TIME People

Former Boston Mayor Thomas Menino Stops Chemotherapy

Ex-Boston Mayor Menino Cancer
FILE - In this April 21, 2014 file photo, from left, Boston Mayor Martin Walsh, former Mayor Thomas Menino, and four-time Boston Marathon champion Bill Rodgers walk past the finish line before the start of the 118th Boston Marathon in Boston. Elise Amendola—AP

The announcement came as a shock to Bostonians who see Menino as an indelible presence in their city

Former Boston mayor Thomas M. Menino has stopped treatment for advanced cancer, the much-beloved titan of Boston politics said on Wednesday.

Menino’s announcement startled and saddened Bostonians, who have seen the five-term mayor — perhaps still the most recognizable person in Boston’s political scene — carry on with business as usual since he was diagnosed with advanced-stage cancer in Feb., the Boston Globe reports. Menino had left office just a month before the diagnosis.

“While I continue to fight this terrible disease, I feel it is time for me to spend more time with my family, grandkids, and friends,” Menino said in a statement. “Angela [Menino’s wife] and I are grateful for the tremendous outpouring of support and kindness shown to our family and ask that everyone keep us in their thoughts and prayers.”

The 71-year-old also suspended a tour to promote his book, Mayor for a New America.

Menino helmed Boston for two decades as the city’s longest-serving mayor, and he is widely credited with shepherding Boston through tough economic times to become a bright, resurgent city.

“It’s hard to do anything in the public eye, and even this, even this, you do with class,” said one commentator on the statement posted to Menino’s Facebook page.

“Thanks Mr. Mayor,” he said.

[The Boston Globe]

TIME Cancer

Here’s How Well Your Genes Can Predict Your Breast Cancer Risk

Researchers say genetic sequencing can predict breast cancer risk better than previously thought

Your genes have a lot to say about who you are and how healthy you are. But for certain diseases, including cancer, so many genes are likely involved that it’s hard for doctors to come up with a useful, reliable way to turn your DNA information into a precise risk score.

But in a paper published in the journal Cancer Epidemiology, Biomarkers & Prevention, researchers say that combining the known genetic players in breast cancer can predict with much higher accuracy a newborn girl’s theoretical risk of developing the disease.

MORE: Angelina Jolie’s Surgery May Have Doubled Genetic Testing Rates at One Clinic

Alice Whittemore, a professor of epidemiology and biostatistics at Stanford University School and Medicine, and her colleagues included 86 known genetic variants that have been associated with breast cancer—including BRCA1 and BRCA2, which are relatively rare but confer a very high risk of disease compared to those that have a smaller contribution—and created a computer model that took into account the rates of breast cancer among 120,000 women who had these genetic variants.

This model served as a predictor for breast cancer based on womens’ genetic makeup. When researchers looked at the top 25% of risk scores, they found that these would account for about half of breast cancer cases in the future. Using previous models, genetic variants could account for only 35% of future cancer cases.

“Our results are more optimistic than those that have been previously published,” says Whittemore, “because we took 86 known genetic variants associated with breast cancer, and took what was in the world’s literature about how common those variants are, and by how much a factor they increase risk. And the more genetic variants that are identified, the better we will get at this.”

MORE: BRCA Gene Can Be A Cancer Triple Whammy, Study Finds

Since the paper was submitted, several new genetic variants have been linked to breast cancer, and adding those to the model, says Whittemore, could make it more effective.

But just because a woman may have been born with a high genetic risk for breast cancer doesn’t mean that she can’t change that risk. The model found that lifestyle factors, which are in a woman’s control, can generally lower the genetic risk by half. And the higher a woman’s genetic risk, the more she can reduce it with healthy behaviors. So avoiding excessive amounts of alcohol and smoking, or maintaining a healthy weight, for example, can bring a genetic risk of 30% down to around 15%, while a woman with a 4% genetic risk of developing breast cancer can reduce her risk by 2%.

“The news is that even if you are at high genetic risk of developing breast cancer, it’s all the more reason to do what you can to modify your lifestyle to lower your risk by changeable factors even if your genes aren’t changeable,” says Whittemore.

TIME health

Dear Brittany Maynard: Our Lives Are Worth Living, Even With Brain Cancer

This undated photo provided by the Maynard family shows Brittany Maynard.
This undated photo provided by the Maynard family shows Brittany Maynard. AP

Philip Johnson is a Catholic seminarian from the Diocese of Raleigh.

I was diagnosed with incurable brain cancer, but suicide is a temptation that avoid the important reality of life

Last week I came across the heartbreaking story of Brittany Maynard, a 29-year-old woman who was diagnosed with terminal brain cancer one year after her wedding. When doctors suggested that she might only have six months to live, she and her family moved from California to Oregon in order to obtain the prescriptions necessary for doctor-assisted euthanasia. She is devoting her last days to fundraising and lobbying for an organization dedicated to expanding the legality of assisted suicide to other States.

Brittany’s story really hit home, as I was diagnosed with a very similar incurable brain cancer in 2008 at the age of 24. After years of terrible headaches and misdiagnosis, my Grade III brain cancer (Anaplastic Astrocytoma) proved to be inoperable due to its location. Most studies state that the median survival time for this type of cancer is 18 months, even with aggressive radiation and chemotherapy. I was beginning an exciting career as a naval officer with my entire life ahead of me. I had so many hopes and dreams, and in an instant they all seemed to be crushed. As Brittany said in her online video, “being told you have that kind of timeline still feels like you’re going to die tomorrow.”

I was diagnosed during my second Navy deployment to the Northern Arabian Gulf. After many seizures, the ship’s doctor sent me to the naval hospital on the Persian Gulf island nation of Bahrain, where my brain tumor was discovered. I remember the moment I saw the computer images of the brain scans – I went to the Catholic chapel on base and fell to the floor in tears. I asked God, “why me?” The next day, I flew home to the United States to begin urgent treatment. A few months after radiation and chemotherapy, I was discharged from the Navy and began formation for the Roman Catholic priesthood, a vocation to which I have felt called since I was 19 years old. Despite all of the hardships and delays in my training and formation over the past six years, I hope to be ordained to the transitional diaconate this Spring and to the priesthood one year later.

I have lived through six years of constant turmoil, seizures and headaches. I often changed hospitals and doctors every few months, seeking some morsel of hope for survival. Like Brittany, I do not want to die, nor do I want to suffer the likely outcome of this disease. I do not think anyone wants to die in this way. Brittany states relief that she does not have to die the way that it has been explained that she would – she can die “on her own terms.” I have also consulted with my doctors to learn how my illness is likely to proceed. I will gradually lose control of my bodily functions at a young age, from paralysis to incontinence, and it is very likely that my mental faculties will also disappear and lead to confusion and hallucinations before my death. This terrifies me, but it does not make me any less of a person. My life means something to me, to God, and to my family and friends, and barring a miraculous recovery, it will continue to mean something long after I am paralyzed in a hospice bed. My family and friends love me for who I am, not just for the personality traits that will slowly slip away if this tumor progresses and takes my life.

Obviously, I have lived much longer than originally expected, and I attribute this to the support and prayers of others who have helped me to keep a positive outlook. I will never claim that I have dealt with my illness heroically or with great courage, no matter what others might observe or believe from my reserved disposition. I am shy and introverted, so I have not let many people become aware of the depth of my suffering. There have been times over the past six years that I wanted the cancer to grow and take my life swiftly so that it would all be over. Other times, I have sought forms of escape through sin and denial just to take my mind off of the suffering and sadness, even if only for a few moments. However, deep in my heart I know that this approach is futile. My illness has become a part of me, and while it does not define me as a person, it has shaped who I am and who I will become.

In Brittany’s video, her mother mentions that her immediate hope was for a miracle. My response to my diagnosis was the same – I hoped for a miraculous recovery so that I would not have to deal with the suffering and pain that was likely to come. However, I now realize that a “miracle” does not necessarily mean an instant cure. If it did, would we not die from something else later in our lives? Is there any reason that we deserve 15, 20, or 30 or more years of life? Every day of life is a gift, and gifts can be taken away in an instant. Anyone who suffers from a terminal illness or has lost someone close to them knows this very well.

I have outlived my dismal prognosis, which I believe to be a miracle, but more importantly, I have experienced countless miracles in places where I never expected to find them. Throughout my preparation for the priesthood I have been able to empathize with the sick and suffering in hospitals and nursing homes. I have traveled to Lourdes, France, the site of a Marian apparition and a place of physical and spiritual healing that is visited by millions of pilgrims each year. I have had the great opportunity to serve the infirm there who trust in God with their whole hearts to make sense of their suffering. Through my interaction with these people, I received much more than I gave. I learned that the suffering and heartache that is part of the human condition does not have to be wasted and cut short out of fear or seeking control in a seemingly uncontrollable situation. Perhaps this is the most important miracle that God intends for me to experience.

Suffering is not worthless, and our lives are not our own to take. As humans we are relational – we relate to one another and the actions of one person affects others. Sadly, the concept of “redemptive suffering” – that human suffering united to the suffering of Jesus on the Cross for our salvation can benefit others – has often been ignored or lost in modern times. It is perfectly understandable that medication should be made available to give comfort and limit suffering as much as possible during the dying process, especially during a terminal illness, but it is impossible to avoid suffering altogether. We do not seek pain for its own sake, but our suffering can have great meaning if we try to join it to the Passion of Christ and offer it for the conversion or intentions of others. While often terrifying, the suffering and pain that we will all experience in our lives can be turned into something positive. This has been a very difficult task for me, but it is possible to achieve.

There is a card on Brittany’s website asking for signatures “to support her bravery in this very tough time.” I agree that her time is tough, but her decision is anything but brave. I do feel for her and understand her difficult situation, but no diagnosis warrants suicide. A diagnosis of terminal cancer uproots one’s whole life, and the decision to pursue physician-assisted suicide seeks to grasp at an ounce of control in the midst of turmoil. It is an understandable temptation to take this course of action, but that is all that it is – a temptation to avoid an important reality of life. By dying on one’s “own terms,” death seems more comfortable in our culture that is sanitized and tends to avoid any mention of the suffering and death that will eventually come to us all.

Brittany comments, “I hope to pass in peace. The reason to consider life and what’s of value is to make sure you’re not missing out, seize the day, what’s important to you, what do you care about – what matters – pursue that, forget the rest.” Sadly, Brittany will be missing out on the most intimate moments of her life – her loved ones comforting her through her suffering, her last and most personal moments with her family, and the great mystery of death – in exchange for a quicker and more “painless” option that focuses more on herself than anyone else. In our culture, which seeks to avoid pain at any cost, it is not difficult to understand why this response is so common among those who suffer.

I have experienced so much sadness due to my illness, but there have also been times of great joy. The support I have received from others encourages me to keep pushing on. I want to be a priest, I want to see my three young nephews grow up, and these goals give me the hope to wake up each day and live my life with trust.

I will continue to pray for Brittany as she deals with her illness, as I know exactly what she is going through. I still get sad. I still cry. I still beg God to show me His will through all of this suffering and to allow me to be His priest if it be His will, but I know that I am not alone in my suffering. I have my family, my friends, and the support of the entire universal Church. I have walked in Brittany’s shoes, but I have never had to walk alone. Such is the beauty of the Church, our families, and the prayerful support that we give to one another.

May Brittany come to understand the love that we all have for her before she takes her own life, and that if she chooses instead to fight this disease, her life and witness would be an incredible example and inspiration to countless others in her situation. She would certainly be an inspiration to me as I continue my own fight against cancer.

Philip Johnson is a Catholic seminarian from the Diocese of Raleigh who has terminal brain cancer. This article was originally published on DioceseOfRaleigh.org.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Cancer

Study Links Latina Women With Gene That Lowers Breast Cancer Risk

Some Latina women have a gene that significantly lowers the risk of getting breast cancer, according to a new study.

The study, published in the journal Nature Communications, suggests that the gene is most effective at protecting against the variations of the disease that lead to the worst prognosis.

Researchers at the University of California San Francisco reported that 20% of self-identified Latinas had one copy of the gene, which led to 40% reduced risk of breast cancer. The 1% of Latinas who had two copies of the gene were about 80% less likely to have breast cancer, the study found.

Other medical research has shown that Latina women have lower a incidence of breast cancer than women with other backgrounds, but it wasn’t clear from what caused the disparity.

“After our earliest studies, we thought there might be a genetic variant that led to increased risk in European populations,” said UCSF professor and study author Elad Ziv in a press release. “But what this latest work shows is that instead there is a protective variant in Native American and Latina populations.”

Mammograms conducted for the study showed that women with the genetic variation had less dense breast tissue, which is thought to correlate with reduced breast cancer risk.

“We have detected something that is definitely relevant to the health of Latinas,” said Laura Fejerman, UCSF assistant professor and an author of the study, in a press release. “As a Latina myself, I am gratified that there are representatives of that population directly involved in research that concerns them.”

TIME Etiquette

How To Act Around Someone Who Was Just Diagnosed With Cancer

Cancer puzzle
Getty Images

The best thing someone did for me was to just be calm

xojane

This story originally appeared on xoJane.com.

I was diagnosed with thyroid cancer two years ago.

It was a confusing whirlwind where I felt more alive than ever, then flushed with the irony of that, became scared and isolated. And then I just wanted everything to go back to normal.

What I realized very quickly is that people don’t know what to say when something like this happens. And as someone who’s been on the other side, I thought I’d write a little bit about what helped me and what didn’t.

Listen and follow their lead.

When I wanted to talk about it, I talked about it. When I didn’t, I didn’t. If I’m not talking about it with you, I’ve made that choice.

There is a circling-the-wagons thing that happens with a cancer diagnosis, and the information and the fear and the mood swings can only be entrusted to the very top tier of one’s support system. If you are a friend of someone diagnosed with cancer and all they want to do is talk about work problems and good books they’ve read and this one brunch place they’re loving right now… let them. They’re not in denial and they don’t need you to brave the waters of talking about The Cancer. They need time off from The Cancer and the service you’re providing by letting them not talk about it is invaluable.

Prayers and good thoughts. Talismans and good luck charms. A stiff drink and nice big popcorn movie. Normalcy becomes the hottest commodity when one’s life has been hijacked.

Be ready for “weird.”

A cancer diagnosis feels like the most surreal thing in the world. It’s not an easy thing to process — if we can ever truly process it at all. You might not feel sick. You might not look sick. And now you’re being told there’s essentially a time bomb in your body… so you know, come back in a week and we’ll take some blood. NO! GET IT OUT RIGHT NOW?

And you have to make plans and keep showing up to work and follow orders and act like it’s not a big deal for your worried loved ones and be positive about it because you totally got it in time and what a blessing and all you can think about is going back to a time when you didn’t have cancer.

So you’re off. You know you’re off, too. You can’t get into the groove of things. And you want to keep apologizing, which, for me, comes out like, “I know I’m weird, just…” Because when you are a friend to someone who has been diagnosed, they aren’t going to know what’s happening either.

When you get a diagnosis, you’ve been told some crazy stuff about how your life is going to be in the coming months. It’s like the worst, most morbid Choose Your Own Adventure book ever. “Has your cancer spread to the lymph nodes? Turn to page 76!” Either you’re going to be fine or you’re… not. And that information hits you in waves.

You never know when it’s coming it’s just… you know when you think of some really embarrassing stuff you did back in the day? And that flush sweeps across your face? That’s what it feels like. The paralyzing fear.

So, let your friend be weird. They don’t know why they’re like that either.

Don’t preach.

Please don’t tell me that meditation really worked for you. Don’t tell me to marvel at trees because none of us knows how long we’re going to be here. Please don’t quote Eckhart Tolle and implore me to “find the joy.” Also, please don’t assume that I haven’t found my own ministry during this hard time.

Instead of trying to arrogantly educate me on what you’d do in the hypothetical, why don’t you listen to me about what I’m actually doing in the reality of it. Because you don’t have cancer. I do. So your platitudes about the evils of gluten and the wondrous qualities of kale sound so stupid to someone thinking about dying.

Please understand that there is a difference between what you expect from your life in the best of times and what I’m muddling through in the worst phases of mine. And I know. You read this article once where… I don’t care. I really don’t. I really don’t want to sit across a table from you and listen to what more you think I should be doing to fight for my life. Save it. It really is wildly tone deaf and most of all? Doesn’t help.

Complicated isn’t bad.

People really wanted me to be OK. Are you OK? I wonder if she’s OK.

Thing is, I wasn’t going to be OK right then. And that turned out to not necessarily be a bad thing.

Having cancer changed the course of my life. It made me think differently and live differently. On a cellular level. And that wasn’t an easy thing to excavate. It really was a trial by fire.

So, if your friend doesn’t seem OK? It’s complicated. It’s not necessarily a bad thing. It’s not something you think you need to talk to them about. They may not be “sad” — they could be thinking about their life and how they’ve lived it and how they want to live differently. Maybe they’re getting angry. That’s a good thing. Maybe they’re overwhelmed by the outpouring of love and feeling grateful. It’s all such a majestically beautiful, terrible Jackson Pollack painting.

Feelings are good. Feelings are messy. And feelings make us grow. Let your friend feel. Let your friend not be OK. Let your friend be comfortable in the not OK.

Talk about the right now.

It’s hard not to tell your friend that everything is going to be OK. We feel like we’re helping by shrugging off their worries and lightening the mood with “But you’re going to be fine!” It might not be. And also? It’s not all that fine right now.

The best thing someone did for me was to just be the calm flight attendant on the plane telling me where the exits are. They’re not fazed. They’re not worried. They’re hearing me, they’re providing copious amounts of tea and making sure that I have a blankie. They’re right here, right now. They’re pragmatic and sympathetic.

How was the appointment? Let’s talk about that. What’s up with that ham-fisted phlebotomist? Stay in the moment. Feel what’s happening now and talk about this moment on the checklist. Lighten the mood when you think it needs it or just listen and let them see your concern.

I think it’s actually the toughest tightrope to walk because it demands that you experience what’s happening in real time with your friend and most importantly understand that it’s not about you. By staying in the moment and not defaulting to a day when everything is going to be OK, you are telling your friend that you’re in this and moreover, you’re not going to be bringing your psyche to the party. This isn’t going to be about making you feel better. This isn’t going to be about acting fine so you don’t worry. This is just two people going through some scary stuff, making sure your seatbelt is buckled safely and that the drinks cart is on its way.

Also, don’t tell me I should start checking things off my Bucket List or Carpe Diem! Let’s not act like I have one foot in the grave.

Don’t get off on my drama.

You can sniff ‘em out on Facebook. You have suspicions. We all know them. The Drama Vampires.

There’s a part of you that actually thinks they’ll hold it together when your diagnosis comes down. They couldn’t make this about them… No? That’s… I mean, how… And then you’re sitting across from them and reassuring them and making sure they’re fine and making sure they’re taken care of during this trying time. THEIR FRIEND HAS CANCER, GUYS. Uh, yeah. You know. You’re the friend.

If you’re one of these people, it comes down to one simple question: Is the drama and attention you’re receiving worth more to you than the friend you are most certainly going to lose? Because cancer has a way of clarifying things. And a friend selfish enough to make your diagnosis about them is going to be the first one on the chopping block.

Furthermore, your friend’s cancer diagnosis is theirs to tell. Not yours. You should never divulge someone else’s diagnosis just so you can feel important or in-the-know. It’s a breach of trust. You’re not helping your friend; you’re feeding your own ego.

In the end, your friend is still your friend. And I think that’s the most important thing to remember: yes, this is a particularly challenging time but it’s not the only thing about them.

Make sure to let them be something other than A Person With Cancer. Help them remember this, because sometimes when you’re in the thick of it, that’s all you fear you are.

Liza Palmer is an author living in Los Angeles.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Aging

How to Talk About The End of Your Life

The toughest conversation might also be the most important

The video of Brittany Maynard, 29, describing her choice to move to Oregon for the right to end her life due to her terminal cancer has received well over 7 million views. It’s also left many people shocked, saddened and inspired by her decision.

“I am not suicidal. If I were, I would have consumed that medication long ago. I do not want to die. But I am dying. And I want to die on my own terms,” Maynard wrote on CNN.com.

Talking about death—and the circumstances surrounding it—is uncomfortable for most people. But my colleague Lily Rothman, 28, just wrote her will. “My eventual death was something I’d been mentioning to lots of people, on Facebook and at engagement parties and at my high-school reunion,” she writes. “It wasn’t that I thought death was going to come any time soon or in any special way, it’s just that, as they say on Game of Thrones, all men must die.”

MORE: 5 Tips For Families Facing End-Of-Life Care

Many people argue that it’s time we had more conversations about the end of life and how we want to go. It’s a conversation that can become awkward, especially for adult children bringing it up to their parents, but it allows people to avoid having to make very difficult decisions at the most sensitive times. “It’s critically important for us to have these conversations at the kitchen table,” says Ellen Goodman, founder of The Conversation Project, a nonprofit organization that campaigns for the expression and respect of wishes for end-of-life care. “Too many people are not dying in the way that they choose, and we need to change that.”

Goodman, who had to make medical decisions for her dying mother that they had never discussed beforehand, also created the Conversation Starter Kit, which you can download for free. So far, people in 50 states and 176 countries have downloaded the kit. That’s great news, considering about 90% of Americans believe it’s important to talk about their end-of-life care wishes and those of their loved ones, but only 30% actually have those discussions, according to the Conversation Project. “We would hope that this really tragic story of [Brittany Maynard] has an outcome that will really help people talk about these issues,” says Goodman.

Here are some other preparations you might consider if preparing an end-of-life checklist, from the National Institute on Aging:

  • A living will, which records a person’s wishes for medical treatment near the end of life.
  • Designating a durable power of attorney for health care, which names a person, sometimes called an agent or proxy, to make health care decisions when a person can no longer do so.
  • Talking about a do-not-resuscitate (DNR) order, which instructs health care professionals not to perform cardiopulmonary resuscitation if a person’s heart stops or if he or she stops breathing. A DNR order is signed by a doctor and put in a person’s medical chart.
  • Writing a will—a document that indicates how a person’s assets and estate will be distributed upon death.
  • Naming a durable power of attorney for finances, someone to make financial decisions when the person no longer can. It can help terminally ill people and their families avoid court actions that may take away control of financial affairs.
  • Penning a living trust, which provides instructions about the person’s estate and appoints someone, often referred to as the trustee, to hold the title to property and funds for the beneficiaries. The trustee follows these instructions after the person can no longer manage his or her affairs.
TIME Cancer

Can Low-T Therapy Promote Prostate Cancer?

lab rat
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New rat research raises health questions for researcher

“Low T” therapy is a fast-growing trend for men who want to jack up testosterone—which declines naturally with age but which can also be clinically low in some people—and the testosterone therapy industry is predicted to reach $5 billion by 2017. The long-term safety effects of supplementing with the hormone is still in question, however—especially in light of a study earlier this year that found double the heart attack risk in certain men after starting testosterone treatments. Other research suggested there was no meaningful increase in heart risk, adding to the confusion. But a new rat study published in the journal Endocrinology raises some alarming questions about the increasingly popular drugs.

Maarten Bosland, PhD, study author and professor of pathology at the University of Illinois at Chicago’s College of Medicine, devised an animal model to test the tumor-promoting effects of testosterone in rats. He exposed a group of rats to a carcinogen, which would put them at risk of developing cancer. He also gave some of the rats testosterone, but no carcinogen. In a third group, he administered both the carcinogen and the testosterone. Then, he measured tumor growth among the two groups.

None of the rats developed prostate cancer when they were just exposed to the carcinogen, but 10-18% of them did when they were just given testosterone. When the rats were exposed to the carcinogen and then given testosterone—even at very low doses—50-71% developed prostate cancer. “I was totally amazed about how strong testosterone can work to promote the formation of prostate cancer in these animals,” he says.

Of course, an animal model can’t determine what will happen in men, but Bosland thinks a similar effect is possible. “Absent of having solid human studies, we won’t be able to say that—it’s just an extra warning signal,” he says. “But I think it’s a clear indication that there is risk.”

TIME Cancer

Why Cancer Drugs May Work Better While You Sleep

The body doesn't process drugs in the same way throughout the day, so it's possible to time your doses to make anti-cancer meds more effective

It’s news to no one that your body works differently when you’re awake and when you’re sleeping. But could the different states also affect how your body processes certain life-saving drugs? Researchers, reporting Friday in the journal Nature Communications, found that when it comes to cancer drugs, the answer may be yes.

Researchers at the Weizmann Institute of Science discovered—by happy accident—that some of the body’s molecular functions during the day may interfere with the effectiveness of certain cancer medication. Specifically, they found that the normal day-time production of some steroid hormones in the body actually inhibited the work of epidermal growth factor (EGF) receptors—which are the proteins targeted by a class of anti-cancer drugs. Tumor cells plant these receptors on their surfaces to attract nutrients that help them survive and grow. Drugs, including the breast cancer agent lapatinib, can block these receptors on tumors, and such medications are a popular way to treat breast cancers expressing epidermal growth factor.

But Yosef Yarden, a professor in the department of biological regulation, and his team found that when the tumor cells simultaneously bind to something else—such as steroid hormones—the EGF receptors are less active, making drugs like lapatinib less potent.

The findings are still preliminary, but there is other evidence that the day-night cycle may be a potentially important factor in determining cancer treatment dosing in coming years. Some studies showed, for example, that when the 24-hour rest and activity cycle is broken metabolically, and the EGF receptors aren’t given enough time to be active, certain tumors in animals grow two to three times faster.

“The study developed out of a mistake. We accidentally omitted a synthetic steroid…from the medium in which we routinely grow mammary gland cells,” Yarden wrote in an email response to TIME. “And we noticed that the cells acquired a faster rate of migration when we followed them under a microscope.”

Intrigued, they turned to mice to answer some more questions. Knowing that steroid levels peak during the day and drop off during sleep, Yarden and his colleagues wondered whether the timing of anti-tumor drugs would affect tumor growth. So they gave a group of mice with breast cancer tumors lapatinib at different times over a 24-hour period and tracked any differences in the size and growth of the tumors.

Indeed, the mice given the drug while they slept showed significantly smaller tumors after seven days than those who received the drug during the day. Yarden suspects that the lower levels of steroid hormones circulating at night allows more of the EGF-targeting drug to hone in on its receptors on the tumor cells and inhibit their growth. Not only that, but the tumors in the mice taking the drug at night looked different; they showed less blood vessel infiltration which meant they were less robust.

Does that mean it’s better to get cancer therapy at night? So far, the results only apply to animal models, and to cancers driven by EGF. More work needs to be done, but if it’s validated, shifting therapies to just before bed “seems logical,” says Yarden. Especially since drugs like lapatinib come in pill form, so it would be relatively easy to take medications before turning in rather than in the morning.

TIME Cancer

Smoking and Drinking Raise Your Risk for Oral HPV

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Research sheds new light on HPV risk factors

Your favorite health vices—smoking and drinking—may pave paths to HPV, two new studies find.

A new study published in a research letter in JAMA looked at detailed health profiles from 6,887 participants in the National Health and Nutrition Examination Survey (NHANES). Those people with higher levels of biomarkers for tobacco exposure in their blood and urine also tended to have a higher prevalence of oral HPV type 16. That’s a strain that causes more than 90% of HPV-related oropharyngeal—or throat—cancers, says study co-author Dr. Gypsyamber D’Souza, associate professor at Johns Hopkins Bloomberg School of Public Health.

(By the way, you can only get oral HPV through intimate oral contact—not by sharing forks or kisses on the cheek, D’Souza says. It’s unclear whether French kissing, when you’re actually exchanging saliva, also does the trick.)

The main causes of throat cancers are tobacco, alcohol and HPV, she says, but since tobacco use has declined in the U.S., HPV is becoming an increasingly important player.

“HPV is the primary causal agent of HPV-related oral cancer,” D’Souza says, and most people clear the infections on their own. “But these results suggest that tobacco may make these infections less likely to clear, and therefore smokers may have a higher risk of eventually developing oropharyngeal cancers.”

The increased risk doesn’t only come from smoking cigarettes: the researchers found an association with oral HPV-16 and tobacco exposure in general, even at very low levels indicative of secondhand smoke. People who were current tobacco users had more cases of oral HPV-16 than former users or people who had never used it.

The good news is that the HPV vaccine protects against HPV type 16, and though it hasn’t been definitively shown yet to protect against oral infection, some data suggest that it does, D’Souza says.

In other HPV-related news, a separate questionnaire study on 1,313 men published earlier this month in BMJ found that men who reported drinking more alcohol tended to also have higher levels of HPV. In fact, the biggest drinkers in the study had 69% of HPV prevalence vs 57% among the men who drank the least. (For HPV types that may increase the risk of cancer, those numbers were 35% vs 23%.)

Neither study could definitively point to a cause or mechanism, but studies have shown that smoking and drinking have immunosuppressive effects, which can promote inflammation and infection.

“What this adds to the story is an understanding of one reason why people who have not had very heavy sexual history, people who’ve had one lifetime partner . . . develop these cancers,” D’Souza says. “This cross-sectional study suggests that in some people tobacco use might be an explanation.”

TIME Innovation

Five Best Ideas of the Day: October 2

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. A global competition could prime the pump for development of disease-fighting treatments.

By James Surowiecki in New Yorker

2. Cancer detecting yogurt? New technology could make diagnosing colon cancer as simple as taking a pregnancy test.

By Kevin Bullis at the MIT Technology Review

3. Youth-targeted networks are leading a surge in LGBT-friendly television programming.

By Joanna Robinson in Vanity Fair

4. California’s massive expansion of teledentistry could revolutionize delivery of oral hygiene to underserved areas.

By Daniela Hernandez in Kaiser Health News

5. The climate change movement desperately needs diversity and corporate leadership.

By Caitlin Colegrove in conversation with M. Sanjayan in the Aspen Idea

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

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