I was diagnosed with thyroid cancer in Nov., 1999. Surgery and radioactive iodine followed. In Dec., 2006, I found a lump in my neck that turned cancerous. Shortly thereafter, it was found to have metastasized throughout my body and to be untreatable and inoperable. I started a clinical trial with Sutent (sunitinib) since Apr., 2007.
In Nov., 2013, the tumors began growing again and I was removed from the Sutent Clinical Trial. I started a clinical trial taking of CEDIRANIB on 04/09/14.
The report, in Current Biology, lends weight to concerns about the damaging impact of shift work on health.
The
researchers said women with a family risk of breast cancer should never
work shifts, but cautioned that further tests in people were needed.
The data also indicated the animals were 20% heavier despite eating the same amount of food.
Studies in people have often suggested a higher risk of diseases such as breast cancer in shift workers and flight attendants.
One argument is disrupting the body's internal rhythm - or body clock - increases the risk of disease.
However,
the link is uncertain because the type of person who works shifts may
also be more likely to develop cancer due to factors such as social
class, activity levels or the amount of vitamin D they get.
Mice prone to developing breast cancer had their body clock delayed by 12 hours every week for a year.
Normally
they had tumours after 50 weeks - but with regular disruption to their
sleeping patterns, the tumours appeared eight weeks earlier.
The
report said: "This is the first study that unequivocally shows a link
between chronic light-dark inversions and breast cancer development."
Interpreting
the consequences for humans is fraught with difficulty, but the
researchers guesstimated the equivalent effect could be an extra 10kg
(1st 8lb) of body weight or for at-risk women getting cancer about five
years earlier.
'Definitive experimental proof'
"If
you had a situation where a family is at risk for breast cancer, I
would certainly advise those people not to work as a flight attendant or
to do shift work," one of the researchers, Gijsbetus van der Horst,
from the Erasmus University Medical Centre, in the Netherlands, said.
Dr
Michael Hastings, from the UK's Medical Research Council, told the BBC:
"I consider this study to give the definitive experimental proof, in
mouse models, that circadian [body clock] disruption can accelerate the
development of breast cancer.
"The general public health message
coming out of my area of work is shift work, particularly rotational
shift work is a stress and therefore it has consequences.
"There
are things people should be looking out for - pay more attention to your
body weight, pay more attention to inspecting breasts, and employers
should offer more in-work health checks.
"If we're going to do it, then let's keep an eye on people and inform them."
A study of long-term thyroid cancer outcomes
shows, among other findings, that moderate suppression of
thyroid-stimulating hormone (TSH), which drives the disease, may be as
beneficial as more extreme hormone suppression. Extreme TSH suppression
is associated with increased side effects including osteoporosis and
heart rhythm irregularities. Results are published online ahead of print
in the journal Thyroid.
"In these patients, if TSH levels are elevated, recurrence rates are
higher. Moderate TSH suppression tends to bring the level just below
the normal range and what we show is that heavily suppressing TSH even
further may have diminishing returns," says Bryan Haugen, MD,
investigator at the University of Colorado Cancer Center, professor and
head of the Division of Endocrine, Metabolism & Diabetes and Kern
Chair of Endocrine Neoplasms Research at the University of Colorado
School of Medicine. Haugen is also chair of a task force currently
updating guidelines that define the standard of care for the treatment
of thyroid cancer.
The international, multi-center study, which began in 1987, collected data from 4,941 thyroid cancer patients.
"This is a unique data resource," Haugen says. "Previous studies
have been limited to the small number of patients that could be enrolled
at a single center or to studies that mine data from more general
cancer registries. Because we combined the patient data from about 14
participating centers and collected the data ourselves, we have a large
set of high-quality, prospectively collected data."
For example, Haugen points out, the group could be sure that terms
like "progression-free survival" and "recurrence" were measured the same
way for every patient.
"Basically, because we built the database ourselves, we could be sure we were comparing apples to apples," Haugen says.
Additional findings include confirmation of previous, smaller
studies showing that patients with stage III and IV disease had improved
survival when treated with radioactive iodine after surgery. Also,
while the study showed that extreme hormone suppression offered no
additional survival benefit in high-risk patients, it showed that mild
suppression was useful even with low-risk patients.
"In my mind, this study might give doctors pause when prescribing
long-term, extreme TSH suppression in thyroid cancer patients. Contrary
to our results, there is evidence from previous studies that extreme
suppression may help in high-risk patients, but maybe then after a few
years, when there is no evidence of disease recurrence, this study
suggests that doctors could back off when we wouldn't have before,"
Haugen says.
In Haugen's opinion, this study shows the necessity of a
prospective, randomized control trial testing extreme versus moderate
TSH suppression in high-risk thyroid cancer patients.
###
Disclaimer: AAAS and EurekAlert! are
not responsible for the accuracy of news releases posted to EurekAlert!
by contributing institutions or for the use of any information through
the EurekAlert system.
A new study published in the journal Neurology
shows that Type 2 diabetes triggers a significant reduction in
cognitive ability within just a two-year period. The main culprits
appear to be increased tissue inflammation and decreased blood flow to
the brain.
Researchers conducted several tests on 65 participants (average age
66) at the beginning of a two-year study, roughly half of whom had
already been diagnosed with Type 2 diabetes. All of the participants
took tests to assess cognitive function and memory performance, and
underwent MRI scans and blood tests to measure blood flow and pressure,
rate of tissue inflammation, and brain volume.
The tests were repeated after two years, with the following results:
Thinking and memory test scores for participants with Type 2 diabetes
dropped 12% over the two-year period. Test scores for participants
without diabetes remained steady.
Participants with Type 2 diabetes experienced a 65% decrease in blow flow regulation.
The diabetic participants also experienced a 50% decline in
“vasoreactivity” – the ability of blood vessels to contract in response
to stimuli, a key indicator of blood vessel health.
“People with type 2 diabetes have impaired blood flow regulation,” according to study co-author Vera Novak, MD, PhD, of Beth Israel Deaconess Medical Center
in Boston. “Our results suggest that diabetes and high blood sugar
impose a chronic negative effect on cognitive and decision-making
skills.”
Negative
effects of diabetes on blood flow and blood vessel function are
well-evidenced in prior research, but this study added the dimension of
linking these effects to changes in brain function over a brief window
of time.
“These correlations provided the link between altered cerebral
vasoregulation and cognitive deterioration in participants with type 2
diabetes that can be tracked prospectively even over a relatively short
time period of 2 years,” according to the research team.
Although this was a small study that should be validated with larger
groups of participants, the results further substantiate a link between
diabetes and cognitive impairment. Previous studies have found a similar
link, including a potential link between diabetes and Alzheimer’s disease.
“Early detection and
monitoring of blood flow regulation may be an important predictor of
accelerated changes in cognitive and decision-making skills,” Novak said
in a statement.
Interesting article. I find most of what is says to be true. Many seem to doubt the existence of "Chemo Brain", but in my experience it definitely exists and is a very real problem for those of us who suffer from it.
Medically complex patients with Type 2 diabetes could benefit from seeing a specialist soon
Healthier patients do well with family doctors
St. Michael's Hospital
TORONTO, June 25, 2015 - People recently diagnosed with Type 2
diabetes and who have other serious chronic health issues have less
heart disease and lower death rates if they see an endocrinologist
within one year of diagnosis, new research suggests. Patients with Type 2 diabetes who are not as medically complex did
well when managed solely by primary care providers - a finding the
researchers called optimistic.
"This study showed that Ontario's primary care system is functioning
as it should by providing good care for the majority of newly diagnosed
patients with Type 2 diabetes," said Dr. Gillian Booth, an
endocrinologist at St. Michael's Hospital and researcher at the
Institute for Clinical Evaluative Sciences.
"With more than a million people living with diabetes in Ontario,
endocrinologists don't expect, or necessarily need, to see every
patient. We really wanted to look at who would stand to benefit from
early specialist care and should be referred as soon as possible."
The study, published online today in Diabetic Medicine,
found medically complex patients with newly diagnosed diabetes receiving
early endocrinologist care had 10 to 20 per cent lower risk of
cardiovascular events (heart attack, stroke and death from coronary
heart disease); those with at least three or more visits had 30 per cent
lower rates.
The study used Ontario health data examining almost 80,000 adults 30
and older diagnosed with Type 2 diabetes between April 1, 1998, and
March 3, 2006.
There are no specific guidelines in Canada for referring patients
with Type 2 diabetes for specialist care. Often, primary care providers
(doctors, together with nurses and dieticians) will solely manage the
care of patients with Type 2 diabetes. But Type 2 diabetes can be a
complicated condition to manage, involving a combination of diet,
physical activity and medications to control blood sugar, blood pressure
and cholesterol levels. When a patient's care becomes complex,
endocrinologists often step in. Endocrinologists are doctors who
specialize in the diagnosis and treatment of medical conditions caused
by hormone imbalances.
"The earlier we can help provide targeted care to these patients, the better," said Dr. Booth.
"Our research will hopefully contribute to the efficiency of our
health-care system, ensuring people with diabetes are living healthy
lives, as long as possible."
It's estimated 360 million people worldwide live with Type 2
diabetes, in which the pancreas does not produce sufficient insulin, or
doesn't properly use the insulin it produces. This leads to a buildup of
glucose in blood, instead of energy use.
Diabetes rates in Ontario have doubled in the last 12 years, with
one in 10 adults now living with the disease; this number rises to one
in four adults over the age of 65. The Canadian Diabetes Association
forecasts that with the aging population and dramatic rise in obesity,
one in three Canadians will live with diabetes by 2020.
###
Dr. Booth's work was funded by an Applied Health Research Grant from
the Canadian Diabetes Association and by the University of Toronto
Dean's Fund.
About St. Michael's Hospital
St. Michael's Hospital provides compassionate care to all who
enter its doors. The hospital also provides outstanding medical
education to future health care professionals in 27 academic
disciplines. Critical care and trauma, heart disease, neurosurgery,
diabetes, cancer care, cares of the homeless and global health are among
the hospital's recognized areas of expertise. Through the Keenan
Research Centre and the Li Ka Shing International Healthcare Education
Centre, which make up the Li Ka Shing Knowledge Institute, research and
education at St. Michael's Hospital are recognized and make an impact
around the world. Founded in 1892, the hospital is fully affiliated with
the University of Toronto.
About ICES
ICES is an independent, non-profit organization that uses
population-based health information to produce knowledge on a broad
range of health care issues. Our unbiased evidence provides measures of
health system performance, a clearer understanding of the shifting
health care needs of Ontarians, and a stimulus for discussion of
practical solutions to optimize scarce resources. ICES knowledge is
highly regarded in Canada and abroad, and is widely used by government,
hospitals, planners, and practitioners to make decisions about care
delivery and to develop policy. For the latest ICES news, follow us on
Twitter: @ICESOntario
Media contacts
For more information, or to arrange an interview with Dr. Booth, please contact:
