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    Top 4 Cancer Screenings That Should Be on Your Radar in 2019

    Many of the lives lost to cancer each year could’ve been saved through earlier detection. Here are four screenings that should be at the top of your list in the new year.

    As the new year approaches, there’s no better time to schedule those cancer screenings your doctor has been recommending.

    According to the American Cancer Society, approximately 610,000 people were expected to die from cancer in 2018.

    But many of the lives could’ve been saved through earlier detection.

    “Cancer screening is so critical because early on in early stages of cancer there are no signs of the disease, and that is precisely when the cancer is most treatable,” Dr. Carmen Guerra, national board scientific officer of the American Cancer Society (ACS) and associate professor of medicine at the University of Pennsylvania, told Healthline.

    Guerra urges people to learn more about the guidelines from the ACS and to keep screenings for these four cancer types at the top of their list.

    1. Breast cancer
    Women ages 40 to 44 years old who are not at increased risk for breast cancer should be offered the choice to start an annual mammogram.

    “Between 45 and 54 years old, women should definitely get a mammogram every year. After 55 they can switch to every other year or continue yearly mammograms,” said Guerra.

    While there is no age maximum for a mammogram, women should discuss with their doctor what screening is best for them after age 54.

    “If their physician believes they will live for another 10 years or longer, he or she may recommend screening,” Guerra said.

    She also points out that even if you don’t have a history of breast cancer in your family, you should still follow these guidelines.

    “The truth is over 90 percent of the cases occur in people without a family history. Also, many patients tell me that they don’t feel a breast lump [during self-exams] so they don’t need screening,” Guerra said. “Mammograms detect tumors that are not able to be captured with a self-exam or even a clinician exam. Some breast cancers are the size of an eyelash. That’s what a mammography detects, something you could never feel with an exam.”

    Women who are at increased risk of breast cancer due to personal history, genetic history or because they carry a gene mutation, such as BRCA1 or BRCA2, should talk with their doctor about screening options, such as an MRI scan.

    2. Cervical cancer
    All women should begin cervical cancer screening at the age of 21.

    Between 21 and 29, screens should be conducted with a Pap smear every three years.

    Starting at age 30 and continuing all the way up to 65 years old, in addition to a Pap smear every 5 years, women should also have an HPV test.

    “We know there’s a strong link between HPV and cervical cancer,” said Guerra. “After 65, women can discontinue cervical cancer screening if their last two Pap smears over the last 10 years were normal.”

    For women who have had the HPV vaccine, Guerra says, the ACS is currently looking into whether or not screening is still needed.

    “I’m on the panel that’s looking at that question now. We don’t know yet if women will have to continue cervical cancer screening in the same way I just stated. New guidelines may come out in the next year or so and may affect the recommendations,” she said.

    Guerra also notes that the FDA has approved the HPV vaccination to be offered to people 27 to 45 years, which is an update from the approval of up to 26 years old.

    “It’s new, but hasn’t been implemented widely yet. Talk to your doctor,” she said.

    3. Lung cancer
    Lung cancer kills more people than colon, breast, and prostate cancers combined.

    Screening for lung cancer involves a low-dose CAT scan of the chest for people who are known to be at higher risk of developing the disease.

    Recommendations are to screen people (men and women) who are 55 to 74 years old, and who currently smoke or have smoked in the past, but quit in the last 15 years.

    “They have had to have smoked approximately 30 pack years or more. What that means is smoking one pack a day times 30 years or half a pack a day times 60 years,” Guerra explained.

    In addition to screening, she suggests smoking cessation counseling.

    “Smoking rates have been declining since the publication of the reports of the Surgeon General in 1964. That began to raise awareness of the harms of smoking and a lot of public health research and investment has been put into smoking cessation,” Guerra said. “We suspect that all, along with improvement in treatment, has something to do with declining rates of lung cancer.”

    4. Colon cancer
    Screening for colon cancer not only detects cancer early, but by removing polyps, which can turn into cancer, the screening can actually prevent cancer.

    “This is the only cancer screening that can do this,” Guerra said.

    Recommendations for colon cancer screening changed earlier this year.

    Previously, the ACS stated that anyone over 50 years old should start screening with colonoscopy or a stool-based test. The new guidelines lowered the age to 45 years old.

    “There is a concerning increased rate of colon cancer that we are seeing in younger individuals, even millennials, and we don’t know why. To better address this new trend, the recommendations were lowered and should continue through age 75,” said Guerra.

    Between the ages of 76 and 85, you should talk with your doctor about whether screening makes sense, and once you reach 85, screening should stop.

    Your healthcare provider will also determine how often to screen, but generally, screening is performed once every 10 years with a colonoscopy. If no polyps are found, then screening may continue in intervals of 3 or 5 years.

    For those who are concerned that colonoscopy is embarrassing or painful, Guerra says, “The truth is people who have had a colonoscopy almost universally say that the worst part is the prep, which may vary, but generally consists of a liquid you take in two portions and a clear liquid diet.”

    She adds that most people don’t remember the procedure because they receive a sedative that helps them sleep.

    “Sometimes the sedative is combined with a medicine that makes you forget things, so most people wake up and don’t think they had the colonoscopy, yet it’s over,” Guerra said.

    Is it possible to screen too much?
    Concern about over-testing and over-screening is a legit one, says Guerra. Doing so can lead to negative consequences such as time spent, cost, and in some cases harmful health effects, such as exposure to radiation (from mammograms).

    However, she says this is more reason to adhere to the guidelines.

    “For instance, the reason breast cancer screening focuses on age 45 to 54 is because if you were to plot all the cases of breast cancer that occur, it looks like a bell curve that has a peak at those years. Then it falls down,” she said. “As it falls, it’s okay to cut back on screening because the risks are also falling.”

    She adds that work needs to be done to get more doctors and patients to realize this.

    “Patients want to receive good care, and to them the yearly screening means good care, but it’s actually complex,” Guerra said. “Good care means cutting back for some people. The guidelines are based on a lot of scientific data.”

    From Healthline

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    When Support Groups Make You Feel Worse
    Support groups are meant to offer the insight of others who "get it" but for some people, they can be terrifying and depressing.

    The day I was diagnosed with a bladder condition called interstitial cystitis (IC), I joined a Facebook group called IC Warriors. There, I learned about dietary guidelines and supplements that became helpful to my recovery. I also learned how bad my condition could get. People talked about being unable to work, have sex, or function successfully day-to-day. My depression grew as I started worrying I could reach that point.

    My next experiment with support groups, after learning I had Lyme Disease, was very short-lived. One evening spent in an in-person support group left me frightened over how long Lyme can go on and how serious it can get. Several people had it for years, and one woman needed heart surgery. I didn’t come back.

    Sarah Neal Montgomery, a 27-year-old student in Georgia, has similarly mixed feelings about the IC support groups she uses on Facebook. “Seeing that there are so many people with my condition was a comfort,” she says. However, she adds, “It can be overwhelming when so many people are suffering and sharing their suicidal thoughts. I have the same depressing thoughts at times. I try to stay positive and keep those thoughts far away, but it's hard to forget about it when I see it daily.”

    Laurina Esposito, a 37-year-old CEO of a car restoration company in Los Angeles, limits her time on Lyme support groups on Facebook for similar reasons. “The negative posts can actually drain me a bit and make me worry more,” she says.

    Support groups for mental health issues can have similar problems. “There can be triggering moments where people talk about assault or something, and sometimes it stirs up a lot of emotion that I then have to deal with,” says Sarah, a 28-year-old student in Boston (who declined to share her last name so that prospective employers can’t identify her) who is a sexual assault survivor herself, of the group she attends for depression and anxiety.

    Of course, there can be lots of benefits to support groups, too. Jennifer L. FitzPatrick, a Maryland-based psychotherapist and author of Cruising Through Caregiving: Reducing The Stress of Caring For Your Loved One, says that most of her clients report positive experiences with support groups. “Experiencing a physical, mental health, or cognitive condition can make people feel like they are the only one going through it,” she says. “Friends and family who don’t have the condition can offer love but can never truly identify with the experience. Support groups offer the insight of others who ‘get it.’” They can also empower patients by giving them an opportunity to help others.

    “Support groups provide relief from overwhelming isolation associated with chronic illness,” says Ruschelle Khanna, a psychotherapist who has run outpatient mental health and substance abuse clinics in New York City. They can also help educate people about their conditions and treatment options. Terry Lynn Arnold, 60-year-old founder of the Inflammatory Breast Cancer Network Foundation who runs online support groups for people with inflammatory breast cancer, has even heard from people who were deterred from committing suicide after receiving support in groups.

    However, this type of group therapy often involves—as I experienced—the sharing of unpleasant experiences and emotions, FitzPatrick adds. Listening to these stories may provide insight into your own situation, but if they leave you feeling depressed, you have to assess whether the lessons are worth i

    Another risk of support groups is that, if not supervised by professionals, they could spread inaccurate information. “Sometimes feedback is not always appropriate or can be unsound when it is related to a medical or behavioral condition,” says social worker Caitlin Simpson, director of clinical operations at Footprints to Recovery, a network of drug and alcohol treatment centers.

    “I don't run any groups that they don't have medical people volunteering to help the group understand the science,” Arnold says. “Sometimes patients say things like ‘well, you can get that care differently than what your doctor recommends because I did and I'm fine.’ But that is an anecdotal story. That is not a scientifically based story.”

    And in online support groups especially, there’s the possibility of encountering trolls, FitzPatrick says. Even when not intended, people often end up offending people online because the tone and intention of written words can easily be misinterpreted, Arnold adds.

    To avoid these problems, Khanna recommends finding support groups with good moderators and guidelines. “Structure is needed to keep the group on task and to keep people in check when they want to focus on things other than support, such as consistent complaining or negativity,” she says. Simpson even recommends going to multiple support groups to figure out which is most conducive to your healing.

    And for the sake of your sanity, don’t assume anyone else’s situation is the same as yours. This can lead you down the rabbit hole I fell into, where you’re just waiting for every dreaded symptom other people have reported to arrive. “It's important to remember that even if someone’s experience is similar to your own, your outcome and needs may be entirely different,” Simpson says. Based on many needless freakouts, I can assure you that just because someone in your support group is in a flare today doesn’t mean you will be tomorrow.

    FitzPatrick also cautions against pushing away your loved ones just because the people in your support group understand your condition better. “While your family and friends don’t understand precisely what you’re going through, they usually know you best and love you,” she says.

    Even when support groups are structured in the healthiest way, they aren’t for everyone, Khanna says. It’s important to keep taking stock of how you’re feeling after you participate in a meeting or visit a Facebook group. “If you are in a support group and you find yourself becoming overwhelmed by sadness or always leave feeling worse than before the group, the support group may not be for you,” she adds.

    Sometimes, the solution is simply to be more thoughtful about how you use these types of groups. I’m still in several IC and Lyme support groups on Facebook, but I try to only read comments on my own posts or posts on specific topics I search for, rather than mindlessly scrolling through the page. That way, I can get the information and encouragement I need without the negativity.

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    Cognitive problems are a common side effect after chemotherapy. A new study suggests how one type of chemo may contribute.

    How does chemo brain work? One cancer drug might interfere with brain signaling

    For the millions of people treated for cancer, “chemo brain” can be an unnerving and disabling side effect. It causes memory lapses, trouble concentrating, and an all-around mental fog, which appear linked to the treatment and not the disease. Although the cognitive effects often fade after chemotherapy ends, for some people the fog persists for years, even decades. And doctors and researchers have long wondered why. Now, a new study suggests an answer in the case of one chemotherapy drug: Brain cells called microglia may orchestrate chemo brain by disrupting other cells that help maintain the brain’s communication system.

    “I can’t tell you how many patients I see who look at me when I explain [chemo brain] and say, ‘I’ve been living with this for 10 years and thought I was crazy,’” says Michelle Monje, a pediatric neuro-oncologist and neuroscientist at Stanford University in Palo Alto, California. It’s still mostly a mystery how common long-term cognitive impairment is after chemo. In one recent study by clinical neuropsychologist Sanne Schagen at the Netherlands Cancer Institute in Amsterdam, it affected 16% of breast cancer survivors 6 months after treatment.

    Monje began to probe the cognitive effects of cancer treatment in the early 2000s, starting with radiation, a therapy that can be far more debilitating than chemotherapy. A Science paper she and her colleagues published in 2003 suggested radiation affected a type of brain cell called microglia, which protect the brain against inflammation. Just like immune cells in the blood, microglia—which make up at least 10% of all brain cells—become activated during injury or infection.

    The symptoms of chemotherapy-related cognitive dysfunction pointed to abnormalities in myelin, the fatty sheath around nerve fibers that helps them transmit brain signals. More than 10 years ago, stem cell biologist Mark Noble at the University of Rochester in New York and his colleagues reported that brain cells called oligodendrocyte precursor cells (OPCs), which ultimately help form myelin, were exquisitely sensitive to chemotherapy. But later work suggested OPCs could rapidly repopulate in a healthy brain, and the long-term effects of chemotherapy on OPC cells remained mysterious.

    Monje began the new study almost 7 years ago. First, she and her colleagues examined stored brain tissue samples from children and young adults who had died from various cancers, and control patients who’d died of something else. Some had received a host of chemotherapy drugs, and some had never gotten chemotherapy. In those who’d had chemo, OPCs were markedly depleted, but only in the white matter of the brain, which is a heavily myelinated brain region. The researchers focused on a particular chemotherapy drug, methotrexate, which is especially associated with long-term cognitive problems.

    Monje’s team wanted to confirm the findings in just-donated tissue, which was offered to them by the families of two children: a 3-year-old whose brain cancer was treated with high doses of methotrexate, and a 10-year-old whose brain cancer progressed so rapidly that there was no time to administer much therapy. Again, the child who’d received methotrexate—with the last dose well over a month before he died—had a near-wipeout of OPCs in white matter. The other child did not.

    Next up for the scientists was designing a mouse model of chemo brain caused by methotrexate. The mice got the same chemotherapy treatment as the 3-year-old, adjusted for their tiny body size. The animals “have a very clear impairment in attention and short-term memory,” Monje says. The animals also had the same decrease in white matter OPCs. Studying the organ 6 months after chemotherapy ended—a long time in the life of a mouse—the researchers saw that “the myelin sheaths were thinner,” Monje says, which would disrupt brain signaling.

    The big question for Monje was whether chemotherapy was directly killing OPCs or creating an environment that was hostile to them. To answer this, her team transplanted healthy OPCs into the brains of mice previously administered methotrexate. Those healthy cells showed the same disregulation, Monje says. Typically, the brain replenishes OPCs as needed, but in the mice, it didn’t. Something in the brain’s environment was causing the cells’ decay and disappearance.

    Ultimately, the story came full circle back to the microglia that Monje had first eyed more than 15 years ago. Additional experiments on brain cells revealed methotrexate activates microglia in the brain’s white matter, causing a cascade of effects and ultimately depleting OPCs. Because several compounds that deplete microglia are in clinical trials for cancer and other indications, the scientists were able to test one of them on their chemo brain–affected animals. They found that depleting microglia was effective: It restored OPCs, normalized myelin, and rescued short-term memory, the research team reports today in Cell. That means, they write, that the microglia are likely behind chemo brain for this particular drug.

    “The authors did a great job at trying to look at this phenomenon from very different angles,” says Schagen, making sure, for example, that findings in brain tissue also held true in mice. The activation of microglia, Schagen says, looks like an “important” direct mechanism. But Schagen, who has studied the effects of several chemotherapy drugs on mouse brains, also stresses that these findings are limited to methotrexate; other chemotherapy drugs may cause cognitive problems in different ways. The dose and its timing may also affect a drug’s brain effects, Schagen says.

    Monje says there’s a lot left to do before launching a clinical trial of any potential chemo brain fighter. One question is how long any such drug must be used. Another is what molecular mechanisms are driving the brain cells to behave as they do. But she’s hopeful that, after many years of trying, she and others are moving in the right direction.

    Posted in: Brain & BehaviorHealth

    Jennifer Couzin-Frankel
    Staff Writer

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    How is your sleep going? Getting plenty, or not at all, or somewhere in between?

    • GregP_WN's Avatar

      LIve, my problem was staying asleep. Falling asleep was no problem, but I would wake up several times through the night and sometimes not go back to sleep. I would go to the living room, watch TV for an hour or two, and then fall asleep, just in time to get up and go to work. I started taking Ibuprofen PM, or any of those, now I take a generic Motrin PM and it works like a charm. I go to sleep and stay asleep all night long. I approve this message. Wait, the election is over.

      8 days ago
    • LiveWithCancer's Avatar

      @GregP_WN, staying asleep has been a recent problem for me, too. I have always been one to wake up several times during the night, but i have always been able to fall back to sleep with ease. Lately, I can't. Or, sometimes, i have nightmares and don't want to go back to sleep.

      I will try one of your solutions if the Benadryl fails me.

      Thank you, Russ!

      8 days ago
    • Russ' Avatar

      You're welcome LWC...I wish you nothing but sweet dreams.

      5 days ago
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    CancerNews posted an update

    sFrom: forbes.com

    An Israeli medical technology company is set to begin testing its new radiation cancer therapy in leading medical centers in Italy. The Alpha DaRT (Dіffusіng Alpha-emіtters Radіatіon Therapy) device delivers high-precision alpha radiation that is released when radioactive substances decay inside the tumor and kills cancer cells while sparing the surrounding healthy tissue, the company says.

    The company hopes to get approval from the European Commission by next year for the therapy.

    Early results from an ongoing pre-clinical trial on patients with squamous cell carcinoma (SCC) tumors at the Rabin Medical Center in Israel and the IRST (Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori) in Italy showed a reduction in all tumor sizes and more than 70 percent of the tumors completely disappearing within a few weeks after treatment, NoCamels reported.

    The therapy has already been tested on more than 6,000 animals and has been found “to be effective and safe for various indications, including tumors considered to be resistant to standard radiotherapy.” according to the breakthrough innovation news site NoCamels.

    Alpha Tau Medical was founded in 2016 to focus on research and development as well as commercialization of its Alpha DaRT cancer treatment. The therapy was initially developed in 2003 by Professors Itzhak Kelson and Yona Keisari at Tel Aviv University.

    According to the National Cancer Institute (NCI), cancers that are known collectively as head and neck cancers, or squamous cell carcinomas of the head and neck, usually begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck (for example, inside the mouth, the nose, and the throat).