International travel for business or pleasure keeps growing at a fast pace, and a slowdown is not in the cards. The most serious problem the international traveler faces when he is on the move is the possibility of having a medical problem in a foreign country. International medical insurance goes a long way in softening the problem.

There are so many types of insurance, each with its range of small prints, that most people are better off taking assistance from reputed brokers or other professionals who are in the know. For a start, US insurance, like Medicare, should be checked about the extent of its coverage, or the possibility of buying additional coverage. The coverage of health and accident insurance must cover hospitalization, doctor bills and medications. The time frame needs to be restricted to the actual time of being out of the country. The shorter duration obviously will reduce the cost.

Evaluating a person who has met with an accident or taken ill in an isolated place can be terribly expensive. So ensure that emergency evacuation is fully covered in any insurance that you buy. Some insurance policies do not cover pre-existing illnesses, and they ask for a history of medical problems. Others do not accept hazardous vocations like mountain climbing or even skating. Many plans have a waiting period after the premium is paid. Ensure that the coverage is in place before leaving abroad. Keep the addresses and phone numbers of relevant persons who are to be notified to make a claim.

In case emergency medical treatment is needed, have all expenses listed in itemized bills to make a claim in the USA. The watchword in international medical insurance should be prudence and care to the smallest detail. If you find an insurance company with integrity, it will be possible to take the financial worry out of your travel.

Medical insurance is an agreement whereby the insure pays a monthly amount of money to the company, so that in the event of a need for medical treatment, the company pays the often-exorbitant bills. This is a way of making sure you stay healthy, no matter what. Medical insurance can be of immense importance to us. One pays premiums to a particular health insurance company so that when one needs monetary support for health care, the insurance company would pay for the person. The first step for an individual who is responsible for taking care of himself is to have a comparative evaluation of medical insurance quotes from a considerable number of medical insurance plan providers. This not only makes an individual aware of the different health and medical insurance plans that these companies have to offer, but helps the individual make informed decisions about the exact kind of medical insurance plans he or she wants to join.

Insurance quotes are available from various medical insurance companies throughout the United States. Medical insurance quotes are available in company offices and even on the Web. The rates for premiums payable to the medical insurance companies are determined by the companies and are regulated by every state. There are different types of medical insurance available depending on the situation and the purpose of the insurance. They are:

(a) Medical insurance for the individual

(b) Medical insurance for the family

(c) Medical insurance for a group of individuals

(d) International medical insurance

(e) Travel medical insurance

(f) Major medical insurance

One of the most important factors for anyone is taking care of one’s health and being financially capable to pay for medical care. Medical insurance is currently the best way to do this, but if you are planning to travel outside of the country your regular policy might not cover costs incurred in foreign countries. For this, you need international medical insurance.

International medical insurance can be bought on a temporary basis - for vacations, infrequent business trips, short visits with family in other countries, and so on. But it can also be bought on a more permanent basis, for those who travel often. Either way, you should be able to find some good health insurance to cover any mishaps, sudden outbreaks of disease, or continuing treatment for a recurring syndrome you might have. Be sure to shop around for the different rates and terms of service, and read the fine print.

Do not mistake international medical insurance companies with those of the non-government organizations (NGOs) who conduct social and charitable works throughout the nation and the world. International medical insurance agencies are for-profit businesses. Actually, international medical insurance groups have to abide by a complex patchwork of federal and state regulations. There are a number of different types of rules depending on the mode of operation of the international medical insurance groups in various parts of the United States, and these rules depend on the insurance coverage purchased directly by individuals or on behalf of a group, just as it is the case in employment-based medical insurance.

Results from a recent survey of European women with early breast cancer, presented for the first time at the European Society for Medical Oncology (ESMO) congress, show that the information needs of patients are not being met and that there is an unacceptably low level of patient involvement in potentially life-extending treatment decisions.  The survey revealed that older women, those with a low level of education and those without Internet access are particularly uninformed.

“Our survey shows that information provided to patients about adjuvant endocrine therapy is sub-optimal”, says GAEA steering committee member Yvonne Wengström, President of the European Oncology Nursing Society (EONS) from the Karolinska Institute, Stockholm, Sweden.  “Health professionals are a highly trusted source of information for patients yet the survey has shown that patients were not given comprehensive information about the rationale for treatment and the potential consequences of treatment.  Indeed many patients were not even told about the available treatment choices. The patients who took part in the survey told us that they want to have more information about treatment and especially side effects.”

The survey, part of The GAEA Initiative, involved 547 post-menopausal women with early breast cancer from nine European countries.  It was designed to find out women’s knowledge and understanding about adjuvant endocrine (hormone) therapy and their risk of recurrence, their involvement in treatment decision making and their information and support needs.  Adjuvant endocrine therapy is given after breast cancer surgery to reduce the risk of recurrence and is usually continued for at least five years.  There are different types of therapies available, each of which has a different risk-benefit profile for the patient. Patients need to know the purpose of adjuvant endocrine treatment and the different risk-benefit profiles of each therapy so that they can make an informed choice.

“As doctors we are clearly failing some patients by not involving them in the decision about starting adjuvant endocrine therapy and by not giving them the information they need to make these decisions”, says Dr Alberto Costa, Director of the European School of Oncology (ESO), Milan, Italy and GAEA steering committee member. “This is not effective medical practice.  On the basis of these findings, ESO will develop initiatives aimed at helping doctors hone their communication skills and become more effective in meeting patients’ needs.”

Only 22% of patients were fully or highly involved in the decision to start adjuvant endocrine therapy with the lowest levels of involvement found in women over the age of 60 years. Many of the women who took part in the survey were not satisfied with the degree to which they were involved in treatment decision making.

Not surprisingly, women who were the most actively involved in the decision to start hormone treatment were provided with more information on side effects and treatment duration compared to women who were not involved.  Actively involved patients also received more information on the benefits of taking long term adjuvant therapy and the risk of their breast cancer returning.

“We know from past experience that well informed and active patients get better treatment”, said Ingrid Kössler, President of Europa Donna - the European Breast Cancer Coalition.  “These results expose a clear knowledge divide among breast cancer patients. Better education begins with better communication, and we need to work harder to address this situation to meet the needs of older and less well-educated women.”

Reuters UK on Monday examined efforts by an HIV/AIDS advocacy group in India to help find partners for HIV-positive men and women who often are shunned by their families and communities. Thirty men and women living with the virus on Sunday in Surat, India, met at a session called “HIV+ Find a Life Partner,” which was hosted by the local HIV/AIDS advocacy group Network of Surat People Living with HIV+, Reuters UK reports. During the two-hour “matchmaking” event, the men and women “shared their experiences, discussed their families, medical histories and professions, with some even introducing their prospective partners to accompanying relatives, before agreeing [to] marry,” according to Reuters UK. Daksha Patel, an event organizer, said the goal was to help as many HIV-positive people as possible find compatible partners. “Let them find, choose and decide on a partner. It will add a new spark to the lonely lives and give them a new zest to start all over again,” Patel said. Patel, who also is HIV-positive, said many of the women who participated in Sunday’s event were widows or divorcees who contracted HIV from their husbands and were disowned by their relatives. According to Reuters UK, many HIV-positive people “face acute stigma” because of misconceptions and lack of education about the disease. HIV-positive people and HIV/AIDS advocates have been pushing for a law to prevent discrimination against people living with the virus but have said the Indian government is intentionally delaying action on the legislation (Jain Nair, Reuters UK, 10/2).

Health care spending on U.S. residents with private health insurance increased by 7.4% in 2005, in part because of increased spending on hospital and physician services, according to a study conducted by the Center for Studying Health System Change, the AP/Philadelphia Inquirer reports. In addition, the study finds that health care spending increased by 7.7% in the first quarter of 2006. The study also finds:

* Total spending on hospital services increased by 9% in 2005, compared with 8.5% in 2004;

* Spending on inpatient hospital services increased by 7.1% in 2005, compared with 5.3% in 2004, and spending on outpatient services by increased 10.4% in 2005, compared with 11.2% in 2005;

* Use of inpatient and outpatient hospital services increased by 4.5% in 2005, compared with 1.3% in 2004;

* Spending on physician services increased by 7.1% in 2005, compared with 6% in 2004, an indication of increased use of such services;

* Spending on home health care and ambulance services increased by 12% in 2005, compared with 6.3% in 2004; and

* Spending on prescription drugs increased by 4.9% in 2005, compared with 8.3% in 2004 and 18.4% in 1999.

According to HSC President Paul Ginsburg, the 7.4% rise in health care spending in 2005 marked the third consecutive year of increases of between 7% and 8%, a trend that could lead to larger increases in health insurance premium rates in the future (Agovino, AP/Philadelphia Inquirer, 10/3). Ginsburg said, “Health insurance will be less affordable to more and more people, especially low-to-moderate wage workers and their employers” in the event that the trend continues (Lopes, Washington Times, 10/3).

A chemically altered form of vitamin E mixed into mouse chow dramatically reduced spread of aggressive mammary cancer in mice, suggesting that the compound in pill form could be used to treat human metastatic cancer, according to a report in the October 1 issue of the journal Cancer Research.

The study, by investigators at the University of Arizona, is the first to show that the synthetic compound has potent anti-cancer properties when given in the simplest way possible - as a dietary supplement.

“We tried other ways of delivering different forms of the synthetic vitamin, such as by force feeding and injections, but found that one form, a-TEA, was more effective when incorporated into food, and that makes it much more clinically useful,” said the study’s lead investigator, Emmanuel T. Akporiaye, Ph.D., professor in the Department of Immunobiology at the University of Arizona.

Mice eating the super chow had a 4.8-fold reduction in the number of tumors that spread to the lungs, compared to control mice, Akporiaye said. An even greater effect was seen when the animals began eating a-TEA-laced food as a cancer preventive, he said.

“These preliminary studies are very promising, and it could be that combining this synthetic vitamin E derivative with other anti-cancer treatments may offer the potential of both treating and preventing human breast cancer,” Akporiaye said.

Although vitamin E (alpha tocopherol) is an anti-oxidant, it cannot destroy tumor cells by itself, he said. To improve the vitamin, derivatives have been created by swapping a hydroxyl chemical group with an acid. One is alpha-tocopheryl succinate (a-TOS), which used a succinic acid residue, and another is alpha-tocopheryloxyacetic acid (a-TEA), which used acetic acid.

Replacing the hydroxyl group in vitamin E helps force cancer cells to self destruct, Akporiaye said, because the compounds work to free up pro-apoptotic proteins that are normally held in check within cells. “Cell survival is maintained when pro-apoptotic proteins are confined, and these synthetic forms of vitamin E release them, pushing the cell into committing suicide,” he said.

“Only a little part of vitamin E is changed in these synthetic derivatives, but they show amazing anticancer properties, and they selectively target tumor cells,” Akporiaye said.

To make the synthetic vitamins water soluble (not fat soluble like natural vitamin E), researchers have added sodium hydroxide. In this way, these vesiculated forms, called Va-TOS and Va-TEA, can be delivered clinically through injection or oral gavage (feeding through a tube), and experiments have shown they can treat melanoma, lung and breast cancer in rodent models.

In this study, the Arizona researchers evaluated the anti-tumor effect of Va-TOS and Va-TEA on mice with an aggressive form of mammary cancer that is similar to human breast cancer that readily metastasizes. They also looked at how well a-TEA would affect tumor growth if incorporated into the food (”chow”) that the mice ate.

They found that injecting Va-TOS or Va-TEA into the peritoneal cavity of the mice reduced the average volumof tumors by two fold, compared to control mice that did not receive the injections. Administering Va-TOS daily through a feeding tube had the same effect on tumor size, but Va-TOS was ineffective when delivered in this way, Akporiaye said. “We found that Va-TOS wasn’t stable, and returned to its natural vitamin E state,” he said.

To gauge the effectiveness of a dietary treatment, the researchers had special rat chow manufactured that incorporated a fairly large quantity of a-TEA into the food. They then tested the chow as a cancer preventive and as a cancer treatment.

For the prevention study, the mice ate a-TEA chow starting on the same day that they were injected with rodent mammary tumor cells known to spread quickly to the lungs and bones. The mice were allowed to eat as much food as they wanted, and at the end of 29 days, the average tumor volume was reduced by 6.7-fold, compared to control mice who had not been fed a-TEA.

In the therapy experiment, mice started eating a-TEA chow 11 days after tumors were implanted, and in the experimental group, there was a 3.6-fold reduction in average tumor volume compared to control mice, Akporiaye said.

In both preventive and therapeutic studies, mice fed a-TEA chow had a 4.8-fold reduction in the number of tumors that had spread to the lungs, compared to control mice. “The results were very impressive,” he said. “The chow was very effective in slowing down the growth rate of the tumor and significantly reducing metastases.”

The a-TEA diet produced no visible adverse side effects, not even weight loss, Akporiaye said.

“The combined characteristics of ease of delivery, relevance of route of delivery and selectivity for killing tumor cells suggest that dietary a-TEA may be useful for treating metastatic breast cancer,” he said.

The researchers are now testing the effect of reduced doses of a-TEA in the chow and plan to test the synthetic vitamin in combination with dendritic cell immunotherapy. “When you kill tumor cells, they release antigens that can be picked up by specialized cells that stimulate the immune system,, and this two-step process could provide a longer lasting outcome,” Akporiaye said.