Fighting Cancer: Ins and Outs of Immunotherapy

 

Cancer can play a cat and mouse game with our immune systems, hiding cells and making it harder to fight off the disease.

One treatment to help combat this is immunotherapy, a type of cancer treatment that helps strengthen patients’ immune systems and fight off cancer.

NIH and the National Cancer Institute are working to research and improve immunotherapy to help save lives.

What is cancer?

Our body usually forms new cells when our old cells die. Sometimes this process goes wrong. With cancer, new cells grow when you don’t need them, and old cells don’t die when they should. These extra cells can form a mass called a tumor.

How does immunotherapy combat cancer?

Some types of immunotherapy help find extra cancer cells so that they can be destroyed. Others boost your immune system to work better against cancer.

Who could benefit from immunotherapy?

Immunotherapy is not as widely used as surgery, chemotherapy, and radiation therapy. But immunotherapies have treated people with many types of cancer and are being tested in clinical trials.

Ask your health care provider if immunotherapy may be a good option for you or a loved one.

How is immunotherapy given?

Treatment can be given intravenously (in your vein), by taking a pill, or through your bladder. For patients with early skin cancer, there is an immunotherapy cream you can rub on your skin.

Where do you get immunotherapy?

You may get immunotherapy treatment at a doctor’s office, a clinic, or an outpatient unit at a hospital.

What are possible side effects of immunotherapy?

Side effects are unique to each patient and each cancer.

Some common side effects include fever, chills, weakness, dizziness, nausea or vomiting, fatigue, and other flu-like symptoms.

If you had immunotherapy through your vein, you may have pain, swelling, soreness, itchiness, or a rash at the needle site.

What is NIH’s role in immunotherapy research?

NIH and the National Cancer Institute are leading the way in immunotherapy research and development.

NCI’s Center for Cancer Research is dedicated to finding new and better treatments for cancer, including immunotherapy.

Steven Rosenberg, M.D., Ph.D., and his team at the center have pioneered immunotherapy treatment. They also work with patients at the NIH Clinical Center to test new immunotherapies and improve cancer patients’ lives.

What new immunotherapy research is NCI studying?

Just recently, Dr. Rosenberg and his team saw a complete cancer regression in a late-stage breast cancer patient thanks to an experimental immunotherapy treatment they are working on.

The patient, who is part of an ongoing clinical trial at NCI’s Center for Cancer Research, was not responsive to other treatments.

15 percent of patients in the same trial have seen similar results with both liver and colon cancers.

SOURCES: MedlinePlus: Cancer; National Cancer Institute: Immunotherapy; Opens new window National Cancer Institute: Press Releases Opens new window

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Diagnosing Pancreatic Tumors and Cysts – Mayo Clinic

Thank you for joining us in this eight-part video series on pancreatic cancer. In the second video, physicians at Mayo Clinic in Arizona, Mitesh Borad, M.D., oncologist, and Douglas Faigel, M.D. gastroenterologist, discuss the diagnostic procedures available for the evaluation of pancreatic cancer and pancreatic cysts. Dr. Faigel highlights treatments offered to improve the quality of life of a patient diagnosed with these conditions.

To schedule an appointment with a Mayo Clinic pancreatic cancer specialist, please call (800) 446-2279 or email PancreaticCancer@mayo.edu.

For more information on the symptoms, diagnosis, and treatment of pancreatic cancer, please visit: http://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/basics/definition/con-20028153.

To watch all the videos in this pancreatic cancer series, please click the following link: http://www.youtube.com/playlist?list=PLSWR1ylG_6JbuNhywmJwtk5o1rM4eqbio

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How to Check Your Blood Pressure

Roll up your sleeve and slide on that blood pressure cuff. It’s important to check how well your heart pumps blood. Here’s how.

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Are We Infertile? Finding Help When Trying to Get Pregnant

Infertility happens when a couple cannot conceive after having regular unprotected sex.  It may be that one partner cannot contribute to conception, or that a woman is unable to carry a pregnancy to full term. It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control.

In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant. Worldwide, 8 to 12 percent of couples experience fertility problems. Between 45 and 50 percent of cases are thought to stem from factors that affect the man.

Treatment is often available.

Causes in men

The following are common causes of infertility in men.

Semen and sperm

Semen is the milky fluid that a man’s penis releases during orgasm. Semen consists of fluid and sperm. The fluid comes from the prostate gland, the seminal vesicle, and other sex glands.

The sperm is produced in the testicles.

When a man ejaculates and releases semen through the penis, the seminal fluid, or semen, helps transport the sperm toward the egg.

The following problems are possible:

  • Low sperm count: The man ejaculates a low number of sperm. A sperm count of under 15 million is considered low. Around one third of couples have difficulty conceiving due to a low sperm count.
  • Low sperm mobility (motility): The sperm cannot “swim” as well as they should to reach the egg.
  • Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg.

If the sperm do not have the right shape, or they cannot travel rapidly and accurately towards the egg, conception may be difficult. Up to 2 percent of men are thought to have suboptimal sperm.

Abnormal semen may not be able to carry the sperm effectively.

This can result from:

  • A medical condition: This could be a testicular infection, cancer, or surgery.
  • Overheated testicles: Causes include an undescended testicle, a varicocele, or varicose vein in the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments.
  • Ejaculation disorders: If the ejaculatory ducts are blocked, semen may be ejaculated into the bladder
  • Hormonal imbalance: Hypogonadism, for example, can lead to a testosterone deficiency.

Other causes may include:

  • Genetic factors: A man should have an X and Y chromosome. If he has two X chromosomes and one Y chromosome, as in Klinefelter’s syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm.
  • Mumps: If this occurs after puberty, inflammation of the testicles may affect sperm production.
  • Hypospadias: The urethral opening is under the penis, instead of its tip. This abnormality is usually surgically corrected in infancy. If the correction is not done, it may be harder for the sperm to get to the female’s cervix. Hypospadias affects about 1 in every 500 newborn boys.
  • Cystic fibrosis: This is a chronic disease that results in the creation of a sticky mucus. This mucus mainly affects the lungs, but males may also have a missing or obstructed vas deferens. The vas deferens carries sperm from the epididymis to the ejaculatory duct and the urethra.
  • Radiation therapy: This can impair sperm production. The severity usually depends on how near to the testicles the radiation was aimed.
  • Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing’s syndrome, diabetes, and thyroid disease.

Some medications increase the risk of fertility problems in men.

  • Sulfasalazine: This anti-inflammatory drug can significantly lower a man’s sperm count. It is often prescribed for Crohn’s disease or rheumatoid arthritis. Sperm count often returns to normal after stopping the medication.
  • Anabolic steroids: Popular with bodybuilders and athletes, long-term use can seriously reduce sperm count and mobility.
  • Chemotherapy: Some types may significantly reduce sperm count.
  • Illegal drugs: Consumption of marijuana and cocaine can lower the sperm count.
  • Age: Male fertility starts to fall after 40 years.
  • Exposure to chemicals: Pesticides, for example, may increase the risk.
  • Excess alcohol consumption: This may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility in most men, but it may affect those who already have a low sperm count.
  • Overweight or obesity: This may reduce the chance of conceiving.
  • Mental stress: Stress can be a factor, especially if it leads to reduced sexual activity.

Laboratory studies have suggested that long-term acetaminophen use during pregnancy may affect fertility in males by lowering testosterone production. Women are advised not to use the drug for more than one day.

Causes in women

Infertility in women can also have a range of causes.

Risk factors

Risk factors that increase the risk include:

  • Age: The ability to conceive starts to fall around the age of 32 years.
  • Smoking: Smoking significantly increases the risk of infertility in both men and women, and it may undermine the effects of fertility treatment. Smoking during pregnancy increases the chance of pregnancy loss. Passive smoking has also been linked to lower fertility.
  • Alcohol: Any amount of alcohol consumption can affect the chances of conceiving.
  • Being obese or overweight: This can increase the risk of infertility in women as well as men.
  • Eating disorders: If an eating disorder leads to serious weight loss, fertility problems may arise.
  • Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements.
  • Exercise: Both too much and too little exercise can lead to fertility problems.
  • Sexually transmitted infections (STIs): Chlamydia can damage the fallopian tubes in a woman and cause inflammation in a man’s scrotum. Some other STIs may also cause infertility.
  • Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. A mouse study has suggested that ingredients in some household detergents may reduce fertility.
  • Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity.

Medical conditions

Some medical conditions can affect fertility.

Ovulation disorders appear to be the most common cause of infertility in women.

Ovulation is the monthly release of an egg. The eggs may never be released, or they may only be released in some cycles.

Ovulation disorders can be due to:

  • Premature ovarian failure: The ovaries stop working before the age of 40 years.
  • Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur.
  • Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.
  • Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is, the higher the risk.
  • Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance.
  • Chronic conditions: These include AIDS or cancer.

Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb.

If the egg does not travel, it can be harder to conceive naturally.

Causes include:

  • Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus.
  • Submucosal fibroids: Benign or non-cancerous tumors occur in the muscular wall of the uterus. They can interfere with implantation or block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine fibroids may make the uterus’ cavity bigger, increasing the distance the sperm has to travel.
  • Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body.
  • Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high.

Medications, treatments, and drugs

Some drugs can affect fertility in a woman.

  • Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive.
  • Chemotherapy: Some chemotherapy drugs can result in ovarian failure. In some cases, this may be permanent.
  • Radiation therapy: If this is aimed near the reproductive organs, it can increase the risk of fertility problems.
  • Illegal drugs: Some women who use marijuana or cocaine may have fertility problems.

Cholesterol

One study has found that high cholesterol levels may have an impact on fertility in women.

Treatment

Treatment will depend on many factors, including the age of the person who wishes to conceive, how long the infertility has lasted, personal preferences, and their general state of health.

Frequency of intercourse

The couple may be advised to have sexual intercourse more often around the time of ovulation. Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. In theory, it is possible to conceive on any of these 6 days that occur before and during ovulation.

However, a survey has suggested that the 3 days most likely to offer a fertile window are the 2 days before ovulation plus the 1 day of ovulation.

Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference.

Fertility treatments for men

Treatment will depend on the underlying cause of the infertility.

  • Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility.
  • Varicocele: Surgically removing a varicose vein in the scrotum may help.
  • Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory.
  • Retrograde ejaculation: Sperm can be taken directly from the bladder and injected into an egg in the laboratory.
  • Surgery for epididymal blockage: A blocked epididymis can be surgically repaired. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. If the epididymis is blocked, sperm may not be ejaculated properly.

Fertility treatments for women

Fertility drugs might be prescribed to regulate or induce ovulation.

They include:

  • Clomiphene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder. It makes the pituitary gland release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
  • Metformin (Glucophage): If Clomiphene is not effective, metformin may help women with PCOS, especially when linked to insulin resistance.
  • Human menopausal gonadotropin, or hMG (Repronex): This contains both FSH and LH. Patients who do not ovulate because of a fault in the pituitary gland may receive this drug as an injection.
  • Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.
  • Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate.
  • Gonadotropin-releasing hormone (Gn-RH) analogs: These can help women who ovulate too early—before the lead follicle is mature—during hmG treatment. It delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH.
  • Bromocriptine (Parlodel): This drug inhibits prolactin production. Prolactin stimulates milk production during breastfeeding. Outside pregnancy and lactation, women with high levels of prolactin may have irregular ovulation cycles and fertility problems.

Reducing the risk of multiple pregnancies

Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. The chance of a multiple birth is lower with an oral fertility drug.

Careful monitoring during treatment and pregnancy can help reduce the risk of complications. The more fetuses there are, the higher the risk of premature labor.

If a woman needs an HCG injection to activate ovulation and scans show that too many follicles have developed, it is possible to withhold the HCG injection. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.

If too many embryos develop, one or more can be removed. Couples will have to consider the ethical and emotional aspects of this procedure.

Surgical procedures for women

If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through.

Endometriosis may be treated through laparoscopic surgery. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it. The surgeon can remove implants and scar tissue, and this may reduce pain and aid fertility.

Assisted conception

The following methods are currently available for assisted conception.

Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected.

The woman may be given a low dose of ovary stimulating hormones.

IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. It can also help if a man has severe erectile dysfunction.

In-vitro fertilization (IVF): Sperm are placed with unfertilized eggs in a petri dish, where fertilization can take place. The embryo is then placed in the uterus to begin a pregnancy. Sometimes the embryo is frozen for future use.

Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure. The likelihood of fertilization improves significantly for men with low sperm concentrations.

Sperm or egg donation: If necessary, sperm or eggs can be received from a donor. Fertility treatment with donor eggs is usually done using IVF.

Assisted hatching: The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid. The opening improves the ability of the embryo to implant into the uterine lining. This improves the chances that the embryo will implant at, or attach to, the wall of the uterus.

This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. In some women, and especially with age, the membrane becomes harder. This can make it difficult for the embryo to implant.

Electric or vibratory stimulation to achieve ejaculation: Ejaculation is achieved with electric or vibratory stimulation. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury.

Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis.

Types

Infertility can be primary or secondary.

Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control

Secondary infertility is when they have previously conceived but are no longer able to.

Diagnosis

Most people will visit a physician if there is no pregnancy after 12 months of trying.

If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s.

A doctor can give advice and carry out some preliminary assessments. It is better for a couple to see the doctor together.

The doctor may ask about the couple’s sexual habits and make recommendations regarding these. Tests and trials are available, but testing does not always reveal a specific cause.

Infertility tests for men

The doctor will ask the man about his medical history, medications, and sexual habits and carry out a physical examination. The testicles will be checked for lumps or deformities, and the shape and structure of the penis will be examined for abnormalities.

  • Semen analysis: A sample may be taken to test for sperm concentration, motility, color, quality, any infections, and whether any blood is present. Sperm counts can fluctuate, so that several samples may be necessary.
  • Blood test: The lab will test for levels of testosterone and other hormones.
  • Ultrasound: This may reveal issues such as ejaculatory duct obstruction or retrograde ejaculation.
  • Chlamydia test: Chlamydia can affect fertility, but antibiotics can treat it.

Infertility tests for women

A woman will undergo a general physical examination, and the doctor will ask about her medical history, medications, menstruation cycle, and sexual habits.

She will also undergo a gynecologic examination and a number of tests:

  • Blood test: This can assess hormone levels and whether a woman is ovulating.
  • Hysterosalpingography: Fluid is injected into the woman’s uterus and X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. If a blockage is present, surgery may be necessary.
  • Laparoscopy: A thin, flexible tube with a camera at the end is inserted into the abdomen and pelvis, allowing a doctor to look at the fallopian tubes, uterus, and ovaries. This can reveal signs of endometriosis, scarring, blockages, and some irregularities of the uterus and fallopian tubes.

Other tests include:

  • ovarian reserve testing, to find out how effective the eggs are after ovulation
  • genetic testing, to see if a genetic abnormality is interfering with fertility
  • pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries
  • Chlamydia test, which may indicate the need for antibiotic treatment
  • thyroid function test, as this may affect the hormonal balance

Complications

Some complications can result from infertility and its treatment. If conception does not occur after many months or years of trying, it can lead to stress and possibly depression.

Some physical effects may also result from treatment.

Ovarian hyperstimulation syndrome

The ovaries can swell, leak excess fluid into the body, and produce too many follicles, the small fluid sacs in which an egg develops.

Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomiphene and gonadotrophins. It can also develop after IVF.

Symptoms include:

  • bloating
  • constipation
  • dark urine
  • diarrhea
  • nausea
  • abdominal pain
  • vomiting

They are usually mild and easy to treat.

Rarely, a blood clot may develop in an artery or vein, liver or kidney problems can arise, and respiratory distress may develop. In severe cases, OHSS can be fatal.

Ectopic pregnancy

This is when a fertilized egg implants outside the womb, usually in a fallopian tube. If it stays in there, complications can develop, such as the rupture of the fallopian tube. This pregnancy has no chance of continuing.

Immediate surgery is needed and, sadly, the tube on that side will be lost. However, future pregnancy is possible with the other ovary and tube.

Women receiving fertility treatment have a slightly higher risk of an ectopic pregnancy. An ultrasound scan can detect an ectopic pregnancy.

Coping mentally

It is impossible to know how long treatment will go on for and how successful it will be. Coping and persevering can be stressful. The emotional toll on both partners can affect their relationship.

Some people find that joining a support group helps, as it offers the chance to talk to others in a similar situation.

It is important to tell a doctor if excessive mental and emotional stress develop. They can often recommend a counselor and others who can offer appropriate support. Online support from organizations such as Resolve can be helpful.

Outlook

For couples who experience fertility problems and those who wish to have children at an older age, there are more options available than ever before.

In 1978, the first baby was born as a result of IVF. By 2014, over 5 million people had been born after being conceived through IVF.

As new technology becomes available, fertility treatment is now accessible to more people, and success rates and safety are improving all the time.

Financing fertility treatment can also be costly, but there are programs that can help with this.

Finding Help

HealthLynked is a great platform for connecting and communicating with medical professionals who can guide and counsel you through the issues of infertility.  Create a free profile today and LYNK with physicians in your area immediately.

Ready to get Lynked?  Go to HealthLynked.com to get started for free…right away!

 

Source:

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT, Infertility in men and women, Medical News Today, 4 January 2018

 

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Basics | Treating for Two: Medicine and Pregnancy

 

Pregnant or thinking about pregnancy? Talk to your doctor about any medication you are taking. Treating for Two. Visit: http://www.cdc.gov/treatingfortwo to learn more. Safer medication use in pregnancy.

Are you pregnant or thinking of getting pregnant? Talk to your healthcare providers before starting or stopping any medicines. Be sure to discuss the following with your healthcare providers:

  1. All medicines you take, including prescriptions, over-the-counter medicines, herbal and dietary supplements, and vitamins
  2. Best ways to keep any health conditions you have under control
  3. Your personal goals and preferences for the health of you and your baby

Share our poster with family and friends to encourage conversations about safer medicine use in pregnancy and help prevent birth defects and other health problems.

What We Know About Medicine Use in Pregnancy

Almost every pregnant woman will face a decision about taking medicines before and during pregnancy. However, we know little about the effects of taking most medicines in pregnancy because pregnant women are often not included in studies that determine the safety of new medicines. We do know

  • 9 in 10 women report taking some type of medicine during pregnancy, and 7 in 10 report taking at least one prescription medicine. Over the last 30 years, women’s use of prescription medicines during the first trimester (first 3 months) of pregnancy increased by more than 60%;1
  • Many women need to take medicines during pregnancy to control their health conditions. In some cases, avoiding or stopping a medicine during pregnancy may be more harmful than taking that medicine;
  • At the same time, we know that taking certain medicines during pregnancy can increase the risk for birth defects, pregnancy loss, prematurity, infant death, or developmental disabilities; and
  • The effects of medicine on you and your baby may depend on many factors, such as
    • How much medicine you take (sometimes called the dose),
    • When during the pregnancy you take the medicine,
    • Other health conditions you have, and
    • Other medicines you take.

Have a Healthy Pregnancy

Is it safe for me to take medicines before I get pregnant?

If you are trying to have a baby or are just thinking about it, it is not too early to start getting ready for pregnancy. Many women need to take medicine to stay healthy during pregnancy. If you are planning to become pregnant, you should discuss your current medicines with a healthcare provider, such as your doctor or pharmacist. Some medicines can cause birth defects very early in pregnancy, often before you even know you are pregnant. Creating a treatment plan for your health condition before you are pregnant can help keep you and your developing baby healthy.

Check out 10 ways to plan for a healthy pregnancy for more quick tips and advice.

Medscape Video: Medication & Pregnancy


Dr. Cherl Brossard Video Screen Shot
Watch Dr. Cheryl Broussard, a health scientist at CDC, talk about the effects of taking medicine during pregnancy, including birth defects, pregnancy loss, prematurity, infant death, and developmental disabilities. Medscape allows free unlimited access to materials after registration.

I need to take a medicine while pregnant. What do I do?

If you are pregnant, talk with a healthcare professional about any medicines you have taken or are thinking of taking. You should go over all prescriptions, over-the-counter medicines, herbal and dietary supplements, and vitamins. The FDA’s Office of Women’s Health developed a tool in English and Spanish to help you keep a record of the medicines you take. Although no medicine is completely risk-free, a healthcare professional, such as a doctor or pharmacist, can help you pick a treatment plan that works for you. You should not start any new medicines or stop a current medicine without talking to a healthcare professional.

You might need to take medicines to treat a health condition. For example, if you have asthma, epilepsy, high blood pressure, or depression, you may need to take medicines to stay healthy during pregnancy. Some untreated health conditions may actually be more harmful than the medicines used to control them. However, we know that some medicines can increase the risk of birth defects, pregnancy loss, prematurity, infant death, or developmental disabilities. A healthcare professional can help you weigh the risks and benefits of each medicine and determine the safest treatment for you and your developing baby.

Good Medicine Can Be Bad for Baby Podcast

Listen to an expert discuss why you should talk to a healthcare professional about the medicines you take during pregnancy.

Check out ways you can stay healthy during pregnancy.

I took a medicine before I knew I was pregnant. What do I do?

If you took medicines before you learned you were pregnant, you may want to talk with a healthcare professional about any concerns you may have. Some medicines can be harmful when taken during pregnancy, but others are unlikely to cause harm. If you are concerned and cannot reach your doctor, you can contact an expert for free through email, text, call, or live chat on the MotherToBaby website.

Should I trust online information about medicine safety in pregnancy?

Use caution when consulting online sources about medicine safety in pregnancy– instead, use this information to start a conversation with a healthcare professional. Many websites post lists of medicines that are “safe” to take during pregnancy. However, for many medicines listed, there is not enough scientific evidence of their safety during pregnancy.

Take caution when watching online videos as well. A 2015 study found that content in current YouTube videos does not accurately describe the safety of specific medicines used during pregnancy. This is an important reason for you to talk with a healthcare professional about potential risks of using medicines during pregnancy.

Can I take medicine once I’m no longer pregnant?

After pregnancy, keep you and your baby healthy by talking with a healthcare professional, such as a doctor or pharmacist, about the medicines you are thinking of taking. LactMed is an online database that provides information about specific medicines, ways they might affect you or your baby, and potential alternatives to consider. Information in this database can help guide the conversation with your healthcare professional about managing your health condition while breastfeeding.

Check out more ways to keep you and your baby healthy after pregnancy.

How You Can Help

We know little about the effects of taking most medicines in pregnancy, because pregnant women are often not included in studies that determine the safety of new medicines. As a result, women and healthcare professionals have limited information about the safety of most medicines – especially newer medicines— in pregnancy.

Treating for Two and its partners are gathering new information on medicines taken during pregnancy and how medicines might affect the pregnancy.

You can help improve the evidence on medicines and pregnancy by doing the following:

  • Report suspected problems. First, tell your healthcare provider about any problems you have with your medicine. You can also report suspected problems with medicines directly to the Food and Drug Administration (FDA) MedWatch Program.
  • Enroll in a pregnancy registry. Pregnancy registries are systems for tracking outcomes in pregnant women who take a particular medicine. After these women give birth, researchers compare the health of their babies with the babies of women who did not take the medicine. Pregnancy registries are a useful way to study the effects of a particular medicine and gather health information during pregnancy and after delivery. For a list of current pregnancy registries and how to enroll, visit the FDA Pregnancy Registry website.
  • Sign up for a research study. Help researchers find answers about the safety of medicines during pregnancy by signing up for a MotherToBaby Pregnancy Study. If you choose to join a study, you will not be asked to take any medicines or vaccines or change any part of your routine. To see if you are eligible, visit the MotherToBaby website or call (877) 311-8972 (Toll-Free).

Additional Resources

Many organizations are committed to understanding more about medicines and pregnancy and providing helpful resources for women and healthcare providers.

Food and Drug Administration (FDA)
FDA’s site contains information about taking medicines during pregnancy:

LactMed
Hosted by the National Library of Medicine, LactMed is a database that contains information about specific medicines, ways they might affect breastfeeding mothers and their babies, and potential alternatives to consider, if needed.

March of Dimes
This webpage provides information related to the use of medicines and herbal products during pregnancy.

MotherToBaby
MotherToBaby provides information and fact sheets, in English and Spanish, on the risks and safety of taking specific medicines during pregnancy and breastfeeding. To speak with a MotherToBaby counselor about the safety of a medicine you have taken or you are thinking of taking, call 1-866-626-6847. This service is free and confidential.

Office on Women’s Health, U.S. Department of Health and Human Services
This website and toll-free call center provide free, reliable health information for women everywhere. The site contains a database of resources and includes topic areas, such as pregnancy and medicine.

Source link

Mayo Clinic Completes Proton Beam Therapy Facility

Mayo Clinic’s new, state of the art, Proton Beam Therapy Facility delivers radiation oncology in a way that promises lower side effects and higher cure rates, often for patients whose cancers cannot be treated safely any other way.

source

Feeding Your Friends

FIT’s Chef Lizzie shows you how to feed your hungry friends healthy food they’ll love.

To watch more Chef Lizzie videos and help your family become healthier eaters, visit WebMD.
http://www.webmd.com/parenting/raising-fit-kids/food/food-videos?vid=vd-1863-rfk-1003

Reviewed by Hansa Bhargava, 10/22/12
SOURCES: USDA Choose My Plate, Chef Lizzie Marie Cuisine
©2012 WebMD, LLC. All rights reserved.

When your friends come over, instead of asking your mom to fix you a snack, have you ever thought about just making something yourself?

You might even have fun doing it. Stick around and I’ll share some of my ideas.

“Lizzie!…Hurry up!…We’re hungry.”

Ok, just give me a second! Welcome to Healthy Cooking with Chef Lizzie. When my friends come over, it’s usually not too long before we’re in the kitchen looking for something to eat. So I learned to plan ahead.

I always have some quick, healthy snacks on hand that I can pull out and serve quickly, and one of my favorites is frozen grapes…

Just wash them and pop them in the freezer and they’re ready anytime…
I froze these last night… Mmmm

Another easy way to make fruit more fun, along with cheeses too, is to use cookie cutters to make them into fun shapes. It pretty much tastes the same, but my friends always like it this way the best.

Those are the quick ideas, but if you want to get a little fancier, and have a little fun, I’ve got a special recipe for something kids love.

Pizza!

Start with whole-wheat English muffin halves and put them in a toaster. Or you can use sprouted grain muffins instead. That’s what I’m using. Once they’re toasted, it’s time for the fun.

Spread about a tablespoon of marinara sauce on each half. Marinara adds some Italian flavor, and doesn’t have as much sugar as pizza sauce does.

Top the marinara with turkey pepperoni for more flavor—and protein.

Finish the pizzas by sprinkling mozzarella cheese on top. And now it’s time for the rest.

Now ask an adult to help by putting the pizzas in the oven at 350 degrees for 5–7 minutes, or until the cheese is melted and a little brown on top.

And that’s all there is to it!

“we’re outta here!”

You and your friends can have lots of fun making these. In fact there’s only one thing that’s more fun—eating them.

Thanks for watching Healthy Cooking with Chef Lizzie! Follow WebMD here:
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ANA (Antinuclear Antibody) Test: MedlinePlus Lab Test Information

 

What is an ANA (Antinuclear Antibody) Test?

An ANA test looks for antinuclear antibodies in your blood. If the test finds antinuclear antibodies in your blood, it may mean you have an autoimmune disorder. An autoimmune disorder causes your immune system to attack your own cells, tissues, and/or organs by mistake. These disorders can cause serious health problems.

Antibodies are proteins that your immune system makes to fight foreign substances like viruses and bacteria. But an antinuclear antibody attacks your own healthy cells instead. It’s called “antinuclear” because it targets the nucleus (center) of the cells.

Other names: antinuclear antibody panel, fluorescent antinuclear antibody, FANA, ANA

What is it used for?

An ANA test is used to help diagnose autoimmune disorders, including:

  • Systemic lupus erythematosus (SLE). This is the most common type of lupus, a chronic disease affecting multiple parts of the body, including the joints, blood vessels, kidneys, and brain.
  • Rheumatoid arthritis, a condition that causes pain and swelling of the joints, mostly in the hands and feet
  • Scleroderma, a rare disease affecting the skin, joints, and blood vessels
  • Sjogren’s syndrome, a rare disease affecting the body’s moisture-making glands

Why do I need an ANA test?

Your health care provider may order an ANA test if you have symptoms of lupus or another autoimmune disorder. These symptoms include:

What happens during an ANA test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for an ANA test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

A positive result on an ANA test means that antinuclear antibodies were found in your blood. You may get a positive result if:

  • You have SLE (lupus).
  • You have a different type of autoimmune disease.
  • You have a viral infection.

A positive result doesn’t necessarily mean you have a disease. Some healthy people have antinuclear antibodies in their blood. In addition, certain medicines can affect your results.

If your ANA test results are positive, your health care provider will likely order more tests, especially if you have symptoms of disease. If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about an ANA test?

Antinuclear antibody levels tend to increase with age. As many as one-third of healthy adults over the age of 65 may have a positive ANA test result.

References

  1. American College of Rheumatology [Internet]. Atlanta: American College of Rheumatology; c2017. Antinuclear Antibodies (ANA) [updated 2017 Mar; cited 2017 Nov 17]; [about 3 screens]. Available from: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Antinuclear-Antibodies-ANA
  2. Hinkle J, Cheever K. Brunner & Suddarth’s Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Antinuclear Antibodies (ANAS); 53 p.
  3. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2018. Antinuclear Antibody (ANA); [updated 2018 Feb 1; cited 2018 Feb 8]; [about 2 screens]. Available from: https://labtestsonline.org/understanding/analytes/ana/tab/test
  4. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2018. Scleroderma; [updated 2017 Sep 20; cited 2018 Feb 8]; [about 2 screens]. Available from: https://labtestsonline.org/understanding/conditions/scleroderma
  5. Lupus Research Alliance [Internet]. New York: Lupus Research Alliance; c2017. About Lupus [cited 2017 Nov 17]; [about 2 screens]. Available from: https://www.lupusresearch.org/understanding-lupus/what-is-lupus/about-lupus
  6. Lupus Research Alliance [Internet]. New York: Lupus Research Alliance; c2017. Symptoms [cited 2017 Nov 17]; [about 3 screens]. Available from: https://www.lupusresearch.org/understanding-lupus/what-is-lupus/symptoms
  7. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2017. Sjögren’s Syndrome [cited 2017 Nov 17]; [about 3 screens]. Available from: https://www.merckmanuals.com/home/bone,-joint,-and-muscle-disorders/autoimmune-disorders-of-connective-tissue/sj%C3%B6gren-syndrome
  8. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2017. Systemic Lupus Erythematosus (SLE) [cited 2017 Nov 17]; [about 3 screens]. Available from: http://www.merckmanuals.com/home/bone,-joint,-and-muscle-disorders/autoimmune-disorders-of-connective-tissue/systemic-lupus-erythematosus-sle
  9. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2017. ANA test: Overview; 2017 Aug 3 [cited Nov 17]; [about 3 screens]. Available from: https://www.mayoclinic.org/tests-procedures/ana-test/home/ovc-20344718
  10. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2017. ANA test: Results; 2017 Aug 3 [cited Nov 17]; [about 7 screens]. Available from: https://www.mayoclinic.org/tests-procedures/ana-test/details/results/rsc-20344732
  11. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2017. ANA test: Why it’s done; 2017 Aug 3 [cited Nov 17]; [about 4 screens]. Available from: https://www.mayoclinic.org/tests-procedures/ana-test/details/why-its-done/icc-20344722
  12. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2018 Feb 8]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  13. NIH U.S. National Library of Medicine: Genetics Home Reference [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; rheumatoid arthritis; 2017 Nov 14 [cited 2017 Nov 17]; [about 2 screens]. Available from: https://ghr.nlm.nih.gov/condition/rheumatoid-arthritis
  14. UF Health: University of Florida Health [Internet]. University of Florida; c2017. Antinuclear antibody panel: Overview [updated 2017 Nov 17; cited 2017 Nov 17]; [about 2 screens]. Available from: https://ufhealth.org/antinuclear-antibody-panel
  15. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2017. Health Encyclopedia: Antinuclear Antibody [cited 2017 Nov 17]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=antinuclear_antibodies
  16. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2017. Antinuclear Antibodies (ANA): Results [updated 2016 Oct 31; cited 2017 Nov 17]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/antinuclear-antibodies/hw2297.html#hw2323
  17. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2017. Antinuclear Antibodies (ANA): Test Overview [updated 2016 Oct 31; cited 2017 Nov 17]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/antinuclear-antibodies/hw2297.html
  18. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2017. Antinuclear Antibodies (ANA): Why It’s Done [updated 2016 Oct 31; cited 2017 Nov 17]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/antinuclear-antibodies/hw2297.html#hw2304

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Fibromuscular Dysplasia- Patient Experience, Struggles, and Living with FMD

Kari Ulrich, a patient with Fibromuscular Dysplasia (FMD), shares her story of struggles before and after being diagnosed with FMD in 2007. Kari reveals details of symptoms, treatments, lifestyle changes, living her life with FMD, and resources available for patients to obtain more information about this often misdiagnosed disease.

More information is available at: http://www.mayoclinic.com/health/fibromuscular-dysplasia/DS01101

Learn more about the Medical side of FMD with Dr. Rooke here: http://www.youtube.com/watch?v=n9QTpvP_sYg

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Living as a Gallbladder Cancer Survivor

 

For some people with gallbladder cancer,
treatment can remove or destroy the cancer. The end of treatment can be both stressful and exciting. You may be relieved to finish treatment, yet it’s hard not to worry about cancer coming back. This is very common if you’ve had cancer.

For other people, the cancer might never go away completely. Some people may get regular treatment with chemotherapy or other treatments to try and help keep the cancer in check. Learning to live with cancer that doesn’t go away can be difficult and very stressful.

Life after cancer means returning to some familiar things and also making some new choices.

Follow-up care

After you have completed treatment, your doctors will still want to watch you closely. It’s very important to go to all follow-up appointments. During these visits, your doctors will ask about symptoms, and do physical exams, and may order blood tests or imaging tests, like CT scans.

If you’ve had surgery and have no signs of cancer remaining, many doctors recommend follow-up with imaging tests about every 6 months for at least the first 2 years, but not all doctors follow this same schedule. Follow-up is needed to check for cancer that has come back or spread. It’s also needed to check for possible side effects of certain treatments.

This is the time for you to ask your cancer care team any questions and discuss any concerns you might have.

Almost any cancer treatment can have side effects. Some may last for a few weeks to months, but others can last the rest of your life. Don’t hesitate to tell your cancer care team about any symptoms or side effects bothering you so they can help you manage them.

Ask your doctor for a survivorship care plan

Talk with your doctor about developing a survivorship care plan for you. This plan might include:

  • A suggested schedule for follow-up exams and tests
  • A schedule for other tests you might need in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
  • A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
  • Diet and physical activity suggestions
  • Reminders to keep your appointments with your primary care provider (PCP), who will monitor your general health care

Keeping health insurance and copies of your medical records

Even after treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

At some point after your cancer treatment, you might find yourself seeing a new doctor who doesn’t know about your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.

Can I lower my risk of gallbladder cancer progressing or coming back?

If you have (or have had) gallbladder cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. Unfortunately, it’s not yet clear if there are things you can do that will help.

Adopting healthy behaviors such as not smokingeating wellgetting regular physical activity, and staying at a healthy weight might help, but no one knows for sure. Still, we do know that these types of changes can have positive effects on your health that can extend beyond your risk of gallbladder cancer or other cancers.

About dietary supplements

So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of gallbladder cancer progressing or coming back. This doesn’t mean that no supplements will help, but it’s important to know that none have been proven to do so.

Dietary supplements are not regulated like medicines in the United States – they do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you’re thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that might be harmful.

If the cancer comes back

If the cancer does recur at some point, your treatment options will depend on where the cancer is located, what treatments you’ve had before, and your overall health. For more information on how recurrent gallbladder cancer is treated, see Treatment Options Based on the Extent of Gallbladder Cancer.

For more general information on recurrence, you may want to see Understanding Recurrence.

Getting emotional support

Some amount of feeling depressed, anxious, or worried is normal when cancer is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others. Learn more in Life After Cancer.

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