Q: I'm taking an SSRI for depression and am trying to get pregnant. I hear that taking the medication may cause my baby to be autistic. I am worried about going off the medication; I really need it. But I also really want to have a child. What should I do? - Genevieve L., Toronto
A: We're glad you asked! We believe you're referring to the Canadian study that reported a significant increase in the likelihood that you'll have an autistic child if you take an antidepressant while pregnant. Truth is, the increased risk goes from around 1 percent of births to around 2 percent (the study gives a hazard ratio of 2.17), meaning 98 percent of women who take SSRIs (selective serotonin reuptake inhibitors) while pregnant will not have an autistic child. That's not zero, but, as our friend Sanjay Gupta asks in The Gupta Guide, "Is the association causal or casual?" Other important points about the study:
1. There was no increased risk for autism associated with taking an SSRI the year before becoming pregnant or during the first trimester.
2. A 2013 study in the New England Journal of Medicine did not detect a significant association between taking SSRIs while pregnant and autism in offspring.
3. The study's authors used data from SSRI prescriptions filled, not actual use; they didn't have any data on moms' lifestyle choices, including smoking and body mass index.
Given this information, you and your doctor must discuss the pros and cons of going off or staying on your antidepressant; then you can make an informed decision. Tip: There's an indication that taking a prenatal multivitamin with DHA for three months prior to conception (have your significant other take them too), helps reduce the risk of autism in your offspring.
Q: I couldn't believe that Jimmy Carter was cured of cancer by new drugs! What are the details, and how long will it be before we can cure all cancers? - Jordan P., Indianapolis
A: Hold the phone, and "whoa, Nelly"! Here's what's true and what many news stories got wrong.
True: President Jimmy Carter was diagnosed with metastatic melanoma. He took advantage of the latest medical breakthroughs to get the most effective treatment available (and it's available to anyone who sees a specialist).
True: He underwent surgery (liver), radiation therapy (brain) and treatment with a newly approved immunotherapy drug, Keytruda. Keytruda is part of a new class of drugs that unmasks the cloaking power of some cancer cells so they can be destroyed by your immune system. Wow!
True: The latest surgical techniques and targeted radiation therapies also are amazingly effective. Given the type of metastasis in President Carter's brain and the highly specialized stereotactic radiation treatment he received, it was not so surprising that the radiation took care of his brain lesions.
True: President Carter recently told family and friends, "My most recent MRI brain scan did not reveal any signs of the original cancer spots, nor any new ones."
False: The claim that President Carter was "cured"; that's not an accurate statement. He is in remission. There are no detectable cancer cells, but that does not mean there are none in his body or that the cancer cannot re-emerge.
Unfortunately, medical reporting often sensationalizes the news, and facts go into remission. Then folks become disappointed when the reality of the situation is revealed later on. Don't think that the treatments didn't work for Carter if his symptoms reoccur, or that immunotherapy is anything less than remarkable.
And here's some medical news that should have created a sensation: Researchers in Texas found that more than 30 percent of advanced cancer patients rated financial distress more severe than their physical, family and emotional distress. That's another reality we should be talking about. Dr. Mike and the financial journalist Jean Chatzky are writing a book about actions you can take to avoid those issues, so stay tuned.
Distributed by King Features Syndicate, Inc.
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