Friday, February 21, 2014

The path to mindfulness and gratitude

By Sheryl M. Ness, R.N. February 19, 2014

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A few weeks ago, I mentioned a new resource — "The Mayo Clinic Guide to Stress-Free Living" by Amit Sood, MD, a Mayo Clinic specialist in the science of stress management and resiliency.
Two of the primary practices that Dr. Sood discusses in the book are mindfulness and gratitude. As part of our blog discussion, I thought we could take a deeper dive into these practices this week.
Mindfulness is a way of being fully conscious and completely present in the moment — setting aside your worries, expectations, emotions and other thoughts that take your mind away from the current moment. Researchers have studied the effects of mindfulness meditation and found that the practice can reduce stress and anxiety which has a positive effect on the mind and body.
If you'd like to get started with mindfulness meditation, try this simple exercise. In the morning, as you open your eyes and take in the world around you, think of three positive aspects of your life — this could be people that have been a positive influence in your life, or opportunities or circumstances that you're thankful for.
If you're thinking of people in your life — remember how you feel when you were with them (safe, loved, and accepted). Sometimes it helps to picture a fond memory in your mind and remember the special ways in which they have made a difference.
Next, send out a silent thank you to them for being a part of your life. Then think of a way that you might show them your gratitude — a little note, a phone call, or an extra-long hug next time you see them.
Dr. Sood also speaks of gratitude and joyful attention to the little things that are taking place around us. In our busy days, we're conditioned to multi-task and try to fit as much as possible into our days. Being mindful is the opposite of this.
It involves slowing down and focusing on only one thing at a time. If you're with a friend, pay attention to their smile, the way their eyes look, what you're doing together. What about your conversation? Are you thinking about the list of things you need to do or are you being present in the moment?
As you include mindfulness and gratitude in your routine each day, it becomes more and more natural. You'll gradually find your attention is more focused and relaxed and that you have deeper, more meaningful daily experiences.
Do your best to free your mind from negative thoughts and anxiety. Fill them instead with positive thoughts, gratitude and an appreciation of the world around you. When this happens, you'll find that you have more room in your mind for joy and happiness.
The Mayo Clinic Guide to Stress-Free Living is available from the Mayo Clinic Store. To preview the book and order online, go to:
https://store.mayoclinic.com/products/books/Details.cfm?mpid=154&trkid=22786S947976180
I'd love to hear about your experiences with mindfulness and gratitude. What has worked for you?
With
Follow on Twitter: @SherylNess1
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Wednesday, February 19, 2014

Device helps surgeons see cancer cells during operations

February 18, 2014
3 Comments
MD Julie Margenthaler wears the eyepiece during cancer surgery
MD Julie Margenthaler wears the eyepiece during cancer surgery
When doctors are operating on a patient to remove a cancer, they face a major challenge: telling healthy and cancerous cells apart. But a new, as yet unnamed device being developed by researchers at Washington University in St. Louis' School of Medicine could provide a safe, affordable and portable solution.
The team's goggle-based device allows the surgeon to see the cancer cells, glowing blue. Tests have shown it could make visible tumors as small as 1 mm in diameter. To make the cells appear blue, the FDA-approved contrast agent indozyanine is injected into the tumor.
The compact system is battery-operated, wireless, wearable and most importantly, hands-free. A night vision viewer from which it was developed was retrofitted to provide near-infrared excitation and white light illumination simultaneously. The visual data captured by near-infrared (NIR) fluorescence is displayed directly on the eyepiece with adjustable amplification.
The wireless capability, adapted from a battery-operated radio frequency video transmitter, allows the system to transfer real-time video to a remote site, where the wearer's view can be displayed graphically. This enables a remote expert to observe what is happening during the operation from the point of view of the local surgeon, and provide expert feedback and image analysis. This way the system could be applied to point-of-care medical interventions, help generate real-time pathologic assessment of tissues, and even allow for remote medical consulting.
The new eyepiece could represent an improvement on current methods of intra-operative imaging. These are usually expensive, logistically complex, time-consuming and at times risky, as in cases when radioactive tracers are needed. These emit hazardous ionizing radiation to both patients and surgeons. The blue dyes used for visualizing sentinel lymph nodes with the naked eye, for example, can also cause adverse reactions.
The technology has been developed by a team led by Samuel Achilefu, a PhD professor of radiology and biomedical engineering at Washington University in St. Louis. Earlier in February, breast surgeon Julie Margenthaler, an associate professor of surgery at the university, performed a surgery wearing the glasses. “Imagine what it would mean if these glasses eliminated the need for follow-up surgery and the associated pain, inconvenience and anxiety," she said in a press statement.
Currently, surgeons usually remove the tumor and some neighboring tissue that may not include cancer cells. Once analyzed, and if cancer cells are found in the sample, then a second surgery is recommended to remove additional tissue that once again will be tested for cancer. In cases of breast cancer patients, between 20 and 25 percent of those who have lumps removed require a second surgery.
An article with details on the technology behind the device appeared in a recent edition of the Journal of Biomedical Optics.
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Study shows dogs can sniff out lung cancer

August 19, 2011
A new study has found that sniffer dogs can reliably detect lung cancer in the breath of p...
A new study has found that sniffer dogs can reliably detect lung cancer in the breath of patients
Last year we reported in the development of a cancer-detecting electronic nose inspired by dogs' ability to literally sniff out different types of ovarian cancer. Now a new study has found that sniffer dogs' abilities extend to reliably detecting lung cancer. The researchers say the results of the study confirm that there is a stable marker for lung cancer, which offers the possibility that a "breath test" for the early detection of lung cancer could be developed.
According to the European Lung Foundation, lung cancer is the second most frequent form of cancer in men and women across Europe and accounts for over 340,000 deaths each year. Although the chances of survival are relatively high when detected early, because many of the symptoms of lung cancer are nonspecific it is often not diagnosed before the cancer has spread and early detection is often only by chance.
To provide a simple way to detect lung cancer in its early stages, researchers have been working to identify volatile organic compounds (VOCs) that are linked to the presence of cancer. In an attempt to confirm the presence of such identifying compounds, researchers fromSchillerhoehe Hospital in Germany conducted tests using exhaled breath specimens provided by 220 volunteers, including lung cancer patients, chronic obstructive pulmonary disease (COPD) patients and healthy patients.
Specially trained sniffer dogs successfully identified 71 samples of lung cancer out of a possible 100 and correctly detected 372 samples that didn't have lung cancer out of a possible 400. Although it isn't known which specific chemical the dogs are responding to, the researchers say the results confirm there is indeed a stable marker for lung cancer that is independent of COPD and is detectable in the presence of tobacco smoke, food odors and drugs.
"In the breath of patients with lung cancer, there are likely to be different chemicals to normal breath samples and the dogs' keen sense of smell can detect this difference at an early stage of the disease," says author of the study, Thorsten Walles. "Our results confirm the presence of a stable marker for lung cancer. This is a big step forward in the diagnosis of lung cancer, but we still need to precisely identify the compounds observed in the exhaled breath of patients. It is unfortunate that dogs cannot communicate the biochemistry of the scent of cancer!"
While it isn't feasible to use sniffer dogs in clinics, the results of the study offer hope that once the chemical the dogs are responding to is identified, an electronic nose could be developed to literally sniff out lung cancer in a patient's breath.
The new study is published in the European Respiratory Journal.
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Monday, February 17, 2014

10 States Where Cancer Incidence Is the Highest

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February 16, 2014 | Comments (13)
I would attest that there is perhaps no word or diagnosis scarier to me in the English language than cancer. A survey conducted in 2010 by Cancer Research UK in Britain would appear to agree with me, as more respondents chose cancer as their biggest fear over a number of other ailments including Alzheimer's disease, a heart attack, or being in a plane crash.
The reasons cancer is often viewed so negatively is twofold.
Source: Novartis.
First, we still have very little understanding as to how cancer cells form, activate, and replicate in the first place. This isn't to say that there isn't novel research going on at this very moment into specific proteins and characteristics within cancer cells that can help us fight their replication process, but generally speaking, if we understood how cancer worked we'd probably have considerably higher overall response rates for a number of cancer treatments, wouldn't we?
Second, there are also a number of common misconceptions built into a cancer diagnosis -- the worst of all being that getting cancer is a roll of the dice, and that there's nothing you can do to reduce your chance of developing cancer. Although certain cancer risks are based on hereditary (i.e., genetic) factors, about one-third of cancer incidence can be reduced or eliminated by simple lifestyle habit corrections according to the latest report from the World Health Organization. WHO suggests simple factors like quitting tobacco products, not drinking alcohol, eating healthfully, and avoiding becoming overweight or obese are key factors to reducing your risk of developing cancer.
10 states where cancer incidence in the highest
Within the United States, according to the Centers for Disease Control and Prevention, cancer incidence rates (inclusive of all types of cancers) can vary wildly from as low as 380.4 incidents per 100,000 to as high as 510.7 incidents per 100,000 people among our 50 states.
Today, utilizing that data from the CDC, which you can access here if you'd prefer to peruse it for yourself, we're going to look at the 10 states with the highest age-adjusted incidence rates of cancer, focus on some of the more common cancer types, and examine a few of the groundbreaking therapies that are on the market or being developed that could drastically change the outlook for cancer patients to positive.  
Here are the 10 states with the highest age-adjusted incidence rates of cancer:
State
Age-Adjusted Cancer Incidence Rate
Kentucky
510.7
Delaware
491.2
Pennsylvania
489.1
Maine
486.7
New Hampshire
485.7
Louisiana
485.3
Connecticut
485
New York
482.5
Iowa
480
Michigan
477.1
Source: Centers for Disease Control and Prevention, rates per 100,000 people according to 2000 U.S. Census.
My intent is certainly not to alarm anyone, but there is a significant bias east of the Mississippi River when it comes to cancer rate incidence in the U.S. To add some context to the above figures, the average age-adjusted cancer incidence in this country is roughly 445 people per 100,000.

Source: Centers for Disease Control and Prevention.
Breaking down these figures
There are four particular cancer types that are diagnosed more in this country than any other form of cancer: prostate cancer in men, breast cancer in women, lung and bronchus cancer, and colorectal cancer.
As these states relate to prostate cancer incidence, five of the eight highest incidence states are listed above in Louisiana, Michigan, Delaware, New York, and New Hampshire. In female breast cancer, four of the aforementioned states are in the top nine -- Connecticut, Delaware, New Hampshire, and Iowa. The story is similar in colorectal cancer, with only Louisiana, Kentucky, and Iowa showing up within the top six incident rate states. Finally, three of the states above -- Kentucky, Maine, and Louisiana -- crack the top nine in terms of highest incidence for lung and bronchus cancer.
Clearly, there are a number of factors at work here, but I suspect obesity could be a prime one. WHO, the CDC, and the Mayo Clinic all list obesity as a major cancer-causing risk factor. In addition, obesity can lead to a number of other serious diseases such as type 2 diabetes and heart disease. As of 2010, as you can see below, three of these 10 states -- Louisiana, Kentucky, and Michigan -- all had obesity levels in excess of 30%, likely increasing their cancer incidence rates.

2010 U.S. obesity rates, Source: Centers for Disease Control and Prevention. 
Another prime cancer-causing factor that you'll see some commonality to in these states is smoking. According to a compilation from Health.com, Kentucky and Louisiana rank third and fourth in terms of the percentage of the adult population that smokes.There is perhaps no greater cancer-causing risk factor than tobacco products, so I feel pretty confident surmising that this is a reason why these aforementioned two states are among the highest in terms of cancer incidence rates in the country.
Battling the bulgeNow that we have a better understanding of where cancer incidence rates are the highest, and what some of the risk factors are that could be pushing these rates higher, let's examine a few therapies, both approved and in clinical studies, that could be used to win the war against cancer.
However, before I dive into three cancer therapies I'd suggest you have your eyes on, I think it prudent to mention, especially given how much of a risk factor obesity can be, that increasing awareness about obesity and obesity prevention could push physicians, consumers, and insurers toward a greater adoption of chronic weight management drugs over the coming years.
Both Arena Pharmaceuticals (NASDAQ: ARNA  ) and VIVUS have FDA-approved anti-obesity drugs already on the market in Belviq and Qsymia; however, sales of both has been nothing short of abysmal thus far. VIVUS' Qsymia was the first to reach pharmacy shelves and has delivered the greater percentage of weight loss in trials, yet Belviq offers the more favorable safety profile of the two drugs, making it the more logical choice, at least in my opinion, for physicians.
What investors and chronic weight sufferers will want to watch, though, is Orexigen Therapeutics (NASDAQ: OREX  ) , which has an experimental weight control drug known as Contrave currently under review by the FDA. Although weight control drugs are faring poorly, I believe a lot of this has to do with skepticism about their safety. Orexigen has alreadycompleted a study (the Light Study) involving 9,800-plus patients that demonstrated its drug is effective and safe over the long term without any serious adverse effects on the cardiovascular system. This alone could give Contrave an edge over its peers if it's approved, and go a long way to reducing obesity rates, and therefore cancer risk, in the United States.
Source: Novartis.
Breakthroughs on the cancer frontIn addition to fighting high risk factors and encouraging Americans to alter poor lifestyle habits, biopharmaceutical companies are also tackling cancer with a myriad of groundbreaking drugs.
One, in particular, that I'd suggest keeping your eyes on is an experimental estrogen receptor positive, HER2-negative locally advanced or newly diagnosed metastatic breast cancer drug, palbociclib. Developed by Pfizer (NYSE: PFE  ) , and co-administered with Novartis' (NYSE: NVS  ) Femara, palbociclib was recently noted to have met its primary endpoint in the mid-stage PALOMA-1 study with detailed data to come at the American Association for Cancer Research annual meeting in April. Last year, however, the combination of palbociclib and Femara delivered early stage data which demonstrated progression-free survival hadmore than tripled to 26.1 months, compared with just 7.5 months for the Femara-only control arm. It's a very intriguing, and potentially life-altering drug for the most common type of breast cancer.
Another statistically impressive clinical therapy is LDK378, a breakthrough therapy designated non-small cell lung cancer drug from Novartis. In June, Novartis announced that LDK378 delivered an impressive 60% overall response rate among the 78 patients who were studied in ALK-positive NSCLC. Being the most common type of lung cancer, and delivering a superior overall response rate, this therapy could have the makings for an early approval in 2014.
Finally, turning toward an FDA-approved indication we have Medivation (NASDAQ: MDVN  ) and Astellas Pharma's Xtandi, a treatment for advanced-stage prostate cancer. There are, admittedly, a number of therapies on the market to treat this most common form of cancer, but Xtandi has stepped it up a notch with superior results in a pre-chemotherapy setting. In recently released final phase 3 results, Xtandi reduced the risk of death by 29% and the risk of radiographic progression by 81% in treatment-naïve patients. Perhaps most impressive, it delayed the start of chemotherapy in the Xtandi intent-to-treat group to 28 months compared to just 10.8 months in the placebo arm. Finally, the median time patients were able to take Xtandi was more than three times longer than the placebo (16.6 months versus 4.6 months), speaking to its impressive tolerability. Long story short, Xtandi looks like a game-changing drug in prostate cancer treatment.
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Saturday, February 15, 2014

My Wild, Irish Skin Cancer: Actor Donal Logue Goes Under the Knife

By Everyday Health Guest Contributor
Published Feb 13, 2014
YOUR REACTION?
I LIKE IT
SO SO
INSPIRING
INTRIGUING
IMPORTANT
DLBy Donal Logue, Special to Everyday Health
I am a redhead. Yes, I know we’re called “gingers” these days, but when I was growing up this was a term I only heard when visiting my equally pale, redheaded relatives back in Ireland or the UK, so I’ll stick with redhead. Which is what I am. Or was. Over time my hair has darkened, my beard has whitened, and many of the freckles on my face and shoulders have morphed into a morass of blues, pinks and greens floating on the fish-belly white sea of my skin.
Unlike my pale Irish relatives, however, I grew up in the desert on the Mexican border, just a hop, skip and a jump south from where the highest temperature on this sun-splashed sphere was ever recorded. You can see where this is going. I spent the seventies like a lot of Californian desert youth, playing baseball and soccer, running, skateboarding, and generally baking outside in the sun all day, back when baby oil was my generation’s “sunscreen” of choice.
So it was really no surprise when this past summer, while back in Ireland, where I was spending many hours a day outdoors, shooting a TV show under the sunniest skies the Emerald Isle—thanks to global warming—had seen in decades, I noticed that the bump of reddish/flaky skin on my scalp-line was acting up again.
Some years back I had off-handedly mentioned this abnormal patch, one of dozens I have on my body, to a dermatologist in LA. He was sufficiently concerned to have subsequently frozen it off with liquid nitrogen. That seemed to do the trick until this past summer, when it suddenly, like a tiny Dionysus revived by the wild, Irish sun, came back from the dead.
This time I was concerned enough that I actually paid a visit to a doctor in Ireland, who glanced at it and said, “Ah sure, ye’re grand. ‘Tis nothing.” But when the shoot was finished, and I was finally back in the States, I mentioned it to my best friend Gilles. He immediately dragged me to Dr. Gene Rubenstein, an awesome dermatologist whom I knew from my son’s school. Donal Logue in desert
A sample was cut out of my noggin for biopsy, and then, not thinking I would ever have to deal with whatever it might or might not be in any immediate sense, I drove 12 hours north to my home in Oregon.
Two days later, Gilles called me from LA, and said, in his fairly unintelligible French accent, “You have to call the doctor!”
“Calm down,” I said. “He has my number.”
“Call him now,” he snapped.
When I finally spoke to Dr. Rubenstein, he told me I had squamous cell carcinoma and that I had to schedule a surgery. I told him I had to go to Canada to shoot a film in a week and asked if I could go under the knife in March.
“No,” he said. “You’re doing it tomorrow morning.” He assured me that though squamous cell carcinoma is usually treatable, this one gravely concerned him because it had apparently traveled lower into my scalp through some hair follicles. He was worried about how long it had been active in the subcutaneous part of my forehead: the danger zone.
I immediately turned around and drove the 12 hours back to LA, completely calm. I remained so even after the initial hole cut into my head was deemed insufficiently large enough to get rid of all the cancer.  A second bout of cutting ensued, and now I realized I had a pretty significant crater in my head.
“No problem,” the doc said. “We’ll sew it shut. It’ll smooth out your forehead.” Good lord, I thought: an accidental facelift.
I recently had my stitches pulled and the doc gave me a good prognosis but also a stern warning: “You are at very high risk to have more squamous, so no sun and a hat and sunscreen at all times!”
This was, suffice it to say, a wake-up call. Now that I’ve had skin cancer, I know I have to be extra vigilant in the future: to check for new spots, to stay out of the sun if I can, to wear sunscreen when I can’t. Today, when I check my face in the mirror for new growths, I wish I could shake that young boy I once was, running around under the hot, desert sun without protection, for doing such ineradicable damage to his future skin.
On the other hand, my 14-year-old son just did say to me, when he saw my 47-year-old visage after the stitches were pulled out, “Dad, it’s like your face is 75, but your forehead is 25.” So there’s that.

Award winning actor Donal Logue may just be the busiest man in show biz these days, appearing most recently in Copper, Sons of Anarchy, and Vikings, which begins its second season this February. He was also just tapped to star as Detective Harvey Bullock in Fox’s new Batman prequel TV series, Gotham, and joins the cast of Law and Order SVU, where he will appear on March 12th. He is also a trucker and now novelist, whose first novel, AGUA, will be released by Harper Collins later this year. He joins Everyday Health–and skin cancer survivors everywhere–in urging you to please get any unusual-looking spots on your skin checked out by a doctor.
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Thursday, February 13, 2014

Chemotherapy Side Effect: Dark Undereye Circles—5 Tips that May Help

By Britta Aragon on May 9, 2011 | No Comments
It’s bad enough to feel sick while you’re going through cancer treatments. Worse still to look sick, and nothing makes you look more worn out and down than dark circles under your eyes.
“These dark circles make me look so tired,” writes one fighter. “Can you please tell me some remedy for this problem?”
I’ve had several people ask me about this. You may think that it’s all because of lack of sleep or stress, but actually dark circles are more closely related to bruising—and that’s why they tend to happen during chemotherapy.
According to darkcircles.net, dark circles under the eyes are caused by leaky capillaries. Blood leaks out into the surrounding skin, and as your body works to mop it up, you see the dark, purplish or blue-black discoloration. It’s much like when you injure yourself and see a bruise a few hours later. This process may happen elsewhere in the body and you wouldn’t even notice, but the skin under the eyes is so thin and delicate and the capillaries so close to the surface that the change in color becomes very visible.
Chemotherapy can cause excess bruising and bleeding, as I mentioned in a former post, so it’s no wonder some of that excess bruising can show up under your eyes.
There are some products out there that claim to help diminish dark circles, but unfortunately many of them contain parabens, ureas, and ingredients that are potentially toxic and best toavoid during treatment. Below I’ve given you five at-home tips to help battle dark undereye circles. Give them a try, and let me know if they help!
1. Tea bags. It’s one of those old tried-and-true remedies and it really does help. The caffeine in the tea diminishes water in the tissues to reduce puffiness, and the tea itself contains beneficial antioxidants. Squeeze out a cooled, used teabag and leave one on (or under) each eye for about 10 minutes. Since chamomile is a natural anti-inflammatory, chamomile tea bags may be extra helpful.
2. Cucumber slices. They feel cool and soothing on your eyes, and are known to help liven up the skin around the eyes.
3. Try some homemade mixtures. An old natural remedy recommends mixing a teaspoon of tomato juice, a half teaspoon lemon juice, a pinch of turmeric powder and a pinch of flour into a paste, applying under the eyes, and leaving for 10 minutes. At night, try mixing half almond oil and half honey and applying under the eyes before bed.
4. Puree a potato. Place an uncooked potato into a blender or liquidizer and puree, then place a little under each eye, lay down, and wait for up to 30 minutes.
5. Apply a cream with vitamin K. Vitamin K has shown in some studies to help diminish bruising. Try to find a non-toxic undereye cream with vitamin K. One possibility: CSI Recovery Eye Cream with Vitamin K & Arnica.
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General Information About Endometrial Cancer

Key Points for This Section




Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium.
The endometrium is the lining of the uterus. The uterus is part of the female reproductive system. It is a hollow, pear-shaped, muscular organ in the pelvis, where a fetus grows.
Enlarge
Anatomy of the female reproductive system; drawing shows the uterus, myometrium (muscular outer layer of the uterus), endometrium (inner lining of the uterus), ovaries, fallopian tubes, cervix, and vagina.
Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.
Cancer of the endometrium is different from cancer of the muscle of the uterus, which is called sarcomaof the uterus. See the PDQ summary on Uterine Sarcoma Treatment for more information.
See the following PDQ summaries for more information about endometrial cancer:
Endometrial cancer is the most common invasive cancer of the female reproductive system.
Endometrial cancer is diagnosed most often in postmenopausal women at an average age of 60 years.

Since 1992, the number of white women diagnosed with endometrial cancer has remained stable, but the number of new cases in black women has increased slightly. Endometrial cancer occurs more often in white women than in black women. When endometrial cancer is diagnosed in black women, it is usually more advanced and less likely to be cured. The number of deaths from endometrial cancer has stayed about the same in white women but has increased slightly in black women each year since 1998.
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