San Antonio about a process that is crucial to cell division and therefore to all of human health.

Cells divide through instructions from our genetic code called DNA, which can be seen in our cells in X-shaped strands called chromosomes. We are endowed with 23 pairs of chromosomes.

When cells divide, the chromosomes first come together, physically pair and then separate. This process, called homologous recombination, ensures that each new cell receives the correct amount and type of DNA, thus preserving the genetic integrity of cells from one generation to the next. “Since pairing of chromosomes is critical to ensure their proper segregation, defects in homologous recombination can lead to birth defects and cancer,” said Wendy Bussen, a contributing author of an article in the May 27 issue of Nature. She is a fourth-year graduate student in the Health Science Center’s department of molecular medicine.

Bussen and Stefan Sigurdsson, Ph.D., a co-leading author and also of the Health Science Center, in collaboration with colleagues at Yale University, studied a protein called Dmc1 that stimulates homologous recombination. “How this protein functions has remained mysterious,” Bussen said. “Our findings have very important implications as to how cells maintain the integrity of the chromosomes.”

The group demonstrated the interaction of Dmc1 with another protein in the homologous recombination pathway, Rad54B. “Little is known about this latter protein, but it has been found to be mutated in some tumors from lymphoma and colon cancers,” Bussen said. “As our research continues, we hope to uncover how Dmc1 and other recombination proteins may work together to prevent cellular DNA damage, the consequences of which can lead to birth defects and cancers.”

Frequently asked questions about PSA and prostate cancer

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What is the prostate? The prostate is a gland that is a part of the reproductive organs and lies below the urinary bladder in men. It serves to produce fluids that are a component of the man’s ejaculate.

What is prostate cancer? Prostate cancer is a cancer that develops from the cells lining the duct structure of the prostate. Most cancers are called adenocarcinomas.

Who is at risk of prostate cancer? All men are at risk. About 17 percent of U.S. men will be diagnosed with prostate cancer during their lifetime, making about one man in six at risk. More than 200,000 men annually in the United States are diagnosed with prostate cancer and about 30,000 men each year die from this disease. Risk factors for developing prostate cancer include:

  • Age – prostate cancer is unusual before age 50 but increases in frequency with age.
  • Ethnicity/race – Black men have a higher risk for prostate cancer.
  • Family history – men with one or more close male relatives with prostate cancer have a higher risk of the disease. In general, the more relatives affected, the greater a man’s risk.

What are the symptoms of prostate cancer? In general, prostate cancer is silent. By the time symptoms develop, such as bone pain, urinary symptoms, blood in urine or weight loss, the prostate cancer has spread and cure is unlikely. While urinary symptoms (arising at night to urinate, slower stream) are common in aging men, these symptoms generally are not related to prostate cancer. Because prostate cancer develops without symptoms, early detection is necessary for cure of the disease.

How is prostate cancer diagnosed? Traditionally, two tests have been used to detect prostate cancer – digital rectal examination (DRE) and prostate-specific antigen (PSA). DRE involves the physician using the gloved finger to examine the prostate through the rectum. The physician is examining for bumps or irregularities in the prostate that can indicate the presence of cancer. The PSA test measures a protein that is made generally only by the prostate and that is increased in men with prostate cancer.

What is a prostate biopsy? If either the DRE or PSA is suspicious for prostate cancer, the physician may recommend a prostate biopsy. The biopsy is performed on an outpatient basis and generally involves use of an ultrasound unit to guide a biopsy needle. Several needle biopsies are obtained, removing tissue for analysis. A pathologist examines the tissue removed to determine if prostate cancer is present.

What is an abnormal PSA reading? Over the past two decades, many physicians have used a PSA level of 4.0 ng/ml (nanograms per milliliter) to separate men who may have prostate cancer from men with a low risk of prostate cancer. Men with a value over 4.0 ng/ml have often been offered a prostate biopsy to determine if prostate cancer is present. For men with a PSA between 4.0 and 10.0 ng/ml, it is frequently cited that the risk of cancer if a biopsy is performed is about 25 percent. (For values over 10.0 ng/ml, the risk increases further.) However, with some exceptions, many men with PSA levels less than 4.0 ng/ml have not been offered a prostate biopsy. While there have been some small groups of men with these ‘normal’ values of PSA who have had a biopsy, very few series have examined this group.

How does this report change what we know about PSA? The Prostate Cancer Prevention Trial, a study funded by the National Cancer Institute and coordinated by the Southwest Oncology Group, reported its conclusions in June 2003. The study enrolled 18,882 men, half receiving the drug finasteride (Proscar) and half receiving an inactive agent (a placebo). Over seven years, men had DRE and PSA testing. If either were abnormal, a prostate biopsy was recommended. At the end of seven years, to ensure that prostate cancer had not developed, all men, even those with a normal DRE and PSA, were recommended to have a prostate biopsy.

In the 2,950 men who had received placebo and who had never had an elevated PSA or abnormal DRE (and who met several other rigorous criteria for this analysis), prostate cancer was detected in 15 percent. The risk of prostate cancer in men with PSA in the ranges of < 0.5, 0.6 to 1.0, 1.1 to 2.0, 2.1 to 3.0, and 3.1 to 4.0 ng/ml was 6.6, 10.1, 17.0, 23.9 and 26.9 percent, respectively. While high-grade (aggressive) prostate cancer increased with higher levels of PSA, there was no level of PSA below which such aggressive cancer did not occur.

How can this information be used? First, it is important to recognize that PSA continues to be an important blood test for the detection of prostate cancer. The risk of both cancer itself and of aggressive disease increases with higher levels of PSA.

For a man with a normal PSA, it must be understood that prostate cancer may be present. For some, the prostate cancer will be of no consequence and could be followed until a PSA level increased. For some men, however, cure of aggressive prostate cancer may be best achieved by detecting the cancer while the PSA level is less than 4.0 ng/ml.

Individuals with a PSA less than 4.0 ng/ml who may consider undergoing a prostate biopsy could include (1) a man with a strong history of prostate cancer, including one or more relatives who developed the disease at a young age, (2) a black man. Both of these groups have a significantly higher risk of prostate cancer and are at risk of developing the disease at a younger age.

Because prostate cancer, even aggressive prostate cancer, can develop in men with no risk factors at all for the disease, a man with a normal level of PSA may want to examine the prostate cancer detection risk for his own level of PSA, using the results from this study. Different men will have different levels of risk that will lead them to select a prostate biopsy.

What is the future of prostate cancer detection?

Work is ongoing to examine improved methods of prostate cancer detection. The PSA test measures only one of more than 100,000 proteins in the blood, and there is evidence to suggest that other substances may help to find those men with prostate cancer. The University of Texas Health Science Center at San Antonio’s SABOR program, the San Antonio Center For Biomarkers Of Risk Of Prostate Cancer, is a member of the National Cancer Institute’s Early Detection Research Network and is working to identify a group of tests and risk factors.

A panel of genetic markers, dietary factors and other measures are being examined to determine if they can improve prostate cancer detection. The ultimate goal of this program is to identify not just the man with prostate cancer (because in some men, the cancer will never cause him problems in his lifetime), but to identify those men whose prostate cancers are destined to cause problems and to detect them sufficiently early to allow treatment for cure.

Who can participate in SABOR? Currently, more than 3,000 men from San Antonio and South Texas are enrolled in the study. Of these men, more than half are either Hispanic or black. This is a major feature of the SABOR study, as evidence suggests that risk factors and blood tests may work differently in men of different ethnic and racial backgrounds. While men over age 40 generally enter in the SABOR study, some men at younger ages have enrolled due to strong family history of prostate cancer or other factors that increase their risk.

What is involved in SABOR visits? Men who are interested in SABOR are given information to read and have an opportunity to ask questions about the study. Because this is a research study, an informed consent is required and the study is overseen by The University of Texas Health Science Center at San Antonio’s Institutional Review Board. At the first visit, in addition to a prostate examination and blood tests, questions are asked about family history of cancer and personal medical history, as well as any urinary symptoms. Men are asked to take home and complete questionnaires regarding their diet and use of dietary supplements. The next time SABOR participants cut their toenails, they are requested to send in the clippings, as these can help to examine dietary selenium, a possible prostate cancer preventive factor. On an annual basis, men in SABOR have a prostate examination and a blood test and are asked to update their medical and family history.

Complete information regarding SABOR can be obtained by calling (210) 567-0214 or (800) 335-4594. SABOR clinics are held in a number of locations around San Antonio, in Laredo and in McAllen.

Are there any other options other than early detection of prostate cancer? The results of the Prostate Cancer Prevention Trial demonstrated that a man who took finasteride, a drug that is used for enlarge of the prostate – both to treat urinary symptoms as well as to reduce the risk of progression of urinary symptoms – lowered his risk of prostate cancer by 25 percent. The side effects of finasteride include a risk of sexual problems and a possibility of development of a more aggressive prostate cancer. The additional benefit of this medication is the improvement in urinary function and reduction in long-term risk of urinary problems. A smaller dose of finasteride (1mg) is used to treat male pattern baldness.

 

‘Out of the 4.0 box thinking’ benefited South Texas patient

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San Antonio (May 27, 2004) – Like many Americans, Edgar Smith loathes the words “prostate cancer.” His father had it, he had it, and his two brothers had it. That’s why he strongly encourages men to have themselves checked and to understand their options.

“My youngest brother, Harry, passed away March 6 and he died very sadly,” Smith said. “He was in hospice care. I remember it was bad, and it was so sad. I have that picture in my mind. I told myself, this doesn’t have to happen with early detection.”

Early detection of prostate cancer includes a digital rectal exam (during which the physician feels for prostate abnormalities), the prostate-specific antigen or PSA test, and prostate biopsy. The PSA test measures the level of one protein in the blood. Physicians often consider that if a man has a PSA of 4.0 nanograms per milliliter (ng/ml) or lower, he does not need a prostate biopsy, during which tissue is taken from the prostate to be examined for cancer by a pathologist.

Smith said he benefited from “out of the 4.0 box thinking” on the part of his physician, Dr. Javier Hernandez, and his surgeon, Dr. Ian M. Thompson, professor and deputy chair of the department of surgery and chief of urology at The University of Texas Health Science Center at San Antonio. Smith had a 0.9 ng/ml reading for two years, but because of his family history Dr. Hernandez suggested a biopsy, which was positive for prostate cancer. “It looked like I was doing really well, but I wasn’t,” Smith said.

His cancer was of the aggressive variety but had not spread. Dr. Thompson performed a prostatectomy on Smith at University Hospital, the Health Science Center’s teaching hospital. “If I had not seen the docs, I would not be in as great a shape,” Smith said.

Smith, 69, is retired from the Texas Workforce Commission and lives in Floresville near San Antonio. He said he has already told his two sons about the importance of checkups for prostate cancer.

Study finds 15 percent of men with ‘normal’ PSA had prostate cancer

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ThompsonPC1_BODY
Ian M. Thompson Jr., M.D., professor of surgery and chief of urology at The University of Texas Health Science Center at San Antonio, discusses the results of the Prostate Cancer Prevention Trial with reporters. Dr. Thompson was interviewed by local and national media regarding the trial’s results, which were published in the May 27 issue of “The New England Journal of Medicine.”

San Antonio (June 8, 2004) – Some men who have received good marks on the prostate-specific antigen (PSA) test from their physicians may be getting a false sense of confidence about not having prostate cancer, according to a study released May 27 in The New England Journal of Medicine.

The results of the Prostate Cancer Prevention Trial (PCPT) were announced last June in Washington, D.C. Additional information gleaned from this study has enabled researchers to study the risk of prostate cancer in men who had what physicians consider “normal” PSA scores – under 4.0 nanograms per milliliter (ng/ml). Of 2,950 men who throughout the trial always had PSA scores below 4.0, a surprising 15 percent (449 men) had prostate cancer. Not only that, 67 of the men had high-grade cancers, the type of cancer that poses the greatest risk.

“There are many men who have been told that, based on their PSA score, they don’t have prostate cancer,” said lead author Ian M. Thompson Jr., M.D., professor of surgery and chief of urology at The University of Texas Health Science Center at San Antonio, one of the institutions that participated in the PCPT. “Based on this study, we now know they have a substantial risk of cancer and some can have high-grade disease. Waiting for a PSA level to go above 4.0 may be too late in some men.”

The number of U.S. men who have been told they have “normal” PSA readings is estimated at 25 million to 35 million, researchers said.

“There is no PSA value below which a man can be assured that he has no risk of prostate cancer,” wrote the authors, who include Leslie G. Ford, M.D., of the National Cancer Institute (NCI) and Charles A. Coltman Jr., M.D., chairman of the Southwest Oncology Group, one of the largest NCI-supported cancer clinical trials cooperative groups in the United States.

The results suggest that men as young as 40 with a strong family history of prostate cancer and a PSA level even lower than 2.0 should seek consultation with their physicians. “I am familiar with a family in which every man had prostate cancer in his 40s,” Dr. Thompson said at a briefing at the Cancer Therapy and Research Center, the clinical partner with the Health Science Center in the San Antonio Cancer Institute, an NCI Clinical Cancer Center.

“The bad prostate cancers in the men with normal PSA scores may be more numerous than all the prostate cancers we are currently detecting,” Dr. Thompson added. “It calls into question whether our definition of prostate cancer risk is correct.”

The new study reveals the need for a more specific test for prostate cancer, Dr. Thompson said. “Very clearly, we can’t tell for sure which prostate cancers are slow growing and which are aggressive and we need a screening test that doesn’t just find cancer – it finds only those cancers that will cause problems in an individual man. Certainly, a man who is at risk of prostate cancer should think about the use of finasteride, the agent we demonstrated last year that can reduce the risk of prostate cancer by 25 percent. If you don’t ever get prostate cancer, you don’t have to worry about whether it is aggressive or not. From a philosophical standpoint, what we need to do is a ‘Manhattan Project’ of prostate cancer, an intensive, large-scale study of men who are characterized by family history, medications, diet and genes, and follow them for 20 years. Then we would have a much clearer picture.”

Men should speak with their physicians about the possibility of a prostate biopsy, which can be done on an outpatient basis in the doctor’s office, Dr. Thompson said.

Dr. Coltman, in his role as director of the Southwest Oncology Group, served as principal investigator on the study and Dr. Thompson served as clinical coordinator. The Fred Hutchinson Cancer Research Center at The University of Washington, Seattle, provided statistical support. Other co-authors are from The University of Texas M.D. Anderson Cancer Center and The University of Colorado Health Sciences Center.