Showing posts with label Cancer. Show all posts
Showing posts with label Cancer. Show all posts

May 13, 2018

Who is Really Pissed About The White House "McCain is Dying Anyway'" (Trump is Not one of The Upset ones)


Even by today's hyper-partisan, anything-goes standard in politics, the crass comment attributed to a White House aide about Sen. John McCain's health condition seemed to jolt the nation's sensibilities.
Kelly Sadler, a White House special assistant, reportedly made the snide remark during a Thursday meeting with communications staffers when talking about McCain's opposition to President Donald Trump's nominee to lead the Central Intelligence Agency, Gina Haspel. McCain was troubled by Haspel's refusal to say that torture is immoral during a Senate committee hearing. 
Sadler reportedly said the view of McCain — a six-term senator, the 2008 Republican presidential nominee and former prisoner of war — was immaterial because "he's dying anyway."
McCain is 81. He has brain cancer. 
The White House later commended McCain's service to his country, but refused to address the aide's comment when pressed Friday. 
President Trump did not comment on the controversy created by his staffer, nor did Vice President Mike Pence, who last week in Tempe asked hundreds gathered at a pro-Donald Trump rally to keep McCain in their thoughts and prayers. 
Top political figures from Arizona largely remained silent, including: Arizona Republican Gov. Doug Ducey; former Arizona Republican Gov. Jan Brewer, who remains a political player in Arizona and beyond; Arizona Republican Party chairman Jonathan Lines; and Republican U.S. Reps. Andy Biggs, Paul Gosar, Debbie Lesko, Martha McSally and David Schweikert.
Likewise, Democratic Reps. Ruben Gallego, Raúl Grijalva, Rep. Tom O'Halleran and Kyrsten Sinema have issued no public statements. 
Plenty of others condemned the remark, including those closest to him: his wife, Cindy, and daughter, Meghan.

Former Vice President Joe Biden

The Democrat and close friend of the senator said he deserves better. Biden lost his son Beau to glioblastoma, the same deadly form of brain cancer that struck McCain. 
"John McCain is a genuine hero —  a man of valor whose sacrifices for his country are immeasurable," Biden's statement to NBC said. "As he fights for his life, he deserves better —so much better.
"Given this White House's trail of disrespect toward John and others, this staffer is not the exception to the rule; she is the epitome of it."
Biden was in town recently to visit the senator and Cindy at their home near Sedona. 

U.S. Sen. Jeff Flake, R-Arizona

"There are no words," the junior senator and McCain colleague posted on Twitter Friday.  

John Kerry

The 2004 Democratic presidential nominee replied to Flake's tweet. "Actually Jeff, you’re too kind. There are words - four letter ones," Kerry wrote. "... And they all apply to anyone who would say anything like that about John or any family battling cancer." 
U.S. Sen. Joni Ernst, R-Iowa
On Twitter, she encouraged Americans to think hard about McCain's sacrifice to the country. 
In 1967, while flying a mission over North Vietnam, his plane was shot down. McCain was captured and endured 5 1/2 years as a prisoner of war. He was pummeled, his bones were repeatedly broken. He was interrogated. He was held in isolated captivity and repeatedly refused early release in favor of adhering to a military code that allows earlier captives to be freed first. 
Ernst, who serves with McCain on the Senate Armed Services Committee, tweeted that McCain should be treated as a "war hero" and his family deserves "civility and respect." m

Ohio Gov. John Kasich

In a video message posted on Twitter, the 2016 GOP rival of Trump demanded that the White House apologize for the "outrageous and totally out-of-line" comment about "American hero" McCain.
"God bless John McCain, and for what he's meant for our country, and what he has meant to all of us," Kasich said. 

Hiral Tipirneni

A Democrat who unsuccessfully ran in Arizona's 8th Congressional District race during a March special election — and has vowed another run for the seat — tweeted a line from Biden's statement and added her own commentary. 
"'As he (Sen. McCain) fights for his life, he deserves better - so much better.' What else can be said? #BeBest," tweeted Tipirneni, using the hashtag for First Lady Melania Trump's anti-bullying initiative. 

September 28, 2017

See What is Being Done To Save HIV Gay and BI Men from a Cancer Epidemic


The medical and scientific language is just as it appeared at the Medical Press study page. If you have a question about anything on this posting please don't hesitate to ask by using the comment section. You can also email the publisher at his email page included on the main page (left and down)of the blog.






Almost 620,000 gay and bisexual men in the United States were living with HIV in 2014, and 100,000 of these men were not even aware of their infection. These men are 100 times more likely to have anal cancer than HIV-negative men who exclusively have sex with women. Yet, no national screening guidelines exist for anal cancer prevention in any population.

Anal cancer is predominantly caused by chronic or persistent human papillomavirus (HPV) infection. HPV infection can lead to the development of anal precancer which, if remains undetected or not adequately treated, may lead to anal cancer. Likewise, HPV infection is also responsible for causing cervical, vaginal, vulvar, oropharyngeal, penile and rectal cancers.

The objective of screening is to identify and treat these precancers to prevent occurrence of anal cancer. However, one of the reasons for the lack of screening guidelines is that anal precancer treatment has not yet been shown to prevent invasive cancer. Our study, published today in the journal Cancer, attempts to find a possible solution to prevent anal cancer in HIV-positive gay and bisexual men, using the best available data. We found that age-specific anal precancer management, including post-treatment HPV vaccination, can potentially lead to an 80 percent decrease in lifetime risk of anal cancer and anal cancer mortality among gay and bisexual men.
Anal cancer: the next big crisis

Some in the medical community have identified anal cancer as the next big crisis among HIV-infected gay and bisexual men. Initiation of anti-retroviral therapy in the 1990s greatly reduced the AIDS-related death rate and improved survival. However, this improvement in survival led to an increase in the lifetime risk of developing anal cancer, especially among HIV-positive gay and bisexual men.
Anal cancer is typically preceded by persistent HPV infection that often leads to precancer. HPV is common among U.S. men; about one out of two men in the general population has HPV infection. HPV typically clears naturally; however, under certain circumstances, it might persist longer and might progress to anal precancer. If it remains undetected, untreated or inadequately treated, this precancer can progress to anal cancer.

The American Cancer Society estimates there will be 8,200 new anal cancer cases in 2017. In the absence of national screening recommendations, more than 50 percent of these individuals will be diagnosed at stage III or IV, when five-year survival is less than 40 percent. This creates a major public health concern.

We do not yet know how best to manage anal precancer (also known as high-grade squamous intraepithelial lesions) so that anal cancer could be prevented. A national randomized clinical trial study – Anal Cancer HSIL Outcomes Research (ANCHOR) – is currently determining optimal anal precancer management by comparing treatment and active monitoring.

How the anal cancer epidemic in gay and bi HIV-positive men can be prevented

The question then arises: How do we start managing our patients using the best available evidence? Likewise, it is imperative that these individuals have as much information as possible about anal cancer prevention.

How our study brings insight

Using a mathematical model, we simulated the life course of 100,000 hypothetical HIV-positive men who have sex with men (MSM) who were 27 years or older and were diagnosed with high-grade squamous intraepithelial lesions. In our model, we compared four different management strategies:
(1) individuals were not provided any form of treatment, which is the current practice; 

(2) individuals were actively monitored (followed biannually) and those who developed early cancer were treated;

(3) individuals were immediately treated using surgery (current most popular strategy among clinicians who treat precancer); and 

(4) individuals in addition to surgical treatment received HPV vaccination (potential strategy).

We followed these hypothetical patients over their lifetime in our computer model to estimate harms and benefits of the management strategies. We tracked the number of individuals who developed anal cancer and then estimated their risk of death from anal cancer. We then estimated above outcomes by patient age. For each strategy, we estimated age-specific lifetime outcomes considering cost, quality of life and life expectancy.

We found that HIV-infected gay and bisexual men who are 38 years or older should be treated using surgical treatment of ablation (either infrared coagulation or electrocautery), and that HPV vaccination should be administered at the time of surgery. This strategy is cost-effective and has the potential to decrease the lifetime risk of anal cancer by up to 80 percent in those men.

The model also found that because younger men are more likely to be cured of their precancer without intervention, patients younger than 29 should not be treated and those between 29 and 38 years old should be actively monitored (watch-and-wait approach) in order to prevent treatment-related inconvenience and morbidity that might affect their quality of life.
How the HPV vaccine could help

Currently, HPV vaccination is not recommended for administration among individuals 27 years or older. However, multiple observational studies have shown, and our findings have confirmed, that a practice of vaccinating individuals who have already been diagnosed with precancer may decrease the risk of the precancer coming back after treatment.

Given that the HPV vaccine has minimal side effects, we believe that clinicians can consider adopting this practice. Such practice may have many advantages, such as decreasing the number of treatments a patient needs for precancer recurrence thus decreasing the adverse outcomes of surgical treatment (possibility of scarring, anal stenosis and incontinence). 

In the long run, post-treatment HPVvaccination also has the potential to decrease the lifetime risk of anal cancer, save health care costs for treating patients for recurrence and cancer, and improve their life expectancy and quality of life.






March 9, 2017

How Did Jimmy Carter Survived Cancer? New Cancer Pill Gleevec



Everyone hopes and wishes for that last-minute cancer breakthrough that will save doomed patients. It almost never actually happens. With Gleevec, it did. 
The once-a-day pill turned chronic myelogenous leukemia, or CML, from a certain death sentence into a manageable disease. Now data shows it's helped 83 percent of patients live 10 years or longer, even with side-effects that include a characteristic rash, nausea and fatigue. 

Gleevec

Gleevec the cancer drug. Carlos Chavez / LA Times via Getty Images

And some may be able to stop taking the pills altogether, even though they are not cured, the original team of researchers reported in the New England Journal of Medicine Thursday. 
"It's the first targeted personalized medicine that had ever been used. It was also the most successful," said Dr. Richard Silver, a hematologist and oncologist at New York Presbyterian-Weill Cornell Medical Center who helped first test the drug in patients. 
"This has been the thrill of my life," Silver told NBC News. 
Before Gleevec hit the market, CML patients had three options: treatment with toxic chemotherapy, a bone marrow transplant, or just dying. Even with treatment, patients rarely lived longer than three years. "It was really a death warrant," Silver said. 
Gleevec worked so well and so quickly that the trial testing the drug against the older chemo regimen was stopped so everyone could get the pill. Food and Drug Administration approval was swift and now the Leukemia & Lymphoma Society estimates 36,000 to 100,000 Americans are CML survivors. 


Bharat Shah of Atlanta is one of them. 
Shah had brought his wife Milan and his daughter-in-law Dr. Reshma Shah, a family practice physician, to the meeting where his oncologist gave him the diagnosis in 2000. "I looked at Reshma, and as soon as her head went down and she started crying I knew that the news was not good," Shah recounted. 
"I had like six months to three years to live." 
 Shah felt fine, but his blood told a different story. His white blood cells, the immune system cells, were proliferating wildly. Just 60, he faced harsh chemo and all its side-effects before near-certain death. 
He and his family hit the Internet. Several relatives are physicians and they heard Silver's lab was taking part in a clinical trial of Gleevec. Through a coincidence, one physician relative met a former staffer of Silver's and Shah enrolled in the trial. 

Bharat and Milan Shah

Bharat and Milan Shah pose for a recent photo. Bharat Shah was one of the patients to first try Gleevec to treat chronic myelogenous leukemia, or CML. He's still alive 17 years later, having been given 6 months to 3 years to live. Now researchers report more than 83 percent of patients who take the once-a-day pill are still alive. Courtesy Shah Family

"Within two months I was back to normal," Shah said. He became a regular commuter between Atlanta and New York. He takes Gleevec every day. 
"After 17 years of treatment, the only side-effect that I feel is that my eyes are a little puffy," Shah told NBC News. 
He plays golf every week and does charity work. And Silver has him talk to his medical school class every year. 
"He might have been dead. It's been unbelievable," said Silver. 
"To have lived through the opportunity where we can go to a patient and say, 'We have got this new drug and it looks great' and it is great," Silver added. "You can imagine what a thrill it is to see these people and see them live their lives productively, with their jobs and their families and children and grandchildren." 
The researchers, led by Dr. Brian Druker of Oregon Health & Science University, published their final report Thursday on the original Gleevec trial, which had 1,100 patients. 


The drug was the first to be designed to match the particular genetic mutation that causes CML. Up to then, most chemotherapy went after rapidly dividing cells -- a hallmark of cancer, but an approach that also damages hair follicles, the inside of the mouth, the lining of the intestines and other healthy tissue. 
Gleevec is targeted to a mutation specific to CML. Now targeted therapies are common and can have remarkable results in a small group of patients with specific genetic mutations in their tumors. With CML, the same genetic changes affected almost every patient. 
"It's a 10-year survival of 83 percent, which is extraordinary," Silver said. "It has led to what we call biologic cures." Patients still have leukemia, but it's not affecting their blood cell counts. 
In Europe, doctors are beginning to recommend that patients who are doing well on the drug for a year or longer try stopping. Druker and colleagues believe that about 10 percent of all Gleevec patients will be able to safely stop taking the drug, and 40 percent or more of those who show a quick response to the drug. 
Shah tried stopping, but his blood count soon shot up and he and Silver decided he should resume the pills. 
It's not all sweetness and light. Even though Gleevec has been on the market for more than 15 years, it still costs more than $140,000 a year, according to Dr. Hagop Kantarjian of the University of Texas MD Anderson Cancer Center, one of the original Gleevec trial leaders. 
 Shah, now on Medicare, pays for his own travel to and from New York to see Silver and follow up on his care. "Without insurance, it would have cost me like $20,000 a month," he said. Even so, he spends $8,000 to $10,000 out of pocket for the drug. "Medicare is paying a lot of money on my behalf," Shah said. 
Gleevec, known generically as imatinib, now has generic rivals. The price is not down in the U.S. yet but the pills made by one Indian generic company cost $400 a year and a Canadian version costs $8,800, Kantarjian wrote in a review for the American Society for Clinical Oncology. 
"Imatinib was priced at $26,000 a year in 2001. The price of imatinib has increased by 10 percent to 20 percent annually," he noted. 
Oncologists have been pressuring Gleevec's maker, Novartis, and generic makers to bring the price down.  
"The cost to manufacture a one-year supply of 400-mg imatinib tablets is $159," Kantarjian wrote. "Two years from now, the price of generic imatinib in the United States (or purchased from abroad) will be significantly lower, hopefully less than $1,000/year." 
And there are two rival drugs in the same class as Gleevec. Tasigna,known generically as nilotinib, and Sprycel or dasatinib, work in patients who have not been helped by Gleevec or whose cancer has mutated to resist its effects. 
They can also cost as much as $150,000 a year. 
"Each of the newer agents has a distinct safety and efficacy profile," Druker's team wrote. 
In 2014, every new cancer drug approved by the FDA cost more than $120,000 a year to use. 
Drug companies point out that they don't always charge that price to insurance companies and say they also offer discounts and special coupons for patients who don't have insurance. 
Novartis, which makes Gleevec and earns more than $4 billion a year from it, says most patients pay less than $100 a month out of their own pockets. 
“It’s worth it, I am telling you," Shah said.

by 

December 1, 2016

Man Cured of Bladder Cancer with Testosterone Experimental Therapy





 

A man with advanced prostate cancer that didn’t seem to be treated has been “cured” by a new experimental therapy.

The new treatment involved shocking tumours to death using testosterone.

Other very ill men involved in the trial saw astonishing results, with tumours being seen to shrink and the progress of the disease stopping in its tracks.

Overall, most of the people involved in the trial seemed to undergo positive results. Scientists tested that by looking at levels of Prostate Specific Antigen (PSA), a blood marker used to monitor prostate cancer – and found that it fell in most of the 47 people involved in the study.

 
And one individual had so little of the market in his body – and no trace of the disease – that doctors said he appears to be cured after 22 cycles of the treatment.

The trial saw the men complete at least three cycles of what is called bipolar androgen therapy, or BAT. That sees their bodies get flooded with testosterone and then starved of it.

Until now, the male hormone had thought to help spur prostate cancer on. And so scientists have traditionally looked to treat it by cutting off the supply of testosterone.

 
Mouth cancer rates up 68% – and unhealthy lifestyles are to blame
But the new study comes off the back of lab experiments that have seen cancer cells get suppressed or even killed by blasts of the same hormone.

Professor Sam Denmeade, from Johns Hopkins University School of Medicine in Baltimore, US, who led the new study, said: "We think the results are unexpected and exciting.

"We are still in the early stages of figuring out how this works and how to incorporate it into the treatment paradigm for prostate cancer.

"Thus far we have observed dramatic PSA response in a subset of men; PSA levels declined in about 40% of men and in about 30% of men levels fell by more than 50%.

"Some men also have objective responses with a decrease in the size of measurable disease, mostly in lymph nodes. Many of the men have stable disease that has not progressed for more than 12 months.

"I think we may have cured one man whose PSA dropped to zero after three months and has remained so now for 22 cycles. His disease has all disappeared."

Early findings from the on-going Restore study were presented at the EORTC-NCI-AACR symposium on Molecular Targets and Cancer Therapeutics in Munich, Germany.

All the patients had spreading cancer that was resistant to treatment with two of the latest hormone therapy drugs, abiraterone and enzalutamide.

The men received high dose injections of testosterone once every 28 days. At the same time, they were given a drug that stopped testosterone being produced naturally by the testicles.

"Our goal is to shock the cancer cells by exposing them rapidly to very high followed by very low levels of testosterone in the blood," said Prof Denmeade.

Six of the men tested positive for a protein called AR-V7 that may be associated with resistance to enzalutamide.

After BAT treatment, no sign of the protein was seen in the blood of all six. Two of the men had declines in PSA level of 50% or more.

The therapy appears to be well-tolerated by the patients, one man experiencing an increase in pain and another having a problem with urine retention.

Prof Denmeade said it was still not clear how the treatment worked, but it appeared to involve cell signalling and part of the process of cell division. Large doses of testosterone also seemed to cause prostate cancer cells to make breaks in their DNA.

Cancer cells stopped dividing and turned "senescent", meaning they "become like old men who sit around and tell stories but don't make much trouble", said the professor.

He cautioned that the therapy was still highly experimental and only suitable for men not suffering painful symptoms.

"Testosterone treatment can definitely worsen pain in men with prostate cancer who have pain from their disease," he said.

A multi-centre randomised US trial called Transformer is now comparing BAT with enzalutamide in men who have become resistant to abiraterone. It aims to recruit a total of 180 participants.

Prof Denmeade said: "If we find testosterone is superior then we would hope to move on to larger trials. Our problem is this is not a drug that is owned by a pharmaceutical company; it is generic testosterone. So moving forward is going to be difficult due to issues with finding funds to run a bigger trial."

Each year around 47,000 men are diagnosed with prostate cancer in the UK and 11,000 die from the disease.

Dr Matt Hobbs, deputy director of research at the charity Prostate Cancer UK, said: "Drugs that reduce the levels of testosterone (androgen deprivation therapy) are an effective treatment for thousands of men with advanced prostate cancer.

"However, at some point the cancer evolves and those drugs stop working. This research is intriguing because it offers a hint that - somewhat unexpectedly - for some men whose cancers have reached that 'hormone-resistant' stage it may be possible to kill or stop growth of the cancer cells by actually overloading them with testosterone.

"Many exciting new lines of attack against prostate cancer are emerging of which this is one.

“However, this is early stage research and further studies are needed in order to understand exactly how intriguing developments like this work and to test the findings more robustly in large clinical trials."


Press Association

May 18, 2016

Study: HIV Cancer Patients Less Likely to be Treated


 
Image result for cancer cells






 






ATLANTA -A new study finds HIV-infected patients with cancer in the United States appear to be less likely to receive cancer treatment, regardless of insurance and other existing health conditions. The study, by researchers at the University of Utah, National Cancer Institute and the American Cancer Society, appears early online in Cancer.

Cancer is an increasingly common cause of morbidity and mortality among individuals infected with the human immunodeficiency virus (HIV). In the United States, cancer incidence rates in this population have increased since the introduction of highly active antiretroviral therapy (HAART). Cancer is now the second most common cause of death among HIV-infected individuals, after AIDS-related deaths.

While previous studies have shown that cancer patients who are infected with HIV are less likely to receive cancer treatment compared with HIV-uninfected individuals, whether that was due to insurance status and other conditions was largely unstudied. For the new study, researchers led by Gita Suneja, MD, MSHP, from the Department of Radiation Oncology at the University of Utah used the National Cancer Data Base to study non-elderly adults diagnosed with ten common cancers from 2003 to 2011. They examined associations between HIV status and lack of cancer treatment, taking into account insurance status and comorbidities.

After adjusting for those two known predictors of lack of treatment, the disparity remained for all cancers studied, except anal cancer. HIV-infected patients were more likely to lack cancer treatment for cancers of the head and neck (relative risk [RR] = 1.48); upper gastrointestinal tract (RR = 2.62); colorectum (RR = 1.70); lung (RR = 2.46); breast (RR = 2.14); cervix (RR = 2.81); prostate (RR = 2.16); Hodgkin lymphoma (RR = 1.92); and diffuse large B-cell lymphoma (RR = 1.82).

The authors say factors that predicted a lack of cancer treatment among HIV-infected individuals varied by tumor type (solid tumor vs lymphoma), but black race and a lack of private insurance (e.g.: having Medicaid, Medicare or no insurance) were found to be predictors for both groups. However, even among privately insured cancer patients, HIV-infected cancer patients are less likely to receive cancer directed treatment compared to HIV-uninfected patients.

The study says several factors may contribute to the finding. HIV-infected patients have historically been excluded from cancer clinical trials, thereby limiting the applicability of clinical trial results for this population. Cancer treatment guidelines specific to HIV-infected patients are not available for most cancer types. Clinicians may lack experience treating HIV infected patients with cancer. Furthermore, the psychosocial and economic challenges associated with the dual management of cancer and HIV treatment may make adherence to treatment a challenge.

"...cancer care providers and policy makers need to devote special attention to the HIV-infected patient population to understand and address the factors driving differential cancer treatment," write the authors. "Cancer treatment not only extends survival from cancer, but also can improve quality of life, even for patients with advanced stage disease. The observed disparity is of particular importance given the extended survival of HIV infected patients treated with antiretroviral therapy and the rising number of cancer cases."

###

The study was a collaboration between the University of Utah School of Medicine Department of Radiation Oncology, American Cancer Society Intramural Research, Emory University Epidemiology, and the National Cancer Institute Division of Cancer Epidemiology and Genetics.

Article: Disparities in Cancer Treatment among Patients Infected with the Human Immunodeficiency Virus, CANCER; published early online May 17, 2016 DOI: 10.1002/cncr.30052
eurek

alert.org

November 6, 2015

On Organic Diet and No Family Hist of Cancer but Still gets Stomach Cancer? Organic Salt?



                                                                       

There’s plastic in your salt, Organic Salt.
That’s the finding of a new study published in the journal Environmental Science & Technology. 
When researchers analyzed fifteen brands of common table salt bought at supermarkets across China, they found among the grains of seasoning micro-sized particles of the common water bottle plastic polyethylene terephthalate, as well as polyethylene, cellophane, and a wide variety of other plastics.
The highest level of plastic contamination was found in salt sourced from the ocean: The researchers measured more than 1,200 particles of plastic per lb of sea salt. The team, led by Huahong Shi of East China Normal University also found tiny particles of plastic in salt sourced from briny lakes, briny wells, and salt mines, although at lower levels—between 15 and 800 particles/ lb.
Where’s all that plastic coming from? Microbeads, for one — those tiny bits of plastic in your face wash that go down the drain and into the water table, where they eventually end up in the ocean, and then your stomach. That’s not good because microplastics soak up cancer-causing and endocrine-disrupting pollutants in the water and deposit them in your body.
This study looked specifically at salt sold in Chinese markets, but is it possible that salt sold in the U.S. is contaminated with microplastics as well? Definitely, according to Sherri Mason, professor at SUNY Fredonia, and an expert on microplastics. “Plastics have become such a ubiquitous contaminant, I doubt it matters whether you look for plastic in sea salt on Chinese or American supermarket shelves,” she told Scientific American.
How big a problem is this, and what’s the conscientious consumer to do? Well, the concentration of plastics in salt is still less than it is in shellfish, so it probably shouldn’t be the biggest concern on your plate. Besides that, salt is both essential for life and fairly easy on the environment, compared to most things we eat, so don’t go cold turkey on it just yet. So what’s the solution? You can start by ditching the microbeads: The less plastic that ends up in the ocean, the less that ends up in your gut.

August 12, 2015

Ex President Jimmy Carter has Cancer


                                                                         



Former U.S. President Jimmy Carter said on Wednesday that recent liver surgery revealed he had cancer that had spread to other parts of his body.

"I will be rearranging my schedule as necessary so I can undergo treatment by physicians at Emory Healthcare," Carter, 90, said in a statement. "A more complete public statement will be made when facts are known, possibly next week."

Carter, a Democrat, served as the 39th president from 1977 to 1981 after defeating Republican incumbent Gerald Ford. He was defeated for re-election in 1980 by Republican Ronald Reagan.

The Carter Center in Atlanta said last week that he had undergone elective surgery at Emory University Hospital to remove a small mass in his liver.

It added that the operation had proceeded without issues and that the prognosis was excellent for a full recovery.

Carter cut short a trip to Guyana in May after feeling unwell and returned to Atlanta. He had traveled to the South American country to observe national elections. At the time, the center said only that Carter had departed after "not feeling well."

Reuters
 

May 25, 2015

Ejaculation Reduces Chances of Prostate cancer




Good news, men: you may be able to decrease your risk for prostate cancer by ejaculating — frequently, according to research presented here at American Urological Association 2015 Annual Meeting.
The frothy advice is not new but is now backed up by the "strongest evidence to date" on the subject, according to lead author Jennifer Rider, ScD, MPH, an epidemiologist at the Harvard T.H. Chan School of Public Health in Boston.
"There is no modifiable risk factor for developing prostate cancer," Dr Rider told Medscape Medical News. "It would be exciting to tell men that there was a way to modify their risk."
However, she noted that these are observational data and urged caution when "interpreting them."
The results are "fascinating," said Jesse Sammon, MD, a urologist at the Henry Ford Hospital in Detroit, who attended Dr Rider's presentation. "It was the highlight of the session on cancer epidemiology; the moderator called it the 'study most likely to be tweeted'."
These are "incredibly high-quality data," said Dr Sammon, who was not involved with the study.
The data come from nearly 32,000 men in the prospective Health Professionals Follow-up Study, who now have been followed for 18 years.
During the study period, 3839 men have been diagnosed with incident prostate cancer, 384 cases of which were lethal.
At recruitment in 1992, all participating men were asked to report their average monthly frequency of ejaculation from the ages of 20 to 29 years and 40 to 49 years, and during the previous year. A lifetime average was then computed from these reports.
After potential confounders were controlled for, the risk for prostate cancer was 20% lower in men who ejaculated at least 21 times a month than in men who ejaculated 4 to 7 times a month. The 20% risk reduction was seen at ages 20 to 29 and 40 to 49, and for the lifetime average (P trend < .0001 for all).
At ages 40 to 49, men most (38.0%) reported 8 to 12 ejaculations per month; only 8.8% reported at least 21 ejaculations per month.
"We shouldn't dwell on the exact numbers of ejaculation, but instead should focus on the dose–response relation," Dr Rider advised.
She summarized: "Safe sexual activity could be good for prostate health."
Notably, there was no association between ejaculation frequency and the risk for high-grade, advanced, or lethal disease, she reported. The reason for this exception is not known.
These results are an update of the last major report from the Health Professionals Follow-up Study, which was published about 10 years ago (JAMA2004;291:1578-1586). At that time, investigators concluded that "high ejaculation frequency may possibly be associated with a lower risk of total and organ-confined prostate cancer," as reported by Medscape Medical News.
Many other studies have likewise reported that ejaculation frequency might be tied to prostate cancer risk, with more orgasms being protective.
But these new data have three outstanding strengths, Dr Rider said.
First, the study is prospective, whereas most other studies have been retrospective, and the data are long term. Second, the study involves the largest cohort to date. And third, the study has specific information on ejaculation, she explained.
Whereas previous studies have tended to rely on "proxies" for ejaculation, such as age at marriage, number of children, and number of sex partners, the Health Professionals Follow-up Study investigators were bold; they explicitly asked about ejaculations from sexual intercourse, masturbation, and nocturnal emissions.
The average age of the men in the study was about 59 years, and they had undergone an average of five PSA tests by 2008. Most of the men were married, but the men who reported at least 21 ejaculations per month at ages 40 to 49 were more likely to be divorced than less robust ejaculators (11.8% vs 4% - 7%).
American Urological Association (AUA) 2015 Annual Meeting: Abstract PD6-07. Presented May 15, 2015.

January 7, 2014

The Best Treatment of Pancreatic Cancer





The best treatment for pancreatic cancer depends on how far it has spread, or its stage. The stages of pancreatic cancer are easy to understand. What is difficult  is attempting to stage pancreatic cancer without resorting to major surgery. In practice, doctors choose pancreatic cancer treatments based upon imaging studies , surgical findings, and an individual’s general state of well being. 
Stages of Pancreatic Cancer
Stage is a term used in cancer treatment to describe the extent of spread of the cancer. The stages of pancreatic cancer are used to guide treatment and to classify patients for clinical trials. The stages of pancreatic cancer are:
  • Stage 0: No spread. Pancreatic cancer is limited to a single layer of cells in the pancreas. The pancreatic cancer is not visible on imaging tests or even to the naked eye.
  • Stage I: Local growth. Pancreatic cancer is limited to the pancreas, but has grown to less than 2 centimeters across (stage IA) or greater than 2 centimeters (stage IB).
  • Stage II: Local spread. Pancreatic cancer has grown outside the pancreas, or has spread to nearby lymph nodes.
  • Stage III: Wider spread. The tumor has expanded into nearby major blood vessels or nerves but has not metastasized.
  • Stage IV: Confirmed spread. Pancreatic cancer has spread to distant organs.
Determining pancreatic cancer's stage is often tricky. Imaging tests like CT scans and ultrasound provide some information, but knowing exactly how far pancreatic cancer has spread usually requires surgery.
Since surgery has risks, doctors first determine whether pancreatic cancer appears to be removable by surgery (resectable). Pancreatic cancer is then described as follows:
  • Resectable: On imaging tests, pancreatic cancer hasn't spread (or at least not far), and a surgeon feels it might all be removable. About 10% of pancreatic cancers are considered resectable when first diagnosed.
  • Locally advanced (unresectable): Pancreatic cancer has grown into major blood vessels on imaging tests, so the tumor can't safely be removed by surgery.
  • Metastatic: Pancreatic cancer has clearly spread to other organs, so surgery cannot remove the cancer.
If pancreatic cancer is resectable, surgery followed by chemotherapy or radiation or both may extend survival.

Treating Resectable Pancreatic Cancer

People whose pancreatic cancer is considered resectable may undergo one of three surgeries:
Whipple procedure (pancreaticoduodenectomy): A surgeon removes the head of the pancreas, parts of the stomach and small intestine, some lymph nodes, the gallbladder, and the common bile duct. The remaining organs are reconnected in a new way to allow digestion. The Whipple procedure is a difficult and complicated surgery. Surgeons and hospitals that do the most operations have the best results.
About half the time, once a surgeon sees inside the abdomen, pancreatic cancer that was thought to be resectable turns out to have spread, and thus be unresectable. The Whipple procedure is not completed in these cases.

Treating Resectable Pancreatic Cancer continued...

Distal pancreatectomy: The tail and/or body of the pancreas are removed, but not the head. This surgery is uncommon for pancreatic cancer because most tumors arising outside the head of the pancreas within the body or tail are unresectable.
Total pancreatectomy: The entire pancreas is surgically removed. Although once considered useful, this operation is uncommon today.
Chemotherapy or radiation therapy or both can also be used in conjunction with surgery for resectable and unresectable pancreatic cancer in order to:
  • Shrink pancreatic cancer before surgery, improving the chances of resection (neoadjuvant therapy)
  • Prevent or delay pancreatic cancer from returning after surgery (adjuvant therapy)
Chemotherapy includes cancer drugs that travel through the whole body. Chemotherapy ("chemo") kills pancreatic cancer cells in the main tumor as well as those that have spread widely. Either of three chemotherapy drugs can be used for pancreatic cancer:
Both 5-FU and gemcitabine are given into the veins during regular visits to an oncologist (cancer doctor).  An oral drug, capecitabine, may be substituted for 5-FU, especially with radiation.
In radiation therapy, a machine beams high-energy X-rays to the pancreas to kill pancreatic cancer cells. Radiation therapy is done during a series of daily treatments, usually over a period of weeks.
Both radiation therapy and chemotherapy damage some normal cells, along with cancer cells. Side effects can include nausea, vomiting, appetite loss, weight loss, and fatigue as well as toxicity to the blood cells. Symptoms usually cease within a few weeks after radiation therapy is complete.

Treating Locally Advanced (Unresectable) Pancreatic Cancer

In locally advanced pancreatic cancer, surgery can't remove the entire tumor. Since surgery to remove only part of the pancreatic cancer has been shown not to help, nonsurgical therapies are best.
Treatment consists of chemotherapy with or without radiation therapy. Either 5-FU or gemcitabine can extend life in people with locally advanced pancreatic cancer.

Treating Metastatic Pancreatic Cancer

In metastatic pancreatic cancer, surgery is used only for symptom control, such as for pain, jaundice, or gastric outlet obstruction.. Radiation may be used for symptom relief as well.  
Gemcitabine is the single most active drug for treating metastatic pancreas cancer. Many studies have been performed to improve on the results of gemcitabine. The latest study,demonstrated that a 4 drug regimen, known as FOLFIRINOX (5-FU/leucovorin/oxaliplatin/irinotecan), is superior to gemcitabine. However due to toxicities, this therapy should be reserved for persons with good activity levels. Other combinations include gemcitabine with erlotinib, gemcitabine with capecitabine gemcitabine with cisplatin, gemcitabine with nab-paclitaxel. .
If an individual progresses on gemcitabine, usual regimens include oxaliplatin with 5-FU or capecitabine or cisplatin with 5-FU or capecitabine. However, efficacy of these regimens is limited.

Palliative Treatment for Pancreatic Cancer

As pancreatic cancer progresses, the No. 1 priority of treatment will shift from extending life to alleviating symptoms, especially pain. Numerous treatments can help protect against the discomfort from advanced pancreatic cancer:
  • Procedures like bile duct stents can relieve jaundice, thus reducing  itching and loss of appetite associated with bile obstruction.
  • Opiod analgesics can help relieve pain.
  • Antidepressants and counseling can help treat depression common in advanced pancreatic cancer.

Clinical Trials for Pancreatic Cancer

New pancreatic cancer treatments are constantly being tested in clinical trials. You can find out about clinical trials for the latest treatments for pancreatic cancer on the web sites of the American Cancer Society or the National Cancer Institute.

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