Rare malignancies of immune system studied

Implants may bring a new disease to cancer patients with mastectomies, N.Y. Times says 

Can breast cancer implants give a woman who's had a mastectomy another cancer?

According to a recent article by Denise Grady in The New York Times, the answer is a definite yes.

The new cancer, it indicates, may not be breast cancer "but a rare malignancy of the immune system —  caused by the implants used to rebuild her chest."

The disease, anaplastic large-cell lymphoma, is a cancer that's "been linked to implants with a textured or slightly roughened surface, rather than a smooth covering," the piece says.

Although the federal Food and Drug Administration first reported a link between implants and the disease in 2011, an FDA update in March linked nine deaths to the implants and helped raise awareness, Grady's article notes.  

The FDA has also received 359 voluntary reports of implant-associated lymphoma from doctors or patients around the world.

That number, the story says, "is expected to rise as more doctors and pathologists recognize the connection between the implants and the disease."

As of now, however, no implants have been recalled — and "what's inside the implant, silicone or saline, seems to make no difference."

Between 2000 and 2016, the number of U.S. breast augmentations rose 37 percent — "and reconstruction after mastectomy rose 39 percent," Grady writes.

"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," the story adds.

Lymphoma, if detected early, is often treatable and rarely fatal — although its symptoms "usually include painful swelling and fluid buildup around the implant. Sometimes there are lumps in the breast or armpit."

Dr. Mark W. Clemens II

In cases with bad outcomes, the Times quotes Dr. Mark W. Clemens II, a plastic surgeon and expert on the disease at the University of Texas MD Anderson Cancer Center in Houston, "it was usually because they were not treated or there was a major delay in treatment, on the level of years."

Clemens believes that as late as 2015, "only about 30 percent of plastic surgeons were routinely discussing the cancer with patients," the Times piece says.

The newspaper also notes that what causes the disease isn't known. "One theory," Grady's story postures, "is that bacteria may cling to textured implants and form a coating called a biofilm that stirs up the immune system and causes persistent inflammation, which may eventually lead to lymphoma."

Clemens noted that researchers are also looking for mutations that might contribute to the disease.

More information about women's difficulties after reconstruction can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Fed task force changes its mind — for a change

Whether to get PSA prostate cancer screenings can still be guesswork, N.Y. Times warns

Should men between the ages of 55 and 70 get prostate cancer screening?

Depends on whom you're listening to, and when, I guess — especially if it's the federal government making the suggestions.

Aaron E. Carroll

According to a story by Aaron E. Carroll  in The New York Times today, the U.S. Preventive Services Task Force "changed its recommendation…from a D (that is, don't do it) to a C (discuss it with your doctor)."

Five years ago, the piece indicated, "the task force gave prostate cancer screening a D recommendation because there are real harms from over-diagnosis of the disease."

The story went on to say that "over-diagnosis leads to unnecessary treatments, and a newly discovered cancer could lead to no symptoms or harm over the patient's lifetime."

It also said that — while "there appeared to be little evidence that screening with with prostrate-specific antigen blood test (PSA) reduced prostate cancer mortality" — "about 75 percent of all the men treated will have impotence, incontinence or both."

A 2014 study that was the largest randomized controlled trial to that date showed, however, "that offering men screening reduced their relative risk of dying of prostate cancer over 13 years by 21 percent."

Those figures are applicable for men between the ages of 55 and 70; after that age, the harms seem to definitely outweigh the benefits.

Carroll is a professor at Indiana University School of Medicine who blogs on health research and policy.

To learn more about research regarding prostate cancer and other diseases, check out "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Activist disputes truths of many scientists

Link between abortion, breast cancer debunked but Trump advisor may still believe it

A high-ranking Trump advisor may still accept as true a debunked connection between abortion and breast cancer.

Charmaine Yoest

According to a recent fact-checking article by Michelle Ye Hee Lee in The Washington Post, Charmaine Yoest, assistant secretary of Health and Human Services, is "a prominent opponent of abortion rights" who declined to give a yes-or-no answer to the question of whether she still believes it.

The Post story cites a 2012 feature story in The New York Times that described her position "supporting the discredited theory that abortion increases a woman's risk for breast cancer."

It also cites the conclusion of the National Cancer Institute, the American Cancer Society, the American Congress of Obstetricians and Gynecologists and others in the scientific community that the theory, which has been spread for decades, is false, and that although "abortion has not been scientifically proven to be a factor," there are "many risk factors for breast cancer, including: family history, the woman's age (older women face increased risks), how old she was at her first menstrual period (people who get their first periods earlier face a higher risk), how old she was when she delivered her first full-term pregnancy (women who have children later or who never have children face a higher risk), and obesity after menopause."

The Times piece specifically mentions an "analysis of 53 studies involving 83,000 women that found no link between abortion and a higher rate of cancer."

Yoest, herself a breast cancer survivor, has been a national anti-abortion activist (including a stint as president and chief exec of the anti-abortion group, Americans United for Life).

The discredited theory, according to the Post, "was widely promoted in the wake of the 1973 Roe v. Wade decision" and perpetuates the myth that "the development of breast tissues at certain periods of the pregnancy cycle leads to an increased chance of breast cancer [and that] if a woman ends her pregnancy in the second trimester, from about 20 to 32 weeks, she faces a greater risk."

The theory doesn't differentiate, by the way, between pregnancies ended via abortions, miscarriages or premature deliveries.

Other debunked theories about breast cancer risks are detailed in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

5 cups of java might halve malignancy risks

Drinking coffee may help prevent some liver cancers, new British study suggests

A new British analysis shows that people who drink more coffee, even decaffeinated, are less apt to develop liver cancer.

The analysis took into consideration 26 studies, according to a story in a recent Guardian.

For those who drank two cups a day, the risk of hepatocellular cancer (HCC), the most common form of primary liver cancer, dropped by 35 percent compared to those who drank no coffee, the article reported.

"Those who drank one cup a day had a 20 percent lower risk," it added, noting, too, that for those who drank five cups, "the risk was halved." 

The research — published in the journal BMJ Open — was done by experts at the universities of Southampton and Edinburgh. It "examined data involving more than 2.25 million participants." 

Results also showed that "the protective effect for decaf was 'smaller and less certain than for caffeinated coffee.'"

The analysis' lead author, Dr. Oliver Kennedy of the U. of Southampton, was quoted as saying that coffee "is widely believed to possess a range of health benefits [but] we're not suggesting that everyone should start drinking five cups of coffee a day...There needs to be more investigation into the potential harms of high coffee-caffeine intake, and there is evidence it should be avoided in certain groups such as pregnant women."

According to another article — in the Southern Daily Echo, also a British publication — "liver cancer is one of the leading causes of cancer death globally because of its poor prognosis and high frequency…it is estimated that, by 2030, the number of new cases annually will have risen by about 50 percent to more than 1.2 million."

Cancer risks clearly come from a variety of sources, and reductions can come from multiple actions. Details can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

4 screenings called unnecessary; 2 others advised

Cancer screenings after 70 can do more harm than good, AARP magazine piece indicates

If you've hit 70 — when, according to my primary doc, "you've already won the game" — the need for some cancer screenings may vanish.

In fact, at least four of them might do more harm than good, indicates an article by Candy Sagon in a recent double edition of "AARP: The Magazine."

The unnecessary tests, the piece says, are colonoscopy, mammography, PSA and Pap smear.

In their place are recommended two other tests: bone density scan and abdominal aorta aneurysm screening.

The AARP magazine article charges that "a growing number of health experts [worry that] the overtesting of those who are in their 70s, 80s and even older…could lead to invasive procedures or treatments that leave patients worse off than before, especially among those with serious health problems such as heart disease."

Those fears may have been underscored by a 2014 study published in "JAMA Internal Medicine" that found — after looking at more than 27,00 adults age 65-plus — "too many physicians automatically recommend cancer screening tests for older patients whose precarious health puts them at high risk of dying within a decade."

Dr. Harlan Krumholz

The AARP article quotes Dr. Harlan Krumholz, a Yale cardiologist and researcher known to be an outspoken critic of overtesting, as saying, "On average, those over 75 derive fewer benefits than younger people do."

Women, the piece suggests, should be getting routine bone density scans "beginning at 65 (or earlier, depending on their risk factors)," while men 70 and older need that particular test "to check for osteoporosis."

Regarding the abdominal screening, the article says "men 65 to 75 who have been smoking anytime during their lifetimes should have a onetime ultrasound to screen for an abdominal aortic aneurysm (AAA)" — though the story hedges about whether the screening would benefit women who'd smoked.

As for the colonoscopies, it says a new Harvard study of "more than 1.3 million Medicare patients ages 70 to 79" found the risk of complications to be larger than the cancer risk. Obviously, however, "if you've had a polyp removed or have a family history of colon cancer, you risk is higher, and you should probably be screened. If not, you may be able to finally skip all that lovely laxative prep."

The AARP article cites the opinion of the U.S. Preventive Services Task Force when it comes to the mammograms. The USPSTF purportedly found "insufficient evidence" to conclude that mammography past 74 is necessary. It's likely, the agency indicated, that benefits of the screenings at that advanced age are limited.

Not a single medical group apparently recommends PSA screenings for prostate cancer beyond age 75 — even though 41 percent of men in that category still have the test (most often at the urging of their doctors).

If women have, after age 65, had no cancer or precancerous lesions, and have had three negative smears to check for cervical cancer in the previous 10 years, there's no need for one more smear. Unfortunately, the AARP story says at least one study indicates, "most women have become so accustomed to having an annual Pap smear that they have them even after undergoing a hysterectomy."

The benefits and burdens of screenings in general are addressed in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Data from 1.2 million females reviewed

Daily glass of wine or booze can dramatically raise women's risk of breast cancer, review shows

Having just one glass of wine or another alcoholic drink a day is likely to boost a woman's risk of breast cancer.

That's what a new massive review indicates, according to a story by Laurie McGinley in today's editions of The Washington Post.

The increased risk is considered significant.

Statistically, McGinley's piece says, the difference is "5 percent for pre-menopausal women and 9 percent for post-menopausal women."

Reducing risk is also possible, the story also reports, by vigorous exercise such as running and bicycling.

That information translates, according to the study, into "pre-menopausal women who were the most active [having] a 17 percent lower risk of developing malignancies compared to the least active women, while post-menopausal women had a 10 percent decreased risk."

Why the added or diminished risks?

McGinley writes that "alcohol increases estrogen, which is linked to increased breast-cancer risk, while physical activity reduces it."

The review — done by the American Institute for Cancer Research (AICR) and the World Cancer Research Fund — "evaluated research in 119 studies encompassing data on 12 million women from around the world."

AICR estimated that 1 in 3 cases of breast cancer could be prevented if women didn't drink alcohol, were physically active and maintained a healthy weight.

Anne McTiernan

The Post article cites Anne McTiernan, a cancer-prevention researcher at Fred Hutchinson Cancer Research Center in Seattle and one of the report's lead authors, to the effect that the review "suggests there is no level of alcohol use that is completely safe in terms of breast cancer. If a woman is drinking, it would be better if she kept it to a lower amount."

The review showed, too, that women who are overweight or obese run a higher risk of post-menopausal disease in general. Losing just 10 percent of their weight apparently can reduce blood estrogen and inflammation.

But even a healthy lifestyle is no guarantee.

The Post paraphrased the researcher as saying it's more like wearing a safety belt — with many women doing everything they can to reduce their risks but still get diagnosed with breast cancer.

"That's unfortunate, but that's what happens," the newspaper quoted McTiernan as saying.

Many more risks of breast cancer are outlined in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

'Existential dread' matches dread about disease

Cancer patients, survivors fear GOP dismantling Obamacare, return to 'medical dark ages'

Both cancer patients and survivors are having new fears — anxieties that equates to the trepidation they had when first diagnosed with the disease.

According to a recent story by Laurie McKinley in The Washington Post, what they're afraid of is the Republican obsession to dismantle the Affordable Care Act, otherwise known as Obamacare.

The McKinley piece says those patients and survivors "are among the most vocal of groups raising alarms about the GOP's repeal effort. They are calling congressional offices and showing up at their representatives' town hall meetings with angst-filled stories about a pre-ACA world in which they couldn't get individual health plans because of their medical histories."

More than 15 million people in the United States are patients or survivors, the story adds, "with millions more affected as family members."  

McKinley writes that "many people described a kind of existential dread that matches their fear of cancer," still the second-leading cause of death in this country.

Dr. J. Leonard Lichetenfeld

In effect, they fear a return to the "medical dark ages" where their disease is concerned.

"Some worry," the story continues, "that the law's likely dismantling may put the latest oncology treatments, which can run $10,000 a month, out of reach. Others point to research showing that insurance status affects cancer patients' survival."

The piece also quotes Dr. J. Leonard Lichtenfeld, deputy chief medical officer of the American Cancer Society, as telling a recent House committee hearing, "Cancer patients need to know that they have insurance."

Fear, and how to overcome it, is a major topic of "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers. 

TV star has 'no idea how to react' to good news

Remission! Two-year battle with breast cancer being won by actress Shannen Doherty

Actress Shannen Doherty's breast cancer apparently has gone into remission.

After a two-year public battle with the disease.

According to an article by Umberto Gonzales in The Wrap over the weekend, Doherty wrote on Instagram that she has "no idea how to react," and added that "for now, I'm going to just breathe."

Shannen Doherty

But the "Beverly Hills, 90210" television star is realistic.

She noted that "as every single one of my fellow cancer family knows, the next five years is crucial. Recurrences happen all the time."

Meanwhile, she said, "Decisions. Reconstruction, which is several surgeries. Decision on taking a pill for the next five years comes with its own set of problems and side effects."

Her over-all feeling, however, was that "I am blessed."

Her battle became public when, according to Gonzales, "she sued her former management firm after her health insurances lapsed," which led to a delay in having her breast cancer diagnosed.

The star has undergone chemotherapy and a mastectomy.

Details about the disease, reconstruction, side effects and follow-up treatments can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.