New cancer test isn’t ready for prime time

(CNN)A simple blood test to detect cancer early. How great is that?

A widely reported study in the journal Science described a liquid biopsy test — CancerSEEK — which combined measuring eight tumor biomarkers with testing for pieces of DNA with cancer associated mutations in 16 genes.
It’s not one test; it’s a battery of tests. And while collecting the blood may be simple, the subsequent analysis is extraordinarily complex.
    The task at hand is particularly challenging. We all have pieces of DNA in our blood. Distinguishing the tumor DNA from the background DNA requires finding the mutations specifically associated with cancer.
    Adding to the complexity, healthy individuals can have mutations. To avoid labeling innocuous mutations as cancerous requires a bunch of statistical fine-tuning.
    In other words, there are a lot of steps in a liquid biopsy and much potential for things to go awry.
    To their credit, the CancerSEEK investigators were very forthright that the study conditions were ideal for the test to accurately detect cancer. The liquid biopsy simply had to discriminate between patients with known cancer (the majority of whom had symptoms) and healthy individuals. And the statistical fine-tuning was tailored to the study participants — with the knowledge of who had, and who did not have, cancer.
    Although the test was able to detect most of the late-stage cancers, it detected less than half of the stage 1 cancers.
    But doctors don’t screen to find advanced cancer, we screen to find early cancer. And we don’t screen people with symptoms of cancer, we screen people who don’t have symptoms of cancer.
    There’s no doubt that there would be more detection errors in the less controlled environment of the real world.
    Just how often was made clear in a recent JAMA-Oncology study. Forty patients with metastatic prostate cancer received liquid biopsies to tailor therapy in real time to the genetics of their spreading tumors. That’s the vision for precision medicine.
    But the investigators added a little twist. They wanted to know whether it mattered which lab the liquid biopsies were sent to. So they sent each patient’s blood for two different commercial liquid biopsies: Guardant360 and PlasmaSELECT. Both tests were designed to detect mutations in the same genes.
    Yet in over half of the 40 patients, the tests gave different answers about which mutations were present. Different liquid biopsy tests give different answers in a majority of patients? That’s not precision, that’s awful.
    Sure, the analyses of liquid biopsies will improve. But if this much confusion exists about what mutations are present in the blood of patients with metastatic cancer (who have a lot of tumor DNA), imagine the uncertainty that will exist for asymptomatic individuals not known to have cancer — the very people who would be screened.
    And then there is the question of what to do with a positive result. This is very different than detecting a concerning lung nodule on a screening chest CT scan or a concerning breast mass on a screening mammogram. In these cases, it’s clear what to do to get a definitive answer: surgically biopsy the nodule or the mass. But with a liquid biopsy, the anatomic location of a cancer can be a mystery. It may not even be clear what organ the cancer is in.
    Imagine what this might mean for a patient: A doctor says, “It looks like you have cancer, but we are not sure where.”
    Even if there is certainty that the cancer is in, say, the liver, doctors may not know where in the organ. What to do then? Randomly biopsy different parts of the liver?
    This is doubly concerning when screening average-risk individuals, because most positive results are expected to be false alarms. We typically learn that a screening test is falsely positive because a surgical biopsy is normal. But absent the knowledge of where to biopsy, how can we ever be sure a positive liquid biopsy is wrong?
    Doctors won’t know where to look, but we will keep looking. Liquid biopsies are a recipe for more health anxiety, more procedures, more complications and more overdiagnoses. Not to mention, more out-of-pocket costs for our patients.
    Of course, we should continue to study liquid biopsies. The detection of circulating tumor DNA may ultimately prove useful in selected settings, such as tailoring therapy for aggressive cancers that are rapidly mutating. But the real enthusiasm is for screening average-risk individuals.

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    One reason is obvious: there is a lot of money to be made. A Goldman Sachs video estimated the potential liquid biopsy market to be $14 billion annually, adding “and we’re just at the beginning.” That kind of money doesn’t come from testing the few patients with aggressive cancer, that comes from screening millions of people.
    And there is a less obvious reason: it is easier for a new test to pass regulatory muster than it is for a new drug. While the FDA has a longstanding mandate to protect us from snake oil treatments, this often doesn’t extend to snake oil testing.
    The enthusiasm for finding things that might benefit people in the future ignores the fact that doing so can cause people to have problems now. In short, a bad test can do as much damage as a bad drug. Worrisome liquid biopsies will start a cascade of subsequent, not-so-simple tests and procedures. People will be hurt in the process.

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    ‘My sister died of lung cancer but never smoked’

    Image copyright Julie Brown Harwood

    In December my younger sister Sarah died of lung cancer, two years after first being diagnosed.

    She had led an admirably healthy life, didn’t drink and had never smoked.

    The disease seemed to come out of nowhere, shattering the life of a brilliant and much loved mum, wife and writer.

    Sarah had been working on a historical novel for the past eight years and her death meant that she missed its publication by a few days.

    Before her illness I knew very little about lung cancer and probably shared the common view that it was a smoker’s disease.

    I had no idea how many healthy people who had never smoked got it, and how in the UK it kills more people than breast, prostate and pancreatic cancer combined.

    Targeted therapies

    Sarah’s cancer was caused by a non-inherited genetic mutation.

    She was treated with a number of the relatively new targeted drugs available.

    What was so frustrating was that when they worked they could shrink a tumour the size of an orange to nothing.

    But Sarah was particularly unlucky.

    With some people these drugs work well for quite some time, but the nature of her cancer meant that she burned through a number of them very quickly.

    When the drug stops working, the tumours spring back almost immediately to the size they were before – or worse.

    Like my sister, Joanna Marshall is a young mother to two children, has never smoked, and yet has stage four lung cancer because of a non-inherited fault in her genes.

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    Media captionThe UK’s biggest cancer killer

    She has also been treated with targeted drug therapies.

    “They provide a very effective stay of execution. So for me, for example, I have been on a targeted therapy for about a year which meant that I could live essentially a normal life,” she said.

    “I was very active. I could breathe properly but they don’t last for ever. The problem is that cancer tends to be one step ahead.

    “My husband – his life has completely changed and it’s not what I wanted for him; but you know, if we get through this, we’ll be so strong,” she added.

    ‘A disaster’

    According to the leading medical charity Cancer Research UK (CRUK), 98 people die of lung cancer in the UK each day – making it the country’s biggest cancer killer.

    In around 14% of cases, those who get the disease have never smoked.

    Despite this, there is no screening programme for the disease, something which the Roy Castle Lung Cancer Foundation, the UK’s only charity exclusively dedicated to lung cancer, is campaigning for.

    Cancer Research says there is no national programme in part because it is not clear that screening would save lives, the tests have risks and they can be expensive.

    Plus, there is a concern screening could cause over-diagnosis – meaning some people may have treatment they do not need.

    Dr David Gilligan, a consultant oncologist at Addenbrookes and Papworth hospitals in Cambridge, says late diagnosis is a disaster for patients.

    “It’s a massive problem because these people who are diagnosed with lung cancer and have never smoked are really quite angry that they are assumed to have smoked and they have self-inflicted this cancer… when clearly they haven’t,” he said.

    “Because of the way that the disease behaves, and that these people are not expected to be diagnosed with lung cancer, they are not high risk, they are usually diagnosed at a later stage and therefore treatment can often not be curative, which is a complete and utter disaster for them.”

    Most lung cancers are diagnosed at stage four, which means that the tumours have spread.

    Sufferers often experience no symptoms and many of them are first diagnosed when they present at Accident and Emergency departments.

    The average prognosis is 200 days but if caught early, there is up to a 73% increased chance of surviving over five years.

    The British Journal of Cancer predicts that lung cancer cases in the UK will double from 65,000 in 2010 to 137,000 in 2040 and that women will be worst affected.

    The number of women with lung cancer is expected to almost quadruple within the next 30 years, from around 26,000 in 2010 to about 95,000 in 2040.

    In contrast, the figures for men are predicted to increase by 8%, from 39,000 to 42,000 over the same period.

    However, partly due to the negative associations of smoking, lung cancer remains the poor relation in the cancer family.

    It receives a fraction of the research funding of other cancers.

    Just £708 is spent on research per lung cancer death, compared with £3,570 for breast cancer, £7,640 for leukaemia and £10,116 for testicular cancer.

    The entertainer and host of BBC TV’s “Record Breakers” Roy Castle, also a lifelong non-smoker, died of lung cancer in 1994.

    Paula Chadwick, chief executive of the Roy Castle Lung Cancer Foundation, paints a stark picture of why research and treatment is so poorly funded.

    She argues that it is almost a “Cinderella” disease, because of the stigma that comes with the idea that it might be self-inflicted.

    “A lot of patients believe that it is their fault as well,” she says.

    “But it doesn’t matter if you are a smoker, non-smoker, or ex-smoker, if you have lungs you can get lung cancer, it does not discriminate.

    “Sadly we don’t have that army of advocates or those ex-patients who can help us raise the profile because it does have poor survival rates, she adds.

    Image copyright Genetech

    A cure or effective long-term drug therapy for lung cancer in both smokers and non-smokers remains a way off.

    There will be many more cases like that of my sister Sarah before this disease, which can strike down healthy young people indiscriminately, is tackled and beaten.

    Watch Clive Coleman’s full report on the Six O’Clock News on BBC One this evening.

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    Amber Roses new luxury sex toys aim to de-stigmatize the industry

    Amber Rose this week unveiled her new line of luxury sex toys. They’ve been curated and endorsed by the sex-positive social media star herself and developed by Swedish industry luminaries Lelo.

    The partnership is a $10 million endorsement deal between Rose and Lelo. If it seems excessive, consider that last year’s Rose offering, a clitoral stimulator called the Sona, became 2017’s fastest-selling sex toy, according to Lelo. The two also partnered during one of Rose’s annual “Slutwalks,” a series of marches that protest rape culture.

    “Before I found Lelo, sex toys weren’t a big part of my life. But that’s all changed—I waited a long time to find the perfect toys for me,” Rose said in a statement. “I’m a real Lelo convert. I’m passionate about empowering everyone to embrace their bodies and their pleasure.”

    Lelo (Fair Use)

    Lelo says that only 25 percent of adults in their research admit to owning sex toys, and hopes this collection helps break down their stigma. Lelo adds that Rose is a philosophical fit and that the company needed “a partner on board that truly has her ear to the ground and literally knows what women want in today’s society when it comes to sex.”

    The “Amber Rose Toybox” includes a G-spot massager, prostate massager, remote control couples massager, a silicone vibrating ring for men, and an oral sex simulator—all sold separately, of course.

    Lelo (Fair Use)

    Last year, Lelo made headlines when 30,000 of its condoms were stolen from a Las Vegas warehouse. But the Stockholm company is thriving by turning to social media and attacking stigmas.

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    The Agony and Ecstasy of Dennis Edwards, Temptations Lead Singer and Soul Legend

    Dennis Edwards, lead singer of the Temptations from 1968 to 1977, passed away on February 2 at the age of 74. Edwards famously joined the iconic Motown group to replace David Ruffin, the bespectacled vocal dynamo whod been center stage on such classics as Aint Too Proud To Beg, My Girl and I Wish It Would Rain. Stepping into such large shoes has never been easy, but Dennis Edwards would not only sustain the Temptationshe would amplify their musical legacy.

    It was Ruffin who gave the thumbs-up for his friend Edwards to replace him in the group, even telling Edwards about the proposed hiring beforehand. Hed been performing with another Motown act, The Contours, and had been vying for a chance at stardom for years. Born in Alabama, Edwards moved to Detroit with his family when he was ten years old. He sang in his fathers church and eventually joined the gospel act The Mighty Clouds of Joy but was turned on by the growing soul sounds coming out of Detroit. And he was inspired by a legend who had crossed over.

    Sam Cookewas a gospel singer like myself and when he crossed over and started singing rock n roll, it kind of gave me the green light to go ahead and do it, Edwards told The News Times in 2004. At that time, our parents thought it was a bad thing to do. Singing rock n roll, they called it singing for the devil. But we all wanted an opportunity to compete in the music industry and that was the opportunity.

    After some false starts, Dennis landed at Motown and with The Contours. But replacing Ruffin in one of the worlds most famous musical acts was stepping up to another level.

    Edwards made his Temptations debut on the 1968 single Cloud Nine, a song that would win the group its first Grammy (and Motowns first as a label) and put them at the forefront of the burgeoning psychedelic soul movement. With producer Norman Whitfield now helming most of their hits (replacing the Tempts former main songwriter Smokey Robinson), the group was going into a more topical direction, with a funky, less ballad-driven sound that was heavily influenced by Sly Stone.

    Edwards was more than the other guy who stepped in to replace a legend. Edwards was one of the best gospel shouters in the history of soul music and one of the defining voices of the Temptations.

    The Temptations commercial run continued into the 1970sas did the personnel changes, personality conflicts, and drama. Mainstays Eddie Kendricks and Paul Williams left; Damon Harris and Richard Street joined; and Dennis began to bump heads with long-running members Melvin Franklin and Otis Williams. The group departed Motown in 1977 for Atlantic after complaints with the label over money, but Otis Williams told Edwards prior to the label move that he was out. Williams had been growing frustrated with producer Jeffrey Bowen focusing too much on Edwards as lead vocalist; Bowen had replaced Whitfield (who departed Motown in the mid-70s to start his own label) and the Temptations commercial run dried up. To Williams, Bowenand Edwardswas the cause.

    Fame had the expected effect on Dennis and hed fallen into some of the trappings. Aretha Franklin wrote her 1972 classic Day Dreaming about the Temptations singer. The two fell in love and were close to marriage but things came to a harsh end when Edwards began seeing Ruth Pointer of The Pointer Sisters. Edwards and Pointer would briefly marry but the two fell deep into cocaine addiction in the late-1970s. The drugs eventually played a role in Edwards dismissal from the Temptations. But he rejoined the group when they returned to Motown in 1980.

    Drugs were a major part of Ruffins notoriety, and it didnt help when Edwards began performing with ex-Temptations Ruffin and Eddie Kendricks, who reunited with the Temptations for the Reunion album in 1982. The reunion eventually fell apart, as Ruffins addictions made him unreliable and, soon, Edwards began missing shows as well. He would be fired from the Temptations in 1984. Following a successful solo run (which saw Edwards release the hit 1984 duet Dont Look Any Further with Siedah Garrett), he rejoined the group, only to leave again for a third and final time in 1987.

    Over the years, notable Temptations passed on suddenly. David Ruffin would die from a cocaine overdose in 1991 following a tour with Edwards and Kendricks; Kendricks from lung cancer in 1993; and Melvin Franklin fell into a diabetic coma and died in 1995. Damon Harris died of prostate cancer in 2013. Richard Street died a week later of a pulmonary embolism.

    I never imagined Id be one of the last ones standing, me and Otis, said Edwards in a 2013 interview with the St. Louis Post-Dispatch. We really got caught up in the times, and how the heck did I make it?

    We dibbled and dabbled with alcohol and drugs. But its important for people to know if you change your lifestyle and wake up, there is hope. I had a mother who prayed for me, and prayer changes everything.

    In the popular 1998 NBC miniseries The Temptations, Edwards role in the group is given minimal attention as compared to the Classic Five. The only noteworthy moment depicted the infamousand slightly apocryphalargument between Edwards and legendary songwriter/producer Norman Whitfield over the opening lines of Papa Was A Rolling Stone. The story goes that Whitfield had written the famous line It was the 3rd of September not knowing that Edwards father had really died on that day, infuriating the singer. In reality, Edwards father had passed in October.

    When [Whitfield] wrote the song, I thought he was talking about my father. I was a little upset, Edwards recalled in 2004. I got kind of perturbed about that. But when I really found out it was just a coincidence and the record did so well, I let it alone.

    That bit of lore has lingered for decades, but Dennis Edwards was more than the other guy who stepped in to replace a legend. Edwards was one of the best gospel shouters in the history of soul music and one of the defining voices of the Temptations. It was Edwards voice that carried them through their most sonically ambitious period, and it was Edwards approach that came to define the Temptations vocally throughout the 1970s and into the 1980s.

    With his death, music fans lose yet another pillar of that legendary group. But that voice is part of the fabric of American music. Dennis Edwards was soul personified. The man was nobodys footnote. He was always a headliner.

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    86% of Teens Have These Toxic Chemicals in Their Bodies

    Research published Monday in the journal BMJ Open revealed some frightening statistics about the incidence of Bisphenol A (BPA) among teenagers: 86 percent of 94 teenagers tracking their diet and submitting urine samples in a study showed evidence of BPA in their urine.

    The culprit: plastic containers and bottles that seep potentially cancer-causing chemical through food and beverages. The teenage participants attempted to reduce their exposure to BPA by avoiding fruits and vegetables packaged in plastic containers, tinned food, and meals designed to be reheated in a microwave in packaging containing BPA, according to a press statement. Welpanyone whos had a long day and wants to just nuke some food in a microwave could be getting a dose of BPA to boot.

    And while the teens were able to reduce their exposure to BPA, one author of the paper noted that its next to impossible to avoid BPA: Our students who followed the BPA-free diet reported that it would be difficult to follow it long term, because labelling of BPA products was inconsistent. They found it difficult to source and identify BPA-free foods.

    Thats the crux of a problem highlighted BPA literature for the better part of a decade: Warnings about the health effects of cancer-causing chemicals that trickle into food and beverages from common plastic household products that then enter our systemsfrom babies sucking out of sippy cups to adults storing leftovers to heat up the next day. But its a problem neither public health nor the government has figured out yet.

    Its not the first time that urine samples have shown that an overwhelming majority of people have BPA floating in their bodies. A 2003-04 survey conducted by the National Institute of Environmental Health Sciences (NIEHS) on behalf of the Centers for Disease Control and Prevention showed that 93 percent of 2,517 urine samples of people over the age of 6 had BPA in their system, primarily from food and beverage containers; for infants, breast milk was a primary source.

    But wasnt BPA labeled a bad guy nearly a decade ago, when bespoke water bottles flashed the fact that they werent made of BPA and made slinging one around in public practically cool? Yes, but the history of BPA in our plastics runs deepand continues to plague Western plastics consumption.

    Public health advocates began warning of BPAs dire effects several years ago, as bombshell study after study reported the chemical, which is used to harden polycarbonate plastics and epoxy resins, could seep into humans as they broke down. Used since the 1960s, the chemical is found in everything from plastic food storage containers to helmets to dental sealants to water bottlesproducts with high usage across all demographics, including children. BPA can seamlessly enter our bodies because its cloaked in a chemical disguise that makes it similar to estrogen. That means genes that respond to estrogen respond to BPA instead, disrupting the endocrine system and wreaking havoc in the regulation of hormones.

    Getting even a minute trace of BPA into the bloodstream isnt pretty: Once in the bloodstream, it can lead to a host of serious health issues, including affecting the prostate gland of fetuses, increased risk of high blood pressure, and hyperactivity. BPA has been connected to other, more serious diseases as well, ranging from prostate cancer and heart disease to fundamental disruptions in the endocrine system and genetic expression, according to a database of BPA studies the NIEHS maintains.

    Because of their dangerous side effects, children and pregnant women have been especially warned against using products that contain BPA. But health agencies have been slow to react to BPA outside warning Americans to be careful of exposing themselves to products. In fact, a 2008 report from the National Toxicology Program found minimal concern for females, infants, and children exposed to BPA in mammary glands (i.e., breast milk), and negligible concern for pregnant women and those who might be exposed to BPA in their workplace. Meanwhile, there was some concern about how BPA affected brain, behavior, and prostate gland development in fetuses, infants, and children at current human exposures.

    What makes sense from a consumer frontavoiding products that explicitly say they are free of BPAisnt necessarily a safe strategy.

    That leads to the latest study on BPA, which suggests that the effects are showing up in a majority of teens (who probably went through the first wave of BPA health warnings) and can lay latent until symptoms of more serious diseases show up later in life. On average, the participants in the studystudents in six southwest England aged between 17 and 19 years oldhad 1.22 ng/mL of BPA in their urine. The students were part of a public health initiative designed to see if tracking diet would help them identify sources of BPA, particularly around plastic food storage containers. The researchers not only found that 86 percent of the students showed signs of BPA in their urine, buttroublinglythat it was nearly impossible to avoid BPA in daily life due to poor labeling: We found no evidence in this self-administered intervention study that it was possible to moderate BPA exposure by diet in a real-world setting.

    What's even more worrisome is the sheer prevalence of products that contain BPA in everyday life, despite regulations not only in the United States but across the world. As the studyfrom researchers at England's University of Exeterpoints out, the European Food Safety Authority has investigated the health effects of BPA. Similarly, the Food and Drug Administration has not outright banned the use of BPA but warned in the 2008 National Toxicology Report that it had some concern for effects on the brain, behavior, and prostate gland in fetuses, infants, and children at current human exposures, along with a 108-page report that outlined the negative health effects of BPA.

    Whats more, alternatives arent exactly a safe bet. The public outcry over BPA had the plastics industry scrambling to create alternate products that were BPA-free yet helped harden plastics the way BPA did, but some early research indicated that these BPA-replacements had the ability to induce estrogenic activity, including baby bottles and sippy cups, that stressed they were BPA-free and used resins like polysterene and Tritan instead.

    So what makes sense from a consumer frontavoiding products that explicitly say they are free of BPAisnt necessarily a safe strategy, and its one that the researchers themselves ran into while working with the 94 teens, who reported that they had a hard time outright avoiding products that contained BPA.

    We found no evidence in this self-administered intervention study that it was possible to moderate BPA exposure by diet in a real-world setting, the authors noted. Furthermore, our study participants indicated that they would be unlikely to sustain such a diet long term, due to the difficulty in identifying BPA-free foods.

    The study has its limits: It focuses on fewer than 100 British teenagers in a specific region in England, and the students self-reported their own dietary restrictions.

    But the study highlights two things. First, its nearly impossible to avoid BPA in our food packaging. Second, safe substitutes arent necessarily safe. Better labeling might help, but what will ultimately make for less dismal statistics are outright bans of BPA and better-tested substitutes of plastic hardenersor better yet, avoiding them altogether with equally effective, affordable, accessible optionsthat dont make BPA the unavoidable health threat it has become.

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    Utah Billionaire Philanthropist Jon Huntsman Sr. Dies at 80

    Jon Huntsman Sr., a Utah billionaire and philanthropist, passed away on Friday at the age of 80. He made his money from founding and chairing the Huntsman Corporation, which manufactured specialty chemicals for products like the McDonald's clamshell burger containers. In the early 1990's, Huntsman was diagnosed with prostate cancer, leading to the founding of the Huntsman Cancer Institute at the University of Utah. His son, Jon Huntsman Jr., currently serves as the ambassador to Russia. Huntsman was born poor in 1937 in Idaho and for a period of his life lived with his family in a modest house without plumbing.

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    Prostate cancer deaths overtake breast cancer

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    Media caption‘I didn’t want to be a statistic’

    The number of men dying from prostate cancer has overtaken female deaths from breast cancer for the first time in the UK, figures show.

    An ageing population means more men are developing and dying from the disease.

    Prostate Cancer UK says advances in the diagnosis and treatment of breast cancer are paying off, and increased funding could benefit prostate cancer.

    The biggest cancer killers in the UK remain lung and bowel cancer, with prostate now in third place.

    The latest figures from 2015 show there were 11,819 deaths from prostate cancer compared with 11,442 from breast cancer.

    Although deaths from prostate cancer have been rising over the past 10 years or so, the mortality rate or the proportion of men dying from the disease has fallen – by 6% – between 2010 and 2015.

    For breast cancer the mortality rate has come down by 10%, meaning deaths in women are declining more quickly.

    Image copyright Prostate Cancer UK
    Image caption Gary Pettit works in the City of London

    Gary Pettit was 43 when he was diagnosed with prostate cancer, five years ago, after a routine medical through work.

    He had no symptoms – only an abnormally high PSA (prostate-specific antigen) blood test, which led to further tests and biopsies.

    Within weeks, he had a seven-hour operation at the Royal Marsden in London to remove the cancer.

    “I’m a lucky boy. I stored my sperm before the op and now we’ve got a little seven-month-old miracle baby, called Teddy. I can’t say how lucky I’ve been.”

    Gary says recovering from the surgery took quite a while and there were some side-effects which he is still getting used to – but he is clear of cancer and keen to raise awareness among other men.

    “It is still a taboo subject with men. They get shy and embarrassed, but it’s so important to get checked out.”

    ‘Tremendous progress’

    Angela Culhane, chief executive of the charity Prostate Cancer UK, said the disease currently received half the funding and half the research that is devoted to breast cancer.

    She said developing better diagnostic tests that could be used as part of a nationwide screening programme would be a priority.

    At present, there is no single, reliable test for prostate cancer – the PSA test, biopsies and physical examinations are all used.

    Men with prostate cancer can also live for decades without symptoms or needing treatment because the disease often progresses very slowly.

    What are the symptoms?

    There can be few symptoms of prostate cancer in the early stages, and because of its location most symptoms are linked to urination:

    • needing to urinate more often, especially at night
    • needing to run to the toilet
    • difficulty in starting to urinate
    • weak urine flow or taking a long time while urinating
    • feeling your bladder has not emptied fully

    Men with male relatives who have had prostate cancer, black men and men over 50 are at higher risk of getting the disease.

    Image copyright Getty Images
    Image caption Prostate cancer is the most common cancer in men in the UK

    Ms Culhane said: “It’s incredibly encouraging to see the tremendous progress that has been made in breast cancer over recent years.

    “The introduction of precision medicine, a screening programme and a weighty research boost has no doubt played an important role in reducing the number of women who die from the disease.

    “The good news is that many of these developments could be applied to prostate cancer and we’re confident that with the right funding, we can dramatically reduce deaths within the next decade.”

    Living longer

    Michael Chapman, director of information and involvement at Cancer Research UK, said: “The number of men getting and dying from prostate cancer is increasing mostly because of population growth and because we are living longer.

    “We’re dedicated to improving diagnosis and treatments for all cancers which is why we’re investing in research to help develop more treatments to give more people more time this World Cancer Day on Sunday.”

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    Trump has first presidential physical: What to know

    The results of this doctor’s appointment is of global interest. The high-profile patient? President Donald J. Trump.

    The 71-year-old president went to Walter Reed National Military Medical Center in Bethesda, Md., on Friday to undergo his first physical exam in office. Dr. Ronny Jackson, the White House physician, performed the assessment.

    “The president’s physical exam today at Walter Reed National Military Medical Center went exceptionally well,” Jackson said following the examination.

    “The president is in excellent health and I look forward to briefing some of the details on Tuesday,” he continued. 

    The physical came just one week after Trump slammed Michael Wolff’s White House exposé, “Fire and Fury,” which raised questions about the president’s mental health and fitness to run the Oval Office. The president said he considered the book a “work of fiction,” adding that Wolff’s purported hours-long interviews with him never took place.

    “Ran for president one time and won. And then I hear this guy who doesn’t know me at all, didn’t interview me for three hours, his imagination,” Trump told reporters at Camp David, a day after the book was officially released.

    When it comes to his health, Trump has always been quick to defend himself.

    “….Actually, throughout my life, my two greatest assets have been mental stability and being, like, really smart,” Trump tweeted on Jan. 6.

    During his campaign for president in December 2015, Trump released a letter from his longtime personal physician, Dr. Harold Bornstein, predicting he would be “the healthiest individual ever elected to presidency.” Now the nation is eager to find out whether or not that declaration holds true.

    Here’s what you need to know about Trump’s first physical as commander-in-chief.

    Is Trump required to have an annual physical?

    No, the president has no legal obligation to have a physical exam. It’s completely voluntary. In fact, the president isn’t even required to disclose any of his health information. He can pick and choose what’s released to the public.

    Will Trump’s physical exam results be released?

    White House Press Secretary Sarah Sanders confirmed to reporters in December that the presidential physical would be made public after Trump appeared to slur several words while addressing the nation on his decision to recognize Jerusalem as Israel’s capital.

    “The president’s throat was dry — nothing more than that,” Sanders told reporters on Dec. 7, a day after Trump’s speech.

    If so, when?

    Jackson is expected to release intitial test results during a press briefing, where he will take questions, on Tuesday, Jan. 16.

    What does the exam entail?

    Results from previous presidential physicals listed information such as height, weight, body mass index, blood pressure and cholesterol levels among other basic data.

    So, it’s safe to assume we can expect to see similar information from Trump’s test results. Trump’s physical will not include a psychiatric test, a White House spokesman said.

    The summary of former President Barack Obama’s last presidential physical, which was also conducted by Jackson in February 2016, was two pages long. It detailed Obama’s overall health, providing vital statistics, results from the physical exam of the former president’s vital organ systems, lab results and other studies. Jackson also listed medications Obama was taking at the time including Vitamin D, Nexium, nicotine gum and Malarone.

    Why does it matter?

    At least 30 percent of U.S. presidents have suffered from “significant illnesses” while in the White House, according to a 2002 report from the Journal of Medicine. The academic research notes Vice President Dick Cheney’s heart troubles, former President Woodrow Wilson’s stroke and former President Franklin Delano Roosevelt’s congestive heart failure.

    What we know about Trump’s health

    Trump’s health has been a hot topic of discussion both before and after he took office. Bornstein released several letters summarizing Trump’s health status during the 2016 presidential race.

    In the first report, made public on Trump’s campaign website, Bornstein confirmed Trump is “in excellent physical health.”

    The physician described Trump as 6’3”, weighing 236 pounds, adding he had only been hospitalized once at the age of 11 for an appendectomy.

    Bornstein provided Trump’s cholesterol, blood pressure, calcium range, testosterone and PSA level. Trump’s latest liver function and thyroid tests, colonoscopy, EKG and chest X-ray were “normal,” Bornstein wrote.

    “He takes a lipid lowering agent (rosuvastatin) and a low dose aspirin,” Bornstein wrote in the report. “He does not use tobacco products or alcohol.”

    Trump sat down to discuss the medical records on the “Dr. Oz Show,” saying he has a tremendous amount of stamina, despite being the oldest president to enter the Oval Office.

    “I would say just based on my life…I feel as good today as I did when I was thirty,” Trump told Dr. Mehmet Oz in the Sept. 2016 interview.

    Bornstein later spoke with The New York Times, telling the newspaper Trump takes a prostate drug marketed to promote hair growth.

    “He has all his hair,” Bornstein, who has been Trump’s personal physician since the 1980s, told the Times.

    Bornstein also said Trump takes an antibiotic to control rosacea, a common skin condition that causes redness and dilated blood vessels, and a statin for elevated blood cholesterol and lipids.

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    Coffee may come with a cancer warning in California

    (CNN)California coffee shops may soon be forced to warn customers about a possible cancer risk linked to their morning jolt of java.

    The state keeps a list of chemicals it considers possible causes of cancer, and one of them, acrylamide, is created when coffee beans are roasted.
    A lawsuit first filed in Los Angeles County Superior Court in 2010 by the nonprofit Council for Education and Research on Toxics targets several companies that make or sell coffee, including Starbucks, 7-Eleven and BP. The suit alleges that the defendants “failed to provide clear and reasonable warning” that drinking coffee could expose people to acrylamide.
      The court documents state that, under the California Safe Drinking Water and Toxic Enforcement Act of 1986, also known as Proposition 65, businesses must give customers a “clear and reasonable warning” about the presence of agents that affect health– and that these stores failed to do so.
      In addition to paying fines, the lawsuit wants companies to post warnings about acrylamide with an explanation about the potential risks of drinking coffee. If the suit is successful, the signs would need to be clearly posted at store counters or on walls where someone could easily see them when making a purchase.
      Raphael Metzger, the attorney representing the nonprofit, said it really wants the coffee companies to reduce the amount of the chemical to the point where there would be no significant cancer risk.
      Coffee has been much studied over the years, and research has shown that itprovides several health benefits, including lowering your risk of early death. It may reduce your risk of heart disease, multiple sclerosis, type 2 diabetes, Alzheimer’s and even some cancers like melanoma and prostate cancer. However, a review by the International Agency for Research on Cancer, a branch of the World Health Organization, found that drinking very hot beverages was “probably carcinogenic to humans” due to burns to the esophagus; there was no relation to the chemical acrylamide.
      The science on human exposure to acrylamide still needs “future studies,” according to a 2014 review of scientific research on the chemical’s relationship to a wide variety of cancers in the Journal of Nutrition and Cancer.
      In addition to coffee, acrylamide can be found in potatoes and baked goods like crackers, bread and cookies, breakfast cereal, canned black olives and prune juice, although its presence is not always labeled. It’s in some food packaging and is a component of tobacco smoke. According to the National Cancer Institute, people are exposed to “substantially more acrylamide from tobacco smoke than from food.”
      In 2002, the International Agency for Research on Cancer classified acrylamide as a group 2A carcinogen for humans based on studies done in animals. Studies done on humans have found “no statistically significant association between dietary acrylamide intake and various cancers,” according to the 2014 research review.
      A few additionalstudies have seen an increased risk for renal, ovarian and endometrial cancers; however, “the exposure assessment has been inadequate leading to potential misclassification or underestimation of exposure,” according to the 2014 research review.
      Even the studies showing cancer links between acrylamide in rats and mice used doses “1,000 to 100,000 times higher than the usual amounts, on a weight basis, that humans are exposed to through dietary sources,” the research review said.
      Humans are also thought to absorb acrylamide at different rates and to metabolize it differently than rodents, earlier research showed.
      The National Toxicology Program’s Report on Carcinogens considers acrylamide to be “reasonably anticipated to be a human carcinogen.”
      The Food and Drug Administration website says it “is still in the information gathering stage” on the chemical, but the FDA gave consumers suggested ways to cut it out of their diet. The FDA also provided guidance to the industry intended to suggest a range of approaches companies could use to reduce acrylamide levels. The recommendations are only a guide and are “not required,” according to the website.

      See the latest news and share your comments with CNN Health on Facebook and Twitter.

      California added acrylamide to its carcinogen list in January 1990, and the state has successfully taken companies to court over it.
      In 2008, the California attorney general settled lawsuits against Heinz, Frito-Lay, Kettle Foods and Lance Inc. when the companies agreed to reduce the levels of acrylamide found in potato chips and French fries.
      In 2007, fast food restaurants in California posted acrylamide warnings about fries and paid court penalties and costs for not posting the warnings in prior years.
      “We have a huge cancer epidemic in this country, and about a third of cancers are linked to diet,” Metzger said. “To the extent that we can get carcinogens out of the food supply, logically, we can reduce the cancer burden in this country. That’s what this is all about.”

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      OMG! Mitt Romney Had A Cancer Scare Last Summer!

      Mitt Romney had it pretty rough in 2017.

      The former GOP presidential candidate was treated for prostate cancer over the summer, according to an inside source.

      Related: Trump Calls His Presidency ‘Consensual’!

      The insider did not provide any additional details other than that Romney was treated surgically and his prognosis is “good,” telling CNN on Monday:

      “He was treated surgically by Dr. Thomas Ahlering at UC Irvine Hospital in California. His prognosis is good; he was successfully treated.”

      A Romney aide added that the cancer was removed surgically and did not spread beyond the prostate.

      Now with a clean bill of health, the former governor of Massachusetts is being encouraged to run for Utah Senator this year. Last week, Sen. Orrin Hatch announced he would retire from the Senate — and we’re sure Donald Trump would love to make Romney his next congressional puppet boy since that whole Roy Moore thing didn’t pan out.

      Either way, we’re glad Romney’s health is holding up… just like that beautiful head of hair!

      [Image via WENN.]

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