Australian Doctor Australian Doctor 17th November 2017 | Página 9

‘Cosmetic surgeon’ under the scope
ANTONY SCHOLEFIELD
DOCTORS could be banned
from using the term ‘cos-
metic surgeon’ unless they
are qualified specialist sur-
geons under a crackdown by
health ministers.
Recent reports of botched
cosmetic procedures, includ-
ing multiple patients experi-
encing seizures and cardiac
arrests at the Cosmetic Insti-
tute in Sydney, has again put
the qualifications and train-
Warfarin’s
anti-cancer
effect
AMANDA DAVEY
WARFARIN may protect
against common cancers, an
observational study suggests.
A population-based study of
more than 1.2 million people
over 50 showed a “remarkable
association” between
warfarin use and lower cancer
incidence, said the researchers
from Norway.
Their review, based on
national registry data over a
seven-year period, found that
warfarin users had a 16%
reduced risk of all cancers after
a minimum two-year interval
compared with non users.
Warfarin use was linked with
a 31% reduced risk of prostate
cancer, a 20% reduced risk of
lung cancer and a 10% lower
risk of breast cancer.
There were no overall
differences in skin and colon
cancer rates.
However, in the subgroup
of people using warfarin for
atrial fibrillation, cancer risk
was lower in all four common
sites (lung, prostate, breast
and colon).
“We detected in the warfarin
users group a lower incident
rate ratio [IRR] with the
shortest and longest warfarin
exposures, as well as a lower
IRR for men than women,” the
researchers said.
The biological mechanism
for an anti-cancer effect
might involve warfarin’s ability
to block “malignant traits
of aggressive carcinoma
cells” via vitamin K-linked
receptors, they suggested. The
anticoagulant also enhanced
antitumour natural killer cell
activity.
While warfarin was still
the most widely used
anticoagulant worldwide,
non-vitamin K novel oral
anticoagulants (NOACs)
were now more frequently
prescribed for atrial fibrillation
in Australia, they noted.
The researchers also said
an unintended consequence of
the switch to NOACs may be
an increased risk of cancer.
ing of cosmetic surgeons
under the spotlight.
Health ministers agreed at
this month’s Council of Aus-
tralian Governments meeting
to review the regulations.
NSW Minister for Health
Brad Hazzard said new laws
would target unqualified
doctors who “dressed them-
selves up as cosmetic sur-
geons”.
“Agreement
will
be
referred to the Medical Board
[of Australia] to ... investigate
... appropriate ways to safe-
guard consumers,” he told
the Sydney Morning Herald.
One option again being
flagged is making “cosmetic
surgeon” a protected title.
The idea has been wel-
comed by the Australasian
Society of Aesthetic Plastic
Surgeons whose 300 mem-
bers are Fellows of the Royal
Australasian College of Sur-
geons.
President Dr Mark Mag-
nusson claimed that under
current laws, doctors could
“just hang around” a cos-
metic clinic, then start oper-
ating without any training.
The Australasian College
of Cosmetic Surgery, which
is not formally accredited
by the Australian Medical
Council (AMC), admitted the
widespread use of “cosmetic
surgeon” was confusing for
patients.
But it argued the title
should not be restricted to
specialist plastic surgeons.
“The premise that ‘plas-
tic surgeons’ are safer than
appropriately trained and
highly experienced cosmetic
surgeons is simply not cor-
rect,” it said in a statement.
In 2012 the college applied
to the AMC for formal recog-
nition of cosmetic surgery as
a distinct medical specialty,
but was knocked back.
‘Cosmetic surgeon’ could
become a protected title.
Patient factors are important
for optimal T2DM management
* ≥ 65 years of age
* Established long
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* Renal impairment
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