Category: Press Release

Drinking Alcohol Might Make Your Cells Age Faster

Drinking Alcohol Might Make Your Cells Age Faster

While experts generally agree that drinking alcohol in moderation is OK, having too much alcohol has been linked to a slew of serious health problems like liver disease, heart disease, stroke, high blood pressure, and certain cancers. Now, there’s a new concern to add to the list: Drinking can age you on a cellular level.

That’s the takeaway from a new study from Kobe University that was presented at the 40th annual scientific meeting of the Research Society on Alcoholism. For the study, researchers analyzed the drinking history, alcohol habits, and DNA of 255 people, about half of whom sought alcoholism treatment services at a hospital in Japan.

After analyzing each person’s data, the researchers determined that the more alcohol people drank, the more their cells appeared to age. Alcoholic patients specifically had shortened telomeres, the protein caps on the ends of human chromosomes that are markers of aging and overall health. Every time a cell replicates, a little amount of telomere is lost. As a result, they get shorter over time, but certain things like alcohol abuse can also speed up this aging process. And, by having shortened telomere lengths, alcoholic participants were at a greater risk of developing age-related diseases like heart disease, diabetes, cancer, and dementia.

“Telomere shortening has been well described as a manifestation of the aging process,” Jack Jacoub, MD, an internist, medical oncologist, and director of thoracic oncology at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, Calif., tells Yahoo Beauty. “There’s no dispute about that.” However, he says, the alcohol link is new.

Health expert Jennifer Wider, MD, tells Yahoo Beauty that the news is concerning given that it places people who drink heavily at risk for age-related diseases. In those individuals who are already at a higher risk for diseases like cancer and stroke “this could have dire consequences,” she says.

Naturally, you’re probably wondering what this means if you’re not an alcoholic but still drink on occasion. The Dietary Guidelines for Americans recommends that, if you drink, you drink in moderation, which is defined by having up to one drink a day for women and up to two drinks a day for men. (For the record, a “drink” is a 12-ounce beer, 5-ounce glass of wine, or 1.5 ounces of hard alcohol.) Anything above that is generally considered heavy drinking.

Jacoub says it’s possible that any amount of alcohol can speed up cell aging, but the quantity you drink and how long you drink matters. Meaning, if you’ve been a heavy drinker for years, you’re probably putting yourself at a higher risk of age-related diseases than someone who only drinks occasionally and has maintained that habit for a long time. “Moderation is definitely key,” Jacoub says.

Wider points out that the study was small and focused on alcoholics, and that more studies are needed before any definitive conclusions can be drawn. “The effects for moderate drinkers are likely less significant,” she says.


Cancer Patients Warned About Using Marijuana

The death of a California man who was being treated for cancer is being blamed on a rare fungal infection.

According to a CBS report, the man may have been exposed to the fungus while using contaminated medical marijuana.

Following his death, researchers tested 20 medical marijuana samples from dispensaries around Northern California.

A study from the University of California, Davis, found that most were contaminated with unsafe bacteria and fungi.

Many of them can cause serious lung infections.

Fungi included cryptococcus, mucor, and aspergillus.

Bacteria included E. coli, Klebsiella pneumonia, and Acinetobacter baumannii.

The findings are published in Clinical Microbiology and Infection.

Researchers caution people with cancer

The U.C. Davis researchers warn that smoking, vaping, or inhaling aerosolized marijuana could be dangerous to some people with serious ailments.

People with leukemia, lymphoma, AIDS, or others undergoing immune suppressing therapies are at particular risk.

They also advise against using marijuana in baked goods. At least for now.

They theorize that cooking would destroy the bacteria and fungi, but they have not seen experimental evidence of this.

“Patients with impaired immune systems are routinely advised to avoid exposure to plants and certain raw foods because of the risk of infection from soil-dwelling organisms,” Dr. George Thompson III, said in a press release.

Thompson is an associate professor of clinical medicine at U.C. Davis in the Department of Medical Microbiology and Immunology. He was also a lead author of the study.

“But at the same time, they are increasingly turning to medical marijuana to help them with symptom control,” he continued. “Because microorganisms known to cause serious infections in immunocompromised patients were found to be common on marijuana, we strongly advise patients to avoid it.”

According to the study’s authors, marijuana from legal dispensaries isn’t necessarily safe. That’s because there’s no federal regulation for quality.

Also, doctors may not link an infection to medical marijuana.

How marijuana helps people with cancer

“Medical marijuana seems to be potentially helpful for many cancer problems,” said medical oncologist Dr. Jack F. Jacoub.

In an interview with Healthline, Jacoub said medical marijuana can help with numbness and tingling (neuropathy), nausea, and loss of appetite.

“It can also help with chronic pain syndromes related to the disease or treatment,” continued Jacoub, who is director of thoracic oncology at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Southern California.

Jacoub said these are tough symptoms to control. And he’s seen better-than-expected results.

“Other prescription medications have a role. Without a doubt. But you have to work with the side effects. Some patients really respond to medical marijuana,” he said.

Medical marijuana can be delivered in many ways, including smoking, inhaling, eating, and even in oil. Marijuana also has some side effects, including the “high.”

“I’m quite convinced we’re only beginning to understand its use in cancer patients,” said Jacoub. “Some people come back after trying many things and medical marijuana is the one thing that helped. There’s definitely a group of people that benefit. You’d have to be shortsighted not to see that.”

What cancer patients need to know

Not all cancers are alike.

Jacoub explained that in general, cancer develops due to a preexisting degree of immune system incompetence. Some cancers are tightly associated with a compromised immune system. These include leukemias and lymphomas.

In addition, some chemotherapy drugs will further suppress the immune system.

“Patients are notified of this. Infection can be severe and life-threatening. They’re told what to avoid and what to report to their physician,” said Jacoub.

They’re advised not to eat fresh fruits and vegetables without cooking or steaming. Some can’t even have fresh plants in their rooms.

These people should be very careful.

“Please discuss this with a physician experienced in dealing with compromised immune systems,” Jacoub suggested. “They will understand the nuances and can advise you. Don’t take it upon yourself.”

If you have cancer and want to try medical marijuana, Jacoub has a few other suggestions.

First, decide what symptoms you need help with that you’re not getting help with now.

Second, visit a dispensary that has an abundance of experience dealing with your condition. Ask about the potential side effects of various products.

“The route probably most concerning for infection like the one reported is smoking,” said Jacoub. “Warning signs of infection are a nagging cough and phlegm. Some people have chest pain. But the biggest one is fever.”

Regulations vary from state to state and aren’t always clear.

“There should be tighter regulations. Without them, it’s still a risk, even when you buy from a dispensary. But it’s probably safer than buying on the street. Hopefully, that part of the market will ultimately disappear,” said Jacoub.

There’s limited data on medical marijuana use.

“We don’t have large clinical trials. But there have been some really interesting outcomes in patients who report improvements in symptoms,” he said.

Making informed decisions

“Cannabis is an agricultural product and it is unreasonable to expect that it would be free of bacteria and fungus that are found routinely in soil,” said cannabis therapeutics expert Dr. Jordan Tishler of Inhale MD in Massachusetts.

In an email to Healthline, Tishler explained that it’s not well understood if any of those pathogens routinely survive smoking, vaporizing, or cooking.

“Best evidence to date suggests that temperatures around 350 degrees Fahrenheit and higher will kill these agents. What isn’t clear is whether smoking and vaporizing achieve these temperatures in a thorough enough manner to kill whatever’s in there. What we need, and do not yet have, is testing of the smoke/vapor output to viable organisms,” said Tishler.

Tishler makes the point that marijuana use by people with cancer is not new. It’s been going on for decades, if not longer. Even so, it’s rare that an illness is traced back to medical marijuana.

“It could be countered that we haven’t been looking for such. But if it were enough of a hazard, I would suspect we would have noticed,” he said.

Tishler said there’s no doubt we need more research. But he believes there’s adequate data to make informed decisions.

“The key is to have a detailed and thorough discussion of the risks and benefits of cannabis therapy with a caring, educated cannabis specialist in conjunction with the rest of your medical team,” he advised.


Experimental Treatment Provides Hope for Infants with Cancer

An experimental treatment has saved the lives of two infants with difficult to treat leukemia.

The two children, 11 and 16 months old, each experienced complete cancer remission within 28 days of receiving treatment.

Diagnosed with B-cell acute lymphoblastic leukemia (ALL), both infants had exhausted all other treatment options.

ALL is an aggressive type of cancer that begins in immature white blood cells called lymphocytes. Without treatment, ALL can be fatal within months.

According to the American Cancer Society, children with B-cell ALL who are between the ages of 1 and 9 have better cure rates. Infants under 1 year old tend to have a poorer outlook.

The two infants given the experimental treatment have both been cancer-free for more than a year.

The research was published in Science Translational Medicine.

How T cell treatment works

When other methods such as chemotherapy don’t work, there’s a newer leukemia treatment that involves using a patient’s own T cells.

The T cells are removed and manipulated with chimeric antigen receptors (CARs) that instruct them to attack ALL cells. Then they’re returned to the patient’s blood.

However, most infants during their first year haven’t developed enough healthy T cells.

Dr. Waseem Qasim, professor of cell and gene therapy at Great Ormond Street Institute of Child Health, University College in London, and his colleagues, wanted to find a solution to this problem.

Unable to get enough T cells from the infants, they decided to use donor blood.

Through gene editing, they created functional T cells that could evade immune system attacks in unmatched recipients.

The T cells were then infused into the infants’ blood.

Two months after the procedure, one infant developed mild graft-versus-host disease in the skin. It cleared up following a bone marrow transplant and steroid treatment. The other infant had no complications.

It’s the first time doctors have ever treated cancer with altered T cells from a donor.

The doctors showed it’s possible to create universal, or “off-the-shelf,” therapies from altered donor T cells.

The experiment could lead to big advances in hard to treat ALL.

The promise of off-the-shelf T cells

With no need to match patients with donors, patients could be treated more quickly and more efficiently.

“Engineered T cells are the most important story in difficult to treat leukemias and lymphomas,” said medical oncologist Dr. Jack Jacoub in an interview with Healthline.

“A lot of progress has been made in this type of treatment. It’s an area that has excellent promise and definitely needs to be considered,” said Jacoub, the director of thoracic oncology at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in California.

“This type of lymphoblastic leukemia is a very bad disease,” he added. “There’s often little to be lost. This is the case with these two infants. They were provided therapy on a compassionate basis. All other therapies failed, so there was nothing to lose. They would have succumbed to this illness.”

“The paper’s authors suggest there are limitations in getting lymphocytes in young patients. They have a less mature immune system. They don’t have enough T cells, and that’s a problem,” said Jacoub.

“The authors are implying we don’t need to go to the patient or have a donor. We don’t need either route,” he explained.

Next steps for researchers

“In these two infants, they’ve showed they can do it,” said Jacoub. “It’s only two [patients] and they tried it because there was nothing else. But it’s not even a phase I trial structure.”

Jacoub notes that the paper was published in a small journal that may not be widely received throughout the field of hematology. He’s fairly certain, however, that this paper is on the radar of scientists involved in the field.

Also worthy of note is the small sample size.

“We don’t know how the next patients will do. This is just an observation, but an exciting one that must be expanded,” he said.

Jacoub suggests the need for more collaboration with larger institutions with research infrastructure, more of these types of patients, and the expertise to manage this disease.

“Whether it will go to phase I trial is a big leap. It will have to involve more than one institution. Right now, it’s just an observation of two patients. We won’t be rushing out to try to do this now, but this is how things start,” he said.

Jacoub sees a lot of potential in this type of treatment. But there’s a long way to go.

“The U.K. trial would have to be reproducible in the United States to see if this is feasible. With more scientific scrutiny and oversight — if we can reproduce it — it could be enormous. Barriers would be overcome,” he said. “They’re taking available technology a few extra steps. The technology is there. If it really was a true effect and can be reproduced in different settings and countries, it could lead to widely available therapeutic options. If this observation could be accurately reproduced, we’ll probably know in the next year or two. That’s how fast this field moves.”

Jacoub said this is exciting news for patients and their families.

“It’s not widely available or the current standard of care. But families of these patients are usually medically savvy,” he said.

He’s all for families bringing it up with their physicians.

“It’s OK if their doctor hasn’t seen this published report. Copies of this journal may not go everywhere. Usually these things happen in collaboration. Emails to scientists and institutions start discussions. So they should definitely bring it up.”


Two Days After Surgery for Cervical Cancer, Erin Andrews was Back at Work

Erin Andrews made a startling revelation in a new Sports Illustrated profile: She quietly battled cervical cancer last year, shortly after her nude video lawsuit took place — for which she was awarded $55 million after she was secretly taped in her hotel room.

The Fox NFL reporter says she had a routine checkup in June that included tests that led to her diagnosis. Andrews, 38, was in a meeting at the New York Giants’ team facility when she got a call from her doctor, telling her she had cervical cancer. Andrews’ doctor said she would need surgery soon.

Andrews didn’t tell her coworkers about her diagnosis. Instead, she reported on a game and then flew home to L.A. Her surgery was scheduled for Oct. 11 and before she was taken into the operating room, Andrews told her oncologist, “I’m not watching any football games at home. This is [Fox’s] Super Bowl year, and I’m not missing the Super Bowl.”

Two days after her surgery, she took a red-eye flight from L.A. to Green Bay, where she filmed a feature with the Green Bay Packers’ Jordy Nelson. She then went on to cover more games. “Should I have been standing for a full game five days after surgery? Let’s just say the doctor didn’t recommend that,” Andrews says.

“But…sports were my escape. I needed to be with my crew.”

Andrews eventually revealed her diagnosis to her colleagues after her boss noticed that she wasn’t herself. It was then she says she realized her cancer wasn’t a weakness. “After the trial everyone kept telling me, ‘You’re so strong, for going through all of this, for holding down a job in football, for being the only woman on the crew,’ ” Andrews says. “Finally I got to the point where I believed it too. ‘Hey, I have cancer, but dammit, I am strong, and I can do this.’ ”

According to the Centers for Disease Control and Prevention (CDC), 11,955 women in the U.S. were diagnosed with cervical cancer in 2013 (the most recent year for which numbers are available), and 4,217 women died from the disease. The main cause of cervical cancer is human papillomavirus (HPV), the most common sexually transmitted infection, the CDC states, and it’s often detected by an abnormal Pap test.

Hye Sook Chon, M.D., a gynecological oncologist at the Moffitt Cancer Center, tells Yahoo Beauty that recovery time varies for cervical cancer surgery, depending on what stage a woman’s cancer is in, and what type of surgery she had.

Jack Jacoub, M.D., a medical oncologist at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, Calif., tells Yahoo Beauty that surgical options typically range from conization, a form of biopsy in which abnormal tissue is removed from the cervix to a hysterectomy, in which all or parts of a woman’s uterus are removed.

Jacoub points out that it’s natural—and even helpful—for people to want to get back to normal as soon as possible. “When people are given a diagnosis of cancer, there’s a bit of a loss of control—you’ve given your body to your physicians and healthcare team,” he says. “It can be a very stressful period.”

That’s why he says striving to have a sense of normalcy after cancer surgery is an important part of the recovery process. “If someone has the ability to set goals and do them through motivation and energy, whether that’s exercising sooner or going back to work sooner, it can help recovery,” Jacoub says. In fact, he says not being engaged in regular life can lead to a slower recovery.

Chon says many of her patients want to know how soon they can resume their normal life after surgery, and she says it varies. If a person was active before surgery, they’re likely to get back to normal sooner than someone who was more inactive. “If it’s possible, it’s very important for patients to resume their normal activities,” she says.

However, recovery timeframes vary for everyone and even Andrews’ father points out that she wasn’t acting like herself again for several weeks. If a patient is active again too soon after surgery, she’s at a higher risk of bleeding and can be in more pain than if she rested more, Jacoub says: “That’s why we typically recommend that people take it slowly after surgery.” However, it’s best to consult your doctor if you’re not sure.


8 Surprising Signs Of Lung Cancer You Should Know

Chest pain is the most obvious sign of lung cancer, but there are plenty of other signals you should know about—even if you’ve never smoked. Lung cancer is the leading cancer killer of both men and women in the US, and up to 20% of people who die from it have never smoked at all.

Why might a nonsmoker get lung cancer? Exposure to radon (an odorless gas found in homes) is often to blame, explains Robert McKenna, Jr., MD, a thoracic surgeon at Providence Saint John’s Health Center in Santa Monica, CA. Other possible culprits include air pollution, secondhand smoke, and environmental hazards like asbestos. (Here are 10 of the most painful conditions.)

Whether you smoke regularly or have never lit up in your life, keep an eye out for the following symptoms. Although there are plenty of less nefarious reasons why these issues might crop up, play it safe and discuss them with your doctor.

A lingering cough

“The majority of people with lung cancer have a cough, occasionally with blood,” says McKenna. Bringing up thick, rust-colored mucus can also be an early sign. But even if you have a dry cough, if it’s lingered for over a month, it’s worth getting checked out.

Chronic infections

Most of the time, viruses are to blame for lung infections like chronic bronchitis. But if you’re repeatedly getting sick and every illness seems to go straight to your chest, it could be a sign of cancer.

Weight loss

Dropping pounds without a change in your diet or workout? “As with any cancer,” notes McKenna, “a more advanced tumor may make proteins that tell your body to lose weight.” That’s why you may also notice a drop in your appetite. (If you’re gaining weight and not sure why, it could be one of these weird reasons.)

Bone pain

If lung cancer has spread to other organs in your body, you may feel an ache deep down in your bones or joints, says Jack Jacoub, MD, a medical oncologist and director of thoracic oncology at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, CA. The back and hips are common sore spots. (Though this may also be a sign of vitamin D deficiency.)

Swelling in your neck and face

If a lung tumor begins pressing against your superior vena cava (the large vein that carries blood from your head and arms to your heart), you may notice swelling in your neck and face, says Jacoub. Your arms and upper chest can also be affected. (Try this simple 12-day liver detox from Rodale and lose up to 13 pounds!)

Overwhelming fatigue

“This is different than feeling tired,” Jacoub notes. “It’s feeling so worn out that you can’t wait to climb into bed,” and getting lots of rest doesn’t help. As many as 80% of people with cancer note “excessive tiredness” as a symptom. (Here are 7 reasons you’re tired all the time.)

Muscle weakness

Lung cancer affects your muscles as well as your organs. One of the first areas to be impacted: your hips. “You might find it hard to even get out of a chair,” says Jacoub. Weakness in the shoulders, arms, and legs is also typical.

High calcium levels

Certain lung cancers make hormone-like substances that upset the balance of minerals in your body. In some instances, says McKenna, excess calcium gets released into the bloodstream. While you may not realize your levels are through the roof until your doctor orders a lab test, you should notice the symptoms that go along with high calcium: frequent urination, excessive thirst, constipation, nausea, belly pain, and dizziness.


Inexpensive Diabetes Drug May Be New Weapon in War on Cancer

Researchers are a step closer to figuring out how metformin may help prevent cancer.

Metformin is generally used to treat type 2 diabetes. The drug helps the body use insulin more effectively.

It also helps lower glucose production in the liver. And it’s relatively inexpensive.

Observational studies have suggested that people who take it may have a lower risk of certain types of cancer.

Researchers at the University of California, San Diego, wanted to know why. The answer could lead to better prevention and more effective cancer treatment.

Details of their research are published in the journal eLife.

What the research says

All cells possess cell polarity. It’s what allows them to perform specific tasks.

Polarity lets epithelial cells form protective walls in cavities and organs. The walls protect against toxins, pathogens, and inflammatory triggers.

Any crack in the wall can open the door to cancer.

The research team identified the mechanism that helps keep the wall strong.

Researchers already knew about something called the stress-polarity pathway.

As stated in the researchers’ press release, it’s “a specialized pathway mobilized only during periods of stress. It is orchestrated by a protein kinase called AMPK that protects cellular polarity when epithelial cells are under energetic stress and an activator of AMPK called LBK1.”

LBK1 is a tumor suppressor. LBK1 mutations are associated with loss of cell polarity and cancer.

The mystery was in how the LKB1-AMPK pathway preserves cell polarity during stress.

The new research found that the stress-polarity pathway relies on a protein called GIV/Girdin. Metformin affects this protein.

“In summary, by identifying GIV/Girdin as a key layer within the stress-polarity pathway we’ve peeled another layer of the proverbial onion,” Dr. Pradipta Ghosh, the study’s senior author, said in the press release.

Ghosh explained that the research provided new insights into the epithelium-protecting and tumor-suppressive actions of metformin.

Cancer fighting properties

Dr. Timothy Byun is a medical oncologist with the Center for Cancer Prevention and Treatment at St. Joseph Hospital in Southern California.

He told Healthline that metformin has several mechanisms that may contribute to its anticancer property.

Byun said multiple epidemiologic studies show an association between metformin use and reduced cancer incidence and mortality.

“It’s also well-known that individuals with diabetes or metabolic syndromes have increased insulin production or insulin-resistance state. Hyperinsulin state is associated with increased risk of certain cancers,” said Byun.

He explained that metformin has insulin-lowering activity. This may slow cancer in hyperinsulinemic patients.

It also suppresses production of adenosine triphosphate (ATP). ATP transports energy within cells.

By suppressing it, cancer cells have less energy available. This makes it harder for cancer cells to spread or survive.

“Population studies suggest cancer incidence reduction of 14 to 40 percent. And mortality reduction. The main sites appear to be in breast, colon, liver, pancreas, endometrium, and lung,” said Byun.

The cancer-nutrition connection

“It’s exciting, if you think about it,” said medical oncologist Dr. Jack Jacoub in an interview with Healthline.

“There’s an increasingly loud voice about how important nutrition might be in cancer. In fact, it could become one of the tools we use to treat it,” explained Jacoub, director of thoracic oncology at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in California.

“There’s been some skepticism in the field,” he added. “This is part of a new area of looking at prevention and treatment related to glucose and insulin. Also, cholesterol, triglycerides, and other pathways that affect cancer cells.”

Jacoub said nutrition, weight control, and level of activity all matter. All affect development, progression, and response to therapy.

“Metformin is part of a growing story. It would be irresponsible to say metformin is the standard of care at this point. It’s early in the research. But if you’re already on it for diabetes, there may be a lot of benefits to you beyond controlling sugar,” advised Jacoub.

Next steps

Will metformin eventually help prevent or treat cancer?

It’s too soon to say.

“Researchers have been looking at metformin for several years,” said Jacoub. “There are unique features in terms of risk factors of specific cancers. Maybe a drug like metformin could impact cancer cells of that group. There are ongoing trials involving women with a history of breast cancer to learn if it could reduce the risk of recurrence. It’s a well-established concept in breast cancer. There’s a very large trial going on specifically asking that question.”

Byun suggested that phase III studies may be able to determine if metformin is effective in prevention or decreasing recurrence. Or if it could make chemotherapy or radiation therapy more effective.

There’s no immediate role for metformin in treating cancer, according to Byun. He would like to see positive phase III study data before changing his pattern of practice.

“There is a phase III study in France looking at hepatocellular cancer risk in patients with viral hepatitis C cirrhosis. [Cirrhotic patients are at high risk of developing liver cancer due to underlying liver damage.] This study randomizes patients on metformin vs. placebo for three years,” he said. “Another phase III study is in prostate cancer [and patients with] localized disease who are undergoing active surveillance, rather than definitive surgery or radiation therapy. It is looking at time to disease progression.”

“These efforts are underway. But it will take some time for us to know,” said Byun.


Why Cancer Symptoms Can Sometimes Seem Like The Flu

Rapper Taboo is talking about his tough battle with testicular cancer. The Black Eyed Peas member (real name: Jaime Luis Gomez) revealed in a new interview that he actually thought his cancer symptoms were the flu. “It all started with a pain in my back and abdomen,” he told People. “I was so busy working that I wasn’t worried about it, but I went to the emergency room to get checked out.” After undergoing a slew of tests, Gomez was diagnosed with Stage 2 testicular cancer.

“The very next day I went into surgery to have the ‘mother ship’ removed. But my fight had just begun,” he says. “My family and the group were all in shock, but instantly reached out to a great doctor who helped me figure out a treatment plan. I was racing against the clock.” Following his surgery, Gomez went through 12 weeks of “intense, aggressive” chemotherapy and is now cancer-free.

“There were times that I wanted to give up, but I became inspired by sports figures who have gone through similar battles,” he says. “I wanted to share my story and inspire others like those who had inspired me.”

About 8,720 new cases of testicular cancer will be diagnosed by the end of 2016, and 380 men will die from the disease, according to American Cancer Society estimates. Testicular cancer is not common, the organization says, but rates of the disease have been increasing for several decades. Testicular cancer largely impacts young and middle-aged men, the society reports.

Lower back pain like Gomez experienced is a sign of advanced testicular cancer, along with shortness of breath, chest pain, stomach pain, and headaches or confusion, per the American Cancer Society. However, a lump or swelling in the testicle is the most common symptom.

Flu-like symptoms—joint aches and pains, fatigue, and occasionally a fever—aren’t rare for cancers, Jack Jacoub, M.D., medical oncologist and director of thoracic oncology at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, California, tells SELF. Cancers secrete various hormones that make you feel run-down and achy, cause general weakness, and give you a fever, he explains. However, these symptoms are pretty nonspecific. “A lot of things can present that way,” Jacoub says.

Wade Sexton, M.D., senior member in the Department of Genitourinary Oncology at Moffitt Cancer Center, tells SELF that a lot of this really depends on the type of cancer and how advanced it is. A man with testicular cancer who has fatigue and back pain likely had the cancer spread to the lymph nodes in his abdomen, Sexton says. (However, that typically also comes with a lump in a man’s testicles, he says, so men shouldn’t freak out and assume any back pain is cancer.) “It’s also not uncommon for us to see a patient with advanced kidney cancer to present with general malaise, fatigue, and even a low-grade fever,” Sexton says.

Jacoub says back or abdominal pain can also present in people suffering from ovarian, uterine, stomach, colon, and bladder cancers. Fatigue is also a big symptom, which can be mistaken for the flu, he says.

If you think you have the flu or are generally feeling ill, no need to worry that it’s a sure sign of something worse. Sexton says time is a big factor in distinguishing the flu from a more serious issue like cancer. “The flu tends to be transient—the majority of us get better over a few days,” he says. With cancer, however, your symptoms would continue for a longer period of time and typically get worse. “That would be the tip-off that maybe you’re not dealing with a run-of-the-mill flu,” Jacoub says.

If you find that you’re having flu-like symptoms that don’t get better, talk to your doctor, especially if pain is involved. While there’s a small chance it could be cancer, it could also be a sign of one of a host of other issues that can be easily fixed. Either way, it’s a good idea to get it checked out.


What We Can Learn From How David Bowie Coped With Terminal Illness

David Bowie received a terminal cancer diagnosis more than 18 months before he died, but reportedly kept it hidden from many, including some close friends.

The 69-year-old music icon suffered from liver cancer, Ivo van Hove, the director of a musical based on Bowie’s songs, told Dutch radio station “He told me more than one year and three months ago that he had liver cancer, just after he had been told himself,” van Hove said, per the U.K.’s Daily Mail. “He said that because he knew that he may not always be able to be around.”

Bowie reportedly wrote thank you notes to friends before his death, who weren’t aware of his diagnosis until Monday’s announcement of his death. He also released his final album Blackstar on Jan. 8, as well as a video for the song Lazarus, which begins with the lyrics, “Look up here, I’m in heaven.”

Tony Visconti, a producer who worked on Blackstar, said in a Facebook post that the album was deliberately created as a “parting gift” for Bowie’s fans. “He always did what he wanted to do,” Visconti said. “And he wanted to do it his way and he wanted to do it the best way.“

Unfortunately, liver cancer rates are growing in the U.S., the American Cancer Society reports, and it often affects men more than women. According to Society estimates, more than 35,000 news cases were diagnosed in 2015, and more than 24,500 people died of the disease last year.

“It almost always is terminal,” Lewis Roberts, MD, a gastrointestinal cancer expert at Mayo Clinic, tells Yahoo Health. Liver cancer can be treated if it’s caught early, Roberts says, but in most industrialized countries like the U.S., only 15 to 20 percent of liver cancer patients are still alive five years after their diagnosis.

People who are diagnosed early enough can be treated with a liver transplant, surgery, or a procedure in which a needle-like probe is inserted into the liver, which “cooks” the area around the cancer. “Those treatments can be extremely successful,” says Roberts.

Liver cancer can be caused by hepatitis, alcohol, or fatty liver disease, Roberts says, the latter of which is tied to obesity, which may explain the growing incidence of the disease in the U.S.

But Jack Jacoub, MD, an oncologist at California’s Orange Coast Memorial Medical Center tells Yahoo Health that liver cancer “only develops in individuals who have a diseased liver.” If a liver disease is caught, patients must have regular liver cancer screenings to try to catch liver cancer at an early point. “You don’t want to come in with advanced liver cancer,” Jacoub says. “That’s a situation where the prognosis is not good.”

Unfortunately, Roberts and other clinicians like him have to give terminal diagnoses, which he calls “challenging.”

“It’s very stressful for people to hear about having a diagnosis like that, especially if it’s an advanced diagnosis where a lot can’t be done,” Roberts says.

Not everyone turns their grief into art, like Bowie. Some patients may become depressed by the news and will be referred to a psychologist or psychiatrist who can help them come to terms with the diagnosis. They also can receive support from terminal care and hospice programs, Roberts says.

There are several stages that a person goes through once they’re diagnosed with a terminal illness, Joseph Nowinski, PhD, co-author of Saying Goodbye: A Guide to Coping with a Loved One’s Terminal Illness, tells Yahoo Health.

“The first thing that happens is a state of crisis for the individual and loved ones,” he says. “There’s a lot of anxiety, needless to say, and sometimes panic.”

The second stage involves loved ones pulling together after getting through the shock to help comfort each other, figure out next steps, and what needs to be done. This is typically when someone would make a will, if they haven’t already, and try to figure out what they can do to take care of their loved ones, says Nowinski.

The third stage is the final and most difficult one. “This is where it begins to wear on the terminally ill person and their loved ones,” Nowinski says. “The strain begins to show as time wears on.” During this time, Nowinski says it’s incredibly important to support a terminally ill patient, emotionally and physically.

It’s also often during this time that people think about their legacy, he notes, and often work to be remembered in a certain way.

There are some treatment options available to people with a terminal diagnosis but it depends on how advanced their cancer is. Some may extend a person’s life by several months, but others may make things worse if the cancer is advanced. “Most drugs or chemotherapies have to be processed by the liver,” Roberts says. “For people with very advanced liver disease, there is nothing we can recommend.”

While Roberts stresses the importance of early detection, he also wants people to know about the severity of liver cancer: “This is one of the fastest growing cancers in the U.S. It’s important for people to be aware.”

CML Monitoring Guidelines

CML Monitoring Guidelines Not Consistently Followed in Community Setting (Online First)

Patients with chronic myeloid leukemia (CML) who are receiving care in a community setting may not be undergoing the proper amount of cytogenetic and molecular monitoring to assess their response to tyrosine kinase inhibitors (TKIs). That is the conclusion of a study published in Clinical Lymphoma, Myeloma & Leukemia.

The results showed that molecular and cytogenetic response assessments were conducted less frequently than recommended by the National Comprehensive Cancer Network in patients with chronic-phase CML–“which was surprising,” said the study’s lead author, Nicholas J. Di Bella, MD, a hematologist at Rocky Mountain Cancer Centers in Aurora, Colorado and the McKesson Specialty Health/US Oncology Network in The Woodlands, Texas.

“This was an eye opener for us, and a matter of concern. The main reason for reporting these data was that we felt that community physicians need to be following these guidelines more closely.”

‘Amazingly Low Compliance Rate to Medication’

While the researchers found that the overall effectiveness of TKIs in patients treated in the community reflected that found in previous clinical trials, patients had “an amazingly low compliance rate” to medication, Di Bella said.

Still, despite the troubling findings of this report, TKI therapy for newly diagnosed CML patients in actual clinical practice remained highly successful, which was reassuring, commented Eunice Wang, MD, Chief of the Leukemia Service and Associate Professor of Oncology and Assistant Member of the Tumor Immunology Program at Roswell Park Cancer Institute in Buffalo.

Also asked for her perspective for this article, Maen Hussein, MD, a medical oncologist at Florida Cancer Specialists and a member of the Advisory Committee for the Association of Community Cancer Centers’ 2010-2011 project on CML, said: “Overall, I don’t think community oncologists are lacking. As the study demonstrated, patients were experiencing good response rates, regardless of monitoring.

Study Details

Using electronic medical records and medical charts, the researchers conducted a retrospective, observational cohort study of 300 chronic-phase CML patients who received first-line imatinib, dasatinib, or nilotinib in community clinical practices at the McKesson Specialty Health/US Oncology Network from July 2007 to March 2011.

Patients were followed for at least 18 months. Overall, 222 received imatinib, 34 had dasatinib, and 44 had nilotinib.

During the time period observed, 40 percent of patients did not receive genetic or molecular monitoring. Seventy-six percent did not receive both a cytogenetic and molecular response assessment. Molecular monitoring frequency fluctuated, with 18 percent of individuals assessed at 13 to 18 months, ranging from 30 percent of patients tested at seven to 12 months and 18 percent tested at 13 to 18 months.

Eighty-nine percent of CML patients treated with first-generation imatinib and 94 percent of patients treated with either second-generation dasatinib or nilotinib achieved a complete hematologic response at four to six months; at seven to 12 months, these rates were 84 and 82 percent, respectively.

For individuals who did undergo cytogenetic or molecular testing, the cumulative response rates as indicated by these tests increased for both imatinib and second-generation TKIs. However, the rates were higher in patients who took dasatinib or nilotinib versus imatinib at six, 12, and 18 months.

For example, 61 percent of individuals taking a second-generation TKI achieved a cytogenetic or molecular response by 12 months versus 38 percent of those taking imatinib. Time to a major molecular response was significantly faster in patients treated with a second-generation TKI compared with those receiving imatinib.

Dasatinib and nilotinib were more effective than imatinib as first-line therapy for CML in a community setting, as observed in prior clinical trials, which was to be expected, since dasatinib and nilotinib are more potent TKIs, Di Bella noted.

The time to discontinuation was significantly longer for patients treated with second-generation TKIs than for those receiving imatinib.

Adherence was estimated as the actual days of TKI therapy divided by the total days of recommended treatment, converted to a percentage. The researchers considered 90 percent or higher as adherent. Adherence rates were 56 percent in the imatinib group and 55 percent in the second-generation TKI group.

Time Factor

Hussein noted that while the findings may motivate community oncologists to look at the issue of guideline adherence more closely, the timing of the study may not reflect how physicians are currently practicing.

“In 2007, not many of us had an EMR. When these systems were first introduced, doctors may not have been routinely documenting how they were practicing. Moreover, documents from other care providers may not have been regularly scanned into the EMR.”

In 2007, oncologists also had less of an understanding of how to best monitor CML because of the relative newness of TKIs, whether it was with complete blood counts or polymerase chain reaction (PCR), which was not easy to order at the time, Hussein added. “It takes time to adapt guidelines into clinical practice.”


Wang said that the study results clearly demonstrated that the importance of performing monitoring tests has not been conveyed to the majority of community practitioners.

Di Bella said several challenges can interfere with adherence to monitoring guidelines. For example, in some practices, one physician may be managing many different types of cancer and may not be particularly interested in following the specifics for hematologic malignancies: “It’s becoming increasingly challenging for oncologists to keep up with all the advances in treatment and monitoring.”

In practices with at least four to five oncologists, having one physician dedicated to treating hematologic malignancies would be ideal, but is not always feasible, Di Bella said.

Also asked for his perspective, Jack Jacoub, MD, Medical Director of Orange Coast Blood & Cancer Care and Director of Thoracic Oncology at MemorialCare Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, California, said that physicians also need to recognize that while sharing information with patients about the efficacy of CML medications, “this assurance can be a double edged sword. Patients assume that they will do well, regardless of whether or not they are monitored and attend appointments.”

In addition, Jacoub said, in some cases, patients who do well for many years and over decades may stop receiving care at a specialty center and then see a primary care physician, who may not be aware of monitoring guidelines. Because CML is a long-term disease, the intensity of follow-up may thus wane over time.

Physician and Patient Education

Physicians need to be aware that adhering to guidelines of monitoring and adjusting therapy accordingly may improve overall outcomes, Jacoub said.

Di Bella noted that there is still a debate about whether to start patients on imatinib or second-generation TKIs. “However, if you’re monitoring patients on imatinib at appropriate intervals and the CML is not responding, it’s easy to switch to another TKI.” The critical factor is to be monitoring serial measurements to make an informed decision.

He noted that he and his colleagues have added reminders in their EMR system to alert physicians about the need to conduct molecular and cytogenetic monitoring tests in newly diagnosed CML patients at three, six, nine, and 12 months. The researchers are considering conducting a prospective analysis of their centers’ monitoring activities now that they have EMR reminders in place.

Oncologists also need to ensure that their patients and caregivers understand the significance of testing and the milestones in the treatment of chronic phase CML, said Pamela Crilley, DO, Chair of the Department of Medical Oncology at Cancer Treatment Centers of America and Chief of Medical Oncology at the Eastern Regional Medical Center in Philadelphia.

In addition to being aware that laboratory testing needs to occur at three-month intervals, patients need to understand that the treatment goal is to achieve a complete hematologic response first, followed by a complete cytogenetic response, ideally within the first 12-month period. Following that, the goal is to achieve a major molecular response, which can be assessed by PCR testing, she said.

Addressing the Problem

Adherence and its impact on outcomes needs to be addressed with any chronic illness in which patients are asked to take daily medications indefinitely, Jacoub emphasized.

And, Di Bella noted, many patients have difficulty following a routine and taking drugs regularly. However, if patients know that the success of treatment depends on adherence, they will be more likely to comply.

Oncologists may be able to improve the TKI compliance rate by taking a more active role in educating patients, both verbally and in writing, at each clinic visit, Wang concluded. Providing patient diaries and enlisting the help of a nurse educator, pharmacist, or family member to reinforce instructions may also be beneficial.


Should You Be Really Worried That Hormonal Birth Control Will Give You Breast Cancer?

A new study links the Pill and hormonal IUDs to cancer. But we asked a doc to weigh in.

If you want to avoid an unintended pregnancy, taking birth control is usually a no-brainer. But what if that same birth control upped your risk of breast cancer?

According to research published in The New England Journal of Medicine, women who take hormonal birth control pills or use hormonal IUDs for years experience a small yet significant increase in their risk of breast cancer compared to those who don’t.

The study followed 1.8 million Danish women for more than 10 years and found that, for every 100,000 women, hormonal birth control caused an extra 13 cases of breast cancer a year. Specifically, there were 55 breast cancer cases each year among the 100,000 women who didn’t use hormonal birth control, and 68 cases of breast cancer among those who did.

The study didn’t find any big distinctions between the hormonal method women used—those who used combined oral contraceptives (which use estrogen and progestin) and those who used progestin-only methods each had a higher risk. Ditto for whether women used a hormonal IUD or took a pill. A woman’s risk went up the longer she used hormonal birth control, the study found. So, obviously, hormones are to blame for the increased risk, but the exact mechanisms aren’t yet known.

But before you panic, know this: The birth control-breast cancer link actually isn’t news to your doctor. Previous research has found a link between ongoing hormonal contraceptive use and breast cancer, points out Jack Jacoub, M.D., a medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, California. For instance, a large-scale 2010 study found that birth control pills came with a “marginally significant higher risk” of breast cancer.

However, older versions of hormonal birth control had more estrogen than current versions, and many medical professionals have assumed that the risk has been lowered with the newer versions. Still, “we’ve known this for a long time,” Jacoub says.

Jacoub says that women “definitely should not freak out about this,” but notes that it’s good to be aware of the risks. Given that being on hormonal birth control for a long period of time raises your risk, he says it’s a good idea to try to cut back on how long you use it or, at least, try to swap in some non-hormonal methods after you’ve been on a hormonal method for years. If you have a strong family history of breast cancer, Jacoub says it’s a good idea to talk to your doctor about potentially switching to a non-hormonal birth control method. So, for example, you might switch from a hormonal IUD to the copper version. (And it’s always a good idea to keep condoms on hand—these LELO Hex condoms from the Women’s Health Boutique ship in discreet packaging.)

Ultimately, though, you shouldn’t stress about this. Just be aware and informed about the pros and cons of any birth control method you use. Breast cancer development depends on a whole slew of factors, Jacoub says, and taking hormonal birth control alone is unlikely to cause you to develop breast cancer.