10 things breast cancer doctors wish you knew

1. I have breast cancer. Am I going to die? According to several doctors participating in Pink Power TODAY, this is a common question women ask immediately after being diagnosed. "Breast cancer is not a death sentence," Dr. Deepa Halaharvi, a board-certified general surgeon specializing in breast surgery, told TODAY via email. "Most people do really well and 5-year survival for all stages of breast cancer is 91 percent. We really need to be catching this at an early stage."

2. I don't have a family history of breast cancer. Why did I get it? "Most commonly, breast cancer is sporadic and most people (85 percent to 90 percent of breast cancer patients) don’t have a family history of breast cancer," said Halaharvi. "It’s a common misconception that it’s inherited through a family history. So regular screenings are very important, regardless of what your family history may be. At OhioHealth, we recommend average-risk women begin screening mammograms at age 40." According to the American Cancer Society, women ages 40 to 44 should start having annual mammograms if they want. Women ages 45 to 54 should get mammograms every year, and women 55 and older should switch to every two years, or can continue yearly screenings.

3. What are the most important risk factors for breast cancer? "A previous history of breast cancer, a significant family history of the disease (particularly when a genetic mutation in BRCA1 or BRCA2 are present), and specific conditions such as atypical hyperplasia and LCIS that are only detected when breast tissue is biopsied and examined microscopically," explained Dr. Freya Schnabel, the director of breast surgery at Perlmutter Cancer Center at NYU Langone. Schnabel noted that these risk factors have different magnitudes, and you should try to discuss with your doctor what makes a family history significant (close relatives, diagnosed at young ages, multiple generations).

4. I am a BRCA carrier. What do I need to know? "BRCA carriers are the highest risk group for breast cancer," stated Schnabel. "BRCA1 carriers are at risk for breast and ovarian cancer — their lifetime risk for breast cancer may be as high as 50 to 85 percent. BRCA2 carriers have a 40- to 60-percent lifetime risk for breast cancer, and are at an increased risk for ovarian cancer, and are also at increased risk for pancreatic cancer." According to Schnabel, BRCA carriers have three options to manage their breast cancer risk: intensive surveillance (to maximize the opportunity for early detection of disease should it occur) chemo-prevention (the use of drugs like tamoxifen to reduce the risk of developing breast cancer) risk-reducing surgery (bilateral mastectomies with reconstruction to lower the risk of breast cancer to as low as we can make it)

5. What can you tell me about the alcohol and breast cancer link? While countless studies support that wine is good for your heart health, you have to weigh these benefits against its link to cancer. "There is good evidence that alcohol increases the risk for breast cancer," Schnabel explained. "Specifically, women who drink at the rate of seven drinks per week have about a 20-percent increase in their risk for breast cancer."

6. My mother was diagnosed with breast cancer at 45, when should I start getting mammograms? "If you have a family history of breast cancer, you should start screening mammograms 10 years prior to your family member getting diagnosed," Halaharvi explained. "So in this case, you’d start at age 35. Again, make sure to talk with your physician and discuss your family history."

7. How quickly do I need to start treatment for my breast cancer? When you're first diagnosed, it may feel like there is pressure on you to decide on a treatment plan right away. But Dr. Lisa Newman, a breast cancer surgery specialist at Henry Ford Health System in Detroit, advises clients to take a beat to process everything and make the right decision for you. "You should not feel that you are 'racing the clock' — the cancer is not spreading or becoming more advanced in your breast or your body by the day," Newman said. "You have the time to make sure that you are properly informed about your cancer diagnosis and treatment options before jumping into something irreversible."

8. Should I get a second opinion? For many women, taking the time to weigh their options means getting more than one medical opinion, or looking into clinical trials or research studies, Newman said. "There is no magic deadline," she stressed. "But a general rule of thumb is that we don’t like to see patients delaying the start of their treatment more than four to six weeks after the diagnosis has been made. The stage and type of breast cancer can influence how quickly the treatment should be initiated."

9. There are so many conflicting reports about breast self-exams, should I be doing them? The American Cancer Society no longer recommends frequent breast self-exams because research has found they don't provide a clear benefit or save women's lives. However, it does stress that women should have self-breast awareness — "be familiar with how their breasts normally look and feel and report any changes to a health care provider right away." "Women should be aware of changes to their breasts such as a palpable mass, skin changes, nipple discharge, skin dimpling, nipple inversion and mass underneath the arms such as enlarged lymph nodes," Halaharvi stressed. "You don’t necessarily need to have a mass to have breast cancer such as inflammatory breast cancer (redness, an orange peel appearance) are seen."

10. How and when should I tell my children? This is one of those answers that is tricky, depending on the ages of your children, but Newman offered this advice: "In general it is best to be as honest with them as possible, because they are likely to sense and/or see that something major is happening, and it is important to provide them with reassurance that you are taking care of yourself," she said. "Very young children may need to also be reassured that cancer is not contagious like the flu, and older children may actually feel empowered if they are allowed to help out and provide support during your treatment. All children need to understand that the cancer diagnosis was not anyone’s fault."

Julia Louis-Dreyfus has breast cancer

Julia Louis-Dreyfus announced she has breast cancer in a post on her official Twitter account. "1 in 8 women get breast cancer. Today, I'm the one," Louis-Dreyfus wrote. The 56-year-old actress went on to say "The good news is that I have the most glorious group of supportive and caring family and friends, and fantastic insurance through my union." "The bad news is that not all women are so lucky, so let's fight all cancers and make universal healthcare a reality," she concluded.

The news comes on the heels of what has been a triumphant year for Louis-Dreyfus. She broke the record for the most Emmys won by a performer for a single role earlier this month, after snagging her sixth consecutive win for lead actress in a comedy for her work on HBO's "Veep." It was her seventh statue in that category overall as she had previously won in 2006 for "The New Adventures of Old Christine." HBO told CNN that Louis-Dreyfus received her diagnosis the day after her historic Emmy win.

Her health did not factor into the decision to end "Veep" with Season 7, which writers are currently working on. HBO added the show's production schedule will be adjusted if needed to accommodate its star. "Our love and support go out to Julia and her family at this time," HBO said in a statement. "We have every confidence she will get through this with her usual tenacity and undaunted spirit, and look forward to her return to health and to HBO for the final season of 'Veep.'" (HBO and CNN share parent company Time Warner.) Louis-Dreyfus has advocated for cancer research in the past by teaming up with the Livestrong Foundation, according to Web MD.

"I was asked, and it was a no-brainer," she told the site. The former "Seinfeld" star is also a long-time advocate of environmental causes and green living, leading to a Mediaplanet feature on her work. "My actions have an impact on humanity and generations to come," she told the publication.

Signs of Lymphedema

Lymphedema is somewhat unpredictable and doctors do not fully understand why some people develop lymphedema and others do not. People who have had several lymph nodes removed and/or radiation treatment in the axillary area (underarms) during cancer treatment are at higher risk of developing lymphedema. Lymphedema can occur after treatment for any type of cancer, but it is most commonly associated with breast cancer, prostate cancer, lymphoma, melanoma and cancers in the pelvic area such as bladder, testicular or gynecological cancers. Obesity, lack of exercise and infections after surgery are also risk factors.

Signs and symptoms of lymphedema:
-Swelling in the arm or leg (clothes or jewelry feel tighter)
-Arm or leg feeling heavy or tight
-Weakness, decreased flexibility, difficulty moving
-The skin thickens (hyperkeratosis) or hardens
-Pain and redness in the arm, hand, leg or foot

Apple-shaped women are at risk of a deadlier form of breast cancer (and those who store fat on their thighs, hips and buttocks are prone to a more treatable form of the disease)

Apple-shaped women are at risk of developing a deadlier form of breast cancer, a new study suggests. But those who have a pear-shaped figure, with fat stored on their thighs, hips and buttocks, are prone to a more treatable form of the disease.

For years, scientists have warned of the dangers of obesity due to evidence of its role in triggering breast cancer among other health risks. But the Chinese study shows the link between obesity and this form of the disease to be more complex than previously thought.

They discovered women with a higher BMI, which measured subcutaneous fat, were more likely to have ER+ (oestrogen-receptor positive) breast cancer. This form of the disease can be influenced by oestrogen, as the hormone can attach to proteins in cancerous cells to stimulate growth. Patients are often given Tamoxifen, a drug that costs 6p a day and which work by blocking oestrogen, which is known to stimulate the formation of tumour cells.

In contrast, those with a high waist-to-hip ratio, showing belly fat, were more likely to have ER- (oestrogen-receptor negative) breast cancer. This form of the disease can't be tackled with hormone blocking drugs, and have to go down traditional chemotherapy routes. The greater risk of developing ER- breast cancer for women with a high waist-to-hip ratio existed even if they weren't obese, Shandong University scientists noted.

Lead researcher Dr Zhigang Yu said: 'A possible reason is that subcutaneous fat is involved in estrogen production, which may promote ER+ breast cancer. 'Visceral fat is more closely related to insulin resistance and may be more likely to promote ER- breast cancer.' The researchers said that clinicians should assess ER- risk by assessing a woman's body shape before prescribing Tamoxifen, which is often given to those at high risk.

Experts stressed the findings, published in The Oncologist, were important as breast cancer is becoming a 'pandemic'. Around one in eight women will develop breast cancer in their lifetime and the illness is becoming increasingly prevalent as the population ages. There were 55,222 new cases recorded in the UK in 2014 and 11,433 deaths. In the US, 252,710 are expected to receive a diagnosis this year. Around 40,000 will die.

Researchers recruited 1,316 women who were newly diagnosed with breast cancer for the study. They were compared to a control group. Body measurements were taken, alongside details of their form of cancer - whether it was ER+ or ER- breast cancer.

How one app is helping to tighten the link between cancer patients and their doctors

When chemotherapy patient Allison Hailey meets with Dr. Angela Kueck at Texas Oncology in Austin, she comes prepared. That is because Hailey's phone displays graphs, charts and logs of her medications, mood changes and physical health — courtesy of an app called ChemoWave. Since its launch on June 29, ChemoWave is giving chemotherapy patients and their doctors more insight on treatment plans, side effects and mental health. The app arrives on the scene at a time when health care is becoming a major focus for tech giants like Amazon and Apple, and joins an increasingly crowded field of biometric tech that helps people track vital health information.

ChemoWave is designed to help track a wide variety of vital data like symptoms, exercise, water intake and medications. It then compiles those figures into a health compliance database, then graphs the information so patients — and their doctors — can connect what symptoms are related to what medication or activity. Patients can also send daily updates to their doctors, which can be critical when treating cancer. A recent study by the Journal of the American Medicine Association found a 21 percent increase in survival time for patients who tracked and reported their symptoms. Thirty-one percent were more likely to report better quality of life and physical functions, the study said. "I have a better understanding as opposed to when I see [Hailey] every couple weeks in the office with her trying to remember what side effects she had on what day," Kueck told CNBC. "You can see trends over time, so we can plan for her next cycle" of chemo, she added. "It improved communication and we're connected more."


Matt Lashey, the developer of the app and co-founder of Treatment Technologies & Insights, came up with ChemoWave when his partner Richard Grenell was diagnosed with cancer in 2013. Each morning, Lashey would administer Grenell a survey about how he was feeling emotionally and physically, along with any side effects. Lashey's background in data analysis propelled him to do some correlation analysis from the surveys to track Grenell's symptoms. "I started doing some simple correlation analysis to see what things were related to his highs and lows, and our doctor loved (the charts)," the former research consultant for Discovery Communications and Nationwide Insurance told CNBC. "We could point to very specific days when something had occurred, and having those graphs and data really led to a lot more efficient collaboration with him." ChemoWave features an added benefit, according to Kueck: helping to improve communication between patient and doctor. "I might see a patient every three weeks, and when trying to recount what happened on day two or four, it's hard for them to remember so it does take a lot of time of the visit," Kueck said. Using the app, she now gets daily updates.

Kueck said there haven't been any widely used apps among her patients, and ChemoWave is fulfilling a large need among those involved in chemotherapy. "I'm already in the loop. We can just talk about today and the future. It's definitely streamlined the visits in the office," she said. ChemoWave is free to download, in order to get it as widely disseminated as possible, according to Lashey. He's also meeting with care organizations, doctors and pharmaceutical companies to explore future partnerships and possible financing. "There could be a lot of money to be made if we were to charge money for this app, but we decided that the real value is in the data," Lashey said. "The hope is that getting it into the hands of patients will start to add value to their life on an immediate basis, and that if we can stick with this and we can get the app with funding that we need, there's going to be money to be made in the future," he added. Grenell is now healthy and sees his doctor regularly, while Hailey said she plans on using the app throughout her treatment. "It does exactly what it's supposed to do, and it provides even more information for a patient to have some control over what what's going on with us," she said.

Neighborhoods with more light have higher breast cancer risk, study says

A new study from Harvard has found greater risk of breast cancer in women who live in neighborhoods that have higher levels of outdoor light during the night.

The findings are based on the Nurses' Health Study (NHS), which has for decades been advancing our understanding of risks to women's health. For this study, epidemiologist Peter James and colleagues followed nurses in the NHS for breast cancer occurrence from 1989 to 2013. The home of each of 109,672 nurses was geocoded, and the average light level in the immediate neighborhood at night was estimated from satellite images taken by the Defense Meteorological Satellite Program. These estimates were updated over the 15-year follow-up period. By 2013, a total of 3,549 new cases of breast cancer had been diagnosed, about what's expected among this number of women.

The study found a direct relationship between a woman's neighborhood nighttime light level before diagnosis and her later risk of developing breast cancer: The higher the light level, the higher the risk. These findings held even when taking into account many other factors that may also affect risk such as age, number of children, weight, use of hormone medications and a long list of additional potential confounders. Of importance if confirmed in more studies, the relationship was strongest in young women diagnosed before menopause.

The study is significant because it adds a strong piece of evidence to the growing body of studies supporting the idea that excessive electric light exposure at night increases a woman's risk of breast cancer.

The idea that electric light at night (LAN) might explain a portion of the breast cancer pandemic dates back to 1987. It was pretty far-fetched at the time because light doesn't seem toxic in any way that could cause cancer. It can't break chemical bonds and damage DNA, and it's not a hormone like estrogen, which, in excess, can cause changes in the breast that can lead to cancer. Light is, by definition, the visible part of the electromagnetic spectrum, and so it does not include X-rays or even ultraviolet radiation, which can burn skin.

Light is an exposure that challenges the conventional definition of a toxic substance. If a little asbestos is bad for you, more is certainly worse. The same holds for ionizing radiation (like X-rays), dioxin and lead. The difference is that the effects of exposure to light on human health depend crucially on timing. Over millions of years, we have evolved with a daily cycle of about 12 hours of bright light (the sun) and about 12 hours of dark. So during the day, our body expects light, whereas during the night it expects dark. There is a deep biology to this, and electric light is throwing it out of kilter. One perplexing possible consequence of this light exposure is an increased risk of breast cancer in women. Researchers, including me, have been exploring this possible link in part because breast cancer has no single known major cause. This is unlike many of the other common cancers such as lung, liver, cervix and stomach, for which a major cause has been identified for each; these major causes are, respectively, smoking, hepatitis viruses, human papilloma virus and the bacterium Helicobacter pylori.

But how could the nighttime light level outside a woman's home in her neighborhood affect her risk of breast cancer? The rationale for studying the outside light level is the assumption that communities that shine brightly to a satellite at night are composed of people who in general are bathed in LAN: They have greater exposure in their home, outside on the street, and for evening entertainment in the city. So, the satellite data are thought to be a surrogate, or a proxy, for this actual LAN exposure to each woman, particularly in the evening before sleep.

My colleagues and I did a similar analysis using satellite data in the state of Connecticut. We also found a stronger effect in younger women, as did another study from 2014 conducted among teachers in California. The studies from Harvard and from California are superior to ours because they both had individual-level data on many more potential confounders than just age, which we did not. Yet all three studies do point in the same direction.

The Harvard study comes closely on the heels of a very public warning from the American Medical Association on potential health problems from "white" LED street lights. It is important to note that the nighttime light levels used in this new study were recorded before any widespread use of "white" LED street lighting.

If the results from Harvard are real, and too much light at night from any and all sources does increase a woman's risk of breast cancer, then retrofitting street lighting all across America should be done in a way that does not further contribute to the problem. It would be best to select luminaires that are as dim as possible, and weak in the short wavelengths (e.g., blue), yet still consistent with accomplishing their intended purpose. Electric light is one of the signature inventions of an inventive species. But its overuse has caused an obliteration of night in much of the modern world. The loss of night has consequences for all forms of life, including us. And the mounting evidence for a connection to breast cancer is alarming.

A Cancer Conundrum: Too Many Drug Trials, Too Few Patients

With the arrival of two revolutionary treatment strategies, immunotherapy and personalized medicine, cancer researchers have found new hope — and a problem that is perhaps unprecedented in medical research. There are too many experimental cancer drugs in too many clinical trials, and not enough patients to test them on.

The logjam is caused partly by companies hoping to rush profitable new cancer drugs to market, and partly by the nature of these therapies, which can be spectacularly effective but only in select patients. In July, an expert panel of the Food and Drug Administration recommended approval of a groundbreaking new leukemia treatment, a type of immunotherapy. Companies are scrambling to develop other drugs based on using the immune system itself to attack cancers. Many of these experimental candidates in trials are quite similar. Yet each drug company wants to have its own proprietary version, seeing a potential windfall if it receives F.D.A. approval.

As a result, there are more than 1,000 immunotherapy trials underway, and the number keeps growing. “It’s hard to imagine we can support more than 1,000 studies,” said Dr. Daniel Chen, a vice president at Genentech, a biotechnology company. In a commentary in the journal Nature, he and Ira Mellman, also a vice president at the company, wrote that the proliferating trials “have outstripped our progress in understanding the basic underlying science.”

“I think there is a lot of exuberant rush to market,” said Dr. Peter Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center. “And we are squandering our most precious resource — patients.” Take melanoma: There are more than 85,000 cases a year in the United States, according to Dr. Norman Sharpless, director of the Lineberger Comprehensive Cancer Center at the University of North Carolina, who was recently named director of the National Cancer Institute.

Most melanomas are cured by surgery, leaving about 10,000 patients who have had relapses and could be candidates for an experimental treatment. But nearly all will be treated by doctors outside of academic medical centers, who are not part of the clinical trials network and so do not offer patients experimental treatments. Companies therefore must compete for the few patients with relapsed melanoma who are at centers offering clinical trials.

Many end up struggling to find enough subjects to determine whether a treatment actually works — and if so, for whom. And these drugs often are not so different from one another. Immunotherapy drugs that attack a protein known as PD-1 are approved for treatment of lung cancer, renal cell cancer, bladder cancer and Hodgkin’s disease, noted Dr. Richard Pazdur, director of the F.D.A.’s Oncology Center of Excellence. Yet many pharmaceutical companies want their own anti-PD-1. Companies are hoping to combine immunotherapy drugs with other cancer drugs for added effect, and many do not want to have to rely on a competitor’s anti-PD-1 drug along with their own secondary drugs. So in new trials, additional anti-PD-1 drugs are being tested all over again against the same cancers — a me-too business strategy taken to multibillion-dollar extremes. “How many PD-1 antibodies does Planet Earth need?” wondered Dr. Roy Baynes, a senior vice president at Merck, which received approval for its first such drug in 2014.

Immunotherapy trials have proliferated so quickly that major medical centers are declining to furnish patients to them. The Yale Cancer Center participates in fewer than 10 percent of the immunotherapy trials it is asked to join. The problem is that many of the trials are uninteresting from a scientific view, said Dr. Roy Herbst, the center’s chief of medical oncology. The companies sponsoring these trials are not addressing new research questions, he said; they are trying to get proprietary drugs approved. If the struggle to find patients for immunotherapy trials is challenging, finding patients for another new type of cancer treatment can be next to impossible.

Why Inflammation in Your Mouth May Raise Your Risk of Cancer

Women with gum disease are 14% more likely to develop cancer than those with healthy teeth and gums, according to a study published in Cancer Epidemiology, Biomarkers & Prevention. The link appears to be strongest for esophageal cancer, but associations were also found between poor oral health and lung, gallbladder, breast, and skin cancer.

The study looked at data from nearly 66,000 postmenopausal women, ages 54 to 86, who were followed for about eight years. At the start of the study, they completed a health survey and reported whether they had ever been diagnosed with periodontal disease, an inflammation off the gums that can lead to tooth loss. Gum disease is caused by sticky, bacteria-laden plaque that forms on teeth. In the early stages, known as gingivitis, the gums can be swollen and bleed easily. Daily flossing and brushing can usually reverse gingivitis. If plaque is left on teeth, it can progress to periodontal disease, which is inflammation around the teeth that causes gums to pull away and form pockets, which can trap more food and bacteria.

With time, the bacteria, inflammation, and body's immune reaction can damage teeth and supporting bone structures, which can lead to tooth loss. During the study’s follow-up period, about 7,100 of those women developed cancer. Overall, those with a history of periodontal disease were more than three times as likely to develop esophageal cancer—and nearly twice as likely to develop gallbladder cancer—than women without. Their risk for lung cancer, skin melanomas, and breast cancer was also increased by 31%, 23%, and 13%, respectively.

Periodontal disease is more common in people who smoke and drink, which are also risk factors for several types of cancer. And in the new study, women with periodontal disease were more likely to report a history of smoking, exposure to secondhand smoke, and alcohol consumption. But even among non-smokers, gum disease was still associated with a 12% increased risk of developing cancer overall. For some types of cancer, the link to gum disease did disappear when the researchers factored out smoking habits. For other types—like melanoma and cancers of the gastrointestinal tract—the connection remained.

This isn’t the first study to suggest that gum disease is associated with certain cancers, but few studies—and none on older women—have calculated an overall increased risk. The researchers focused on this population because risks for gum disease and cancer both increase with age, and because a link had already been established in men. Researchers don’t know for sure why gum disease and cancer are linked, says senior author Jean Wactawski-Wende, dean of the School of Public Health and Health Professions at the State University of New York at Buffalo. But she and other researchers believe that bacterial pathogens in the oral cavity may play a role.

“These pathogens can travel to different parts of the body through your saliva, and they come in contact with your stomach and esophagus when you swallow, or end up in your lungs through aspiration,” says Wactawski-Wende. When gums become inflamed and infected, pathogens—or disease-causing toxins—can also permeate the tissue and enter the blood stream, and travel to other parts of the body as well. Previous studies have shown that these pathogens may play a direct role in the formation of cancer tumors and other inflammatory health issues throughout the body. Gum disease has also been tied to obesity, diabetes and cardiovascular disease, but it’s not clear whether gum disease contributes to these conditions or vice versa.

The study authors point out that they were only able to find an association, not a cause-and-effect relationship, between gum disease and cancer risk. And it’s possible that gum disease in the study was under-reported, they add, since they relied on survey responses rather than a doctor's or dentist's exam. But the large study size and the strength of their findings make a good argument for more research, they say. In fact, they’re currently studying the oral microbiome—the type and variety of mouth bacteria—of women with gum disease, and they plan to see if there are any patterns or links to the cancers the women may develop n the future.

The study also makes a good argument for taking care of those pearly whites, says Wactawski-Wende—and the gums that keep them in place.“Between this and other studies, we’ve seen a link between periodontal disease and heart disease, diabetes, and now cancer, so it seem to me that it would be prudent to recommend maintaining good oral health,” says Wactawski-Wende. “That involves brushing and flossing, but also seeing a dental professional who can monitor and clean your teeth, and who can prevent periodontal disease or treat any cases that do arise.”

California says key ingredient in Roundup weed killer can cause cancer

One of the most popular herbicides in the world can cause cancer, California health officials say, and they might demand warnings saying so. That herbicide, glyphosate, will be added to California's list of chemicals that can cause cancer, the state's Office of Environmental Health Hazard Assessment said this week. Glyphosate is the key ingredient in weed killers such as Roundup. California keeps a list of carcinogenic chemicals because of a law commonly called Proposition 65, which "requires businesses to provide warnings to Californians about significant exposures to chemicals that cause cancer, birth defects or other reproductive harm."

The decision to add glyphosate to that list stemmed from the International Agency for Research on Cancer's assessment that glyphosate is "probably carcinogenic to humans," said Sam Delson, deputy director of OEHHA. But Monsanto, the maker of Roundup, is fighting back. "Glyphosate is not carcinogenic, and the listing of glyphosate under Prop 65 is unwarranted on the basis of science and the law," said Scott Partridge, Monsanto's vice president of global strategy. The company sued California's OEHHA to stop the listing, but last week the California Supreme Court rejected Monsanto's request for a stay. "That led us to move forward," Delson said Wednesday. As CNN reported last month, more than 800 non-Hodgkin's lymphoma patients are suing Monsanto, claiming Roundup gave them cancer. And an internal Monsanto company email said an EPA official had offered to "kill" a separate investigation into glyphosate.

That official, who was the head of the EPA's Cancer Assessment Review Committee, has since retired. Monsanto has consistently maintained that the herbicide is safe. "California's sole reason for listing glyphosate under Prop 65 is the fatally flawed classification by IARC, which ignored crucial scientific data that undermines its conclusion," Partridge said. Monsanto said more than 800 studies have demonstrated glyphosate's safety, including studies conducted internationally. "In fact, since IARC classified glyphosate, regulatory authorities in the United States, Europe, Canada, Japan, New Zealand and Australia have publicly reaffirmed that glyphosate does not cause cancer," Monsanto spokeswoman Charla Lord said in April. In March, the European Chemicals Agency ruled glyphosate is "not classified as a carcinogen."

But Christine Sheppard, one of the cancer patients suing Monsanto, said she's thrilled by California's decision to list glyphosate as carcinogenic. "I thank all the powers that be that I live in California, a state that actually looks after its citizens," she said Wednesday. "It is a great start, and let's hope that others follow California's wise leadership." Despite California's ruling, it's not certain whether Monsanto will have to issue cancer warnings for its glyphosate products sold in the state. Under California law, "a warning must be given for listed chemicals unless the exposure is low enough to pose no significant risk of cancer or is significantly below levels observed to cause birth defects or other reproductive harm."

That leaves one big question: Is the amount of glyphosate exposure from using Roundup enough to pose a "significant risk"? "As for Roundup itself, we're not sure," Delson said. Delson said his agency is trying to establish a level for how much glyphosate exposure would equal a significant risk. He said the current proposal is 1.1 milligrams a day, though a final answer might not be ready until July 2018. It's unclear how much exposure a user might have, given the wide variation in how glyphosate products are used. And if a certain product is deemed to pose a significant risk, the manufacturer doesn't have to put a warning label on each container, Delson said.

It could instead have a warning sign next to the product in stores. If makers of glyphosate products have to issue cancer warnings in California, they would have a year before that requirement would be enforced. "That year gives them time to either change their labeling or ... hopefully modify their products to make them safer," Delson said. Meanwhile, Monsanto says it will keep appealing California's decision. "This is not the final step in the process, and it has no bearing on the merits of the case," Partridge said. "We will continue to aggressively challenge this improper decision."

Exercise Cure: Working Out Cuts Cancer Risk in Half, Study Shows

A landmark new research project, analyzing the medical records of about 70,000 cancer patients, provides the strongest evidence yet that exercise slashes the risk of dying from the deadly disease. In fact, cancer patients who exercise regularly are almost half as likely as non-exercising peers to die from the life-threatening illness, the study reveals.

“Based on what scientific research tells us, if cancer patients exercise regularly they will significantly improve their health and well-being, potentially improving their longevity,” lead researcher Dr. Prue Cormie tells Newsmax Health. Cormie, a principal research fellow at the Australian Catholic University’s Institute for Health and Aging in Melbourne, Australia, conducted the study with Dr. Kathryn H. Schmitz.at the University of Pennsylvania’s Perelman School of Medicine. She says she hopes the findings, published in the journal Epidemiologic Reviews, “will help inspire people with cancer to start exercising” and encourage doctors to “prescribe” physical fitness the way they would medication to treat cancer. “The real novelty and impact of this work comes from the fact that it is the most comprehensive analysis of the available data,” she explains.

“This research has established exercise as an effective medicine that can be prescribed to counteract the adverse effects caused by cancer treatments and reduce the relative risk of cancer death or cancer recurrence.” Cormie adds that the research suggests it doesn’t matter what type of exercise people do. Walking and lifting weights have been shown to be particularly beneficial, but other forms of exercise are also beneficial. To reach their conclusions, Cormie’s medical scientists analysed 100 studies worldwide to confirm key findings showing death rates among cancer patients who exercise regularly plunged by almost half — up to 44 percent — compared with those who didn’t.

The researchers excluded studies that didn’t differentiate between deaths from cancer and other causes. They also took into account other factors that might contribute to the differences. In addition to cutting cancer deaths, exercise was linked with a lower risk — up to 35 percent — of cancers recurring. Physical activity also reduced the impacts of side effects from chemotherapy and other treatments. Cancer death risks were also “significantly lower” for those who engaged in the highest levels of exercise, compared to those who did were not as physically active.

“The findings of this review support the view that exercise is an important adjunct therapy in the management of cancer,” the researchers concluded. “Compared with patients who performed no exercise, patients who exercised following a diagnosis of cancer were observed to have a lower relative risk of cancer mortality and recurrence and experienced fewer adverse effects. Dr. Kathy Chapman, chairwoman of Cancer Council Australia’s nutrition and physical activity committee, suggests the landmark study should change the way doctors care for cancer patients. "This study confirms the importance of recommending exercise to people with cancer,” she says. "The evidence has been building over the past 10 years that exercise should be an adjunct to regular cancer treatment — especially for people with bowel, breast and prostate cancer.

People with cancer who incorporate exercise into their lifestyle have better overall survival rates and also experience better quality of life. Exercise has been shown to be beneficial in alleviating fatigue, a common side effect of cancer treatment.

Texans' David Quessenberry returns to practice after completing cancer treatment

Lineman David Quessenberry joined the Houston Texans for practice on Tuesday after spending nearly three years away from the game of football while undergoing treatment for non-Hodgkins T lymphoblastic lymphoma.

“When I finished my intensive treatment I felt like the furthest thing from a football player – no hair, skinny – but your body is an amazing thing,” Quessenberry, 26, told The Houston Chronicle. “We just took it slowly. We just did one workout at a time, one treatment at a time and eventually here we are.” In April, Quessenberry shared a video of his ceremonial ringing of the “chemo bell” to signify the end of his treatment. More than 33,000 people watched him ring the bell so hard that it actually broke off the wall. “Cancer did NOT make me strong.

Cancer did NOT make my family strong. Cancer did NOT galvanize my community. Cancer did NOT bring rival team Head Coaches and players together to support me,” Quessenberry posted in part alongside the moving video. “Cancer did NOT bring people together. Cancer did NOT make people travel hundreds of miles to help me and my family in our time of need. Cancer did NOT make people pray for me. Cancer did NOT bring me my Angel. Cancer did NOT make me thankful for my life. Cancer did NOT make me a believer that there is more to this world than just our eyes can see. Cancer did NOT shape me in the man I am today. Love did.”

Quessenberry was waived by the Texas after the 2015 season but was put on the non-football illness list and remained on the team’s roster. He said Texans coach Bill O’Brien and the entire organization have supported him since the day he was diagnosed. O’Brien, he said, offered him wisdom throughout his treatments, which he said have made him mentally and physically stronger than ever.

He’s now focused on regaining the weight and strength so he can compete for a spot on the roster. “We’re in uncharted territory,” Quessenberry told The Houston Chronicle. “But I feel great and it will be very soon where I can play.” The Texans shared a photo of Quessenberry in his practice gear on Twitter Tuesday, which he retweeted with the caption, “It’s so much more to me than just OTAs. THANK YOU!!!!!” Quessenberry was drafted by the Texas in the sixth round of the 2013 NFL draft.

One cancer is linked to highest suicide risk

Suicide is more common among cancer patients, but a new study suggests people suffering from lung cancer are at a higher risk than those who struggle with other forms of the disease.

For the study, researchers from Weill Cornell Medical College/New York Presbyterian Hospital analyzed information from a large patient database of 3,640,229 people, looking at suicide deaths for lung, prostate, breast and colorectal cancers individually. They found that over four decades, there were 6,661 suicides among cancer patients. When they compared suicides among cancer patients to the general population, the rate in patients with any kind of cancer was 60 percent higher.

"Cancer patients are under a lot of duress and stress when they're under treatment," said study author Dr. Jeffrey Port, a thoracic and cardiac surgeon at Weill Cornell Medical Center, told CBS News. When the scientists broke down the data on suicide by cancer type, they found dramatic differences. The suicide rate among lung cancer patients stood out: it was more than four times higher than the general population. They also found suicide rates were 40 percent higher than average among colorectal cancer patients, and 20 percent higher among those diagnosed with breast cancer or prostate cancer. Despite this, many doctors don't consider suicide risk in cancer patients, Port said. Patients may feel anxiety, depression or hopelessness after hearing stories from family members or friends who knew someone with the disease.

Port said doctors need to reassure their patients that every case is unique and that there are good treatments for early stage patients. "As lung cancer surgeons, we know the lung cancer diagnosis is a very serious diagnosis, but what's not out there is that patients with early stage disease are highly curable," said Port. What was most striking about the findings, Port said, is that 50 percent of suicides in lung cancer patients occurred in people who had what specialists consider highly treatable disease. "There's a disconnect about patients understanding their particular outcomes," he said. Suicide rates were also higher among Asians, men, older patients, those who were widowed, those who refused surgical treatment, and those with metastatic lung cancer , according to the study, which was presented at the American Thoracic Society 2017 International Conference, in Washington, D.C. Lung cancer (small cell and non-small cell types) is the second most common type among both men and women in the U.S. (not counting skin cancer, which was not included in the study).

The American Cancer Society estimates that in 2017, there will be about 222,500 new cases of lung cancer diagnosed and approximately 155,870 deaths from the disease. Lung cancer specialists don't tend to be well trained on the mental health side of patient care, said Port. "For us as a group it's striking that we're trained in medical school – we learn about the physical aspects of exam, but especially surgeons, we don't do a deeper dive into the psychosocial exams. It's pretty eye-opening that we should have to learn to ask patients, 'Are you sleeping, are you eating, how are your feeling about your diagnosis?' Doctors need to include these questions as part of the exam," said Port, adding that their care should be integrated with nurses and others who provide health care during cancer treatment.

One factor that may weigh heavily on the shoulders of patients: the consequences of lifelong health choices. "Eighty-five percent of our patients have traditionally been smokers and may have guilt about smoking all their life," Port said. But he also noted, "There's reason to be hopeful." "Each person's tumor is different genetically and we now have unique targeted therapies —immunotherapy — for early stage disease regardless of tumor type," he said. Dr. Joseph Weiner, an psychiatrist at Zucker Hillside Hospital, in Glen Oaks, New York, told CBS News that while the new study shows a correlation between lung cancer and suicide, other issues may come into play. "There may be other variables contributing that may be related to chemotherapies. And some people with lung cancer have changes in hormone secretions that may affect mood. A decrease in oxygen going to the brain may affect judgment and impulsivity, too," said Weiner.

Over much of Weiner's career he's worked with people who have had medical illnesses, including cancer. "I've gotten to see people suffer tremendously, emotionally. Some are unable to cope with a serious diagnosis and fall into depression, while others transcend their suffering and find hope even in the face of death," Weiner said. The way a doctor speaks to a cancer patient can have a big impact on that person's mental health and how he or she copes with the disease, said Weiner, whose wife died of lung cancer in 2015 almost a year after her diagnosis. He said she was a very strong person, but had some physicians who were better than others when it came to communication and compassion. "My wife asked her oncologist, 'Will I live long enough to watch my daughter graduate?' and the oncologist said, 'Now you're pushing it,'" said Weiner.

He said his wife was a strong person and didn't let it get in her way of focusing on her dream. But Weiner said a better alternative would have been to say, "I can't promise, but I can promise we'll try as hard as we can." For patients struggling with depression and suicide risk, words can have a powerful affect, he noted. Support can make a difference. "One of the destructive things a clinician can say is that there's nothing more we can do for you. There's always something we can do for you, whether it's pain management, symptom control, holding a hand, giving a hug, connecting with a chaplain or mental health provider, or discussing medication for depression and anxiety. It's not just the application of chemotherapy.

It's about the provision of humanity," he said. Most of all, he said doctors treating lung cancer and other cancer patients can provide hope. "Hope is broad. None of us live forever. What are we hoping for? Are we hoping to be loved? Are we hoping to leave a legacy for our lives? To see someone get married? Are we hoping to demonstrate to our loved ones that we can approach a life circumstance with great dignity? Are we looking to thank people? Are we looking to ask for forgiveness? I'm talking about hope as a process of how you want to live your life. Focusing on the day rather than the medical outcome."

A Shocking Diagnosis: Breast Implants ‘Gave Me Cancer’

Raylene Hollrah was 33, with a young daughter, when she learned she had breast cancer. She made a difficult decision, one she hoped would save her life: She had her breasts removed, underwent grueling chemotherapy and then had reconstructive surgery.

In 2013, six years after her first diagnosis, cancer struck again — not breast cancer, but a rare malignancy of the immune system — caused by the implants used to rebuild her chest. “My whole world came crumbling down again,” said Ms. Hollrah, now 43, who owns an insurance agency in Hermann, Mo. “I had spent the past six years going to the oncologist every three months trying to keep cancer away, and here was something I had put in my body to try to help me feel more like a woman, and it gave me cancer. I thought, ‘I’m not going to see my kids grow up.’”

Her disease — breast implant-associated anaplastic large-cell lymphoma — is a mysterious cancer that has affected a tiny proportion of the more than 10 million women worldwide who have received implants. Nearly all the cases have been linked to implants with a textured or slightly roughened surface, rather than a smooth covering. Texturing may cause inflammation that leads to cancer. If detected early, the lymphoma is often curable.

The Food and Drug Administration first reported a link between implants and the disease in 2011, and information was added to the products’ labeling. But the added warnings are deeply embedded in a dense list of complications, and no implants have been recalled. The F.D.A. advises women only “to follow their doctor’s recommended actions for monitoring their breast implants,” a spokeswoman said in an email this month. Until recently, many doctors had never heard of the disease, and little was known about the women who suddenly received the shocking diagnosis of cancer brought on by implants. An F.D.A. update in March that linked nine deaths to the implants has helped raise awareness. The agency had received 359 reports of implant-associated lymphoma from around the world, although the actual tally of cases is unknown because the F.D.A.’s monitoring system relies on voluntary reports from doctors or patients.

The number is expected to rise as more doctors and pathologists recognize the connection between the implants and the disease. Women who have had the lymphoma say that the attention is long overdue, that too few women have been informed of the risk and that those with symptoms often face delays and mistakes in diagnosis, and difficulties in receiving proper care. Some have become severely ill. Implants have become increasingly popular. From 2000 to 2016, the number of breast augmentations in the United States rose 37 percent, and reconstructions after mastectomy rose 39 percent. Annually, nearly 400,000 women in the United States get breast implants, about 300,000 for cosmetic enlargement and about 100,000 for reconstruction after cancer, according to the American Society of Plastic Surgeons. Allergan and Mentor are the major manufacturers. Worldwide, an estimated 1.4 million women got implants in 2015.

Read more from the New York Times here.

When Cancer Patients Should Ask For Genetic Sequencing

Cancer DNA can provide important clues about the best way to treat the disease, finds a new study published in the journal Nature Medicine. Doctors can genetically profile tumors by sequencing the DNA from a person’s cancer cells, revealing which mutations are responsible for causing the cancer. By comparing the tumor’s DNA to DNA from the same person’s healthy cells, the scientists can pinpoint which genetic changes were unique to the cancer cells.

In the new research, scientists at Memorial Sloan Kettering Cancer Center (MSKCC) sequenced more than 10,000 tumor biopsies and found that 37% of the people had at least one mutation that could be addressed, either with a prescription for an existing cancer drug or by taking part in a clinical trial testing new therapies. Other patients learned that they could take advantage of some of the newer immune-based therapies that are showing great promise. These findings are especially encouraging, says Michael Berger, associate director of the Center for Molecular Oncology at MSKCC, since the people in the study all had advanced cancer. That means they had tried traditional therapies that hadn’t worked and needed new options.

“What’s unique about our data set is that we collected samples from patients with advanced, metastatic cancer,” says Michael Berger, associate director of the Center for Molecular Oncology at MSKCC. “A lot of the other large-scale genomic databases look at untreated tumors [when patients are first diagnosed], and they provide a different genomic landscape and makeup than advanced cancers which are collected after several rounds of therapy.” Genetic testing is available at many major cancer centers, but it is still not a routine part of care for all cancer patients. And not all genetic tests look at so wide a swath of genes as the one used by MSKCC in the study, which analyzed more than 340 genetic changes. Another barrier is that not all insurance companies cover the cost of tumor sequencing, since they aren't yet convinced that it's a critical part of cancer care.

Berger and his colleagues hope that more data, like the kind provided by this study, will change that. For now, the technology is most useful for people with advanced cancers that have spread and those who have exhausted all of their treatment options. (For many people with early-stage cancers, existing therapies work well in controlling the disease.) Some hospitals offer commercial tests, but these often look at a limited number of cancer-related genes; the current study shows the value of doing a more comprehensive analysis. Doctors at MSKCC offer the test to people who might benefit from the genetic information, and it is either paid for by their insurance or covered by the hospital's philanthropic efforts, in most cases. The main advantage of the database, says Berger, is the fact that it is connected to patients who are currently receiving care at the hospital.

That means their tumor profiles are linked to the treatment options they chose and how well they did. This helps other doctors start to identify which treatment options lead to longer survival and better outcomes for people.That’s why the database is also being made available for free to any cancer doctor who is interested in learning from the information. Berger and his colleagues say that the database will only become more helpful for doctors treating patients, since the information will include how well they did on their various therapies.

10 Ways Women Can Stay Healthy

May is Women’s Health Month. Experts from the UConn Health Women’s Center are urging all women to take action each and every day to maintain their overall health and prevent breast and other cancers by keeping these health tips top of mind:

Exercise 30 Minutes a Day: “The number one thing women can do to maintain their health and keep disease at bay is exercise daily,” says Molly Brewer, chair of the Department of Obstetrics and Gynecology at UConn Health, who recommends all women exercise 30 minutes per day. It will not only improve your cardiovascular health but also help you maintain a healthy weight, body mass index, and lower your risk of developing endometrial (uterine) cancer, breast cancer, and colon cancer, which are all linked with obesity. “With rising rates of obesity in America there has been a parallel increase in cancer diagnoses, especially for uterine cancer,” Brewer says. In addition, exercise can lower excess hormones in the body, which in turn lowers cancer risks, along with stress levels.

Make Time for Your Health: Women generally lead busy lives. In addition to making time to exercise daily, make sure you are maintaining a healthy lifestyle, including seeing your OB/GYN annually. “A simple chat with your doctor is key for maintaining your overall health, whether for cancer prevention, a healthy pregnancy, or managing menopause – make time for you,” says Danielle E. Luciano, a gynecologist and minimally invasive surgeon at UConn Health’s Women’s Center.

Listen to Your Body: Over the course of a woman’s lifetime, a host of conditions can arise. The most common issues can be endometriosis, ovarian cysts, uterine fibroids, breast cancer, or gynecological cancers such as endometrial, cervical, or ovarian. “It is very important to see your OB/GYN annually for preventive screenings, potential early cancer catches, and also to report any warning signs or worrisome health changes,” says Luciano. Warning signs are changes in your menstrual cycle, abnormal bleeding and bloating, fatigue, and any health change leading you to just not feel like yourself. Alerting your doctor right away can help the physician identify the culprit and offer a minimally invasive solution to treat your condition and potentially save your life.

Eat Healthy Every Day: Similarly to preventing heart disease, eating a healthy daily dose of nutritious, colorful fruits and vegetables is key to preventing and lowering your risk of developing breast and other women’s cancers fueled by obesity. “Women should minimize the processed foods they eat from a box,” says Alex Merkulov, a radiologist at the Beekley Imaging Center of the Women’s Center at UConn Health. “Natural, whole, and fresh foods are always the best choices. Also, avoid fried foods, which often contain trans-fats, and reach for foods and snacks low in saturated fats, sugar, and salt.”

Quit Smoking: More than 13 percent of women are still smoking cigarettes in the U.S., even though the evidence is clear that it leads to premature death, heart disease such as hardening of the body’s arteries, heart attack and stroke, and lung and other cancers. In fact, lung cancer is the second leading cause of cancer death among women. “If women are currently smoking, they need to quit the habit now to lower their future health risks,” says Brewer. “Cancers caused by smoking are preventable if you put the cigarettes down. Seek a smoking-cessation program to help you quit for good.”

Check Your Breasts: One in eight women will develop breast cancer in their lifetime. But the good news according to Merkulov is that if breast cancer is caught early, it can be treated effectively. “It is critical that, starting at age 40, women come in for a baseline mammogram so their breast health and any abnormal changes can be monitored annually as they age.” While more than 90 percent of abnormal mammogram findings in the end turn out to be benign, Merkulov stresses than an early mammogram is the only tool available to help reduce a woman’s chance of dying from breast cancer. In between yearly mammograms, women should perform monthly breast self-exams.

Get a Pap Smear: Once a woman becomes sexually active, experts say she should be going to the OB/GYN for regular pelvic exams and pap smear screenings. The pap smear tests for signs of vaginal and cervical cancers, along with sexually transmitted diseases such as human papillomavirus (HPV) or genital warts. “Some HPV strains place a woman at higher risk of cervical cancer,” says Shannon DeGroff, an OB/GYN at UConn Health Canton. “HPV infection is very common in both women and men who are sexually active. However, the virus doesn’t always cause symptoms, which is why screening is so important, especially for high-risk cancer-causing strains.”

Prevent HPV: High HPV prevalence is leading to increased rates of cervical cancer, and also a rise in head and neck cancer from oral sex transmission. In 2006, a vaccine to prevent HPV became available. However, data shows that only 25 percent of eligible young women ages 11-26 are actually getting the vaccine. “The HPV vaccine is only effective in preventing the spread of the disease if male and female youth are vaccinated,” says Brewer. Brewer says studies in Australia, where the HPV vaccine was mandated for school-aged children more than a decade ago, show it is working to prevent the disease’s spread and reduce the country’s cervical cancer rates.

Prenatal Care to Prepare for Pregnancy: A healthy pregnancy and baby starts with a healthy mom-to-be. “The most important focus is on a woman’s overall health and wellness before pregnancy in order to have a healthy pregnancy,” says Christopher Morosky, an OB/GYN at UConn Health. If you’re hoping to become pregnant for the first time or again, make sure to visit your OB/GYN for a pre-conception visit. Early prenatal care – including taking folic acid, getting to a healthier pre-pregnancy weight, practicing a good daily diet, and following an exercise routine are all critical for both fertility and a healthy pregnancy. It is also important to avoid drinking alcohol and ingesting tobacco, and to take a close look to see if your medication list needs to be adjusted for pregnancy. “If you are struggling to become pregnant don’t worry,” says Morosky. “There are OB/GYN and fertility experts and technology available to help you and your significant other find out why and help you succeed.”

Get a Colonoscopy: Colon cancer is the third largest cause of cancer death among women. “At age 50, women need to make sure they start getting their regular colonoscopy screening,” says Brewer. Catching any abnormal colon polyp growths early with colonoscopy can prevent cancer from further developing or spreading. Also, practicing a healthy lifestyle and diet can help prevent the disease.

Vitamin D Fails To Reduce Cancer Risk in Postmenopausal Women

Supplementation with vitamin D3 and calcium did not significantly reduce the risk of cancer among postmenopausal women, according to a randomized, controlled study published in JAMA.

Some studies showed an inverse relationship between vitamin D levels and cancer risk. The purpose of this trial was to evaluate the effect of vitamin D3 supplementation on cancer risk. This trial randomly assigned 2303 postmenopausal women to receive 2000 IU of vitamin D3 and 1500 mg of calcium per day or placebo for 4 years, with follow-up up visits every 6 months.

At baseline, the mean age was 65, 99% were non-Hispanic Caucasian, and the mean serum 25-hydroxyvitamin D level was 33 ng/mL. The mean serum 25-hydroxyvitamin D levels rose to 43.9 ng/mL by 12 months and was maintained during the 4-year study. In the placebo group, the mean serum 25-hydroxyvitamin D level remained around 31 ng/mL throughout the study.

At 4 years, 3.89% of women in the vitamin D3 group and 5.58% in the placebo group were diagnosed with cancer (difference, 1.69%; 95% CI, -0.06-3.46%; P = .06), resulting in an incidence of 0.042 (95% CI, 0.032-0.056) and 0.06 (95% CI, 0.048-0.076; P = .06), respectively. Vitamin D supplementation was not associated with reduced cancer risk with a hazard ratio of 0.70 (95% CI, 0.47-1.02). The lack of association may be a result of the higher baseline serum levels of 25-hydroxyvitamin D compared with the general US population, according to the authors.

Exercise better than drugs for cancer fatigue

Cancer patients may ease fatigue more effectively with exercise and psychotherapy than with medication, a recent study suggests. Researchers examined data from 113 previously published studies involving more than 11,500 cancer patients with fatigue. Patients were randomly assigned to treat their exhaustion with exercise or psychotherapy, or both, or with drugs. Exercise and psychotherapy were associated with a 26 percent to 30 percent reduction in fatigue during and after cancer treatment, the study found.

Drugs, however, were tied to only a 9 percent decline in fatigue. "Patients need to try exercise or psychotherapy before they reach for a pharmaceutical," said lead study author Karen Mustian of the University of Rochester Medical Center in Rochester, New York. Cancer-related fatigue is common and may be tied to the effects of tumors or treatments, researches note in JAMA Oncology. Unlike other types of exhaustion, just getting more sleep or giving aching muscles a break from strenuous activities can't address fatigue associated with tumors. Fatigue tied to cancer can persist for years and may be worsened by other cancer-related health problems like depression, anxiety, sleep disturbance and pain. It's not clear why exercise and psychotherapy may be more effective than drugs, Mustian said by email.

"We do not know for sure why exercise works, but some research is beginning to suggest it is due to anti-inflammatory effects and also improvements in physical function - cardiovascular, pulmonary and muscular," Mustian added. "In terms of psychotherapy, the most beneficial form was group therapy that used a cognitive behavioral approach to educate patients, help them to change the way they think about fatigue and managing it, and adopting behaviors to help alleviate it." Most participants in the studies were female, and almost half of the studies involved women with breast cancer. Age, gender, cancer type and forms of exercise didn't appear to influence how effective exercise or psychotherapy was relative to medications, researchers found.

Overall, the analysis included 14 drug studies, mostly looking at stimulants or drugs designed to promote wakefulness. Among the 69 evaluations of exercise, most looked at aerobic activity alone or in combination with other types of movement. Of the 34 psychological interventions tested in the studies, most involved therapies focused on behavior and education. One benefit of the current study is that researchers were able to pool the data from several individual research efforts that were, alone, too small to draw meaningful conclusions about the relative advantages of different treatments, the authors note. Limitations include the varied designs in the studies, which made it difficult to assess how factors such as race, education, income or other demographic differences might have impacted the results, the researchers also point out.

Even so, the findings confirm previous research on interventions to ease cancer-related fatigue, Dr. Jens Ulrich Rueffer, head of the German Fatigue Society in Cologne, said by email. "We already knew that exercise and/or psychological interventions were beneficial for treating cancer-related fatigue," said Kerry Courneya, a researcher at the University of Alberta, in Edmonton, Canada. "What we learned from this new meta-analysis is that exercise and psychological counseling are roughly equal in their benefits for cancer-related fatigue," Courneya, who wasn't involved in the study, added by email. "And both appear superior to current pharmaceutical treatments."

Cancer burger? Fast food wrappers contain carcinogenic chemicals, study says

The next time you get a craving for a greasy burger from the drive-thru, you may want to reconsider. A new study has found that fast food packaging contains cancer-causing chemicals – showing that the risk of quick meals goes beyond trans fats and calories. It's no secret that fast food contains a huge amount of oils, but in an effort to repel those oils, the packaging is actually posing a huge risk to consumers, according to a new study published in the journal Environmental Science and Technology Letters.

In an effort to determine whether the wrappers contained harmful chemicals, the researchers gathered 400 take-out packaging samples from fast food restaurants across the US. They then analyzed them for fluorinated chemicals, a family of chemicals which has been linked to kidney and testicular cancer, elevated cholesterol, decreased fertility, thyroid problems, changes in hormone functioning in adults, and adverse developmental effects and decreased immune response in children. Forty-six percent of food contact papers and 20 percent of paperboard were found to contain the harmful chemicals. But the problem wasn't just contained to the wrappers.

The chemicals were found to migrate from the packaging to the food itself. "Food contact material is a direct route of exposure to these chemicals for us, it’s as if you were drinking them in your drinking water,” Tom Brunton of the Green Science Policy Institute, which was involved in the study, told CBS Bay Area. Study co-author Graham Peaslee, a physicist at the University of Notre Dame, said he was "very surprised to find these chemicals in food contact materials from so many of the samples we tested," according to a Green Science Policy Institute press release.

He went on to note that the chemicals are "persistent and some bioaccumulate in the body," and stressed that "safer non-fluorinated alternatives" are available. Co-author Dr. Arlene Blum of UC Berkeley and the Green Science Policy Institute also stressed that "we can stop using fluorinated chemicals where they are not necessary, such as in food packaging, and all be healthier." And although fluorinated chemicals are also found in everyday products including water-repellent outdoor gear, stain-resistant clothing and furniture, and non-stick pans, Brunton was quick to point out that they are likely the most harmful in the fast food context. "You're likely not going to get the same exposure from those products...you're not eating your rain jacket...," Brunton said. The Green Science Policy Institute noted, however, that many major retailers have eliminated high-fluorinated chemicals from their products, and encouraged the fast food industry to do the same.

Teen Girl with Cancer Makes Chemo Survival Bags for Fellow Patients

When you’re diagnosed with cancer, people will give you gifts – trinkets, blankets, stuffed animals, but most of them aren’t very practical. “You end up using none of it,” 19-year-old Kyla Pokorny told InsideEdition.com Tuesday. “It’s very nice, but I found stuff that is a lot more helpful.” She should know. At age 14, she was diagnosed with bone cancer. It’s gone into remission and come back twice.

Now, at age 19, it has spread to every bone in her body and she has been receiving her latest blast of radiation since September. It is important to her to take care of others as she takes care of herself. She spends at least three days a week in the hospital, and she usually visits with the babies and the children in the cancer ward. So for Christmas, she wanted to put together survival bags for young cancer sufferers – things that soothe the body and occupy the mind, things that she wished someone had given to her.

Things like a thermometer. Scent-free lotion. A really good heating pad. Coloring books. Pretty, comfortable head scarves. “If you’re a kid with cancer, if you have a temperature, you need to know right away,” Pokorny said. “It’s super dangerous. You need to go to the E.R.” Radiation can burn the skin. “Mine just got like peely, like a sunburn,” she said. “Some people have open wounds.” Thus the importance of a scentless, non-stinging lotion. All of this goes in her care packages. She estimates the bags cost between $100 to $200.

She has started a GoFundMe page to help finance her holiday project. Some of her bags will also be for cancer babies and very young children. She loves spending time with them, and they bask in her presence. “I feel like I have more little friends than big friends, because I’m always at the hospital,” she said. “I’m really good with kids. They like me.” She originally thought she would become a nurse when she grew up. Now she thinks she will become a child-life specialist, a professional who works with hospitalized cancer patients.

The hardest part about being a teenager with cancer, she says, is that all her same-age friends are away at college, working away at their majors. “I can’t make any plans,” she said. “I’m like stuck. Chemo messes with your brain. If I read a chapter, I wouldn’t remember it 20 minutes later.” So she waits. And undergoes her radiation treatments as needed. Her hair is gone and will never come back in its original glory. She just got a new wig – dark brown and waist-length. Life goes on, in its ever-changing way. Pokorny rides it like a wave. “I’m doing pretty good,” she says.

New trial over talc, cancer link: What you need to know

Two lawsuits ended in jury verdicts worth $127 million. Two others were tossed out by a judge who said there wasn’t reliable evidence that the talc in Johnson & Johnson’s iconic baby powder causes ovarian cancer. This week, yet another lawsuit is going to court, alleging that a California woman’s use of talcum powder over many years caused cancer. Her lawsuit accuses Johnson & Johnson of “negligent conduct” in making and marketing its baby powder.

So who’s right? And is baby powder safe? Most scientific research finds no link or a weak one between ovarian cancer and using baby powder for feminine hygiene, a practice generations of American mothers passed on to their daughters. Most major health groups have declared talc harmless. Johnson & Johnson, whose baby powder dominates the market, says it’s perfectly safe. Yet some 2,000 women have sued, and lawyers are reviewing thousands of other potential cases, most generated by ads touting the two big verdicts.

Jury selection in the latest trial began Monday. A look at the issue: What is talc? Talc is a mineral that is mined from deposits around the world, including the U.S. A naturally-occurring mineral, talc is mainly made up of the elements magnesium, silicon, and oxygen. The softest of minerals, it’s crushed into a white powder. It has been widely used in cosmetics and other personal care products to absorb moisture since ancient times, and Johnson & Johnson’s Baby Powder has been sold since 1894. But it’s mainly used in a variety of other products, including paint and plastics. In its natural form, talc can sometimes contain asbestos​, which is known to cause cancers in and around the lungs when inhaled. But all talcum products sold in the U.S. have not contained asbestos since the 1970’s. Does it cause ovarian cancer? Like many questions in science, there’s no definitive answer.

Determining the cause of cancer is difficult. It would be unethical to do what’s considered the best type of controlled study, asking a group of women to use talcum powder on their genitals and wait to see if it causes cancer, while comparing them to a group who didn’t use it. While ovarian cancer is often fatal, it’s relatively rare. It accounts for only about 22,000 of the 1.7 million new cases of cancer expected to be diagnosed in the United States this year. Factors that are known to increase a women’s risk of ovarian cancer include age, obesity​, use of estrogen therapy after menopause, not having any children, certain genetic mutations and a personal or family history of breast or ovarian cancer. What research can be done? Two other kinds of studies are possible. Neither of them, though, can conclusively prove something causes cancer. One looks back in time, after an illness has occurred. It compares two groups of people, one with the illness, one without, and asks about past exposures that might be factors. But people don’t always accurately remember details years later. The second approach tracks a large group of people over time. It assesses their health at the start and follows them for years, recording any illnesses they develop while tracking possible influences such as diet and use of medication, alcohol​ or other substances. Scientists generally find these “prospective” studies more reliable.

What research shows The biggest prospective studies have found no link between talcum powder applied to the genitals and ovarian cancer. But about two dozen smaller, look-back studies over three decades have mostly found a modest connection – a 20 percent to 40 percent increased risk among talc users. However, that doesn’t mean talc causes cancer. Several factors make that unlikely and there’s no proof talc, which doesn’t interact with chemicals or cells, can travel up the reproductive tract, enter the ovaries and then trigger cancer. One large study published in June that followed 51,000 sisters of breast cancer patients found genital talc users had a reduced risk of ovarian cancer, 27 percent lower than in nonusers.

An analysis of two huge, long-running U.S. studies, the Women’s Health Initiative and the Nurses’ Health Study, showed no increased risk of ovarian cancer in talc users. What experts say If there were a true link, Dr. Hal C. Lawrence III says large studies that tracked women’s health for years would have verified the results of the smaller look-back ones. “Lord knows, with the amount of powder that’s been applied to babies’ bottoms, we would’ve seen something” if talc caused cancer, said Lawrence, vice president of the American College of Obstetrics and Gynecology. Similarly, Dr. Francisco Xynos, a gynecologic oncologist at SSM Health St. Mary’s Hospital in St. Louis, told CBS affiliate KMOX Radio earlier this year that the scientific evidence of a cancer link is weak. “I think the concern for the general population should be negligible, because there is no scientific proof of that,” Xynos said.

The National Cancer Institute’s Dr. Nicolas Wentzensen says the federal agency’s position is that there’s not a clear connection. “It is very hard to establish causal relationships,” he said. “A lot of ovarian cancers occur in women who have never used talc, and many women have used talc and not gotten ovarian cancer.” The International Agency for Research on Cancer (IARC), which is part of the World Health Organization, classifies genital use of talcum-based body powder as “possibly carcinogenic to humans.” The American Cancer Society (ACS) says more research is needed on the topic. ACS research director Elizabeth Ward says it is unusual to have so much discrepancy between studies. “The risk for any individual woman, if there is one, is probably very small,” Ward said. What lawyers and courts say Like the studies, courts have produced mixed results. In the first trial two years ago, a South Dakota jury found Johnson & Johnson liable for one woman’s ovarian cancer but didn’t award any damages. This year, state court juries in St. Louis awarded plaintiffs $72 million and $55 million – verdicts the company is appealing. But U.S. District Judge Nelson Johnson in Atlantic City, New Jersey, threw out the first two of the 400 lawsuits in his court.

He reviewed the research and testimony from two doctors who are the plaintiffs’ key expert witnesses and concluded they aren’t reliable, noting they had previously written that there was no proof talc causes ovarian cancer. Other courts approved them as experts, noted the plaintiffs’ attorney, Ted Meadows of Montgomery, Alabama. J&J attorney John Beisner says the health care giant plans to fight every lawsuit, rather than settle, “for the fundamental reason that the science on which they’re based is totally lacking.” Most of the pending cases are in Missouri, California and New Jersey, where J&J is based. In the case that began Monday in St. Louis, lawyers for Deborah Giannecchini of Modesto, California, say she was diagnosed with ovarian cancer in 2012 after years of talcum use. Her lawsuit accuses the company of “negligent conduct” in making and marketing its talc.