PubMed ***My personal opinion is that Chemotherapy takes your “Quality of Life” and if losing that is not important then what is?? Chemotherapy patients have a 55-60% chance of recurrent cancer within 5 years and most die from that. But in the interim, they suffer the terrible side effects and then die anyways, and what quality is their life? Poor. Seriously think about using Natural Alternatives Products. I did, I am a survivor and no side effects. A Personal Choice!!   Brighter-works.ca The Bad and the UGLY side effects Chemotherapy drugs can damage healthy, fast-growing cells, such as the new blood cells in bone marrow or cells in the mouth, stomach, skin, hair and reproductive organs. When healthy cells are damaged, it causes side effects. Understanding side effects Everyone reacts to chemotherapy treatment differently. You may have many side effects or a few. Whether you experience side effects and whether they are mild or severe can depend on the type and dose of drugs you are given. Your reaction can also change from one treatment cycle to the next. If you have side effects, they may start during the first few weeks of treatment and occasionally become more intense with each treatment cycle. Before treatment begins, your doctor, pharmacist or nurse will discuss the side effects to watch out for or report, how to help prevent or manage them, and who to contact after hours if you need help. Keep a record of side effects It can be useful to keep a record of your chemotherapy treatment and any side effects you develop. This will help you remember when you had side effects, how long they lasted and what helped to make them better. You can use a notebook, diary or an app on a smartphone or tablet. Tell your treatment team about all side effects. They will be able to suggest ways to manage the side effects or, if appropriate, they may change the treatment schedule or arrange a break. How long side effects may last Most side effects are short term, but some may be permanent. Side effects tend to gradually improve once treatment stops and the normal, healthy cells recover. Most side effects can be managed. Some side effects from chemotherapy may not show up for many months or years. These are called late effects. Before treatment starts, talk to your doctor about whether you are at risk of developing late effects and ways to prevent them. Long-term and late effects of treatment Permanent side effects of chemotherapy may include damage to your heart, lungs, kidneys, nerve endings or reproductive organs. If damage to your heart muscle or lungs is a possibility, your doctor will monitor how your heart and lungs are working and adjust your chemotherapy if early changes are seen. Occasionally, many years after having chemotherapy, some people develop a new, unrelated cancer. The risk of this is very low but can increase with factors such as continuing to smoke or rare genetic conditions .***55-60% is NOT low!!! If you notice symptoms, even many years after treatment, ask your GP whether they could be related to the cancer treatment you received. Ask whether your hospital has a late effects clinic to help you manage any side effects you may experience after treatment.  Record your treatments List the doses and names of your chemotherapy drugs, and the names of your specialists. This will save time if you become ill and need to visit a hospital emergency department. Make sure you tell the hospital staff that you are having chemotherapy, or other therapies such as targeted therapy and immunotherapy Blood-related side effects Blood cells are made in the bone marrow, which is the spongy part in the centre of the bones. The bone marrow makes three main types of blood cells, which have specific functions: red blood cells –  carry oxygen around the body white blood cells –  fight infection platelets –  help blood to clot and prevent bruising. New blood cells are constantly being made in the bone marrow. These rapidly dividing cells can be damaged by chemotherapy, and the number of blood cells (your blood count) will be reduced. Low numbers of blood cells may cause anaemia or bleeding problems and increase the risk of infections. You will have blood tests when you start treatment and before each chemotherapy cycle to check that your blood count is adequate. Anaemia If your red blood cell count drops below normal, this is called anaemia. A reduced amount of oxygen circulates through your body, which can make you feel tired, lethargic, dizzy or breathless. To minimise dizziness, take your time when you get up from sitting or lying down. Your treatment team will monitor your red blood cell levels. Let them know if you have any symptoms of anaemia during your course of chemotherapy. Bleeding problems A low level of platelets (thrombocytopenia) can cause problems. You may bleed for longer than normal after minor cuts, have nosebleeds or bleeding gums, or bruise easily. Periods may be longer or heavier. Your treatment team will monitor your platelet levels. If chemotherapy causes severe thrombocytopenia, you may need a platelet transfusion. Ask your specialist to explain the risks and benefits of this procedure. How to manage a low platelet count Be careful when using knives, scissors or needles, as you may bleed easily from small cuts or nicks. Use an electric razor when shaving your face or body to reduce the chance of nicking yourself. Wear thick gloves when gardening to avoid injury. This will also prevent infection from soil, which contains bacteria. Avoid contact sports and high-impact activities, as these could cause bruising or bleeding if you get knocked or fall over. When brushing your teeth, use a soft-bristled toothbrush to avoid irritating your gums. Wear comfortable, well fitting shoes indoors and outdoors to avoid cuts on your feet. Blow your nose with care. If you bleed, apply pressure to the area for about 10 minutes and bandage as needed. Taking care with infections "After chemotherapy I became very susceptible to infections. A small scrape can quickly become serious. But when I feel like an infection is coming on, I've learnt to see my doctor straightaway."  – Brigita Beausce Chenotherapy essentially destroys your immune system even a scratch can become infected easily and turn into a very serious, body wide infection. It is vitally important to monitor every bump and bruise to ensure that the skin is not broken to prevent infection from gaing hold. If you see a scratch starting to turn red, itch or become painful seek immediate medical assistance. Those with cats need to be especially careful due to the presence of cate feces in the fur of the paws and on their nails. Fatigue Feeling tired and lacking energy is the most common side effect of chemotherapy. It is known as cancer-related fatigue. You may also: develop muscle aches and pains have trouble thinking clearly or concentrating find it difficult to do daily tasks such as getting dressed, showering and cooking. Fatigue can affect you suddenly and it doesn’t always get better with rest or sleep. If you find it hard to do everyday things, you might feel frustrated and isolated. Fatigue caused by chemotherapy may last for months or years after a treatment, however, many people find that their energy levels return to normal 6–12 months after treatment ends. While fatigue is a common side effect of chemotherapy, it can also be a symptom of depression. If you have continued feelings of sadness, you may have depression, and treatment may help. How to manage fatigue Get extra rest the day of and day after chemotherapy to allow your body to recover. Plan activities for the time of day when you tend to feel most energetic. Try to be physically active with moderate exercise (e.g. walking, swimming) and some strength training (e.g. weights or resistance bands). See an accredited exercise physiologist or physiotherapist. They can develop a suitable program. Accept offers of help or ask family, friends and neighbours to help with shopping, driving, housework or gardening. If you have children, ask trusted family and friends to look after them during your chemotherapy sessions and to be on call in case you become unwell afterwards. Find ways to manage anxiety or sleeping difficulties as these can increase fatigue. Try relaxation or meditation techniques to help reduce stress, improve your sleep and boost your energy levels. Talk to your GP about trying acupuncture – some studies suggest this may help with reducing fatigue after chemotherapy. Check with your doctor whether your fatigue is related to low levels of red blood cells (anaemia). Anaemia can be treated. Speak to your employer about how they can support you (e.g. you may be able to take a few weeks off, reduce your hours or work from home). Eat a healthy, well-balanced diet and don’t skip meals. Try to limit how much you drink, smoke and vape. Hair loss Whether you lose your hair will depend on the drugs prescribed. Some people lose all their hair (alopecia); others find it becomes thinner, or they may lose only a little hair. Some people lose none at all. Although losing hair from the head is most common, eyebrows, eyelashes, hair from your underarms, legs, chest, beard and pubic area can also fall out. When hair loss does occur, it usually starts during cycle two or three – or sometimes after the first cycle. It may be sudden or happen gradually. Before and while your hair is falling out, your scalp may feel hot, itchy, tender or tingly. Some people find that the skin on their head is extra sensitive, and they may develop pimples on their scalp. It’s not unusual to feel sad or less confident. It may take time to adjust to how you look, then more time to feel good about yourself again. Hair growing back After treatment ends, it can take 4–12 months to grow back a full head of hair. When your hair first grows back, it may be a different colour, softer or curly (even if you have always had straight hair). In time, your hair usually returns to its original condition. Scalp cooling Some treatment centres provide cold caps, which may reduce hair loss from the head. Cold caps can only be used with certain drugs and some types of cancer, and they don’t always stop hair loss. Worn while chemotherapy is being given, the cap is attached to a cooling unit. This reduces blood flow and the amount of chemotherapy drug that reaches the scalp. Some people find the cold cap uncomfortable, and the cold temperature may be painful. If you are interested in trying a cold cap, ask your treatment centre if it is an option for you. Tips for managing hair loss Keep your hair and scalp very clean. Use a mild shampoo like baby shampoo. If you want to use lotion on your head, use sorbolene. Check with your nurse before using any other hair or skin care products on the scalp. Comb or brush your hair gently using a large comb or a hairbrush with soft bristles. Explain to family and friends, especially children, that the chemotherapy may make your hair fall out. Consider cutting your hair before it falls out. Some people say this gives them a sense of control. Wear a wig, hat, turban or scarf, or go bare-headed – whatever feels best to you. If you prefer to leave your head bare, protect it against sunburn and the cold. If you plan to wear a wig, choose it before treatment starts so you can match your own hair colour and style. Or consider a new style or colour for a bit of fun. Some treatment centres have wig loan services; call Cancer Council 13 11 20 for more information. Try using a pillowcase made from silk, satin or bamboo as these smooth fabrics can decrease hair tangles. Avoid dyeing your hair during chemotherapy and for about 6 months afterwards to allow the hair to become stronger. Vegetable-based hair dyes may be gentler on the hair and scalp. If your eyelashes fall out, wear sunglasses outside to protect your eyes from dust and sunlight.  If your eyebrows fall out, you may wish to wear reusable eyebrow wigs or transfers until they grow back. Contact Look Good Feel Better. This program helps people manage the appearance-related effects of cancer treatment.  How to manage appetite changes Managing appetite loss Eat what you feel like, when you feel like it, but avoid going for long periods without eating. Try eating frequent snacks rather than large meals. Avoid strong odours and cooking smells that may put you off eating. It might help to prepare meals ahead and freeze them for days you don’t feel like cooking. If the taste of certain foods has changed, don’t force yourself to eat them. If you don’t feel like eating solid foods, have drinks enriched with powdered milk, yoghurt or honey. Or try easy-to-swallow foods such as scrambled eggs. Don’t use nutritional supplements, vitamins or medicines without your doctor’s advice, as some products could affect how chemotherapy works. Ask a dietitian for advice on the best foods or nutritional supplements to have during treatment and recovery. Managing nausea Have a light, bland meal before your treatment (e.g. soup with dry biscuits). Sip water or other fluids throughout the day so that you don’t get dehydrated. Sucking on ice cubes or iceblocks, or eating jelly can also increase your fluid intake. If water tastes unpleasant, flavour it with ginger cordial or syrup.  If your stomach is upset, try drinking fizzy drinks such as soda water or dry ginger ale. If you wake up feeling sick, eat something small rather than skipping a meal. If you can’t keep fluids down, contact your doctor or hospital immediately. They may be able to treat the vomiting, or you may need to have fluids through an intravenous drip in hospital.  Constipation or diarrhoea Some chemotherapy drugs, pain medicines and anti-nausea medicines can cause constipation or diarrhoea. If your bowel habits have changed during your treatment, talk to your doctor, pharmacist or nurse. For some people, there will be ongoing bowel problems after cancer treatment has finished. For ways to manage bowel issues at home, see the opposite page. How to manage bowel changes Constipation Eat more high-fibre foods, such as wholegrain bread and pasta, fruits and vegetables, bran, nuts and legumes (e.g. baked beans or lentils). If you are having treatment for bowel cancer, ask your treatment team if there are any foods you should or shouldn’t eat to help avoid constipation. Drink plenty of fluids, both warm and cold. Prune, apple or pear juice can work well. Do some light exercise, such as walking. Ask your doctor about using a laxative, stool softener or fibre supplement. Avoid using medicines delivered through the rectum (e.g. enemas or suppositories) as they may cause infection. Let your treatment team know if you have constipation for more than a couple of days. They will be able to help. Diarrhoea Choose bland foods such as clear broth, boiled rice or dry toast. Avoid spicy foods, wholegrain products, fatty or fried foods, rich sauces, and raw fruits or vegetables with skins or seeds. It may help to eat foods that are high in soluble fibre such as oats, white bread, white rice, bananas, nuts and pasta. Limit alcohol, fruit juice, soft drinks, strong tea or coffee, and foods containing artificial sweeteners, as these stimulate the bowel. Drink plenty of water to help replace fluids lost through having diarrhoea. Talk to your treatment team. They may change the drugs or doses you are on or suggest other solutions. If diarrhoea is severe or ongoing, let your treatment team know. It can cause dehydration, and you may need to go to hospital. Thinking and memory changes Some people say they have difficulty concentrating, focusing and remembering things after they have had chemotherapy. This is called cancer-related cognitive impairment or, sometimes, "chemo brain", "cancer fog" and "brain fog". Thinking and memory changes may be caused by treatment or medicines, fatigue and sleep problems, or how you feel, such as stressed or depressed. These problems usually improve with time, although some people experience issues for years. Tell your doctor about any thinking and memory changes you are having, and if this issue is affecting your day-to-day life or your return to work. How to improve concentration Use a calendar or smartphone features, such as reminders, alarms or lists to keep track of tasks, medical appointments, when to take medicines, social commitments, birthdays, etc. Write down anything you need to remember (e.g. to-do items, where you parked the car). Focus on one thing at a time (try not to multitask). Aim to get 7–8 hours of sleep each night. Deep sleep is important for memory and concentration. Do light exercise every day to help you stay alert and sleep better.  Learn a new skill (e.g. take up a new hobby or do crosswords or puzzles). Talk to your partner, family or workplace about changes to your memory and concentration. This can prevent misunderstandings, and they may be able to support you.  Mouth problems Some chemotherapy drugs can damage healthy cells in the mouth and cause mouth sores, ulcers (oral mucositis) or infections. Chemotherapy treatment may also reduce the amount of saliva (spit) in your mouth, make your saliva thick or sticky, or make your mouth dry. This is called xerostomia or dry mouth. If you notice any sores, ulcers or thickened saliva, or if you find it difficult to swallow, tell your doctor. How to look after your mouth Discuss any dental issues with your oncologist or haematologist before seeing the dentist. If you need to have any dental work, tell your dentist you’re having chemotherapy. Use a soft toothbrush to clean your teeth twice a day. Rinse your mouth often – when you wake up, after you eat or drink, and at bedtime. Ask your doctor, nurse or pharmacist what type of alcohol-free mouthwash to use. They may give you a recipe for a homemade mouthwash. Talk to your doctor or nurse about medicines to relieve pain. Sip fluids, especially water, and eat moist foods such as casseroles or soups if you have a dry mouth. Soothe tender gums or mouth with plain yoghurt. Try sucking on ice during chemotherapy sessions. This may help to prevent mouth ulcers. Blend foods to make them easier to eat. Try smoothies made of fruit and yoghurt. Avoid smoking, vaping and alcoholic drinks, as well as very hot foods and spicy, acidic or coarse foods (e.g. nuts). These can all make mouth sores worse. Skin and nail changes Some chemotherapy drugs may cause your skin to peel, darken or become dry and itchy. During treatment and for several months afterwards, your skin is likely to be more sensitive to the sun. You may find your nails also change and become darker than usual or develop ridges or white lines across them. Your nails may also become brittle and dry or lift off the nail bed. These changes usually grow out. It is recommended that you avoid having your nails done at a nail salon, as this can increase the risk of infection during chemotherapy. Ways to take care of your skin Use a soap-free wash when showering. Gently pat your skin dry with a towel rather than rubbing it. Use a good quality moisturising lotion or a cream containing the ingredient urea to help ease the dryness. Wear loose, non-restricting clothing. Choose clothes made from soft cotton fabric instead of rough wool or synthetic fibres. Use mild detergent to wash your clothing if you have sensitive skin. Don’t shave or wax until your skin has healed. Protect your skin from the sun when UV levels are 3 or above. Wear highprotection sunscreen (SPF 50), a broad-brimmed hat, protective clothing and sunglasses, and try to stay in the shade. This advice applies to everyone, but is especially important for people having chemotherapy. Avoid chlorinated swimming pools as the water can make skin changes worse.  If your skin becomes red or sore in the area where the intravenous device went in, let your doctor or nurse know immediately. Sexuality, intimacy and fertility issues Chemotherapy can affect your sexuality and fertility in emotional and physical ways. These changes are common. Some changes may be only temporary while others can be permanent. Changes in sexuality You may notice a lack of interest in sex or a loss of desire (libido), or you may feel too tired or unwell to want to be intimate. You may also feel less confident about who you are and what you can do. There may be physical reasons for not being able to have sex or being interested in having sex (e.g. vaginal dryness or erection difficulties). Changes in how you look can also affect feelings of self-esteem and, in turn, your interest in sex. If you have a partner, it may be helpful for them to understand the reasons why your libido has changed, and to know that people can usually have a fulfilling sex life after cancer, but it may take time. Some partners may feel concerned about having sex. They might be worried about injuring or hurting the person with cancer, or being exposed to chemotherapy drugs during sex . Even if some sexual activities are not always possible, there are many ways to express closeness. Talking openly with your partner about how you’re feeling can be difficult but it is often very helpful. It’s important to take time to adapt to any changes. If you’re worried about changes to how you feel about yourself, your relationships or sexual functioning, you may find talking to a psychologist or counsellor helpful. Using contraception In most cases, your doctor will advise you to use some form of barrier contraception (condom, female condom or dental dam) during treatment and for a period after. This is to protect your partner from any chemotherapy drugs that may still be in your body fluids. As chemotherapy drugs can harm an unborn baby, your doctor may talk to you about using contraception for some months after chemotherapy. Although chemotherapy often affects fertility, it doesn’t always. If you are in a heterosexual relationship and sexually active, you will need to use a reliable form of contraception to avoid pregnancy while having treatment. Talk to your specialist immediately if you or your partner become pregnant. Changes in fertility Chemotherapy can affect your ability to have children (fertility), which may be temporary or permanent. If you may want to have a child in the future, talk to your doctor before starting chemotherapy about how the treatment might affect you and what options are available. Eggs (ova), embryos, ovarian tissue or sperm may be able to be stored for use at a later date. This needs to be done before chemotherapy starts. In some cases, hormone injections can reduce activity in the ovaries and protect eggs from being damaged by chemotherapy. Effects of chemotherapy on ovaries Some chemotherapy can reduce the levels of hormones produced by the ovaries. This can cause your periods to become irregular or even stop for a while, but they often return to normal within a year of finishing treatment. If your periods do not return, the ovaries may have stopped working, causing early menopause. After menopause, you can’t get pregnant naturally. Signs of menopause include hot flushes, night sweats, aching joints and dry or itchy skin. Menopause – particularly when it occurs under 40 – may, in the long term, cause bones to become weaker and break more easily. This is called osteoporosis. Talk to your doctor about ways to manage menopause symptoms. Effects of chemotherapy on sperm Some chemotherapy drugs can lower the number of sperm produced and reduce their ability to move. This can sometimes cause infertility, which may be temporary or permanent. The ability to have and keep an erection may also be affected (erectile dysfunction or impotence), but this is usually temporary. If impotence is ongoing, talk to your doctor. “All my life I wanted to be a father. I didn’t want cancer to ruin my chances, so I stored my sperm before treatment started. I think of this as a bit of an insurance policy.” Other side effects Some other common side effects of chemotherapy may include hearing problems, watery eyes and body odours. Changes in hearing –  Your doctor may recommend that you have a hearing test before you start treatment, and this may be repeated before each treatment cycle. You may be at risk of losing the ability to hear high-pitched sounds. Some types of chemotherapy drugs may also cause a continuous ringing noise in the ears known as tinnitus. These changes can happen alone or together and are usually temporary. Let your doctor know if you notice any change in your hearing. Watery eyes –  This can be a symptom of a blocked tear duct, which can be caused by some chemotherapy drugs. Massaging the area regularly with a small towel soaked in warm water (compress) and using eye drops can help clear blockages. Let your cancer care team know if this issue is ongoing. Body odour –  Chemotherapy can affect your sense of smell and you may notice that your body odour is unpleasant. Talk to your cancer care team if you are concerned about a change in body odour. Neuropathy (A horrible side effect!) Nerve and muscle effects Some chemotherapy drugs can damage the nerves that send signals between the central nervous system and the arms and legs. This is called chemotherapy-induced peripheral neuropathy (CIPN). Most often, the nerve damage causes tingling (“pins and needles”), numbness or pain in your hands and feet, and muscle weakness in your legs. For many people, peripheral neuropathy is a short-term issue. But sometimes, it can last a longer time or be permanent. If you experience numbness and tingling, tell your doctor or nurse straightaway. Your treatment may need to be changed, or the problem carefully monitored How to manage numb hands or feet "I had no idea that I would still be feeling tired five months after finishing treatment. I didn't know how to make it better and I was scared that's how it would be: that I wouldn't go back to normal, that I would never go back to having energy again."  - Judy Neuropathy is nerve pain caused by damaged nerves. It often affects the hands and feet, causing tingling, numbness, and unusual burning sensations. Some people also experience weakness and pain. A Patient Perspective A few summers ago, Andrea lost a flip-flop. Anyone can misplace a shoe. But this was the only thing between Andrea’s foot and the London pavement. She didn’t notice that it was gone. She began dropping things then, too. “I couldn’t feel the pressure that I was applying when I was holding drinks. Quite often, they would just slip through my hands.” As they smashed and shattered on the floor, glasses didn’t feel like the only things Andrea was struggling to keep hold of. She was a young mother with bowel cancer, grappling with her mortality while trying to do her daughter’s hair. And these symptoms weren’t caused by the disease. The thing taking her body away from her was the treatment. “When you’re going through a cancer diagnosis, trying to be strong for your children and trying not to worry your family, just something as simple as breaking a glass, for the third time in a week, becomes so overwhelming,” Andrea says. “I would very often just burst into tears. And someone looking in would probably think, ‘Why’s she overreacting?’ But it’s because it’s just another thing – and it has nothing to do with the cancer. What’s trying to save my life is causing me its own set of problems. It’s making my life worse.” What was happening? The problem Andrea was – and, to some extent, still is – dealing with is a type of nerve damage called chemotherapy-induced peripheral neuropathy (CIPN, or neuropathy from chemo). The symptoms of neuropathy can range from mild pins and needles to losing all feeling and control of your hands and feet. It can be caused by cancer treatment, but doctors don’t have a way to treat it. Why might chemotherapy cause pins and needles? Chemotherapies are especially good at killing cancer cells, but they can also harm healthy ones. These include the peripheral nerve cells that carry messages back and forth between the brain and spinal cord (the central nervous system) and the rest of the body. When peripheral nerve cells are damaged, it becomes harder for the messages to get through. Healthy vs Damaged Nerve A damaged peripheral nerve cell (right) compared to a healthy one. That’s a big problem when messages have to travel a long way, like to the hands or lower legs. Andrea’s peripheral neuropathy started as pins and needles on the soles of her feet. Then the feeling moved up to her hands. “You know if you sleep on your arm and it goes a bit tingly? I thought that’s what had happened. But it progressively got worse until it was really overwhelming. “It’s not something you can ignore. When I’m sleeping, when I’m walking, when I’m sitting down – constant pins and needles.”  Then, despite the hot summer, Andrea’s feet became freezing cold. Eventually, she began to lose all sense of them at all. It’s hard to walk when you don’t know where your feet are, so Andrea had to drive everywhere. That’s not much easier. If they weren’t strapped into heavy winter boots, the things on the end of her legs wouldn’t stay on the pedals.  After her eighth cycle of chemotherapy, Andrea’s doctors had to stop giving her the platinum-based drug oxaliplatin. Although it was helping to shrink Andrea’s cancer, oxaliplatin is one of the drugs most likely to cause peripheral neuropathy. It was putting her at risk of permanent, life-altering nerve damage, so her last four cycles of treatment couldn’t include it.  Why is chemotherapy-induced peripheral neuropathy such a problem? Andrea is now cancer-free. In some cases, though, when side-effects stop cancer treatment, they shorten people’s lives.   As Professor Alison Lloyd, from University College London, makes clear, “Neuropathy is one of the major limiting factors for chemotherapy.” That’s because, once a chemotherapy drug starts causing neuropathy, the only way doctors can stop it getting worse is by taking the drug away.  The problem is made worse by the fact we can’t even test people to see who’s at risk of developing neuropathy from chemo. All doctors and patients can do is wait to see if symptoms will appear. Uncertainty like that can make treatment decisions much more difficult. “We don’t have an identifiable biomarker, or sign in the body to predict which patients will suffer this toxicity and how severe it will get,” says Professor Lillian Siu, who’s been treating head and neck cancers, often with drugs that can cause neuropathy, for 25 years. “I can’t give more information than ‘You have to take it and see what happens’. And that’s not necessarily attractive to anybody.” To make things better, we need to find out more about how chemotherapy drugs affect nerve cells. That’s Lloyd’s specialism. Her investigations have brought an almost unknown system in our bodies into the spotlight. They could give doctors a way to predict, treat and even prevent neuropathy from chemo. The blood, the brain and the nerves We already knew a lot about how the nerve cells in the brain and spinal cord interact with chemotherapies. Or, more commonly, how they don’t. A special protective system called the blood-brain barrier (BBB) stops most drugs getting to them. That makes brain tumours hard to treat, but it can protect the brain and central nervous system from toxic side effects. Neuro-toxicities like brain fog or ‘chemo brain’, which Andrea has also experienced, are very difficult problems, but they’d be much worse without the BBB. Things are a little different in the rest of the body. Exactly how different has long been a mystery. A lot of scientists know a lot of things about the BBB. Lloyd is the rare one who has found something out about its not-so-distant cousin: the blood-nerve barrier. That works similarly to the BBB, stopping substances in the blood getting to sensitive peripheral nerves – it just gets nowhere near as much attention. “When we first went to the blood-brain barrier meetings and said, ‘We’re trying to understand the blood-nerve barrier,’ the response was mostly, ‘There’s a blood-nerve barrier?’” recalls Lloyd. What have we found out about chemotherapy-induced peripheral neuropathy? The main difference, as Lloyd got used to explaining, is that the blood-nerve barrier is a little less secure. This might help explain how chemotherapy drugs can get through and cause peripheral neuropathy. And it might also make the blood-nerve barrier a promising area to study. While everyone else was looking the other way, Lloyd’s team made a breakthrough. They found a way of opening and closing the blood-nerve barrier, simply by activating a signal in one of the types of cells that support it. No one’s ever managed to do something similar in the brain. “There was always this idea that you had to break down these barriers,” explains Lloyd. “But that would be toxic. We’ve shown you that can help things cross it, just for a short time, which makes side effects less likely.” Blood nerve barrier Open & Closed In the left image, the blood-nerve barrier is closed, which means drugs (red spots) can't enter peripheral nerves. It’s very different when the barrier is open (right). On the one side, opening the blood-nerve barrier is an important step towards delivering new types of cancer drugs to cancers that start in or spread through the nervous system. Then, quite apart from cancer, it could help treat nerve cell disorders and brain conditions like Huntington’s disease. It could even be the foundation for opening the blood-brain barrier and improving how we treat brain tumours. At the same time, understanding how to strengthen or close the blood-nerve barrier could help us stop chemotherapy-induced peripheral neuropathy. How doctors deal with peripheral neuropathy Siu knows just how important that could be. Because there aren’t any tests for peripheral neuropathy today, all doctors like her can do is help patients talk about their symptoms. “You can monitor other issues with scans and blood tests, but you can’t guess what’s happening to the nerve cells in every patient,” explains Siu. “You have to rely on them to tell you how they feel. “We bring it up every visit. And I try not to wait till the symptoms become obvious, because sometimes there’s a delayed effect. If you wait till you have moderate toxicity to do something, it could be severe by the next treatment cycle.” That discussion goes deeper than symptoms, though. Siu has learned that ‘who’ is just as important as ‘what’, ‘where’ and ‘when’. Our hands and feet can root us in the world and connect us to each other. Some people will choose to continue treatment when their symptoms become severe, but others couldn’t imagine life with long-term peripheral neuropathy. “I’ve treated a concert pianist, and they’re exquisitely sensitive about their finger movements,” says Siu. “With someone like that, we may mutually decide not to give a life-saving treatment and use an alternative, or to stop an effective drug early, because it could affect the most important part of their bodies. “Sometimes you know the best drug to give, but you can’t give it, or you have to stop, because you’ve decided together that it’s too risky. “It’s always such a tough decision. You can have a patient who’s experiencing a treatment response, which seems to be deepened with every cycle, and then all of a sudden you have no choice but to stop. You don’t want to make the wrong decision that will change the longevity of the patient. But, at the same time, I have to tell them that the neuropathy is only going to get worse if I continue. “We can’t reverse time. The only thing we can do is let time heal. It does get better somewhat. But it’s not fast. And it’s not complete.” Teams with the vision and expertise to uncover more about the processes behind issues like chemotherapy-induced peripheral neuropathy – and, ultimately, to help us understand how to prevent and treat it – have until 22 June 2023 to apply for funding of up to £20m ($25m).  “We have such great knowledge of so many things, and peripheral neuropathy doesn’t seem to be insurmountable,” says Siu. “It’s fitting that it’s a Cancer Grand Challenge, because it can be so difficult for patients, and we have the knowledge in this century to overcome it. If it wasn’t already time, it’s time now. “We may not have leveraged enough knowledge from biologists like Alison. We don’t talk about the blood-nerve barrier very much. There are probably insights there that we haven’t taken advantage of.” Better treatments without compromises Those insights are piling up. In their latest scientific paper, Lloyd’s team covered the ground of decades of studies into the BBB. “We’ve defined the structure and control of the blood-nerve barrier – all the cell types that are involved, how they interact, how it can be regulated and why it’s a barrier. It took more than 10 years of development, but we’ve got a model that enables you to see how a barrier can be opened and closed.” From here, scientists can tackle some of the most debilitating side-effects of cancer treatment, making chemotherapy a better option for everyone. We’re ready with the funding they need to make a difference – and the knowledge of why it’s so important. “You have this kind of love-hate relationship with chemo,” says Andrea. “You acknowledge that it could save your life, but at the same time it can cause you its own set of problems. I understand and respect that that’s why some people don’t want it – they’d much rather protect their quality of life.” We’re with Andrea, and everyone else like her, whatever treatment decision they make. Our job is helping tip the balance. Beating cancer means making sure as many people as possible can get the best quality treatment while living their lives the way they choose. “If chemotherapy didn’t have these side effects, it would be welcomed by so many more people,” says Andrea. And the more people we can treat, the more time we can give. Rash Chemotherapy can alter the immune system in ways that cause rashes and other skin changes. The drugs can also trigger skin changes directly. Severe rashes can cause painful, intense itching. If a person scratches until their skin bleeds, there is a risk of infection. Moisturizing lotions and over-the-counter anti-itch creams may help. Breathing problems Sometimes, chemotherapy can damage the lungs and make it harder to take in enough oxygen. Breathing issues can also result from some types of cancer. Staying calm, sitting and propping up the upper body with pillows, and practicing pursed lip breathing may help. A doctor may prescribe medication if breathing problems continue. Call 911Trusted Source, or otherwise contact local emergency services if anyone has: breathing problems that start suddenly and do not improve a bluish tint to their mouth, nail beds, or skin chest pain weakness or dizziness difficulty speaking Pain Some side effects of chemotherapy can cause pain. For example, there may be: ·       pain in the mouth and throat, possibly due to oral sores ·       nerve pain ·       pain at the injection site ·       headaches Pain can also occur as cancer progresses. The ACSTrusted Source encourages people to contact their cancer care team if they experience headaches or pain at an injection or catheter site. Pain is a potential side effect of chemotherapy. The pain caused by chemotherapy is often described as a burning, numb, tingling, or shooting sensation. It tends to occur in the hands and feet. This is called neuropathic pain. Neuropathic pain is the result of damage to the nerves caused by chemotherapy drugs or, sometimes, the cancer itself. Other types of pain associated with chemotherapy include: ·       headaches ·       muscle and joint pain ·       stomach aches Pain caused by chemotherapy should be manageable. Your doctor can prescribe medication to help ease the pain. It’s important to take pain medication as prescribed. This may involve following a schedule, so you can stay ahead of any potential pain. Don’t wait until your pain is overwhelming to take your pain-relief medication. Keep in mind that your pain levels may fluctuate throughout your treatment. Many cancer treatment resources recommend keeping a record of when and where you feel pain, what it feels like, and how strong it is. Speak with your healthcare team about how pain affects your day-to-day activities. They can help you manage any side effects or discomfort you may be experiencing. Complementary treatments that may ease pain  The following complementary treatments can be used to reduce the pain caused by cancer and chemotherapy: acupuncture and acupressure biofeedback deep breathing hypnosis massage therapy meditation physical therapy yoga

Breast cancer is when breast cells mutate and become cancerous cells that multiply and form tumors. Breast Cancer tumors grow when breast cells mutate and grow What is breast cancer definition? Breast cancer definition is one of the most common cancers that affects women and people assigned female at birth (AFAB) . It happens when cancerous cells in your breasts multiply and become tumors. About 80% of breast cancer cases are invasive, meaning a tumor may spread from your breast to other areas of your body. Breast cancer typically affects women aged 50 and older, but it can also affect women and people AFAB who are younger than 50. Men and people assigned male at birth (AMAB) may also develop breast cancer. Breast Cancer Healthcare providers determine cancer types and subtypes so they can tailor treatment to be as effective as possible with the fewest possible side effects. Common types of breast cancer include: Invasive (infiltrating) ductal carcinoma (IDC) : This cancer starts in your milk ducts and spreads to nearby breast tissue. It’s the most common type of breast cancer in the United States. Lobular breast cancer : This breast cancer starts in the milk-producing glands (lobules) in your breast and often spreads to nearby breast tissue. It’s the second most common breast cancer in the United States. Ductal carcinoma in situ (DCIS) : Like IDC, this breast cancer starts in your milk ducts. The difference is DCIS doesn’t spread beyond your milk ducts. Less common breast cancer types include: Triple-negative breast cancer (TNBC) : This invasive cancer is aggressive and spreads more quickly than other breast cancers. Inflammatory breast cancer (IBC) : This rare, fast-growing cancer looks like a rash on your breast. IBC is rare in the United States. Paget’s disease of the breast : This rare cancer affects the skin of your nipple and may look like a rash. Less than 4% of all breast cancers are Paget’s disease of the breast. Breast cancer subtypes Healthcare providers classify breast cancer subtypes by receptor cell status. Receptors are protein molecules in or on cells’ surfaces. They can attract or attach to certain substances in your blood, including hormones like estrogen and progesterone. Estrogen and progesterone help cancerous cells to grow. Finding out if cancerous cells have estrogen or progesterone receptors helps healthcare providers plan breast cancer treatment. Subtypes include: ER-positive (ER+) breast cancers have estrogen receptors. PR-positive (PR+) breast cancers have progesterone receptors. HR-positive (HR+) breast cancers have estrogen and progesterone receptors. HR-negative (HR-) breast cancers don’t have estrogen or progesterone receptors. HER2-positive (HER2+) breast cancers, which have higher than normal levels of the HER2 protein. This protein helps cancer cells to grow. About 15% to 20% of all breast cancers are HER2-positive. Symptoms and Causes Common signs of breast cancer and what to look for. What are breast cancer symptoms? The condition can affect your breasts in different ways. Some breast cancer symptoms are very distinctive. Others may simply seem like areas of your breast that look very different from any other area. Breast cancer may not cause noticeable symptoms either. But when it does, symptoms may include: A change in the size, shape or contour of your breast. A mass or lump, which may feel as small as a pea. A lump or thickening in or near your breast or in your underarm that persists through your menstrual cycle. A change in the look or feel of your skin on your breast or nipple. Your skin may look dimpled, puckered, scaly or inflamed. It may look red, purple or darker than other parts of your breast. A marble-like hardened area under your skin. A blood-stained or clear fluid discharge from your nipple. What causes breast cancer? Experts know breast cancer happens when breast cells mutate and become cancerous cells that divide and multiply to create tumors. They aren’t sure what triggers that change. However, research shows there are several risk factors that may increase your chances of developing breast cancer. These include: Age : Being 55 or older. Sex : Women and people AFAB are much more likely to develop the condition than men and people AMAB. Family history : If your parents, siblings, children or other close relatives have breast cancer, you’re at risk of developing the disease. Genetics : Up to 15% of people with breast cancer develop the disease because they have inherited genetic mutations. The most common genetic mutations involve the BRCA1 and BRCA2 genes. Smoking : Tobacco use has been linked to many different types of cancer, including breast cancer. Drinking beverages containing alcohol : Research shows that drinking beverages containing alcohol may increase breast cancer risk. Having obesity . Radiation exposure : If you’ve had prior radiation therapy — especially to your head, neck or chest — you’re more likely to develop breast cancer. Hormone replacement therapy : People who use hormone replacement therapy (HRT) have a higher risk of being diagnosed with the condition. What are the complications of breast cancer? The most significant complication is metastatic breast cancer — breast cancer that spreads to other areas of your body, including your brain, bones, liver and lungs. Studies show about 1 in 3 women and people AFAB who have early-stage cancer later develop metastatic breast cancer. Diagnosis and Tests How is breast cancer diagnosed? Healthcare providers may do physical examinations or order mammograms to check for signs of breast cancer. But they do the following tests to diagnose the disease: Breast ultrasound. Breast magnetic resonance imaging (MRI) scan. Breast biopsy. Immunohistochemistry test to check for hormone receptors. Genetic tests to identify mutations that cause breast cancer. Stages of breast cancer Healthcare providers use cancer staging systems to plan treatment. Staging cancer also helps providers set a prognosis, or what you can expect after treatment. Breast cancer staging depends on factors like breast cancer type, tumor size and location, and whether cancer has spread to other areas of your body. Breast cancer stages are: Stage 0 : The disease is non-invasive, meaning it hasn’t spread from your breast ducts to other parts of your breast. Stage I : There are cancerous cells in nearby breast tissue. Stage II : The cancerous cells have formed a tumor or tumors. The tumor is either smaller than 2 centimeters across and has spread to underarm lymph nodes or larger than 5 centimeters across but hasn’t spread to underarm lymph nodes. Tumors at this stage can measure anywhere between 2 and 5 centimeters across and may or may not affect the nearby lymph nodes. Stage III : There’s breast cancer in nearby tissue and lymph nodes. Stage III is usually referred to as locally advanced breast cancer. Stage IV : Cancer has spread from your breast to areas like your bones, liver, lungs or brain. Prevention Can breast cancer be prevented? You may not be able to prevent breast cancer. But you can reduce your risk of developing it. Just as important, regular self-exams and mammograms can help detect breast cancer early on, when it’s easier to treat. How can I lower my risk? There’s no sure way to reduce breast cancer risk, but the American Cancer Society (ACS) has the following advice for all women and people AFAB: Get to and stay at a healthy weight : This is a weight that’s right for you. Ask a healthcare provider for information on setting up healthy weight management. Eat a healthy diet : Some studies show a diet that includes vegetables, fruit, calcium-rich dairy foods and lean protein may reduce your risk of breast cancer. Avoiding red meat and processed meat may also reduce your risk. Get moving : Studies show that regular physical activity lowers breast cancer risk. Avoid beverages containing alcohol : Research shows a link between breast cancer and alcohol. The American Medical Association recommends women and people AFAB limit alcohol to one drink a day. Get screened : Mammograms often detect tumors when they’re too small to be felt. Do regular self-exams : Examining your breasts regularly helps to maintain breast health and may allow you to find breast cancer tumors. Some women and people AFAB have an increased risk for breast cancer because family members have it or they inherited a genetic mutation. If that’s your situation, you may want to consider the following: Genetic screening for breast cancer genes. Medication that may lower breast cancer risk like tamoxifen, raloxifene or aromatase inhibitors. Prophylactic (preventive) mastectomy. Frequent breast cancer screenings and physical examinations. If you have an increased risk for breast cancer, ask your provider if you should have additional tests to detect breast cancer, particularly if you’re under age 40 and have increased risk. Outlook / Prognosis What is the survival rate for breast cancer? Breast cancer survival rates vary based on several factors, like whether the cancer is invasive or non-invasive, the cancer type and the cancer stage. According to data kept by the National Cancer Institute (U.S.), overall, 91% of people with breast cancer were alive five years after diagnosis. The institute organizes breast cancer survival rates by stages: Local: Cancer hasn’t spread outside your breast. Regional: Cancer has spread to nearby lymph nodes and tissue. Distant: Cancer is in more distant areas of your body like your liver or lungs. Breast cancer stage & Five-year survival rate Local 99% Regional 86% Distant 30% As you think about breast cancer survival rates, remember, they’re only estimates based on other people’s experiences. Cancer affects different people in different ways. If you have specific questions about cancer survival rates, talk to your healthcare provider. They’re your best resource because they know your situation. What’s the outlook for breast cancer? Right now, more people are being diagnosed with early-stage breast cancer — meaning they’re diagnosed when it’s easier to treat — and fewer people are dying of breast cancer. Data shows 99% of people with early-stage breast cancer were alive five years after diagnosis. In some cases, they may be considered cured of breast cancer. But breast cancer can come back, and when it does, it may come back as metastatic breast cancer. Outlook may also depend on race. According to the American Cancer Society, Black women and people AFAB are slightly less likely to develop breast cancer than white women. But Black women are more likely to die of breast cancer than white women. Living With How do I take care of myself? Living with breast cancer may not be easy. You may have days when you feel overwhelmed by your situation. Consider the following suggestions for taking care of yourself as you go through breast cancer diagnosis and treatment: Get enough rest : Breast cancer and treatment can be exhausting. Try to remember to rest when you need to, not just when you think you have time. Eat well : Treatment may affect your appetite. A diet of fruit, vegetables, lean protein and healthy grains can help you stay strong during treatment. Manage your stress : Cancer is stressful. Exercise can help, from regular walks to exercise programs. Find support : You’re a breast cancer survivor, starting the day, you were diagnosed. Ask your healthcare provider about cancer survivorship programs, which may help you manage some of the challenges that come with living with breast cancer. When should I see my healthcare provider? Contact your provider if your symptoms seem to be getting worse or if you have new symptoms, like pain or weakness in a different part of your body. When should I go to the emergency room? You should go to the emergency room if your reaction to cancer treatment is stronger than you expected. For example, you should go to the emergency room if you’re severely dehydrated from constant vomiting. What questions should I ask my healthcare provider? Most people have lots of questions when they first learn they have breast cancer. Here are some ideas of questions you may want to ask your provider: What type of breast cancer do I have? What’s the tumor stage, size and grade? What’s my estrogen and progesterone receptor status? What’s my HER2 status? Will I need surgery? What are other treatment options? Is there a clinical trial available for me? Additional Common Questions How long can you have breast cancer without knowing? You can have breast cancer for years before noticing changes in your breasts like a lump. That said, not all lumps or bumps are cancer. Check with a healthcare provider if you have an unusual bump or mass that doesn’t go away after a few days. How fast does breast cancer spread? That depends on several factors, including the type of breast cancer you have, whether it’s hereditary and, the tumor stage and grade. If you have breast cancer, ask your healthcare provider for information about what you can expect. Can men get breast cancer? Yes, men and people AMAB can get breast cancer, but it’s not common. Approximately 2,600 men develop male breast cancer every year in the United States, making up less than 1% of all cases. Transgender women are more likely to develop breast cancer compared to cisgender men. Additionally, transgender men are less likely to develop breast cancer compared to cisgender women. In 2023, 1 in 8 women and people assigned female at birth (AFAB) in the United States will learn they have breast cancer. If you’re among those 1 in 8, there are a few more numbers you may want to consider. Nearly 4 million people in the United States are breast cancer survivors. Data show that overall, 91% of people with breast cancer were alive five years after diagnosis. And many experts are actively gathering information that may help providers tailor breast cancer treatment.

Before we delve into lab origin, we should make one thing clear: Whether the COVID-19 virus came from the Wuhan lab or not, the lab’s history of risky and unethical research—which operates under the Chinese Communist Party (CCP)—is a root problem that needs to be dealt with. The COVID-19 outbreak originated in a city where the world’s most advanced laboratory research on SARS-like viruses has been conducted. This is the main reason the lab-origin scenario was considered. Risky Research and the Lab Origin Theory In the Wuhan lab, virologists have used bat coronaviruses to manipulate SARS-like viruses for at least a decade. In 2010, for the first time, Wuhan virologists discovered that coronaviruses use the spike protein as a key to bind to ACE2 receptors, which are widely distributed on the surface of the cells of the body’s vital organs. In 2013, they isolated a specific bat coronavirus (WIV1) that bore a type of spike protein that can bind to human ACE2. In 2015, they edited the genes of natural viruses and engineered a new SARS-like virus that can infect human cells and jump from animals to humans which again validates the lab Origin Theory. A leaked NIH report reported that WIV created novel SARS-like viruses that can reproduce up to 10,000 times more copies of the original virus in genetically engineered mice expressing human ACE2 receptors, mimicking the human infection. Apart from the naturally occurring bat virus (WIV1), the other coronaviruses found to bind to human ACE2 receptors are the SARS virus, COVID-19 virus, and the purported four created by the WIV through GOF studies—the three viruses mentioned in the above leaked NIH report and the SHC014-MA15 virus reported in the 2015 Nature Medicine study. In 2021, The Intercept released a leaked research proposal called DEFUSE, submitted in 2018. This proposal contained a gain-of-function research plan to insert the specific cleavage site—FURIN—into the virus genes. Though the viruses engineered by WIV have not been proven to be the same as those of COVID-19 viruses, WIV intends to alter and enhance the functions of bat coronaviruses. Some argue that research conducted by WIV was done to better understand natural coronaviruses and their transmission with no surreptitious motives. Eventful Period: October Through November 2019 CCP reported that the first case of COVID-19 occurred on Dec. 1, 2019, with the Wuhan Huanan Seafood Market as ground zero. Multiple investigative reports have revealed that a severe, mysterious infection had already silently emerged in Wuhan at least two months before. 1. A group of U.S. scientific researchers , mainly from the University of California San Diego, examined the genomic data from the first cases of COVID-19 and used a scientific model to determine when the virus started infecting people. Their study suggests infection began in Hubei Province, China, between mid-October and mid-November 2019. It should be noted that this and other genomic studies were retrospective and can’t definitively confirm transmission, although these findings point to the possibility. 2. According to the China surveillance data of Wuhan influenza-like-illness (ILI) presented to the World Health Organization (WHO), a steep increase (Fig. 1) appeared in the last week of November 2019 (Nov. 24–30), rapidly exceeding the trend across 2016–2018. If that week’s ILI cases were caused by COVID-19 infection, considering an incubation period of two to 14 days, the infection-occurring period would fall into the week of Nov. 16 or earlier—the same time frame as reported by the above-mentioned U.S. genomic study report. Moreover, the WHO report also highlighted an unexplained increase (Fig. 2C) in lab test-negative ILI cases in Wuhan in mid-November 2019. Meanwhile, a 2022 published study indicates that those influenza-negative ILI cases may have served as potential COVID-19 transmission. 3. Diplomats stationed at the U.S. Consulate General in Wuhan attested valuable first-hand experience of an unusual, mysterious outbreak in Wuhan in October 2019. Subsequently, U.S. personnel decamped from China. The deputy consular chief at the U.S. Consulate in China, Russell J. Westergard, later wrote in State Magazine: “By mid-October 2019, the dedicated team at the U.S. Consulate General in Wuhan knew that the city had been struck by what was thought to be an unusually vicious flu season. The disease worsened in November. When city officials began to close public schools in mid-December to control the spread of the disease, the team passed the word to Embassy Beijing and continued monitoring.” 4. A surveillance report on sewage by the Italian Department of Environment, Health, and Nutrition, and Veterinary Public Health indicates that traces of the COVID-19 virus had been found in wastewater samples from Italy as early as Dec. 18, 2019. Lab Picture

You might already suspect that no single food will for sure protect you from cancer. But loading up on the right foods more often just might lower your odds. “We know that there’s a close relationship between diet and cancer risk,” says Soma Mandal, M.D., an internist at Summit Medical Group of New Jersey. What seems to be the most preventative? In general, you can count on plant foods, especially those that are high in fiber or brightly colored (a sign of lots of antioxidants), Dr. Mandal notes. (Processed meat and alcohol, on the other hand, have the potential do to the most harm.) And even within that framework, certain picks might be particularly potent. Some foods contain compounds that seem to work overtime at helping to stave off cell damage and inflammation, both of which can raise cancer risk. Here are 30 such foods that are worth eating more of. Healthy diet of fruits and vegetables 1 Broccoli Cruciferous veggies like broccoli are loaded with sulfur-containing chemicals called glucosinolates. During chewing and digestion, they get broken down into compounds like indole-3-carbinol and sulforaphane, which have been shown to fight cell damage and inflammation and even block blood vessels from forming in tumors, according to the  National Cancer Institute  (NCI). Try it:  Chili-Orange Shrimp with Broccoli Couscous   2 Flaxseeds They’re a top source of alpha-linoleic (ALA) omega-3 fatty acids, which are tied to lower  breast cancer risk . Clinical trials  have also found  that flaxseeds have the potential to slow the growth of tumors in women who’ve already been diagnosed with  breast cancer . And here’s a tip: Choose ground flaxseeds over whole ones whenever possible—grinding the seeds makes their nutrients more bioavailable,  research shows . Try it:  Apple and Blue Cheese Salad With Ground Flax   3 Green tea Tea consumption is tied to a lower risk of colon, breast,  ovarian , prostate, and  lung cancer , says the  NCI . And  green tea  is thought to pack an extra powerful punch. It’s loaded with polyphenols like epigallocatechin gallate and epicatechin gallate, which help protect cells from cancer-causing damage by neutralizing free radicals. “EGCG may also inhibit the growth of blood vessels that feed cancerous cells,” Dr. Mandal notes. Try it:  Green Tea, Blueberry, and Banana Smoothie 4 Kale It’s another cruciferous vegetable, so you know these hearty leaves have good stuff going for them from a cancer prevention perspective. A single cup of chopped kale serves up more than a day’s worth of antioxidants like vitamins A and C, both of which can scrounge up free radicals and stop them from causing cell damage that could potentially lead to cancer. Try it:  Garlic Shrimp and Kale Stir-Fry 5 Apples Can having one a day really help keep the doctor away? Regular  apple eaters  have a lower risk for lung cancer as well as certain types of breast cancer, according to the  American Institute for Cancer Research  (AICR). Just be sure to have the skin too. “The flavonoid  quercitin  has been associated with a reduced risk of certain cancers, and the highest concentration is found in the skin,” says nutrition expert  Erin Palinski-Wade, R.D. Try it:  Healthy Apple Oatmeal Muffins    6 Blueberries Blueberries ’ deep blue color comes from anthocyanins, powerful compounds that exert antioxidant activity. So it’s worth getting your fill: “Antioxidants function to inhibit the formation of free radicals, rapidly changing molecules that are damaging to DNA,” Dr. Mandal explains. And indeed, people who consume higher levels of anthocyanins have less inflammation and oxidative stress, says  the AICR . Try it:   Chicken & Blueberry Chimichurri Skewers 7 Cauliflower Broccoli’s paler cousin is also a cruciferous vegetable, and it boasts similar cancer-fighting abilities. So feel free to fill up, well, as often as you can. A  Harvard study  of some 124,000 adults found that women who gobbled up more than five servings of crucifers like cauliflower a week were less likely to get  lung cancer  compared to those who ate the veggies less frequently. Try it:   Chicken With Fried Cauliflower Rice 8 Chickpeas Being a regular garbanzo bean eater is tied to a lower risk for  colorectal cancer , found  a review  of 14 studies. Beans are chock-full of fibers that get fermented by the  good bacteria in our guts  and transformed into inflammation-fighting short chain fatty acids. And these acids are thought to potentially have cancer-fighting effects, the  AICR  notes. Try it:  Savory Low-Carb Chickpea Waffles 9 Walnuts Like flaxseeds,  walnuts  are rich in ALA omega-3 fatty acids. But that’s not all. They also serve up antioxidant compounds like ellagitannins, melatonin, and gamma-tocopherol, which  the AICR  says could combat oxidative stress and  inflammation . Just keep your portions in check, since walnuts are calorie-dense. A one-ounce, 150-calorie serving is all you need, says Palinski-Wade. Try it:  Asian Chicken and Walnut Salad 10 Black beans Just like chickpeas, black beans are loaded with gut-friendly fibers that could play a role in staving off inflammation. But that’s not all. Thanks to their dark purple color, black beans are loaded with cancer-fighting flavonoids like anthocyanins.  Tacos  or  black bean soup , anyone? Try it:   Healthy Black Bean Burgers 11 Garlic Population studies have tied higher garlic consumption to lower cancer rates, particularly when it comes to gastrointestinal cancers, according to  one review . Garlic contains sulfur compounds that exert antimicrobial activity as well as inhibit cell-damaging carcinogens, the researchers note. To reap the biggest benefits, chop or crush your garlic and let it sit for 10 minutes before adding it to your cooking. The brief rest helps the garlic produce more sulfur compounds,  the AICR  points out. Try it:   Creamy Roasted Garlic Soup 12 Oatmeal Oats are an easy, delicious source of whole grains, which may boast serious cancer-fighting abilities. People who get three servings of whole grains daily have a 15% lower cancer risk overall compared to those who get less, concluded  one major study . The benefits are even more impressive when it comes to colorectal cancer in particular: Three daily servings of whole grains could slash your risk by as much as 17%, the  AICR  notes. Try it:   Peanut Butter and Jelly Overnight Oats 13 Carrots Their bright orange color is a clue that carrots are loaded with antioxidants, namely beta-carotene—which might have something to do with their cancer-fighting abilities.  One analysis  concluded that high carrot intake was tied to a 21% lower chance for breast cancer, while  another  concluded that carrot consumption could help stave off  prostate cancer . Try it:   Spice-Roasted Carrots and Parsnips with Yogurt and Turmeric Vinaigrette 14 Grapes The juicy fruits are packed with the antioxidant resveratrol, which  research suggests  could play a role in thwarting the development of stomach, breast, liver, and lymphatic cancers. One thing to keep in mind? When it comes to cancer prevention, whole grapes are probably a better choice than red wine. Even though vino’s got resveratrol too,  alcohol consumption  can up your cancer risk,  the CDC  says. Try it:   Chicken Waldorf Tacos 15 Salmon People who take fish oil supplements four times a week are 63% less likely to  develop colon cancer  compared to those who don’t, found  a study  of nearly 70,000 older adults. And fatty fish like  salmon  offer similar benefits. “Consuming two to three servings per week may provide the same quantity of omega-3 fatty acids as supplemental fish oil and provide similar benefits against colon cancer,” Palinski-Wade says. Try it:  Honey-Spiced Salmon with Quinoa 16 Strawberries They might be a sweet treat—but they also pack a potent health punch:  Strawberries  are loaded with antioxidants like flavonoids and tannins. In addition to scavenging harmful free radicals, the compounds are thought to help protect against DNA damage and inhibit the growth of cancer cells, a  recent review  concluded. Try it:   Strawberry Caprese Pasta Salad 17 Tomatoes Another colorful fruit, another cancer-fighting antioxidant.  Tomatoes  are a top source of lycopene, a type of carotenoid thought to help reduce the risk for  prostate ,  breast, and lung cancers . For the biggest antioxidant punch, pick tomato sauce or tomato paste over whole raw ‘maters. “Lycopene increases when tomatoes are cooked,” Palinski-Wade says. Try it:  Roasted Tomato Sauce 18 Quinoa The nutty whole grain is packed with  protein  and  fiber  to keep you satisfied, but that’s not all. Whole grains like quinoa are thought to play a key role in keeping insulin levels steady and staving off inflammation, which could contribute to a lower cancer risk,  the AICR  notes. Try it:   Quinoa, Black Bean, and Avocado Salad 19 Cherries Like strawberries and blueberries,  cherries  are chock-full of protective phytochemicals. “These biologically active compounds can target key areas in the development of cancerous cells,” Dr. Mandal notes. And indeed, eating them regularly can help lower markers of oxidative stress and inflammation, a  major review  found. Try it:  Cherry Chocolate Granola Bars 20 Coffee Here’s just one more reason to love your morning cuppa. Women who drank four cups of  coffee  daily were 20% less likely to develop  endometrial cancer  and 24% less likely to develop cancer overall after  menopause ,  research shows . But you might want to steer clear of the cream and sugar. “Adding large amounts of either can offset coffee’s protective benefits,” Palinski-Wade says. “The best choice is flavoring coffee with a splash of milk and a non-calorie seasoning like cinnamon.” 21 Olive oil Permission to add an extra drizzle to your cooking, granted. A staple of the  Mediterranean diet , people who consume the most  olive oil  were less likely to develop breast or gastrointestinal cancer compared to those who rarely eat the stuff, a  review of 19 studies  found. Part of that may be thanks to olive oil’s healthy monounsaturated fats and phenolic antioxidant compounds, the authors say. Try it:  Lemon-Rosemary Dressing 22 Chia seeds Talk about small but mighty. Just two tablespoons of  chia seeds  delivers 5 grams of fiber. That’s important, since fiber encourages the growth of short-chain fatty acid in the gut that have anti-inflammatory and anti-cancer properties,  research shows . The seeds are also a top source of ALA omega-3 fatty acids, offering 5 grams per serving. Try it:   Vanilla Chia Seed Pudding 23 Brown rice Speaking of fiber, people who eat a fiber-rich diet are around 20% less likely to die from colon cancer compared to those who don’t get much roughage, a  recent study  found. And brown rice is just one more yummy way to get your fill, offering 3 grams per cooked cup. Try it:  Seafood and Brown Rice Paella 24 Milk An eight-ounce glass of low-fat milk delivers 300 milligrams (mg) of calcium, which could play a role in protecting against colon cancer. People who get more than 700 mg of calcium daily are up to 45% less likely to develop certain types of colon cancer compared to those who get 500 mg or fewer per day, found  an analysis  of some 135,000 people. Try it:   Blackberry Nut Butter Smoothie 25 Soy foods Consider replacing some of the beef or pork in your diet with soy-based proteins. While  red meat  consumption  is tied to  a higher risk of some cancers, soy foods serve up antioxidant compounds like isoflavones, which  studies tie  to lower rates of endometrial cancer. “Whole, unprocessed soy like edamame along with fermented soy foods [like miso or tempeh] may be the best choices,” says Palinski-Wade. “Highly processed soy products [like soy burgers or bars] don’t seem to offer the same protective benefits.” Try it:   Corn, Mango, and Edamame Salad   26 Plain yogurt People who ate three to four ounces of yogurt daily were nearly 20% less likely to develop lung cancer compared to non-yogurt eaters, a  recent study  found. Experts suspect that the benefit could at least partly come from yogurt’s  probiotics , which might reduce cancer-causing inflammation by promoting a healthier microbiome. Try it:   Apple-Cinnamon Yogurt 27 Artichokes Believe it or not,  artichokes  are loaded with antioxidants like polyphenols, which  research suggests  could play a valuable role in  breast cancer prevention . They’re also one of the most fiber-packed veggies out there—a half cup of cooked artichoke hearts serves up 7 grams. And a  recent study  found that people who get the most fiber are 17% less likely to develop lung cancer compared to those who get the least. Try it:   Healthy Spinach and Artichoke Pizza 28 Barley Not only is barley a fiber-rich whole grain, offering 6 grams per cooked cup, but it’s also a top source of a beta-glucans, a special type of fiber with a bevy of potential health benefits. When it comes to cancer prevention,  some studies  have found that beta-glucans may exhibit anti-inflammatory and anti-tumor activity. Try it:   Warm Kale-and-Barley Salad with Dill 29 Sweet potatoes Women with high blood levels of the antioxidant beta-carotene are up to 28% less likely to  get breast cancer  compared to those with low levels, found a major 20-year  study . And  sweet potatoes  are loaded with the stuff: Just one has some 700% of the amount you should get in a day. Try it:   Maple-Roasted Sweet Potato Wedges   30 Turmeric The golden-hued spice contains curcumin, an anti-inflammatory antioxidant compound that could help prevent cancer or slow its growth,  Mayo Clinic  experts say. “The potent antioxidant activity might fight against cell damage, which may prevent mutations that could lead to cancerous changes in cells,” Palinski-Wade explains. “Since there are very few side effects of including  turmeric  in your diet, adding a spoonful to your cooking daily may only help to improve your overall health.” Try it:   Turmeric Twist Smoothie All 30 of the above foods are part of an alternative cancer cure!

National Cancer Institute Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide. Genetic changes that cause cancer development can happen because: of errors that occur as cells divide.  of damage to DNA caused by harmful substances in the environment, such as the chemicals in tobacco smoke and ultraviolet rays from the sun. they were inherited from our parents.  The body normally eliminates cells with damaged DNA before they turn cancerous. But the body’s ability to do so goes down as we age. This is part of the reason why there is a higher risk of cancer later in life. Each person’s cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes will occur. Even within the same tumor, different cells may have different genetic changes. Cancer development

John Hopkins Article A spinal cord stimulator is an implanted device that sends low levels of electricity directly into the spinal cord to relieve pain. What You Need to Know Spinal cord stimulation is used most often after nonsurgical pain treatment options have failed to provide sufficient relief. Spinal cord stimulators require two procedures to test and implant the device: the trial and the implantation. Spinal cord stimulation can improve overall quality of life and sleep and reduce the need for pain medicines. It is typically used along with other pain management treatments. What is a spinal cord stimulator and how does it work? Spinal cord stimulators consist of thin wires (the electrodes) and a small, pacemaker-like battery pack (the generator). The electrodes are placed between the spinal cord and the vertebrae (the epidural space), and the generator is placed under the skin, usually near the buttocks or abdomen. Spinal cord stimulators allow patients to send the electrical impulses using a remote control when they feel pain. Both the remote control and its antenna are outside the body. Experts still don’t fully understand the mechanisms behind spinal cord stimulation, but they now know that it may target multiple muscle groups directly from the spine and even alter how the brain senses pain. Traditional spinal cord stimulators replace the sensation of pain with light tingling, called paresthesia. For patients who find these paresthesiae uncomfortable, newer devices offer “sub-perception” stimulation that cannot be felt. Many of the latest devices are placed by physicians with highly specialized training in interventional pain management under X-ray and/or ultrasound guidance. What is spinal column stimulator used for? Spinal column stimulation is used most often after nonsurgical pain treatment options have failed to provide sufficient relief. Spinal cord stimulators may be used to treat or manage different types of chronic pain, including: Back pain, especially back pain that continues even after surgery (failed back surgery syndrome) Post-surgical pain Arachnoiditis (painful inflammation of the arachnoid, a thin membrane that covers the brain and spinal cord) Heart pain (angina) untreatable by other means  Injuries to the spinal cord Nerve-related pain (such as severe diabetic neuropathy and cancer-related neuropathy from radiation, surgery or chemotherapy) Peripheral vascular disease Complex regional pain syndrome Pain after an amputation  Visceral abdominal pain and perineal pain Spinal cord stimulation can improve overall quality of life and sleep and reduce the need for pain medicines. It is typically used along with other pain management treatments, including medications, exercise, physical therapy and relaxation methods. Who should get a spinal cord stimulator? As with all treatments, your doctor will want to make sure spinal cord stimulation is right for you ⁠— and that it is likely to provide significant relief from your chronic pain. To make this recommendation, your pain specialist will likely order imaging tests and psychological screening. Some insurance companies require psychological screening to ensure disorders like depression or anxiety aren’t worsening your pain. Each patient is different, but generally, people who benefit the most from spinal cord stimulation are those who: Have not experienced sufficient pain relief with medications, less-invasive therapies or prior surgeries Do not have psychiatric disorders that would decrease the effectiveness of the procedure Spinal Cord Stimulator Types Spinal cord stimulators come in three main types: Conventional implantable pulse generator (IPG) is a battery-operated spinal code stimulator. A battery is placed in the spine during an operation. When it runs out, the battery must be replaced with another surgery. This device can be a good choice for people with pain in just one body part because it has a lower electrical output. Rechargeable IPG works similarly to the conventional device, with the difference that the battery can be recharged without another surgery. Because the energy source is rechargeable, these stimulators can put out more electricity. This may be a better choice for people with pain in the lower back or in one or both legs, as the electrical signal can reach further. Radiofrequency stimulator uses a battery that’s outside the body. This stimulator is rarely used today because of newer designs and better technology. It has rechargeable batteries, and like the rechargeable IPGs, it may be better for people with pain in the lower back and legs because of the device’s power. Your surgeon will explain how to operate the device and adjust the intensity of the electrical signal, which all three types of stimulators support. Different body positions may require different stimulator settings, such as one setting that works better for sitting and another for walking). To help you easily access the most used settings, most devices allow doctors to save two or three preset programs. Some newer devices feature several waveforms for electricity delivery, including high frequency, burst and high-density stimulation.   Spinal Cord Stimulation Spinal Cord Stimulator Surgery Spinal cord stimulators require two procedures to test and implant the device: the trial and the implantation. Spinal Cord Stimulator Trial The first step is a trial period. Your surgeon will implant a temporary device for you to test out. Guided by a specific type of X-ray called  fluoroscopy , your surgeon will carefully insert the electrodes in the epidural space of the spine. The location of your pain affects where these electrodes will be placed along the spine. Your surgeon may ask for your feedback during the procedure to best position the electrodes. This trial procedure typically requires only one incision in your lower back to place the electrodes. The generator/battery will be outside the body, typically on a belt, you’ll wear around your waist. For about a week, you will evaluate how well the device reduces your pain. The trial is considered a success if you experience a 50% or greater reduction in pain level. If unsuccessful, the wires can easily be removed in the clinic without damage to the spinal cord or nerves. If successful, surgery is scheduled to permanently implant the device. Spinal Cord Stimulator Implantation During the permanent implantation procedure, the generator is placed underneath the skin and the trial electrodes are replaced with sterile electrodes. Unlike the trial electrodes, these will be anchored by sutures to minimize movement. The implantation can take about 1-2 hours and is typically performed as an outpatient procedure. After the local anesthesia has been administered, your surgeon will make one incision (typically along your lower abdomen or buttocks) to hold the generator and another incision (along your spine) to insert the permanent electrodes. The incisions are about the length of a driver’s license. As in the trial procedure, fluoroscopy is used to determine where the electrodes are placed. Once the electrodes and generator are connected and running, your surgeon will close the incisions. Your surgeon may provide sedation to keep you comfortable and ask for your feedback during placement of the electrodes. Spinal Cord Stimulator Recovery Most patients leave the same day as their procedure — once the anesthesia has worn off. For several days after surgery, your incisions may be painful. Try not to stretch, twist or reach, which could pull at the incisions. Dressings will be placed over the incision sites, which can be removed after about 3 days. In most cases, incisions heal within about 2-4 weeks after surgery. Your doctor will discuss your recovery plan, but generally lighter activity is recommended for about 2 weeks after surgery. Once your surgeon approves you for regular activity, you can return to work and drive again (with the stimulator turned off). This is typically 1-2 weeks after surgery. Spinal Cord Stimulator Complications Complications of spinal cord stimulator surgery are rare, but no procedure is without risk. A small percentage of patients may experience: Infection, which may occur in the first 2-8 weeks. Bleeding. Device migration (i.e., the electrodes move from their original location and the stimulator doesn’t block pain as effectively). This often requires a follow-up surgery to put the electrodes back in the proper spot. Device damage (e.g., a fall or intense physical activity breaks the stimulator). Dural puncture. The dura mater surrounds the spinal cord. Spinal cord stimulators are inserted in the epidural space, the area just outside the dura mater. If a needle or electrode goes too deep and pierces it, cerebrospinal fluid may leak out. These punctures can cause severe headaches. Spinal cord trauma. Although extremely rare, spinal cord stimulator insertion can cause nerve injury and paralysis. Living with a Spinal Cord Stimulator Generally, the pain relief provided by spinal cord stimulators allows patients to do much more than they could before surgery, but there are certain restrictions to be mindful of. Can I have X-rays and CT scans with a spinal cord stimulator? So long as your spinal cord stimulator is powered off, X-rays and CT scans are generally safe. Before undergoing any scan, always let your doctor, nurse or technician know you have a spinal cord stimulator. Are spinal cord stimulators MRI compatible? No, MRIs are not always safe for those with spinal cord stimulation devices. Some newer devices are compatible with certain MRI machine models and scan locations, but your doctor will need to evaluate the specifics of your stimulator first. If your device is not MRI compatible, MRIs can cause serious injury. Communicate with your pain specialist beforehand so that he or she can weigh in on whether a procedure will interfere with or harm your stimulator model. Will my spinal cord stimulator set off airport security? Yes, airport security gates will detect your stimulator, but your physician will give you an identification card that may allow you to bypass the machine. Some people find that airport security gates cause uncomfortable (but harmless) interference with their stimulators. If you cannot avoid passing through the security screener, turn off your device before stepping through.  Can I drive with a spinal cord stimulator? No, you should power off your stimulator when you’re driving or operating heavy machinery, as sudden changes in stimulation levels could cause distraction. Can I swim with a spinal cord stimulator? Swimming is fine with a permanent, implanted generator, but you cannot get your temporary stimulator wet. You will need to avoid baths and showers during that short trial period. Can a spinal cord stimulator be removed? Yes, a spinal cord stimulator can be removed safely if you are unsatisfied with the level of pain relief it provides or if there is an infection or mechanical problem with your system.

https://www.news-medical.net/health/Radiation-Therapy-Dosage.aspx What is a radiation dose? When ionizing radiation penetrates the human body or an object, it deposits energy. The energy absorbed from exposure to radiation is called a dose. Radiation dose quantities are described in three ways: absorbed, equivalent, and effective. ·      Absorbed dose The energy absorbed in the human body from exposure to radiation is called an absorbed dose. The absorbed dose is measured in a unit called the gray (Gy). A dose of 1 gray is equivalent to 1 joule of energy deposited in a kilogram of a substance. ·      Equivalent dose When radiation is absorbed in living matter, a biological effect may be observed. However, equal absorbed doses will not necessarily produce equal biological effects. The effect depends on the type of radiation (such as alpha, beta, gamma). For example, 1 Gy of alpha radiation is more harmful to a given tissue than 1 Gy of beta radiation. To obtain the equivalent dose, the absorbed dose is multiplied by a specified radiation weighting factor (wR) to reflect the relative biological effects of the different types of radiation. The equivalent dose is expressed in a measure called the sievert (Sv). This means that 1 Sv of alpha radiation will have the same biological effect as 1 Sv of beta radiation. In other words, the equivalent dose is expressed as a single unit that accounts for the degree of harm that different types of radiation would cause to the same tissue. ·      Effective dose Different tissues and organs have different radiation sensitivities (see Figure 13). For example, bone marrow is much more radiosensitive than muscle or nerve tissue. To obtain an indication of how exposure can affect overall health, the equivalent dose is multiplied by a tissue weighting factor (wT) related to the risk for a particular tissue or organ. The result is the effective dose absorbed by the body. The unit used for effective dose is also the sievert. Dose from background radiation Radiation has always been present all around us. In fact, life has evolved in a world containing significant levels of ionizing radiation. It comes from space, the ground, and even within our own bodies. The doses due to natural background radiation vary depending on location and habits.   Dose from cosmic radiation Regions at higher altitudes receive more cosmic radiation . According to a study by Health Canada, the annual effective dose of radiation from cosmic rays in Vancouver, British Columbia, which is at sea level, is about 0.30 mSv. This compares to the top of Mount Lorne, Yukon, where at 2,000 m, a person would receive an annual dose of about 0.84 mSv. Air travel also increases exposure to more cosmic radiation, for a further average dose of 0.01 mSv per Canadian per year. Dose from terrestrial radiation There are also natural sources of radiation in the ground. For example, some regions receive more terrestrial radiation from soils that are enriched with uranium. The average effective dose from the radiation emitted from the soil (and the construction materials that come from the ground) is approximately 0.5 mSv a year. However, the dose varies depending on location and geology, with doses reaching as high as 260 mSv in Northern Iran or 90 mSv in Nigeria. In Canada, the estimated highest annual dose for terrestrial radiation is approximately 1.4 mSv measured in the Northwest Territories. Dose from inhalation The earth’s crust also contributes to our levels of exposure. Radon gas, which is produced by the earth, is present in the air we breathe. Radon gas naturally disperses as it enters the atmosphere from the ground. However, when radon gas enters a building (through the floor from the ground), a concentration of it tends to build up. Long-term exposure to elevated levels of radon increases the risk of developing lung cancer. The worldwide average annual effective dose of radon radiation is approximately 1.2 mSv. Learn more about radon in your home. Dose from ingestion A number of sources of natural radiation that penetrate our bodies through the food we eat, the air we breathe and the water we drink. Potassium-40 is the main source of internal irradiation (aside from radon decay) found in a variety of everyday foods. The average effective dose from these sources is approximately 0.3 mSv a year. Radiation Sources Dose from artificial sources of radiation Artificial sources of radiation (commercial and industrial activities) account for approximately 0.6 mSv of our annual radiation exposure. X-rays and other diagnostic and therapeutic medical procedures account for approximately 1.2 mSv a year ( UNSCEAR 2000 ). Consumer products like tobacco and smoke detectors account for another 0.1 mSv of our exposure to radiation each year. Radiation Dose Examples In all, natural radiation accounts for approximately 60% of our annual dose. Medical procedures account for roughly 40% of our annual dose. There is no difference between the effects caused by natural or man-made radiation. Dose limits The Canadian Radiation Protection Regulations set limits on the amount of radiation the public and nuclear energy workers may receive. Radiation Sources This image shows examples of nuclear facilities and substances that the CNSC regulates including uranium mining, nuclear power plants, nuclear medicine, research using nuclear substances and storage of nuclear waste. In Canada, the effective dose limits for the public is 1 mSv in one calendar year. Regular reporting and monitoring demonstrates the average annual effective doses to the public from activities licensed by the CNSC range from 0.001 to 0.1 mSv per year. The effective dose limits for a nuclear energy worker is set at 50 mSv in any one year and 100 mSv in five consecutive years. The dose limit for pregnant workers is 4 mSv from the time the pregnancy is declared to the end of the term. In addition, licensees must ensure that all doses are as low as reasonably achievable, social and economic factors being taken into account ( ALARA ). Regular reporting and monitoring demonstrate the average annual doses to the most exposed workers (e.g., industrial radiographer) are approximately 5 mSv per year. How radiation dose limits are set Canadian regulations follow the recommendations of the International Commission on Radiological Protection, which comprises some of the world's leading scientists and other professionals in the field of radiation protection, and also uses many of the standards and guides of the International Atomic Energy Agency. In Canada, the regulations, standards and practices to protect people and workers from radiation that are not governed by the CNSC are implemented by Health Canada, Employment and Social Development Canada, the Department of National Defence and the provincial/territorial governments. In addition, the Federal-Provincial-Territorial Radiation Protection Committee (FPtrPC) develops guidelines with respect to ionizing and non-ionizing radiation and works to harmonize radiation protection regulations across Canada. Co-chaired by the CNSC, Health Canada and the provinces, the FPtrPC provides a national forum on radiation protection issues.

Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body.  Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and multiply (through a process called cell division) to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place. The Definition of Cancer is when the damaged cells multiply out of control. Sometimes this orderly process breaks down, and abnormal or damaged cells grow and multiply when they shouldn’t. These cells may form tumors, which are lumps of tissue. Tumors can be cancerous or not cancerous ( benign ).  Cancerous tumors spread into, or invade, nearby tissues and can travel to distant places in the body to form new tumors (a process called metastasis ). Cancerous tumors may also be called malignant tumors. Many cancers form solid tumors, but cancers of the blood, such as leukemias , generally do not. Benign tumors do not spread into, or invade, nearby tissues. When removed, benign tumors usually don’t grow back, whereas cancerous tumors sometimes do. Benign tumors can sometimes be quite large, however. Some can cause serious symptoms or be life threatening, such as benign tumors in the brain. Electron microscope picture of cancer cell

Cervical cancer originates in the cells of the cervix, the lower part of the uterus (womb), where abnormal cells grow uncontrollably and form a tumor. It is the eighth most common cancer globally and the fourth most prevalent cancer among women. In the United States, the age-standardized rate of cervical cancer is 6.3 per 100,000 women. The American Cancer Society estimates that in 2024, there will be approximately 13,820 new cases of invasive cervical cancer diagnosed, and about 4,360 American women will die from the disease. Cancer of the Cervix

Epoch Health Article Testicular cancer occurs when malignant cells form in the tissues of one or, less commonly, both testicles. It affects approximately one in 250 males at some point in their lifetimes. In the United States, the American Cancer Society estimates approximately 9,760 new cases of testicular cancer and around 500 deaths from the disease in 2024. Since testicular cancer is typically treatable, the lifetime risk of a man dying from it is very low, roughly one in 5,000. The exact cause of testicular cancer is unknown, but most tumors originate in the germ cells contained in the testicles, in the seminiferous tubules. Testicular cancer pisture What Are the Types of Cancer of the Testical ? Germ cells in the testicles produce immature sperm, which is stored there until ejaculation. Although non-germ cell cancers exist, nearly all testicular cancers arise when these germ cells become malignant. Below are the most common types of testicular cancer. Seminomas Seminomas are the most common type of germ cell cancer, accounting for 54 percent of all testicular cancer cases. They typically occur in men between 20 and 45 and grow more slowly than nonseminomas. Nonseminomas Nonseminomas account for about 43 percent of all testicular cancers and primarily affect men in their late teens to 30s. Under a microscope, nonseminoma cells appear distinct from seminoma cells, and their treatments differ from those of seminomas. There are four main types of nonseminomas, including: Embryonal carcinoma:  This nonseminoma grows quickly and can spread beyond the testicle. Under a microscope, these tumors resemble very early embryos, hence their name. Yolk sac carcinoma:  This type is rare in adults but the most common testicular cancer in children and babies. It generally responds well to treatment in children. Choriocarcinoma: This is a rare and aggressive testicular cancer that can rapidly spread to distant organs such as the lungs, bones, and brain. It is often part of a mixed germ cell tumor. Teratoma: Teratoma contains tissue resembling all three layers of a developing embryo (endoderm, mesoderm, and ectoderm). Pure teratomas are rare and more commonly found as part of a mixed germ cell tumor. Mixed Germ Cell Tumors This type of germ cell tumor consists of both seminoma and nonseminoma components. They are treated in the same manner as nonseminomas. Germ cell tumors can sometimes develop outside the testicles. These are known as extragonadal germ cell tumors. These can originate in various parts of the body, most commonly in the mediastinum (area between the lungs), retroperitoneum (abdomen), lower spine, or the pineal gland in the brain. What Are the Symptoms and Early Signs of Testicular Cancer? Cancer of the testical typically starts as a scrotal mass, which is usually painless or causes dull, aching discomfort. Occasionally, bleeding within the tumor may lead to sharp local pain. Many patients notice the mass after minor scrotal injury. Symptoms related to metastases, such as abdominal or back pain, confusion, headaches, shortness of breath, or chest pain, are rare. Symptoms Testicular cancer has a very favorable prognosis when detected early. Men who regularly perform self-examinations are more likely to find the cancer at its earliest stage. Its common symptoms include: Swelling, a lump, hardening, or fluid accumulation in the testicles: Most testicular cancers consist of a painless mass in the testicle, typically palpable and several centimeters in size. Some do cause pain, however. Small, nonpalpable, asymptomatic masses without signs of distant disease are more likely to be benign. Studies show up to 80 percent of nonpalpable, asymptomatic tumors 2 centimeters or smaller are benign. Unusual changes in testicular size. Irregular or lumpy texture of the testicles: For instance, swelling that causes the testicle to become larger than usual. A dull ache in the abdomen or groin: Abdominal, flank, or back pain may be caused by invasion or obstruction of muscles, blood vessels, or the ureters. Decreased sexual activity. Presence of blood in the semen. Gynecomastia: Breast tenderness or growth. A feeling of heaviness in the scrotum or abdomen. Fluid buildup in the scrotum. Enlarged lymph nodes in the neck. Difficulty breathing or shortness of breath: This may be caused by pulmonary metastases. Hemoptysis: Coughing, occasionally with blood. Chest pain: This may be caused by pulmonary metastases. Difficulty swallowing. Swelling in the chest. Pleural effusion: Fluid accumulation around the lungs. Weight loss. Early signs of puberty in boys: Examples include deepening voice and facial and body hair growth. Infertility. Headache. What Causes Testicular Cancer? Testicular cancer occurs when cells divide more rapidly than normal, eventually forming a lump or tumor. The exact cause of testicular cancer is not known, but family history and environmental factors have been linked to it. What Are the Stages of Testicular Cancer? Staging of testicular cancer includes the following: Stage 1: Cancer is confined to the testicles. Stage 2: Cancer has spread to lymph nodes behind or beyond the membrane lining the abdomen and pelvis (retroperitoneal) or near the aorta (paraaortic). Stage 3: Cancer has spread beyond the retroperitoneal or paraaortic lymph nodes. Who Is at Risk of Testicular Cancer? Although testicular cancer can occur at any age and in any ethnicity, certain factors put a man more at risk, including the following: Age : Testicular tumors are most commonly found in young men aged 15 to 45. It is the second most common cancer in young men aged 15 to 19, with about 6 percent of cases occurring in children and teens and around 7 percent in men over 55. Race : In the United States, testicular cancer is most common in white men. Testicular germ cell tumors are currently the most common cancer among young men of white Northern European ancestry but are less so among Asians and Africans. However, the incidence is increasing among Hispanic or Latino men and Asian and Pacific Islander men, who may also develop the disease at a younger age. Cryptorchidism : The most common risk factor is a history of cryptorchidism (undescended testicle). Normally, testicles descend from the abdomen into the scrotum before birth, but in around 3 percent of boys, one or both testicles fail to do so. This condition increases cancer risk, particularly in the undescended testicle (a risk that is four to six times higher), although the risk is also increased in the normally descended testicle. The increased risk isn’t directly due to the failure of the descent itself but instead suggests an underlying abnormality in the testicle that makes cancer more likely. The higher the undescended testicle remains (such as in the abdomen), the greater the cancer risk. Surgery to move the testicle into the scrotum reduces but does not eliminate cancer risk. The risk is higher if the condition remains uncorrected or in men who haven’t undergone surgery by puberty. Personal history : Men who have had testicular cancer are at the highest risk of developing it again, with a 12 times higher risk compared to those without a history of the disease. However, only 2 percent of men will develop cancer in both testicles. Family history : A family history of testicular cancer significantly increases the risk; men have an eight-to-12 times higher risk if a brother has the disease and a two-to-four times higher risk if their father does. Although no specific gene is linked to testicular cancer, it is highly heritable. Men with a first-degree relative who has the disease are typically diagnosed two to three years earlier than the general population. However, since testicular cancer is rare, it is uncommon for it to run in families. Low sperm count : One retrospective cohort study found that men with poor semen quality had a 50 percent higher risk of multiple types of cancer, including testicular. However, those with azoospermia (no sperm count) had no increased risk. The researchers pointed out that this finding could be due to small sample size. Research has shown that sperm counts have been declining globally. While many factors are likely at play, two proposed theories relate to endocrine disruption caused by the increasing ubiquity of microplastics and a growing influx of electromagnetic radiation (EMF) exposure due to wireless devices. Extra X chromosome : Klinefelter syndrome (often referred to as KS, XXY, or Klinefelter’s) is a condition where boys and men are born with an extra X chromosome. Germ cell neoplasia in situ: Most testicular cancers develop from a precursor lesion called germ cell neoplasia in situ (GCNIS). It is found near testicular cancer in 80 percent to 90 percent of cases. If GCNIS is detected for other reasons, there’s a 50 percent risk of developing testicular cancer within five years and a 70 percent risk within seven years, making GCNIS a significant risk factor. Down syndrome : Testicular cancer is more common in men with Down syndrome, possibly because they are more likely to have cryptorchidism. Low birth weight or preterm birth : Males born with low birth weight have a 34 percent higher risk of testicular cancer than men born with normal weight. Preterm males have an increased risk of 31 percent compared to those born at term. Inguinal hernia: An inguinal hernia occurs when a part of the abdomen pushes through a weak spot in the lower abdominal wall, causing a bulge. Men with this condition have a 63 percent higher risk than men without the condition. Hypospadias: Hypospadias is an abnormality that affects the penis and urethra. Marijuana : Since the 1950s, the incidence of seminoma and nonseminoma—particularly affecting men in their 30s and 40s—has increased by 3 percent to 6 percent annually in the United States, Canada, Europe, Australia, and New Zealand. This rise has coincided with an increase in marijuana use in these regions. Research has shown that using marijuana for over 10 years is linked to an increased risk of developing testicular cancer, specifically the nonseminoma type. The study found that long-term marijuana use was associated with a 36 percent higher risk of testicular cancer overall and an 85 percent higher risk of the nonseminoma subtype. Leather tanning : Leather tanners who are exposed to dimethylformamide (DMF) have an increased risk of developing testicular cancer, and DMF is known to cause testicular damage. HIV/AIDS: Men with HIV appear to have an increased risk of developing testicular cancer, with the risk potentially being even higher for those with AIDS. Muscle-building supplements : A study published in 2015 found that muscle-building supplement use is a potentially adjustable risk factor that may be linked to testicular germ cell cancer. Radar guns: A 1993 study observed that all six police officers out of a cohort of 340 who developed testicular cancer had routinely used hand-held radar guns, holding them close to their testicles, which was the only common risk factor among them. Natural and synthetic hormones : Animal studies have shown that synthetic hormones and endocrine disruptors can affect hormone levels and the development of early germ cells, potentially leading to cancer. Endocrine disruptors are natural or synthetic chemicals that can mimic, block, or disrupt hormones. However, more research is needed to determine if these substances are linked to the increase in testicular cancer cases. Human studies are challenging due to the long time between early exposure and cancer development and the many factors that can complicate results, such as contaminants in food, packaging, and cosmetics. Currently, there is limited evidence connecting endocrine disruptors directly to testicular cancer, although some studies have found higher levels of certain toxins in the mothers of men with the disease. How Is Testicular Cancer Diagnosed? Some doctors advise young men to perform a self-exam of their testicles for lumps once a month. Testicular self-examinations are most effective after a warm bath or shower when the scrotum is relaxed, making detecting abnormalities easier. To perform the exam, stand facing a mirror and place your index and middle fingers under the testicle with your thumb on top. Gently roll the testicle between your fingers, checking for lumps, hardness, swelling, or size differences. Both testicles should be similar in size but not identical. Also, identify the soft, tube-like structure behind the testicle (epididymis), which typically isn’t cancerous but should still be checked by a doctor if lumps are found. A hard mass within the testicle is typically considered testicular cancer until proven otherwise. However, other conditions have similar symptoms to testicular cancer that should be ruled out, so a timely evaluation is essential. Screening There is no standard screening test for early detection of testicular cancer. Men discover cancer most often by chance, during self-exams, or by a doctor during a routine physical exam. Early detection can make treatment easier and may reduce the need for extensive chemotherapy or surgery. If a lump is found, further tests may be needed. Exams To diagnose and stage testicular cancer, a series of exams and tests are often required. The doctor will examine the testicles for swelling, tenderness, and lumps and will also check the abdomen, lymph nodes, and other areas of the body for signs of cancer spread. The exam results are typically normal except for any changes in the testicles. Transillumination may also be performed. This is a physical exam in which the doctor holds a flashlight up to the scrotum. In the case of a tumor, the light does not pass through the lump. If a lump or other indication of testicular cancer is detected, further tests will be required to determine the cause. It’s crucial to accurately determine whether scrotal masses are testicular (often malignant) or extratesticular (usually benign), as distinguishing between them can be challenging during a physical exam.  Scrotal ultrasound is an imaging test that looks at the scrotum. It can confirm the scrotal mass’s origin. If a testicular mass is confirmed, a blood test for tumor markers will be needed.  Many testicular cancers produce increased levels of tumor markers, such as alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG), in the blood. For instance, nonseminomas often increase AFP or HCG levels; pure seminomas may raise HCG levels but never AFP levels. Therefore, an increase in AFP indicates a nonseminoma component in the tumor, though tumors can be mixed. Sertoli and Leydig cell tumors do not produce these markers, and some cancers may be too small to affect marker levels. Additionally, increased levels of the enzyme lactate dehydrogenase (LDH) can indicate widespread disease but can also be raised by noncancerous conditions.  The most promising new serum marker for testicular cancer is micro-RNA (miRNA) 371a-3p. It is highly effective in detecting seminomas and nonseminomas in children and adults, except for differentiated pure teratomas. The miRNA 371a-3p test has better specificity than traditional serum markers and is particularly useful for detecting and monitoring seminomas that do not produce HCG or AFP.  If testicular cancer is suspected, instead of a biopsy, doctors typically recommend a radical inguinal orchiectomy, where the entire testicle is removed. A pathologist then examines the removed testicle to confirm the presence of cancer and determine its type and extent. This approach is often based on ultrasound and blood tumor marker tests, which provide enough evidence to proceed directly to surgery.  If cancer is confirmed, computed tomography (CT) scans are necessary to determine the clinical stage using the standard tumor, node, and metastasis (TNM) system (discussed in the staging section). What Are Possible Complications of Testicular Cancer? Complications arising from testicular cancer may include the following: Persistent fatigue Anxiety disorders Complications from metastasis Blood clots There may also be complications due to treatment. What Are the Treatments for Testicular Cancer? Testicular cancer is often curable. Depending on the stage, treatment options include surgery, radiation therapy, chemotherapy, active surveillance, and testosterone replacement therapy. 1. Surgery Radical inguinal orchiectomy: Radical inguinal orchiectomy involves the removal of the testicle and spermatic cord through an incision in the groin to lower the chances of cancer cells spreading to the scrotum. It is the foundation of treatment for testicular cancer. A cosmetic testicular prosthesis, such as a saline implant, may be placed during the procedure. Typically, the removal of one testicle does not significantly affect a man’s sexual performance or fertility. The remaining healthy testicle usually compensates by producing sufficient testosterone and sperm. Most men can still achieve an erection, although the sensation may change. Partial orchiectomy : Partial orchiectomy is a surgical procedure that involves removing only a portion of the testicle, typically the area containing a tumor, while preserving the remaining healthy tissue. It is usually considered when the tumor is benign, small, or low-risk, if both testicles have tumors, or if there is only one testicle. Some urologists support testis-sparing surgery for men with germ cell tumors, although it is not yet a proven or widely accepted technique. Retroperitoneal lymph node dissection (RPLND): Testicular cancer typically spreads in a predictable pattern, with the first metastases often occurring in the lymph nodes of the retroperitoneum, near the kidneys. Because of this, retroperitoneal lymph node dissection is a key surgical option for managing testicular cancer. 2. Radiation Therapy Radiation therapy, commonly prescribed by a radiation oncologist for men with stage 2 seminoma, uses targeted high-energy radiation to shrink tumors and eliminate remaining cancer cells after testicular surgery. While it has a high success rate, it carries potential long-term risks, such as second cancers and early cardiovascular disease. Radiation to the abdominal nodes does not typically affect sexual function or cause infertility. 3. Chemotherapy Chemotherapy, delivered intravenously, targets cancer cells that may have spread after tumor removal and is effective in curing many men with advanced testicular cancer. It typically includes a platinum-based drug such as cisplatin. In cases with large nodal masses, metastases, or elevated tumor markers, platinum-based chemotherapy followed by surgery is recommended for long-term control. Chemotherapy can impair fertility, so sperm banking is advised beforehand. While it does not affect sexual function, many men experience a temporary loss of sex drive after treatment. However, no risk to the fetus has been evident if pregnancy occurs. 4. Active Surveillance Active surveillance is the preferred approach for patients with stage 1 seminoma or nonseminoma germ cell tumors, particularly for those at low risk of relapse. High-risk patients typically receive adjuvant therapy, such as retroperitoneal lymph node dissection or chemotherapy. 5. Testosterone Replacement Therapy Testosterone replacement therapy may be needed if the remaining testicle does not produce enough testosterone or, in rare cases, if both testicles are removed. Low testosterone can lead to symptoms such as reduced sex drive, erectile difficulties, fatigue, low energy, and osteoporosis. If these symptoms occur, a doctor may test testosterone levels to determine if replacement therapy is appropriate. This therapy can be administered through a gel, muscle injection, implant, or skin patch, and it typically helps restore sex drive and energy levels. Patients with nonseminomas have approximately a 30 percent risk of recurrence, even when the disease seems localized. For seminomas, the recurrence rate is around 15 percent to 20 percent. The prognosis for testicular cancer depends on the tumor’s histology and extent. The five-year survival rate exceeds 95 percent for patients with localized seminomas or nonseminomas and those with low-volume metastases in the retroperitoneum. For those with extensive retroperitoneal, pulmonary, or other visceral metastases, the five-year survival rate varies from 48 percent to over 80 percent. However, even patients with advanced disease can potentially be cured. How Does Mindset Affect Testicular Cancer? While mindset doesn’t directly cause or prevent testicular cancer, it can significantly affect how individuals cope with the disease and their treatment outcomes. A positive mindset can help patients better manage the emotional challenges of a cancer diagnosis, such as anxiety, depression, and fear. An adaptive mindset may also lead to better adherence to treatment plans, follow-up appointments, and self-care routines, which can improve physical outcomes. Furthermore, maintaining a positive mindset can reduce stress, potentially indirectly benefiting immune function and overall health. Psychosocial interventions, including Mindfulness-Based Stress Reduction (MBSR) and cognitive behavioral therapy (CBT), may help.  A positive mindset can also help patients engage more effectively with their support care networks to better meet their emotional and practical challenges. What Are the Natural Approaches to Testicular Cancer? Natural remedies cannot completely cure testicular cancer, as conventional treatments are necessary for effective treatment. However, they may help alleviate symptoms and reduce complications or side effects of treatment. Before using any of the ones listed below, please consult a health care professional since clinical trials are needed to establish safety and efficacy, and some can be toxic. 1. Medicinal Herbs Green tea (Camellia sinensis): Green tea is rich in natural polyphenols. Epigallocatechin-3-gallate (EGCG) is the main catechin (a type of polyphenol) in green tea and is known for its various health benefits, such as metabolic regulation and antioxidant, anti-inflammatory, and anti-cancer properties. Research has shown that EGCG can inhibit cancers in the male and female reproductive systems, including testicular cancer. A 2007 in vitro study showed that green tea extract has the potential to inhibit the activity of MMPs (enzymes) and regulate testicular cancer cell invasion. Mayapple (Podophyllum peltatum): Belonging to the Berberidaceae family, mayapple is native to the eastern United States and southern Canada. Chemical tests of the mayapple plant show that it contains several compounds called lignans that have been found to help fight cancer. Etoposide, a drug approved by the U.S. Food and Drug Administration (FDA) for treating testicular cancer, is made from podophyllotoxin, a substance derived from the mayapple plant. American ginseng (Panax quinquefolius): Cyclophosphamide is a chemotherapy drug for testicular cancer treatment. However, it can cause toxic side effects in multiple organ systems, including the testicles. A 2018 rat model showed that cyclophosphamide treatment caused a significant decrease in testosterone and increased DNA damage in lab rats, along with severe damage to testicular tissue. However, when given with cyclophosphamide, American ginseng helped restore testosterone levels, reduce DNA damage, and improve testicular tissue condition. Thus, American ginseng may improve cyclophosphamide-induced toxicity in some cases, but further evidence of safety and efficacy with clinical trials is needed. Astragalus (Astragalus membranaceus): A 2012 study showed that astragalus improved testicle weight and sperm quality affected by cyclophosphamide-induced reproductive toxicity in male mice. 2. Diet Treatments for testicular cancer can cause nutrition-related side effects such as constipation, diarrhea, fatigue, low iron levels, nausea, and weight loss. While there’s no specific diet for treating testicular cancer, the Leukemia & Lymphoma Society recommends the following dietary practices: Incorporate all food groups to get the most cancer-fighting nutrients. Aim to eat a variety of colorful fruits and vegetables. Maintain a healthy weight. Try to have small, frequent meals throughout the day instead of three large ones. Choose lean protein sources, as extra protein helps repair cells and tissues, supports recovery, and boosts the immune system. Drink plenty of fluids like water, milk, or fresh-pressed juice to avoid dehydration and digestive issues. Opt for plant-based fats such as olive oil, avocados, nuts, and seeds. 3. Supplements Nutrient mixture: The aforementioned 2007 cell line study found that a specific nutrient mixture composed of lysine, proline, arginine, vitamin C, and green tea extract can significantly lower the activity of enzymes that help testicular cancer cells spread. Increasing its doses led to a near-complete inhibition of these enzymes and reduced the ability of testicular cancer cells to invade through tissue barriers by 84 percent. Lycopene: Antioxidant lycopene can help prevent weight loss in the testes and epididymis caused by the testicular cancer drug adriamycin, which reduces sperm movement and increases the number of abnormal sperm. How Can I Prevent Testicular Cancer? Most men with testicular cancer have no identifiable risk factors, and some known risk factors, such as a family history, are unchangeable. Consequently, preventing most cases of testicular cancer is currently impossible. However, monthly testicular self-examinations may help detect testicular cancer early, which is crucial for effective treatment and survival. While testicular cancer cannot be prevented entirely, avoiding the risk factors previously discussed is a good place to start. Research has shown that diet and exercise are staples in maintaining general wellness. With this in mind, consider the following for optimal health: Eat a nutritious diet that emphasizes whole foods and restricts processed ones. Try to maintain a consistent sleep schedule, minimize screen use a few hours before bedtime, and get seven to eight hours of sleep per night. Avoid environmental toxins whenever possible, including pollution and endocrine disruptors. Limit or avoid marijuana use. Be mindful of factors that may affect sperm count, such as EMF exposure and other sources of radiation, and therefore, testicular cancer risk.

WHO Article The number of people diagnosed with cancer has jumped by 5 percent in just a year, with prostate cancer driving the sharp increase among men, the latest statistics show. New figures for England show 346,217 new cancer cases were diagnosed in 2022, which equates to 948 people being diagnosed with the disease every day, up from 329,664 in 2021. The Cancer Registration Statistics show that, among men, there was a 7 percent increase in overall cancer cases in 2022, from 167,917 to 180,877. In women, there was a 2 percent overall rise in cases, from 161,747 to 165,340 which is alarming as Cancer cases surge.. The jump in men’s diagnoses was mainly down to an increase in prostate cancer, which rose by more than a quarter to 54,732 cases. Overall, the data showed that more men were diagnosed with cancer than women. ‘Missing Men’ Campaign as cancer Rates in the United States Surge In 2022, prostate cancer was the most commonly diagnosed cancer, and over half (51 percent) of all new cancer cases for both sexes combined were for just four types of cancer: of the prostate, breast, lung, or bowel. The surge of more than 11,000 cases of prostate cancer is the biggest annual increase on record, and follows a campaign to find the “missing men” who did not go for their recommended screening during the lockdown era. Around 14,000 fewer men were diagnosed with prostate cancer than would have been expected in England and Scotland between April 2020 and December 2021, the figures suggest. Factors which are said to increase the risk of cancer include getting older, being obese, drinking too much alcohol, and smoking, although the actual cause of cancer remains unknown. Broadly speaking, cancer is defined as a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. Scientists believe it can be caused by a combination of genetic and environmental factors, or by random mutations, although not all experts agree and many hypotheses have been put forward. NHS England said the higher diagnosis figures could be partly owing to its public information campaigns in 2022 to encourage people to come forward for checks in the aftermath of the COVID-19 lockdown era, when some people declined recommended screenings, or in some cases, were not offered them. COVID-19 Jabs Link Raised Some oncologists, such as Professor Angus Dalgleish, have raised repeated concerns that they have seen previously healthy patients develop aggressive, so-called “turbo” cancers, or patients in remission suddenly relapse, following a COVID-19 vaccine, particularly a booster shot. Writing in January, initially for TCW, Dalgleish said, “Rather than instigating a proper inquiry to investigate this when we raised these concerns, the medical authorities told us that all of what we were witnessing was a coincidence, that we had to prove it and, above all, not to upset our patients.” Booster jabs are now only offered by the health service to the over-75s and those considered to be clinically vulnerable. The NHS said death rates from cancer are falling, from 345 deaths per 100,000 men in 2011 to 299 per 100,000 in 2022. In women, the drop was from 237 deaths per 100,000 in 2011 to 212 deaths per 100,000 in 2022. NHS National Cancer Director Dame Cally Palmer said in a statement: “This data shows the NHS is diagnosing more cancers than ever before, and our work to raise awareness, target those at risk and encourage people to come forward for checks is leading to more people starting treatment promptly—potentially saving lives. “We know that some people are still waiting too long to receive a diagnosis or the all-clear, and there is more to do to ensure all patients receive high-quality and timely care.” The increase in cancer rates can be seen in many other countries, including in the United States. In February, the American Cancer Society warned of a surge in new cancer cases in the country over the past year, with many of them occurring in younger patients. Some oncologists, such as Professor Angus Dalgleish, have raised repeated concerns that they have seen previously healthy patients develop aggressive, so-called “turbo” cancers, or patients in remission suddenly relapse, following a COVID-19 vaccine, particularly a booster shot. Writing in January, initially for TCW, Dalgleish said, “Rather than instigating a proper inquiry to investigate this when we raised these concerns, the medical authorities told us that all of what we were witnessing was a coincidence, that we had to prove it and, above all, not to upset our patients.” Booster jabs are now only offered by the health service to the over-75s and those considered to be clinically vulnerable. The NHS said death rates from cancer are falling, from 345 deaths per 100,000 men in 2011 to 299 per 100,000 in 2022. In women, the drop was from 237 deaths per 100,000 in 2011 to 212 deaths per 100,000 in 2022. NHS National Cancer Director Dame Cally Palmer said in a statement: “This data shows the NHS is diagnosing more cancers than ever before, and our work to raise awareness, target those at risk and encourage people to come forward for checks is leading to more people starting treatment promptly—potentially saving lives. “We know that some people are still waiting too long to receive a diagnosis or the all-clear, and there is more to do to ensure all patients receive high-quality and timely care.” The increase in cancer rates can be seen in many other countries, including in the United States. In February, the American Cancer Society warned of a surge in new cancer cases in the country over the past year, with many of them occurring in younger patients. Professor Angus Dalgleish, have raised repeated concerns that they have seen previously healthy patients develop aggressive, so-called “turbo” cancers, or patients in remission suddenly relapse, following a COVID-19 vaccine, particularly a booster shot. Writing in January, initially for TCW, Dalgleish said, “Rather than instigating a proper inquiry to investigate this when we raised these concerns, the medical authorities told us that all of what we were witnessing was a coincidence, that we had to prove it and, above all, not to upset our patients.” Booster jabs are now only offered by the health service to the over-75s and those considered to be clinically vulnerable. The NHS said death rates from cancer are falling, from 345 deaths per 100,000 men in 2011 to 299 per 100,000 in 2022. In women, the drop was from 237 deaths per 100,000 in 2011 to 212 deaths per 100,000 in 2022. NHS National Cancer Director Dame Cally Palmer said in a statement: “This data shows the NHS is diagnosing more cancers than ever before, and our work to raise awareness, target those at risk and encourage people to come forward for checks is leading to more people starting treatment promptly—potentially saving lives. “We know that some people are still waiting too long to receive a diagnosis or the all-clear, and there is more to do to ensure all patients receive high-quality and timely care.” The increase in cancer rates can be seen in many other countries, including in the United States. Some oncologists, such as Professor Angus Dalgleish, have raised repeated concerns that they have seen previously healthy patients develop aggressive, so-called “turbo” cancers, or patients in remission suddenly relapse, following a COVID-19 vaccine, particularly a booster shot. Writing in January, initially for TCW, Dalgleish said, “Rather than instigating a proper inquiry to investigate this when we raised these concerns, the medical authorities told us that all of what we were witnessing was a coincidence, that we had to prove it and, above all, not to upset our patients.” Booster jabs are now only offered by the health service to the over-75s and those considered to be clinically vulnerable. The NHS said death rates from cancer are falling, from 345 deaths per 100,000 men in 2011 to 299 per 100,000 in 2022. In women, the drop was from 237 deaths per 100,000 in 2011 to 212 deaths per 100,000 in 2022. NHS National Cancer Director Dame Cally Palmer said in a statement: “This data shows the NHS is diagnosing more cancers than ever before, and our work to raise awareness, target those at risk and encourage people to come forward for checks is leading to more people starting treatment promptly—potentially saving lives. “We know that some people are still waiting too long to receive a diagnosis or the all-clear, and there is more to do to ensure all patients receive high-quality and timely care.” The increase in cancer rates can be seen in many other countries, including in the United States. In February, the American Cancer Society warned of a surge in new cancer cases in the country over the past year, with many of them occurring in younger patients. warned of a surge in new cancer cases in the country over the past year, with many of them occurring in younger patients.

Epoch Health Article Celiac disease, also known as gluten enteropathy, affects about 1 percent to 2 percent of the global population. The prevalence in the United States increased fivefold in the United States between 1975 and 2000. Once considered a rare gastrointestinal disease only affecting children, we now know it is a lifelong autoimmune condition that can develop at any age. This disease can produce a wide range of symptoms both inside and outside the intestines, but some people have no symptoms. This variability often leads to delayed recognition and diagnosis, with people waiting as long as 12 years for a diagnosis. What Are the Symptoms and Early Signs of Celiac Disease? Celiac disease is often undiagnosed or misdiagnosed because it can cause so many different symptoms. The autoimmune attack, inflammation, and problems absorbing nutrients (malabsorption) lead to a wide range of symptoms. These symptoms are different for each person and mimic those of other conditions. Children are more likely to have the “classical” gastrointestinal symptoms and signs of malabsorption. However, both children and adults commonly have symptoms outside the digestive system known as extraintestinal manifestations. Underdiagnosis is more unlikely in populations where it may be less expected, such as in older people, men, obese people, and non-white populations. However, it still occurs in these populations. Some of the gastrointestinal symptoms and signs of celiac disease include: Diarrhea or constipation Abdominal pain Bloating and gas Heartburn Steatorrhea (pale-colored or smelly, fatty stool) Nausea or vomiting Weight loss Nutrient deficiencies (e.g., calcium, copper, zinc, vitamins B6 and D) Low blood protein levels Electrolyte imbalance  Extraintestinal manifestations include: Fatigue Anemia (e.g., iron, ferritin, folate, vitamin B12 deficiencies) Headaches Itchy, blistering skin rash Reproductive changes: male or female infertility, absence of menstrual periods (amenorrhea), miscarriage, premature birth, early menopause Recurrent canker sores Reduced bone mineral density (osteopenia or osteoporosis) Peripheral neuropathy Anxiety and depression Cognitive impairment Impaired spleen function (hyposplenism) Elevated liver enzymes The following symptoms and signs may occur in children: Failure to thrive Growth problems Short stature (below the shortest 3 percent for age) Swollen belly Delayed puberty Dental enamel defects Irritability Attention-deficit/hyperactivity disorder (ADHD) or learning disabilities Seizures What Causes Celiac Disease? Celiac disease results from a complex interaction between gluten, genetics, and environmental factors. Components of the gluten found in wheat, barley, and rye resist full breakdown by human digestive enzymes. Gluten or the digestion-resistant proteins in gluten can increase intestinal “leakiness“ even in non-celiac individuals, allowing undigested gluten peptides and particles to enter the bloodstream. When the immune system mistakes gluten as a threat and attacks the intestinal lining, it causes excessive cell death (apoptosis) in the areas that comprise the villi—tiny, finger-like projections lining the small intestine. The intestine cannot keep up with producing new cells to replace those destroyed, so the villi become atrophied and flattened over time. This is the end result of the immune response that leads to malabsorption because the damaged villi cannot absorb nutrients. Celiac Disease In predisposed individuals, the immune system mistakenly attacks gluten, damaging the intestinal lining in the process. This autoimmune attack flattens intestinal villi, making it so the body cannot absorb nutrients and causing gastrointestinal symptoms. Illustration by The Epoch Times, Shutterstock For some individuals with celiac disease, the problem goes beyond gluten. They continue experiencing inflammation and immune system activation due to “cross-reactivity.“ This happens when the immune system gets confused and attacks not only gluten but also proteins from other foods like dairy, coffee, corn, and grains like millet or rice. This cross-reactivity occurs because certain proteins in these foods mimic gluten on a molecular level with similar short amino acid sequences. As a result, the “leaky” gut and these cross-reactive triggers can sustain a state of chronic inflammation and autoimmune attack, even on a gluten-free diet (GFD). Restoring the gut barrier prevents these cross-reactive food proteins from leaking through and triggering the immune system. Removing both gluten and these cross-reactive food triggers while allowing the gut to heal fully can help stop the autoimmune process.   Changes in Bread-Making, Wheat, and Agriculture Our ancestors, who hunted and gathered food, ate little grain. However, with the development of agriculture, people began eating more grain, especially wheat. Today, wheat is often used as a cheap filler in processed foods, significantly increasing the average person’s gluten intake. In the past, breads, such as sourdough, were fermented. Fermenting can help break down the gluten, making it easier for your body to digest. Today, faster bread-making methods use baker’s yeast or chemicals, which do not help break down the gluten. This shift in bread-making practices, coupled with increased wheat consumption, correlates with the rising rates of celiac disease. The selective breeding of wheat to enhance yield and resist pests may have made modern wheat strains more immunogenic (immune provoking) than ancient strains, but not all researchers agree. For those with celiac disease, all strains are problematic. Another modern practice that raises concerns is the use of glyphosate, an herbicide, to dry wheat before harvest. Although it has not been proven to cause celiac disease, glyphosate exposure is suspected of disrupting gut bacteria, increasing gut permeability, and causing inflammation. These changes could potentially contribute to the development of celiac disease. Genetics Most people with celiac disease have specific genetic markers called human leukocyte antigen (HLA) types DQ2 or DQ8, with HLA-DQ2 being more common. While up to 40 percent of individuals of European and Asian descent carry these markers, only a few of them develop celiac disease. This indicates that having the genetic markers alone is not enough to cause the disease; other factors, including environmental, also play a role. Environmental Factors The following are environmental factors that also contribute to the development of celiac disease: Processed food:  Microbial transglutaminase (mTG) is a food additive used to improve the texture and properties of protein-based foods. This enzyme modifies gluten proteins, making them harder to digest and more likely to trigger an immune response. mTG is similar to tissue transglutaminase, the main target of the immune system in celiac disease. mTG can also disrupt the gut barrier and increase intestinal permeability, making gluten more likely to provoke an immune reaction and contribute to the development of celiac disease. Viruses:  Certain viruses are also suspected to play a role in the development of celiac disease, especially when inflammation is present. Enteroviruses, rotaviruses, reoviruses, and influenza have been identified as potential triggers. These viruses might influence the gut microbiome, but research is ongoing to understand the mechanisms involved fully. Impaired gut microbiome: The gut microbiome—the trillions of bacteria and other microbes in our intestines—plays a crucial role in our immune system and overall health. Increasing evidence suggests that the microbiome may play a major role in the development of celiac disease. In fact, research on germ-free mice shows that gut microbes are required for celiac disease development. Studies have shown that people with celiac disease often have lower levels of beneficial bacteria like Bifidobacteria and Lactobacilli and higher levels of potentially harmful bacteria than those without the condition. What Are the Types of Celiac Disease? Celiac disease is part of a spectrum of disorders known as gluten-related disorders. Each is triggered by gluten but affects the body differently. In 2011, 16 celiac disease experts from seven countries met in Oslo, Norway, and established the Oslo definitions for the following types Asymptomatic (formerly silent): No noticeable symptoms are present. This type may include at-risk individuals, such as family members of those with celiac disease who are diagnosed through screening. It may also include people with minor symptoms like fatigue not previously linked to celiac disease. If symptoms improve on a GFD, the condition should be reclassified as subclinical. Interestingly, symptoms may become noticeable only after starting a GFD when a previously unnoticed symptom resolves. Symptomatic (formerly overt): Either gastrointestinal symptoms or extraintestinal manifestations may be present. Classical (formerly typical): Diarrhea, steatorrhea, and weight loss or growth failure are required features of this type. Other signs and symptoms of malabsorption may also be present. Some researchers would prefer this type to be called “intestinal” for clarity. In a few cases, autoantibodies may not be elevated, but villous atrophy (flattened villi) is present. About 27 percent of people fall into this category. Non-classical (formerly atypical): Constipation and abdominal pain may be present but without the typical signs of malabsorption. Some researchers prefer to call this type “extraintestinal.” Over half of those with celiac disease have this type. Sub-clinical:  Signs and symptoms are subtle, not easily detected, or insufficient to prompt testing. About 21 percent of people with celiac disease fall into this category. Potential:  Autoantibodies are elevated, and inflammation with increased intraepithelial lymphocytes is present, but the intestinal lining appears normal. Refractory celiac disease: Symptoms may not resolve after 12 months on a GFD for various reasons that require further investigation. When signs, symptoms, and villous atrophy persist, one potential cause may be refractory celiac disease, a more severe form. Who Is at Risk of Celiac Disease? The following factors elevate one’s risk for celiac disease: Age:  Celiac disease can develop at any age, but around 25 percent of all celiac disease diagnoses are now made in patients over 60 years old, and 20 percent are among those 65 and older. Some research indicates it’s more common in children than adults, though other evidence suggests it’s more commonly diagnosed in adults, likely due to delayed diagnoses. Sex:  As with most other autoimmune conditions, females are more likely to develop celiac disease. One 2018 meta-analysis in Clinical Gastroenterology and Hepatology showed that females were 1.5 times more likely to have biopsy-confirmed celiac disease. Ethnicity:  Celiac disease is more prevalent in individuals of European descent but can affect any ethnicity. Geographic region:  Celiac disease is most common in Europe and Asia, with significant rates also in North America and Africa. In the United States, the disease is less common in the southern states than in the northern states. This may be due to where studies have been conducted, genetic predisposition, and environmental factors like sunlight exposure affecting vitamin D levels. Evidence shows that vitamin D is vital for immunomodulation in celiac disease and other autoimmune diseases. Family history:  If you have a first-degree relative (parent, sibling, or child) with celiac disease, your risk of developing it is 5.5 percent to 22.5 percent based on biopsy-diagnosed criteria. Having a second-degree relative (aunt, uncle, grandparent) poses a lower risk, but higher than the general population. Regular screening for family members can help with early detection and treatment. Autoimmune conditions: Certain autoimmune conditions have up to 10 times the increased risk of celiac disease. These include Type 1 diabetes, Hashimoto’s thyroiditis, Graves’ disease, Addison’s disease, rheumatoid arthritis, Sjogren’s syndrome, multiple sclerosis, autoimmune hepatitis, alopecia areata (hair loss), lupus, and psoriasis. Genetic disorders:  A high prevalence of celiac disease exists in cases of Down’s syndrome, Turner syndrome, and Williams syndrome sufficient to warrant screening. How Is Celiac Disease Diagnosed? Getting an accurate and timely diagnosis of celiac disease is crucial, yet recent studies show that many medical professionals lack a thorough understanding of the condition. Surveys in multiple countries found that many professionals could only answer about half of the questions on basic knowledge about celiac disease, such as its prevalence, diagnostic criteria, and management. Alarmingly, more experienced health care providers were 70 percent less likely to have sufficient knowledge than those recently trained. Diagnosing celiac disease is complex because no single test is 100 percent accurate or specific, and the results can also vary between laboratories. Therefore, doctors use a multistep process that combines several tests. They look at symptoms, perform blood tests (serology), and review intestinal biopsy results taken during an endoscopy to make a diagnosis. It is important to note that for accurate test results, you must regularly consume a gluten-containing diet prior to testing. An example would be three slices of wheat bread daily. Eliminating gluten can interfere with the diagnostic process. Certain conditions commonly co-occur with celiac disease, making it necessary to rule these out while considering a celiac diagnosis. These include microscopic colitis, Crohn’s disease, irritable bowel syndrome (IBS), pancreatitis, anemia, and non-alcoholic fatty liver disease (NAFLD). The recommended tests for diagnosing celiac disease typically include Blood tests:  Total immunoglobulin A (IgA) levels must be checked because IgA deficiency can produce false positives. Tests look for tTG IgA autoantibodies produced in reaction to gluten. If those are elevated, another test can look for endomysial antibodies IgA in adults and deamidated gliadin peptide IgG in children. If IgA results show a deficiency, tTG IgG and deamidated gliadin peptide IgG tests are recommended. Additional testing can be helpful when skin rash or neurological symptoms are present. While tTG2 is more widely distributed in the body, tTG3 is expressed primarily in the skin, and tTG6 is abundant in the brain and in nerve cells. Antibodies to tTG3 or 6 may be elevated when antibodies to tTG2 are not. Genetic tests:  While testing for HLA-DQ2 and HLA-DQ8, the genetic markers associated with celiac disease, is not required, guidelines indicate that not having these markers can rule out the disease. However, a Brazilian study showed that 6.8 percent of people with confirmed celiac disease did not have either marker. Thus, ruling out celiac disease solely based on these genetic tests could result in some missed diagnoses. Intestinal biopsy:  Current guidelines recommend confirming the diagnosis with an intestinal biopsy obtained during an endoscopy. The samples are examined for villous atrophy and intestinal damage indicative of celiac disease. Multiple samples (at least four from the distal duodenum and one or two from the duodenal bulb) are recommended because intestinal damage can be unevenly distributed. Non-biopsy diagnosis:  In select cases where certain criteria are met, a non-biopsy approach may be used for children or adults unable or unwilling to undergo endoscopy. This would include cases where tTG levels are greater than 10 times the upper limit, the person is positive for endomysial antibodies, and the person is positive for HLA-DQ2/DQ8 genetics. Additional tests may be recommended for follow-up care. These include a bone density (DEXA) scan, complete blood count (CBC), metabolic profile, thyroid panel, liver enzyme tests, and vitamin and mineral levels. If you see a functional medicine practitioner, he or she might suggest other tests like a comprehensive digestive stool analysis, food sensitivity or reactivity tests, a comprehensive micronutrient test, or an intestinal permeability and antigen screen. Test Before Going Gluten-Free Deciding whether to get tested or start a GFD without a confirmed diagnosis is a personal choice. However, getting a formal diagnosis before going gluten-free has many benefits. It helps with medical management, provides social acknowledgment, and can offer financial advantages. Here are some things to consider Accurate testing:  Although celiac disease symptoms may take a long time to develop initially, once gluten is eliminated, the symptoms with reintroduction can be immediate and more severe. Thus, you may not be able to eat enough gluten for long enough to get accurate test results later, and if you do, significant damage may occur. Furthermore, not all doctors may be willing to do an “after-the-fact” diagnosis, and you may or may not have the genetics required. Family screening and support: Confirmation emphasizes the need for family members to be tested to potentially catch the disease early in relatives. It can also strengthen your commitment to a strict GFD and garner support from family and friends. Educational and workplace benefits: A formal diagnosis can help you get necessary accommodations in public schools through a 504 plan and in workplaces. Insurance coverage and ongoing health care: A diagnosis ensures insurance coverage for treatments and monitoring for nutritional deficiencies, related conditions, and complications. What Are Possible Complications of Celiac Disease? If celiac disease is not treated, it can cause serious health problems due to poor absorption of nutrients, malnutrition, and an increased risk of early death. The primary causes for higher death rates in people with celiac disease are cancer and cardiovascular disease, likely caused by chronic inflammation. Additionally, being misdiagnosed can lead to unnecessary psychiatric referrals, financial burdens, and potentially harmful treatments like immunotherapy. Therefore, getting a prompt diagnosis and starting treatment is crucial to prevent these issues and the additional complications below. Nutritional deficiency-associated complications include Anemia Stunted growth in children Osteoporosis and increased fracture risk Potential liver disease Intestinal complications include: Severe weight loss and muscle wasting (cachexia and sarcopenia) Electrolyte imbalance requiring hospitalization Lactose intolerance resulting from villous atrophy A leaky gut, which promotes ongoing inflammation and an elevated risk of developing intolerances to other foods and autoimmune disorders Intestinal ulcers, scarring, and strictures as observed in ulcerative jejunoileitis (ulcers and scarring in the small bowel) Neurological complications include Peripheral neuropathy. Ataxia (impaired coordination). Seizures. Potentially increased risk of dementia and Alzheimer’s disease in older people. Prompt treatment may prevent permanent neurological damage and neurodegeneration. Anxiety and depression: In one study, 62.7 percent of celiac patients had anxiety, and 34.9 percent had depression. Schizophrenia: Some research indicates celiac patients may be at an increased risk of schizophrenia. There is also some debate about a link between the disease and mood disorders, such as bipolar disorder, but the findings have been inconclusive.  Pregnancy complications include Infertility Miscarriage Premature births A child’s increased risk of developing psychotic disorders later in life for those whose mothers had elevated gluten antibodies to gluten during pregnancy, ranging from 70 percent to 150 percent depending on the antibody levels Other complications include Small intestinal adenocarcinoma Lymphomas like enteropathy-associated T-cell lymphoma (EATL) Increased risk of ischemic heart disease , heart attacks, and atrial fibrillation likely due to systemic inflammation Increased risk, especially for glomerulonephritis and IgA nephropathy   What Are the Treatments for Celiac Disease? Managing celiac disease requires a strict, lifelong commitment to a GFD. This is the only effective treatment known today. The diet is crucial for allowing the small intestine to heal and preventing further damage. Eliminating all sources of gluten may sound simple, but it involves significant lifestyle changes and can be challenging to follow consistently. However, strict adherence is vital because even trace amounts of gluten can trigger an autoimmune response and persistent intestinal damage. Health Risks and Nutritional Concerns It is essential to be cautious when replacing regular foods with gluten-free alternatives. Many processed gluten-free products are higher in calories, fats, sugars, and simple carbohydrates and lower in fiber. Relying too heavily on these options can lead to weight gain, nutritional imbalances, and worsening inflammation, which can potentially contribute to depression and brain fog. Research highlights the critical nature of maintaining a healthy GFD. A notable study published in the Journal of the American Medical Association revealed that individuals with celiac disease face a 39 percent increased risk of death in the first year following diagnosis. Strikingly, the study found that intestinal inflammation increased the risk by 72 percent. Thankfully, this risk decreases with diligent adherence to a GFD, allowing the inflammation to resolve, though it remains slightly elevated after five years. This highlights the importance of vigilant, lifelong adherence to reduce inflammation and its associated risks. Addressing nutritional deficiencies is also crucial. Since nutrient absorption was likely impaired due to intestinal damage from previous gluten exposure, any deficiencies identified should be corrected through dietary changes, supplements, or possibly intravenous interventions. A Polish study found that 46 percent of 430 doctors, nurses, dietitians, and medical students did not realize there is still a risk of nutritional deficiencies in celiac disease patients following a strict GFD. Thus, you may have to advocate for additional support. Some experts caution against removing gluten from the diet without a diagnosis of celiac disease or gluten sensitivity due to potential nutritional deficiencies, so it is best to consult a health care professional to ensure it is necessary. Managing Symptoms and Seeking Support Even with strict adherence to the GFD, healing is a gradual process. While some symptoms will start to abate in weeks, it may take months for gastrointestinal symptoms to resolve fully, a year for bone density to improve, and years for complete healing of the intestinal villi and microvilli. Incomplete healing, characterized by persistent villous atrophy, is relatively common and is most frequently attributed to unintentional gluten exposure. In the incomplete digestion of gliadin, substances called exorphins are formed, which can bind to opioid receptors in the brain, producing opioid effects like euphoria and addictive behaviors. Researchers believe the impact of these exorphins may account for some cases of asymptomatic celiac disease by masking the harmful effects of gluten on the intestine. Because exorphins may have addictive effects in some individuals, abrupt withdrawal of gluten may lead to withdrawal symptoms. Navigating a GFD can be complex, so seeking support from a nutrition professional specializing in autoimmune conditions and the GFD is wise. With the right support, you will learn about hidden sources of gluten and healthy alternatives to ensure your diet not only avoids gluten but is also nutritionally balanced. How Does Mindset Affect Celiac Disease? Although mindset may influence inflammation, it may not prevent the onset of celiac disease. However, adopting a positive attitude can go a long way in improving one’s quality of life. Managing celiac disease involves more than just dietary changes. It also requires significant psychological adjustment. The need to be watchful for gluten exposure and the difficulty of finding safe foods can lead to anxiety around food. This is especially true in social situations or unfamiliar environments. This “food anxiety,” combined with feelings of being deprived, can result in obsessive thoughts about food. This may lead to broader issues like anxiety, social isolation, and reduced quality of life. Therefore, cultivating a positive mindset and developing robust coping skills is crucial. Research shows that good mental health is essential for adhering to a GFD and managing celiac disease effectively. Viewing the dietary restrictions not merely as limitations but as avenues for positive change can significantly improve your outlook. While celiac disease requires adjustments, it also presents an opportunity to embrace a healthier lifestyle. Adopting an Abundance Mindset Practicing self-compassion and focusing on the abundance of nutritious foods you can still enjoy can be empowering. Many staple foods, such as fruits, vegetables, nuts, seeds, meats, poultry, and fish, are naturally gluten-free. Additionally, the availability of gluten-free products made from whole grains or higher fiber alternatives like almonds, cassava, chickpeas, and lentil flours has improved dramatically. This progress may make it easier to maintain a balanced diet. Finding a supportive community and possibly engaging in behavioral therapy can enhance your ability to manage a gluten-free lifestyle. Therapy can help you reframe negative thoughts about dietary restrictions and develop better coping mechanisms for social interactions. Holistic Health Approach Embracing a nutrient-dense, anti-inflammatory diet based on whole foods not only helps manage the disease but also supports overall physical and mental well-being. A positive mindset can even influence serotonin levels, potentially reducing the risk of depression and anxiety, which are common in untreated celiac disease. With the right mindset, education, and support system, transitioning to a GFD can be a transformative experience that significantly enhances your quality of life. This approach turns the challenge of celiac disease into an opportunity for greater health and vitality. What Are the Natural Approaches to Celiac Disease? Adhering to a strict GFD is vital for managing celiac disease, but it may not be enough to stop the autoimmune attack entirely or heal intestinal damage for everyone. To truly halt the autoimmune process, two things must happen: gut barrier restoration (i.e., healing the “leaky gut”) and removal of the triggers that set off the immune system in the first place. A Functional Medicine Approach A more comprehensive approach may be beneficial to address cross-reactivity and support overall healing. The “5 R’s“ of functional medicine provide a natural approach and framework for reducing overall inflammation, restoring gut barrier function, modulating the immune system, and identifying and eliminating cross-reactive triggers. They are: Remove:  Identify and eliminate factors other than gluten that cause an immune reaction and potentially contribute to inflammation and gut dysbiosis. These include infections, cross-reactive foods, stressors, and toxins. Antimicrobials may be used to treat underlying infections. A food sensitivity test, reactivity test, or elimination diet can help identify problematic foods. Replace:  Replenish deficient nutrients, enzymes, and acids essential for proper digestion and absorption, enhancing the gut’s ability to heal. Some enzyme supplements may help minimize the effects of accidental gluten exposure, though they will not completely prevent a reaction. Reinoculate:  Reduce inflammation and support the healing process and a healthy gut microbiome with specific probiotics and prebiotics tailored to your microbial profile, which can be identified through detailed stool testing. Repair:  Address factors contributing to intestinal permeability, such as stress, alcohol, processed foods, hormonal imbalances, and nonsteroidal anti-inflammatory drugs (NSAIDs). Nutrients like glutamine, zinc, vitamin D, and fiber can support gut healing and barrier function. Rebalance:  Optimize overall health through balanced nutrition, stress management, regular exercise, and other supportive lifestyle habits to reduce systemic inflammation and promote long-term well-being. Ayurvedic Herbs Incorporating Ayurvedic herbs into a natural approach to celiac disease may offer complementary benefits by reducing inflammation and promoting gut healing. A recent study highlighted the potential therapeutic effects of the following herbs: Turmeric (Curcuma longa):  a common spice in Indian cuisine containing curcumin, known for its anti-inflammatory and antioxidant effects Ashwagandha (Withania somnifera): an adaptogenic herb with potential anti-inflammatory and gut-healing properties Long pepper (Piper longum): a relative of black pepper believed to have anti-inflammatory and immune-modifying properties Heart-leaved moonseed (Tinospora cordifolia): an Ayurvedic herb proposed to have anti-inflammatory and immune-modifying properties How Can I Prevent Celiac Disease? Preventing celiac disease, especially for those at risk, currently involves strictly avoiding gluten for life. Although manipulating the microbiome might offer future preventive measures, today’s best strategy hinges on managing gluten intake. Deciding to avoid gluten is a personal choice. It is essential to weigh the potential benefits of preventing disease and intestinal damage against the challenges of maintaining a strict GFD. Further emphasizing the importance of gluten management, researchers discovered that during the first five years of life, the risk of developing celiac disease increased with every gram of gluten consumed per day. This suggests that moderating gluten intake from an early age could potentially delay or prevent the onset of the disease.