TIME Cancer

Nearly 1 in 10 Cancer Survivors Still Smokes

And only about 40% said they planned to quit

Nearly one in 10 cancer survivors reports smoking years after their diagnosis, according to a new study from the American Cancer Society.

Researchers analyzed data from 2,938 patients nine years after their diagnosis, and 9.3 percent were current smokers (within the pat 30 days). Of those patients, 83 percent smoked every day, averaging 14.7 cigarettes per day.

The study, published in the journal Cancer Epidemiology, Biomarkers & Prevention, included patients with the 10 most common types of cancer: breast, prostate, bladder, uterine, melanoma, colorectal, kidney, Non-Hodgkin Lymphoma, ovarian, and lung.

The highest rates of smoking appeared in patients who were diagnosed with bladder (17.2 percent) and lung (14.9 percent) cancer, which are both smoking-related cancers.

Cigarette smoking is known to decrease the effectiveness of cancer treatments, increase the probability of recurrence, and reduce survival time.

“We need to follow up with cancer survivors long after their diagnoses to see whether they are still smoking and offer appropriate counseling, interventions, and possible medications to help them quit,” Lee Westmaas, director of tobacco research at the American Cancer Society (ACS) and lead author of the study, said in a statement.

Of the patients who reported smoking, 46.6 percent said they planned to quit, but 10.1 percent said they did not plan to quit, and 43.3 percent were unsure. In addition, 88.6 percent of the current smokers had quit before their diagnosis.

Researchers also looked at a variety of sociodemographic factors among the patients. Survivors were more likely to smoke if they were younger, female, had lower education, lower income or drank more alcohol. Those who smoked more, were older or were married were less likely to want to quit.

The study suggests the lack of intent to quit in older patients could suggest they don’t believe the difficulties of quitting will be worth the gains in quality of life or life expectancy.

Future studies should examine the importance of psychosocial variables and their relationships to current smoking or motivation to quit, the authors wrote in the study. “Those who smoke heavily long after their diagnosis may require more intense treatment addressing specific psychosocial characteristics such as perceptions of risk, beliefs of fatalism, etc. that may influence motivation to quit.”

TIME Infectious Disease

U.S. Will Evacuate 2 Americans With Ebola from West Africa

Emory Hospital in Atlanta announced on Thursday that it will treat at least one patient

The State Department announced Friday that together with the Centers for Disease Control, it is working to bring home two U.S. citizens infected with the Ebola virus in West Africa “over the coming days.”

Although the State Department did not identify the patients by name, two Americans working in Liberia— one as a physician and the other as a missionary — have been infected with the virus. Both Dr. Kent Brantly and missionary Nancy Writebol were working to fight the outbreak of the deadly virus.

CDC protocols and equipment are used for these kinds of medical evacuations, according to State Department spokesperson Marie Harf, who added:

The safety and security of U.S. citizens is our paramount concern. Every precaution is being taken to move the patients safely and securely, to provide critical care en route on a non-commercial aircraft, and to maintain strict isolation upon arrival in the United States.

Harf did not disclose where the patients would be sent in the U.S., but on Thursday Emory University Hospital said in a statement that it expects to receive one patient with Ebola in the “next several days.” it is unclear if the second patient will be treated at Emory as well.

The Ebola virus, which has infected at least 729 people in West Africa this year, only spreads through direct contact with bodily fluids. Margaret Chan, the director-general of the World Health Organization, told presidents from affected countries on Friday that it is moving faster than it can be controlled. “If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives but also severe socio-economic disruption and a high risk of spread to other countries,” she said.

Medical personnel caring for the two patients in the U.S. will wear full-body protective suits, and the patients will remain “in strict isolation upon arrival” and while being treated on U.S. soil, according to Harf.

CDC director Dr. Thomas Frieden has said he does not believe Ebola will spread in the U.S. “That’s not in the cards,” he said in a call with press on Thursday.

TIME

Julia Roberts Can Still Recite Her Lines From Pretty Woman and Notting Hill

"The Normal Heart" New York Screening
Actress Julia Roberts attends "The Normal Heart" New York Screening at Ziegfeld Theater on May 12, 2014 in New York City. Jim Spellman—WireImage

Julia Roberts is still "just a girl"

Julia Roberts reminisced about her most famous roles in an interview with Matt Lauer on the Today show Friday morning.

When people approach the uber-famous star in public, they typically reach far back in her repertoire, Roberts said. “I hear Pretty Woman more than any other movie,” Roberts said. She said she asks if they know anything more recent, but fans love her 1990s roles.

Lauer shared that his favorite scene from the hit rom-com is when Roberts’ character returns to a shop after her makeover and tells the sales girl she made a “Big mistake! Big! Huge!” Roberts recited the famous line before it could play on the screen behind her.

When Lauer brought up another of Roberts’ career-making ’90s films, Notting Hill, she started in on the iconic line from that as well: “I’m just a girl, standing in front of a boy, asking him to love her.”

The actress also talked about balancing motherhood with her career as a movie star. “I’m really proud of what I’ve accomplished in my career and what I had done in the 18 years of my career before I had kids,” the star said. “By then I felt I had really earned staying home and raising my kids and being with my family.”

As for her kids, they may be getting a new present in the near future. Roberts’ Oscar statue, which she won for her lead role in Erin Brokovitch in 2000, is still in her sister’s apartment, she told Lauer. “I’m going to go get it. I’m going to go get it and take it home,” Roberts said. “It can be Ken’s competition for Barbie’s affection.”

TIME Diet/Nutrition

5 Fruits and Veggies A Day Can Lower Your Risk of Death

Fruits and vegetables
Carlos Daniel Gawronski—Getty Images/iStockphoto

An apple (or five) a day may do more than keep the doctor away

We all know the cliche “an apple a day keeps the doctor away,” but in recent years, many studies have taken that promise even further, linking the daily consumption of fruits and vegetables to a reduced risk of mortality—especially from heart disease and cancer.

In a review and analysis of such studies published in The BMJ, researchers from China and the U.S. found that indeed, consuming fruits and vegetables is correlated with a lower risk of death in some cases—but that the association is not consistent for all types of death.

The researchers looked at 16 studies, which included a total of 833,234 participants, 56,423 of whom died. In order to minimize bias, investigators took into account various differences in study design and quality, and analyzed subgroups to confirm that results did not vary significantly by location.

Consuming more fruits and vegetables was significantly associated with a reduced risk of death from most causes. The average risk of death from all causes was lowered by 5 percent for each additional daily serving of fruit and vegetables, and the risk for cardiovascular death was reduced by 4 percent.

Interestingly, researchers found that once you reach five portions of fruits and vegetables per day, more of the healthy foods will not further reduce the risk of death.

This contradicts another recent study published in The BMJ’s Journal of Epidemiology and Community Health that suggested seven or more daily portions of fruits and vegetables were linked to lowest risk of death. However, researchers said studies may differ in their classifications of fruits and vegetables, and there was room for error in how people reported their eating habits on surveys used.

Eating more fruits and vegetables was not appreciably associated with risk of death from cancer, according to the study. Researchers said more studies are needed to examine specific types of cancer and the role of different groups of fruit and vegetables.

TIME Mental Health/Psychology

The Part of Your Brain That Senses Dread Has Been Discovered

This tiny part of your brain tracks bad experiences

A tiny part of the brain can keep track of your expectations about negative experiences—and predict when you will react to an event—researchers at University College London say.

The brain structure, known as the habenula, activates in response to negative events such as electric shocks, and they may help people learn from bad experiences.

The findings, published in Proceedings of the National Academy of Sciences, marks the first time this association has been proven in humans. Earlier studies showed that the habenula causes animals to avoid negative stimuli by suppressing dopamine, a brain chemical that drives motivation.

In this study, investigators showed 23 people random sequences of pictures followed by a set of good or bad outcomes (an electric shock, losing money, winning money, or neutral). The volunteers were asked to occasionally press a button to show they were paying attention, and researchers scanned their brains for habenula activity using a functional magnetic resonance imaging (fMRI) scanner. Images were taken at high resolution because the habenula is so small—half the size of a pea.

When people saw pictures associated with painful electric shocks, the habenula activated, while it did not for pictures that predicted winning money.

“Fascinatingly, people were slower to press the button when the picture was associated with getting shocked, even though their response had no bearing on the outcome,” lead author Rebecca Lawson from the University College London Institute of Cognitive Neuroscience, said in a statement. “Furthermore, the slower people responded, the more reliably their habenula tracked associations with shocks. This demonstrates a crucial link between the habenula and motivated behavior, which may be the result of dopamine suppression.”

The study also showed that the habenula responds more the worse an experience is predicted to be. For example, researchers said the habenula responds much more strongly when an electric shock is certain than when it is unlikely to happen. This means that your brain can tell how bad an event will be before it occurs.

The habenula has been linked to depression, and this study shows how it could play a part in symptoms such low motivation, focusing on negative experiences and pessimism in general. Researchers said that understanding the habenula could potentially help them develop new ways of treating depression.

TIME Breast Cancer

Promising Cancer Drug Fails to Slow Breast Cancer

NEXAVAR
Nexavar Bayer Pharmaceuticals Corporation

Researchers had hoped to add breast cancer to the list of cancers for which the drug is already approved

A Phase 3 trial of cancer drug Nexavar in patients with advanced breast cancer failed to delay progression of the disease, according to the drug’s makers, Bayer and Onyx Pharmaceuticals, Inc., an Amgen subsidiary.

The study, called Reslience, evaluated Nexavar in combination with capecitabine, an oral chemotherapeutic agent, in patients with HER2-negative breast cancer.

The drug is approved to treat certain types of liver, kidney and thyroid cancer and works by targeting signalling pathways that tumor cells use to survive. Researchers hoped that Nexavar would have the same tumor-stalling effect on breast growths.

“We are disappointed that the trial did not show an improvement in progression-free survival in patients with advanced breast cancer,” Dr. Joerg Moeller, Member of the Bayer HealthCare Executive Committee and Head of Global Development, said in a statement. “While the primary endpoint of this trial was not met, the trial results do not affect the currently approved indications for Nexavar. We would like to thank the patients and the study investigators for their contributions and participation in this study.”

Data from the study will be presented at an upcoming scientific conference.

TIME Music

Hear YouTube Superstar Troye Sivan’s Single ‘Happy Little Pill’

EMI Australia

His EP drops Aug. 15 — and pre-orders have already buoyed it to the top of the charts

One of YouTube’s biggest stars may be on his way to becoming the next big pop act.

Troye Sivan, a 19-year-old from Australia, is one of the video blogging community’s most beloved personalities; his YouTube channel has more than 3 million followers and his clips have accumulated 91.4 million views. (No big.) Earlier this summer, Sivan announced he’d signed a deal with EMI Australia and would release an EP, titled TRXYE, on Aug. 15. “Happy Little Pill,” the first single from the five-track set, dropped earlier this week — and it seems primed to move the teen into the big leagues, with melancholy lyrics and a downtempo electronic sound that give off a world-weary vibe.

“I wrote this song during a bit of a rough time for someone super close to me, and for myself, and it still means as much to me as the day i wrote it, and i’m still as in love with it as the day i wrote it,” the singer wrote on his Tumblr, when he shared the song with fans.

Now, the EP is No. 1 on iTunes and has soared to the top of iTunes charts all over the world. Earlier today, the star tweeted that TRXYE had hit No. 1 in 17 countries, while “Happy Little Pill” was at No. 1 in 13 countries. (Again, no big.)

Sivan isn’t new to singing — he was performing on shows like StarSearch in the early 2000s and has created other EPs in the past — but his crazy popularity suggests the teen is ready for the big leagues and testifies to the mounting influence of YouTube celebrities. Given, too, the massive success of his earlier song “The Fault in Our Stars” (inspired by the film), Sivan seems ready for IRL superstardom.

It’s about time — the world could use a replacement for #BieberFever.

TIME Reproductive Health

Morning-After Pill May Not Be Affected By Body Weight

Morning-after pill
Jacques LOIC—Getty Images/Photononstop RM

Recent studies raised questions about the effectiveness of the contraceptive method among heavier women.

But after an investigation, the European Medicines Agency (EMA) says that emergency contraceptives are effective for women of all weights.

Last year, the agency requested a warning on the label of Norlevo, the European equivalent of Plan B containing levonorgestrel, indicating that it might not be as effective in preventing pregnancy for women with a body mass index (BMI) greater than 25. This decision was based on a 2011 study that showed heavier women who took products containing levonorgestrel—which prevents pregnancy after intercourse—were four times as likely to become pregnant as those with lower BMIs.

After that recommendation, the regulatory agency conducted a review of other emergency contraceptives containing levonorgestrel or ulipristal acetate, and found that the data in the earlier studies was limited and not substantial enough to conclude that the contraceptives’ effect was decreased with increased body weight. That doesn’t mean that weight may not play a role in the drugs’ effectiveness, but for now, the EMA’s Committee for Medicinal Products for Human Use (CHMP) recommends that Norlevo remove the current warnings from its label. It also said emergency contraceptives should continue to include on their product inserts some study results showing potentially reduced effects in heavier women.

While the European health authorities took action on Norlevo last year, the U.S. Food and Drug Administration has not issued any similar warnings for Plan B. “I don’t necessarily think it’s inevitable that the FDA would act on this,” Dr. Carolyn Westhoff, professor of obstetrics and gynecology and public health at Columbia University and senior medical adviser at Planned Parenthood Federation of America, told TIME in November 2013 regarding the data at the time. “People in the field have been scratching their heads since [the 2011 study] was published, saying what sorts of studies could we do to get more data to help us understand this better. To my knowledge, nobody has done those additional studies.”

EMA also admits that such data isn’t available yet, but says that there isn’t enough data to support the previous warning to women about weight.

TIME

Your Great Grandmother’s Exposure to Pesticides Could Be Making You Obese

The effects of pesticides can span three generations, according to the latest research

Your health, or unhealthy state, may be traced back to the stuff your grandparents were exposed to, say researchers from Washington State University (WSU).

They found that exposure to the pesticide methoxychlor, for example, can contribute to diseases in descendants up to three generations later, suggesting that the environment conditions in which your great grandparents lived and worked could affect your risk of obesity, kidney and ovarian diseases.

The heightened susceptibility to these conditions is passed down through genetics, although not in the direct, inherited way. The pesticide probably affected how genes were turned on or off in people three generations ago, and some of these changes, which are normally erased when the reproductive cells — the egg and sperm — join together, somehow were not deleted completely and were passed on to the next generation. And these changes may be affecting weight and cells in the kidneys and ovaries.

“What you’re ancestors were exposed to could radically affect the kind of diseases you get,” says Michael Skinner, the study’s lead author and founder of WSU’s Center for Reproductive Biology.

Skinner has been studying the genetic effects of pesticides for 15 years. His lab has observed such so-called transgenerational epigenetic effects from other toxins such as DDT, plastics, pesticides, fungicides, dioxins, hydrocarbons and bisphenol-A or BPA.

But this was the first study to show that disease risk was transmitted primarily through females. (The study also found the legacy of mutations in the sperm epigenome of great-grandchild male rats.)

Methoxychlor—also known as Chemform, Methoxo, Metox or Moxie—was introduced in 1948 and was widely used in the 1960s as a less toxic substitute for DDT. The pesticide can behave like the hormone estrogen, disrupting reproductive organs. It was used on crops, ornamental plants, livestock and pets, but was banned from the U.S. in 2003 after regulators determined that it, too, was toxic for people. But a generation of individuals had already been exposed, and the effects of that exposure, says Skinner, is still being seen today.

While it is no longer used in the U.S., the pesticide is still sprayed in Mexico, South America and in other countries around the world. But even people who were born after the compound was banned in the U.S., and who have never traveled to areas where it is used, showed the same genetic changes found in people who have been exposed to the chemical.

That means that it may be possible to scan for and potentially predict people’s increased risk for certain diseases by searching for these genetic legacies. “We have the ability to identify the epigenetic marks in ourselves. Some of these marks are exposure-specific. So in the future, we may be able to do an analysis of what you were exposed to or what your ancestors were exposed to and predict what diseases you’re going to get,” says Skinner.

And that could lead to improved treatments for these diseases, based on their epigenetic roots. “Knowing the high statistical probability that you’re going to get this disease, we may be able to come up with therapeutic things in advance,” he says. And by treating them, we may also be helping our great-grandchildren to live without them too.

TIME Aging

Gains in Life Expectancy in the U.S. May Be Slipping

Nearly four in five Americans over age 67 have multiple chronic medical conditions

The more chronic medical conditions you have, the shorter your life will be, say researchers from Johns Hopkins Bloomberg School of Public Health.

In the study, published in the journal Medical Care, the team found that nearly four in five Americans over the age of 67 have multiple chronic conditions such as heart disease, hypertension and diabetes.

Obesity may be driving much of this trend, and may responsible for slowing recent gains in life expectancy. Life expectancy has been growing at about .1 years per year in the U.S., (that’s slower than rates in other developed countries).

The study used the Medicare 5 percent sample, a nationally representative group of 1.4 million Medicare beneficiaries, which included data on 21 chronic conditions. On average, life expectancy decreased by 1.8 years with each additional chronic condition among older Americans.

“When you’re getting sicker and sicker, the body’s ability to handle illness deteriorates and that compounds,” says senior study author Gerard Anderson, a professor in the Department of Health Policy and Management at Johns Hopkins. “Once you have multiple conditions, your life expectancy becomes much shorter.”

For example, he says, a 75-year-old woman with no chronic medical conditions would likely live to at least 92 years old, or another 17.3 years. However, a 75-year-old woman with five chronic conditions will likely only live another 12 more years, and a woman of the same age with 10 chronic conditions would only live to about 80 years old. According to the data, women fare better than men and white people live longer than black people even with the burden of additional health conditions.

The type of chronic disease older people develop also seems to affect their life expectancy. A 67-year-old diagnosed with Alzheimer’s will only live an additional 12 years, while someone with a heart condition can expect another 21.2 years. But once people develop more than one chronic condition, the specific illnesses no longer matter.

“There are interaction effects among the diseases that result in decreases in life expectancy. Any condition on its own has a particular effect. When you have heart disease plus cancer, that has a particular affect, and then those start to accumulate,” says lead study author Eva DuGoff.

The findings may be important for calculating health costs in coming years, especially for Social Security and Medicare programs. Currently, 60% of people over age 67 have three chronic medical conditions that require medical care — a significant increase from previous years when individuals didn’t live long with chronic conditions.

“In some ways we’re a victim of our own success. As we’re living longer and our health system has gotten better, no longer are people dying of heart disease at age 50 so now they’re dying of heart disease later when they have other things like cancer as well,” says DuGoff. Whatever gains improved health care has provided may be eroded by the effect of these accumulating chronic conditions. “We need to reorient our healthcare system to care for chronic conditions. If we don’t reorientate ourselves in that way, the impact of chronic conditions on life expectancy could be extremely negative.”

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