Study: Fish in drug-tainted water suffer reaction


BOSTON (AP) — What happens to fish that swim in waters tainted by traces of drugs that people take? When it's an anti-anxiety drug, they become hyper, anti-social and aggressive, a study found. They even get the munchies.


It may sound funny, but it could threaten the fish population and upset the delicate dynamics of the marine environment, scientists say.


The findings, published online Thursday in the journal Science, add to the mounting evidence that minuscule amounts of medicines in rivers and streams can alter the biology and behavior of fish and other marine animals.


"I think people are starting to understand that pharmaceuticals are environmental contaminants," said Dana Kolpin, a researcher for the U.S. Geological Survey who is familiar with the study.


Calling their results alarming, the Swedish researchers who did the study suspect the little drugged fish could become easier targets for bigger fish because they are more likely to venture alone into unfamiliar places.


"We know that in a predator-prey relation, increased boldness and activity combined with decreased sociality ... means you're going to be somebody's lunch quite soon," said Gregory Moller, a toxicologist at the University of Idaho and Washington State University. "It removes the natural balance."


Researchers around the world have been taking a close look at the effects of pharmaceuticals in extremely low concentrations, measured in parts per billion. Such drugs have turned up in waterways in Europe, the U.S. and elsewhere over the past decade.


They come mostly from humans and farm animals; the drugs pass through their bodies in unmetabolized form. These drug traces are then piped to water treatment plants, which are not designed to remove them from the cleaned water that flows back into streams and rivers.


The Associated Press first reported in 2008 that the drinking water of at least 51 million Americans carries low concentrations of many common drugs. The findings were based on questionnaires sent to water utilities, which reported the presence of antibiotics, sedatives, sex hormones and other drugs.


The news reports led to congressional hearings and legislation, more water testing and more public disclosure. To this day, though, there are no mandatory U.S. limits on pharmaceuticals in waterways.


The research team at Sweden's Umea University used minute concentrations of 2 parts per billion of the anti-anxiety drug oxazepam, similar to concentrations found in real waters. The drug belongs to a widely used class of medicines known as benzodiazepines that includes Valium and Librium.


The team put young wild European perch into an aquarium, exposed them to these highly diluted drugs and then carefully measured feeding, schooling, movement and hiding behavior. They found that drug-exposed fish moved more, fed more aggressively, hid less and tended to school less than unexposed fish. On average, the drugged fish were more than twice as active as the others, researcher Micael Jonsson said. The effects were more pronounced at higher drug concentrations.


"Our first thought is, this is like a person diagnosed with ADHD," said Jonsson, referring to attention deficit-hyperactivity disorder. "They become asocial and more active than they should be."


Tomas Brodin, another member of the research team, called the drug's environmental impact a global problem. "We find these concentrations or close to them all over the world, and it's quite possible or even probable that these behavioral effects are taking place as we speak," he said Thursday in Boston at the annual meeting of the American Association for the Advancement of Science.


Most previous research on trace drugs and marine life has focused on biological changes, such as male fish that take on female characteristics. However, a 2009 study found that tiny concentrations of antidepressants made fathead minnows more vulnerable to predators.


It is not clear exactly how long-term drug exposure, beyond the seven days in this study, would affect real fish in real rivers and streams. The Swedish researchers argue that the drug-induced changes could jeopardize populations of this sport and commercial fish, which lives in both fresh and brackish water.


Water toxins specialist Anne McElroy of Stony Brook University in New York agreed: "These lower chronic exposures that may alter things like animals' mating behavior or its ability to catch food or its ability to avoid being eaten — over time, that could really affect a population."


Another possibility, the researchers said, is that more aggressive feeding by the perch on zooplankton could reduce the numbers of these tiny creatures. Since zooplankton feed on algae, a drop in their numbers could allow algae to grow unchecked. That, in turn, could choke other marine life.


The Swedish team said it is highly unlikely people would be harmed by eating such drug-exposed fish. Jonsson said a person would have to eat 4 tons of perch to consume the equivalent of a single pill.


Researchers said more work is needed to develop better ways of removing drugs from water at treatment plants. They also said unused drugs should be brought to take-back programs where they exist, instead of being flushed down the toilet. And they called on pharmaceutical companies to work on "greener" drugs that degrade more easily.


Sandoz, one of three companies approved to sell oxazepam in the U.S., "shares society's desire to protect the environment and takes steps to minimize the environmental impact of its products over their life cycle," spokeswoman Julie Masow said in an emailed statement. She provided no details.


___


Online:


Overview of the drug: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682050.html


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U.S. can proceed with plans to close Oakland pot shop, court says









SAN FRANCISCO — A U.S. magistrate judge on Thursday sided with federal prosecutors in dismissing a lawsuit by the city of Oakland that challenged as illegal federal attempts to shutter the nation's largest medical marijuana dispensary.


In filing the suit last October, Oakland became the first city to take on federal enforcement actions that have led to the closure of hundreds of dispensaries in recent years.


Attorney Cedric Chao, representing Oakland, had argued that the city has broad interests in ensuring Harborside Health Center remains open, as its closure would compel many of the dispensary's 108,000 patients to turn to the illegal market, triggering a public health and safety crisis.








But U.S. Magistrate Judge Maria-Elena James ruled in San Francisco that there was no appropriate legal avenue for Oakland's intervention.


Federal attorneys had moved to dismiss the suit against U.S. Atty. Gen. Eric Holder and Melinda Haag, U.S. attorney for the Northern District of California, on the grounds that any party seeking to weigh in on an asset forfeiture must do so within a specified period of time, which had elapsed.


Chao had countered that since Oakland has no direct interest in the Harborside property, the city instead sought to litigate its concerns under the Administrative Procedure Act, which governs the way federal agencies propose and establish regulations.


But James concluded that Oakland had not met the required legal hurdles to sue under that act. 


Oakland City Atty. Barbara Parker said officials were going to consider all of their options, including an appeal, which would require City Council approval


"We're disappointed," she said Thursday, "but we have strong convictions about the harm Oakland will suffer and is already beginning to suffer as a result of the forfeiture actions."


Those actions, which target Harborside's landlords in Oakland and San Jose, are proceeding. Harborside has weighed in and will make the same argument that Oakland asserted in its suit — that federal prosecutors knew of cannabis sales at the dispensaries for years and missed the statute of limitations to seek forfeiture.


Steve DeAngelo, executive director of Harborside, said in a statement that he was disappointed in Thursday's ruling, but "the message of Oakland's lawsuit remains powerful and relevant: The city council and mayor have determined that if Harborside Health Center is closed, the entire city will be harmed."


Federal prosecutors declined to comment on James' ruling.


Meanwhile Thursday, more than a dozen members of Congress co-introduced legislation pertaining to medical marijuana.  U.S. Rep. Earl Blumenauer (D-Ore.) wrote the "States' Medical Marijuana Patient Protection Act," which, in addition to allowing marijuana for medical use, would allow states to establish production and distribution laws without interference from the federal government, and would also remove current obstacles to research.


U.S. Rep. Sam Farr (D-Carmel), wrote the "Truth in Trials Act," a separate bill that would overturn the prohibition on medical marijuana evidence in federal court, allowing defendants who were complying with state and local laws to introduce such evidence in their own defense.


The bills come in advance of a national medical marijuana conference organized by Americans for Safe Access to be held next week in Washington, D.C.


lee.romney@latimes.com





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Woman Found Fatally Shot at Home of Pistorius


Emilio Morenatti/Associated Press


Oscar Pistorius, the South African Olympic and Paralympic track star, in September.







JOHANNESBURG — Paralympic champion Oscar Pistorius was taken into police custody early Thursday morning after he shot and killed a woman in his home in Pretoria, according to South African police officials.




Mr. Pistorius, 26, won two gold medals and a silver at last year’s Paralympic Games in London. He was the first double amputee to run in the Olympics and reached the 400-meter semi-final in 2012 in London. Known by the nickname Blade Runner, he races using carbon fiber prosthetic blades.


Early Thursday morning, the police responded to a report of gunshots in the upscale housing complex where Mr. Pistorius lives, said Col. Katlego Mogale, a police spokeswoman. When they arrived, they found paramedics treating a 30-year-old woman for gunshot wounds. The woman was pronounced dead and a 26-year-old man was taken into custody, Colonel Mogale said. She declined to identify the man as Mr. Pistorius, but another police official confirmed that it was the runner.


Colonel Mogale said that the case is being investigated as a murder and that the suspect is expected to appear in court later Thursday. She would not comment on a possible motive for the shooting.


“A case of murder has been opened,” Colonel Mogale said. “Currently the investigators and the forensic people are on the scene.”


Reports from local media said that Mr. Pistorius told the police that the shooting was an accident and that he had mistaken the woman, who was said to be his girlfriend, for an intruder.


South Africa has one of the world’s highest rates of violent crime, and break-ins by armed robbers are relatively common. Legal handgun ownership is also common, with some restrictions.


Adele Kirsten of Gun-Free SA, an anti-gun violence organization, said that whatever the motive, the shooting was an avoidable tragedy.


“The idea that you have a gun to protect your family against intruders, the data doesn’t bear that out,” Ms. Kirsten said. “What it tells us is that having a gun in your home puts you and your family at risk of being shot.”


In the Paralympics last September, Mr. Pistorius won individual gold, when he successfully defended his Paralympic 400 meter title. He had lost his 100- and 200-meter titles, but was part of the gold medal-winning 4x100 meter relay team. He same second in the 200 meter race.


After that contest, Mr. Pistorius damaged his reputation among his followers by criticizing the winner, Alan Oliveira of Brazil, raising questions about the length of the winner’s blades. Mr. Pistorius later apologized and praised the gold medalist in the 100 meter race, Jonnie Peacock of Britain.


Mr. Pistorius, who was born without fibulas, had both legs amputated below the knee before his first birthday and he battled for many years to compete against able-bodied athletes. In 2008, he qualified for the Beijing Games but was ruled ineligible by track’s world governing body because his blades were deemed to give him a competitive advantage.


South African journalists said Mr. Pistorius lived in an upscale, walled complex near the South Africa capital of Pretoria and that his girlfriend was a fashion model. A reporter outside the complex on Thursday said it was protected by high walls and razor wire.


Lydia Polgreen reported from Johannesburg, and Alan Cowell from Paris.



This article has been revised to reflect the following correction:

Correction: February 14, 2013

An earlier version of this article referred incorrectly in one reference to the sprinter at whose home a woman was fatally shot. He is Oscar Pistorius, not Pretorius.



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Lady Gaga Cancels Born This Way Ball Tour Due to Severe Injury















02/13/2013 at 08:50 PM EST



It's a somber week for Lady Gaga – and her Little Monsters.

Following Tuesday's Facebook announcement that she was "devastated and sad" because she couldn't walk and had to postpone several Born This Way Ball concerts, the pop star, 26, has officially canceled the remaining dates of her world tour.

"After additional tests this morning to review the severity of the issue, it has been determined that Lady Gaga has a labral tear of the right hip," the singer's rep told PEOPLE Wednesday in a statement. "She will need surgery to repair the problem, followed by strict down time to recover. This unfortunately, will force her to cancel the tour, so she can heal."

Refunds for the cancelled performances will be available at point of purchase starting on Thursday.

"I hope you can forgive me, as it is nearly impossible for me to forgive myself," she wrote the previous day of postponing the dates. "I hate this. I hate this so much. I love you and I'm sorry."

Get well, Gaga!

Reporting by CHUCK ARNOLD

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Morning-after pill use up to 1 in 9 younger women


NEW YORK (AP) — About 1 in 9 younger women have used the morning-after pill after sex, according to the first government report to focus on emergency contraception since its approval 15 years ago.


The results come from a survey of females ages 15 to 44. Eleven percent of those who'd had sex reported using a morning-after pill. That's up from 4 percent in 2002, only a few years after the pills went on the market and adults still needed a prescription.


The increased popularity is probably because it is easier to get now and because of media coverage of controversial efforts to lift the age limit for over-the-counter sales, experts said. A prescription is still required for those younger than 17 so it is still sold from behind pharmacy counters.


In the study, half the women who used the pills said they did it because they'd had unprotected sex. Most of the rest cited a broken condom or worries that the birth control method they used had failed.


White women and more educated women use it the most, the research showed. That's not surprising, said James Trussell, a Princeton University researcher who's studied the subject.


"I don't think you can go to college in the United States and not know about emergency contraception," said Trussell, who has promoted its use and started a hot line.


One Pennsylvania college even has a vending machine dispensing the pills.


The morning-after pill is basically a high-dose version of birth control pills. It prevents ovulation and needs to be taken within a few days after sex. The morning-after pill is different from the so-called abortion pill, which is designed to terminate a pregnancy.


At least five versions of the morning-after pills are sold in the United States. They cost around $35 to $60 a dose at a pharmacy, depending on the brand.


Since it is sold over-the-counter, insurers generally only pay for it with a doctor's prescription. The new Affordable Care Act promises to cover morning-after pills, meaning no co-pays, but again only with a prescription.


The results of the study were released Thursday by the Centers for Disease Control and Prevention. It's based on in-person interviews of more than 12,000 women in 2006 through 2010. It was the agency's first in-depth report on that issue, said Kimberly Daniels, the study's lead author.


The study also found:


—Among different age groups, women in their early 20s were more likely to have taken a morning-after pill. About 1 in 4 did.


—About 1 in 5 never-married women had taken a morning-after pill, compared to just 1 in 20 married women.


—Of the women who used the pill, 59 percent said they had done it only once, 24 percent said twice, and 17 percent said three or more times.


A woman who uses emergency contraception multiple times "needs to be thinking about a more regular form" of birth control, noted Lawrence Finer, director of domestic research for the Guttmacher Institute, a nonprofit group that does research on reproductive health.


Also on Thursday, the CDC released a report on overall contraception use. Among its many findings, 99 percent of women who've had sex used some sort of birth control. That includes 82 percent who used birth control pills and 93 percent whose partner had used a condom.


___


Online:


CDC report: http://www.cdc.gov/nchs/


Emergency contraception info: http://ec.princeton.edu/index.html


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Couple recounts harrowing Dorner ordeal









Fugitive former police officer Christopher Jordan Dorner was apparently holed up inside a Big Bear area condo for as many as five days before the husband and wife who own the property surprised him and then were tied up and gagged, the couple said Wednesday night.


Dorner bound the husband's and wife's hands with plastic zip ties, stuffed small towels in their mouths so they couldn't scream and covered their heads with pillowcases that he tied with electrical cords, they said.


"I really thought it could be the end," Karen Reynolds, 56, told reporters gathered outside her condominium.





She and husband Jim Reynolds, 66, provided new details on some of Dorner's movements in the apparent final hours of his life. He is believed to have died Tuesday in a cabin fire after a mountainside gun battle with officers.


Law enforcement authorities previously said Dorner had held two cleaning women hostage. The Reynoldses spoke to reporters to end the confusion.


The couple said Dorner had been at the condo in the 1200 block of Club View Drive since as early as Friday, when they arrived to do maintenance in the yard. He told them he watched them — and even said they were "hardworking, good people." The couple slept at another property nearby.


When they entered the condo about noon Tuesday, the couple said, they were surprised to find the fired Los Angeles police officer inside the home, which is near the command post where authorities provided media briefings. They said they were held captive for about 15 minutes by Dorner, whom they recognized immediately.


The Reynoldses stumbled on the suspected killer when they went upstairs. Once they saw him, they said, he brandished a "big gun" and yelled, "Stay calm!"


Karen Reynolds said she tried to run down the stairs, but Dorner chased after her and caught her. He then took the couple to a bedroom, where he tied them up.


Dorner was a menacing presence but at other times tried to reassure the couple that he did not want to harm them, they said.


"He tried to calm us down, saying very frequently, he would not kill us," said Jim Reynolds, who has owned the condo with his wife for 12 years. "He huddled down beside me and said, 'You're going to be quiet right? Not make a fuss and let me get away?' "


Dorner identified himself as the man wanted by law enforcement authorities. "I know you know who I am, I know you've been seeing the news," Karen Reynolds recalled him saying.


Karen Reynolds said Dorner left the condo and stole their purple Nissan. About two minutes after they heard the car leave, Karen Reynolds propped herself up and shuffled to her cellphone. She grabbed it with her bound hands and called 911, using the speaker function.


"Dorner tied us up and he's in Big Bear," she recalled telling the dispatcher.


The couple, who have been married for 36 years, said they were "happy to be alive." They said they had mixed feelings about Dorner, whom they described as calm, alert and methodical. Karen Reynolds said she wasn't expecting to see any of the $1-million-plus reward money offered in the Dorner case. "We heard nobody was getting that because he needed to be captured and convicted," she said.


They said they found evidence that someone had been staying in the cabin, including a gallon of milk in the fridge, but that they didn't know if a previous tenant had left it behind. The last guests were there on Jan. 29.


All of the units are equipped with cable television and Internet. There was no sign of a forced entry.


It was Karen Reynolds' 12:20 p.m. 911 call that set in motion the chain of events that led to a shootout between Dorner and a state Fish and Wildlife warden, then to the standoff at another cabin where he is believed to have exchanged hundreds of rounds in the gun battle with officers before dying.


As the couple described their harrowing ordeal, they recalled that Dorner was insistent about what he wanted to do.


"I don't have a problem with you," he told them. "I just want to clear my name."


adolfo.flores@latimes.com


robert.lopez@latimes.com


Flores reported from Big Bear, Lopez from Los Angeles. Times staff writers Andrew Blankstein and Rong-Gong Lin II contributed to this report.





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Pope to Make First Public Appearance Since Decision to Resign





VATICAN CITY — As Christians embarked on the 40-day period of Lent preceding Easter, Pope Benedict XVI made his first public appearance on Wednesday since the stunning announcement of his resignation two days ago, holding a general audience at the Vatican before a mass at St. Peter’s described by officials as likely to be his final celebration of a major mass in the huge basilica before his retirement on Feb. 28.




Loud cheers greeted the pope as he entered the Vatican’s audience hall which has a capacity of around 8,000 people.


The day — Ash Wednesday at the beginning of one of the most important periods in the Christian religious calendar — offered the pope’s followers a chance to see and hear him before he withdraws into a far more sheltered life in a convent within the Vatican walls where an apartment has been prepared for him.


Still unclear, however, are some of the practical consequences of Benedict’s decision, Vatican officials acknowledged Tuesday, from how the former pope will be addressed, to what to do with the papal ring used to seal important documents, traditionally destroyed upon a pope’s death.


“There are a series of questions that remain to be seen, also on the part of the pope himself, even if it is a decision that he had made some time ago,” the Rev. Federico Lombardi, the Vatican spokesman, said at a news conference. “How he will live afterward, which will be very different from how he lives now, will require time and tranquillity and reflection and a moment of adaptation to a new situation.”


Thousands of Catholics gathered for a glimpse of Benedict, including Francesca Meggiorini, from Verona, who had brought her four children with her because, she said, “this is special. I wanted my kids to be present. The pope was a man whose simple words went straight to the heart. So it’s wonderful for my children to be here. I think this experience will remain in their memory.”


Kevin Murphy, on a pilgrimage from Saint Benedict School in Bury St. Edmunds in eastern England, called Benedict “a great moral and spiritual leader.” And Fabio Semeraro, a ballet dancer from Rome, said he came to see the pope after “because it’s an important event. You get attached to a pope, but then again, after there will be another.”


Even though the Code of Canon Law allows popes to resign, the occurrence was rare enough to have caught Vatican officials off guard, including on issues like the protocol and potentially awkward logistics of having a former pope and his successor share a backyard.


When he leaves the papacy at the end of the month, Benedict will retire to his summer home in Castel Gandolfo, in the hills outside Rome, before moving to the Mater Ecclesiae convent, a plain, four-story structure built 21 years ago to serve as an international place “for contemplative life within the walls of Vatican City,” as it is described on a Vatican Web site.


Workers began transforming the building into a residence in November, after the cloistered nuns who had occupied the convent left, Father Lombardi said. He did not tip his hand about whether the renovations were carried out with the pontiff as the future occupant in mind. “The pope knew this place, this building and thought it was appropriate for his needs,” he said.


The timing, however, raised suspicions that the pope had been planning the details of his retirement for some time. The editor of the Vatican newspaper, L’Osservatore Romano, wrote Monday that the pope had made his decision “many months ago,” after a demanding trip to Mexico and Cuba in March 2012, “and kept with a reserve that no one could violate.”


Father Lombardi said that the stress of that trip had further convinced the pope that he no longer had the stamina to do the job.


In fact, the pope had meditated on the possibility of resigning for years. In the 2010 book “Light of the World: The Pope, the Church and the Signs of the Times,” from a series of interviews conducted by Peter Seewald, a German journalist, Benedict said that if a pope “clearly realized that he is no longer physically, psychologically and spiritually capable of carrying out the duties of his office,” he would have “the right, and under some circumstances also an obligation, to resign.”


Rumors of his imminent resignation began to appear periodically in the Italian news media in recent years, as the pope appeared increasingly frail in public appearances.


A Vatican official, who asked not to be named because he was discussing papal business, said that the number of people who had known about the pope’s decision “a long time, could be counted on one hand.” But the pope had informed a small group of other collaborators “in recent days.”


When he retires to Vatican City, the pope will be able to move freely, Father Lombardi said, though it was “premature” to say how involved he will be in day-to-day activities — like saying Mass — at the Vatican.


He would not, however, intervene in the choice of his successor. “You can be sure that the cardinals will be autonomous in their decision and he will have no specific role in this election,” Father Lombardi said, adding that the pope was “a very discreet person.”


The conclave to choose the next pope will begin 15 to 20 days after the pope resigns, and a new leader of the Roman Catholic Church is expected to be in place by Easter, which falls on March 31 this year.


Father Lombardi said the pope would continue to perform his regular duties until the end of the month, and would keep all the appointments on his calendar. Some parts of his schedule will be modified to take into account the heightened public interest in the pope during his final days in office, Father Lombardi indicated.


For instance, the Ash Wednesday mass usually takes place in a church on the Aventine Hill. But this year it will be conducted in St. Peter’s to allow a greater number of the faithful to attend, Father Lombardi said.


His final audience, on Feb. 27, will be moved to St. Peter’s Square instead of the usual indoor venue used in winter, “to allow the faithful to say goodbye to the pope.”


Elisabetta Povoledo reported from Vatican City, and Alan Cowell from Paris.



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Westminster Names Affenpinscher Banana Joe Best in Show















02/12/2013 at 11:55 PM EST



Westminster has its top dog!

After two days of meticulous primping, prizes and the less-pretty realities of any spirited championship, the 137th Annual Westminster Kennel Club Dog Show came to its finale Tuesday night, declaring Affenpinscher Banana Joe the best in show.

The competition proved fur-rocious as the pint-sized, black-haired furball bested six other finalists (and 2,721 entries total) for the honor, including Old English Sheepdog Swagger, who was named the reserve best in show. It’s the first time the breed has ever taken home the top prize in Westminster history.

Earning top marks at Westminster is the latest accolade in Banana Joe's storied run. The paw-dorable pooch, who is 5 years old, has been named best in show 86 times in his career, and his Westminster win will go down as his last.

"It's all so indescribable. It's just a wonderful thing as a tribute for a small breed with such a big heart," handler Ernesto Lara said post-victory. "The plans for him now is for him to retire back home where he was born, and that's in the Netherlands."

Describing his little buddy, Lara praised the breed for its commendable qualities as a canine companion.

"An Affenpinscher is a very human-like dog," he said. "It's definitely a breed you don’t want to tame or train, in the proper sense."

"You want to befriend it," Lara continued. "Once you gain the friendship, they're loyal just like a human friend."

As for Banana Joe's big victory, "Nobody told him he's small," said Lara, "and I don't think he'll believe that."

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Study questions kidney cancer treatment in elderly


In a stunning example of when treatment might be worse than the disease, a large review of Medicare records finds that older people with small kidney tumors were much less likely to die over the next five years if doctors monitored them instead of operating right away.


Even though nearly all of these tumors turned out to be cancer, they rarely proved fatal. And surgery roughly doubled patients' risk of developing heart problems or dying of other causes, doctors found.


After five years, 24 percent of those who had surgery had died, compared to only 13 percent of those who chose monitoring. Just 3 percent of people in each group died of kidney cancer.


The study only involved people 66 and older, but half of all kidney cancers occur in this age group. Younger people with longer life expectancies should still be offered surgery, doctors stressed.


The study also was observational — not an experiment where some people were given surgery and others were monitored, so it cannot prove which approach is best. Yet it offers a real-world look at how more than 7,000 Medicare patients with kidney tumors fared. Surgery is the standard treatment now.


"I think it should change care" and that older patients should be told "that they don't necessarily need to have the kidney tumor removed," said Dr. William Huang of New York University Langone Medical Center. "If the treatment doesn't improve cancer outcomes, then we should consider leaving them alone."


He led the study and will give results at a medical meeting in Orlando, Fla., later this week. The research was discussed Tuesday in a telephone news conference sponsored by the American Society of Clinical Oncology and two other cancer groups.


In the United States, about 65,000 new cases of kidney cancer and 13,700 deaths from the disease are expected this year. Two-thirds of cases are diagnosed at the local stage, when five-year survival is more than 90 percent.


However, most kidney tumors these days are found not because they cause symptoms, but are spotted by accident when people are having an X-ray or other imaging test for something else, like back trouble or chest pain.


Cancer experts increasingly question the need to treat certain slow-growing cancers that are not causing symptoms — prostate cancer in particular. Researchers wanted to know how life-threatening small kidney tumors were, especially in older people most likely to suffer complications from surgery.


They used federal cancer registries and Medicare records from 2000 to 2007 to find 8,317 people 66 and older with kidney tumors less than 1.5 inches wide.


Cancer was confirmed in 7,148 of them. About three-quarters of them had surgery and the rest chose to be monitored with periodic imaging tests.


After five years, 1,536 had died, including 191 of kidney cancer. For every 100 patients who chose monitoring, 11 more were alive at the five-year mark compared to the surgery group. Only 6 percent of those who chose monitoring eventually had surgery.


Furthermore, 27 percent of the surgery group but only 13 percent of the monitoring group developed a cardiovascular problem such as a heart attack, heart disease or stroke. These problems were more likely if doctors removed the entire kidney instead of just a part of it.


The results may help doctors persuade more patients to give monitoring a chance, said a cancer specialist with no role in the research, Dr. Bruce Roth of Washington University in St. Louis.


Some patients with any abnormality "can't sleep at night until something's done about it," he said. Doctors need to say, "We're not sticking our head in the sand, we're going to follow this" and can operate if it gets worse.


One of Huang's patients — 81-year-old Rhona Landorf, who lives in New York City — needed little persuasion.


"I was very happy not to have to be operated on," she said. "He said it's very slow growing and that having an operation would be worse for me than the cancer."


Landorf said her father had been a doctor, and she trusts her doctors' advice. Does she think about her tumor? "Not at all," she said.


___


Online:


Kidney cancer info: http://www.cancer.net/cancer-types/kidney-cancer


and http://www.cancer.gov/cancertopics/types/kidney


Study: http://gucasym.org


___


Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP


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Dorner manhunt leads to deadly standoff









When authorities hemmed in the man they suspected of killing three people in a campaign of revenge that has gripped Southern California, he responded as they had feared: with smoke bombs and a barrage of gunfire.


The suspect, who police believe is fugitive ex-cop Christopher Dorner, shot to death one San Bernardino County sheriff's deputy and injured another Tuesday. He then barricaded himself in a wood cabin outside Big Bear in the snow-blanketed San Bernardino Mountains, police said.


Just before 5 p.m., authorities smashed the cabin's windows, pumped in tear gas and called for the suspect to surrender. They got no response. Then, using a demolition vehicle, they tore down the cabin's walls one by one. When they reached the last wall, they heard a gunshot.





Then the cabin burst into flames. By late Tuesday evening, the smoldering ruins remained too hot for police to enter, but authorities said they believed Dorner's body was inside.


The standoff appeared to end a weeklong hunt for the former L.A. police officer and Navy reserve lieutenant, who is also suspected of killing an Irvine couple and a Riverside police officer. But Los Angeles Police Chief Charlie Beck said he would not consider the manhunt over until a body was recovered and identified as Dorner.


"It is a bittersweet night," said Beck as he drove to the hospital where the injured deputy was undergoing surgery. "This could have ended much better, it could have ended worse. I feel for the family of the deputy who lost his life."


According to a manifesto Dorner allegedly posted on Facebook, he felt the LAPD unjustly fired him in 2009, when a disciplinary panel determined that he lied in accusing his training officer of kicking a mentally ill man during an arrest. Beck has promised to review the case.


Dorner, 33, vowed to wage "unconventional and asymmetrical warfare" against law enforcement officers and their families, the manifesto said. "Self-preservation is no longer important to me. do not fear death as I died long ago."


Last week, authorities had tracked Dorner to a wooded area near Big Bear Lake. They found his torched gray Nissan Titan with several weapons inside. The only trace of Dorner was a short trail of footprints in newly fallen snow.


On Tuesday morning two maids entered a cabin in the 1200 block of Club View Drive and ran into a man who they said resembled the fugitive, a law enforcement official said. The cabin was not far from where Dorner's singed truck had been found and where police had been holding press conferences about the manhunt.


The man tied up the maids, and he took off in a purple Nissan parked near the cabin. About 12:20 p.m., one of the maids broke free and called police.


Nearly half an hour later, officers with the California Department of Fish and Wildlife spotted the stolen vehicle and called for backup. The suspect turned down a side road in an attempt to elude the officers but crashed the vehicle, police said.


A short time later, authorities said the suspect carjacked a light-colored pickup truck. Allan Laframboise said the truck belonged to his friend Rick Heltebrake, who works at a nearby Boy Scout camp.


Heltebrake was driving on Glass Road with his Dalmatian, Suni, when a hulking African American man stepped into the road, Laframboise said. Heltebrake stopped. The man told him to get out of the truck.


"Can I take my dog?" Heltebrake asked, according to his friend.


"You can leave and you can take your dog," the man said. He then sped off in the Dodge extended-cab pickup — and quickly encountered two Department of Fish and Wildlife trucks.


As the suspect zoomed past the officers, he rolled down his window and fired about 15 to 20 rounds. One of the officers jumped out and shot a high-powered rifle at the fleeing pickup. The suspect abandoned the vehicle and took off on foot.


Police said he ended up at the Seven Oaks Mountain Cabins, a cluster of wood-frame buildings about halfway between Big Bear Lake and Yucaipa. The suspect exchanged gunfire with San Bernardino County sheriff's deputies as he fled into a cabin that locals described as a single-story, multi-room structure.


The suspect fired from the cabin, striking one deputy, law enforcement sources said. Then he ducked out the back of the cabin, deployed a smoke bomb and opened fire again, hitting a second deputy. Neither deputy was identified by authorities. The suspect retreated back into the cabin.


The gun battle was captured on TV by KCAL 9 reporter Carter Evans, who said he was about 200 feet from the cabin. As Evans described on air how deputies were approaching the structure, he was interrupted by 10 seconds of gunfire.





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