Here’s Why Some Women Are Forgoing Treatment For This Type of Breast Cancer

When Laura Colletti was told that she had ductal carcinoma in situ (DCIS), or early-stage breast cancer, she dreaded what the diagnosis would mean for her life. Laura’s daughter had some straightforward advice: “Mom, if it was me I’d take it out. You just get rid of it.”

But Laura wasn’t ready for a mastectomy. She and her husband researched DCIS, which is known as stage 0 cancer, and found that at her stage, her lump was made of pre-cancerous cells fully contained inside the ducts of the breast. The cells might never break out of the duct and become an invasive cancer. Laura says she found that, “really we don’t have to have surgery. That it’s not life-threatening, and I’ll probably die from something else.”

Some doctors agree. Surgeon Shelley Hwang, Chief of Breast Surgery at Duke Medical Center, says it makes her sad when patients feel they have to undergo a major mastectomy surgery in order to rid themselves of the anxiety of breast cancer. Dr. Hwang explains that in ductal carcinoma in situ, the in situ phrase means that the abnormal cells are contained, and if they stay contained, they pose much less risk than having a preventative surgery.

Doctors are now finding breast cancer tumors at higher rates because of how detection technology has improved in recent years. But while early detection has improved, breast cancer death rates have stayed about the same from 2002 to 2015. Shouldn’t more detection, especially early detection, mean more lives saved?
Cases of DCIS account for 20- 25 % of breast cancers detected by screening, whereas DCIS made up about 3 percent of detected cancers before screening became more popular in the 1980s. The reaction of many doctors and patients, understandably, is to want to remove any tumors regardless of stage. Even if a woman does have very early stage breast cancer, it may seem far better to undergo surgery than to worry over whether or not the cancer will become invasive.

But not all tumors are the same, and some are so slow-growing that they might not ever cause death, or even symptoms. They key is to know which ones are which. Cancer is the blanket term applied to low-risk DCIS and to stage IV metastatic cancer, but they don’t pose near the same amount of risk, though the terminology can cause an equal amount of fear in both cases.

But even stage 0 DCIS poses some risk of becoming invasive; isn’t it better to operate and be done with it? According to Dr. Hwang, not always: “There have been a couple of very important studies that have been published lately which have shown that for the really low risk DCIS, whether you ever operate on them, whether you do a lumpectomy or whether you do a mastectomy, the patients are equally likely to not die of breast cancer.”

This is a serious consideration, especially because treatment comes with its own set of risks. The side effects of chemotherapy and radiation are both short-and long-term, and even a double mastectomy is not a magic bullet. Aside from the emotional side effects, a mastectomy may involve  revisions, prolonged pain, loss of sensation, or hernias. 

Some doctors are beginning to think there are times when treatment risks outweigh the benefits, and they’re putting a new option on the table: active surveillance. Active surveillance involves screenings every six months and may include estrogen-blocking drugs. This is the route that Laura Colletti chose. Her daughter was, understandably, against the decision at first. But after talking to her mom about the research the the pros and cons of more aggressive treatment, she become supportive.

Laura was relieved that she wouldn’t have to, at least at this stage, undergo surgery. “I feel great about my decision. If options were given to women, more women would choose active surveillance. But because there’s no options out there, people don’t know to even ask.”

Dr. Hwang is not suggesting that people stop getting mammograms; she’s simply questioning the rapid-fire reaction to all types of cancer. If active surveillance can help women avoid surgery without sacrificing peace of mind, it may be a good option for those with very low-risk DCIS—at least it should be one of the options presented. 

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New molecular mechanism can reverse genetic defect responsible for Friedreich's ataxia

Scientists at Tufts University have identified a molecular mechanism that could reverse the genetic defect responsible for Friedreich's ataxia, a neurodegenerative disease that leaves its victims with difficulty walking, a loss of sensation in the arms and legs and impaired speech caused by degeneration of nerve tissue in the spinal cord.

The researchers report today in the Proceedings of the National Academy of Sciences that the genetic anomaly that causes the disease -- the multiple repetition of a three letter DNA sequence -- could potentially be reversed by enhancing a natural process that contracts the repetitive sequences in living tissue.

Friedreich's ataxia is a genetic disease caused by the presence of an expanded repetition of a three letter genetic sequence, GAA in the FXN gene, which encodes for frataxin, a protein required for proper function of the mitochondria -- the cell's "batteries" that generate the fuel to keep all other cell functions running.

Healthy people usually have 8 to 34 GAA repeats, carriers have 35 to 70 repeats, and individuals that exhibit disease symptoms have more than 70 -- and commonly have hundreds of repeats.

With more DNA repeats, it becomes increasingly difficult for the cells to "read" the FXN gene and produce the protein required by the mitochondria, which in turn cease to function properly. One in 40,000 individuals has this condition.

The DNA repeats literally gum up the works. They can also cause other mutations in the surrounding DNA, or make chromosomes extremely fragile, breaking into pieces, or rearranging themselves. If we can shrink the DNA repetition in tissues to levels found in healthy people, we might be able to stabilize the DNA and reduce the effects of disease."
Sergei Mirkin, professor and chair, Department of Biology, School of Arts & Sciences, Tufts University

It is known that in patients' tissues, the GAA repeats are unstable and continuously expand and contract. Understanding the mechanism of GAA repeat expansion and contraction -- especially contraction -- is important to developing this strategy for battling the currently incurable disease.
Numerous theories have been advanced as to how the DNA repeats contract, although the precise details of the mechanism remained largely unknown.

In order to pinpoint the actual mechanism, the authors of the study developed an experimental system in yeast (Saccharormyces cerevisiae) to quantitatively measure the effects of different interventions on contractions of DNA repeats, and found that contractions happened usually during the process of DNA replication, in the course of what is referred to as "lagging strand synthesis."

When the two strands of DNA are copied, one strand is replicated in a continuous manner, while the other must be assembled from smaller pieces stitched together.

This is the lagging strand, so named because its more complex synthesis limits the rate at which the DNA can be copied.

The Tufts researchers found that the contraction of repeats depends on the ability of the DNA repeat to form an unusual triple-helical DNA structure along the laggin strand.

The normal structure of DNA is a double helix consisting of two strands winding around each other. A triple helix, in contrast, consists of three strands wrapped in a helical twist.

As the replication machinery moves across the lagging strand, it cannot easily bypass a triplex formed by the repeat.

When the replication machinery jumps over this triple helix hurdle, the copied DNA strand ends up with fewer GAA repeats.

"While these results were uncovered in a yeast model, they do provide us with a clue into the mechanism of DNA repeat instability in Friedreich's ataxia," said Alexandra Khristich, graduate student in Mirkin's lab and first author of the study.

"I hope that our discovery would become a starting point for the potential development of therapeutic strategies that tip the balance toward DNA repeat contraction in patient tissues."

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15 Surprising Signs of Cancer

1) Loss of sensation-
You know that tingling sensation when your foot is " falling asleep"? If this feeling continues for an extended period of time, it's best to consult a Dr. Lack of sensation in one more body parts suggests a tumour near the cerebrum, spinal cord or nerve channels.

2) Neck and face swelling
Lung cancer can cause swelling in the face, neck, arms and upper chest, when a tumour is pressing against the vein that goes from the head to the heart, This particular symptom is called superior vena cava obstruction and is commonly caused by cancer.

3) Bone pain
Discomfort ranging from a dull aching sensation to shooting pain is a common complaint of patients with bone cancer. As the cancer grows, the irritation will be  more consistent and will likely interfere with common movements such as walking or lifting.

4) Muscle weakness
We're all guilty of missing our exercises sometimes. However, if you find it difficult to do daily tasks like pick up a large book or get out of bed, this may be a threat of cancer- especially when paired with exhaustion and swelling. For e.g., lung cancer can spur muscle disorders around the hip area causing balance issues.

5) Fatigue
Who doesn't get a little tired these days? Although, long-term weakness and exhaustion could be more serious than you think. Paired with pain, nausea or vomiting, could mean cancer or other diseases. Simply be mindful of fluctuating energy patterns.

6) Weight loss
If you see your pant size shrinking without a change of diet, workout routine or lifestyle, you may want to guess the cause. Cancer cells use a bulk  of the body's main energy supply and may even begin to change the way your body creates energy or protein, causing you to lose weight at a rapid pace.

7) High calcium levels
Hypercalcemia, or high levels of calcium in the blood, is both a sign and a consequence of multiple cancers- ranging from breast to lung cancers. This symptom can be diagnosed through blood tests by your doctor.

8) Bloating
Bloating is completely normal every now and then, but paired with other side effects like abdominal pain, trouble eating, or extreme fatigue, it is recommended to consult your doctor, especially when these signs are consistent. Many of these symptoms can be mistaken for that time of the month, however, it is always better to be safe than sorry as these are common signs of ovarian cancer.

9) Stomach pain
Stomach aches tipped off a number of people to liver tumours and stomach cramps or frequent upset stomachs may indicate colorectal cancer. Most patients with early stage stomach cancers have no symptoms so, " listen" to your body when you feel anything out of the ordinary.

10) A lingering cough
Not only is a persistent cough exhausting and downright annoying, but it can be a serious risk to your health. If your coughing continues for months at a time, it is likely caused by bronchitis, pneumonia, or post-nasal drip, but do bring this to your doctor's attention as a relentless cough  can be a sign of lung cancer.

11) Heartburn
Frequent heartburn episodes or a consistent dull pains in the chest area eating can mean esophageal cancer, so always connect with your doctor for a screening to double check.

12) Painful periods
Many women reported unusually heavy and painful periods or bleeding between periods ( otherwise known as spotting) as the tip-off to endometrial or cervical cancer. Abnormal cycles isn't out of the norm, but it's wise not to wait for symptoms to exacerbate if you feel they're interfering with you day-to-day activities.

13) Sore chest
This symptom is not to be confused with PMS. In women, breasts that appear red or purplish in colour or feel hot , swollen, or irritated can mean inflammatory breast cancer, but we recommend being conscious of apparent bodily changes like this.

14) Swallowing problems
Difficulty swallowing or eating is commonly associated with esophageal or throat cancer, but can also be one of the first signs of lung cancer. A hoarse voice or strong pressure in the throat can be an early sign of thyroid or laryngeal cancer.

15) Wheezing
One of the first signs of lung cancer patients  remember is the inability to catch their breath or a whistling noise while breathing. Thyroid cancer can also cause breathing problems paired with throat pain.

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WHAT IS NERVE PAIN, CAUSES, TREATMENTS

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How Nerve Pain Feels
People with nerve pain feel it in different ways. For some, it's a stabbing pain in the middle of the night. For others, symptoms can include a chronic prickling, tingling, or burning they feel all day.
Uncontrolled nerve pain can be hard to bear. But with treatment, it can often be adequately controlled.

Understanding Nerve Pain
Pain is supposed to be a warning. When your hand gets too close to a stove, the nerves send a pain signal to the brain -- and you pull back before you burn yourself. But if you have nerve damage, that system isn't working. Damaged nerves may send false signals -- and you feel real pain, often without a cause. Damaged nerves may also result in you not feeling pain when you have an injury.

Nerve Pain Triggers
Some find that certain body positions or activities -- like standing in line or walking -- become painful. Nerve damage may also make your body overly sensitive. Some people may experience pain from bed sheets draped lightly over the body.

Loss of Feeling
Nerve damage may cause loss of sensation or numbness in the fingertips, making it harder to do things with your hands. Knitting, typing, and tying your shoes may become difficult. Many people with nerve damage say that their sense of touch feels dulled, as if they are always wearing gloves.

Nerve Pain and Sleep
Nerve pain is often worse at night. The touch of sheets or the pressure of lying down may be terribly uncomfortable. If you can't sleep because of your nerve pain, make sure to mention it to your doctor. Modifying lifestyle habits or taking medicine could help.

Losing Balance
In addition to dulling your sense of touch, nerve damage can result in muscle weakness or affect your sense of balance. Either of these could lead to falls.  Assistive devices -- like braces, canes or walkers -- may help. Physical and occupational therapy may also help.

Unseen Injuries
Nerve damage doesn't just cause pain. It may also cause numbness that may prevent you from feeling pain when it matters. People with nerve damage sometimes injure themselves without realizing it. Your doctor may recommend that you check yourself for injuries regularly -- especially your feet.

Nerve Pain Progression
Left untreated, nerve damage may worsen over time. It usually starts in the nerves farthest from the brain and spinal cord -- like those in the feet and hands. Then it may move up into the legs and arms.
However, if you get treatment for the medical condition causing the nerve damage, you may be able to stop the damage -- and even reverse it.

Assessing Your Pain
In many cases, nerve pain may be controlled. Start by getting an assessment at the doctor's office. Be ready to answer questions. How long have you had pain? What does it feel like? How does it affect you? The answers will help your doctor figure out what's causing your pain and how to treat it.

Conditions That Cause Nerve Pain
Many conditions -- such as diabetes, shingles, and cancer -- may cause injury and nerve pain. Some people develop nerve pain for no known reason.
It is important to try to find the underlying cause of your nerve pain, such as uncontrolled diabetes, and seek appropriate treatment for it. It may help ease your pain and stop the progression of damage. But be sure you seek treatment for your pain too.

OTC Treatments for Nerve Pain
Over-the-counter painkillers may be the first treatment your doctor recommends. These may include nonsteroidal anti-inflammatory drugs (NSAIDs) -- such as ibuprofen -- or other analgesics, such as acetaminophen or prescription medicines. Other options include painkilling creams, ointments, oils, gels, or sprays that are used on the skin.
 
Medicines for Nerve Pain
There are many prescription medicines that may help with nerve pain. Some are powerful painkillers. Other drug types might help too. Medicines originally used for depression and epilepsy are often prescribed to relieve nerve pain.

Supplements and alternative treatments for Nerve Pain
Complementary or alternative treatments may help. For instance, studies have found that acupuncture may ease nerve pain. In some cases, nerve pain is caused or aggravated by a deficiency of vitamin B-12. Taking supplements -- under your doctor's care -- could help.

Taking Control of Your Health
In addition to working with your doctor to find treatment that works, you can take other steps to fight chronic pain. Getting regular exercise, keeping a healthy weight, and improving your diet may help.

Ultrasound speeds up healing among diabetics

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FOR CROCHET DESIGNS- http://My Crochet Creations.blogspot.com/Healing times for skin ulcers and bedsores particularly among diabetics and the elderly can be reduced by a third with the use of low-intensity ultrasound, a study says.

The low-intensity ultrasound that transmits vibration through the skin and wakes up cells in wounds, helps to stimulate and accelerate the healing process.

The ultrasound treatment also reduces the chance of wounds getting infected, and is particularly effective when treating diabetics and the elderly.

"Using ultrasound wakes up the cells and stimulates a normal healing process because it is just speeding up the normal processes, and the treatment does not carry the risk of side effects often associated with drug treatments," said lead author Mark Bass of the Centre for Membrane Interactions and Dynamics (CMIAD), University of Sheffield.

A quarter of diabetics suffer from skin ulcers, particularly foot ulcers, due to the loss of sensation and circulation in the legs.

"Skin ulcers are excruciatingly painful for patients and in many cases can only be resolved by amputation of the limb," Bass said.

The study appeared in the Journal of Investigative Dermatology.

"Now that we have proven the effectiveness of ultrasound we need to explore the signal further," Bass said adding, "the ultrasound signal we currently use is effective, but it is possible that by refining the treatment we could improve the effects even further."

"Because ultrasound is relatively risk free we could expect to see it in broad clinical use within three or four years," Bass said.