Health
A Wake-Up Call for Women
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March 14, 2024âActress Olivia Munnâs candid disclosures on Instagram about her aggressive breast cancer â a surprise discovery after a âcleanâ mammogram and negative genetic tests â were a poignant mix of details about her cancer journey and a cautionary tale for women. Â
Munn earlier this week revealed her 10-month battle with breast cancer, which resulted in four surgeries and a double mastectomy, and used the social media site as a way of encouraging women to educate themselves about the disease and the importance of appropriate screening tests.
Munnâs experience reveals some truths that women may not know: Most women who get breast cancer donât have a genetic predisposition. Mammograms donât detect all cancers. An individual risk assessment — which Munnâs OB/GYN doctor recommended — can point to the need for additional testing to find tumors mammograms have missed.
Munn, 43, known for her work on The Daily Show with Jon Stewart, as economist Sloan Sabbith on the HBO political drama The Newsroom, and movies including Magic Mike, wrote in detail on Instagram about finding out she had an aggressive form of cancer known as luminal B despite having a normal mammogram and testing negative on a genetic test that she said checked for 90 different cancer genes.Â
Her doctor did an individual risk assessment, finding Munnâs lifetime risk was 37%, considered very high, and referred her to more extensive testing, which detected cancer in both breasts.
Munn said in a series of Instagram posts that she initially kept her diagnosis private, explaining, âI needed to catch my breath and get through some of the hardest parts before sharing.â She lauds her OB/GYN, Thais Aliabadi, MD, who decided to calculate the risk score. âThe fact that she did saved my life,â Munn wrote.Â
Munnâs fighting spirit and positive attitude are apparent. âIâm lucky,â she posted. âWe caught it with enough time that I had options.â She praised the efforts of John Mulaney, her partner with whom she shares a 2-year-old son. He researched treatments and medication and posted pictures bedside of their son.
Munn thanked her doctors and other staff at Cedars-Sinai Medical Center in Los Angeles and Providence Saint Johnâs Health Center in Santa Monica, including her surgical oncologist, Armando Giuliano, MD, her reconstructive surgeon, Jay Orringer, MD, her oncologist, Monica Mita, MD, and Aliabadi.
A spokeswoman for Munn said the actress is not doing interviews at this time. Spokespersons at Cedars-Sinai declined to comment on Munnâs case.
Genetics and Breast CancerÂ
âMost people who get breast cancer donât have an inherited genetic mutation,â said Nathalie Johnson, MD, medical director of the Legacy Health Systems Cancer Institute and the Legacy Breast Health Centers in Portland, OR, who was not involved in Munnâs treatment.Â
âOnly 5 to 10% of people who get breast cancer have a gene that tests positive,â agreed Joanne Mortimer, MD, director of Womenâs Cancers Program and a medical oncologist at City of Hope in Duarte, CA. Mortimer was also not involved in Munnâs care and spoke generally about breast cancer treatment in cases similar to Munnâs.
Cancer Subtypes
Luminal breast cancers are those originating inthe luminal or inner lining of the mammary ducts. Both luminal A and luminal B need estrogen to grow, Johnson said. Luminal A has a better prognosis and is easier to treat. Luminal B has a worse prognosis, she said, and itâs sometimes dubbed B for âbad.âÂ
Luminal B ârequires chemotherapy and if it recurs; itâs just harder. It stops responding to endocrine therapy or estrogen-blocking drugs and so we have to use other therapies.âÂ
Genomic testing helps doctors decide if the luminal tumors are A or B forms, she said. The prognosis for luminal B cancers can still be good, Johnson said.
Beyond Mammograms
âMammograms arenât perfect,â Johnson said. The screening can especially miss cancers in breasts with dense tissue because the cancers donât show up as well on the imaging.Â
Density refers to the amount of fibrous and glandular tissues in the breast compared to fatty tissue. About half of women age 40 and above have dense breasts, according to the CDC. The mammogram report may include information about whether breast density is high or low.Â
If breasts are dense, an ultrasound or breast MRI would be good supplementary tests, Johnson said.
Even though mammograms miss some cancers, Johnson urges women to undergo the exams as recommended. The U.S. Preventive Services Task Force, in its draft recommendation, calls for mammograms beginning at age 40 and repeated every other year.
Even if mammogram results show no evidence of cancer, if a woman feels something unusual in her breasts, itâs time to return to the doctor and ask about further testing, Johnson said.
An MRI is often done in women as young as Munn, Mortimer said, if they are known to have dense breasts or a family history, both known to raise breast cancer risk. âIn someone with a family history, we alternate MRIs with mammograms to increase the chances of detection,â she said.
Individual Assessments
In her Instagram posts, Munn praises her OB/GYN for suggesting an individual risk assessment. âDr. [Thais] Aliabadi looked at factors like my age, familial breast cancer history, and the fact that I had my first child after the age of 30,â Munn wrote on Instagram. âShe discovered my lifetime risk was at 37%.âÂ
That score prompted the doctor to refer Munn for an MRI and then an ultrasound and biopsy. âThe biopsy showed I had Luminal B cancer in both breasts,â Munn wrote. âLuminal B is an aggressive, fast-moving cancer.â Thirty days later, Munn had a double mastectomy.
One such risk assessment is on the National Cancer Institute site. It takes into account a history of breast cancer, previous radiation to the chest, genetic mutations, age, race, ethnicity, history of a breast biopsy with a benign diagnosis, age at first menstrual period, age when first child was born (over 30 raises risk), and first-degree relatives (your parents, sibling, or child) with breast cancer.
From that, it predicts a 5-year risk and a lifetime risk of developing breast cancer, comparing the patientâs risk with the average risk of the population.
For instance, a 43-year-old White woman with no history of breast cancer or previous radiation, no genetic mutations, no previous breast biopsies, first period at age 12, 30 or older at first childbirth, and no first-degree relatives with breast cancer has a 13.2% lifetime risk of breast cancer, slightly above the average risk of 12.1%.
Treatment Options
Besides the type of tumor detected, factors such as lymph node involvement drive treatment decisions, Johnson and Mortimer said.Â
For a young woman with luminal B breast cancer, the usual regimen would be surgery, chemotherapy, and estrogen-blocking therapy. âThe luminal B prognosis is still good if you do the chemo as well as the endocrine therapy.â Johnson said.
Models can assess survival rates if the treatment includes chemotherapy or does not, Johnson said, helping women to make their own decisions.
Mortimer called Munnâs OB/GYN âpretty amazingâ to suggest the risk calculator and take action, finding the tumor much earlier than the next scheduled mammogram would have.
Health
Walmart Is Selling a $300 Power Tower for Just $128, and Shoppers Say It's 'Surprisingly Sturdy'
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When building a home gym, it’s easy to get overwhelmed by all the equipment options, especially when you’re working with limited space and a tight budget. But when you focus on versatile gear and hunt for deals, creating a useful setup is easily doable. Thankfully, Walmart has been slashing prices on a ton of fitness equipment, including its bestselling adjustable dumbbells and even a complete home gym system. Now, it’s reduced the price of a popular power tower by over $170, and it even ships for free.
The Pooboo Body Champ Multifunction Power Tower is on sale for $128, a 57% discount on its normal price of $300. This incredibly versatile workout station has earned nearly 250 five-star ratings from Walmart shoppers who’ve praised its “strong and sturdy” build and “quality fit and finish,” and it’s currently one of the top 5 bestselling models on the site.
Pooboo Body Champ Multifunction Power Tower, $128 (was $300) at Walmart
Don’t let the brand’s bizarre name fool you—this power tower is a well-made piece of gym equipment. It features steel construction and is rated to hold up to 480 pounds (the tower itself weighs 66 pounds). A nearly 42-inch H-shaped base gives it excellent stability, so it won’t wobble or shake when you’re exercising, and anti-slip feet on the bottom keep it securely planted on the floor. It’s also adjustable (from 71.4 inches to 94 inches) to accommodate users of varying heights. And, once it’s set up, you can use it for a huge range of exercises, including dips, pull-ups, chin-ups, push-ups, vertical leg raises, knee raises, and more.
According to Walmart reviewers, the Pooboo Body Champ stands out for its solid build and usefulness. “It’s a surprisingly sturdy piece of equipment,” a shopper said. “Everything about this fitness tower is perfect. I originally purchased this with the intention of only doing pull-ups on it, but after quickly assembling the power tower, I came to realize just how versatile it is. It has cushions for knee and leg raises, it’s sturdy, and the perfect width for dips.” Another shopper agreed, saying, “This was a much-needed addition to my home gym.”
“This thing is amazing and worth every penny,” said another, who added that it’s “easy to install and can hold a lot of weight.”
At just $128, this Pooboo power tower is a screaming deal, and it’s sure to get lots of use during your workouts. But this discount won’t last long, so grab one today before the price pumps back up.
Health
Alzheimer’s Drug May Save Lives Through ‘Suspended Animation’
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By Lindsay Brownell | Wyss Institute Communications | Harvard Gazette
Could buy patients more time to survive critical injuries and diseases, even when disaster strikes far from a hospital
Donepezil, an FDA-approved drug to treat Alzheimer’s, has the potential to be repurposed for use in emergency situations to prevent irreversible organ injury, according to researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University.
Using Donepezil (DPN), researchers report that they were able to put tadpoles of Xenopus laevis frogs into a hibernation-like torpor.
“Cooling a patient’s body down to slow its metabolic processes has long been used in medical settings to reduce injuries and long-term problems from severe conditions, but it can only currently be done in a well-resourced hospital,” said co-author Michael Super, director of immuno-materials at the Wyss Institute. “Achieving a similar state of ‘biostasis’ with an easily administered drug like DNP could potentially save millions of lives every year.”
This research, published Thursday in ACS Nano, was supported as part of the DARPA Biostasis Program, which funds projects that aim to extend the time for lifesaving medical treatment, often referred to as “the Golden Hour,” following traumatic injury or acute infection. The Wyss Institute has been a participant in the Biostasis Program since 2018, and has achieved several important milestones over the last few years.
Using a combination of predictive machine learning algorithms and animal models, the Wyss’ Biostasis team previously identified and tested existing drug compounds that had the potential to put living tissues into a state of suspended animation. Their first successful candidate, SNC80, significantly reduced oxygen consumption (a proxy for metabolism) in both a beating pig heart and in human organ chips, but is known to cause seizures when injected systemically.
In the new study, they once again turned to their algorithm to identify other compounds whose structures are similar to SNC80. Their top candidate was DNP, which has been approved since 1996 to treat Alzheimer’s.
Achieving a similar state of ‘biostasis’ with an easily administered drug like DNP could potentially save millions of lives every year.
–Michael Super
“Interestingly, clinical overdoses of DNP in patients suffering from Alzheimer’s disease have been associated with drowsiness and a reduced heart rate — symptoms that are torpor-like. However, this is the first study, to our knowledge, that focuses on leveraging those effects as the main clinical response, and not as side effects,” said the study’s first author, María Plaza Oliver, who was a postdoctoral fellow at the Wyss Institute when the work was conducted.
The team used X. laevis tadpoles to evaluate DNP’s effects on a whole living organism, and found that it successfully induced a torpor-like state that could be reversed when the drug was removed. The drug, however, did seem to cause some toxicity, and accumulated in all of the animals’ tissues. To solve that problem, the researchers encapsulated DNP inside lipid nanocarriers, and found that this both reduced toxicity and caused the drug to accumulate in the animals’ brain tissues. This is a promising result, as the central nervous system is known to mediate hibernation and torpor in other animals as well.
Although DNP has been shown to protect neurons from metabolic stress in models of Alzheimer’s disease, the team cautions that more work is needed to understand exactly how it causes torpor, as well as scale up production of the encapsulated DNP for use in larger animals and, potentially, humans.
“Donepezil has been used worldwide by patients for decades, so its properties and manufacturing methods are well-established. Lipid nanocarriers similar to the ones we used are also now approved for clinical use in other applications. This study demonstrates that an encapsulated version of the drug could potentially be used in the future to buy patients critical time to survive devastating injuries and diseases, and it could be easily formulated and produced at scale on a much shorter time scale than a new drug,” said senior author Donald Ingber, the Judah Folkman Professor of Vascular Biology at Harvard Medical School and Boston Children’s Hospital, and the Hansjörg Wyss Professor of Bioinspired Engineering at Harvard’s John A. Paulson School of Engineering and Applied Sciences.
This research was supported by DARPA under Cooperative Agreement Number W911NF-19-2-0027, the Margarita Salas postdoctoral grant co-funded by the Spanish Ministry of Universities, and the University of Castilla-La Mancha (NextGeneration EU UNI/551/2021).
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This story is reprinted with permission from The Harvard Gazette.
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Health
Can Stuff in Rosemary Extract Fight Cocaine Addiction?
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Researchers have discovered that an antioxidant found in rosemary extract can reduce intakes of cocaine by moderating the brain’s reward response, offering a new therapeutic target for treating addiction.
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The study in the journal Neuron describes researchers’ focus on a region of the brain called the globus pallidus externus, which acts as a gatekeeper that regulates how we react to cocaine.
They discovered that within the GPe, parvalbumin-positive neurons are crucial in controlling the response to cocaine by changing the activity neurons releasing the pleasure molecule dopamine.
“There are currently no effective therapeutics for dependence on psychostimulants such as cocaine, which, along with opioids, represent a substantial health burden,” says corresponding author Kevin Beier, an associate professor of physiology and biophysics at the University of California, Irvine.
“Our study deepens our understanding of the basic brain mechanisms that increase vulnerability to substance use disorder-related outcomes and provides a foundation for the development of new interventions.”
Findings in mice revealed that globus pallidus externus parvalbumin-positive cells, which indirectly influence the release of dopamine, become more excitable after being exposed to cocaine. This caused a drop in the expression of certain proteins that encode membrane channels that usually help keep the globus pallidus cell activity in check. The researchers found that carnosic acid, an isolate of rosemary extract, selectively binds to the affected channels, providing an avenue to reduce response to the drug in a relatively specific fashion.
“Only a subset of individuals are vulnerable to developing a substance use disorder, but we cannot yet identify who they are. If globus pallidus cell activity can effectively predict response to cocaine, it could be used to measure likely responses and thus serve as a biomarker for the most vulnerable,” Beier says. “Furthermore, it’s possible that carnosic acid could be given to those at high risk to reduce the response to cocaine.”
The next steps in this research include thoroughly assessing negative side effects of carnosic acid and determining the ideal dosage and timing. The team is also interested in testing its efficacy in reducing the desire for other drugs and in developing more potent and targeted variants.
Scientists from the University of West Virginia and the University of Colorado participated in the study.
Support for this work came from the National Institutes of Health, One Mind, the Alzheimer’s Association, New Vision Research, BrightFocus Foundation, and the Brain & Behavior Research Foundation.
Source: UC Irvine
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Previously Published on futurity.org with Creative Commons License
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