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Breast cancer screening in Australia may change. Here’s what we know so far

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/brooke-nickel-200747">Brooke Nickel</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>The way women are screened for breast cancer in Australia may <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/early-detection/breast-cancer/rosa/key-findings">change</a>.</p> <p>There’s international debate on the <a href="https://www.bmj.com/content/385/bmj.q1353">age</a> women should be invited for screening. But an even larger change being considered worldwide is whether to screen women at <a href="https://www.nature.com/articles/s41416-021-01550-3">high and low risk</a> of breast cancer differently.</p> <p>But what such a “risk-based” approach to screening might look like in Australia is not yet clear.</p> <p>Here’s why researchers and public health officials are floating a change to breast cancer screening in Australia, and what any changes might mean.</p> <h2>Why breast cancer screening may need to change</h2> <p>Mass screening (known as population-based screening) for breast cancer was introduced in Australia and many other developed countries in the 1980s and 90s.</p> <p>This was based on <a href="https://pubmed.ncbi.nlm.nih.gov/26756588/">robust research</a> that found early detection and treatment of cancers before there were symptoms prevented some women from dying from breast cancer.</p> <p>These programs offer regular breast cancer screening to women within a specific age group. For example, <a href="https://www.aihw.gov.au/reports/cancer-screening/national-cancer-screening-programs-participation/contents/breastscreen-australia">in Australia</a>, women aged 40-74 years can have free mammograms (x-rays of the breasts) every two years. The BreastScreen program sends invitations for screening to those aged 50-74.</p> <p>However, evidence has been mounting that mammography screening could be inadvertently causing <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61611-0/abstract">harm</a> for some women.</p> <p>For some, screening causes a false alarm that may cause anxiety, and unnecessary tests and procedures. Even though these tests rule out cancer, these women may remain anxious and perceive something is wrong <a href="https://bmjopen.bmj.com/content/13/4/e072188">for many years</a>.</p> <p>A more insidious harm is <a href="https://theconversation.com/five-warning-signs-of-overdiagnosis-110895">overdiagnosis</a>, where screening detects a non-growing or slow-growing lesion that looks like “cancer” under the microscope, but would not have progressed or caused harm if it had been left alone. This means some women are having unnecessary surgery, radiotherapy and hormone therapy that will not benefit them, but may harm.</p> <p>Although trials have shown screening reduces the risk of dying from breast cancer, questions are being raised about how much it <a href="https://www.bmj.com/content/352/bmj.h6080.abstract">saves lives overall</a>. That is, it’s uncertain how much the reduced risk of dying from breast cancer translates into improvements in a woman’s overall survival.</p> <h2>How about better targeting women?</h2> <p>One idea is to target screening to those most likely to benefit. Under such a “<a href="https://www.nature.com/articles/s41416-021-01550-3">risk-based</a>” approach, a women’s personal risk of breast cancer is estimated. This may be based on her age and many other factors that may include breast density, family history of breast cancer, body-mass index, genetics, age she started and stopped her periods, and the number of children she’s had.</p> <p>Women who are at higher risk would be recommended to start screening at a younger age and to screen more frequently or to use different, more sensitive, imaging tests. Women at lower risk would be recommended to start later and to screen less often.</p> <p>The idea of this more “precise” approach to screening is to direct efforts and resources towards the smaller number of women most likely to benefit from screening via the early detection of cancer.</p> <p>At the same time, this approach would reduce the risk of harm from false positives (detection of an anomaly but no cancer is present) and overdiagnosis (detection of a non-growing or slow-growing cancer) for the larger number of women who are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230256/">unlikely to benefit</a>.</p> <p>On face value this sounds like a good idea, and could be a favourable change for breast cancer screening.</p> <h2>But there’s much we don’t know</h2> <p>However, it’s uncertain how this would play out in practice. For one thing, someone’s future risk of a cancer diagnosis includes the risk of detecting both <a href="https://www.acpjournals.org/doi/10.7326/m17-2792">overdiagnosed cancers</a> as well as potentially lethal ones. This is proving to be a problem in risk-based screening for <a href="https://www.nature.com/articles/s41698-022-00266-8">prostate cancer</a>, another cancer prone to overdiagnosis.</p> <p>Ideally, we’d want to predict someone’s risk of <a href="https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00113-9/fulltext">potentially lethal cancers</a> as these are the ones we want to catch early.</p> <p>It is also still uncertain how many women found to be at <a href="https://pubmed.ncbi.nlm.nih.gov/31701797/">low risk</a> will accept a recommendation for <a href="https://pubmed.ncbi.nlm.nih.gov/23092125/">less screening</a>.</p> <p>These uncertainties mean we need robust evidence the benefits outweigh the harms for Australian women before we make changes to the breast cancer screening program.</p> <p>There are several international <a href="https://www.nature.com/articles/s41416-021-01550-3">randomised controlled trials</a> (the gold standard for research) under way to evaluate the effectiveness of risk-based screening compared to current practice. So it may be prudent to wait for their findings before making changes to policy or practice.</p> <p>Even if such trials did give us robust evidence, there are still a number of issues to address before implementing a risk-based approach.</p> <p>One key issue is having enough staff to run the program, including people with the skills and time to discuss with women any concerns they have about their calculated risk.</p> <h2>How about breast density?</h2> <p>Women with dense breasts are at <a href="https://www.sciencedirect.com/science/article/pii/S0960977622001618#:%7E:text=Mammographic%20density%20is%20a%20well,increased%20risk%20of%20breast%20cancer.">higher risk of breast cancer</a>. So notifying women about their breast density has been proposed as a “first step” on the pathway to risk-based screening. However, this ignores the many other factors that determine a woman’s risk of breast cancer.</p> <p>Legislation in the <a href="https://www.fda.gov/radiation-emitting-products/mammography-quality-standards-act-and-program">United States</a> and changes in some <a href="https://australianbreastcancer.org.au/news-stories/latest-news/breast-density-reporting-at-all-sa-clinics/">Australian states</a> mean some women are already being notified about their breast density. The idea is to enhance their knowledge about their breast cancer risk so they can make informed decisions about future screening.</p> <p>But this has happened before we know what the best options are for such women. An <a href="https://www.mja.com.au/journal/2023/219/9/psychosocial-outcomes-and-health-service-use-after-notifying-women-participating">ongoing Australian trial</a> is investigating the effects that breast density notification has on individual women and the health system.</p> <h2>What next?</h2> <p>Robust evidence and careful planning are needed before risk-based screening or other changes are made to Australia’s breast cancer screening program.</p> <p>Where changes are made, there needs to be early evaluation of both the <a href="https://www.bmj.com/content/350/bmj.h1566.abstract">benefits and harms</a>. Programs also need <a href="https://www.bmj.com/content/374/bmj.n2049.long">independent, regular re-evaluation</a> in the longer term.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231917/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/brooke-nickel-200747">Brooke Nickel</a>, NHMRC Emerging Leader Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, Professor in Clinical Epidemiology, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/breast-cancer-screening-in-australia-may-change-heres-what-we-know-so-far-231917">original article</a>.</em></p> </div>

Body

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"A bit grim": Sam Neill shares cancer update

<p>Actor Sam Neill has shared a heartbreaking update on his cancer journey, which he has said he will eventually succumb to. </p> <p>Last year, the 76-year-old revealed that he was battling rare blood cancer, angioimmunoblastic T-cell lymphoma.</p> <p>After undergoing chemotherapy that failed to work, Neill's doctor switched him to an anti-cancer drug which has put him in remission for more than 12 months. </p> <p>The treatment requires him to have infusions every two weeks, and while his condition is currently stable, the drug will eventually stop working. </p> <p>Speaking candidly to the <em>Herald Sun</em> about his condition, he said while he is maintaining a positive outlook, the gruelling treatment is impacting the way he lives his life.</p> <p>“It’s just meant that every second week it was a case of forget about the weekend because that would be a bit grim,” he explained of his treatment schedule. “But other than that, it’s great to be alive and working and in beautiful places, like York.”</p> <p>Last year, Sam insisted while he wasn’t afraid of death after battling the disease, he “would be annoyed” because he still has plenty he wants to achieve.</p> <p>“I’m prepared for that,” Neill said at the time, adding that while dying would be “annoying” he’s not “remotely afraid” of it.</p> <p>“The last thing I want is for people to obsess about the cancer thing because I’m not really interested in cancer," he added. "I’m not really interested in anything other than living.” </p> <p><em>Image credits: Matt Baron/BEI/Shutterstock Editorial </em></p> <p> </p>

Caring

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"It’s a lot to take in": Carly Findlay reveals cancer diagnosis

<p>Australian writer, speaker and disability advocate Carly Findlay has revealed she has cancer in an emotional post shared on Instagram. </p> <p>"I have cancer. I also had a hysterectomy, and I’ll have early menopause," she began her post. </p> <p>Findlay said she had been taken to hospital the day she returned from an overseas trip, with severe stomach pain and bloating. </p> <p>“Tests showed that I have a large ovarian cyst, also known as an ovarian mass,” she said in an earlier post.</p> <p>The 42-year-old, known for her work as an appearance advocate as she lives with ichthyosis, a genetic disorder that affects her skin and hair said she had been experiencing symptoms for six months before they discovered the cyst. </p> <p>She was required to have a full hysterectomy, which means that she had lost the choice to have children, and may also experience early menopause as a result. </p> <p>"The surgery went well. I seem to be recovering ok, but this is the first time I’ve had this type of surgery so I don’t know what’s normal," she continued in her post. </p> <p>"Unfortunately two types of cancer were detected during surgery." </p> <p>“I’ll find out more about the diagnosis and treatment soon.”</p> <p>She added that: "Everyone around me has been incredibly gentle and kind.</p> <p>"The surgeon who led the surgery held my hand as she told me the news. Nurses are angels and should be paid more." </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/C88-o6kyZOH/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C88-o6kyZOH/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Carly Findlay OAM (@carlyfindlay)</a></p> </div> </blockquote> <p>The appearance advocate also said that while she suspected it may have been cancer, it was difficult for her to take it all in. </p> <p>“Even though I knew cancer was a possibility, it’s a lot to take in, especially while recovering from major surgery.”</p> <p>Friends and fans have shared their well wishes. </p> <p>"Ah. Lovely Carly. Praise be for the intervention of medicine. Your heart and spirit and those who love you will carry you through this, and you will emerge, as always, with grace and courage. You are a gift. Much love and strength," wrote Kate Langbroek. </p> <p>"Sending you so much love, light and hugs. Thinking of you. You got this.🙏❤️" added Jelena Dokic</p> <p>"Sending you so much love 💕" added one fan. </p> <p><em>Images: Instagram</em></p>

Caring

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I’ve been diagnosed with cancer. How do I tell my children?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/cassy-dittman-1380541">Cassy Dittman</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/govind-krishnamoorthy-1467986">Govind Krishnamoorthy</a>, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a>, and <a href="https://theconversation.com/profiles/marg-rogers-867368">Marg Rogers</a>, <a href="https://theconversation.com/institutions/university-of-new-england-919">University of New England</a></em></p> <p>With around <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/cancer/2022">one in 50 adults</a> diagnosed with cancer each year, many people are faced with the difficult task of sharing the news of their diagnosis with their loved ones. Parents with cancer may be most <a href="https://www.sciencedirect.com/science/article/pii/S1462388914000994">worried about</a> telling their children.</p> <p>It’s best to give children factual and age-appropriate information, so children don’t create their own explanations or <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33202-1/fulltext">blame themselves</a>. Over time, supportive family relationships and open communication <a href="https://link.springer.com/article/10.1007/s00520-016-3214-2">help children adjust</a> to their parent’s diagnosis and treatment.</p> <p>It’s natural to feel you don’t have the <a href="https://onlinelibrary.wiley.com/doi/10.1111/ecc.12018">skills or knowledge</a> to talk with your children about cancer. But preparing for the conversation can improve your confidence.</p> <h2>Preparing for the conversation</h2> <p>Choose a suitable time and location in a place where your children feel comfortable. Turn off distractions such as screens and phones.</p> <p>For teenagers, who can find face-to-face conversations confronting, think about talking while you are going for a walk.</p> <p>Consider if you will tell all children at once or separately. Will you be the only adult present, or will having another adult close to your child be helpful? Another adult might give your children a person they can talk to later, especially to answer questions they might be worried about asking you.</p> <p>Finally, plan what to do after the conversation, like doing an activity with them that they enjoy. Older children and teenagers might want some time alone to digest the news, but you can suggest things you know they like to do to relax.</p> <p>Also consider what you might need to support yourself.</p> <h2>Preparing the words</h2> <p>Parents might be worried about the <a href="https://www.bmj.com/content/321/7259/479.full.pdf+html">best words or language</a> to use to make sure the explanations are at a level their child understands. Make a plan for what you will say and take notes to stay on track.</p> <p>The toughest part is likely to be saying to your children that you have cancer. It can help to practise saying those words out aloud.</p> <p>Ask family and friends for their feedback on what you want to say. <a href="https://www.cancer.org.au/cancer-information/types-of-cancer/childhood-cancers/talking-to-kids-about-cancer">Make use of guides</a> by the Cancer Council, which provide age-appropriate wording for explaining medical terms like “cancer”, “chemotherapy” and “tumour”.</p> <h2>Having the conversation</h2> <p>Being open, honest and factual is important. Consider the balance between being too vague, and providing too much information. The <a href="https://www.sciencedirect.com/science/article/pii/S1462388914000994">amount and type</a> of information you give will be based on their age and previous experiences with illness.</p> <p>Remember, if things don’t go as planned, you can always try again later.</p> <p>Start by telling your children the news in a few short sentences, describing what you know about the diagnosis in language suitable for their age. Generally, this information will include the name of the cancer, the area of the body affected and what will be involved in treatment.</p> <p>Let them know what to expect in the coming weeks and months. Balance hope with reality. For example:</p> <blockquote> <p>The doctors will do everything they can to help me get well. But, it is going to be a long road and the treatments will make me quite sick.</p> </blockquote> <p>Check what your child knows about cancer. Young children may not know much about cancer, while primary school-aged children are starting to understand that it is a <a href="https://journals.sagepub.com/doi/epdf/10.1177/0165025408093663">serious illness</a>. Young children may worry about becoming unwell themselves, or other loved ones becoming sick.</p> <p>Older children and teenagers may have experiences with cancer through other family members, friends at school or social media.</p> <p>This process allows you to correct any misconceptions and provides opportunities for them to ask questions. Regardless of their level of knowledge, it is important to reassure them that the cancer is not their fault.</p> <p>Ask them if there is anything they want to know or say. Talk to them about what will stay the same as well as what may change. For example:</p> <blockquote> <p>You can still do gymnastics, but sometimes Kate’s mum will have to pick you up if I am having treatment.</p> </blockquote> <p>If you can’t answer their questions, be OK with saying “I’m not sure”, or “I will try to find out”.</p> <p>Finally, tell children you love them and offer them comfort.</p> <h2>How might they respond?</h2> <p>Be prepared for a range of <a href="https://link.springer.com/article/10.1007/s00520-016-3214-2">different responses</a>. Some might be distressed and cry, others might be angry, and some might not seem upset at all. This might be due to shock, or a sign they need time to process the news. It also might mean they are trying to be brave because they don’t want to upset you.</p> <p>Children’s reactions will change over time as they come to terms with the news and process the information. They might seem like they are happy and coping well, then be teary and clingy, or angry and irritable.</p> <p>Older children and teenagers may ask if they can tell their friends and family about what is happening. It may be useful to come together as a family to discuss how to inform friends and family.</p> <h2>What’s next?</h2> <p>Consider the conversation the first of many ongoing discussions. Let children know they can talk to you and ask questions.</p> <p>Resources might also help; for example, The Cancer Council’s <a href="https://www.campquality.org.au/kids-guide-to-cancer/">app for children and teenagers</a> and Redkite’s <a href="https://www.redkite.org.au/service/book-club/">library of free books</a> for families affected by cancer.</p> <p>If you or other adults involved in the children’s lives are concerned about how they are coping, speak to your GP or treating specialist about options for psychological support.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/228012/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/cassy-dittman-1380541">Cassy Dittman</a>, Senior Lecturer/Head of Course (Undergraduate Psychology), Research Fellow, Manna Institute, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a>; <a href="https://theconversation.com/profiles/govind-krishnamoorthy-1467986">Govind Krishnamoorthy</a>, Senior Lecturer, School of Psychology and Wellbeing, Post Doctoral Fellow, Manna Institute, <a href="https://theconversation.com/institutions/university-of-southern-queensland-1069">University of Southern Queensland</a>, and <a href="https://theconversation.com/profiles/marg-rogers-867368">Marg Rogers</a>, Senior Lecturer, Early Childhood Education; Post Doctoral Fellow, Manna Institute, <a href="https://theconversation.com/institutions/university-of-new-england-919">University of New England</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-been-diagnosed-with-cancer-how-do-i-tell-my-children-228012">original article</a>.</em></p> </div>

Family & Pets

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Nat Barr shares scary cancer diagnosis

<p>Sunrise co-host Nat Barr has shared a recent personal health scare that underscores the importance of regular skin checks.</p> <p>Barr disclosed that doctors diagnosed her with skin cancer after a persistent “pimple” on her nose prompted her to seek medical advice.</p> <p>On Tuesday's <em>Sunrise </em>program, Barr detailed her experience, explaining how a seemingly innocuous blemish led to an unexpected and concerning diagnosis. “I’ve had this pimple on my nose, it’s been about three weeks. It keeps going up, down, up, down, won’t go away,” Barr shared. This irregularity convinced her to consult a dermatologist, who used advanced AI technology along with a Spectrascope to examine the lesion.</p> <p>The specialist diagnosed the 3mm lesion as cancerous, with Barr receiving a score of 7.4 on the test, where any score above seven is indicative of cancer. “That was so tiny, it was just a tiny little red thing,” Barr said, showing just how easily such a small detail could be overlooked.</p> <p>The dermatologist’s use of AI to analyse photos of Barr’s entire body further highlighted the cutting-edge methods now available in skin cancer detection. This technology can compare images over time to identify changes more accurately than the human eye, providing a powerful tool in early diagnosis and treatment.</p> <p>Following the diagnosis, Barr was prescribed an anti-cancer cream to treat the lesion and also underwent red light therapy, a treatment that selectively targets and kills cancer cells.</p> <p>Reflecting on her experience, Barr expressed how this health scare made her more aware of the importance of regular skin checks. “It’s just a good reminder for everyone," she urged, "remember to get your skin checked regularly."</p> <p>Despite the scare, Barr reassured her fans about her health. “The outlook for my health is fine,” she confirmed, noting that her next appointment is scheduled for Friday. In the meantime, she mentioned that the lesion is currently concealed with make-up. “I do the same process this Friday, and then it gets all crusty, and then it will be fine,” she added.</p> <p>Skin cancer, often underestimated, can start as something as small as a persistent pimple or a red spot. Early detection and treatment are vital, and advancements in technology now offer more precise and early diagnoses, potentially saving lives.</p> <p><em>Images: Sunrise</em></p>

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Princess Kate makes first public appearance since cancer diagnosis

<p>The Princess of Wales has made her first public appearance in almost six months following her cancer diagnosis. </p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Princess Kate</span>, who was last seen in public at a church service on Christmas Day, underwent abdominal surgery in January and has been receiving chemotherapy since late February. </p> <p>The royal took part in Trooping the Colour on Saturday, after taking time away from royal duties, and left Buckingham Palace in a carriage with her children shortly before 11am local time to watch the parade. </p> <p>After the King's Birthday Parade, she appeared at the balcony alongside King Charles, Queen Camilla, Prince William and other members of the royal family. </p> <p>The family waved to the cheering crowd as they watched military aircrafts fly by to mark the monarch's official birthday. </p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/C8Pt2DrN61b/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C8Pt2DrN61b/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a></p> </div> </blockquote> <p>Princess Kate confirmed in a statement on Friday that she would be attending the King's Birthday Parade, as well as a few other public engagements over the summer. </p> <p>However, she also said that her treatment was "ongoing, and will be for a few more months". </p> <p>"On the days I feel well enough, it is a joy to engage with school life, spend personal time on the things that give me energy and positivity, as well as starting to do a little work from home," she wrote in the statement on Friday. </p> <p>"I am learning how to be patient, especially with uncertainty.</p> <p>"Taking each day as it comes, listening to my body, and allowing myself to take this much needed time to heal."</p> <p>King Charles, who is also being treated for an undisclosed form of cancer, travelled in a carriage with Queen Camilla this year, instead of on horseback as he did last year. </p> <p>He has also been easing back into public duties, and just last week he attended commemorations for the 80th anniversary of D-Day, the Allied invasion of Nazi-occupied Europe. </p> <p><em>Image: Ray Tang/ Shutterstock Editorial</em></p>

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"Do not cry for me": Teacher announces own death

<p>A teacher and mum-of-two who chronicled her breast cancer journey online has announced her own death, through a social media post written before her passing. </p> <p>"If you're reading this, it means I have died," Kate Rackham, 45, shared on her <em>Teacher With Cancer </em>X account. </p> <p>"But do not cry for me. I have lived my life on my own terms, the way I have wanted to."</p> <p>The mum told her followers that she joined X, formerly Twitter, as she "needed an outlet", but "what I got was so much more". </p> <p>"You made me feel validated in my feelings and much less alone. Thank you."</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">If you’re reading this, it means I have died. But do not cry for me. I have lived my life on my own terms, the way I have wanted to. I joined X because I needed an outlet, what I got was so much more. You made me feel validated in my feelings and much less alone. Thank you ❤️</p> <p>— Teacher with Cancer (@kate_rackham) <a href="https://twitter.com/kate_rackham/status/1801137648146243756?ref_src=twsrc%5Etfw">June 13, 2024</a></p></blockquote> <p>The British mum was only 39 when she was diagnosed with  incurable oestrogen-receptive breast cancer and spent the past six years fighting the disease. </p> <p>She began documenting her journey online, and explained that she had no obvious risk factors leading to the disease. </p> <p>Just before her passing, she was admitted into hospital and was told by doctors that "there is nothing more we can do" and that she "needed a bit of time" to process the news. </p> <p>"I'm now home, where I want to be. With Mark and the girls. Surrounded by love, family and friends," she shared at the time. </p> <p>"Everyone is rallying around and I have so much support. Despite everything I feel blessed."</p> <p>Many have shared their condolences, including friends and those who are also battling breast cancer. </p> <p>"When my time comes, I can but hope I display the dignity and strength of character you did. Much love and condolences to your family and friends," one wrote.</p> <p>"I hope you are free from the pain. You still live in your children your husband. Your legacy," another said.</p> <p>"Thank you for sharing your journey with grace and dignity," a third added. </p> <p>"I hope wherever you are you are no longer in pain. Sending love and thoughts to your family."</p> <p>Rackham is survived by her husband Mark and their two daughters Ruby and Nancy. </p> <p><em>Images: X/ Nine</em></p> <p> </p>

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Cancer-causing chemicals found in Aussie tap water sparks safety concerns

<p>A landmark ruling in the US has sparked safety concerns over Australian tap water, with many wondering if it is safe to drink. </p> <p>After the US tightened their regulations around drinking tap water, cutting the maximum level of cancer-causing so-called “forever chemicals” allowed, experts have urged Australia to do the same. </p> <p>Earlier this year, the US Environmental Protection Agency found there was “no safe level of exposure” of the chemicals perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) in drinking water and they were likely to cause cancer.</p> <p>The toxic substances have also been linked to kidney and liver disease, thyroid dysregulation, reproductive problems, and developmental problems.</p> <p>According to a federally funded University of Queensland study published in 2011, Australia permits per-and-poly-fluoroalkyl (PFAS) substances at levels up to 140 times higher than those allowed in the US.</p> <p>Health Minister Mark Butler has asked key political players, including Chief Medical Officer Paul Kelly, for an urgent briefing following the US developments.</p> <p>The National Health and Medical Research Council, which shapes the nation’s water rules, is reviewing its guidelines relating to the chemicals, and that could be expedited ahead of its 2025 end date.</p> <p>“Australian drinking water is regularly monitored for the presence of chemicals, including PFAS, to ensure those are within the limits assessed as safe by Australian regulators,” a spokesperson for the Health Minister said.</p> <p>“This independent review will consider recent guidance and reviews from international and national jurisdictions and determine whether they are suitable to adopt or adapt for Australia.”</p> <p>Nicholas Chartres, a senior research fellow at the University of Sydney, called for a precautionary approach and immediate widespread testing of the nation’s water supplies.</p> <p>“The government needs to take action. They need to be testing the water (and) it will come at a cost,” he said.</p> <p><em>Image credits: Shutterstock</em></p>

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Urgent investigation into potential cancer cluster after mass diagnosis

<p>An urgent investigation has been launched into a potential cancer cluster after five women from the same workplace all developed cancer. </p> <p>Liverpool City Council confirmed five staff members working at its Moore Street office building, in Sydney’s southwest, were diagnosed with thyroid cancer within three to five years of each other. </p> <p>Four of the five workers are taking part in an urgent investigation by the NSW Department of Health, while sixth worker who has reported a thyroid condition has also opted out.</p> <p>The staff members were all working on the sixth floor of the office building, which has since been shut down upon the commencement of the investigation, with workers being relocated to other floors. </p> <p>Jenny Havilah, who works on level six of the building and was recently diagnosed with thyroid cancer, told <em><a href="https://www.9news.com.au/national/liverpool-council-cancer-cluster-investigation-three-staff-diagnosed-thyroid-cancer/75ef3ccd-1ca6-4b41-b3b5-8c614886f093#:~:text=Liverpool%20Council%20has%20made%20the,were%20%22well%20and%20working%22." target="_blank" rel="noopener" data-tgev="event119" data-tgev-container="bodylink" data-tgev-order="75ef3ccd-1ca6-4b41-b3b5-8c614886f093#:~:text=Liverpool%20Council%20has%20made%20the,were%20%22well%20and%20working%22." data-tgev-label="national" data-tgev-metric="ev">9News</a></em> she was concerned for her colleagues' health and safety. </p> <p>“It certainly sounds very sinister,” she told the outlet when asked about how three of her workmates who sat five metres apart were experiencing the same health issue. </p> <p>“I’m worried about my colleagues, not just on the sixth floor (but) that worked in that building.”</p> <p>“I had my thyroid and some lymph nodes removed and I’ll get the results in a week or so.”</p> <p>In a statement, Liverpool City Council said it was taking the matter “very seriously”, and have employed a third-party environmental health consultant while the NSW Department of Health undertakes a separate epidemiological investigation.</p> <p>“The decision to relocate staff is in response to the council’s high level of concern for the welfare of its staff,” the council said. </p> <p>“Our thoughts are with those affected and we wish them a prompt recovery.”</p> <p><em>Image credits: Nine News </em></p>

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The growing promise of cancer vaccines

<div class="copy"> <p>A cure for cancer — which is <a href="https://ourworldindata.org/grapher/burden-of-disease-by-cause" target="_blank" rel="noopener">second only to cardiovascular diseases</a> in its contribution to the global burden of disease — has long been a dream.</p> <p>While no magic bullet is yet in sight, three vaccines for particular skin and lung cancer types have advanced to the last stage of clinical trials in recent months.</p> <p>If successful, these vaccines should be available to patients in the next three to 11 years. Unlike vaccines which prevent diseases, these aim to cure them or prevent relapses.</p> <p>Cancer in every person is different because the cells in every cancerous tumour have different sets of genetic mutations. Recognising this, two of the vaccines are personalised and tailor-made for each patient. Oncologists working with pharmaceutical companies have developed these individualised neoantigen therapies.</p> <p>A vaccine typically works by training the immune cells of our body to recognise antigens – proteins from pathogens, such as viruses – against future attacks by the pathogen.</p> <p>In cancer, however, there is no external pathogen. The cells of a cancerous tumour undergo continuous mutations, some of which help them to grow much faster than normal cells while some others help them evade the body’s natural immune system. The mutated proteins in cancerous cells are called ‘neoantigens’.</p> <p>In individualised neoantigen therapy, the gene sequence of the tumour and normal blood cells are compared to identify neoantigens from each patient, and then a subset of neoantigens are chosen that are most likely to induce an immune response. The vaccine for an individual patient targets this chosen subset of neoantigens.</p> <p>These vaccines, jointly developed by pharma giants Moderna and Merck, have been shown in trials conducted so far to be significantly more effective in combination with immunotherapy than immunotherapy alone in preventing both the relapse of melanoma — a type of skin cancer — and non-small cell lung cancer after the tumours had been surgically removed.</p> <p>Following these promising results in phase II clinical trials, the vaccines are now being tested on a larger group of patients in phase III trials. The studies are expected to be complete by 2030 for <a href="https://clinicaltrials.gov/study/NCT05933577" target="_blank" rel="noopener">melanoma</a> and 2035 for <a href="https://www.clinicaltrials.gov/study/NCT06077760?intr=mRNA-4157&amp;rank=3" target="_blank" rel="noopener">lung cancer</a>.</p> <p>The Moderna-Merck cancer vaccine may not be the first to reach the market. The French company OSE Immunotherapeutics <a href="https://www.clinicaltrialsarena.com/news/ose-shares-pipeline-updates-with-plans-phase-iii-trial-for-tedopi/" target="_blank" rel="noopener">published positive results</a> last September from phase III clinical trials of a vaccine using a different approach for advanced non-small cell lung cancer. Its vaccine, Tedopi, is scheduled to start <a href="https://finance.yahoo.com/news/ose-immunotherapeutics-receives-8-4-160000694.html?guccounter=1&amp;guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&amp;guce_referrer_sig=AQAAADAX7Kqu7RTAEowvwOw2f-2cJ7SJ4uLpvjH-3tXzGtifqidaZfPs4eHLz23UqqjHDPjbVE1Vwel5qIKzKbmWvPLfLQzzH_PvKJAMsqTHuz8p5nPoR39RbIToLShEUG53eOeDFg6pWlRc2JPqrX7sGnc3ByO9FFfqXQYpZ4FZ-jgr" target="_blank" rel="noopener">confirmatory trials</a> – which are the last step before regulatory approval – later this year and may be available by 2027.</p> <p>Vaccines for pancreatic cancer being developed by BioNTech and Genentech, and for colon cancer by Gritstone, are also showing promising results in the early phases of clinical trials. Like the vaccines being developed by Moderna and Merck, these too are individualised neoantigen therapies based on messenger RNA (mRNA).</p> <p>There is another kind of RNA therapy also under development that uses small interfering RNA (siRNA) and microRNA (miRNA). Since 2018, six siRNA-based therapies have been approved by the US Food and Drug Administration for the treatment of neural, skin, heart and renal diseases. Several more siRNA drugs are at various clinical trial stages for different types of cancer and a diverse range of other diseases.</p> <p>Within cells, there are two kinds of nucleic acid molecules that contain coded information vital to life: DNA and RNA. While DNA contains genetic information, mRNA — one among the different types of RNA — carries the codes for the proteins. In addition, there are also non-coding RNA, some of which are functionally important. siRNA and miRNA are examples of such non-coding RNA.</p> <p>The RNA vaccine for an individualised neoantigen therapy is a cocktail of mRNA carrying the codes for neoantigens — the mutated fingerprint proteins in cancerous cells. For the <a href="https://www.nature.com/articles/d41591-023-00072-0" target="_blank" rel="noopener">Moderna-Merck study</a>, scientists identified 34 neoantigens per patient. They delivered the corresponding mRNA vaccine cocktail packed in lipid nanoparticles, just like the mRNA vaccines for COVID-19 developed by Moderna and Pfizer-BioNTech.</p> <p>When the vaccine is delivered after removing the tumour, it trains the immune system to recognise neoantigens and fight back against the cancer returning. Usually, the body’s natural immune system corrects mutations and prevents us from having cancers. However, in some cases this natural immune response is insufficient, leading to tumour growth. In individualised neoantigen therapy, these mutations in the tumour cells are used for vaccine development and for training the immune system to fight back against relapse after removal of the tumour.</p> <p>Recent advances in artificial intelligence are helping identify potential neoantigens and manage personalised therapies. Firstly, gene sequencing of tumours and normal blood cells of a patient and their comparison produces a huge amount of data. AI is used to find the genetic mutations of the patient’s cancer in such ‘big data’. Moreover, individualised therapy requires timely production and delivery of vaccines that are different for each patient. AI is also useful in the management of such data.</p> <p>The individualised nature of the treatment is probably why it has been <a href="https://www.nature.com/articles/d41591-023-00072-0" target="_blank" rel="noopener">more effective in trials</a> than previous, unsuccessful RNA vaccine candidates. However, this personalisation is also likely to raise challenges for the timely and cost-effective delivery of treatment to populations around the world.</p> <p>The siRNA and miRNA treatments work in a way opposite to mRNA. While each mRNA in a vaccine carries the code for producing a protein from a pathogen (antigen) or tumour (neoantigen) to train our immune systems against future attacks by the pathogen or tumour, siRNA directly targets the mRNA of the antigen or neoantigen and terminates the production of the protein it codes. Thus, the effect of a siRNA is more direct and immediate (like a drug), rather than a protection against future attacks (like a vaccine).</p> <p>Discovered at the turn of this millennium, siRNA-based therapeutics attracted immediate attention, but their initial success was limited due to their inherent low stability, difficulties in delivering them to desired locations, and rapid clearance from the bloodstream. However, in recent years, siRNA therapies have been boosted through chemical modifications that have increased their stability and ability to be delivered to specific locations such as tumours, and improved delivery systems such as lipid nanoparticle encasings.</p> <p>These improvements led to recent successes in FDA approvals of siRNA-based therapies and further <a href="https://www.rockefeller.edu/news/35461-a-new-way-to-target-the-culprit-behind-a-deadly-liver-cancer/" target="_blank" rel="noopener">promising reports of advances</a> in the treatment of diseases including a type of liver cancer.</p> <p><em>Research scientist </em><em><strong>Dr Bidyut Sarkar</strong></em><em> is the DBT-Wellcome Trust India Alliance Intermediate Fellow in the Department of Chemistry at Shiv Nadar Institute of Eminence, Delhi NCR, India.</em></p> <p><em>Originally published under <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener">Creative Commons</a> by <a href="https://360info.org/" target="_blank" rel="noopener">360info</a>™.</em></p> <p><em>Image credits: Shutterstock </em></p> <div> <p align="center"><noscript data-spai="1"><em><img decoding="async" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/12/MICROSCOPIC-TO-TELESCOPIC__Embed-graphic-720x360-1.jpg" data-spai-egr="1" width="600" alt="Buy cosmos print magazine" title="the growing promise of cancer vaccines 2"></em></noscript></p> </div> <p><em><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=304875&amp;title=The+growing+promise+of+cancer+vaccines" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /> <!-- End of tracking content syndication --></em></div> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/the-body/the-growing-promise-of-cancer-vaccines/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/360info-2/">360info</a>. Originally published under Creative Commons by 360info™.</em></p> </div>

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Kate Middleton's positive cancer update

<p>More than two months after Kate Middleton shared the news of her cancer diagnosis with the world, a source close to the royals has issued a positive update on her condition. </p> <p>Vanity Fair’s royal correspondent Katie Nicholl, who has well connected sources inside Buckingham Palace, shared that the Princess of Wales has "turned a corner", as she continues treatment for the disease.</p> <p>“It has been a great relief that she is tolerating the medication and is actually doing a lot better,” a family friend of Kate’s told <a href="https://www.vanityfair.com/style/story/kate-middleton-update" target="_blank" rel="noopener"><em>Vanity Fair</em></a>. </p> <p>“It has, of course, been a very challenging and worrying time. Everyone has rallied around her—William, her parents, and her sister and brother.”</p> <p>While undergoing treatment, the Princess has been at home in Sandringham Castle, although recent reports claim Kate has been well enough to be out and about with her children while they are on school holidays.</p> <p>Despite the positive news about her condition, sources inside the Palace shared that Kate's number one priority is still her health, and will not be returning to royal duties for the foreseeable future. </p> <p>According to Nicholl, Kate “is in no hurry to return to work, with her focus being entirely on her recovery.”</p> <p>A well-placed source told her, “There is no timeline, and there is certainly no hurry. It will be when Catherine feels ready and when she gets the greenlight from her medical team. But she will 100 per cent be coming back to work, of that there is no question.”</p> <p><em>Image credits: Supplied</em></p>

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"Family unity is key": Sarah Ferguson gives cancer update

<p>Sarah Ferguson has shared an update on her cancer journey during her appearance at the Cannes Film Festival. </p> <p>The Duchess of York was diagnosed with <a href="https://www.oversixty.com.au/health/caring/fergie-reveals-second-cancer-diagnosis" target="_blank" rel="noopener">skin cancer</a> in January, not long after getting a mastectomy for her breast cancer, which she was diagnosed with in June 2023. </p> <p>When asked about her health, the royal told <em>People</em>: "This evening I am doing very well. I think that we've managed to get cancer in the right place rather than cancer ruling me. I've put cancer in the corner." </p> <p>Speaking on the amfAR Gala red carpet, the 64-year-old added that it was important to be aware and get checked for both breast cancer and melanoma. </p> <p>“I think you always have to be aware. I think it’s great to get checked for breast cancer [and] melanoma. I think you just have to be very candid about it," she told the publication. </p> <p>“I think a lot of people get very frightened to talk about these things. I’m very happy with my mastectomy and my breasts and just to talk about it.”</p> <p>Her diagnosis coincided with both her brother-in-law King Charles, and Princess Catherine's cancer diagnoses, although both of them have not disclosed what types of cancer they have. </p> <p>She praised the royal family for their "unity" during these difficult times and how she has been able to offer support to Charles and Catherine. </p> <p>"I think family unity is key… I think the key to life is that we all support each other," she said. </p> <p>"And also forgiveness is a great thing. I think forgiveness of yourself, and forgiveness of others." </p> <p>Earlier this month, the duchess' eldest daughter Princess Beatrice spoke about her mother's health in her debut TV interview on <em>This Morning</em>. </p> <p>"She’s such a phenomenal icon. As a mum she’s been amazing," she said, adding that despite going through so much in the last year, she felt inspired by her mum's resilience and sense of purpose. </p> <p>“She’s doing really well. She had a bumpy health scare last year but she’s all clear now. But I think at 64, she’s thriving. She’s been through so much, but now she’s coming into her own.</p> <p>“We are just reminded when any parent or individual has a health scenario, you really need to get the checks you need as early as you possibly can.”</p> <p><em>Image: DGP/imageSPACE/ Shutterstock editorial</em></p> <p> </p>

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Exercise, therapy and diet can all improve life during cancer treatment and boost survival. Here’s how

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/rob-newton-12124">Rob Newton</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p>With so many high-profile people <a href="https://www.theguardian.com/uk-news/2024/mar/23/cancer-charities-princess-of-wales-speaking-about-diagnosis">diagnosed with cancer</a> we are confronted with the stark reality the disease can strike any of us at any time. There are also reports certain cancers are <a href="https://www.cancer.org/research/acs-research-news/facts-and-figures-2024.html">increasing among younger people</a> in their 30s and 40s.</p> <p>On the positive side, medical treatments for cancer are advancing very rapidly. Survival rates are <a href="https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21763">improving greatly</a> and some cancers are now being managed more as <a href="https://www.cancer.org/cancer/survivorship/long-term-health-concerns/cancer-as-a-chronic-illness.html">long-term chronic diseases</a> rather than illnesses that will rapidly claim a patient’s life.</p> <p>The <a href="https://www.cancer.org/cancer/managing-cancer/treatment-types.html">mainstays of cancer treatment</a> remain surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy and hormone therapy. But there are other treatments and strategies – “adjunct” or supportive cancer care – that can have a powerful impact on a patient’s quality of life, survival and experience during cancer treatment.</p> <h2>Keep moving if you can</h2> <p>Physical exercise is now recognised as a <a href="https://www.exerciseismedicine.org/">medicine</a>. It can be tailored to the patient and their health issues to stimulate the body and build an internal environment where <a href="https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/tre.884">cancer is less likely to flourish</a>. It does this in a number of ways.</p> <p>Exercise provides a strong stimulus to our immune system, increasing the number of cancer-fighting immune cells in our blood circulation and infusing these into the tumour tissue <a href="https://jitc.bmj.com/content/9/7/e001872">to identify and kill cancer cells</a>.</p> <p>Our skeletal muscles (those attached to bone for movement) release signalling molecules called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288608/">myokines</a>. The larger the muscle mass, the more myokines are released – even when a person is at rest. However, during and immediately after bouts of exercise, a further surge of myokines is secreted into the bloodstream. Myokines attach to immune cells, stimulating them to be better “hunter-killers”. Myokines also signal directly to cancer cells <a href="https://www.sciencedirect.com/science/article/pii/S2095254623001175">slowing their growth and causing cell death</a>.</p> <p>Exercise can also greatly <a href="https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/tre.884">reduce the side effects of cancer treatment</a> such as fatigue, muscle and bone loss, and fat gain. And it reduces the risk of <a href="https://doi.org/10.2337/diacare.27.7.1812">developing other chronic diseases</a> such as heart disease and type 2 diabetes. Exercise can maintain or improve quality of life and mental health <a href="https://www.hindawi.com/journals/tbj/2022/9921575/">for patients with cancer</a>.</p> <p>Emerging research evidence indicates exercise might increase the effectiveness of mainstream treatments such as <a href="https://aacrjournals.org/cancerres/article/81/19/4889/670308/Effects-of-Exercise-on-Cancer-Treatment-Efficacy-A">chemotherapy</a> and <a href="https://www.nature.com/articles/s41391-020-0245-z">radiation therapy</a>. Exercise is certainly essential for preparing the patient for any surgery to increase cardio-respiratory fitness, reduce systemic inflammation, and increase muscle mass, strength and physical function, and then <a href="https://www.jsams.org/article/S1440-2440(18)31270-2/fulltext">rehabilitating them after surgery</a>.</p> <p>These mechanisms explain why cancer patients who are physically active have much <a href="https://journals.lww.com/acsm-msse/fulltext/2019/06000/physical_activity_in_cancer_prevention_and.20.aspx">better survival outcomes</a> with the relative risk of death from cancer <a href="https://journals.lww.com/acsm-msse/fulltext/2019/06000/physical_activity_in_cancer_prevention_and.20.aspx">reduced by as much as 40–50%</a>.</p> <h2>Mental health helps</h2> <p>The second “tool” which has a major role in cancer management is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016045/">psycho-oncology</a>. It involves the psychological, social, behavioural and emotional aspects of cancer for not only the patient but also their carers and family. The aim is to maintain or improve quality of life and mental health aspects such as emotional distress, anxiety, depression, sexual health, coping strategies, personal identity and relationships.</p> <p>Supporting quality of life and happiness is important on their own, but these barometers <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1349880/full">can also impact</a> a patient’s physical health, response to exercise medicine, resilience to disease and to treatments.</p> <p>If a patient is highly distressed or anxious, their body can enter a flight or fight response. This creates an internal environment that is actually supportive of cancer progression <a href="https://www.cancer.gov/about-cancer/coping/feelings/stress-fact-sheet">through hormonal and inflammatory mechanisms</a>. So it’s essential their mental health is supported.</p> <h2>Putting the good things in: diet</h2> <p>A third therapy in the supportive cancer care toolbox is diet. A healthy diet <a href="https://www.cancer.org/cancer/survivorship/coping/nutrition/benefits.html">can support the body</a> to fight cancer and help it tolerate and recover from medical or surgical treatments.</p> <p>Inflammation provides a more fertile environment <a href="https://www.cancer.gov/news-events/cancer-currents-blog/2022/reducing-inflammation-to-treat-cancer">for cancer cells</a>. If a patient is overweight with excessive fat tissue then a diet to reduce fat which is also anti-inflammatory can be very helpful. This <a href="https://www.frontiersin.org/articles/10.3389/fnut.2021.709435/full">generally means</a> avoiding processed foods and eating predominantly fresh food, locally sourced and mostly plant based.</p> <p>Muscle loss is <a href="https://onlinelibrary.wiley.com/doi/10.1002/rco2.56">a side effect of all cancer treatments</a>. Resistance training exercise can help but people may need protein supplements or diet changes to make sure they get enough protein to build muscle. Older age and cancer treatments may reduce both the intake of protein and compromise absorption so <a href="https://www.sciencedirect.com/science/article/pii/S0261561421005422">supplementation may be indicated</a>.</p> <p>Depending on the cancer and treatment, some patients may require highly specialised diet therapy. Some cancers such as pancreatic, stomach, esophageal, and lung cancer can cause rapid and uncontrolled drops in body weight. This is called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233663/">cachexia and needs careful management</a>.</p> <p>Other cancers and treatments such as hormone therapy can cause rapid weight gain. This also needs careful monitoring and guidance so that, when a patient is clear of cancer, they are not left with higher risks of other health problems such as cardiovascular disease and metabolic syndrome (a cluster of conditions that boost your risk of heart disease, stroke and type 2 diabetes).</p> <h2>Working as a team</h2> <p>These are three of the most powerful tools in the supportive care toolbox for people with cancer. None of them are “cures” for cancer, alone or together. But they can work in tandem with medical treatments to greatly improve outcomes for patients.</p> <p>If you or someone you care about has cancer, national and state cancer councils and cancer-specific organisations can provide support.</p> <p>For exercise medicine support it is best to consult with an <a href="https://www.essa.org.au/Public/Public/Consumer_Information/What_is_an_Accredited_Exercise_Physiologist_.aspx">accredited exercise physiologist</a>, for diet therapy an <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitian</a> and mental health support with a <a href="https://psychology.org.au/psychology/about-psychology/what-is-psychology">registered psychologist</a>. Some of these services are supported through Medicare on referral from a general practitioner.</p> <hr /> <p><em>For free and confidential cancer support call the <a href="https://www.cancer.org.au/support-and-services/cancer-council-13-11-20">Cancer Council</a> on 13 11 20.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226720/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/rob-newton-12124">Rob Newton</a>, Professor of Exercise Medicine, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/exercise-therapy-and-diet-can-all-improve-life-during-cancer-treatment-and-boost-survival-heres-how-226720">original article</a>.</em></p> </div>

Caring

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Seinfeld star's worrying health update

<p><em>Seinfeld</em> star Michael Richards has revealed his secret battle with prostate cancer in 2018, and how he only survived after making the decision to undergo surgery. </p> <p>Richards, who played the ever-eccentric Cosmo Kramer in the 1990s sitcom, received the stage one diagnosis after a routine check-up showed he had elevated prostate-specific antigen (PSA) levels.</p> <p>He opened up about the diagnosis to <em>People</em> magazine, saying, “I thought, ‘Well, this is my time. I’m ready to go’.”</p> <p>“But then my son came to mind just a few seconds later, and I heard myself saying, ‘I’ve got a nine-year-old, and I’d like to be around for him. Is there any way I can get a little more life going?’”</p> <p>Richards’ doctor recommended removing the comedian’s entire prostate because the biopsy “didn’t look good”, as Richards explained it "had to be contained quickly”.</p> <p>“I had to go for the full surgery. If I hadn’t, I probably would have been dead in about eight months,” the 74-year-old said. </p> <p>After facing the difficult health battle, Richards felt inspired to write his forthcoming memoir, Entrances and Exits, using a collection of diaries he had kept over the years.</p> <p>“I had over 40 journals I’d kept over the years and wanted to do a full review of my life. I’m turning 75, so maybe wanting to do that is something that comes with being my age. I wanted to connect with feelings and memory,” he told the publication. </p> <p>“I’m surprised at how much I was able to remember.”</p> <p><em>Greg Grudt/UPI/Shutterstock Editorial </em></p>

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If I’m diagnosed with one cancer, am I likely to get another?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/terry-boyle-1521638">Terry Boyle</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Receiving a cancer diagnosis is life-changing and can cause a range of concerns about ongoing health.</p> <p>Fear of cancer returning is one of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9321869/">top health concerns</a>. And <a href="https://www.cancercouncil.com.au/cancer-information/living-well/after-cancer-treatment/fear-of-the-cancer-returning/managing-fear-of-recurrence/">managing this fear</a> is an important part of cancer treatment.</p> <p>But how likely is it to get cancer for a second time?</p> <h2>Why can cancer return?</h2> <p>While initial cancer treatment may seem successful, sometimes a few cancer cells remain dormant. Over time, these cancer cells can grow again and may start to cause symptoms.</p> <p>This is known as cancer recurrence: when a cancer returns after a period of remission. This period could be days, months or even years. The new cancer is the same type as the original cancer, but can sometimes grow in a new location through a process called <a href="https://theconversation.com/how-does-cancer-spread-to-other-parts-of-the-body-219616">metastasis</a>.</p> <p>Actor Hugh Jackman has gone public about his <a href="https://www.skincancer.org/blog/is-basal-cell-carcinoma-serious/">multiple diagnoses</a> of basal cell carcinoma (a type of skin cancer) over the <a href="https://www.bbc.com/news/world-australia-65158945">past decade</a>.</p> <p>The exact reason why cancer returns differs depending on the cancer type and the treatment received. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8486871/">Research</a> is <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.3408">ongoing</a> to identify genes associated with cancers returning. This may eventually allow doctors to tailor treatments for high-risk people.</p> <h2>What are the chances of cancer returning?</h2> <p>The risk of cancer returning differs between cancers, and between <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019423/">sub-types</a> of the same cancer.</p> <p>New screening and treatment options have seen reductions in recurrence rates for many types of cancer. For example, between 2004 and 2019, the risk of colon cancer recurring dropped by <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2812113">31-68%</a>. It is important to remember that only someone’s treatment team can assess an individual’s personal risk of cancer returning.</p> <p>For most types of cancer, the highest risk of cancer returning is within the <a href="https://pubmed.ncbi.nlm.nih.gov/31231898/">first three years</a> after entering remission. This is because any leftover cancer cells not killed by treatment are likely to start growing again sooner rather than later. Three years after entering remission, recurrence rates for most cancers decrease, meaning that every day that passes lowers the risk of the cancer returning.</p> <p>Every day that passes also increases the numbers of new discoveries, and cancer drugs being developed.</p> <h2>What about second, unrelated cancers?</h2> <p>Earlier this year, we learned Sarah Ferguson, Duchess of York, had been diagnosed with malignant melanoma (a type of skin cancer) <a href="https://www.bbc.com/news/uk-68047608">shortly after</a> being treated for breast cancer.</p> <p>Although details have not been confirmed, this is likely a new cancer that isn’t a recurrence or metastasis of the first one.</p> <p>Australian research from <a href="https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-11-83">Queensland</a> and <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.31247">Tasmania</a> shows adults who have had cancer have around a 6-36% higher risk of developing a second primary cancer compared to the risk of cancer in the general population.</p> <h2>Who’s at risk of another, unrelated cancer?</h2> <p>With improvements in cancer diagnosis and treatment, people diagnosed with cancer are living longer than ever. This means they need to consider their long-term health, including their risk of developing another unrelated cancer.</p> <p>Reasons for such cancers <a href="https://www.cancer.net/survivorship/what-second-cancer">include</a> different types of cancers sharing the same kind of lifestyle, environmental and genetic risk factors.</p> <p>The increased risk is also likely partly due to the effects that some cancer treatments and imaging procedures have on the body. However, this increased risk is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435077/">relatively small</a> when compared with the (sometimes lifesaving) benefits of these treatment and procedures.</p> <p>While a 6-36% greater chance of getting a second, unrelated cancer may seem large, only around 10-12% of participants developed a second cancer in the Australian studies we mentioned. Both had a median follow-up time of around five years.</p> <p>Similarly, in a <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.30164">large US study</a> only about one in 12 adult cancer patients developed a second type of cancer in the follow-up period (an average of seven years).</p> <p>The kind of first cancer you had also affects your risk of a second, unrelated cancer, as well as the type of second cancer you are at risk of. For example, in the two Australian studies we mentioned, the risk of a second cancer was greater for people with an initial diagnosis of head and neck cancer, or a haematological (blood) cancer.</p> <p>People diagnosed with cancer as a <a href="https://www.mja.com.au/journal/2020/212/3/second-primary-cancers-people-who-had-cancer-children-australian-childhood">child</a>, <a href="https://www.liebertpub.com/doi/10.1089/jayao.2022.0074">adolescent or young adult</a> also have a greater risk of a second, unrelated cancer.</p> <h2>What can I do to lower my risk?</h2> <p>Regular follow-up examinations can give peace of mind, and ensure any subsequent cancer is caught early, when there’s the best chance of successful treatment.</p> <p><a href="https://www.lymphoma.org.au/lymphoma/treatments/maintenance-therapy/">Maintenance therapy</a> may be used to reduce the risk of some types of cancer returning. However, despite ongoing <a href="https://febs.onlinelibrary.wiley.com/doi/10.1111/febs.15626">research</a>, there are no <em>specific</em> treatments against cancer recurrence or developing a second, unrelated cancer.</p> <p>But there are things you can do to help lower your general risk of cancer – not smoking, being physically active, eating well, maintaining a healthy body weight, limiting alcohol intake and being sun safe. These all reduce the chance of <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21719">cancer returning</a> and <a href="https://www.cancer.net/survivorship/what-second-cancer">getting a second cancer</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226386/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, Senior Research Officer, Blood Cells and Blood Cancer Division, <a href="https://theconversation.com/institutions/walter-and-eliza-hall-institute-822">Walter and Eliza Hall Institute</a> and <a href="https://theconversation.com/profiles/terry-boyle-1521638">Terry Boyle</a>, Senior Lecturer in Cancer Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/if-im-diagnosed-with-one-cancer-am-i-likely-to-get-another-226386">original article</a>.</em></p> </div>

Body

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Doctor beats cancer using his own treatment

<p>Australian doctor Richard Scolyer has been declared cancer free, thanks to a first-of-its-kind treatment he helped to develop.</p> <p>The 56-year-old professor, who has been recognised around for the world for his pioneering melanoma research, was diagnosed with aglioblastoma, a terminal kind of brain tumour, after suffering a seizure last June.</p> <p>After receiving his devastating diagnosis, the doctor agreed to be a "guinea pig" to undergo a world-first cancer treatment that he had a hand in developing. </p> <p>Now the world-leading pathologist and Australian of the Year has given a remarkable update, stating he is cancer free.</p> <p>“I had brain #MRI scan last Thursday looking for recurrent #glioblastoma (&/or treatment complications). I found out yesterday that there is still no sign of recurrence. I couldn’t be happier!!!!!” the professor shared on X, formerly known as Twitter.</p> <p>Before Dr Scolyer was diagnosed with cancer, he was fit and active, and had been hiking mountains in Poland with his wife.</p> <p>“I felt normal. I didn’t have any symptoms at all,” he told <em>A Current Affair</em> earlier this year.</p> <p>Just days after, he suffered a devastating seizure, and when he returned to Australia, underwent a series of tests which resulted in a diagnosis with glioblastoma – an aggressive and terminal form of brain cancer that would give him a average of 14 months to live. </p> <p>Teaming up with his friend and medical oncologist Georgina Long, Scolyer decided to undergo the new treatment, which came with a long list of risks. </p> <p>“No one knew what it was going to do, people were nervous because it could actually cause my life to end more quickly. But when you’re faced with certain death, it’s a no-brainer for me,” said Professor Scolyer, who also hoped the treatment would make a difference for other cancer patients.</p> <p>Dr Scolyer also underwent surgery to remove as much of his tumour as possible, and in April, he updated his social media followers to share that10 months after his diagnosis, his tumour had not returned. </p> <p>Speaking to ABC’s <em>Australian Story</em> at the time, Professor Scolyer said he was “blown away” by the results.</p> <p>“This is not what I expected. The average time to recurrence for the nasty type of brain cancer I’ve got is six months. So, to be out this far is amazing,” he said. </p> <p><em>Image credits: Instagram</em></p>

Caring

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"I love you all": Social media star announces her own death

<p>Social media star Kimberley Nix has passed away at the age of 31 after a gruelling battle with cancer, and has announced the news of her own death to her dedicated followers. </p> <p>The TikTok star, who has amassed a following of 143,000 people as she documented her cancer journey, spoke candidly in a pre-filmed video that was posted to her page, letting her followers know that her "journey here is over". </p> <p>Kimberley, who was also a doctor in training, told her fans that if they were seeing the heartbreaking clip, that she had "passed", before sharing that they had made her "so happy".</p> <p>She captioned the viral video, which has so far amassed more than 5.1 million views, "My journey here is over and I can't thank each and every one of you enough. You have all made me so happy and your comments and support are more than enough to have gotten anyone through anything!"</p> <p>"If you wish, please donate through my link in bio to sarcoma cancer research and follow my husband [Michael MacIsaac] in his updates."</p> <p>At the beginning of the clip, Kimberley said, "Hello followers, if you're seeing this clip, I have passed away peacefully. "</p> <p>Holding back tears, she said that she had a "very beautiful life" that she was "so proud" of. </p> <p>"Those who know me, know I love my pets, my husband, and makeup. And though being a doctor is a big part of my identity, those are the things that matter," she said during the heartbreaking clip.</p> <p>Kim went on to note that in 2021 she got the "opportunity to start making TikTok videos", admitting that she "never thought anything would come of it".</p> <p>"I shared about love, joy, and gratitude because in this journey, I was grateful for the people and the little moments."</p> <p>"Those little parts of your day, like that warm first sip of tea in the morning or how it feels when snow is fresh on your face, those are the most beautiful [moments]."</p> <p>At the end of the clip, she thanked her followers for helping her and said that they meant the world to her. </p> <p>"I can't thank you enough, I will miss you TikTok. I love you all. Thank you for this amazing opportunity, I am in happy tears because I have found so much purpose in the end of my life," she said.</p> <p>"Thank you from the bottom of my heart, goodbye."</p> <p>Kimberley was diagnosed with metastatic sarcoma, which is known as cell cancer, at just 28 years old, and she was finishing up her final year of her internal medicine core residency when she got the diagnosis. </p> <p>She is survived by her husband Michael, who she married in February. </p> <p><em>Image credits: TikTok</em></p>

Caring

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Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/leah-williams-veazey-1223970">Leah Williams Veazey</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>In the 2007 film <a href="https://www.imdb.com/title/tt0825232/">The Bucket List</a> Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades.</p> <p>Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common.</p> <p>You can read articles listing <a href="https://www.cnbc.com/2023/01/11/cities-to-visit-before-you-die-according-to-50-travel-experts-and-only-one-is-in-the-us.html">the seven cities</a> you must visit before you die or <a href="https://www.qantas.com/travelinsider/en/trending/top-100-guide/best-things-to-do-and-see-in-australia-travel-bucket-list.html">the 100</a> Australian bucket-list travel experiences.</p> <figure><iframe src="https://www.youtube.com/embed/UvdTpywTmQg?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life <a href="https://onlinelibrary.wiley.com/doi/10.1002/pon.4821">is regret</a> for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret.</p> <p>The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness.</p> <p>In a <a href="https://journals.sagepub.com/doi/10.1177/14407833241251496">study</a> published this week, we spoke to 54 people living with cancer, and 28 of their friends and family. For many, a key bucket list item was travel.</p> <h2>Why is travel so important?</h2> <p>There are lots of reasons why travel plays such a central role in our ideas about a “life well-lived”. Travel is often linked to important <a href="https://doi.org/10.1016/j.annals.2003.10.005">life transitions</a>: the youthful gap year, the journey to self-discovery in the 2010 film <a href="https://www.imdb.com/title/tt0879870/">Eat Pray Love</a>, or the popular figure of the “<a href="https://theconversation.com/grey-nomad-lifestyle-provides-a-model-for-living-remotely-106074">grey nomad</a>”.</p> <p>The significance of travel is not merely in the destination, nor even in the journey. For many people, planning the travel is just as important. A cancer diagnosis affects people’s sense of control over their future, throwing into question their ability to write their own life story or plan their travel dreams.</p> <p>Mark, the recently retired husband of a woman with cancer, told us about their stalled travel plans: "We’re just in that part of our lives where we were going to jump in the caravan and do the big trip and all this sort of thing, and now [our plans are] on blocks in the shed."</p> <p>For others, a cancer diagnosis brought an urgent need to “tick things off” their bucket list. Asha, a woman living with breast cancer, told us she’d always been driven to “get things done” but the cancer diagnosis made this worse: "So, I had to do all the travel, I had to empty my bucket list now, which has kind of driven my partner round the bend."</p> <p>People’s travel dreams ranged from whale watching in Queensland to seeing polar bears in the Arctic, and from driving a caravan across the Nullarbor Plain to skiing in Switzerland.</p> <p>Nadia, who was 38 years old when we spoke to her, said travelling with her family had made important memories and given her a sense of vitality, despite her health struggles. She told us how being diagnosed with cancer had given her the chance to live her life at a younger age, rather than waiting for retirement: "In the last three years, I think I’ve lived more than a lot of 80-year-olds."</p> <h2>But travel is expensive</h2> <p>Of course, travel is expensive. It’s not by chance Nicholson’s character in The Bucket List is a billionaire.</p> <p>Some people we spoke to had emptied their savings, assuming they would no longer need to provide for aged care or retirement. Others had used insurance payouts or charity to make their bucket-list dreams come true.</p> <p>But not everyone can do this. Jim, a 60-year-old whose wife had been diagnosed with cancer, told us: "We’ve actually bought a new car and [been] talking about getting a new caravan […] But I’ve got to work. It’d be nice if there was a little money tree out the back but never mind."</p> <p>Not everyone’s bucket list items were expensive. Some chose to spend more time with loved ones, take up a new hobby or get a pet.</p> <p>Our study showed making plans to tick items off a list can give people a sense of self-determination and hope for the future. It was a way of exerting control in the face of an illness that can leave people feeling powerless. Asha said: "This disease is not going to control me. I am not going to sit still and do nothing. I want to go travel."</p> <h2>Something we ‘ought’ to do?</h2> <p>Bucket lists are also a symptom of a broader culture that emphasises conspicuous <a href="https://www.youtube.com/watch?v=JH_Pa1hOEVc">consumption</a> and <a href="https://productiveageinginstitute.org.au/">productivity</a>, even into the end of life.</p> <p>Indeed, people told us travelling could be exhausting, expensive and stressful, especially when they’re also living with the symptoms and side effects of treatment. Nevertheless, they felt travel was something they “<a href="https://doi.org/10.1080/14461242.2021.1918016">ought</a>” to do.</p> <p>Travel can be deeply meaningful, as our study found. But a life well-lived need not be extravagant or adventurous. Finding what is meaningful is a deeply personal journey.</p> <hr /> <p><em>Names of study participants mentioned in this article are pseudonyms.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225682/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/leah-williams-veazey-1223970">Leah Williams Veazey</a>, ARC DECRA Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, Professor of Sociology &amp; Director, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, ARC DECRA Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/paris-in-spring-bali-in-winter-how-bucket-lists-help-cancer-patients-handle-life-and-death-225682">original article</a>.</em></p> </div>

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Qantas apologises after rejecting cancer patient's refund request

<p>Qantas has issued an apology for rejecting a cancer patient's refund request after his case allegedly did not qualify based on “compassionate reasons”. </p> <p>Neil Ross, 62, decided to book a holiday to Cairns with his wife for a couple of weeks, but two weeks later he was diagnosed with face cancer. </p> <p>“It hit me like a rock,” Mr Ross told <em>news.com.au</em>.</p> <p>“I wasn’t in the life of me, expecting that news.”</p> <p>The Brisbane local was initially told he had Bells Palsy, but was later diagnosed with cancer and had to undergo a 13-hour operation to remove the tumour, causing the right side of his face to be significantly disfigured. </p> <p>He underwent radiation almost every day for six weeks saying it “knocked him to no end”.</p> <p>“I was very thankful that my wife had helped me and still is helping me to get through this.”</p> <p>Ross is yet to be given the all-clear and is still undergoing treatments, including rehab following the loss of muscle mass. </p> <p>He will also undergo plastic surgery to reconstruct the right side of his face.</p> <p>“I had notified Flight Centre that I needed to cancel my flight due to finding out that I had cancer and that l needed treatment urgently,” he said. </p> <p>“As I said to the girl at Flight Centre – ‘look at my face, do you think I want to get a refund for the hell of it? I rather be healthy and go on holiday.”</p> <p>Ross said that the airline issued him a credit note until April 22 of this year, but with his current circumstances, he was unable to travel before that date and applied for a full refund. </p> <p>He also claims that despite sending two medical certificates - the first which stated that Ross was unfit to fly for 12 months, and the second which included detailed information about his condition -  it “did not meet requirements on compassion”.</p> <p>“I thought ‘what the hell, what more can I do?’ This has done nothing but cause me a great deal of stress that I don’t need,"  he said. </p> <p>Ross submitted two different refund requests, one on March 20, which was rejected on the fourth of April, and another on April 9 which was rejected two weeks later. </p> <p>The email from a Flight Centre representative reportedly said: "They have advised that ‘the attached medical certificate does not fit into the GF guidelines for a refund due to compassionate reasons’." </p> <p>According to <em>news.com.au</em>,  Qantas has since contacted Ross and issued a refund, after an error was made in processing the supplementary material, by not connecting it to the earlier application.</p> <p>“We apologise to Mr Ross for this experience and have let him know we’re processing a refund for him.”</p> <p>They have also reportedly apologised for any distress they may have caused and are investigating how the error occurred so that it doesn't happen again. </p> <p><em>Images: news.com.au/ Getty</em></p>

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King Charles returns to public duties for the first time since diagnosis

<p>King Charles has made his first official public appearance since being diagnosed with cancer in February. </p> <p>In a symbolic appearance on Tuesday morning, the royal visited the Macmillan Cancer Centre at the University College Hospital donning a navy pinstripe suit with a light blue shirt and a pink dinosaur tie.</p> <p>The monarch was joined by his wife, Queen Camilla, with the couple sporting huge smiles as they waved to the crowd outside of the London hospital. </p> <p>The royal couple met with clinicians, patients and families of patients during the visit, and when asked by one patient how his treatment was going, Charles replied: "I'm alright, thank you".</p> <p>In one photo Charles can be seen tenderly placing his hand on the arms of a patient as he spoke with them. </p> <p>One patient discussed her chemotherapy with Charles, who who told her: “I’ve got to have my treatment this afternoon as well,” according to the <em>Mirror</em>.</p> <p>He also shared his reaction to finding out about his diagnosis for the first time, telling one patient: “It’s always a bit of a shock, isn’t it, when they tell you?”</p> <p>The King's hospital visit comes just days after the Palace released a statement confirming that he was showing progress with his treatment and would be resuming official duties. </p> <p>“His Majesty The King will shortly return to public-facing duties after a period of treatment and recuperation following his recent cancer diagnosis,”  it read, before announcing the visit to the cancer centre. </p> <p>“This visit will be the first in a number of external engagements His Majesty will undertake in the weeks ahead.”</p> <p>Despite this, his upcoming summer schedule would not be a full one, with events like the King's Birthday parade, known as Trooping the Colour, and the Royal Ascot, being undertaken on a case-by-case basis. </p> <p>He also plans to host the Emperor and Empress of Japan in late June. </p> <p>“As the first anniversary of the Coronation approaches, Their Majesties remain deeply grateful for the many kindnesses and good wishes they have received from around the world throughout the joys and challenges of the past year,” the statement concluded. </p> <p><em>Image: Getty</em></p>

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