Background/Objectives: The associations of statins and testosterone replacement therapy (TTh) with the risk of obesity-related cancers (ORC, breast [BrCa], colorectal [CRC], ovarian, and endometrial cancers) in older women remain poorly understood. This study examined the associations between the use of statins and TTh with risk of ORC and its cancer-specific sites in women aged 65 years and older. Methods: A retrospective cohort study was conducted using 2007–2015 SEER-Medicare data, including 142,772 women aged ≥ 65 years. We identified 52,086 women with incident ORC (BrCa [n = 32,707], CRC [n = 11,070], ovarian [n = 2601], and endometrial [n = 5708] cancers). The primary exposures were use of statins and TTh. Weighted multivariable time-dependent Cox proportional hazards and models were conducted to estimate hazard ratios (HRs) of incident ORC. Results: We found an inverse association of statins with incident [HR, 0.76; 95% CI: 0.74, 0.78], high-grade [HR, 0.75; 95% CI: 0.72, 0.78], and advanced-stage [HR, 0.91; 95% CI: 0.88, 0.95] ORC. Concurrent use of statins and TTh was associated with a reduced incidence of ORC and high-grade ORC. Similar associations were observed with BrCa. Statins were inversely associated with high-grade ovarian cancer and endometrial cancer (incident, high-grade, and advanced-stage). Conclusions: Use of statins was inversely associated with ORC, BrCa, and endometrial cancer (high-grade and advanced-stage) and high-grade ovarian cancer in older women. Concurrent use of statins and TTh was inversely associated with ORC and BrCa and their high-grade disease. Future prospective studies are needed to substantiate these findings, especially with a focus to examine time– and dose–response associations and to identify underlying biological mechanisms through which statins and TTh influence incidence of ORC.

Background: Clips placed after core needle biopsy are often several millimeters to centimeters from the biopsy cavity. Radiofrequency and radar (R) localization involve a second localization procedure based on the prior clip placement, potentially compounding the distance from the area localized to the original biopsy site. Fluoroscopic intraoperative neoplasm detection (FIND) obviates the need for a second localization by using intraoperative fluoroscopy to localize the original biopsy clip. We hypothesized that intraoperative localization using FIND is feasible and may result in fewer positive margins. Methods: A retrospective review was performed of patients with non-palpable malignancy who underwent partial mastectomy from Sept 2016 to August 2023. Results were compared between patients who underwent R localization vs. FIND. The Pythagorean theorem was used to calculate the distance in space between the biopsy clip and the R localization device. Chi-square was used to calculate the two-tailed p-value. Results We identified 219 patients: 161 localized with FIND and 55 with R. Three percent (6 out of 161) of the patients with FIND and 12% (7 out of 55) of the patients with R had positive margins (p= value 0.01). The average distance between the R device and biopsy clip in patients with positive margins was 19.1 mm, and with negative margins, it was 12.45 mm (p=0.09). Conclusions The positive margin rate with R localization was significantly greater than with FIND. The positive margin rate trended toward increased distance from the localization device to the biopsy clip. Eliminating the second localization decreases painful procedures for the patient and may result in improved tumor-free margins.

Importance: Understanding trends in the use of hormonal therapy (HT) for prostate cancer (PCa) is crucial to optimize treatment strategies, particularly for older men with locally advanced and metastatic disease. Objective: To evaluate changes in the patterns of adjuvant and primary HT use over time in older U.S. men diagnosed with locally advanced and metastatic prostate cancer. Design, Setting, and Participants: This cohort study utilized SEER-Medicare data, which covers approximately 48% of the U.S. population and links cancer registry data with Medicare claims, including 149,515 men aged ≥66 years diagnosed with PCa between 2010 and 2019. We analyzed trends in the use of adjuvant HT for higher-risk and primary HT for lower-risk PCa. Multivariable logistic regression models were used to adjust for clinical and demographic factors. Main Outcomes and Measures: The primary outcome was the proportion of men receiving any form of HT within 6 months of PCa diagnosis. HT included injectable Gonadotropin-releasing hormone (GnRH) agonists and antagonists, orchiectomy, and anti-androgens agents. Results: The rate of adjuvant HT in higher-risk PCa patients increased significantly from 53.6% in 2010 to 68.1% in 2019 (p < 0.0001), with a steady rise in the last four years. In contrast, the rate of men with lower-risk disease receiving primary HT declined from 25% in 2010 to 16.9% in 2013, then peaked at 28.2% in 2015, and stabilized between 25% and 27.3% from 2017 to 2019. The overall HT usage increased from 33.5% in 2010 to 45.2% in 2019, showing a consistent increase over the years. These patterns persisted after adjusting for clinical and demographic factors. Conclusions and Relevance: The increasing use of adjuvant HT in higher-risk PCa patients aligns with evolving treatment guidelines, while the stable rate of primary HT in lower-risk patients represents persistent inappropriate use and highlights the need for further efforts to optimize treatment choices. While previous studies focused on men with intermediate-risk PCa receiving radiation therapy, our study broadens the scope to include men who did not undergo radiation therapy, providing a more inclusive view of HT trends. Future research should focus on refining strategies to reduce inappropriate primary HT use and improve adjuvant HT administration.

This study tests the utilization of Bluetooth noise-canceling headphones in improving the quality of eye exams in patients with hearing loss. University of Texas Medical Branch patients above 55 years of age were screened for hearing loss using SoundCheck audiometry. All 29 subjects (18 red-zone and 11 yellow-zone) answered pre-recorded Amsler grid and patient education questions that solicited precise responses. As controls, subjects were randomly administered half of the questions via headphones and half via a smartphone at normal speech volume (60 decibels). Points were awarded for responses demonstrating comprehension, and a post-exam survey was collected. Collectively, the mean score was 1.79 with headphones versus 0.96 with control on the Amsler grid segment and 1.90 with headphones versus 0.97 with control on education questions (p=0.001). Between the red and yellow zone hearing loss patients, the red-zone group answered significantly better in both Amsler (1.78 versus 0.50; p=0.0003) and education questions (1.88 versus 0.44; p<0.0001) with headphones. The yellow zone group answered better with headphones overall but failed to reach significance. Post-exam survey indicated that 28 of 29 patients (97%) preferred the headphones during ophthalmic exams. Patients with severe hearing loss demonstrated better comprehension with the noise-canceling headphones; thus these devices show great promise in improving effective, compassionate communication between providers and hearing-loss patients.