Top Cancer-Fighting Foods

Fighting Cancer by the Plateful

No single food can prevent cancer, but the right combination of foods may help make a difference. At mealtimes, strike a balance of at least two-thirds plant-based foods and no more than one-third animal protein. This "New American Plate" is an important cancer fighting tool, according to the American Institute for Cancer Research. Check out better and worse choices for your plate.

Fighting Cancer With Color

Fruits and vegetables are rich in cancer-fighting nutrients -- and the more color, the more nutrients they contain. These foods can help lower your risk in a second way, too, when they help you reach and maintain a healthy body weight. Carrying extra pounds increases the risk for multiple cancers, including colon, esophagus, and kidney cancers. Eat a variety of vegetables, especially dark green, red, and orange vegetables.

The Cancer-Fighting Breakfast

Folate is an important B vitamin that may help protect against cancers of the colon, rectum, and breast.  You can find it in abundance on the breakfast table. Fortified breakfast cereals and whole wheat products are good sources of folate. So are orange juice, melons, and strawberries.

More Folate-Rich Foods

Other good sources of folate are asparagus and eggs. You can also find it in beans, sunflower seeds, and leafy green vegetables like spinach or romaine lettuce. The best way to get folate is not from a pill, but by eating enough fruits, vegetables, and enriched grain products.

Pass Up the Deli Counter

An occasional Reuben sandwich or hot dog at the ballpark isn't going to hurt you. But cutting back on processed meats like bologna, ham, and hot dogs will help lower your risk of colorectal and stomach cancers. Also, eating meats that have been preserved by smoking or with salt raises your exposure to chemicals that can potentially cause cancer.

Cancer-Fighting Tomatoes

Whether it's the lycopene -- the pigment that gives tomatoes their red color -- or something else isn't clear. But some studies have linked eating tomatoes to reduced risk of several types of cancer, including prostate cancer. Studies also suggest that processed tomato products such as juice, sauce, or paste increase the cancer-fighting potential.

Tea's Anticancer Potential

Even though the evidence is still spotty, tea, especially green tea, may be a strong cancer fighter. In laboratory studies, green tea has slowed or prevented the development of cancer in colon, liver, breast, and prostate cells. It also had a similar effect in lung tissue and skin. And in some longer term studies, tea was associated with lower risks for bladder, stomach, and pancreatic cancers.

Grapes and Cancer

Grapes and grape juice, especially purple and red grapes, contain resveratrol. Resveratrol has strong antioxidant and anti-inflammatory properties. In laboratory studies, it has prevented the kind of damage that can trigger the cancer process in cells. There is not enough evidence to say that eating grapes or drinking grape juice or wine (or taking supplements) can prevent or treat cancer.

Limit Alcohol to Lower Cancer Risk

Cancers of the mouth, throat, larynx, esophagus, liver, and breast are all linked with drinking alcohol. Alcohol may also raise the risk for cancer of the colon and rectum. The American Cancer Society recommends limiting alcohol to no more than two drinks per day for men and one for women. Women at higher risk for breast cancer may want to talk with a doctor about what amount of alcohol, if any, is safe based on their personal risk factors.

Water and Other Fluids Can Protect

Water not only quenches your thirst, but it may protect you against bladder cancer. The lower risk comes from water diluting concentrations of potential cancer-causing agents in the bladder. Also, drinking more fluids causes you to urinate more frequently. That lessens the amount of time those agents stay in contact with the bladder lining.

The Mighty Bean

Beans are so good for you, it's no surprise they may help fight cancer, too. They contain several potent phytochemicals that may protect the body's cells against damage that can lead to cancer. In the lab these substances slowed tumor growth and prevented tumors from releasing substances that damage nearby cells.

The Cabbage Family vs. Cancer

Cruciferous vegetables include broccoli, cauliflower, cabbage, Brussels sprouts, bok choy, and kale. These members of the cabbage family make an excellent stir fry and can really liven up a salad. But most importantly, components in these vegetables may help your body defend against cancers such as colon, breast, lung, and cervix.

Dark Green Leafy Vegetables

Dark green leafy vegetables such as mustard greens, lettuce, kale, chicory, spinach, and chard have an abundance of fiber, folate, and carotenoids. These nutrients may help protect against cancer of the mouth, larynx, pancreas, lung, skin, and stomach.

Protection From an Exotic Spice

Curcumin is the main ingredient in the Indian spice turmeric and a potential cancer fighter. Lab studies show it can suppress the transformation, proliferation, and invasion of cancerous cells for a wide array of cancers

Cooking Methods Matter

How you cook meat can make a difference in how big a cancer risk it poses. Frying, grilling, and broiling meats at very high temperatures causes chemicals to form that may increase cancer risk. Other cooking methods such as stewing, braising, or steaming appear to produce fewer of those chemicals. And when you do stew the meat, remember to add plenty of healthy, protective vegetables

A Berry Medley With a Punch

Strawberries and raspberries have a phytochemical called ellagic acid. This powerful antioxidant may actually fight cancer in several ways at once, including deactivating certain cancer causing substances and slowing the growth of cancer cells.

Blueberries for Health

The potent antioxidants in blueberries may have wide value in supporting our health, starting with cancer. Antioxidants fight cancer by ridding the body of free radicals before they can do their damage to cells. Try topping oatmeal, cold cereal, yogurt, even salad with blueberries to boost your intake of these healthful berries.

Pass on the Sugar

Sugar may not cause cancer directly. But it may displace other nutrient-rich foods that help protect against cancer. And it increases calorie counts, which contributes to overweight and obesity. Excess weight is also a cancer risk. Fruit offers a sweet alternative in a vitamin-rich package.

Don't Rely on Supplements

Vitamins may help protect against cancer. But that's when you get them naturally from food. Both the American Cancer Society and the American Institute for Cancer Research emphasize that getting cancer-fighting nutrients from foods like nuts, fruits, and green leafy vegetables is vastly superior to getting them from supplements. Eating a healthy diet is best.

source:WEBMD

Does This Cause Cancer?

Artificial Sweeteners

Despite all the talk -- and chain emails -- there’s no proof that these sugar stand-ins raise your risk of cancer. Saccharine did cause cancer in rats, but their bodies react to it differently than ours, researchers say. There hasn’t been a cancer warning label on it since 2000. A study of aspartame in people found no link either.

X-rays

Your dentist covers you in a lead blanket for a reason. Even low doses of X-rays raise your chances of getting cancer, but only by a small amount. In general, the higher the dose of radiation, the more the risk. But there’s no amount of this kind of radiation that’s totally safe. That’s why the EPA limits how much you can get.

Cell Phones

This gadget, which you keep near all the time, gives off the same type of energy as X-rays. So far, it hasn’t been linked to cancer, but more research is needed. Just to be safe:

• Save it for short chats or when there’s no landline.
• Use a hands-free device.

Meat

Whether it’s processed or red, you need less of it in your life. Just one hot dog a day could boost your chances of getting colon cancer.  Luncheon meats, cold cuts, and hot dogs all have preservatives called nitrites, which cause cancer. Smoking meats or cooking them at a high temperature creates compounds called PAHs. Studies are under way to see how they affect people.

Bottled Water

If your bottle is clear plastic, it probably has bisphenol A (BPA). This chemical is used in food and drink containers, dental sealants, and other products. Does it cause cancer? The FDA says no, BPA is safe at current levels found in foods. If you’re concerned, avoid canned foods and store chow and drinks in clear plastic. For hot food, use glass or steel instead. 

Sex

It’s true. Human papillomavirus (HPV), the most common sexually transmitted infection, can cause cervical and other cancers. Most adults who have sex will get this virus at some point. But they won’t all get cancer. Most of the time, HPV goes away by itself. To lower your risk:

• Get vaccinated if you’re a female aged 11-26 or a male aged 11-21.
• Use condoms during sex.
• Have sex with only one partner.

Dental Fillings

Don’t call the dentist to have your metal filings removed and replaced. Experts say your current ones are safe. Studies have found no link between fillings with mercury and cancer -- or any other disease.

Coffee

If you feel your day doesn’t really start until you’ve had a shot of caffeine, you’ll love this. New research shows that drinking moderate amounts of coffee (around four cups daily) lessens the risk of some types of cancer, among them skin, liver, and colon.

Deodorant and Antiperspirant

Scientists say more research is needed to know for sure if these products boost the odds of breast cancer. They have different jobs -- deodorant blocks the smell and antiperspirant stops sweat. Many use chemicals that act like the hormone estrogen, which causes cancer cells to grow. These include benzylparaben, butylparaben, methylparaben, and propylparaben.

Fluoride

This compound is found in water and other drinks and in food, toothpastes, and mouth rinses. Though many studies have looked for links between it and cancer, most researchers says there’s no strong tie. If you’re worried about it, you can ask the Environmental Protection Agency how much is in your drinking water. If it’s high, switch to bottled spring water, which usually has the least.

Household Products

Many pesticides, paints, varnishes, and waxes give off gases known as volatile organic compounds  (VOCs). So do some cleaning, cosmetic, automotive, and hobby products. These gases have been linked to cancer in humans and animals. To cut your risk choose products labeled low-VOC and biodegradable when possible. Avoid items labeled as: 

• Danger/Poison
• Corrosive
• Severely Irritating
• Highly Flammable
• Highly Combustible
• Strong Sensitizer 

Power Lines

Anything that makes, sends, or uses electricity gives off extremely low frequency (ELF) radiation. There’s no proof that it causes cancer. Still, the National Institute of Environmental Health Sciences says there’s cause for “limited concern.” To be safe, stay at least an arm’s length away from electrical devices. If you live close to a power line and you're worried, get a gizmo called a gaussmeter. You can use it to measure the ELF fields near you.

Pollution

Air pollution causes over 220,000 lung cancer deaths worldwide a year (most of them in Asia). There’s also a link between dirty air and a higher risk of bladder cancer. But the odds for any one person are low. To cut your chances, listen to local smog alerts. Try to stay inside on days when the air quality is poor.

source:webmd

4 Vitamins and Minerals for Adults

Are you getting enough of the nutrients you need? You might be surprised. Many adults don't.

Four nutrients were singled out as "of concern" in the 2010 Dietary Guidelines for Americans because a lot of people aren't getting enough of them.

Are you one of them? Find out what you may be missing out on, how much you need, and how to get it.

1. Potassium

You may not hear as much about potassium as you do other nutrients, like calcium and vitamin C. But potassium is essential to managing blood pressure.

Sodium raises your blood pressure. Potassium lowers it.

"It also may improve problems with kidney stones and bone loss," says Andrea Giancoli, MPH, RD. She's a spokeswoman for the Academy of Nutrition and Dietetics.

How much you need: For most adults, the recommended daily amount is 4,700 milligrams (mg).

How to get it: The single best food source of potassium is the potato.

"A small potato has about 740 mg of potassium," Giancoli says.

Other good potassium sources include juices such as:

• Prune
• Carrot
• Orange
• Tomato

Also try eating beans, especially these types:

• White
• Lima
• Soy

You can also get potassium in some fish, such as:

• Halibut
• Tuna
• Cod

Potassium is also found in dairy products such as milk and yogurt.

2. Vitamin D

We cover up with hats, slather on sunscreen, and stay indoors to help prevent skin cancer. One unintended side effect of all this sun protection is that some people -- about 20% of the population, it's estimated -- are low in the "sunshine vitamin," vitamin D. Vitamin D works with calcium to build bone strength.

How much you need: Most adults should get 600 IU of vitamin D per day. For adults over 70, the recommendation is 800 IU.

How to get it: Large doses of vitamin D aren't naturally found in too many foods, Giancoli says.

"You can find some in fatty fish like salmon, tuna, and sardines," she says. "It's also found in egg yolks. So if you eat only the egg whites, you may miss a good source of vitamin D."

Milk and orange juice, especially fortified varieties, are also good sources of vitamin D. Another surprising source: mushrooms that are grown in the sunlight.

"You can find packaged mushrooms now that advertise 100% of the daily value of vitamin D," Giancoli says.

3. Calcium

All adults need calcium. Without enough calcium, we risk osteoporosis and bone fractures. But calcium builds more than just bones. It's also important to our nerves and muscles.

How much you need: All adults aged 19 to 50 should get 1,000 mg of calcium daily. The requirement goes up to 1,200 mg a day for women over 50 and for all adults over 70.

How to get it: Dairy products such as milk and yogurt are sources of calcium. But Giancoli says that many non-dairy milks, such as soy and almond milk, are now often fortified with calcium.

Many brands of orange juice are also fortified with calcium. Check the label.

Salmon, kale, turnip greens, and some kinds of tofu are other good dietary sources of calcium.

4. Fiber

Fiber in foods helps your digestive system and may lower your risk of heart disease and diabetes. But the average American diet isn't rich in fiber.

How much you need: Women should get 25 grams of fiber per day, and men 38 grams a day, but most people only get about 15 grams.

How to get it: Beans! Legumes are some of the best sources of dietary fiber. Some beans you can try:

• Navy
• White
• Lima
• Pinto
• Black

Most vegetables and fruits are also good fiber sources. So are whole-grain breads and pastas.

source:webmd

Side effects of copper T This article gives you the information on side effects of using or wearing copper T. All these side effects are experienced and wade away with time. Exceptions are always there and so you should get this done with the help of an experienced medical professional. Read this article and know about the probabilities of side effects and how they can be treated. Copper T is an effective contraceptive and is one of the most immensely used methods of birth control worldwide. The failure rate is considered only 1% and may be this is the reason why many women use this method to remain stress free.  Although this method is very effective and widely used, it comes with some side effects also. These side effects can be common as well as precise depending on the health of the woman as well. It is better to contact the doctor whether you and your body are in perfect condition for insertion of copper T. Side effects of Copper T Untimely Bleeding and Cramps Many women have bleeding between the menstrual cycles after the insertion of copper T. Many women report about cramps occurring, which is usually different from that experienced during menstruation. Sometimes the cramps are unbearable and the woman feels worse. The intramenstrual bleeding that occurs can subside after few months and is less than that experienced during periods. Simple pain killing medicines like ibuprofen can be taken when the cramps occur. Allergy It is only in rare conditions that any woman is allergic to copper T and that is also because of the covering of copper on the IUD device. Usually itching and rashes are seen when someone is allergic to it. The device should be immediately removed under these circumstances and a non-copper IUD can be used instead. Automatic Ejection Expulsion of copper T is not usually seen and is rare. When it is pushed out of the uterus, the woman can get pregnant. Even if this expulsion occurs it goes unnoticed. So yearly check up is must after the insertion of copper T. Cuts in the Uterus In some women, it was seen that the device perforated the uterus and emergency removal had to be done. This is very rare and one should not worry about that beforehand. If discomfort is experienced, you can contact your doctor and consult or go for check up. Chances of Miscarriage While using copper T when any woman gets pregnant, the chances ofmiscarriage are very high. This happens because the egg gets fertilized elsewhere than the uterus wall resulting in lot of complications, which in turn outcomes in miscarriage. So, if pregnancy is suspected, the woman should immediately consult her doctor and get the copper T removed. Dangers of Using Copper T Uterus gets pricked and if the copper T is not removed immediately it can move to other parts of the body. In this case the only solution left is surgical removal of the device. There can be infection in the tube and if not treated in time, it can be hazardous too. If a woman gets pregnant during wearing copper T has the risks of pregnancy outside the uterus. This is very dangerous and full of complications as well. In most cases it results in miscarriage if the device is not removed quickly. Women get pregnant while using copper T because many devices are expelled from the uterus and they come out. The woman is unaware as it is unnoticeable. Women should analyze whether they are allergic to copper T or not because this results in very serious problems. Heavy bleeding during periods and clotting between the periods are experienced for first few months. Some women continue with this problem for longer time also. It is better to get examined before and after wearing copper T and consult freely with your doctor regarding the queries source:parenting.com Side effects of the IUD are limited primarily to the uterus and include: cramps, spotting, heavy menstrual flow, infection, pelvic inflammatory disease (PID), and infertility. It is also possible for the IUD to pass through (perforate) the uterine wall and enter the abdominal cavity, where it must be retrieved surgically. Perforation of or trauma to the uterus by the IUD occurs in 1/1,000 insertions. What are warning signs and symptoms of possible complications from an IUD? Warning signs of possible complications from an IUD include: abdominal pain, heavy bleeding, abnormal spotting or bleeding, and a smelly vaginal discharge. If a woman experiences any of these signs, she should contact her health care professional. What are the types of IUDs (Paragard, Mirena, Skyla)? The TCu380A (Paragard) is a copper-containing IUD. It releases copper from a copper wire that is wrapped around the base. The released copper contributes to an inflammatory reaction in the uterus that helps prevent fertilization of the egg. It is approved to remain in place for up to 10 years.Intrauterine devices (IUDs) that are available in the US come in two different types: 1) copper-releasing, or 2) progesterone-releasing. Levonorgestrel-releasing IUD (Mirena or Skyla): This form of IUD releases a progestin hormone from the vertical part of the T. Progestin acts to thicken cervical mucus, creating a barrier to sperm, as well as renders the lining of the uterus inhospitable to implantation of a pregnancy. The two brand named IUDs in this category contain different amounts of the hormone. Mirena is approved for up to five years of use, and Skyla for up to three years. An IUD may not be appropriate for women who have heavy menstrual bleeding, had previous pelvic infections, have more than one sexual partner, or plan on getting pregnant. This is because IUDs do not protect against sexually transmitted infections (STDs) and should not be in place if a woman intends to become pregnant. If women become pregnant with their IUDs in place, 50% of the pregnancies end in miscarriage. Women who use non-progesterone types of IUDs are less likely to have anectopic pregnancy compared to women using no contraception. When a woman using an IUD does become pregnant, the pregnancy is more likely to be ectopic, but still ectopic pregnancy in a user of an IUD is a rare occurrence. Serious complications due to infection associated with an IUD may prevent a woman from being able to become pregnant in the future. Also, with the progesterone-releasing IUDs (levonorgestrel IUDs), a reduction in menstrual flow and a decrease in painful menstrual cramping are often observed with continued use. This is because the progesterone hormone can cause thinning of the lining of the uterus. These menstrual changes are not dangerous in any way and do not mean that the contraceptive action of the IUD is diminished. source: medicinenet.com

Tuberculosis (TB) facts

• TB is an infectious disease that's transmitted from person to person.
• There are many different types of TB.
• A bacterium, Mycobacterium tuberculosis, causes the disease.
• There are many risk factors for TB. Clinical symptoms and signs of pulmonary TB include fever, night sweats, cough, hemoptysis (coughing up blood-stained sputum), weight loss, fatigue, and chest pain.
• Physicians definitively diagnose TB by culturing mycobacteria from sputum or biopsy specimens, but health-care professionals presumptively diagnose TB by history, physical exam, skin testing, and chest X-rays.
• Treatment of TB infection is related to the type of TB infection and often requires extended treatments (months) with one or more anti-TB drugs.
• Complications of TB range from none to death and include lung, kidney, and liver problems that can be severe.
• The prognosis for appropriately treated TB infection is good. The prognosis declines in people who develop complications or who have had previous TB treatments.
• Prevention of TB involves both early treatment to reduce transmission and isolation of the infected person until they are no longer contagious. There is a vaccine against TB, but it is not used routinely in the U.S. because of efficacy issues and other problems.
• Tuberculosis (TB) is a multisystemic infectious disease caused by Mycobacterium tuberculosis, a rod-shaped bacterium. TB is the most common cause of infectious disease-related mortality worldwide (about 1.1 million to 1.7 million people die from it each year worldwide). TB symptoms can be so diffuse that TB is termed the "great imitator" by many who study infectious diseases because TB symptoms can mimic many different diseases. Additional terms are used to describe TB. The terms include consumption, Pott's disease, active, latent, pulmonary, cutaneous, and others (see the following section), and they appear in both medical and nonmedical publications. In most instances, the different terms refer to a specific type of TB with some unique symptoms or findings. The most common site (about 85%) for TB to develop is in the pulmonary tract. Humans are the only known hosts for Mycobacterium tuberculosis (although animals can get infected). TB has likely been infecting humans for many centuries; evidence of TB infections has been found in cadavers that date back to about 8000 BC, so the disease has a long history of infecting humans. The Greeks termed it as a wasting away disease (phthisis). For many European countries, TB caused death in about 25% of adults and was the leading cause of death in the U.S. until the early 1900s. Robert Koch discovered TB's cause, Mycobacterium tuberculosis, in 1882. With increased understanding of TB, public-health initiatives, treatment methods like isolation (quarantine), and the development of drugs to treat TB, the incidence of the disease, especially in developed countries, has been markedly reduced. There is a vast amount of detailed information available in the medical literature on all aspects of this potentially debilitating and lethal disease. The goal of this article is to introduce the reader to TB and help them to obtain a general knowledge about TB's cause, transmission, diagnostic tests, treatments, and prevention methods.

  Are there different types of tuberculosis (TB)?

  There are many types of tuberculosis, but the main two types are termed either active or latent TB. Active TB is when the disease is actively producing symptoms and can be transmitted to other people; latent disease is when the person is infected with Mycobacterium tuberculosis bacteria, but the bacteria are not producing symptoms (usually due to the body's immune system suppressing the bacterial growth and spread). People with latent TB usually cannot transfer Mycobacterium tuberculosis bacteria to others unless the immune system fails; the failure causes reactivation (bacterial growth is no longer suppressed) that results in active TB so the person becomes contagious.
  Many other types of TB exist in either the active or latent form. These types are named for the signs and for the body systems Mycobacterium tuberculosis preferentially infect, and these infection types vary from person to person. Consequently, pulmonary TB mainly infects the pulmonary system, cutaneous TB has skin symptoms, while miliary TB describes widespread small infected sites (lesions or granulomas about 1 mm-5 mm) found throughout body organs. It is not uncommon for some people to develop more than one type of active TB. More types will be listed in the symptoms and signs section below.
  
  

  What causes tuberculosis?

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  The cause of TB is infection of human tissue(s) by the bacterium Mycobacterium tuberculosis (mycobacteria). These bacteria are slow growing, aerobic, and can grow within body cells (an intracellular parasitic bacterium). Its unique cell wall helps protect it from the body's defenses and gives mycobacteria the ability to retain certain dyes like fuschsin (a reddish dye) after an acid rinse that rarely happens with other bacterial, fungal, or parasitic genera.
  Mycobacteria that escape destruction by body defenses may be spread by blood or lymphatic pathways to most organs, with preference to those that oxygenate well (lungs, kidneys, and bones, for example). Typical TB lesions, termed granulomas, usually consist of a central necrotic area, then a zone with macrophages, giant Langerhans cells and lymphocytes that become surrounded by immature macrophages, plasma cells, and more lymphocytes. These granulomas also contain mycobacteria. In latent infections, a fibrous capsule usually surrounds the granulomas, and in some people, the granulomas calcify, but if the immune defenses fail initially or at a later time (reactivate), the bacteria continue to spread and disrupt organ functions.

What are risk factors for tuberculosis?

There are many risk factors for developing tuberculosis. Certain groups of people have a high risk, such as people who work in hospitals and other areas where TB-infected people may reside (jails, nursing homes, group homes for HIV patients, homeless shelters). Close association with drug users, or people with known TB infections are also at higher risk. Other people at high risk include the following:

• Visitors and immigrants from areas known to have high incidence of TB
• Children and the elderly with weakened immune systems (especially those with a positive TB skin test, see below)
• Patients with HIV infection
• Drug abusers, especially IV drug abuse
• Head and neck cancer patients
• Transplant patients
• Diabetics
• Kidney disease patients
• People undergoing immunosuppressive therapy
• Silicosis

What are tuberculosis symptoms and signs?

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Although there are a number of TB types, pulmonary TB is responsible for the majority (about 85%) of TB infections. Consequently, pulmonary TB symptoms and signs may occur with or even before other types of TB are diagnosed. The classical clinical symptoms and signs of pulmonary TB include fever, night sweats, cough, hemoptysis (coughing up blood-stained sputum), weight loss, fatigue, and chest pain. The elderly may just exhibit pneumonitis.
Other types are loosely classified as extra pulmonary and often have symptoms that are nonspecific but frequently localized to the involved site. The following includes the signs and symptoms of additional types of TB:

• Skeletal TB (also termed Pott's disease): spinal pain, back stiffness, paralysis is possible
• TB meningitis: headaches (variable in length but persistent), mental changes, coma
• TB arthritis: usually pain in a single joint (hips and knees most common)
• Genitourinary TB: dysuria, flank pain, increased frequency, masses or lumps (granulomas)
• Gastrointestinal TB: difficulty swallowing, nonhealing ulcers, abdominal pain, malabsorption, diarrhea (may be bloody)
• Miliary TB: many small nodules widespread in organs that resemble millet seeds (hence its name)
• Pleural TB: empyema and pleural effusions
• MDR TB: patients infected with TB bacteria that are resistant to multiple drugs
• XDR TB: patients infected with TB bacteria that are resistant to some of the most effective anti-TB medications; XDR stands for extensively drug resistant

• How do physicians diagnose tuberculosis?

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  Because TB may occur as either a latent or active form, the definitive diagnosis of active TB depends on the culture of mycobacteria from sputum or tissue biopsy. However, it may take weeks for these slow-growing bacteria to grow on specialized media. Since patients with latent TB do not require isolation or immediate drug therapy, it is useful to determine if a person is either not infected, has a latent infection, or is actively infected with transmissible TB bacteria. Consequently, doctors needed a presumptive test(s) that could reasonably assure that the person was infected or not so therapy could begin. After getting a patient's history and physical exam data, the next usual test is the skin test (termed the Mantoux tuberculin skin test or the tuberculin skin test or TST). The test involves injecting tuberculin (an extract made from killed mycobacteria) into the skin. In about 48-72 hours, the skin is examined for induration (swelling) by a qualified person; a positive test (induration) strongly suggests the patient has either been exposed to live mycobacteria or is actively infected. Another test, IGRA (interferon-gamma release assays) can measure the immune response to Mycobacterium tuberculosis. Other quick tests are useful; chest X-rays can give evidence of lung infection while a sputum smear stained with certain dyes that are retained mainly (but not exclusively) by mycobacteria can show the presence of the bacterium. These tests, when examined by a doctor, are useful in establishing a presumptive diagnosis of either latent or active TB, and most doctors will initiate treatment based on their judgment of these tests. In addition, some of these tests are useful in the U.S. and elsewhere only in people who are not vaccinated with a TB vaccine (see below) but are less useful in vaccinated people. For some patients, culture studies still should be completed to determine the drug susceptibility of an infecting TB strain.
  Other tests have been developed. For example, a PCR test (polymerase chain reaction) to detect TB antigens and the LED-FM microscopic technique to identify TB organisms with microscopy may be used. Two other TB blood tests (also called interferon-gamma release assays or IGRAs) have been approved by the FDA and measure how strongly the body's immune system reacts to TB bacteria. IGRAs are recommended in testing patients who have been vaccinated against TB (see prevention section below).
  People with positive symptoms, positive blood tests, sputum smear, or culture positive are considered infected with TB and contagious. Physicians diagnose and treat people with latent TB infections (LTBI) according to the following 2013 CDC criteria:
  
• No symptoms or physical findings suggestive of TB disease
• TST or IGRA result is usually positive
• Chest radiograph is typically normal
• If done, respiratory specimens are smear and culture negative
• Cannot spread TB bacteria to others
• Should consider treatment for LTBI to prevent TB disease (strongly advised by the CDC)

• What is the treatment for tuberculosis?

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  The treatment for TB depends on the type of TB infection and drug sensitivity of the mycobacteria. For latent TB, three anti-TB drugs are used in four different recommended schedules. The drugs are isoniazid (INH), rifampin (RIF; Rifadin), and rifapentine (RPT; Priftin) and the 2013 CDC's four recommended schedules are below and are chosen by the treating doctor based on the patients overall health and type of TB the patient was likely exposed to.
  
 
 
 


  Latent TB Infection Treatment Regimens

  Drugs	Duration	Interval	Minimum Doses
  Isoniazid	9 months	Daily Twice weekly	270 76
  Isoniazid	6 months	Daily Twice weekly	180 52
  Isoniazid and Rifapentine	3 months	Once weekly	12
  Rifampin	4 months	Daily	120
  Table reproduced from the CDC; http://www.cdc.gov/tb/topic/treatment/default.htm

  First-line drugs used to treat active TB are INH, RIF, ethambutol (EMB; Myambutol), and pyrazinamide. The CDC offers a guide for the basic treatment schedules for active TB as follows:
  

  Basic TB Disease Treatment Regimens

  Preferred Regimen	Alternative Regimen	Alternative Regimen
  Initial Phase Daily INH, RIF, PZA, and EMB* for 56 doses (8 weeks)	Initial Phase Daily INH, RIF, PZA, and EMB* for 14 doses (2 weeks), then twice weekly for 12 doses (6 weeks)	Initial Phase Thrice-weekly INH, RIF, PZA, and EMB* for 24 doses (8 weeks)
  Continuation Phase Daily INH and RIF for 126 doses (18 weeks) or twice-weekly INH and RIF for 36 doses (18 weeks)	Continuation Phase Twice-weekly INH and RIF for 36 doses (18 weeks)	Continuation Phase Thrice-weekly INH and RIF for 54 doses (18 weeks)
  *EMB can be discontinued if drug susceptibility studies demonstrate susceptibility to first-line drugs; Table reproduced from http://www.cdc.gov/tb/topic/treatment/tbdisease.htm#2

  Treatment of drug-resistant TB can be difficult. Patients with these infections are recommended by the CDC to involve infectious-disease specialists as there are multiple approaches that involve other anti-TB drugs and variable treatment schedules that can be used. In addition, there are new drugs and treatment schedules being developed and approved by the FDA. The infectious-disease consultant may be aware of these newest treatments that may benefit specific patients. For example, bedaquiline (Sirturo) has been approved for treatment of MDR TB.
  In some patients, the lung destruction may be severe and the only treatment left may be surgical resection of the diseased lung tissue.

• What are complications of tuberculosis?

  Although some people may develop no complications, others range from mild to severe complications, including death. Some of the more severe complications include lung function damage, bone pain (spine, ribs, and joints), meningitis, kidney and/or liver malfunction, cardiac tamponade, and visual disturbances.
  
  

  What is the prognosis of tuberculosis?

  Comment on this Share Your Story
  For most people, the prognosis of TB is good if they complete the treatment protocols. The recurrence rate of TB is low (0%-14%) and some may be due to reinfection. Drug-resistant TB is more difficult to treat, and the prognosis is not as good. The same prognosis occurs for those patients who are immunocompromised, in the elderly, and in patients with previous infection and treatment for TB.
  
  

  How can people prevent tuberculosis?

  A vaccine against TB is commercially available; it is termed BCG, or Bacille Calmette-Guerin vaccine. However, the vaccine is not recommended for use in the U.S. because of the low risk for TB infections. Also, the vaccine is highly variable in its ability to prevent adult pulmonary disease. Another problem is that the vaccine may interfere with the interpretation of the tuberculin skin test. Despite this, a number of countries still use it to reduce childhood infections and miliary disease. Consequently, the CDC makes this recommendation: "The BCG vaccine should be considered only for very select persons who meet specific criteria and in consultation with a TB expert."
  
  Currently, people who have active TB are suggested to be treated using isolation techniques along with anti-TB drugs to prevent spread according to the CDC. The CDC suggests that patients with probable active TB be isolated in a private room with negative pressure (air exhausted to outside or through a high-efficiency particulate air filter). Further, staff taking care of them must wear high-efficiency disposable masks sufficient to filter out any airborne mycobacteria. Continued isolation is suggested until sputum smears are negative for three consecutive determinations (usually after approximately two to four weeks of treatment).
• source:medicinenet.com

Targeted Drugs Among Successes Against Cancer But aging population and increasing obesity threaten progress

TUESDAY, Sept. 16, 2014 (HealthDay News) -- About 14.5 million U.S.cancer survivors are alive today, compared to just 3 million in 1971, the American Association for Cancer Research reported Tuesday.

These individuals amount to 4 percent of the population and include nearly 380,000 survivors of childhood cancer, according to the association's annual progress report. The paper outlines advances in prevention, identification, research and treatment of cancer and details some of the challenges ahead.

But these numbers can be somewhat misleading unless they take into account advances in identifying cancers earlier, said Dr. Otis Brawley, chief medical officer of the American Cancer Society.

Survival rates refer to how long a person lives with cancer (including inremission) while mortality rates refer to the death rate, but survival will be longer if the cancer is found earlier, even if the person dies at the same time they would have.

"People don't want to live longer with cancer," Brawley said. "They want to not die with cancer." But he said mortality rates have also seen big drops, including an overall decline of 22 percent in cancer deaths from 1991 to 2011.

"Prevention has been the biggest contributor, with smoking cessation as a bigger overall driver of the decline in mortality" than scientific treatment advances, Brawley said. "People who stopped smoking in the 1960s and 1970s did not die in the 1990s and beyond, and that's why it took until 1991 for mortality to start going down big-time."

Yet two looming issues may have a significant impact on increasing cancer rates in the future, the report noted.

One is the currently aging population. Most cancers occur in people aged 65 and older, and the number of Americans in this age group is expected to double by the year 2060, the report said.

That portends an increase in cancer diagnoses from 1.6 million in the United States in 2014 to an estimated 2.4 million in 2035, the report stated.

The other issue relates to widespread obesity. The report notes that one-third of all newly diagnosed cancers in the United States are related to being overweight or obese. These include esophageal, colorectal, endometrial, gallbladder, kidney, pancreatic and postmenopausal breast cancers.

"One of the great threats in terms of cancer in the U.S. is the increasing obesity rates," Brawley said. "We think it's the high levels of insulin that obese people have in their blood because insulin spurs on tumor development."

As smoking rates continue declining, "the leading cause of cancer in the U.S. may very well be obesity rather than tobacco use soon," Brawley said.

Another challenge related to cancer prevention, detection and treatment in the United States are health care access disparities for racial and ethnic minorities and poorer people.

Lower incomes are the primary driver of these disparities, Brawley said.

"There is a whole slew of issues with education and access," he said, noting that the black-white disparity in cancer deaths seen in the general population is particularly striking when compared to a population with equal access to care.

"When you start looking at black women treated for breast cancer in military hospitals," for example, Brawley said, "you end up with a population of black women whose outcomes look a lot more like those of white women than those of black women in the U.S. overall. Access to care and equalization of care is really important."

Also noteworthy, the Food and Drug Administration approved six new anticancer drugs in the past year and allowed new uses for five existing anticancer therapeutics, the report said. The FDA has also approved two imaging agents for uses related to cancer.

The new drugs were approved to treat certain types of stomach cancer, thyroid cancer, leukemia, lymphoma, non-Hodgkin lymphoma,pancreatic cancer, melanoma, lung cancer and breast cancer.

Dr. Tomasz Beer, deputy director of the Knight Cancer Center at Oregon Health and Science University, said it was particularly interesting that only one of the six newly approved therapies was achemotherapy drug.

"I think the public may not know that cancer therapy is not just chemotherapy anymore," Beer said. "What's new now is focusing on biologic agents that are targeted, and immunotherapy agents. What you're seeing in this report is a sign of what's to come."

Those five new drugs are targeted cancer therapies, which fight cancer differently from chemotherapy. Chemotherapy works by killing all cells in an area, including both normal and cancerous cells.

Targeted therapies, however, focus on specific molecules to prevent a tumor from growing or a cancer from progressing and spreading. These therapies might interfere with blood vessel development in a tumor, kill only cancer cells or, in the case of immunotherapy, help the immune system identify and kill cancer cells.

Dr. Carlos Arteaga, president of the American Association for Cancer Research, highlights the progress being made. "We're witnessing quite a transformative change in the way we treat patients with cancer," he said.

"As a result of advances like these, Americans today are more likely to survive a cancer diagnosis and then enjoy a higher quality of life than at any other time in history," Arteaga, who is director of the Center for Cancer Targeted Therapies at Vanderbilt-Ingram Cancer Center in Nashville, said.

One recent discovery that could lead to new treatments for a type of lung cancer reveals where cancer research is heading.

A study released Sept. 16 in the journal Clinical Cancer Researchdescribes two mutations that cause lung cancer resistance to a drug called alectinib.

Alectinib was developed to inhibit the expression of the ALK gene that causes growth of some non-small cell lung cancers -- the most common form of lung cancer -- after the cancer has become resistant to an older drug called crizotinib.

Discovering these mutations helped researchers understand how the cancer becomes resistant to alectinib. The researchers then successfully used a new drug, ceritinib (brand name: Zykadia), to treat a patient whose lung cancer had become resistant to alectinib.

"These studies have been invaluable in learning how ALK-positive cancers become resistant to different ALK inhibitors and in identifying the best therapeutic strategies that will re-induce remissions," said study author Dr. Jeffrey Engelman, director of the Center for Thoracic Cancers at the Massachusetts General Hospital Cancer Center, in a news release.

Blood Test May Identify Status of Prostate Cancer

May help doctors pinpoint best treatment, researchers say

WEDNESDAY, Sept. 17, 2014 (HealthDay News) -- A blood test that measures DNA from a prostate cancer tumor could provide doctors with a better assessment of the state of a man's disease, a new study suggests.

If used routinely, this blood test could reveal when treatment for advanced prostate cancer stops working and actually begins promoting tumor growth, the researchers suggested.

"Our study showed that a steroid treatment given to patients with advanced prostate cancer and often initially very effective started to activate harmful mutations and coincided with the cancer starting to grow again," study leader Dr. Gerhardt Attard, from the Institute of Cancer Research (ICR) in London, explained in an ICR news release.

"In the future, we hope to routinely monitor genetic mutations in patients with advanced disease using just a blood test -- enabling us to stop treatments when they become disease drivers and select the next best treatment option. We need to confirm these findings in larger numbers of patients, but using these types of blood tests could allow true personalization of treatment for prostate cancer patients, based on the cancer mutations we detect," he explained.

Using a blood test to measure circulating tumor DNA levels is less expensive and less invasive than needle biopsies. This test could be an effective way to monitor the emergence of treatment-resistant prostate cancer, the study published on Sept. 17 in Science Translational Medicine suggested.

"Drug resistance is the single biggest challenge we face in cancerresearch and treatment, and we are just beginning to understand how its development is driven by evolutionary pressures on tumors," Paul Workman, interim chief executive at the ICR, said in the news release.

This discovery "reveals how some cancer treatments can actually favor the survival of the nastiest cancer cells, and sets out the rationale for repeated monitoring of patients using blood tests, in order to track and intervene in the evolution of their cancers," Workman said.

"There are currently too few treatment options for men living with advanced stage prostate cancer. Not only do we desperately need to find more treatments for this group of men, we also need to understand more about when those that are available stop working and why," Dr. Matthew Hobbs, deputy director of research at Prostate Cancer UK, said in the news release.

"This research is important as it shows that there might be a new way to monitor how a man's cancer is changing during treatment, and that could help us to pinpoint the stage at which some drugs stop being effective. In the future, this could arm doctors with the knowledge they need to ensure that no time is wasted between a drug that stops working for a man and him moving on to another effective treatment," Hobbs said.

But, Hobbs also noted that this is preliminary research and that the study size was small -- just 16 men. He agreed with Attard that the findings need to be confirmed in a larger study.

The researchers cautioned that any patients currently taking medication for advanced prostate cancer should continue to take their medications as prescribed and discuss any concerns about their treatment with their doctor.

Advanced Prostate Cancer: Frequently Asked Questions

If you just learned that you or a loved one has advanced prostate cancer, you may have many questions and concerns. By taking the time to research your condition, you've taken a good first step. Here are answers to the most common questions. After looking over these answers, click on other articles in this guide to find in-depth information about treatments, side effects, and other issues that affect you and your family.

What is advanced prostate cancer?

Prostate cancer is defined as ''advanced'' when it spreads outside the prostate gland. It may spread to nearby tissues, lymph nodes, bones, or other parts of the body. When it is spread beyond the tissues directly adjacent to the prostate gland, it is called metastatic prostate cancer.

Can advanced prostate cancer be cured?

No cure exists for advanced prostate cancer, but treatments may greatly extend life and reduce symptoms. A look at treatments:

• Most prostate cancer grows in response to male hormones (androgens) in the body, such as testosterone. That’s why one of the first treatments for advanced prostate cancer is to decrease these hormone levels (called androgen deprivation therapy). There are several medications that can do this, including Leupron (leuprolide), Trelstar (triptorelin), or Zoladex (goserelin). These drugs work to reduce testosterone levels to those seen in castrated patients. Other hormonal treatments include antiandrogens, estrogen- and progesterone-type drugs and cortisone derivatives. If these stop working, the drugs Zytiga (abiraterone) or Xtandi (enzalutamide) may still be effective. The most frequent side effects from hormone therapy include reduced sex drive, impotence, erectile dysfunction, infertility, and bone loss. Your doctor may be able to help prevent some side effects, such as bone loss. In the past, it was common for doctors to recommend surgical removal of the testicles to decrease hormone levels. This is usually not necessary, because medications typically work, though such medications are more expensive than the surgical procedure to remove the testes (bilateral orchiectomy). The use of medical rather than surgical treatment offers the option of stopping -- sometimes temporarily, sometimes permanently -- the medicines if the side effects are intolerable, or if the patient or doctor prefers. The surgery is not reversible.
• If hormone therapy ultimately fails to slow the growth of the cancer, the next step may be a prostate cancer "vaccine" called Provenge (sipuleucel-T). Most men who take Provenge survive at least 2 years after starting the treatment. Provenge isn't your everyday vaccine. It's a therapy created by taking immune cells from a patient, genetically engineering them to fight prostate cancer, and then putting them back into the patient. It's used for men with few or no symptoms and when advanced prostate cancer no longer responds to hormone therapy. Though relatively new, Provenge appears to be remarkably safe. However, clinical trials suggested the treatment might cause a slightly increased risk of stroke. The most common side effect is chills, which occurs in most men. Other common side effects include fatigue, fever, back pain, and nausea.
• Chemotherapy is another option when hormone therapy stops working. Only a few chemotherapy medications have been shown to work for advanced prostate cancer. The chemotherapy drug Taxotere, when taken with the steroid prednisone, can help extend survival in some men. When Taxotere stops working, the chemotherapy drug called Jevtana (carbazitaxel) can help extend survival in some men. Possible side effects of Taxotere include nausea, hair loss, and decreased production of blood cells. Men may also develop fluid retention and pain, tingling, or numbness in the fingers or toes. Jevtana has side effects similar to Taxotere.
• One drug, Xofigo (Radium -223), is approved for use in men who have advanced prostate cancer that has spread only to the bones. Candidates should have also received androgen deprivation therapy. Xofigo, given by injection once a month, works by binding to minerals within bones to deliver radiation directly to bone tumors. A study of 809 men showed that those taking Xofigo lived an average of 3 months longer than those taking a placebo.   

External beam radiation therapy may be used to reduce pain from bone metastases in advanced prostate cancer.

source:http://www.webmd.com/