Saturday, July 26, 2014

Tips for skin cancer prevention

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Skin cancer is one of the most preventable types of cancer. Sun damage is the most common cause of skin cancer. Ultraviolet A and B rays play different roles in tanning or burning the skin.
Here are some suggestions and tips to protect your skin from UVA and UVB rays.
  • Apply sunscreens which have a SPF (sun protection factor) of 30 or more. Make sure the packaging mentions clearly that it covers both UVA and UVB rays.
  • Sunscreen should be applied 15 minutes before going outdoors. It should be applied year round and even in cloudy weather. Ideally it should be reapplied every 2 hours or when you get wet.
  • Stay in the shade during day time. Sun exposure between 10 AM to 4 PM is especially bad for the skin. During this period UV rays from the sun are the strongest.
skin girl
  • Wear sun glasses that wrap around the eyes and block both UVA and UVB rays.
  • Wear clothing that covers as much skin as possible, especially the arms and legs.
  • Wet clothes let through more UV rays than dry clothes. Use extra caution and take spare clothes before getting, especially at beaches and swimming ps.
  • Wear a hat with a wide brim to shade your face, head, ears, and neck. These are the areas commonly burned by UV rays.
  • Sand and reflect UV rays, which can increase the chances of sun burn. Use extra caution near water and sand.
  • Avoid tanning bedsing and sunbathing. Tanning is never safe, even ultra lights which are used in salons emit UV rays. These rays can cause sunburn and wrinkling, not to mention cancer.
  • Examine your skin head to toe once a month. If you notice any moles or any new spots, they need to be investigated. Even changes in color, or of existing spots should be evaluated by a dermatologist.

Cancer Lessons I Learned From a Fictional Teenage Boy

Cancer Lessons I Learned From a Fictional Teenage Boy
By Emily HelckPhoto by Twentieth Century Fox Film Corporation
In the days leading up to my reconstructive surgery, I was scouring breast cancer forums, looking at dozens of reconstruction photos and generally fretting while applying creams and packs to the flat side of my chest.
But mostly, I was thinking about Augustus Waters from “The Fault in Our Stars.”
Some things to know: When I was 28, I found out I had cancer. Three years earlier, my then boyfriend, now husband, had gotten the same news. He had lymphoma, I had breast cancer.
When we saw TFiOS together, there were many things hit me hard and made me have to catch my breath: Hazel’s radiation mask, the same type my husband wore during his treatment for non-Hodgkin lymphoma, the stubbly-headed kids gathered for support group in The Literal Heart of Jesus. But none so intensely as Hazel and Augustus’s sometimes awkward, always endearing love scene.
For the uninitiated: Hazel and Augustus are teens who meet in a cancer support group. Augustus is in remission for osteosarcoma, while Hazel is in treatment for stage four thyroid cancer. Hazel is on oxygen, which she brings everywhere in a rolling case. Augustus has a prosthetic leg. For most of the film, Augustus’s amputation is covered by jeans and trendy sneakers, with occasional playful flashes of his high- tech and pretty awesome looking prosthetic. Their friendship leads to romance, which leads to Amsterdam and the aforementioned love scene.
August and Hazel are navigating the tricky waters of each of their conditions, and the trickiness is heightened as the scene progresses.
I have little in common with Augustus, other than the fact that we both lost a part of our bodies to cancer treatment. I’m comparatively old and less adorable. I’m lacking in his particular brand of intensity and charm. I have not lost a limb.
But in the process of undressing, and revealing what is not there, we share a commonality. When Augustus prepares to reveal his amputated leg to Hazel, his face changes. He’s no longer cool and confident; he’s scared, unsure, and timid. It breaks my heart because it’s a face that I know very well.
It’s a face I have worn while reciting side effects and diagnoses. It’s one that I have worn while discussing the properties of radiated skin, and methods for addressing abundant scar tissue. It’s one I have worn when, feeling vulnerable, I reflexively cover the left side of my chest with a scarf or my folded arms. It’s one that conveys a disconnection from the body that has, in one big way, betrayed me. A body that I am so, so angry at. A body that feels wrong.
With his eyes cast down, Augustus describes, in plain and objective language, the basic visual facts of his amputation. His face betrays caution and fear. Fear that, after everything, that this will be the thing that chases Hazel from him. That the truth of his body will be so shocking that she will run.
At this point, perhaps I should say that I don’t disrobe in front of anyone but healthcare professionals. I avoid clothing that might be accidentally revealing. For the same reason as Augustus: I don’t want to scare anyone. I was recently considering rejoining the Y to use the pool and finally learn how to swim. But then I remembered the locker room situation. Not negotiable.
And though my husband has seen the results of my treatment while attending appointments with me, I don’t undress in front of him at home.
But back to the film. In this moment, all of Augustus’s endearing bravado vanishes, and the ultimate truth of the film is revealed: that loss is real, loss is injurious. Loss is a pain that demands to be felt.
But also that loss isn’t everything. Hazel stays. In fact, she teases him for thinking she could be put off.
That body image and self-esteem are affected by cancer seems painfully obvious. But it’s an issue that’s never been put to me by any of my doctors. It’s just not on their radar, or they don’t know how to talk about it.
By conflating loss of virginity and the uncovering of Augustus’s lost limb, the film (and book) makes an important connection. That fragility is fragility. That self-consciousness is self-consciousness. That cancer-scar-revealing can be like losing-your-virginity: awkward, unsure, scary. But also, sometimes, ultimately, okay. (Okay? Okay.)
When I describe the area formerly known as my breast to myself, I fall into using adjectives that are full of negativity and emotion. I need to stop that.
Augustus started with an objective description of his amputation, before actually undressing: “It’s above my knee and it just tapers a little and then it’s just skin.” In the film he does not use words like ugly like I do when I talk about my mastectomy scar. Maybe that’s the first step.
(Is it weird that I’m learning life lessons from a fictional teenaged boy? Probably.)
So here goes: There’s a trapezoidal plane that’s discolored from radiation burns. It’s concave along the incision line. The scar is white and raised, and looks like a caterpillar traveling towards my heart.
It’s a start.
Emily Helck is a 29-year-old artist from Jersey City, N.J. When she began chemotherapy in September 2012, she started her blog, “Real Tumors of New Jersey.” She posted a videocontaining a year of self portraits to her blog on Sept. 29, which has since gone viral.
"A Day in the Life" is a series of blogs written by people who are living with medical conditions.

Friday, July 25, 2014

Living With Cancer: A Tour of Hospice

Before the visit, I had been split in two not by fear of death but by dread of dying — in anxiety, dementia, but mostly in pain from recurrent ovarian cancer.
My mind was always running on two tracks. On one track, I attended to whatever actual event was occurring, be it an outing to the library or the making of a meal. The simultaneous second track was psychic or psychotic, depending on your point of view, but invariably chilling. It took me to scenes of the degeneration that would ensue after the targeted drug I am taking stopped working.
So I welcomed the idea suggested by a member of my cancer support group: that we tour the new hospice facility where our friend Leslie had died. “Not a recruitment visit, just a field trip,” we joked as we decided to invite our partners to join us in meeting with the co-director of Hospice House, Dr. Robert Stone.
On a fearfully cold day, we drove to a lodge on a wooded lot at the edge of our small town. By a blazing fireplace surrounded by comfortable chairs, about 10 of us amassed — six women dealing with gynecological cancer and some of our husbands. We were quiet because the family of a patient was using the adjacent kitchen.
A lanky and gentle Dr. Stone welcomed us and proceeded to explain the program. To enroll in hospice, patients must have a life expectancy of six months or less and promise to forgo further curative treatments. He had issues with these stipulations, but they were put in place by the insurance systems that cover costs. The vast majority of hospice participants remain at home with nurses on call, a smaller percentage in nursing homes, and only 5 percent arrive to reside in the facility — not for long-term residence but for five days or a week. They come to give a respite to their primary caretaker, or to stabilize and return home, or to die during their stay.
“Medicare and Anthem love us,” Dr. Stone said with a laugh. Apparently, the bill for all-inclusive care at Hospice House is something like $550 a day, compared with $5,000 in intensive care. With a passing reference to Woody Allen’s line, “I’m not afraid of death; I just don’t want to be there when it happens,” he pointed out the play area for young children, introduced us to the nurses in charge and took us through a succession of meditation or meeting rooms for caregivers as well as hospital-like rooms for patients.
But even these did not have the feel of a hospital. The place was quiet and beautifully lit. Many rooms had French doors wide enough to open, in better weather, and through which a bed could be slid onto a deck overlooking the woods. There were paintings on the walls and upholstered chairs that converted into beds for caregivers. On the ceiling over a patient’s bed, an odd mechanism — described as a drone with a pulley — could be used to convey the dying person into a large bathtub in the adjoining bathroom.
I saw Julia blanch at the thought of the helpless frailty of the expiring body. But I also overheard the equanimity in Dana’s voice: she was telling her husband what a relief it was to know that he and their kids could be freed from arduous physical caretaking to focus on their emotional leave-taking.
“It feels deeply respectful,” Dana whispered to me as Dr. Stone waved goodbye by grinning and exclaiming, “I don’t want to see you people back here too soon.” I agreed with them both. Is that why an icy weight lifted while I floated back through the fireplace room and the massive front door to the parking lot?
From the moment of diagnosis, I knew that I did not want to end up in a hospital, and especially not in the I.C.U. — with its blinking and beeping machines, its fluorescent lights never turned off, its frantic rhythms of intubations and C.P.R.s and codes and respirators, its endotracheal and feeding tubes, its infections and psychoses. It shocked me to learn that this is what happens to one out of five Americans.
The information I clasped to myself in the car consisted of the answer to a question I had managed to ask Dr. Stone when we stood around the bathtub: “Can you control pain during the dying process?” With extraordinary confidence, this diffident man drew himself up to his full height to explain that he was “fully confident” he could “dial up” sedation when needed and “dial it down” when a patient wanted to gain greater consciousness for, say, a conversation with a family member. He then added, “Pain is treatable.” No equivocation, no qualification.
Hugging that flat statement, I warmed at the thought of leaving behind the wearisome parallel tracks. Perhaps I could fully experience the next library outing, the braising and seasoning, knowing now that the road not yet taken might be less agonizing than I had feared.

Susan Gubar is a distinguished emerita professor of English at Indiana University and the author of “Memoir of a Debulked Woman,” which explores her experience with ovarian cancer.

Wednesday, July 23, 2014

What Doctors Tell Their Friends About Preventing Cancer
By Lisa Mulcahy
Photo by Redbook
You don’t have to give up sweets"Lots of people I know think that sugar causes cancer so you should avoid it at all costs. It’s true that cancer cells do utilize sugar to grow, but when friends tell me proudly, ‘I’ve cut sweets out of my diet completely,’ I tell them, ‘You don’t need to do that.’ Now, that’s not to say you should indulge in all the soda and cupcakes you want, because data shows that a diet packed with empty calories from sugar-filled processed foods or soft drinks can up your cancer risk. But if you’re eating right, filling your plate with healthy food, it’s fine to have the occasional sweet treat. A close friend was recently diagnosed with brain cancer, and even in her situation, enjoying, say, a cookie or slice of pie is more than okay." -Nam Tran, M.D., neuro-oncologist and surgeon at H. Lee Moffitt Cancer Center and Research Institute in Tampa, FL
Related: The Magic Food Formula That Makes You Lose 

Got an abnormal pap smear? Stop smoking, pronto!

“Up to 80 percent of women have been exposed to the HPV virus by the time they hit middle age, so it’s not surprising for me to hear about this diagnosis from my friends. Most women with HPV do not develop cervical cancer. However, it’s not unusual for someone to go in for their Pap test and get abnormal results that can indicate precancer. More than one has said to me, ‘There’s nothing I can do though, right?’ My reply? ‘Uh—yeah, there is!’ Once the precancerous cells are removed, you should stop smoking to minimize the chance of a recurrence. Research has shown that carcinogens found in tobacco actually show up in a woman’s cervical mucus, and those carcinogens create a greater likelihood that HPV will be persistent, upping your risk of developing full-blown cervical cancer. Another reason to ditch the cigs!” -Lauren Streicher, M.D., associate clinical professor of obstetrics and gynecology at Northwestern University in Chicago and author of The Essential Guide to Hysterectomy

Play mole detective with your pals

“Last summer, I was having a lovely time with some houseguests by a pool, and one of my friends walked past me in his swim trunks. Suddenly, I noticed a dark spot on his back. ‘I think you have a melanoma!’ I blurted out. ‘That little mole?’ he replied. ‘I haven’t had time for a doctor to take a look at it, but I’m not worried.’ I told him, ‘That’s not just a mole. Come into my office and we’ll find out what it is for sure.’ It did turn out to be melanoma. Only a doctor can diagnose a suspicious mole as skin cancer, but really anyone can spot one. That’s why monthly self-exams are so important—and friends can examine areas we may not see, like the back and scalp. So be sensitive to your own instincts that tell you something on a friend or spouse has changed. Any mole that looks suspicious, appears out of nowhere, or changes in color or size should be checked by a physician.” -Sandra Read, M.D., spokesperson for the Skin Cancer Foundation
Related: The 25 Best Snacks for Weight Loss 

Snack on some cancer-fighting nuts

“I tell my family and friends to eat an ounce of any kind of nut they like per day; research I’ve just done shows this may powerfully prevent you from getting cancer. My study showed an 11-percent drop in cancer risk for those who ate 160 calories’ worth of tree nuts or peanuts [about an ounce, and no, peanut butter doesn’t count] on a daily, consistent basis. We think this could be because one or more minerals in nuts affect the metabolic pathways in your body in a good way-say, nuts may reduce the inflammation that directly causes some cancer cells to grow. Our study also suggested that people who eat nuts are less likely to put on weight. That’s great, because obesity is another cancer risk, so there’s an additional layer of cancer prevention for you.” -Charles Fuchs, M.D., professor at Harvard Medical School and director of the Gastrointestinal Cancer Treatment Center at Dana-Farber Cancer Institute in Boston
Don’t avoid this lifesaving test
“Friends of mine who haven’t had a colonoscopy worry about how uncomfortable the procedure is. But I tell them that’s no reason to gamble with their health. Screening can spot polyps and other changes in the colon so early that you can be treated before they even develop into cancer. You should have the test starting at age 50, or earlier if your doctor feels that your family history warrants it. I also tell my pals: The procedure is the easy part; you’re safely put under sedation so you’ll be feeling no pain. Truthfully, by the time you’re done preparing for the test-especially drinking that liquid you’re given beforehand—the most uncomfortable part is over. So schedule that appointment, and go through with it.” -Armando Sardi, M.D., surgical oncologist at Mercy Medical Center in Baltimore
Related: 9 Secret Calorie Bombs Lurking in Your Diet 

Making just one diet change can cut your cancer risk

“I tell my friends and relatives that fresh fruit absolutely needs to be in their daily diet; studies have suggested that consuming it is associated with a reduced risk of cancer. The most potent fruits are strawberries, blackberries, raspberries, blueberries, oranges, grapefruits, lemons, cherries, and red grapes. To make getting them in even easier, pick up those prepared fresh fruit cups at the grocery store. I buy them every week for my clinic staff and walk around delivering them personally, saying, ‘This is the way you can prevent cancer!’” -Gerald Gehr, M.D., oncologist/hematologist at Dartmouth-Hitchcock Norris Cotton Cancer Center in Nashua, NH

Saturday, July 19, 2014

HPV test better than Pap for assessing cervical cancer risk: study

By Andrew M. Seaman
NEW YORK (Reuters Health) - Testing for human papillomavirus (HPV) may be the best way to know whether a woman is at risk of developing cervical cancer in the near future, according to a new study.
Negative HPV tests provided women with more reliable assurance that they wouldn’t develop cancer or other abnormal cervical changes in the next three years, compared to traditional Pap tests, researchers report.
“Primary HPV screening might be a viable alternative to Pap screening alone,” said Julia Gage, the study’s lead author from the National Institutes of Health’s National Cancer Institute in Bethesda, Maryland.
About 12,000 U.S. women were diagnosed with cervical cancer in 2010 and about 4,000 died from the disease, according to the Centers for Disease Control and Prevention. Roughly 91 percent of cervical cancers are thought to be caused by HPV.
Pap smears, which require doctors to collect cells from the cervix to look for abnormalities, have traditionally been used to determine whether a woman is at risk of developing cancer in the near future.
In 2012, the government-backed U.S. Preventive Services Task Force recommended women between ages 21 and 65 years be screened using a Pap test every three years and said those ages 30 to 65 years could instead opt for cotesting, which is a Pap test in combination with a HPV test, every five years.
HPV is the most common sexually transmitted infection and affects both men and women. About 79 million people have the infection but most people don’t know they’re infected because symptoms are uncommon.
HPV testing also requires doctors to collect cells like they would during a Pap test but the end result is whether the woman has the virus - not abnormal cells.
“What we wanted to see is whether primary HPV screening could be a good alternative to Pap and compare it to cotesting,” Gage said.
For the new study, the researchers used data from over one million women who were between ages 30 and 64 years and screened for cervical cancer at Kaiser Permanente Northern California since 2003.
The researchers followed women who had a negative Pap or HPV test to see whether they developed cervical cancer during the next three years. They also looked at how many women developed cervical cancer in the five years following cotesting.
Overall, about 20 women out of 100,000 developed cervical cancer in the three years following a negative Pap test. That compared to 11 women out of 100,000 who developed the cancer during the three years after receiving a negative HPV test.
About 14 women out of 100,000 developed cervical cancer in the five years following negative cotests, according to results published in the Journal of the National Cancer Institute.
Gage said the findings were not surprising, since HPV is the cause of most cervical cancers.
She cautioned that the results do not foreshadow the death of Pap smears. The tests may still have a role in monitoring whether women with HPV, who are at an increased risk of cancer, go on to develop abnormal cervical cells.
“We always have to reconsider how we’re screening patients and focus on the best way to screen for certain cancer,” said Dr. Mario Leitao Jr., a gynecological surgeon at Memorial Sloan Kettering Cancer Center in New York City.
“I think this is very interesting because instead of doing (Pap tests) every three years you could do HPV (tests) every three years,” said Leitao, who was not involved with the new study.
He said there will be a lot of variables in deciding which test is best for women.
“The best way to do it is still to be determined but it’s important they have some form of cervical cancer screening at least every three years,” Leitao said.
He added that women also have to be their own advocates and tell their doctors that they don’t need Pap tests every year.
“It shouldn’t be done more frequently than every three years,” he said.
SOURCE: Journal of the National Cancer Institute, online July 18, 2014.

US regulators fast-track novel leukemia therapy

Nurses walk in a corridor on September 20, 2013 in a hospital in France
View photo
Nurses walk in a corridor on September 20, 2013 in a hospital in France (AFP Photo/Philippe Huguen)
Washington (AFP) - US regulators on Monday put an experimental immunotherapy agent on the fast track to market approval, after 89 percent of leukemia patients in early trials saw their cancers disappear.
The personalized immunotherapy known as CTL019 was developed by the University of Pennsylvania and was designated a "breakthrough therapy" by the US Food and Drug Administration.
That means the experimental therapy will benefit from a speedier than average review process and will get extra attention from the FDA toward development for market.
It is the first cancer immunotherapy to receive the breakthrough designation, and only the fifth biologic agent so far.
The approach works by extracting a patient's T-cells, then genetically programming them in the lab to target cancer cells that produce a protein called CD19.
The altered T-cells are then re-injected into the patient's body, where they multiply and attack cancer.
Researchers reported last year that of 27 patients, including 22 children and five adults, with acute lymphoblastic leukemia, 89 percent had a complete response to the therapy, meaning their cancer became undetectable.
The first child to receive the treatment, Emily Whitehead, in May marked two years of being in remission, and the first adult patient has been in remission for one year.
"Our early findings reveal tremendous promise for a desperate group of patients, many of whom have been able to return to their normal lives at school and work after receiving this new, personalized immunotherapy," said the Penn research team's leader, Carl June.
The university in 2012 teamed up with pharmaceutical company Novartis to develop and license personalized chimeric antigen receptor (CAR) T cell therapies for the treatment of cancers.
In addition to the ongoing trials for acute lymphoblastic leukemia, trials using CTL019 began in the summer of 2010 in patients with relapsed and refractory chronic lymphocytic leukemia.
It is also being tried in patients with non-Hodgkin lymphoma and myeloma.
More research is also under way into CAR therapies for mesothelioma, ovarian, breast and pancreatic cancers.