(CNN)California coffee shops may soon be forced to warn customers about a possible cancer risk linked to their morning jolt of java.
(CNN)California coffee shops may soon be forced to warn customers about a possible cancer risk linked to their morning jolt of java.
Two weeks ago, White House physician Ronny Jackson issued a highly anticipated statement on President Donald Trumps health following a complete physical exam. Trump, Jackson claimed, is in excellent health with no concern of physical or cognitive decline.
Jackson also revealed that, in addition to cholesterol medication and a multivitamin, the president pops the oral supplement finasteride (often sold as the brands Propecia, Propecia Pro-Pak, and Proscar) to treat male-pattern baldness. While the use of finasteride to help prevent male-pattern baldness is not newit was first approved for treating prostate enlargement in 1992 before being rebranded and sold in 1997 as a hair-loss drugit has come under fire in recent years for its supposed extreme side effects. In 2015, Merck, the drugs manufacturer, was hit with multiple class-action lawsuits alleging the drug caused severe sexual and emotional side effects.
According to Dr. Nikki Hill, a board-certified dermatologist and hair-loss specialist based in Tucker, Georgia, using finasteride in FDA-approved doses (1 milligram) is not harmful for the vast majority of her patients.
About 2 percent of men in their twenties have sexual side effects, Hill told The Daily Beast. Occasionally, Hills patients will report decreased sperm volume after taking the drug and sometimes even bouts of depressionbut that side effect is thankfully rare, Hill says. Ive had maybe three people in six years tell me that they feel a little more depressed, but they dont know if its circumstantial or due to taking the medicine. I end up taking them off it [if they report depression] just to make sure. The FDA lists depression as a possible side effect of finasteride on its website (PDF).
Finasteride works by blocking an enzyme that converts testosterone to dihydrotestosterone, or DHT. Paradoxically, DHT is the hormone responsible for sexual function and hair growth earlier in life. But as men age and their testosterone decreases, an imbalance of testosterone and DHT can actually cause hair follicles to shrink, inhibiting new hair growth.
In the past few years, however, a growing number of patients are reporting severe neurological side effects after taking finasteride so many that the National Institutes of Health (NIH) recognizes Post-Finasteride Syndrome on their list of genetic and rare diseases. Patients suffering from so-called Post-Finasteride Syndrome have reported mental and neurological side effects, like depression, suicidal ideation, anxiety, and impaired memory, and have reported such symptoms even after several months of discontinuing the drug. But these claims make little sense to most dermatologists.
Finasteride has a very short half-life, said Dr. Nicole Rogers, a board-certified dermatologist and assistant clinical professor of dermatology at Tulane University. The drug is fully metabolized within a week, so for people with Post-Finasteride Syndrome to be reporting decreased libido and brain fog, and having it continue despite stopping the drugfrom a neurological perspective, we dont really understand why that would be.
According to Rogers, finasteride is one of the most potent drugs on the market, and only one of two FDA-approved methods for hair loss (minoxidil, or Rogaine, being the other). While Rogaine needs to be applied to the hairline topically, finasteride is generally taken as an oral medication, which patients prefer since Rogaine can leave them looking greasy. Whats more, finasteride is typically much more effective. It can be a miracle medicine for people who take it, said Rogers, though she cautions that if patients are already prone to anxiety, depression, or have a family history of erectile dysfunction, this may not be the treatment for them.
In addition to possible sexual and neurological side effects, increasing the risk of high-grade prostate cancer may also be a concern.
Nobody who has a strong family history of prostate cancer should go on this medicine, Hill said. And if they do, they need to be closely monitored. According to Hill, doctors are able to screen patients for prostate cancer by checking the level of a chemical called PSA, or prostate-specific antigen, in the bloodstream. Finasteride, however, has been shown to artificially lower the numbereven when prostate cancer is present.
If youre taking finasteride, let your doctor know, and have digital rectal exams to assess prostate cancer, rather than a blood test, Hill suggested. If theres a family history of prostate cancer in my patients, I find other alternatives [to finasteride] because theyll be tested at a younger age, and their PSA levels are very important.
(CNN)When the end draws near, Dr. Roger Kligler, a retired physician with incurable, metastatic prostate cancer, wants to use a lethal prescription to die peacefully in his sleep. As he fights for the legal right to do that, an influential doctors group in Massachusetts has agreed to stop trying to block the way.
Nick Papadopoulos tracks down tumors for a living. Not with X-rays or CT scans, but with DNA. The oncologist and director of translational genetics at the Johns Hopkins Kimmel Cancer Center has spent decades uncovering the unique sets of mutations that define cancers—the kind of genetic signals that not only drive tumor formation and metastasis, but distinguish one cancer from another. And now, he’s working to develop a test that could sniff out those signals before a patient starts to get sick.
It’s the kind of test that Papadopoulos thinks could have saved his uncle’s life, had it been around a few years ago. “He had no symptoms until a cough showed up,” he says. But when it didn’t go away he went in for an X-ray, and there on the radiograph were the lesions. Dozens of them, filling his entire chest cavity. The doctors sequenced the tumors, and got him signed up for a clinical trial for a new, targeted drug. It worked for a few of them, shrinking them back to almost nothing. But the rest developed resistance.
“He was supposed to only live two months, and the drugs prolonged his life by a year. But that year wasn’t good.” says Papadopoulos. “I think it’s time to start thinking more about detecting cancers early and less about treating them when they are late.”
On Thursday, Papadopoulos’ research group at Hopkins revealed a novel blood test based on the combined analysis of DNA and proteins that correctly detected eight kinds of the most common cancers with a range of accuracies—from 98 percent for ovarian cancers to less than 40 percent for breast cancers. Published in Science, the test is just one among many so-called “liquid biopsies” in development; noninvasive tests that classify cancers by identifying the tiny bits of DNA that tumors shed into the bloodstream.
Most published studies, including this one, focus on measuring and monitoring advanced tumor stages. A few liquid biopsies have even been approved to help match tumors to targeted drugs. But the dream is to develop a simple blood test to actually diagnose solid tumors in healthy-looking people. The scarcity of circulating cancer biomarkers (both in quality and quantity; tumor DNA makes up less than 0.1 percent of blood) has held those aspirations back for decades. But now, sensitive assays and computational platforms are driving the discovery of biomarkers and better ways to measure them, luring a pack of well-financed startups into the field.
In 2016, for example, the world’s largest sequencing company, San Diego-based Illumina, spun out a new company called Grail. Its mission is described as “detecting cancer early, when it can be cured.” This ambitious aim is supported by $1.2 billion of venture capital Grail raised last year, which it intends to put toward financing massive, population-based clinical studies and optimizing its sensitive sequencing technologies.
Grail has yet to publish any actual data (its website does advertise a commentary published in Cell last year). And neither has its chief rival in the Valley, a machine learning startup called Freenome. That three-year old company snagged a $65 million Series A last March, led by Andreessen Horowitz. Freenome isn’t limiting itself to the genetic breadcrumbs left by tumor cells—it looks to capture other disease signatures in the blood, like how the immune system changes in response to tumor microenvironments.
Of course, Freenome has offered scant details on how exactly that kind of test would work. “You show your cards at the end, not while you’re playing poker,” says Andreessen partner Vijay Pande, who heads the investment firm’s biofunds. “Publications indicate that you’re not interested in building a company.” That said, he does expect Freenome to publish in a peer-reviewed journal ahead of its first foray into the market.
When that could be, though, is anyone’s guess. To evaluate any of these blood screens, thousands of patients will have to get tested—and then researchers will have to wait for some of them to actually get cancer. That’s the only way to determine not only their predictive power, but also whether they lead to improved patient outcomes. The noninvasive screening tests available today—mammography for breast cancer, a protein-measuring test for prostate cancer—are rife with their own issues. Incorrect diagnoses waste time and money on treatments and burden patients with unnecessary anxiety.
Liquid biopsy is likely to be beset by the same kinds of controversy, says Geoff Oxnard, a thoracic oncologist at the Dana-Farber Cancer Institute and a professor at Harvard Medical School. He routinely uses a single-gene liquid biopsy developed at Dana Farber to figure out which drugs represent the best options for his lung cancer patients. But will early detection versions one day be part of routine doctor’s visits? “No. I think these tests will help us better understand the risks for patients who already have a history of cancer in their family or who’ve already had something show up on a scan,” he says. “But I don’t think we have the kind of data we need to support liquid biopsy as a panacea for diagnosing cancer. At the end of the day, it’s still just a shortcut.”
Still, Oxnard pointed out that Papadopoulos’s test represents an important step forward. One, it starts to identify where a tumor might be located. That’s been a big limitation of liquid biopsies; OK, you’ve found cancer, but what do you do next? Where do you look for the tumor? Most mutations don’t tell you anything about location. But by layering in measurements for 31 additional proteins to their machine learning model, the Hopkins team was able, on the first try, to correctly identify the tissue of origin around 80 percent of the time colorectal cancers, pancreatic, and ovarian cancers.
The other advance is cost. Papadopoulos estimates the test could be commercialized for around $500, and cancer-spotting approaches that rely on ultra-deep sequencing could stretch costs for existing screening tests, which only look for a single gene. “This is great for the field and provides promise that these analyses will become a reality in the clinic,” says Victor Velculescu, an oncologist and colleague of Papadopoulos’ at Johns Hopkins, who has also developed liquid biopsy technologies, though he was not involved in the Science study.
The two have developed a sort of friendly turf war as they’ve turned Baltimore into its own little liquid biopsy hub. Both researchers have recently spun off diagnostics companies to further develop their own early detection technology platforms. Earlier this month, Velculescu’s venture, Personal Genome Diagnostics, hauled in a $75 million Series B led by pharma giant Bristol-Myers Squibb. That brings its total financing to $99 million, putting it on par with some of its better-known counterparts in the Valley, adding some bicoastal intrigue to the race to the market. Whatever the outcome, it’s patients who will ultimately be the winners.
“If it can even catch 50 percent of cancers that right now we have no way of screening for, that’s still 50 percent of patients who can now be treated in Stage 1, when they still have a chance,” says Papadopoulos. “It doesn’t have to be perfect to still save a lot of lives.”
Maybe you've heard of Crispr, the gene editing tool that could forever change life. So what is it and how does it work? Let us explain.
(CNN)President Donald Trump had a physical examination Friday at Walter Reed National Military Medical Center in Bethesda, Maryland. The exam was conducted by US Navy Rear Adm. Dr. Ronny Jackson, the same physician who performed President Barack Obama’s last two physicals while in office.
Tobacco companies have delayed correcting false statements for eleven years since a federal court ordered them to do so
Eleven years after a federal court found tobacco companies conspired to deceive the American public, the companies will air television and newspaper ads to correct lies they told over the course of the 20th century.
The corrective statements to be aired beginning 26 November are part of a 2006 judgment against tobacco companies, which found companies such as RJ Reynolds and Philip Morris broke anti-racketeering laws, lied about how cigarettes harmed health and denied their efforts to market cigarettes to children.
After the judgment, tobacco companies appealed over details of the statements for more than a decade, and delayed correcting false statements into a new media era.
Four in 10 Americans now regularly get news online, where tobacco companies will not have to publish any corrective statements.
The tobacco companies basic strategy for everything, whether its science or regulation or litigation, is delay, said Stan Glantz, an expert on tobacco company strategy at the University of California San Francisco. The school is also home to one of the worlds largest libraries of tobacco company documents, a cache collected from lawsuits like the one decided in federal court in 2006.
They have used a lot of arguing about what in terms of the real world are trivial issues, to delay having to make these statements for 11 years but it is what the tobacco companies do, said Glantz.
The problem is the technology has moved on, and the statements are not in social media because it didnt really exist back then. But better late than never.
Tobacco companies were first ordered to make the statements by US district judge Gladys Kessler, who wrote in a 1,683-page opinion in 2006 that the companies caused, a staggering number of deaths per year, an immeasurable amount of human suffering and economic loss, and a profound burden on our national health care system.
About 480,000 Americans still die each year from tobacco-related disease, and lung cancer is the leading cause of cancer death for both American men and women. Each year, more people die of lung cancer than die of breast, colon and prostate cancer combined.
In appealing against publication of corrective statements, tobacco companies argued against specific words in statements, fonts and even the phrase here is the truth.
The ads will run in more than 50 newspapers across the country and on major broadcasting networks, including ABC, CBS and NBC. Companies will have to buy full-page ads in the first section of each Sunday newspaper, and a total of 260 television ads will be run for one year.
To promote their products, tobacco companies still spend roughly $1m per hour in America, or $8.2bn per year, on advertisements in convenience stores, discounts, coupons, at adult entertainment venues and through wholesalers.
Additionally, unlike in much of Europe, American cigarettes do not display graphic warnings on packs following appeals by tobacco companies and delays from the US Food and Drug Administration.
Male-pattern baldness and premature greying are associated with a greater risk of heart disease before the age of 40 than obesity, according to a new study from India. Does this mean that doctors should be screening our hairline alongside traditional risk factors such as our weight and blood pressure?
(CNN)Selective androgen receptor modulators, known as SARMs, are pharmaceutical drugs that mimic the effects of testosterone. Not yet approved by the US Food and Drug Administration, these compounds are often marketed to bodybuilders online as “legal steroids” that can help them look leaner and more muscular.
Film-maker James Cameron and environmentalist Suzy Amis Cameron writes that to preserve Americas majestic national parks, clean air and water for future generations leaders must be pressed to address foods environmental impact
Our collective minds are stuck on this idea that talking about foods environmental impact risks taking something very intimate away from us. In fact its just the opposite. Reconsidering how we eat offers us hope, and empowers us with choice over what our future planet will look like. And we can ask our local leaders from city mayors to school district boards to hospital management to help, by widening our food options.
On Monday and Tuesday, the city of Chicago is hosting a summit for the Global Covenant of Mayors for Climate and Energy to discuss climate solutions cities can undertake. Strategies to address and lower foods impact should be front and center.
Animal agriculture is choking the Earth, and the longer we turn a blind eye, the more we limit our ability to nourish ourselves, protect waterways and habitats, and pursue other uses of our precious natural resources. Raising livestock for meat, eggs and milk generates 14.5% of global greenhouse gas emissions, the second highest source of emissions and greater than all transportation combined. It also uses about 70% of agricultural land, and is one of theleading causes of deforestation, biodiversity loss, and water pollution.
On top of this, eating too much meat and dairy is making us sick, greatlyincreasing our risk of heart disease, type 2 diabetes, several major cancers (including breast, liver and prostate) and obesity. Diets optimal for human health vary, according to David Katz, of the Yale University Prevention Research Center, but all of them are made up mostly of whole, wholesome plant foods.
So what gives? Why cant we see the forest for the bacon? The truth can be hard to swallow: that we simply need less meat and dairy and more plant-based options in our food system if were to reach our climate goals.
In recent years, the scientific community has come to think about cancer — and cancer treatment — differently.
Whereas in past decades, cancer was diagnosed, classified and treated according to the specific types of tissues it affected — breast cancer, for example, has traditionally been treated with drugs developed specifically for tumours in the breast — modern medicine takes a decidedly more personalised approach.
Today, explains Dr Warren Kaplan, the Chief of Informatics at the Garvan Institute of Medical Research, cancer is thought of as a disease of DNA, rather than something that easily fits into “buckets” based on where in the tissue it originates.
“The three billion base pairs that make up our DNA — our genome — make each and every person in the world unique,” says Kaplan. “But this is also what makes each person’s cancer unique.”
By understanding a patient’s genome, doctors can determine the specific combination of drugs that will best suit their patient.
Researchers and scientists at Garvan and all over the globe are working to decode and sequence genomes in order to investigate the genetic makeup of cancers. The end goal, Kaplan explains, is to deviate from a “one size fits all” approach to treatment options. Once genomes are sequenced, it becomes easier for doctors and scientists to construct tailored treatment programs based on patients’ individual genetic profiles.
The benefit of this approach to treatment is twofold, says Kaplan.
“First, tumours with certain genetic profiles may respond to certain anti-cancer drugs better than others,” he says, citing an example of a pancreatic tumour that responds better to a drug traditionally prescribed for breast cancer. “Secondly, this information can also help tailor a patient’s treatment plan. By understanding a patient’s genome, doctors can determine the specific combination of drugs that will best suit their patient and avoid any harmful side effects.”
One of the obstacles to this approach, however, is the sheer amount of data it takes to sequence a single person’s genome: about 500 gigabytes. That’s equivalent to streaming about 100 HD movies.
In order to lend a hand – and a byte – Vodafone Foundation has released a mobile app, DreamLab, that crowd-sources data from willing donors. All users have to do is download the app (which is now available on iOS and Android), select a project they want to contribute to, and then charge their phone as they do normally. The app then goes to work downloading small bits of information from the cloud, which helps fuel cancer research such as the work being done by Garvan.
To date, users around the world have taken up the night shift as a ‘cancer researcher,’ and “crunched” about 70% of the first research project, which focuses on comparing genetic profiles of patients with four types of cancer (breast, ovarian, prostate and pancreatic). DreamLab now has 165,000 active users – the more people that use the app, the faster researchers can complete projects which lead to discoveries.
Kaplan has high hopes that this data holds at least a few of the answers for solving cancer.
“We hope that in the future, those diagnosed with cancer will have their genomes sequenced and compared to this library, so that they can benefit from much more effective and accurate assessments of their illness,” he explains. “This way, doctors will be able to develop customised treatment plans that are known to be effective for a patient’s specific genetic profile.”
Disclaimer: Downloading DreamLab uses data. DreamLab can be used when your device is charging and has mobile network or WiFi connectivity. Mobile data to use DreamLab is free for Vodafone Australia customers on the Vodafone Australia network. Roaming incurs international rates.