Celebrities such as Julia Louise-Dreyfus, Olivia Newton-John, Christina Applegate and Cynthia Nixon have revealed their breast cancer diagnoses, helping raise awareness for the most common cancer to affect women. It’s the second most common cause of cancer death in females.
1 in 8 women will develop invasive breast cancer over the course of their lifetime. According to the American Cancer Society, an estimated 268,000 cases of invasive breast cancer are expected to be diagnosed in women in the US with 63,000 cases of non-invasive breast cancer, a rise from last year. 41,700 women and 500 men are expected to die this year of breast cancer.
Risk factors for breast cancer include:
Breast cancer is staged based on the size of the tumor, if lymph nodes are affected and whether the cancer has spread to distant areas of the body. Prognosis varies greatly on the stage.
85% of breast cancer cases occur in women with NO family history.
Mammograms are the first line screening tool for breast cancer and are currently recommended biennial for women aged 50-74. However for those at higher risk, mammogram screening should start earlier, with possible follow-up ultrasound, and be performed more regularly.
3-D MAMMOGRAM IMAGE
The FDA has announced that samples of ranitidine, an H2 Blocker used for upset stomach, reflux and ulcers sold generically and under the brand name of Zantac, were found to have the contaminant N-nitroso dimethylamine (NDMA). This is one of the chemicals that prompted the generic ARB blood pressure medication recalls last year.
There have been no reports of users becoming ill and no recall has been suggested at this time. In animals, NDMA is known to cause liver and lung cancer. In humans its carcinogenic risk is unknown, however the CDC states it may cause liver function impairment and cirrhosis.
The FDA writes:
The investigation is ongoing and more needs to be looked at when it comes to this manufacturing process suspected to result in these “impurities” being made.
Last year NDEA was also found in the generic blood pressure medications that were the subject of recall, however has not yet been suggested as being present in ranitidine.
N-Nitroso-N-methyl-4-aminobutyric acid (NMBA) was the third chemical detected resulting in the latest two recalls of losartan, an angiotensin receptor blocker commonly used to treat hypertension (high blood pressure). It is believed to have been created during the manufacturing process of the generic drug.
NMBA, according to Toronto Research Chemicals, is a known carcinogen in a wide range of animal species.
Last Fall, ScieGen Pharmaceuticals, Inc. recalled certain lots of Irbesartan, a similar angiotensin receptor blocker used in blood pressure management.
The recalls initially began last summer when FDA recalled a number of lots of valsartan due to an “impurity,” N-nitroso dimethylamine (NDMA) that is known to cause cancer in animals. Weeks later they additionally found traces of N-nitrosodiethylamine (NDEA).
According to Reuters, earlier last summer, the MHRA, Medicines and Healthcare Products Regulatory Agency, located in the UK, said the appearance of the impurity, N-nitroso dimethylamine (NDMA), came after a change in the process for making valsartan at one facility owned by Zhejiang Huahai Pharmaceuticals, a company in Linhai, China.
With NDEA, data is limited, but due to its classification as a nitrosamine and its prevalence in tobacco smoke it is classified as a probable human carcinogen.
According to New Jersey Department of Health’s website, NDEA has been linked to liver, lung and gastrointestinal tract cancer in animals.
Losartan, valsartan and Irbesartan are medications in the class of angiotensin receptor blockers (ARBs) used for high blood pressure and congestive heart failure.
Those taking either tablet for their blood pressure are urged to not abruptly stop their medication but rather check with their medical provider and pharmacy to see if their particular prescription is involved in the recall.
I suspect more recalls will follow as processes may be similar across multiple pharmaceutical facilities and NMBA, NDMA and NDEA are byproducts that may not be individually unique to just one “brand” of medication manufacturing.
The CDC is currently investigating close to 450 cases of vaping related illness and 5 reported deaths. A recent study in the New England Journal of Medicine has found evidence of lipoid pneumonia in a case where a 21 year old became sick after vaping nicotine and tetrahydrocannabinol (THC) daily.
Macrophages, which are scavengers that rid the body of pathogens and other harmful substances in the body, were found to be “lipid-laden,” or full of a fatty substance. They suspect this fatty substance to be caused by inhalation of Vitamin E acetate that was only present in marijuana vaping products and not the average nicotine e-cig. Vitamin E is commonly used in hand creams, moisturizers and as a supplement due to its oily nature, but is not to be inhaled.
Since the lungs are designed to oxygenate the lungs and exchange out carbon dioxide, oily substances can clog the works.
Experts say the Vitamin E acetate is not believed to be apart of regular e-cigarettes that do not vape THC, the psychoactive component to marijuana.
This is a developing story….
The FDA is investigating 127 reports of seizures in e-cigarette users (up from 35 this Spring).
Many were teenagers and young adults.
Since 2010 the agency has received multiple reports but is unclear if e-cigarettes actually caused the seizures or if there were underlying medical conditions predisposing the neurological disorder.
The 92 additional cases since this April is concerning and the FDA is working to determine if vaping contributes contributes directly to serious neurological conditions.
In April FDA Commissioner Dr. Scott Gottlieb tweeted:
Dr. Ned Sharpless, current acting FDA Commissioner, is encouraging people to report adverse events as, “Additional reports or more detailed information about these incidents are vital to help inform our analysis and may help us identify common risk factors and determine whether any specific e-cigarette product attributes, such as nicotine content or formulation, may be more likely to contribute to seizures,” (Reported by CNBC).
A seizure occurs when there is abnormal electrical activity in the brain. If the electricity doesn’t conduct properly, brain function gets disrupted. This could lead to convulsions (involuntary jerking movements), loss of muscle tone, changes in senses such as vision, hearing and smell, loss of bladder control, loss of consciousness and sometimes stroke, brain damage and death.
Nicotine toxicity has been linked to seizures. E-cigs sometimes contain more nicotine than cigarettes alone.
A study published by the American Heart Association found nine different E-cig flavors to impair blood vessel function, which can impair heart health.
Endothelial cells, which delicately line blood and lymph vessels, were found to become inflamed at low concentrations of some vapor flavors. And at high concentrations of others, exhibited cell death. Nitric oxide production, necessary for vessel dilation to improve blood flow, was impaired as well. These are often the same changes seen in early heart disease.
The 9 flavors (and the chemicals within) cited in the report to cause the endothelial inflammation and/or damage were:
Strawberry flavoring appeared to have the most adverse effect on the cells.
Many other flavors were not included in this study, so it's unknown how safe they may be.
For more on the study, read here.
An alternate study published last November looked at vaping flavors and their effects on heart muscle cells.
For more on this study, read here.
The moral? Just because we love the taste of something, doesn’t mean its safe to inhale.
A study from New York University found the nicotine in electronic cigarettes to cause DNA damage similar to cigarette smoking.
Dr. Moon-shong Tang and his colleagues exposed mice to e-cig smoke during a three-month period, 5 days a week for three hours a day. They found these mice, compared to those breathing filtered air, to have DNA damage to cells in their bladders, lungs and hearts. The amount of nicotine inhaled was approximately 10mg/ml. That dose would be commonly consumed by many humans who vape.
They then looked at human bladder and lung cells and found tumor cells were able to grow more easily once exposed to nicotine and vaping chemicals.
Last May, researchers from Vanderbilt-Ingram Cancer Center in Nashville found e-cig smoke to increase one’s risk of bladder cancer.
In 2015, the University of Minnesota identified chemicals commonly found in e-cig vapor to include:
Although electronic cigarette “juice” may appear safe, it could produce harmful chemicals once heated to become a vapor.
A lethal dose of nicotine for an adult ranges from 30-60 mg and varied for children (0.5-1.0 mg/kg can be a lethal dosage for adults, and 0.1 mg/kg for children). E-cigs, depending on their strengths (0 – 5.4%) could contain up to 54 mg of nicotine per cartridge (a 1.8% e -cig would contain 18mg/ml).
The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing mucus production and a sweeping out of carcinogens trying to make their way down to the lungs.
More research needs to be performed but this recent report reminds us that exposing our delicate lung tissue and immune system to vaping chemicals may not be as safe as we think.
For more on the study read here.
Last week, experts warned that many chemicals in vaping liquid may change to toxic substances (once heated) that can irritate the lungs.
Last year one study reported that toxic levels of lead and other metals may leak from the heating coil element into the vapor inhaled during e-cig use.
Researchers at Johns Hopkins Bloomberg School of Public Health found these metals to include:
We’ve known for some time that vaping fluid could contain chemicals that turn toxic once heated, but this study shed light on e-cig metal components causing metal leakage to the vapor making contact with delicate respiratory epithelium (lining).
Reported by Forbes, Rich Able, a medical device marketing consultant, stated the following, “the FDA does not currently test any of the most popular vaping and e-cigarette instruments being manufactured at unregulated factories in Asia that source low-grade parts, batteries, and materials for the production of these devices,” suggesting that “the metal and parts composition of these devices must be stringently tested for toxic analytes and corrosive compounds.”
These chemicals may act as neurotoxins, affecting our nervous system, cause tissue necrosis (cell death) and even multi-organ failure. Moreover, they can affect how our immune system reacts to other chemicals as well as foreign pathogens, affecting our ability to fight other diseases.
Although studies have suggested e-cig vapor to be safer than tobacco smoke, not enough research has been done, in the relatively few years vaping has been around, looking at how heat-transformed chemicals and leaked metals affect our breathing, lungs and other organs once absorbed into the body.
I like this news. A lot.
Facebook (which owns Instagram) will have a new feature for when a user searches for vaccine related content. The new feature in question pops open a window offering educational information about vaccines and will connect the user to either the CDC (Centers for Disease Control and Prevention) if you are a US user and to the WHO (World Health Organization) if you are outside the US. This is all designed to tackle the rapidly spreading anti-vax movement that has single handedly brought back the measles with outbreaks in 31 states. The measles, a disease eradicated from the US in 2000! And it's back!
Thanks, anti-vaxxers! =(
Well, FB is pushing against anti-medical science with their new educational pop up windows.
Thanks, Facebook! =)
The full Facebook press release:
“We are working to tackle vaccine misinformation on Facebook by reducing its distribution and providing people with authoritative information on the topic. We are starting by taking a series of steps:
How This Will Work
Leading global health organizations, such as the World Health Organization and the US Centers for Disease Control and Prevention, have publicly identified verifiable vaccine hoaxes. If these vaccine hoaxes appear on Facebook, we will take action against them.
For example, if a group or Page admin posts this vaccine misinformation, we will exclude the entire group or Page from recommendations, reduce these groups and Pages’ distribution in News Feed and Search, and reject ads with this misinformation.
We also believe in providing people with additional context so they can decide whether to read, share, or engage in conversations about information they see on Facebook. We are exploring ways to give people more accurate information from expert organizations about vaccines at the top of results for related searches, on Pages discussing the topic, and on invitations to join groups about the topic. We will have an update on this soon.
We are fully committed to the safety of our community and will continue to expand on this work.”
The CDC is now reporting 685 confirmed clinical cases of the fungal infection, Candida auris (C. auris), that unfortunately is resistant to multiple types of antifungal drugs. Moreover another 30 cases are being monitored who were in contact with those infected. This spike is very worrisome.
States reporting C. auris infections include:
The majority of the cases are in New York, Illinois and New Jersey. Many of those infected have died but they did have other comorbid conditions, which could have also contributed to their becoming infected with C. auris to begin with.
Please note that this fungus is different from the species, Candida albicans, which causes common yeast infections.
When investigators first analyzed facilities reporting outbreaks, they found C. auris had colonized mattresses, beds, chairs, counter surfaces, infusion pumps, and window sills. By this, the superbug demonstrates its resilience outside a human host.
The super fungus still has some vulnerability to antifungal medication but its resistance is increasing.
Most hospital disinfectants are currently designed to be antifungal, antibacterial and antiviral. The CDC has urged healthcare facilities to be diligent in their cleaning practices and to be aware of this “super fungus.”
As August approaches, the CDC is asking health care professionals to be on the lookout and report any suspected cases of AFM (Acute Flaccid Myelitis), a paralyzing illness resembling polio, as cases may peak during this time.
Last year a total of 233 cases were confirmed in 41 states. This year 11 have been reported and an additional 57 cases are being investigated. Cases have been reported in California, Maryland, Nebraska, North Carolina, Pennsylvania, Texas, Utah and West Virginia this year.
IMAGE ABOVE FROM CDC
Last year, California, Colorado and Texas appeared to be the worst hit with 15, 16 and 31 cases respectively. Experts are urging states to report any cases of suspected AFM as the above map could be an under-representation of true numbers.
On their website, the CDC reports the following:
The “48 states” refers to cases since 2014. 90% of the cases occurred in children under the age of 4.
The age range of children affected appear to be 3-14. A 6-year-old boy in Washington State died in 2016 and was the first death to be linked to this mysterious illness. His parents reported he had felt ill, became dizzy and within hours suffered swelling in the brain and paralysis. Despite medical efforts, he passed.
In 2018 parents of two children who died from AFM accused the CDC of hiding their deaths.
Although the exact cause of AFM is unknown, health experts are considering a variety of possibilities. They have actually been investigating this since 2014 when reports of AFM began to surface across the United States.
AFM stands for Acute Flaccid Myelitis. It’s a condition that occurs suddenly, causing inflammation of the brain and spinal cord, causing loss of muscle tone and reflexes. Although limb weakness is the primary symptom, patients could also exhibit slurred speech, facial drooping, and in serious cases inability to breath due to paralysis of the respiratory muscles. Mild cases appear to resolve but serious cases can cause residual paralysis or death. Children appear to be more affected than adults.
Although health officials do not know for certain, due to its rapid onset, a pathogen such as a virus seems highly likely. With the 2013-2014 outbreak, some of the cases tested positive for enterovirus (EV-D68), but it is not conclusive whether this was the exact cause or just coincidentally found in the patients tested.
Some postulate a combination of viruses may be a factor or an autoimmune disease. Although Guillain-Barre syndrome causes acute limb weakness and paralysis when the immune system begins attacking the nervous system, the report that many individuals feel feverish or ill prior, seem to point to a pathogen as the primary cause although the latter is not being ruled out. Virus families such as enterovirus (including polio and nonpolio enterovirus), adenovirus (causing respiratory and GI illness) cocksackieviruses and flaviviruses (including West Nile) have been suspected.
Per the CDC, acute flaccid myelitis is rare (less than 1 in a million cases) however currently they report 570 cases have been confirmed since the outbreak began in August 2014.
Medical professionals look at a variety of factors.
Medical professionals look at a variety of factors.
History: how the paralysis/loss of muscle tone began and which limbs did it affect first
Laboratory tests and CSF (cerebrospinal fluid) testing: to look for signs of infection
MRI of the brain: which may show gray matter involvement in a case of AFM.
There is no standard treatment that has been proven effective, however depending on the severity of the symptoms, health professionals can consider a variety of options including steroids, IVIG, interferon, antivirals and supportive measures. Some physicians are using “nerve transfers”, similar to a transplant, to help children regain control of their limbs.
No. Until they can identify the exact cause, or causes, health officials cannot create a vaccine.
If we assume it’s a pathogen causing the illness, avoiding contact with sick individuals, being up-to-date on one’s vaccines and good hand-washing are imperative. Although we do not know if AFM is caused by a mosquito-born illness, avoiding mosquitoes would be wise as well. More therefore needs to be researched to determine why and how those individuals with AFM were infected.
A Hepatitis A outbreak has now been declared in Clark County Nevada.
According to the Southern Nevada Health District, 37 cases have been reported since the start of this year.
Drugs and homelessness have contributed to the outbreak but it can be spread by eating contaminated food.
Per the CDC, 20,133 cases, with 11,595 hospitalizations have been reported in multiple states including Ohio, Tennessee, West Virginia, Kentucky, Indiana, Florida and Arizona to name a few. According to the CDC, California and Utah have declared their outbreaks’ over. 191 deaths have been reported since the outbreak began in 216.
Hepatitis A is a disease that affects the liver. Its caused by a virus (Hepatitis A virus) that is most commonly ingested. Poor hand washing and/or contaminated food are likely culprits. It’s transmitted by the fecal-oral route, where food or drink contaminated by fecal matter enters another person’s GI tract. Sexual transmission of Hepatitis A has been reported during activities involving oral-anal sex.
Hepatitis A can live outside the body for months, so unclean dining areas can be contaminated and transfer to food.
Those who are immunosuppressed run the risk of dying from the infection.
Symptoms of Hepatitis A include:
There is no specific treatment for hepatitis A. Most hepatitis A infections resolve on their own.
We usually recommend rest, fluids, and offer medications to help with nausea and vomiting.
For liver injury we avoid medications and alcohol that can worsen liver damage. The liver will usually recover within months after hepatitis A infection.
There are vaccines for Hepatitis A included in the childhood vaccination schedule. Those older who weren’t vaccinated as a child can get the vaccine from their local provider or health department. Many states require all health care and food workers to be vaccinated.
The best form of prevention however is good hand washing, dining area hygiene, and cooking food thoroughly.
This week the CDC reported their findings of thousands of children being enrolled in school without any waiver for vaccine exemption.
As states aim to limit parental choice to limit vaccination based on religious objections, the country is fighting multiple outbreaks, including Measles, Mumps and Hepatitis A, which are potentially preventable with vaccination.
When the CDC looked at data submitted by 27 states, the majority of unvaccinated or under-vaccinated children in 10 states lacked waivers.
Which brings to question, are other reasons at play when a child is not vaccinated rather than religious or medical objections?
When a family adheres to the vaccination regimen, office visits are need at 1 month, 2 months, 4 months, 6 months, 12 months, sometimes 15 months of age, and 4 years old – 6 years old, in addition to any other follow ups deemed necessary by the medical provider.
Most medical offices that provide vaccines are only open during the weekday, hence a parent who cannot take off work to bring their child in the doctor may have difficulty adhering to the vaccination schedule.
And then when asked why their child wasn’t vaccinated, it may be less embarrassing to cite “religious reasons” rather than fear of losing income or one’s job when taking off for the doctor’s visit.
I suggest weekend or night “vaccination clinics” at schools to make parents aware of alternative times to vaccinate and increase access to those who may not be able to leave their job during the weekday.
Mexican researchers had a major breakthrough in treating HPV (Human Papillomavirus), the most common sexually transmitted disease. In fact, the CDC states that almost 80 million Americans are infected with HPV with approximately 14 million people becoming newly infected per year. Those are just the numbers in the U.S. alone.
What exactly is HPV?
HPV is a group of more than 150 related viruses, named for the warts (papillomas) some HPV types can cause. Some other HPV types can lead to cancer. According to the CDC website:
“In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.
Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.
HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer). Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.”
According to, El Universal, a popular Mexican newsite, a research team at Mexico’s National Polytechnic Institute led by Eva Ramon Gallegos, was able to eliminate HPV in dozens of patients using a non-invasive photodynamic therapy. Which makes us all ask, what is photodynamic therapy? Well, according to cancer.gov:
“Photodynamic therapy (PDT) is a treatment that uses a drug, called a photosensitizer or photosensitizing agent, and a particular type of light. When photosensitizers are exposed to a specific wavelength of light, they produce a form of oxygen that kills nearby cells.”
Sounds like science fiction to me but whatever works! Anyway, according to Ramon’s study, the team was able to eliminate HPV in 100 percent of patients that had no premalignant lesions and in 64.3 percent of subjects with lesions.
Now, I know that viral headlines all across the internet screamed the HPV has been cured but, um - not so fast. There are over 100 different kinds of HPV. Some cause health problems, some do not. Some, but not many, cause cancer. One of the reasons cancer is so hard to cure is because each type of cancer will require a completely different cure. Something that cures cervical cancer, for example, will probably not cure breast cancer. And something that cures type 6,11,16 and 18 (most of the problematic HPV types) types of HPV might not work on other types of HPV.
As pointed out by Liz Highleyman, the editor in chief at www.cancerhealth.com in her A Cure for HPV, not so fast…, there are too many forms of HPV to claim they have all been cured. Highleyman notes the Mexican research only focused on two types of HPV. So, while the research is good news, it’s not exactly a full cure. From her article:
“It’s not clear how photodynamic treatment might eliminate HPV infection, which would seem to require some type of antiviral therapy. But there’s clearly something going on.
Despite the unanswered questions raised by the recent reports, the findings from the Mexican study are good news for people with HPV-associated dysplasia. Photodynamic therapy is well tolerated and noninvasive. Using PDT instead of surgery to remove precancerous tissue could help preserve function in people with anal lesions and the ability to carry a pregnancy in women with cervical lesions.
The news also presents an opportunity to promote HPV vaccination. The new Gardasil 9 vaccine protects against several of the most common cancer-causing HPV types (16, 18, 31, 33, 45, 52 and 58) and two wart-causing types (6 and 11). It is recommended for girls and boys around age 11 or 12, before they become sexually active. However, the FDA recently approved the vaccine for women and men up to age 45, meaning people who were not vaccinated as teens or young adults may still be able to benefit.”
Okay. So perhaps “cures HPV” is too strong a statement. But things seem to be heading in the right direction!
A recent study published in the Lancet finds Millennials to be at much higher risk for cancer than their parents and grandparents ever were.
Those born between 1981 and 1997 appear to be at increased risk of cancer of the:
Study authors cite obesity as the main culprit.
The CDC reports the prevalence of obesity was 35.7% among young adults aged 20 to 39 years.
In 2016 the International Agency for Research and Cancer listed multiple cancers in which obesity plays a role. They include the above as well as breast, ovarian, and esophageal cancer.
Studies have found obesity to alter hormone levels which could incite cells to rapidly divide. Fat acts as if it's another organ, inducing signals that can affect insulin, sugar and fat metabolism and can induce inflammation when it accumulates around other organs.
Moreover it could be an associative relationship in which those who are obese may have poor diets and exercise habits which are linked to cancer as well.
In the above study, non-obesity related cancer, such as lung, appears to be at less risk for millennials as many are saying no to tobacco products.
However, other causes could be at play such as radiation exposure. The verdict is not yet out on vaping either.
Study authors state: