Tuesday, 31 March 2015

How safe is your blog?

How safe is your blog? 

It’s NOT!

You could wake up tomorrow and find it gone. Why? You only have to research on-line to see how many blogs simply disappear. It could have been hacked; someone in far away cyber space could have ‘accidentally’ deleted it and you may never find out who or why. Someone might be annoyed with something you’ve said and persuaded Google (or other host site) to remove it. This is rare because as long as you haven’t printed their address, bank details, phone number or other intimate information, you are safe. Your site will never be taken down for simply mentioning someone by name and something they've done.  If what you said is true, then it would be up to them to prove otherwise.

What if someone has said something about you that you think to be inaccurate? Your best bet is to approach the person, company etc. in person and speak to them of your concerns. This happened to me twice, and on both occasions the information was taken down within days of the request.
Old blogs can sit there forever like abandoned steam trains in disused sidings. The older they get, the more likely you will never find the owner.

Back your blog up at least once a month

If you do this and it disappears, for whatever reason, you can re-launch it within minutes. You can even re-launch it on dozens of other sites, meaning only a major failure of the entire Internet could make it vanish. I’m in the process of duplicating all my blogs on ‘Wordpress’ for this very reason.

Tuesday, 24 March 2015

Sweeping prostate cancer review upends widely held belief on radiation after surgery...

Timothy N. Showalter, of the UVA Cancer Centre, reviewed 16,000 
prostate cancer outcomes to produce his surprising findings on 
radiation after prostectomy.
Important news for men receiving treatment for prostate cancer: Two new studies from the University of Virginia School of Medicine have upended the widely held view that it's best to delay radiation treatment as long as possible after the removal of the prostate in order to prevent unwanted side effects.
"The common teaching has been, without clear evidence, that urinary incontinence and erectile function are worse when is delivered earlier rather than later, but we didn't see any protective effect of delayed radiation compared to earlier radiation," said radiation oncologist Timothy N. Showalter, MD, of the UVA Cancer Center. "It contradicts the clinical principle of delaying radiation as long as possible for the sake of the patient's side effects. It really speaks against that, and that ought not to be used for a reason to delay radiation."
The findings inject hard facts into a debate that has long divided the medical community, with many radiation oncologists preferring adjuvant therapy - radiation given soon after  to kill off any remaining cancer cells - and many urologists preferring salvage therapy - radiation given later, when prostate-specific antigen tests suggest it's needed. "Urologists tend to prefer to forgo adjuvant radiation therapy, because they fear the side effects, and  tend to prefer offering adjuvant radiation therapy because they fear the risk of metastasis [cancer spreading to other sites in the body]," Showalter said.
Showalter conducted his two studies to address the lack of facts, in hopes of providing doctors with the information they need to determine the best course of treatment. "There's this commonly held belief that the longer you delay radiation therapy, the more opportunity a patient has for recovery from prostatectomy, and therefore the better long-term function in terms of urinary and bowel function - the longer you delay it, the better they'll function," he said. "A lot of clinicians believe that if you wait six months, 12 months, 18 months, that each additional step gets you some benefit in terms of toxicity. That didn't make sense to me from a medical perspective, because I can't think of any other surgery where we think recovery requires a year or more. We often, for other cancers, deliver post-operative radiation very soon."
The findings, based on a review of approximately 16,000 patients' outcomes, shed light on the side effects of  after prostate removal. "What we found is that the addition of radiation therapy after prostatectomy does lead to a noticeable increase in GI [gastrointestinal] and GU [genitourinary] . However, delaying radiation therapy offers no protective benefit and in fact may increase the risk of GI complications," Showalter said. The research also found adjuvant therapy did not increase rates of erectile dysfunction.
The takeaway for men receiving  treatment, Showalter said, is that they should discuss the best strategy with their physicians based on their particular case. "If someone's at generally low risk of prostate cancer recurrence and they have low-grade disease, it's probably still reasonable to take a delayed salvage  approach," Showalter said. "Once there's a real, compelling reason to deliver radiation, there doesn't seem to be a benefit to delaying their radiation in terms of avoiding complications. And we know from other studies, the earlier radiation is delivered, the more effective it is for these patients. The more likely it is to cure them."

Tuesday, 17 March 2015

Testosterone levels during ADT may predict prostate cancer outcomes

Testosterone Levels During ADT May Predict Prostate Cancer Outcomes

Blood vialReduced testosterone levels during ADT were linked with improved survi...
A strong reduction in testosterone levels during the first year of androgen deprivation therapy (ADT) correlates with an improved survival in prostate cancer patients undergoing treatment for biochemical failure.
Men with prostate cancer who had testosterone levels ≤ 0.7 nmol/L had significantly longer survival and longer time to hormone resistance compared with men with higher testosterone levels (P = .015 and P = .02, respectively). Men who had testosterone levels consistently > 0.7 nmol/L had a greater risk of dying from their prostate cancer compared with men with lower hormone levels.
Those whose testosterone levels increased to ≥ 1.7 nmol/L developed castration resistance more quickly, compared with men whose hormone levels remained steadily ≤ 0.7 nmol/L.
The current analysis led by Laurence Klotz, MD, of Sunnybrook Health Sciences Centre at the University of Toronto, and colleagues analyzed the prospectively collected testosterone levels and clinical outcomes of the 1,386 men enrolled in the phase III PR-7 trial, which randomized men with biochemically recurrent prostate cancer after primary local therapy to receive either continuous (n = 696) or intermittent (n = 690) ADT.
The results of the analysis were published in the Journal of Clinical Oncology.
Prostate cancer patients with testosterone levels between 0.7 to 1.7 nmol/L were twice as likely to die from their cancer, and those with levels > 1.7 nmol/L were almost three times as likely to die compared with their counterparts who had testosterone levels ≤ 0.7 nmol/L.
ADT typically suppresses testosterone to castrate levels—a 90% to 95% reduction—but not all men achieve such reduction levels and others experience an increase in hormone levels while on ADT. Lower castration levels are defined as ≤ 0.7 nmol/L, but the clinical significance of testosterone levels in early-stage disease are still not well-understood.
Results of the PR-7 trial, published in the New England Journal of Medicine, showed that both intermittent and continuous ADT resulted in similar overall survival, but that several quality-of-life factors improved with intermittent dosing.
“The data from [this] study represent some of the strongest evidence to date that failure to achieve deep testosterone suppression after first-line ADT may herald poor outcomes in men with hormone-sensitive nonmetastatic prostate cancer,” wrote Daniel L. Suzman, MD, and Emmanuel S. Antonarakis, MD, of the Prostate Cancer Research Program at Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore, in their accompanying editorial.
Based on the current analysis of the PR-7 trial, Klotz and colleagues recommend that men starting ADT should have their testosterone and prostate-specific antigen (PSA) levels checked regularly during the first year of therapy. They also recommend that if testosterone levels ≤ 0.7 nmol/L are not achieved during ADT, then the type of hormone therapy be changed.
But, the editorial authors believe that caution is warranted in interpreting these post hoc results because “the primary analysis of the PR-7 study showed that intermittent hormone therapy was non-inferior to continuous therapy with respect to overall survival.” Therefore, the importance of the further manipulation of testosterone levels in prostate cancer patients after ADT is still unclear. They also point to an ongoing trial, the SWOG-S1216 trial, which is currently evaluating the role of deeper testosterone suppression. “Until these or similar results are available, we should not recommend deeper androgen suppression in the first-line setting for men with (metastatic or nonmetastatic) hormone-sensitive prostate cancer,” concluded Suzman and Antonarakis.
- See more at: http://www.cancernetwork.com/prostate-cancer/testosterone-levels-during-adt-may-predict-prostate-cancer-outcomes#sthash.q23XpgCe.dpuf

Friday, 13 March 2015

Statins May Help Improve Prostate Cancer Survival

Statins May Help Improve Prostate Cancer Survival: Study

Finds the cholesterol-lowering drugs linked to slower progression of disease
Statins May Help Improve Prostate Cancer Survival: Study
HealthDay Reporter
MONDAY, March 9, 2015 (HealthDay News) -- Cholesterol-lowering statin drugs may slow down prostate cancer in men who are also taking medication to reduce their levels of male hormones, according to new research.
Taking a statin alongside androgen deprivation therapy slowed the progress of prostate cancer by about 10 months, said the study's lead author, Dr. Lauren Christine Harshman, an assistant professor at Dana-Farber Cancer Institute and Harvard Medical School.
"Patients on a statin have a significantly longer time to progression," Harshman said.
The study's findings were presented recently at a meeting of the American Society of Clinical Oncology (ASCO) in Orlando, Fla. Research presented at meetings is generally viewed as preliminary until published in a peer-reviewed journal.
The study did not prove a cause-and-effect link between statins and prostate cancer survival, just an association.
Prostate cancer feeds on male hormones, which are called androgens and include the commonly known hormone testosterone. Cancer doctors often treat prostate cancer by using medications to suppress androgen levels in a man's body.
Previous research has associated statin use with improved prostate cancer outcomes, said Dr. Charles Ryan, an ASCO expert and associate professor of medicine and urology at the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco.
For the current study, Harshman and her colleagues reviewed medical data from 926 prostate cancer patients being treated with androgen deprivation therapy.
About 31 percent of the men were taking a statin at the time they began prostate cancer treatment. Researchers noted that statin users were less likely to be initially diagnosed with aggressive prostate cancer.
Tracking the men's progress, researchers found that statin users had about 27.5 months of progression-free survival on androgen deprivation therapy. Men not taking statins had about 17 months of progression-free survival, according to the study. The link remained statistically significant even after accounting for other factors, the study authors said.
There are a couple of potential ways that statins might affect prostate cancer, Ryan and Harshman said.
The body produces male hormones "based on a cholesterol backbone," Ryan said. By reducing cholesterol levels, statins might cause a reduction in available androgens by inadvertently robbing the body of a key building block for those hormones.
On the other hand, statins might interfere with the process through which prostate tumor cells absorb male hormones, Harshman said.
Laboratory tests have shown that statins tend to crowd out androgens, beating them in line to be absorbed by prostate cancer cells, she said.
Follow-up research and clinical trials are needed to verify this effect, Ryan said. Additionally, he noted that in this study the men were taking statins due to high cholesterol levels, not to improve their cancer treatment.
"It's a good observation, but it still requires further study and validation," he said.
Harshman agreed that a randomized clinical trial is needed.
"The main thing is, what can you get out of this effect? How does it change therapy?" she said.
More information
For more information on prostate cancer, visit the U.S. National Institutes of Health.
SOURCES: Lauren Christine Harshman, M.D., assistant professor, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Mass.; Charles Ryan, M.D., ASCO expert and associate professor of medicine and urology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, Calif.; Feb. 26, 2015, presentation, American Society for Clinical Oncology meeting, Orlando, Fla.
Last Updated: 

Thursday, 12 March 2015

Prostate/breast cancer genetic link...

Women whose father or brother has prostate cancer are more likely to develop breast cancer, research shows.
Scientists believe the illnesses are caused by the same faulty gene passed down through families.
An American study of 78,000 women found that those whose fathers, brothers or sons had prostate cancer were 14 per cent more at risk of breast cancer.
But women were 80 per cent more likely to get the illness if their father, brother or son had prostate cancer and their mother or sister had breast cancer. 
The findings – published in the journal Cancer – are further evidence that some types of breast and prostate cancer are caused by the same inherited, faulty gene.
Although doctors have been aware the illnesses run in families for several years, this research shows the faulty gene may be more important than they previously thought.
Its lead author says doctors should routinely ask women whether prostate cancer runs in her family when establishing her risk of breast cancer.
Women considered high-risk are offered more frequent x-rays, genetic tests and in some cases, preventative drugs such as Tamoxifen.
Breast and prostate cancers are the most common forms of the illness in women and men respectively.

Dr Beebe-Dimmer said: 'The increase in breast cancer risk associated with having a positive family history of prostate cancer is modest; however, women with a family history of both breast and prostate cancer among first-degree relatives have an almost two-fold increase in risk of breast cancer.
'These findings are important in that they can be used to support an approach by clinicians to collect a complete family history of all cancers - particularly among first degree relatives - in order to assess patient risk for developing cancer
'Families with clustering of different tumors may be particularly important to study in order to discover new genetic mutations to explain this clustering.'
Dr Caitlin Barrand, Senior Policy Manager at Breakthrough Breast Cancer, said: 'Although we've known for some time that there are links between prostate cancer and breast cancer, this study suggests the link might be more important than we previously thought.
'If further research confirms the findings of this study this may further improve our ability to estimate an individual's risk of developing breast cancer, and offer personalised plans to help prevent the disease, or diagnose it early, when it can be more successfully treated.
'We'd recommend that women speak to their GP if they have any concerns about their family history of cancer, and advise that they should be prepared to talk about cancers on both the mother and father's side - the GP should ask about both.'

Sophie Borland

Read more: http://www.dailymail.co.uk/health/article-2985758/Prostate-cancer-raises-breast-risk-daughters-Women-s-risk-increases-14-father-brother-suffered-disease.html#ixzz3UBKbKPml

Monday, 2 March 2015

"In three decades Britain has quick-marched backwards in time by about 150 years".

EVERYBODY’S doing it, doing it, doing it, cheating the tax system and screwing it, screwing it — at least that’s what some fat cat tax avoiders reckon.
It’s not true of course, because the majority of British citizens have no ability whatsoever to influence the amount of tax they pay. They work hard for a living, get a fixed salary and have their income tax deducted without ever seeing the Queen’s face on the notes HMRC take.
When this columnist made his first attempts at writing it wasn’t just a very pleasant surprise that those efforts were deemed worthy of publication but that some people were also prepared to pay for them.
We are not talking celebrity columnist rates here but, even so, the very first thing to be done when the shock wore off was to go straight down to the tax office in Penrith (now closed) to find out how to pay income tax as a self-employed person.
I also elected to pay national insurance because I have always been a law-abiding citizen and because, even though the amounts are very small, I thought it was the right thing to do, and I am also a fool.
Every January I go through the tedious and stressful process of self-assessment under the highly publicised threat that if I am late there will be an automatic penalty of £100, and if I get it wrong they, the HMRC hit-men, will be coming for me because, as they like to remind me, we know where you live.
In effect all the writing I do during November, December and January is for the government, so those readers who think my attacks on the government and politicians are particularly vindictive during those months now know why.
Meanwhile, HSBC bank has published an apology to customers and staff for setting up a Swiss branch specifically to help more than a thousand of its richest clients avoid paying UK tax. I am a long-standing customer of HSBC and I do not accept its empty apology just as I never accepted meaningless apologies from students when I was teaching simply because the deputy head said I had to and also because the kids thought it was the easy option to apologise and walk away smirking.
Sir believed in justice then just as he does now. Laws and rules, including tax rules, should be fair and just and apply to everyone equally, no matter who they are or how rich or famous they are, which is something our establishment seems to have lost sight of.
This whole tax avoidance thing is not really the issue. It is just a symptom of a much bigger problem which has infected and is corrupting society. In three decades Britain has quick-marched backwards in time by about 150 years.
The world that my grandfather and Winston Churchill were both born into within a few years of each other is, in many respects, back after a brief period of dormancy in the 1960s and 70s.
For 30 years we have praised, admired and looked up to the “wealth makers” as David Cameron likes to call them and believed they deserved every hard-earned million pounds they added to their vast fortunes. Grateful governments knighted them and stuck them in the House of Lords and nodded when The Sun wrote that it was perfectly understandable when they skipped the country to avoid paying tax to those horrible Labour governments.
In worshipping mammon we have succeeded in breeding a new “upper” class of people including thousands of vastly overpaid but talentless celebs, very mediocre soccer players and “entrepreneurs”, some who have turned out to be little more than tax-cheating gangsters. Unlike the old upper class this bunch have no sense of duty or responsibility. They think only of themselves, their wealth and their importance and we have allowed this nouveau riche to think they are the special ones who can do whatever they like.
It is not entirely their fault. In a sense it is ours because our governments, whom we are supposed to control, have sucked up to business and in doing so have trodden on the rights and bargaining powers of workers, which has all helped create this view that some people are above the law and that paying tax is for mugs and little people.
Well, I’m a mug but I’m a mug in whom revolution burns. I’d make these leeches dig ditches for a couple of years, on the minimum wage, of course, and see how they like joining in the way lots of “mugs” don’t even earn enough to pay tax.
Brian Nicholls (Cumberland & Westmorland Herald)