Colorectal Polyps

"Polyps of the colon and rectum are most often benign. This means they are not a cancer and do not spread. You may have one or many polyps. They become more common with age. There are many types of polyps.

Adenomatous polyps are a common type. They are gland-like growths that develop on the mucous membrane that lines the large intestine. They are also called adenomas and are most often one of the following:

  • Tubular polyp, which protrudes out in the center of the colon
  • Villous adenoma, which is flat and spreading, and is more likely to become a cancer

When adenomas become cancerous, they are known as adenocarcinomas. Adenocarcinomas are cancers that originate in glandular tissue cells. Adenocarcinoma is the most common type of colorectal cancer."

For more information, please follow the link listed below!

https://medlineplus.gov/ency/article/000266.htm

Carotid Endarterectomy

"Also known as carotid artery surgery.

Carotid endarterectomy is surgery that removes plaque buildup from inside a carotid artery in your neck. This surgery is done to restore normal blood flow to the brain to prevent a stroke if you already have symptoms of reduced blood flow. Carotid endarterectomy also may be performed preventively if a diagnostic test such as carotid ultrasound shows significant blockage that is likely to trigger a stroke. Carotid endarterectomy is not a cure. Your arteries can become blocked again if your underlying condition, such as high blood cholesterol, is not controlled and causes new plaque buildup."

To finish reading this article, please follow the link listed below! 

https://www.nhlbi.nih.gov/health/health-topics/topics/carend/

What Are The Signs?

"The signs and symptoms of varicose veins include:

  • Large veins that you can see just under the surface of your skin.
  • Mild swelling of your ankles and feet.
  • Painful, achy, or "heavy" legs.
  • Throbbing or cramping in your legs.
  • Itchy legs, especially on the lower leg and ankle. Sometimes this symptom is incorrectly diagnosed as dry skin.
  • Discolored skin in the area around the varicose vein.

Signs of telangiectasias are clusters of red veins that you can see just under the surface of your skin. These clusters usually are found on the upper body, including the face. Signs of spider veins are red or blue veins in a web or tree branch pattern. Often, these veins appear on the legs and face.

See your doctor if you have these signs and symptoms. They also may be signs of other, more serious conditions."

https://www.nhlbi.nih.gov/health/health-topics/topics/vv/signs

Deep Vein Thrombosis

"Deep vein thrombosis (DVT) is a condition that occurs when a blood clot forms in a vein deep inside a part of the body. It mainly affects the large veins in the lower leg and thigh, but can occur in other deep veins such as in the arms and pelvis."

Need more information? Click the link below to get caught up!

https://medlineplus.gov/ency/article/000156.htm

All signs, symptoms, triggers, & treatments for hypo & hyperthyroidism

Thyroid issues have been becoming increasingly common in recent years, prompting many questions surrounding thyroid health. What is the thyroid? What does it do? Where is it located? What is the difference between hyperthyroidism and hypothyroidism? Hopefully this article can help answer these questions for you so you can ensure your thyroid stays healthy or, if there are already issues, that it gets better.

Thyroid issues have been becoming increasingly common in recent years, prompting many questions surrounding thyroid health. What is the thyroid? What does it do? Where is it located? What is the difference between hyperthyroidism and hypothyroidism? Hopefully this article can help answer these questions for you so you can ensure your thyroid stays healthy or, if there are already issues, that it gets better.

What Is The Role Of The Thyroid?

The thyroid is a gland that secretes hormones that regulate many metabolic processes, including growth and energy expenditure. If the thyroid becomes overactive or slow it will affect the metabolism accordingly, which can lead to a variety of symptoms that are often misdiagnosed.Thyroid issues are fairly common, with at least one in 20 people affected in their lifetime, and women more susceptible than men.

 

What Is The Difference Between Hypothyroidism And Hyperthyroidism?

The most notable difference between the two dysfunctions is the hormone output from the thyroid.Hypothyroidism means your thyroid gland is not producing enough of the thyroid hormone for the body’s needs, while hyperthyroidism means it is producing too much.

 

What Are The Symptoms?

The symptoms of each of these conditions can vary greatly because hormones affect so many aspects of how our bodies work. With hypothyroidism, you generally feel sluggish, have trouble concentrating, have dry skin and hair, experience muscle pains and cramping, are prone to fluid retention, and feel sensitive to cold.

With hyperthyroidism, unexplained weight loss is common, as are accelerated heart rate, trouble sleeping, irritability, anxiousness, and sensitivity to heat.

Some people even develop a lump on their throats, which is called a goiter. This can signify that your thyroid is working too hard or that you have a severe iodine deficiency.

 

What Causes Thyroid Issues?

The most common causes for thyroid conditions are: chronic stress, toxicity buildup, iodine deficiency, accumulation of heavy metals, and various autoimmune conditions. Hyperthyroidism can be caused by conditions like Grave’s disease, which increase thyroid hormone production. Subacute thyroiditis and toxic adenomas are also conditions that lead to this. Hypothyroidism is generally triggered by conditions that reduce the production of thyroid hormone, like Hashimoto’s thyroiditis. The removal of the thyroid or an excessive exposure to iodide or lithium can also cause it.

Relax, moms — IVF doesn’t increase risk of breast cancer

One less thing to worry about, moms and moms-to-be: Undergoing in vitro fertilization won’t give you breast cancer.

Many women have worried that pumping themselves with extra hormones before IVF treatments to stimulate their ovaries has put them at risk for the Big C. That’s because high estrogen and progesterone levels have been linked to the growth of certain breast cancers.

But a new study of more than 25,000 women in the Netherlands published in JAMA revealed that the moms-to-be who underwent IVF were no more likely to get breast cancer after 21 years than both the general population and women treated for infertility who didn’t do IVF at the same time. In fact, the researchers found breast cancer risk was significantly lower for women who did seven or more IVF cycles.

“This is happy news — making life does not cause cancer! — and for someone that has to undergo IVF, this is at least one less thing to be concerned about,” said Erika, 36, from Manhattan, who took hormones to harvest and freeze her eggs for future IVF treatment last year.

Kristin, a 35-year-old from the upper East Side, also underwent the same procedure last year because she believed her risk of getting cancer was minimal even then.

“The data on possibly getting cancer was inconclusive, but my decreasing fertility was a fact, so I went with the fact,” she told The Daily News.

But after reading about the JAMA study this week, she felt “even more at peace with my decision.”

Fertility doctors who have long tried reassuring jittery patients that IVF’s risks don’t include cancer praised the report for putting women’s minds at ease. Dr. Zitao Liu from the New Hope Fertility Center at Columbus Circle has had six IVF patients come discuss their cancer risks since the study came out who now “certainly are more optimistic.”

Dr. Liu added that, “We’ve known for a long time that there was no correlation between IVF treatment and breast or ovarian cancer. The JAMA study is good because it is a published case to reinforce this idea, and we have many patients who are comforted knowing about the study.”

So where did the idea that IVF causes cancer come from if the scientific community has been so sure there was nothing to worry about? Dr. Alan Copperman, the director of Reproductive Endocrinology and Infertility at Mount Sinai, suggested that fertility treatments decades ago were not as streamlined and successful as they are now. Most women today take hormones for a week or so before their mature eggs are retrieved, whereas once each IVF cycle took a couple of months and used a variety of hormones.

“Maybe years ago, when women would do 12 cycles of hyperstimulation [of the ovaries] ... if someone was taking a whole year of fertility drugs with a really high estrogen level and not getting pregnant ... then you could theorize all that estrogen could have damaging effects,” he said. “There was probably some rationale [for the cancer fears] years ago, but now there’s targeted treatment, and your estrogen levels are only up for a brief time.”

He’s also seen relieved patients come through his doors since the JAMA report. “Word spreads quickly, and I have had several patients come in and say, ‘Wow, that was reassuring, because I had an aunt who had cancer and I was really worried about that,’” he said. “I think this is fantastic news. A lot of patients don't even attempt IVF, patients that would really be benefitted, because of some unfounded fears.”

But this still isn’t license to skip your mammogram, mamas — whether you have done IVF or not.

“We have never made any changes in our recommendations for screening based on a patient’s history of IVF ... but we do know that mammograms save lives,” said Dr. Emily Sonnenblick, radiologist at the Dubin Breast Center in Mount Sinai Hospital. “I would encourage women to just follow the standard, established guidelines, starting screenings at age 40, regardless of whether you’ve had IVF or not.”

How to Handle Hemorrhoids

Hemorrhoids—clumps of swollen veins in or just outside the anal canal, which may cause discomfort along with bleeding during bowel movements—have long been the subject of jokes, but to millions of us they offer little reason for humor.

Up to 75 percent of all Americans may develop hemorrhoids at some point in their lives, usually between the ages of 45 and 65. The likelihood is a bit higher in women, in part because hemorrhoids are common duringpregnancy.

Experts aren’t sure what really triggers the development of hemorrhoids, but inflammation and breakdown of the tissue in anal cushions—pads of thickened tissue that protect the anal canal—are involved. And long-standing constipation, straining to have a bowel movement, sitting on the toilet for a long time, and a low-fiber diet may make exacerbate the problem.

 

 

Self Care for Hemorrhoids

If you have hemorrhoids, your first step might be an over-the-counter hemorrhoid relief product such as a cream or ointment, found on drugstore shelves. But these haven’t been proven effective in clinical trials: they won’t shrink your hemorrhoids, stop bleeding, or reverse what’s called prolapse (when hemorrhoids protrude from the anus). In fact, they can increase irritation by making your skin more sensitive. For that reason, hemorrhoid creams shouldn’t be used for more than a week.

Instead, you might want to try some self-care strategies. A 10-minute “sitz bath” two to three times a day will soothe irritation and relax the internal sphincter muscle. Run a few inches of warm water in your bathtub or use a small sitting tub, available at pharmacies and big-box stores. Keeping stools soft and easier to pass also helps; laboring to have a bowel movement exerts extra pressure on anal cushions. And aim to keep yourself as regular as possible: exercise consistently, drink six to eight glasses of water a day, and consume plenty of fiber-rich vegetables, fruit, beans, and whole grains. Adding a fiber supplement containing psyllium or unprocessed bran may also help in both keeping you regular and preventing the return of your hemorrhoids once they’re under control. And don’t linger on the toilet—it can make things worse even if you’re not actively pushing to have a bowel movement. Do your reading elsewhere.  

 

 

When to See a Doctor for Hemorrhoids

If your hemorrhoids haven’t responded to self-care steps within two weeks, see your doctor. Your problem could be something else, such as an abscess (pus that collects near the anus) or fissure (a tear in the tissue lining the anus). If you’re also experiencing bleeding or you’re age 50 or older and have never had acolonoscopy, your doctor may order one to rule out the possibility of cancer or inflammatory bowel disease.

You may want to ask for a referral to a colorectal surgeon, who can discuss whether you might benefit from an in-office procedure. For internal hemorrhoids, for example, your doctor may use infrared light to shrink hemorrhoids or rubber band ligation, where an elastic band is wrapped around hemorrhoids so they shrivel up.  

5 simple expert diet tips for a healthy gallbladder

  • Gallstones

    The gallbladder is an organ that stores bile pigment produced by the liver, thereby playing a key role in fat metabolism and cholesterol control. However, eating a diet high in cholesterol not only increases your risk of heart disease but also puts you at a risk of gall stones. Dr Akshay Challani, Critical Care Specialist and Physician, Akshjyot Clinic, Navi Mumbai, shares simple tips to prevent gall stones.

  • Crash-Diet

    Say no to crash diets: If you are overweight and are planning to go for crash dieting to lose weight quickly, then drop the idea as it puts undue pressure on the gallbladder. In fact, eating healthy and exercising religiously is the key to keeping your weight in check.

  • oily-food

    Limit the intake of fried foods: Most of us fail to control the urge for fried foods like samosas, puris, pakoras and medu wadas but excess consumption of fried foods hinders digestion and also irritates the lining of gall bladder, increasing your risk of gall bladder problems. Replace fried foods with fresh fruits and vegetables to improve the organ function.

  • cookies

    Eat highly processed foods in moderation: How often do you eat processed foods like cookies or doughnuts? Well, it's time to keep a tab on the intake of processed foods as it might hinder the secretion of digestive gases by increasing the pressure on the gallbladder when had in excess. Add Whole grains (whole-wheat bread, brown rice, oats, bran cereal) to your diet.

  • dairy-product

    Avoid intake of whole-milk dairy milk: If whole milk dairy products like cheese, butter and ice-cream find a place in your platter then shun these foods from your diet. If you can't live without having dairy products, then opt for low-fat dairy products to ease the pressure on the gallbladder.

  • time-your-meals

    Do not have long gaps between meals: If you believe that eating once a day or keeping long hours between meals is ok when you are trying to lose weight, then you are wrong. Instead, eating frequently and having meals at the same time every day is the key for a healthy gallbladder.

The best and worst foods for your thyroid revealed

Most people don’t give two thoughts to their thyroid, the gland that sits at the base of your neck and helps regulate your metabolism, temperature and heartbeat (among other things), but if it’s not performing at its best you’ll soon know about it. You could suffer weight gain, depression and be more sensitive to the cold if your thyroid is underactive, but when it’s overactive it can result in sudden weight loss, irregular heartbeats, sweating and irritability

Most people don’t give two thoughts to their thyroid, the gland that sits at the base of your neck and helps regulate your metabolism, temperature and heartbeat (among other things), but if it’s not performing at its best you’ll soon know about it. You could suffer weight gain, depression and be more sensitive to the cold if your thyroid is underactive, but when it’s overactive it can result in sudden weight loss, irregular heartbeats, sweating and irritability

While a lot of how your thyroid functions is down to genetics, there are foods that can help keep your thyroid firing on all cylinders (and some that don’t).

1. Yoghurt

Dairy products such as yoghurt are full of iodine and your body needs iodine to function properly. You could get a good dose from seaweed, but if that doesn’t sound appealing a low fat Greek yoghurt can make up about 50 per cent of your daily iodine intake. If you don’t like yoghurt, one cup of low fat milk will provide you with around one-third of your daily iodine needs, and it’s also a good source of vitamin D.

2. Brazil nuts

Selenium is another nutrient that helps regulate your thyroid hormones and Brazil nuts are packed with it. In 2003, one study out of France found that women who ate higher amounts of selenium were less likely to develop goiters and thyroid tissue damage than those who didn’t. It was also found to prevent long-term thyroid damage in those who suffered thyroid-related problems such as Hashimoto’s and Graves’ diseases.

One Brazil nut is thought to contain 96 micrograms of selenium, which is almost double the daily intake recommended (55 micrograms). While Brazil nuts are good for your thyroid, it’s important to remember not to indulge in more than 400 micrograms of selenium each day. Too much can cause hair loss, discoloured nails and even heart failure.

3. Chicken and beef

Your thyroid needs a good dose of zinc to keep it functioning properly and this can be found in meat sources, like chicken and beef. If you have too little zinc in your diet it can lead to hypothyroidism, but it’s interesting to note that if you develop hypothyroidism you can become zinc deficient. Go figure! If you have a poor diet or a GI disorder that limits your ability to absorb zinc, eating a 85g serving of beef can contain up to 7mg of zinc, while an 85g serve of chicken contains roughly 2.4mg.

4. Fish and shellfish

While meats have zinc, fish has iodine and you now know that iodine is good for your thyroid, helping it function just the way you need it to.  An 85g serve of baked cod for example contains around 99 micrograms of iodine, or up to 66 per cent of your daily iodine intake. Canned tune is a good option too. If you prefer shellfish like prawns, bugs or lobster then the good news is these also contain iodine with the added bonus of being a top source of zinc too.

5. Eggs

A large egg has roughly 16 per cent of the iodine and 20 per cent of the selenium you need for the day, which makes them a super thyroid food. Unless you’ve been given a reason by your health professional not to, eat the whole egg because much of the nutrients are located in the yolk.

6. Berries

Despite what’s been written until now, it’s not just iodine, selenium and vitamin D that helps your thyroid. Antioxidants are good too and berries are one type of food that are packed full of antioxidants. Research in 2010 that featured in the Nutrition Journal found that wild strawberries, blackberries, goji berries and cranberries ranked incredibly high for their antioxidant level in a study of more than 3,000 foods.

Other foods that are good for your thyroid include cauliflower, broccoli, bok choy and soy, but there are some foods you should consider steering clear of.

Gluten: Gluten is particularly bad for your thyroid if you suffer coeliac disease, an autoimmune disease that is traditionally characterised by an intolerance to gluten in wheat, barley and rye.

Processed foods: Sure, salty processed foods would address your iodine shortage, but with more than 75 per cent of our dietary sodium coming from pre-packaged and processed foods it’s worth noting that manufacturers don’t have to use iodised salt in their products. Taking in too much sodium can lead to high blood pressure and heart disease, but it won’t boost your iodine intake.

Fast food: Again, fast food outlets don’t have to use iodised salt in their products.

How long does 'chemo brain' last?

Cancer survivors have long complained of cognitive decline following chemotherapy. This effect has been studied in some depth, but, for the first time, researchers ask how long these deficits might last.

Cancer survivors have long complained of cognitive decline following chemotherapy. This effect has been studied in some depth, but, for the first time, researchers ask how long these deficits might last.

As treatments for cancer improve, survival rates increase, as do the number of cancer survivors.

This growing population of people who have come through cancer and lived to tell the tale often report cognitive deficits.

Chemo brain, or chemo fog, as it has been dubbed, was first reported by breast cancer survivors.

It affects memory, concentration, and an individual's ability to multitask, among other reductions in function.

Some women with chemo brain report that their ability to follow conversations is impaired and that they are more easily fatigued and confused.

A review that looked at the prevalence of chemo brain estimated that it affects 17-50 percent of female breast cancer survivors.

Although research has established chemo brain as a genuine consequence of chemotherapy, there are still many questions that need to be answered. One such question asks how long chemo brain is likely to last.

 

Measuring the length of chemo brain

A study, conducted at the University of Illinois and published in the journal Behavioural Brain Research, set out to investigate the effects of chemo brain over a longer period of time. For this purpose, the team designed a mouse model that will help researchers of the future investigate this problem and, potentially, rectify it.

The study's lead author, Catarina Rendeiro, worked with a group of researchers across the university, including Justin Rhodes, a psychology professor, and William Helferich, a professor of nutrition.

Quality of life after chemotherapy is critically important, and chemo brain is significant in these survivors.
— Prof. William Helferich

 

Earlier research has shown that the intense physical toll of chemotherapy accounts for the short-term deficits in cognitive ability seen in chemo brain. As Prof. Rhodes says: "The question is, after they completely recover from the acute assault of chemotherapy, many months or years later, do they still have cognitive impairments?"

The researchers used a female mouse model designed to mimic post-menopausal women as closely as possible. To measure the potential long-term effects of chemo brain, they measured how chemotherapy impacted learning and memory. Additionally, they charted the formation of new neurons in the hippocampus - a part of the brain important in memory, among other roles.

The mice were put through their paces using a Morris Water Maze. This type of trial has been widely used in behavioralneuroscience to study memory and spatial learning since the early 1980s. It involves placing a mouse in a circular pool and timing it while they search for a submerged platform.

Mice subjected to chemotherapy were found to take substantially longer to learn the task.

When the brains of the chemotherapy-treated mice were examined, they were found to have 26 percent fewer surviving hippocampal neurons created during the course of treatment, and generated 14 percent fewer hippocampal neurons in the 3 months directly after chemotherapy.

Three months for a mouse corresponds to around 10 years in human terms. If these results can be extrapolated to humans, they demonstrate that the effects of chemotherapy do indeed lead to long-term deficits.

 

Future treatments for chemo brain

Although it may be possible to design drugs to reduce the cognitive effects of chemotherapy, that would bring with it the worry that additional chemicals might interact with the chemotherapy itself, causing other unwanted effects or preventing it from working as it needs to.

Instead, the team hopes that natural interventions might be uncovered that can ward off the damage that results from chemo brain.

To that end, the researchers investigated whether a diet with additional omega-3-fatty acids might help reduce the cognitive impacts of chemotherapy on the mice. Unfortunately, this intervention did not yield significant results.

The current study is the first to produce an animal model demonstrating the long-term effects of chemotherapy on the brain. In the future, the team hopes that the model will be used to investigate other potential nutritional components and chart their effects on chemo brain.

Breast cancer risk may be influenced by type of fat dad eats

New research provides further evidence that a father's lifestyle may impact the health of future generations, after finding that the female offspring of male rats that ate a diet high in animal fats were more likely to develop breast cancer.

New research provides further evidence that a father's lifestyle may impact the health of future generations, after finding that the female offspring of male rats that ate a diet high in animal fats were more likely to develop breast cancer.

Researchers suggest fathers who eat a diet high in animal fats may raise their daughter's risk for breast cancer.
The female offspring of male rats that consumed a diet high in vegetable fats, however, had a reduced breast cancer risk.

Study co-author Thomas Ong, of the University of Sao Paulo, Brazil, and colleagues recently reported their findings in the journal Breast Cancer Research.

The researchers note that if their results are confirmed in human trials, it may pave the way for new interventions to reduce the risk of breast cancer that involve modifying a father's diet prior to conception.

After skin cancer, breast cancer is the most common cancer among women in the United States; around 1 in 8 American women will develop the disease in their lifetime.

A woman's risk for breast cancer is known to be influenced by a number of factors, including a family history of the disease and inherited genetic mutations. Increasingly, researchers are uncovering how a father's health and lifestyle may affect the breast cancer risk of offspring.

Last month, for example, Medical News Today reported on a study that found obesity changes the gene expression of a man's sperm, which may increase breast cancer risk for their daughters.

The new study from Ong and colleagues builds on those findings, suggesting a woman's breast cancer risk may be influenced by their father's diet.

 

Modifying father's diet may reduce daughter's breast cancer risk

To reach their findings, the researchers fed 60 male rats either a lard- or corn oil-based, high-fat diet, from which around 60 percent of energy was derived from fat, or a control diet, from which around 16 percent of energy was fat-derived.

Next, the team mated the male rats with female rats that had been fed normal chow.

The female offspring of the rats were also fed a standard diet, and, when they were 50 days old, they underwent a procedure that initiates the growth of mammary tumors.

The team then assessed tumor incidence among the female rats, as well as how long it took for tumors to emerge, the number of tumors that arose, and the volume of each tumor. This information was used as indicators for the risk of breast cancer.

Compared with the female offspring of male rats that were fed the control diet, the female offspring of those fed the high-fat diets showed reduced death of tumor cells.

However, the team found that the female offspring of male rats that had been fed the corn oil-based, high-fat diet showed a reduction in tumor growth, had fewer tumors, and had longer tumor latency - that is, it took longer for tumor growth to initiate.

Based on their results, the researchers suggest that the type of fat a man consumes may have a significant impact on their daughter's risk for breast cancer, with the consumption of vegetable oil having a potentially preventive effect.

The researchers hypothesize that such effects may be down to altered microRNA and protein expressions; they found changes in such expressions in the sperm of fathers, as well as in the mammary gland tissue of their female offspring. What is more, these changes were associated with cell growth, survival, and death.

The team notes that previous research has shown that exercise and dietary changes can normalize the microRNA expression of male rodents.

Transforming the Care of Patients With Thyroid Cancer

CHICAGO — There were no effective therapeutic options for advanced thyroid cancer until 5 years ago, a presenter said at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting.

"Our understanding of the molecular basis of thyroid carcinogenesis improved, and clinical trials developed based on in vitro data demonstrated that kinase inhibitors interfered with thyroid cancer cell growth," Ann W. Gramza, MD, medical oncologist at the MedStar Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, explained during a poster discussion session.

There are 4 kinase inhibitors approved by the U.S. Food and Drug Administration for thyroid cancer: lenvatinib and sorafenib for differentiated thyroid cancer, and vandetanib and cabozantinib for medullary thyroid cancer. All target the vascular endothelial growth factor receptor (VEGFR).

During her presentation, Dr Gramza discussed 2 studies of novel kinase inhibitors, anlotinib and cediranib, for the treatment of medullary thyroid carcinoma and differentiated thyroid cancer, respectively.1

The activity and tolerability of anlotinib was evaluated in a phase 2 study that included 58 patients with medullary thyroid cancer from 8 centers in China. Anlotinib was administered at a dose of 12 mg orally daily for 2 weeks on and 1 week off. The median progression-free survival has not yet been reached and the 48-week disease control rate was 84.5%.2

In her discussion of the results, Dr Gramza said that compared with vandetanib, the objective response rate was similar (48% with anlotinib vs 45% with vandetanib), but grade 3 or worse diarrhea and hypertension were less frequently reported with anlotinib.1 She also reported that compared with cabozantinib, anlotinib was associated with a higher response rate (48% vs 28%); however, the studies should not be compared as patients in the cabozantinib study were required to have RECIST progression prior to enrollment, unlike the anlotinib trial.1 In terms of safety, anlotinib resulted in fewer reports of hand-foot syndrome vs cabozantinib,1 she noted.

"Anlotinib was associated with a good response rate compared to historical controls with manageable toxicity profile," Dr Gramza said. "However, it is unclear if the drug will be available outside of China."

The other study evaluated cediranib alone or with lenalidomide in iodine-131-refractory patients with differentiated thyroid cancer. That phase 2 trial demonstrated that the addition of lenalidomide was not beneficial; however, cediranib was associated with an objective response rate of 44% and a median progression-free survival of 14 months.3 For comparison, sorafenib and lenvatinib yielded objective response rates of 12% and 65%, respectively, and median progression-free survival of 10.8 months and 18.3 months,1 respectively, according to Dr Gramza.

"This was a negative trial; more is not always better," she explained. "Although cediranib alone has encouraging results in differentiated thyroid cancer, it is unclear as to whether there will be further cediranib trials in differentiated thyroid cancer or other histologies."

Dr Gramza then discussed a comprehensive genomic profiling study of 90 patient samples of anaplastic thyroid cancer, which is the largest sample size of an anaplastic thyroid cancer molecular analysis to date.4

"Anaplastic thyroid cancer is extremely rare and aggressive," Dr Gramza noted. "There are no effective chemotherapy options and it has a higher mutational burden than differentiated thyroid cancers."

The study identified TP53BRAFCDKN2ATERT, and NRAS as the most common gene mutations in the 90 patients, which is similar to what previous research has demonstrated.4

"What are the potential benefits of prospective analyses?" Dr Gramza asked. "Identify genomic abnormalities driving tumorigenesis; identify potential clinical trials and/or potentially effective therapies that target the molecular abnormality; identify molecular factors that predict prognosis; and identify molecular factors that predict response and resistance to therapy."

"Moving forward, we need to better understand mechanisms of carcinogenesis and define targets, develop drugs that are unique or superior in some way to those already available, and discover mechanisms of response and resistance to design rational combination trials," Dr Garza concluded.

It is also unclear how immunotherapy will impact the treatment landscape of thyroid cancer, as it has substantially improved outcomes for patients with other cancer types.

Sodas Linked to Gallbladder Cancer

People who drink lots of soda or other sugary beverages may have a higher risk of developing rare cancers in the gallbladder and bile ducts around the liver, a Swedish study suggests.

Little is known about the causes of biliary tract and gallbladder tumors, but emerging evidence suggests obesity as well as elevated blood sugar levels that are a hallmark of diabetes may increase the risk of these malignancies.

Because sodas and other sugary drinks have been linked to high blood sugar and weight gain, researchers wondered if these beverages might play a role in these types of cancer, said lead study author Susanna Larsson of the Karolinska Institute in Sweden.

To explore this possibility, researchers analyzed survey data on the eating and drinking habits of more than 70,000 adults then followed them for more than 13 years on average to see whether cancers got diagnosed.

Only about 150 people developed biliary tract or gallbladder cancers during the study period.

But compared with people who avoided sugar-sweetened drinks altogether, individuals who consumed two or more juice drinks or sodas, including artificially sweetened sodas, a day had more than twice the risk of developing gallbladder tumors and 79 percent higher odds of getting biliary tract cancer, the study found.

"Soda consumption has been inconsistently associated with risk of biliary tract cancer (only one prior study) and other cancers in previous similar studies," Larsson said by email.

The current study "is the first study to show a strong link between consumption of sweetened beverages, such as soda, and risk of biliary tract cancer," Larsson added.

At the start of the study, participants completed food and drink questionnaires that asked how many sodas or juice drinks they had consumed in the past week and how much they typically consumed during the previous year.

When they answered these questions in 1997, participants were 61 years old on average. About half of them were overweight and roughly 25 percent were current smokers.

Researchers excluded people with a previous cancer diagnosis or a history of diabetes.

The people who drank two or more sodas or sugary beverages a day were more likely to be overweight and eat a higher-calorie diet with more sugar and carbohydrates and less protein and fat.

The increased risk of gallbladder and biliary tract tumors persisted, however, even after researchers adjusted for whether participants were overweight.

Because the study is observational, the findings don't prove soda and sugary drinks cause cancer.

It's also possible that because researchers only had data on drinking habits at the start of the study, the findings might have been influenced by changes over time in the beverages people consumed, the authors note in JNCI: Journal of the National Cancer Institute.

Researchers also lacked precise data to assess how often the drinks people chose were diet sodas, said Dr. Margo Denke, a former researcher at the University of Texas Southwestern Medical School in Dallas who wasn't involved in the study.

Even so, "this study suggests that there is more than a plausible link; the incidence of biliary and gall bladder cancer was higher among individuals who consumed more sodas and juices," Denke said by email.

The exact reasons for the connection between sodas and these tumors may be unclear, but the message for consumers is still simple, said Dr. Igor Astsaturov, a medical oncologist at Fox Chase Cancer Center in Philadelphia who wasn't involved in the study.

"Obviously, this finding signals again and again that healthy lifestyle is the key to cancer-free life," Astsaturov said by email. "Regardless of the cause, it is easy enough to quench the thirst with water to stay fit and healthy."

SOURCE: http://bit.ly/29ISzJVJNCI: Journal of the National Cancer Institute, online June 8, 2016. 

How To Know If Your Thyroid Is The Reason You Can’t Lose Weight

Jane the Virgin" actress Gina Rodriguez said her thyroid disorder made it difficult to drop pounds. Here, experts discuss signs that you might be in the same boat.

Gina Rodriguez was diagnosed with a thyroid disorder when she was 19, and the Jane the Virgin star is now discussing the toll the diagnosis has taken on her health, especially when it comes to weight loss. “It began when I was 19 years old and I got fired, and I realized keeping my weight down was going to be much more difficult,” Rodriguez, 31, told PeopleStyle. “It was difficult for me to stay in the comfortable zone of my weight,” she said, adding that her “fatigue was through the roof.” 

The actress has Hashimoto’s disease, she said in the interview. Hashimoto’s disease is the most common cause of hypothyroidism, or an underactive thyroid, Ruchi Gaba, M.D., an assistant professor of medicine/endocrinology at the Baylor College of Medicine, tells SELF. “Hashimoto’s is an autoimmune thyroid disorder,” she says. “What that means is antibodies are kind of attacking your thyroid and making it produce less thyroid hormone. That can lead to low thyroid levels and cause hypothyroidism.”

Your thyroid helps control your body’s metabolism, explains Gaba. “So if you have low thyroid levels, your metabolism tends to go down—and that’s when you start to gain weight and have low energy.” Other symptoms of low thyroid levels include excessive sleepiness, cold intolerance, constipation, a slow heart rate, swelling, hair loss or skin changes, nail changes, and irregular periods. (On the flip side, high thyroid levels, or hyperthyroidism, can lead to symptoms such as weight loss, heat intolerance, heart palpitations, insomnia, and anxiety.)

The American Thyroid Association estimates that about 20 million people in the U.S. have some type of thyroid disease—but that as many as 60 percent of those affected may not realize it. What’s more, women are significantly more likely than men to suffer from a thyroid disorder, and one in eight women will be have one at some point in their lives.

Since the symptoms are pretty vague and overlap with those of other health problems, it can be difficult to diagnose thyroid problems based only on having one or two of the signs we’ve listed here (and it’s worth noting that Gina Rodriguez toldPeopleStyle she felt hot all the time, even though that’s typically a symptom of hyperthyroidism).

If you’re hoping to lose weight but suspect you might have thyroid issues, don’t freak out. While they may sound scary, the good news is that they’re typically responsive to medicine. “I’ve been treating this for many years, and it’s absolutely treatable with thyroid medication,” says Gaba. “If you’re on an adequate thyroid hormone replacement, then losing weight [as well as treating any other symptoms] should not be an issue at all.” It’s more about finding the right dose of medication for your body, she explains. 

“If you have a combination of all these symptoms, you might want to ask a doctor to evaluate your thyroid,” says Gaba, who explains that a blood test can let you know if you have abnormal thyroid levels. “But you shouldn’t [self-diagnose] off a single symptom.”

Hernias

A hernia happens when part of an internal organ or tissue bulges through a weak area of muscle. Most hernias are in the abdomen.

There are several types of hernias, including

  • Inguinal, in the groin. This is the the most common type.
  • Umbilical, around the belly button
  • Incisional, through a scar
  • Hiatal, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest.
  • Congenital diaphragmatic, a birth defect that needs surgery

Hernias are common. They can affect men, women, and children. A combination of muscle weakness and straining, such as with heavy lifting, might contribute. Some people are born with weak abdominal muscles and may be more likely to get a hernia.

Treatment is usually surgery to repair the opening in the muscle wall. Untreated hernias can cause pain and health problems.

Colonic Polyps

A polyp is an extra piece of tissue that grows inside your body. Colonic polyps grow in the large intestine, or colon. Most polyps are not dangerous. However, some polyps may turn into cancer or already be cancer. To be safe, doctors remove polyps and test them. Polyps can be removed when a doctor examines the inside of the large intestine during a colonoscopy.

Anyone can get polyps, but certain people are more likely than others. You may have a greater chance of getting polyps if you

  • Are over age 50
  • Have had polyps before
  • Have a family member with polyps
  • Have a family history of colon cancer

Most colon polyps do not cause symptoms. If you have symptoms, they may include blood on your underwear or on toilet paper after a bowel movement, blood in your stool, or constipation or diarrhea lasting more than a week.

About Anesthesia

Anesthesia is broken down into three main categories: local, regional, and general, all of which affect the nervous system in some way and can be administered using various methods and different medications.

Here's a basic look at each kind:

  • Local anesthesia. An anesthetic drug (which can be given as a shot, spray, or ointment) numbs only a small, specific area of the body (for example, a foot, hand, or patch of skin). With local anesthesia, a person is awake or sedated, depending on what is needed. Local anesthesia lasts for a short period of time and is often used for minor outpatient procedures (when patients come in for surgery and can go home that same day). For someone having outpatient surgery in a clinic or doctor's office (such as the dentist or dermatologist), this is probably the type of anesthetic used. The medicine used can numb the area during the procedure and for a short time afterwards to help control post-surgery discomfort.
  • Regional anesthesia. An anesthetic drug is injected near a cluster of nerves, numbing a larger area of the body (such as below the waist, like epidurals given to women in labor). Regional anesthesia is generally used to make a person more comfortable during and after the surgical procedure. Regional and general anesthesia are often combined.
  • General anesthesia. The goal is to make and keep a person completely unconscious (or "asleep") during the operation, with no awareness or memory of the surgery. General anesthesia can be given through an IV (which requires sticking a needle into a vein, usually in the arm) or by inhaling gases or vapors by breathing into a mask or tube.

The anesthesiologist will be there before, during, and after the operation to monitor the anesthetic and ensure you constantly receive the right dose. With general anesthesia, the anesthesiologist uses a combination of various medications to do things like:

  • relieve anxiety
  • keep you asleep
  • minimize pain during surgery and relieve pain afterward (using drugs called analgesics)
  • relax the muscles, which helps to keep you still
  • block out the memory of the surgery

How Does Anesthesia Work?

To better understand how the different types of anesthesia work, it may help to learn a little about the nervous system. If you think of the brain as a central computer that controls all the functions of your body, then the nervous system is like a network that relays messages back and forth from it to different parts of the body. It does this via the spinal cord, which runs from the brain down through the backbone and contains threadlike nerves that branch out to every organ and body part.

Will I Get a Needle?

Often, anesthesiologists may give a person a sedative to help them feel sleepy or relaxed before a procedure. Then, people who are getting general anesthesia may get medication through a breathing mask first and then be given an IV after they're asleep. Why? Many people are afraid of needles and may have a hard time staying still and calm, so doctors may need to help them relax first with this medicine.

What Type of Anesthesia Will I Get?

The type and amount of anesthesia given to you will be specifically tailored to your needs and will depend on various factors, including:

  • the type of surgery
  • the location of the surgery
  • how long the surgery may take
  • your current and previous medical condition
  • allergies you may have
  • previous reactions to anesthesia (in you or family members)
  • medications you are taking
  • your age, height, and weight

The anesthesiologist can discuss the options available, and he or she will make the decision based on your individual needs and best interests.

Breast Self-Exam

A breast self-exam is a check-up a woman does at home to look for changes or problems in the breast tissue. Many women feel that doing this is important to their health.

However, experts do not agree about the benefits of breast self-exams in finding breast cancer or saving lives. Talk to your health care provider about whether breast self-exams are right for you.

Information

The best time to do a monthly self-breast exam is about 3 to 5 days after your period starts. Do it at the same time every month. Your breasts are not as tender or lumpy at this time in your monthly cycle.

If you have gone through menopause, do your exam on the same day every month.

Begin by lying on your back. It is easier to examine all breast tissue if you are lying down.

  • Place your right hand behind your head. With the middle fingers of your left hand, gently yet firmly press down using small motions to examine the entire right breast.
  • Next, sit or stand. Feel your armpit, because breast tissue goes into that area.
  • Gently squeeze the nipple, checking for discharge. Repeat the process on the left breast.
  • Use one of the patterns shown in the diagram to make sure that you are covering all of the breast tissue.
  • Next, stand in front of a mirror with your arms by your side.

  • Look at your breasts directly and in the mirror. Look for changes in skin texture, such as dimpling, puckering, indentations, or skin that looks like an orange peel.
  • Also note the shape and outline of each breast.
  • Check to see if the nipple turns inward.
  • Do the same with your arms raised above your head.

    Your goal is get used to the feel of your breasts. This will help you to find anything new or different. If you do, call your provider right away.

Next, stand in front of a mirror with your arms by your side.

  • Look at your breasts directly and in the mirror. Look for changes in skin texture, such as dimpling, puckering, indentations, or skin that looks like an orange peel.
  • Also note the shape and outline of each breast.
  • Check to see if the nipple turns inward.

Do the same with your arms raised above your head.

Your goal is get used to the feel of your breasts. This will help you to find anything new or different. If you do, call your provider right away.

Thyroid Diseases

Your thyroid is a butterfly-shaped gland in your neck, just above your collarbone. It is one of your endocrine glands, which make hormones. Thyroid hormones control the rate of many activities in your body. These include how fast you burn calories and how fast your heart beats. All of these activities are your body's metabolism.

Thyroid problems include

  • Goiter - enlargement of the thyroid gland
  • Hyperthyroidism - when your thyroid gland makes more thyroid hormones than your body needs
  • Hypothyroidism - when your thyroid gland does not make enough thyroid hormones
  • Thyroid cancer
  • Thyroid nodules - lumps in the thyroid gland
  • Thyroiditis - swelling of the thyroid

Skin Biopsy

Procedure Overview

A skin biopsy, where a physician removes a small sample of skin for testing, is a rapid and convenient office procedure that aids in the diagnosis of a patient's skin condition or lesion. Although usually done by a dermatologist, any physician who is skilled and knowledgeable with the technique and its indications can safely perform a skin biopsy. There are several techniques that involve sampling tissue from a skin lesion or eruption. Once removed, the tissue sample is processed and examined under a microscope by a pathologist. It usually takes several days before a final diagnosis is rendered.

Skin biopsy procedure selection very much depends on the suspected diagnosis, size, and location of the lesion.

Expected Results

A skin biopsy is often necessary when a skin condition cannot be diagnosed by the patient's history and what the physician finds on examination alone. Confirming a clinical diagnosis may also be necessary prior to starting therapy.

Skin biopsy types are as follows:

  • Shave biopsies
  • Punch biopsies
  • Excisional biopsies

Skin biopsies can also be submitted for tissue culture if the diagnosis of a bacterial or fungal infection is in question.

Any skin lesion can be biopsied. It is important for patients to realize, however, that in some cases, microscopic examination of tissue may be very nonspecific and not necessarily helpful in rendering a specific diagnosis.

Preparation / Typical Procedure

The doctor performing the biopsy may ask in advance about any allergic reactions to anesthetic medications, about any blood thinner or anticoagulant medications you may be taking, or problems with bleeding in the past. Typically, there are no symptoms or conditions in a patient that would cause a physician to not perform a skin biopsy, but these questions help the doctor anticipate and better manage any potential complications (eg, excess bleeding). Otherwise, there is no special preparation needed prior to the procedure.

Once the area of interest is cleansed with alcohol or antiseptic solution, local anesthetic is injected in and around the skin lesion of interest using a syringe topped with a very fine needle. The skin biopsy is performed by the doctor using one of the methods described below, and the tissue removed is then placed in a bottle. Three commonly performed skin biopsy procedures are as follows:

  • Shave biopsy – This is a superficial skin biopsy performed by a doctor where a thin layer is shaved off the surface of a lesion.
  • Punch biopsy – A doctor removes a cylindrical sample to view layers of a lesion.
  • Excisional biopsy – The doctor uses a scalpel to remove the entire visible portion of a lesion.

Following the Procedure / Aftercare

Antibacterial ointment or Vaseline® with a small dressing or Band-Aid® is placed over the wound.

The patient is advised to keep the wound dry for the next 24 hours; thereafter, it may be gently cleaned with soap and water. Applying antibacterial ointment or Vaseline may be done on a daily basis until the wound heals.

Risks or Side Effects

  • Bleeding
  • Pain
  • Infection
  • Non-healing wound (this is a greater risk if the biopsy is done on the lower legs)
  • Scaring
  • Keloid formation

Additionally, biopsies cannot diagnose all skin conditions. As such, a biopsy of a lesion may not necessarily reveal the correct diagnosis.

Alternatives

A skin biopsy may not be necessary before definitive treatment is offered to a patient. The physician may be able to make a judgement on a diagnosis and proper treatment based on other tests or a physical exam. For example, a physician may be able to do what is known as a skin scraping and view the skin cells under a microscope, or a skin culture can be helpful in diagnosing infection.