Friday, November 19, 2010

Facing Cancer Together

Cancer affects almost every aspect of a woman's life: relationships with her spouse, with family and friends, her work and career, her role as a mother, her sense of self—almost nothing remains untouched.

Facing Cancer Together is designed to offer support and provide information, resources and tools to help women—and those who care about them—manage the social and emotional effects of cancer.

The Facing Cancer Together website provides an online hub where women with cancer, and all those connected to them, can find support and camaraderie with others on the same journey. Shoppers Drug Mart is the title sponsor of this important first initiative of the Facing Cancer Together program.

Facing Cancer Together is a program of the Canadian Cosmetic, Toiletry and Fragrance Association (CCTFA) Foundation.

In one convenient place, we've compiled some of the most reliable and trusted resources that women and those connected to them can turn to.

Wednesday, November 17, 2010

Four Loko Alcoholic Drink to Lose Caffeine Jolt -

The manufacturer of popular caffeinated alcohol drink Four Loko said Tuesday it will remove the caffeine from its products, pulling the blend off the market just as theFood and Drug Administration is poised to ban it.

Phusion Projects said in a statement posted on its website that the company will remove caffeine and two other ingredients from its products going forward.

The announcement came as the FDA is expected to find as early as Wednesday that caffeine is an unsafe food additive to alcoholic drinks. That finding essentially would ban Four Loko and other drinks like it.

The FDA ruling "should be the nail in the coffin of these dangerous and toxic drinks," Sen. Chuck Schumer, D-N.Y., who has pushed the Obama administration to ban the beverages, said Tuesday.

Federal regulators would not confirm Schumer's announcement that a ban was imminent, but Four Loko's statement suggests the company believed it had little choice but to reformulate its drinks.

The statement by the company's three co-founders said they were removing caffeine from the drinks after unsuccessfully trying to deal with what they called "a difficult and politically-charged regulatory environment at both the state and federal levels."

"We have repeatedly contended — and still believe, as do many people throughout the country — that the combination of alcohol and caffeine is safe," said Chris Hunter, Jeff Wright and Jaisen Freeman, who identify themselves as Phusion's three co-founders and current managing partners.

The statement did not mention several recent incidents in which college students were hospitalized after drinking the beverage. In response to such incidents, four states — Washington, Michigan, Utah and Oklahoma — have banned the beverages. Other states are considering similar action.

Four Loko comes in several varieties, including fruit punch and blue raspberry. A 23.5-ounce can sells for about $2.50 and has an alcohol content of 12 percent, comparable to four beers, according to the company's website.

While there is little known medical evidence that the drinks are less safe than other alcoholic drinks, public health advocates say the drinks can make people feel more alert and able to handle tasks like driving. A Wake Forest University study found that students who combine caffeine and alcohol are more likely to suffer alcohol-related injuries than those drinking alcohol without caffeine.

Last year the FDA notified more than two dozen manufacturers of caffeinated alcoholic beverages that it never had specifically approved the addition of caffeine to alcoholic drinks and began studying whether it was unsafe and should be outlawed. The agency noted the mix's growing popularity among college students and its potential health and safety issues.

The FDA said then it had not reached a conclusion about the drinks' safety but cited concerns from several state attorneys general who contended the drinks appealed to underage drinkers and encouraged reckless behavior.

FDA spokeswoman Siobhan DeLancey would not confirm any upcoming action Tuesday but said the agency recognizes "this very important public health issue" and will announce the results of its review when it is complete. The Federal Trade Commission, which regulates the marketing of the drinks, declined to comment.

On the Human - a project of the National Humanities Center

On the Human (OTH) is an online community of humanists and scientists dedicated to improving our understanding of persons and the quasi-persons who surround us. As persons are biological, psychological, historical, moral, and autobiographical beings, we employ modes of inquiry from the sciences and humanities. Contributors explore issues in metaphysics and biology, ethics and neuroscience, experimental philosophy and evolutionary psychology.

Our mission is to deepen understanding of the meaning and significance, if any, of being human. Generally, OTH supports and disseminates scholarship on the philosophical implications of the new biosciences and technologies. Specifically, we employ new media strategies of public education in pursuit of two objectives:

  • To stimulate humanities research on the philosophical and ethical implications of recent advances in bio- and information-technologies, especially as new scientific discoveries help to advance understanding of our evolutionary past and aid ethical evaluation of proposals to enhance future cognitive capacities;
  • To engage the public in this scholarship through three innovative digital methods: 'Structured E-conversation,' 'OpenSeminar,' and 'E-Assignment.' OTH is developing structured e-conversations in our Forum and beta-testing e-assignments in the OpenSeminar on the Human.

In the News is a monthly round-up of research news. We try to provide two links for each story: first, a media story showing how research is being presented to the public and, second, the original research. In the News is compiled by Stephen Zachary.

Monday, November 15, 2010

Cases - A Liver Attack Leads to a Simpler Life -

I first met my liver the night it tried to kill me.

I was at home in Hawaii, alone, relaxing after a dinner of leftovers from a party I hosted the night before: macaroni and cheese with manchego and chorizo, tossed greens, a glass of Rioja and a dark-chocolate truffle to finish. It was my favorite meal, and this was the last time I would eat it.

The attack started innocently, in the form of body aches. It progressed rapidly to nausea, vomiting and dizziness. Pain knifed through my gut. I pulled up my T-shirt and found a lump swelling below my ribs. The bigger it swelled, the harder it was to breathe. I panicked and called my husband, Adam, an M.I.T. professor who lived in Boston at the time. We had commuted all six years of our relationship. Hearing his voice calmed me down enough to act.

A friend drove me to the E.R., where I promptly blacked out. I woke up later in a hospital bed, my swollen body plugged with tubes. Doctors informed me that my levels of the enzymes AST andALT were sky high, signs that my liver was severely damaged and heading toward failure. The cause eluded tests. It took days to convince them that I wasn't an alcoholic.

Until that night my liver had done its work uncomplainingly and unnoticed, securely out of mind. But pain trumps denial.

As Dr. Gregory J. Gores, chairman of gastroenterology and hepatology at the Mayo Clinic in Rochester, Minn., explained in an interview, the liver provides innate immunity, which mounts the first response to invaders; absorbs nutrients and fats; and orchestrates many of the chemical reactions that sustain life. Its functions are so vital that nature endowed it the power to completely regenerate within months of injury. But if the liver fails, a transplant is the only option short of death.

The doctors sent me home the next day and called to check on me between twice-weekly clinic visits while they searched for the cause. But I wasn't safe alone because I could lose consciousness at any moment. Adam cleared his schedule and rushed to my side, remaining there for two months as my body and pride deflated — along with my old self-sufficient life.

This new reality took a few days to sink in. The pain was excruciating, but many drugs work only when the liver does. In my agony I ignored my doctor's words of caution and swallowed narcotic painkillers left over from a root canal. My liver retaliated by invading my dreams: I was flying a plane when, disguised as my co-pilot, it seized control and shot me in the face.

Then it ordered my new diet: organic rice porridge and broth. I survived on that for three months, twitching with cravings for sugar, bacon and spices. I hallucinated those into my bowl of bland white mush. My allergies vanished, and I lost 33 pounds.

In the second week my liver began barking at smells and substances I'd barely noticed before. I considered myself an earthy minimalist, but my house turned out to be a chemical minefield. I developed a doglike olfactory sense that guided me as I sniffed, recoiled and pointed out to Adam what had to go. He tossed out most of our bathroom and kitchen products, along with everything preserved or petroleum-based. (Even now, I continue to detect obscure odors, including what people eat and when they've had sex.)

Of course, there was nothing we could do about the metallic gases billowing from Kilauea volcano. My liver summoned me to cleaner air. The gall! Not even my husband had asked me to choose between him and Maui. But my liver wouldn't negotiate.

The cause of my liver attack remains a mystery, despite the efforts of a half dozen doctors in Hawaii and California. They poked and tested for every infectious agent they could, for cancer and even for some mental disorder. Nothing explained my symptoms.

Finally an infectious-disease specialist reached a diagnosis by elimination: hepatitis E.

The virus thrives in northern Brazil, spreading to people through contaminated water or animals. Two months before the attack, while I was touring the Amazon rain forest, a native boy pressed a wild sloth into my arms. It sneezed on me.

Though hep E remains the likely culprit, I don't know for sure because there is no clinical test. No matter to my liver. Whatever had assaulted it, it was no longer able to absorb the battering of modern life.

I caved in to my liver's demands. I switched to acupuncture for pain relief and help sleeping. I learned to eat like an old monk, take naps and meditate. I added the blood tests for AST and ALT to my annual physical. I followed my nose and left Hawaii, moving to Southern California with Adam. We spend evenings cuddling on the couch with our big dogs, my liver never happier. It's a less tainted, simpler life entirely on my liver's terms, and I'll take it.

Genevive Bjorn is a science writer in San Diego. Her blog about the sense of smell is at

The Downside of a Cancer Study Extolling CT Scans -

Are lung cancer scans really ready for prime time?

News that annual CT lung scans can reduce the risk of lung cancer death among former and current heavy smokers was celebrated by national heath officials this month. A major government study found the screening scans saved the life of one person for every 300 current or former smokers who were scanned.

But now cancer and screening experts are worried that the limited findings will be used by private screening centers to promote the test to a broader group than was studied. That, in turn, could lead to thousands of unnecessary lung scans, causing excess radiation exposure and unnecessary biopsies and surgery.

Dr. Otis W. Brawley, chief medical officer of the American Cancer Society, said he was stunned to hear a radio advertisement for an Atlanta screening center cite the study just a few days after the government had announced the results. The wording of the ad seemed to be aimed at a broad group, ranging from heavy smokers to women who had never smoked, Dr. Brawley said.

"We really need to weigh the harms associated with screening," he said. "The scientific community still needs to digest this. To take a trial that involves people at high risk for lung cancer and to extrapolate it and say it's good for people with intermediate or low risk is not appropriate."

The study, called the National Lung Screening Trial, focused on a specific high-risk group: 53,000 current and former heavy smokers, aged 55 to 74, who had smoked for at least 30 pack-years. That means someone who smoked one pack a day for 30 years, two packs a day for 15 years or three packs a day for at least 10 years would qualify for the study.

Former smokers who had accumulated 30 pack-years were included only if they had stopped smoking within the previous 15 years.

The smokers and former smokers were given either annual CT lung scans or chest X-rays. Compared with conventional X-rays, the CT, or computed tomography, scans create a detailed three-dimensional image of the lungs. The study was stopped when it was found that the scanning group had a 20 percent lower risk of dying from lung cancer than those being screened with X-rays.

But the early results also showed a downside of scanning: one of every four lung scans showed an abnormality, which often led to additional worry, radiation exposure from follow-up scans and, sometimes, lung biopsies and even risky surgery. But because the study was stopped early, a full analysis of the harms caused by screening scans is still months away.

Reading the scans is tricky because harmless nodules can be misinterpreted as suspect lesions. In the study, even experienced radiologists at major cancer centers had a high rate of false positives, suggesting that the rate would be even higher in the real world.

"There is a learning curve to reading spiral CTs," Dr. Brawley said. "I'm concerned that some radiologists might be early in that learning curve and some patients may be harmed because of it."

While the study found a benefit to scanning a specific group of high-risk smokers, that doesn't mean other groups will get the same benefit, says Dr. Peter B. Bach, a pulmonologist at Memorial Sloan-Kettering Cancer Center in New York. In lower-risk groups, for instance, it's likely that thousands of people would need to be exposed to the risks of screening before a single life was saved. And it's possible that many of those scanned unnecessarily could be seriously harmed.

"The aggregate harms to all the people's lives who are not saved have to be taken into account," Dr. Bach said. "Even in these highly controlled settings, about 1 percent of the people had surgery or a part of their lung removed for something they thought was cancer and it wasn't."

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Book Review - The Mind’s Eye - By Oliver Sacks -

Those whose familiarity with Oliver Sacks extends only to his vivid book titles — "The Island of the Color blind," "An Anthropologist on Mars," "The Man Who Mistook His Wife for a Hat" — may picture his writing as a gallery of grotesques, a parade of the exotically impaired. Sacks, a practicing neurologist, does specialize in case studies of highly unusual patients. But even as he entertains and diverts with his dramatic tales, Sacks has always been up to something else: he is gently educating us about the frailties and flaws — and the strengths and capacities — of "normal" people, those whose afflictions are of the most ordinary sort. You may never have confused your spouse for an item of outerwear, but have you ever failed to recognize the face of an acquaintance? Fumbled for a word that eluded your grasp? Read a sentence three times and still didn't get it?

Such familiar slips, and how we handle them, are the stealth subjects of Sacks' latest book. "The Mind's Eye" is a collection of essays — some of which have already appeared in The New Yorker — but it has a remarkably graceful coherence of theme, tone and approach. Once again, Sacks explores our shared condition through a series of vivid characters: the woman who couldn't talk, the man who couldn't read, the "prosopagnosic" who couldn't identify her own face in a photograph. (For those who wonder just how Sacks locates such people, it soon becomes clear that many of his patients find him, after recognizing themselves in his writing. They enter his care through the pages of his books, and in turn become characters in his next round of stories.)

The sufferers who write to Sacks receive a deeply empathetic response. Of one correspondent, a woman who has lost the capacity to read (but, remarkably, retains the ability to write), Sacks notes that he responded to her by telephone. "I normally would have written back," he tells us, but in this case calling "seemed to be the thing to do." Over time this patient, afflicted with a degenerative brain condition called posterior cortical atrophy, loses her ability to recognize objects and people, though she retains a keen sense of color and shape. When Sacks meets her in person to see how she navigates her everyday life, he dresses head to toe in red so she can keep track of him in a crowd.

Given to such un-self-consciously generous gestures, Sacks would seem to be the ideal doctor: observant but accepting, thorough but tender, training his full attention on one patient at a time. For the patient's benefit and for ours, he illuminates every uncanny detail, brings out every excruciating irony. The woman for whom Sacks dresses in red, for example, is a virtuoso pianist, and the first sign of her malady is a sudden inability to read music. She is joined in these pages by a novelist who wakes up one morning unable to read, and an intensely sociable woman who is suddenly struck dumb. But Sacks is not primarily interested in documenting pathology, or even curing disease, which in most cases is impossible. There are no miraculous "awakenings" here.

Rather, he is most engaged by the process of compensation, how people make up for what they have lost, wresting new possibilities from their newly imposed limits. There's the blind man who develops super-sensitive hearing, the deaf woman who catches tiny shifts in facial expression — and that pianist, who loses her ability to read music but gains new richness in her thinking about music. "She felt that her musical memory, her musical imagery, had become stronger, more tenacious, but also more flexible, so that she could hold the most complex music in her mind, then rearrange it and replay it mentally, in a way that would have been impossible before," Sacks writes.

Sometimes these compensations are biological, he explains. The brain, plastic even into adulthood, reshapes itself to fit a new reality. In people who become blind as adults, Sacks notes, the part of the brain that once processed visual information does not atrophy, but is reallocated for another use. "The visual cortex, deprived of visual input, is still good neural real estate, available and clamoring for a new function."

At other times, compensation takes the form of an ingenious tool. The social butterfly rendered mute by a stroke uses a lexicon, a book full of words to which she can point. (The lexicon is devised for her by a speech pathologist who is herself, Sacks notes in passing, a quadriplegic.) The novelist employs a journal-like "memory book" to teach himself how to read again. Such tools can help forge a new whole from patients' shattered identities. As the novelist puts it, "The memory book returned a piece of myself to me."

Sacks is most attuned to the psychological and emotional adjustments patients make to their new status; he clearly admires how they have gone on "to develop other ways of doing things, capitalizing on their strengths, finding compensations and accommodations of every sort." In her piano playing, Sacks writes, the woman who could no longer read "not only coped with disease, but transcended it."

So rewarding are the compensations of Sacks' patients, in fact, that we begin to feel as if the tragedies that befell them were not tragedies at all, but — as the self-help books say — opportunities for growth. Then we arrive at the book's penultimate essay, about Sacks' own ocular cancer. His story is told in journal entries, dated from December 2005 to December 2009, which take on a deepening urgency as we experience along with him one event after another: the strange symptoms, the grim diagnosis, the painful treatment, the halting, incomplete recovery. Sacks' jaunty confidence and sanguine attitude disappear, replaced by a panicked and sometimes piteous voice that is new to the reader and (if I may be so ungenerous) quite unwelcome. On Dec. 25, 2005, he writes: "Everyone says 'Merry Christmas!' and I reply in kind, but this is the darkest Christmas I have ever known. The New York Times today has pictures and stories of various figures who have died in 2005. Will I be among those figures in 2006?"

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Christopher Hitchens: 'You have to choose your future regrets' | interview | Books | The Observer

I wasn't sure what, or perhaps whom, to expect as the door opened at Christopher Hitchens's top-floor apartment in downtown Washington. The last time I had interviewed the renowned polemicist, author, literary critic and new resident in the medical state he's called "Tumortown" was in 2005. On that occasion, after a 5am finish to our extravagantly lubricated conversation, it was I who had felt the pressing need of hospital attention.

Since then there have been two dramatic changes in his circumstances. The first was the international bestselling success of his 2007 anti-theist tomeGod is Not Great. After decades of acclaimed but essentially confined labour, Hitchens suddenly broke out to a mass audience, becoming arguably the global figurehead of the so-called New Atheists. Almost overnight he was upgraded from intellectual notoriety, as an outspoken supporter of the invasion of Iraq, to the business end of mainstream fame. In America, in particular, he has reached that rare position for a journalist of becoming a news story himself.

Unfortunately the news, which provided the second personal transformation, was that in June he was diagnosed with cancer of the oesophagus, a malignancy whose survival ratings do not make soothing bedtime reading. As restraint is a quality for which neither Hitchens nor his critics are known, the ironies proved irresistible to many commentators. For the religiously zealous, the arch atheist suffering a mortal illness spoke of divine retribution – the unacknowledged irony being that belief in such a vindictive god served only to endorse Hitchens's thesis.

For more secular moralists, a different kind of cosmic accountancy was at work. The celebrated drinker and smoker who once claimed that "booze and fags are happiness" had succumbed to a cancer most often associated with drinking and smoking. Having previously gone so far as to promote the benefits of teenage smoking, he offered a public recantation of sorts. "I might as well say to anyone watching," he announced in a TV interview, "if you can hold it down on the smokes and the cocktails you may be well advised to do so."

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