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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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Taking too many medications can pose health risks. Here’s how to avoid them

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a></em></p> <p>When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact?</p> <p>The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines).</p> <p>I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65.</p> <h2>Polypharmacy among older adults</h2> <p>Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics.</p> <p>Is it a good idea to take so many drugs?</p> <p>According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability.</p> <p>In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic.</p> <h2>The risks of polypharmacy: 5 points to consider</h2> <p>When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken.</p> <ol> <li> <p>Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments.</p> </li> <li> <p>A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses?</p> </li> <li> <p>The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences.</p> </li> <li> <p>The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death.</p> </li> <li> <p>Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks.</p> </li> </ol> <p>Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements.</p> <p>Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health.</p> <h2>3 tips to avoid the risks associated with polypharmacy</h2> <p>What can we do as a patient, or as a caregiver?</p> <ol> <li> <p>Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ?</p> </li> <li> <p>Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced?</p> </li> <li> <p>Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter.</p> </li> </ol> <h2>Benefits should outweigh the risks</h2> <p>Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion.</p> <p>Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<!-- 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/230612/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/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</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/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>.</em></p> </div>

Body

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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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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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Princess of Wales and King Charles: one in two people develop cancer during their lives – the diseases and treatments explained

<p><em><a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a></em></p> <p>The Princess of Wales released a <a href="https://x.com/KensingtonRoyal/status/1771235267837321694?s=20">moving video message</a> on March 22 to address speculation about her health. In it, the future queen disclosed that she’d been <a href="https://www.bbc.co.uk/news/health-68641710">diagnosed with cancer</a> following tests conducted after she underwent major abdominal surgery at a clinic in London in January.</p> <p>Catherine explained that she was undergoing “preventative chemotherapy” – but emphasised that her surgery had been successful, and that she was “well” and “getting stronger every day”.</p> <p>The message was the <a href="https://www.theguardian.com/uk-news/2024/mar/22/princess-kate-cancer-royal-family-health-annus-horribilis">second announcement</a> of a royal family cancer diagnosis in recent weeks. On February 5, Buckingham Palace <a href="https://www.royal.uk/a-statement-from-buckingham-palace-5Feb24">published a statement</a> that King Charles III had been diagnosed with an undisclosed form of <a href="https://www.bbc.co.uk/news/uk-68208157">cancer, unrelated</a> to the treatment he had been receiving for an enlarged prostate.</p> <figure><iframe src="https://www.youtube.com/embed/3xzKooCaRXU?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The statement said that he had begun “regular treatments”. The king postponed all public-facing duties during his treatment, but <a href="https://www.bbc.co.uk/news/uk-68213383">reportedly continued</a> with his “constitutional role as head of state, including completing paperwork and holding private meetings”.</p> <p>Cancer is the <a href="https://www.who.int/news-room/fact-sheets/detail/cancer">leading cause of death</a> worldwide. <a href="https://www.nhs.uk/conditions/cancer/#:%7E:text=The%20cancerous%20cells%20can%20invade,of%20cancer%20during%20their%20lifetime.">One in two</a> people will develop some form of cancer in their lifetime – so the condition will affect almost every family. However, many cancers can be cured if, as appears to be the case with the king, the condition is <a href="https://www.bbc.co.uk/news/uk-68213383">detected early</a> and treated effectively.</p> <h2>What is cancer?</h2> <p>Our bodies are made up of more than 100 billion cells, and cancer typically starts with changes in a small group of cells – or even a single one.</p> <p>We have different cell types depending upon where in the body they are and the function that the cell has. The size, amount and function of each of these cells is normally tightly regulated by genes – groups of codes held within our DNA – that instruct cells how to grow and divide.</p> <p>However, changes (mutations) to DNA can alter the way cells grow and multiply – often forming a lump, or solid tumour. Cancers can also develop in blood cells, such as white blood cell cancer which is known as leukaemia. This type of cancer does not form solid tumours; instead, the cancer builds up in the blood or sometimes the marrow in the core of bones, where blood cells are produced.</p> <p>In all, there are <a href="https://www.cancerresearchuk.org/about-cancer/what-is-cancer/how-cancer-starts/types-of-cancer#:%7E:text=For%20example%2C%20nerves%20and%20muscles,of%20cell%20they%20start%20in.">more than 200</a> types of cancer, but all start with mutations in the DNA contained within each and every cell.</p> <h2>What exactly are mutations?</h2> <p>Think of your DNA as a big recipe book, and your genes as individual recipes for making different dishes. Mutations are smudges or missing words from this recipe that can result in key ingredients not being added into the mix.</p> <figure><iframe src="https://www.youtube.com/embed/8BJ8_5Gyhg8?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Regardless of the type of cancer or the cells from which it develops, mutations in our genes can result in a cell no longer understanding its instructions.</p> <p>These mutations can happen by chance when dividing, but can also be the result of lifestyle choices such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141049/">smoking</a>, <a href="https://www.ndph.ox.ac.uk/news/new-genetic-study-confirms-that-alcohol-is-a-direct-cause-of-cancer#:%7E:text=These%20mutations%20both%20disrupt%20the,aldehyde%20dehydrogenase%202%20(ALDH2).">drinking</a>, and <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet">inactivity</a>.</p> <p>Research has found that in order for a normal cell to turn into a cancerous cell, anywhere from <a href="https://www.sanger.ac.uk/news_item/1-10-mutations-are-needed-drive-cancer-scientists-find/">one to ten different mutations</a> are normally required.</p> <h2>How is cancer treated?</h2> <p>Treatment options for cancer depend on a variety of factors, including where your cancer is, how large it is, and whether it has spread to other parts of the body. The main treatments for cancer include surgery, chemotherapy, and radiotherapy.</p> <p>Chemotherapy uses drugs to target and kill cells that are rapidly dividing in our bodies. This approach is effective at targeting fast-growing cells in various cancers – but also has negative side effects. It also targets healthy cells that rapidly divide, such as hair and the cells lining our digestive system. This can lead to commonly reported <a href="https://www.nhs.uk/conditions/chemotherapy/side-effects/">side-effects</a> such as hair loss, nausea and diarrhoea.</p> <p><a href="https://www.cancerresearchuk.org/about-cancer/treatment/chemotherapy?gad_source=1&amp;gclid=Cj0KCQjw-_mvBhDwARIsAA-Q0Q6tyQxTuBzU7vVD7SHjQ5dF-fRdqnL7S74-k5LXyTqODydsrPfJVsoaAkgyEALw_wcB&amp;gclsrc=aw.ds">Chemotherapy</a> can be used both preventatively – as in the case of the princess – and therapeutically.</p> <figure><iframe src="https://www.youtube.com/embed/FkZn5u3MIiY?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Preventative chemotherapy, also known as <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/adjuvant-therapy">adjuvant chemotherapy</a>, is given after surgery or other primary treatments to eliminate any remaining cancer cells in the body. It aims to reduce the risk of the cancer returning (known as recurrence).</p> <p>Therapeutic chemotherapy is used as a treatment option for cancer that has spread or is well established, such as advanced-stage cancers.</p> <p><a href="https://www.cancerresearchuk.org/about-cancer/treatment/surgery/about">Surgery</a> involves the physical removal of cancerous tissues as well as nearby lymph nodes – small glands which act as filters in your body that cancers can spread through – to eliminate the tumour. Surgery is often used to remove localised cancers that haven’t spread throughout the body.</p> <p><a href="https://www.cancerresearchuk.org/about-cancer/treatment/radiotherapy">Radiotherapy</a> uses high-energy radiation beams that are able to target specific areas where tumour cells are located to destroy or shrink the tumour. Radiotherapy can be applied externally or internally.</p> <p>Chemotherapy, surgery, and radiotherapy are often combined in cancer treatment to improve outcomes for patients.</p> <p>Thanks to developments in cancer research over the last 50 years, survival rates have improved greatly – although the rate of improvement has <a href="https://news.cancerresearchuk.org/2024/02/02/world-cancer-day-2024/#:%7E:text=Improvements%20in%20cancer%20survival%20have%20slowed%20in%20recent%20years&amp;text=Survival%20increased%20three%20to%20five,consistently%20lags%20behind%20comparable%20countries.">slowed recently</a>. Cancer survival depends on various factors such as age – people under 40 have a <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/age">greater chance</a> of survival – overall health and fitness, as well as family history.</p> <h2>What you should do</h2> <p>Particular changes in your body or warning symptoms could indicate the presence of cancer. These include, but are not limited to:</p> <ul> <li>Unexplained weight loss;</li> <li>Fatigue that doesn’t improve with rest;</li> <li>Changes in bowel or bladder habits;</li> <li>Persistent cough or coughing up blood;</li> <li>Difficulty swallowing;</li> <li>Persistent pain;</li> <li>Noticing lumps, such as in a breast or testicle.</li> </ul> <p>The symptoms may not necessarily be the result of cancer. But it is important to get checked by a doctor if you notice anything out of the ordinary or have had persistent symptoms that don’t ease. Early detection and treatment can <a href="https://www.science.org/doi/full/10.1126/science.aay9040">significantly improve</a> outcomes for many types of cancer.<!-- 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/226456/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/gavin-metcalf-1340598">Gavin Metcalf</a>, Cancer Biologist and Lecturer in Biomedical Science, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</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/princess-of-wales-and-king-charles-one-in-two-people-develop-cancer-during-their-lives-the-diseases-and-treatments-explained-226456">original article</a>.</em></p>

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What is minoxidil, the anti-balding hair growth treatment? Here’s what the science says

<p><a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Hair loss (also known as alopecia) often affects the scalp but can occur anywhere on the body. It’s very common and usually nothing to worry about; about <a href="https://www.sciencedirect.com/science/article/pii/S0022202X15525840">half of Australian men</a> show signs of visible baldness at age 50 and <a href="https://www.sciencedirect.com/science/article/pii/S0022202X15525840">over a quarter of Australian women</a> report hair thinning by the same age. It’s often genetic.</p> <p>But if you’ve noticed hair loss and are worried by it, see a GP or dermatologist for a diagnosis before trying any treatments. Products claiming to reverse hair loss are everywhere, but few have been scientifically tested for how well they work.</p> <p>One group of products that have actually been scientifically tested, however, are known as topical minoxidil products. These include products such as Regaine®.</p> <p>So, do they work? Here’s what the research evidence says, what you can realistically expect and what you need to know if you’re considering this treatment.</p> <h2>What is minoxidil – and does it work?</h2> <p>Topical minoxidil usually comes as a kind of foam or serum you apply to your scalp.</p> <p>It’s been approved by the <a href="https://www.tga.gov.au/">Therapeutic Goods Administration</a>, Australia’s regulatory authority for therapeutic goods, for the treatment of hereditary hair loss in males and females. Minoxidil is also available in tablet form, but this isn’t currently approved for hair loss (more on that later).</p> <p>So, is topical minoxidil effective? In short – yes, but the results vary widely from person to person, and it needs to be used consistently over several months to see results.</p> <p>Scientists don’t know exactly how minoxidil works. It may affect the different phases of the hair life cycle, thereby encouraging growth. It also <a href="https://www.tandfonline.com/doi/full/10.1080/09546634.2021.1945527?casa_token=KhIM_u0u8nwAAAAA:5njp_XE5cHhip454ycvU1p9p_t0VVzpjRu0ozDZ9YqNb04fmhmngWzYeiowZcG5UugLQkTVIzCcj7A">opens up blood vessels</a> near hair follicles.</p> <p>This increases blood flow, which in turn delivers more oxygen and nutrients to the hair.</p> <p>While minoxidil is unlikely to restore a full head of thick, lush, hair, it can slow down hair loss and can <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007628.pub4/full?highlightAbstract=minoxidil">stimulate regrowth</a>.</p> <p>It is the over-the-counter option with the most evidence. Two strengths are available: 5% and 2%.</p> <p>An analysis of randomised controlled trials found minoxidil applied to the scalp twice a day increased the number of hairs per square centimetre by <a href="https://pubmed.ncbi.nlm.nih.gov/28396101/">eight to 15 hairs</a>, with the higher strength treatment having a slightly greater effect.</p> <h2>Can I use it for non-genetic balding?</h2> <p>There are many causes of hair loss. The main cause in both males and females is a hereditary condition called androgenic alopecia.</p> <p>Although topical minoxidil is only approved for use in Australia for androgenic alopecia, there is some evidence it can also help in other conditions that cause hair loss.</p> <p>For example, it may hasten hair regrowth in patients who have lost hair due to <a href="https://www.jaad.org/article/S0190-9622(96)90500-9/abstract">chemotherapy</a>.</p> <p>Unfortunately, minoxidil is not effective when the hair follicle is gone, like after a burn injury.</p> <p>Although small studies have found promising results using minoxidil to promote hair growth on the face (for <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.13312">beard</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/24471459/">eyebrow</a> enhancement), topical minoxidil products are not currently approved for this use. More research is required.</p> <h2>What else do I need to know?</h2> <p>Minoxidil won’t work well for everyone. Early in treatment you might notice a temporary increase in <a href="https://pubmed.ncbi.nlm.nih.gov/22409453/">hair shedding</a>, as it alters the hair cycle to make way for new growth. Minoxidil needs to be trialled for three to six months to determine if it’s effective.</p> <p>And as it doesn’t cure hair loss, you must <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.14624?casa_token=P-zW7kDNRs8AAAAA%3AaUgUzxU7lbwBpg1BYPajOfXFhpb_mU5g_ounZ6GtjsLLkHO_AdVQ2Kf-8zZkW80ykBj3N_sOsyn392uc">continue</a> to use it each day to maintain the effect. If you stop, you will start losing the new hair growth <a href="https://www.nps.org.au/assets/medicines/1f8127a5-2a98-4013-a7c3-a53300feb0e5-reduced.pdf">within three to four months</a>.</p> <p>Minoxidil products may not be suitable for everyone. If you have any medical conditions or take any medications, you should speak with your doctor or pharmacist before using minoxidil products.</p> <p>It has not been tested for safety in <a href="https://www.nps.org.au/assets/medicines/1f8127a5-2a98-4013-a7c3-a53300feb0e5-reduced.pdf">people under 18, over 65, or those who are pregnant</a>.</p> <p>You can read the <a href="https://www.nps.org.au/medicine-finder/regaine-for-men-regular-strength-application">consumer medicines information sheet</a> for more information about using over-the-counter minoxidil products.</p> <p>Many people do not like to use minoxidil solution or foams long-term because they need to be applied everyday day, which can be inconvenient. Or they may notice side effects, such as scalp irritation and changes to hair texture.</p> <p>Some people <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.14624?casa_token=P-zW7kDNRs8AAAAA%3AaUgUzxU7lbwBpg1BYPajOfXFhpb_mU5g_ounZ6GtjsLLkHO_AdVQ2Kf-8zZkW80ykBj3N_sOsyn392uc">tolerate the foam products better</a> than the solution, as the solution contains more of a compound called propylene glycol (which can irritate the skin).</p> <h2>What about the oral tablet form of minoxidil?</h2> <p>Minoxidil is also available on prescription as an oral tablet. While traditionally used for high blood pressure, it has also been used as a treatment for hair loss.</p> <p>In 2020, a <a href="https://www.jaad.org/article/S0190-9622(20)32109-5/abstract">systematic review</a> identified 17 studies involving 634 patients using oral minoxidil for various hair loss conditions.</p> <p>The authors found oral minoxidil was effective and generally well tolerated in healthy people who were having trouble using the topical products.</p> <p>The review noted oral minoxidil may increase hair growth over the whole body and may cause heart-related side effects in some patients. More research is required.</p> <p>In Australia, oral minoxidil is available under the trade name <a href="https://www.nps.org.au/assets/medicines/df29e16f-6464-4652-ba1f-a53300fed275.pdf">Loniten</a>®. However, it is currently only approved for use in high blood pressure.</p> <p>When people seek a prescription treatment for a non-approved purpose, this is called “off-label” prescribing. Off-label prescribing of oral minoxidil, potentially for use in alopecia, may have contributed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170338/">shortages</a> of Loniten® tablets in recent years. This can reduce availability of this medicine for people who need it for high blood pressure.<!-- 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/223736/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><a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, Senior Lecturer in Pharmacy Practice, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, Senior Lecturer in Pharmacy, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></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/what-is-minoxidil-the-anti-balding-hair-growth-treatment-heres-what-the-science-says-223736">original article</a>.</em></p> <p><em>Image: Getty</em></p>

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King Charles delivers heartfelt message amidst cancer treatment

<p>In times of adversity, the power of unity and compassion shines through, and this sentiment has never been more evident than in the heartfelt message delivered by King Charles amidst his cancer treatment.</p> <p>As news of his diagnosis spread, an outpouring of support enveloped the King from all corners of the Commonwealth. His gratitude and appreciation for this unwavering kindness were palpable as he addressed the nations in a video message, unable to personally attend the 2024 Commonwealth Day celebrations due to his health.</p> <p>"I have been most deeply touched by your wonderfully kind and thoughtful good wishes for my health and, in return, can only continue to serve you, to the best of my ability, throughout the Commonwealth," he said.</p> <p>"My belief in our shared endeavours and in the potential of our people remains as sure and strong as it has ever been. I have no doubt that we will continue to support one another across the Commonwealth as, together, we continue this vital journey."</p> <p>The absence of the Princess of Wales, still in recovery from surgery, served as a reminder of the fragility of life and the importance of cherishing every moment with loved ones. In such moments, the strength of familial bonds and the support of a caring community become invaluable lifelines.</p> <p>As we celebrate the 75th anniversary of the Commonwealth, we reflect not only on its historical significance but also on its enduring relevance in today's world. The theme of "One Resilient Common Future: Transforming our Commonwealth" resonates deeply as we navigate the challenges of the modern age together.</p> <p>King Charles' words remind us of the interconnectedness of our shared humanity, transcending borders and differences. He likened the Commonwealth to the wiring of a house, where each nation contributes to the collective energy and strength that sustains us all:</p> <p>"As I have said before, the Commonwealth is like the wiring of a house, and its people, our energy and our ideas are the current that runs through those wires. Together and individually we are strengthened by sharing perspectives and experiences, and by offering and borrowing the myriad ways we have each tackled the challenges of our time. This is true both at the level of nations and, indeed, at the local level. We recognise today that our diversity is our greatest strength."</p> <p>In facing global challenges such as climate change, biodiversity loss and socioeconomic shifts, the importance of collaboration and cooperation cannot be overstated. King Charles eloquently underscored the power of diversity as our greatest strength, recognising that it is through our varied perspectives and experiences that we find innovative solutions to complex problems.</p> <p><iframe title="YouTube video player" src="https://www.youtube.com/embed/lR6Z8ss_AW0?si=Gf8lGHmG-xnw9zCP" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe></p> <p><em>Image: Youtube</em></p>

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Sarah Ferguson diagnosed with malignant melanoma – here are the latest treatments for this increasingly common skin cancer

<p><em><a href="https://theconversation.com/profiles/sarah-allinson-137762">Sarah Allinson</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p>News that Sarah Ferguson, the Duchess of York, has recently been diagnosed with malignant melanoma highlights the dangers of this increasingly common skin cancer.</p> <p>Malignant melanoma affects <a href="https://www.iarc.who.int/cancer-type/skin-cancer/">325,000 people worldwide</a> every year. While it’s not the most common form of skin cancer – typically, for every one diagnosed case of melanoma, up to ten non-melanoma skin cancers are diagnosed – it causes <a href="https://theconversation.com/skin-cancer-more-people-die-from-types-that-arent-melanoma-surprise-new-finding-215378">almost as many deaths</a>. The reason for this is because it’s far more likely to spread, or metastasise, to other sites in the body compared to non-melanoma skin cancers.</p> <p>Melanoma arises in a type of pigment-producing skin cell called a <a href="https://www.cancer.org/cancer/types/melanoma-skin-cancer/about/what-is-melanoma.html#:%7E:text=Melanoma%20is%20a%20type%20of,to%20grow%20out%20of%20control.">melanocyte</a>. These cells produce and export melanin in order to provide a protective layer in the skin which helps to screen out ultraviolet (UV) radiation.</p> <p>Mutations in genes that normally carefully regulate cell growth and survival override the controls that ensure the body only produces the cells it needs. The result is uncontrolled cellular growth, or a tumour, that normally appears as an unusual-looking mole.</p> <p>The mutations that drive the growth of a melanoma usually happen as a result of exposure to UV from the sun or from an artificial source, such as a tanning bed. We know this because when a melanoma’s genome is compared to that of a normal cell we can see a high number of mutations that have a <a href="https://www.nature.com/articles/s41586-020-1943-3">characteristic “UV signature”</a>. For this reason, melanoma skin cancers occur most frequently in people who have light-coloured skin and who are exposed to high amounts of UV.</p> <p>Non-melanoma skin cancers are also mainly caused by exposure to UV but arise from a different kind of skin cell called a keratinocyte. These are the cells that normally make up the majority of the outer part of our skin, called the epidermis. Cancers that arise from keratinocytes are less likely to spread than those that come from melanocytes – although <a href="https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/non-melanoma-skin-cancer#heading-One">they can still be fatal</a>.</p> <p>In the duchess’s case, the melanoma was discovered during treatment for breast cancer. Her dermatologist recommended that some moles be removed for biopsy during breast reconstruction surgery. After testing, one was identified as malignant melanoma.</p> <p>If the results of the biopsy show that the cancer hasn’t spread, then like the majority of patients with melanoma, the duchess will be treated with surgery. In this case the tumour will be removed along with some of the surrounding normal skin.</p> <p>The amount of normal skin removed depends on the results of the biopsy – in particular, how deep into the skin the tumour has penetrated (called the <a href="https://www.macmillan.org.uk/cancer-information-and-support/melanoma/staging-of-melanoma">Breslow thickness</a>). The normal skin will be checked for any signs that cancerous cells might have spread out of the tumour.</p> <p>For most people diagnosed with melanoma, particularly if it’s at an early stage, <a href="https://www.ncbi.nlm.nih.gov/books/NBK481850/">surgery will cure the cancer</a> and they will be able to go on with their lives. But for around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544364/">20% of patients</a>, additional treatment will be needed. This happens if their cancer has spread further into the body or if their cancer can’t be treated surgically. The <a href="https://ascopubs.org/doi/10.1200/OP.21.00686">good news</a> for these patients is that the past decade has seen huge improvements in treatment.</p> <p>Previously the only options other than surgery were radiotherapy or non-specific chemotherapy treatments. These treatments work by affecting the ability of cells to copy their DNA, which prevents them from duplicating and causes fast-growing cancer cells to die. But because these also affect the patient’s normal cells, they were accompanied by severe side effects – and were often ineffective.</p> <p>But we now have a better understanding of the specific changes melanoma makes to cell growth pathways. This has led to the development of drugs, such as <a href="https://www.cancer.gov/news-events/cancer-currents-blog/2022/fda-dabrafenib-trametinib-braf-solid-tumors">dabrafenib</a> and <a href="https://pubchem.ncbi.nlm.nih.gov/compound/Trametinib">trametinib</a>, that specifically target cells with these altered pathways. In other words, they only target the cancerous cells.</p> <p>These drugs are much more effective and have fewer side effects than traditional chemotherapies – although about half of patients who initially respond to them relapse within a year. In these patients a few of the tumour cells survive by activating other pathways for growth and use these to <a href="https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.30435">regrow the tumour</a>. Promisingly, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417341/">a recent study</a> suggests that re-using these drugs after a period off them can have good results in relapsed patients.</p> <p>Another exciting development in the treatment of malignant melanoma has been the use of immunotherapies. These involve harnessing the patient’s own immune system to fight the tumour.</p> <p>One particularly successful immunotherapy approach for melanoma involves the use of drugs called checkpoint inhibitors. These prevent cancer cells from being able to hide from the body’s immune system. A <a href="https://www.ejcancer.com/article/S0959-8049(23)00694-9/fulltext">recent report</a> has highlighted how the introduction of these treatments has led to improved survival for melanoma patients.</p> <p>Although the duchess’s skin cancer was discovered while she was being treated for breast cancer, it’s unlikely that the two are related. A more likely risk factor is the duchess’s famous red hair. People with red hair and pale skin that tends to freckle and burn in the sun are at a greater risk of developing skin cancer because their skin produces <a href="https://medlineplus.gov/genetics/gene/mc1r/#conditions">less melanin</a>. This means that their melanocytes are exposed to higher levels of UV and are more likely to undergo cancer-causing mutations.</p> <p>While melanoma is much more common in people with the duchess’s skin type, it’s important to be aware that anyone can get it. It’s a good idea to regularly check your skin for unusual looking moles and to contact a doctor for advice if you have a mole with any of the so-called <a href="https://www.cancerresearchuk.org/about-cancer/melanoma/symptoms">ABCDE characteristics</a>: such as an asymmetrical shape, irregular, blurred or jagged border, uneven colour, is more than 6mm wide and is evolving (either in size, texture or even bleeding).<!-- 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/221647/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-allinson-137762">Sarah Allinson</a>, Professor, Department of Biomedical and Life Sciences, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p><em>Image credits: Getty </em><em>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/sarah-ferguson-diagnosed-with-malignant-melanoma-here-are-the-latest-treatments-for-this-increasingly-common-skin-cancer-221647">original article</a>.</em></p>

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How can I get some sleep? Which treatments actually work?

<p><em><a href="https://theconversation.com/profiles/alexander-sweetman-1331085">Alexander Sweetman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Do you have difficulty falling asleep? Do you stay awake for a long time at night? Do these sleep problems make you feel fatigued, strung-out, or exhausted during the day? Has this been happening for months?</p> <p>If so, you’re not alone. About <a href="https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia">12-15%</a> of Australian adults have chronic insomnia.</p> <p>You might have tried breathing exercises, calming music, white noise, going to bed in a dark and quiet bedroom, eating different foods in the evening, maintaining a regular sleep pattern, or reducing caffeine. But after three to four weeks of what seems like progress, your insomnia returns. What next?</p> <h2>What not to do</h2> <p>These probably won’t help:</p> <ul> <li> <p><strong>spending more time in bed</strong> often results in more time spent <em>awake</em> in bed, which can make <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">insomnia patterns worse</a></p> </li> <li> <p><strong>drinking coffee and taking naps</strong> might help get you through the day. But <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">caffeine</a> stays in the system for many hours, and can disrupt our sleep if you drink too much of it, especially after about 2pm. If naps last for more than 30 minutes, or occur after about 4pm, this can reduce your “sleep debt”, and can make it <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">more difficult</a> to fall asleep in the evening</p> </li> <li> <p><strong>drinking alcohol</strong> might help you fall asleep quicker, but <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">can cause</a> more frequent awakenings, change how long you sleep, change the time spent in different “stages” of sleep, and reduce the overall quality of sleep. Therefore, it is not recommended as a sleep aid.</p> </li> </ul> <h2>What to do next?</h2> <p>If your symptoms have lasted more than one or two months, it is likely your insomnia requires targeted treatments that focus on sleep patterns and behaviours.</p> <p>So, the next stage is a type of non-drug therapy known as cognitive behavioural therapy for insomnia (or <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a> for short). This is a four to eight week treatment that’s been shown to be <a href="https://doi.org/10.1016/j.smrv.2022.101687">more effective</a> than sleeping pills.</p> <p>It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia.</p> <p>You can do this one-on-one, in a small group with health professionals trained in CBTi, or via self-guided <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online programs</a>.</p> <p>Some GPs are trained to offer CBTi, but it’s more usual for specialist <a href="https://psychology.org.au/find-a-psychologist">sleep psychologists</a> to offer it. Your GP can refer you to one. There are some Medicare rebates to subsidise the cost of treatment. But many psychologists will also charge a gap fee above the Medicare subsidy, making access to CBTi a challenge for some.</p> <p><a href="https://doi.org/10.12703%2Fr%2F11-4">About 70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://doi.org/10.1016/j.smrv.2019.08.002">at least a year</a>.</p> <h2>What if that doesn’t work?</h2> <p>If CBTi doesn’t work for you, your GP might be able to refer you to a specialist sleep doctor to see if other sleep disorders, such as <a href="https://doi.org/10.1016/j.smrv.2016.04.004">obstructive sleep apnoea</a>, are contributing to your insomnia.</p> <p>It can also be important to manage any mental health problems such as <a href="https://doi.org/10.5694/mja2.51200">depression and anxiety</a>, as well as physical symptoms such as pain that can also disrupt sleep.</p> <p>Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor.</p> <h2>What about sleeping pills?</h2> <p>Sleeping pills are <a href="https://www.sleepprimarycareresources.org.au/insomnia/pharmacological-therapy">not the recommended</a> first-line way to manage insomnia. However, they do have a role in providing short-term, rapid relief from insomnia symptoms or when CBTi is not accessible or successful.</p> <p>Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep.</p> <p>However, these can have <a href="https://doi.org/10.1136/bmj.38623.768588.47">side-effects</a> including a risk of falls, being impaired the next day, as well as tolerance and dependence.</p> <p>Melatonin – either prescribed or available from pharmacies for people aged 55 and over – is also often used to manage insomnia. But the <a href="https://doi.org/10.1016/j.smrv.2022.101692">evidence suggests</a> it has limited benefits.</p> <h2>Are there new treatments? How about medicinal cannabis?</h2> <p>Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant).</p> <p>These block the wake-promoting pathways in the brain. <a href="https://doi.org/10.4088/PCC.22nr03385">Early data suggests</a> they are effective in improving sleep, and have lower risk of potential side-effects, tolerance and dependence compared with earlier medicines.</p> <p>However, we don’t know if they work or are safe over the long term.</p> <p><a href="https://doi.org/10.1093/sleep/zsab149">Medicinal cannabis</a> <a href="https://doi.org/10.1111/jsr.13793">has only in recent years</a> <a href="https://doi.org/10.1093/sleepadvances/zpac029.048">been studied</a> as a treatment for <a href="https://doi.org/10.1093/sleepadvances/zpac029.005">insomnia</a>.</p> <p>In an Australian survey, <a href="https://doi.org/10.2147/nss.s390583">more than half</a> of people using medicinal cannabis said they used it to treat insomnia. There are reports of <a href="https://doi.org/10.1371/journal.pone.0272241">significant benefit</a>.</p> <p>But of the four most robust studies so far, <a href="https://doi.org/10.1093/sleep/zsab149">only one</a> (led by one of us, Jen Walsh) has demonstrated an improvement in insomnia after two weeks of treatment.</p> <p>So we need to learn more about which cannabinoids – for example, delta-9-tetrahydrocannabinol, cannabidiol or cannabinol – and which doses may be beneficial. We also need to learn who can benefit most, and whether these are safe and effective over the long term.</p> <h2>What now?</h2> <p>If you’ve had trouble sleeping for a short time (under about a month) and nothing you try is working, there may be underlying reasons for your insomnia, which when treated, can provide some relief. Your GP can help identify and manage these.</p> <p>Your GP can also help you access other treatments if your insomnia is more long term. This may involve non-drug therapies and/or referral to other services or doctors.</p> <hr /> <p><em>For more information about insomnia and how it’s treated, see the Sleep Health Foundation’s <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">online resource</a>.</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/212964/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/alexander-sweetman-1331085">Alexander Sweetman</a>, Research Fellow, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/jen-walsh-1468594">Jen Walsh</a>, Director of the Centre for Sleep Science, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a>, and <a href="https://theconversation.com/profiles/nicole-grivell-1468590">Nicole Grivell</a>, Research Coordinator and final year PhD Candidate at FHMRI Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders 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/how-can-i-get-some-sleep-which-treatments-actually-work-212964">original article</a>.</em></p>

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How do hay fever treatments actually work? And what’s best for my symptoms?

<p><em><a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p>Spring has sprung and many people are welcoming longer days and more time outdoors. But for <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/allergic-rhinitis-hay-fever/contents/allergic-rhinitis">almost one in five Australians</a>, spring also brings the misery of watery, itchy red eyes, a runny, congested nose, and sneezing.</p> <p>Hay fever (also known as allergic rhinitis) is caused when an allergen enters the nose or eyes. Allergens are harmless airborne substances the body has incorrectly identified as harmful. This triggers an immune response, which leads to the release of inflammatory chemicals (mediators) – one of which is histamine.</p> <p>Allergens that trigger hay fever differ from person to person. Common seasonal allergens include tree, grass and weed pollens (year-round allergens include dust mites, mould and pet dander). It’s now <a href="https://www.sciencedirect.com/science/article/pii/S132602002302191X">pollen season</a> in many parts of Australia, with pollen counts at their highest and hay fever cases surging.</p> <p>So what medicines can prevent or reduce hay fever symptoms, and how do they work?</p> <h2>Antihistamines</h2> <p>Knowing the release of histamine is a cause of hay fever symptoms, it’s unsurprising that <em>anti</em>-histamines are one of the most frequently recommended medicines to treat hay fever.</p> <p>Antihistamines block histamine from binding to histamine receptors in the body and having an effect, reducing symptoms.</p> <p>In Australia, we broadly have two types. The older sedating (introduced in the <a href="https://www.tga.gov.au/news/safety-alerts/first-generation-antihistamines-winter-warning">1940s</a>) and newer, less-sedating (introduced in the 1980s) antihistamines.</p> <p>Less-sedating antihistamines used to treat allergic rhinitis include bilastine (Allertine), cetirizine (Zyrtec), loratadine (Claratyne) and fexofenadine (Telfast). Bilastine, which came onto the Australian market only last year, is only available from a pharmacy, on recommendation from a pharmacist. The others have been around longer and are available at supermarkets and in larger quantities from pharmacies. Cetirizine is the <a href="https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-accsacms-november-2016/35-cetirizine-hydrochloride#:%7E:text=Risks%20of%20cetirizine%20hydrochloride%20use,significant%20at%20the%20proposed%20doses.">most likely</a> (of the less-sedating antihistamines) to cause sedation.</p> <p>The older sedating antihistamines (such as promethazine) cross the blood-brain barrier, causing drowsiness and even brain fog the next day. They have lots of side effects and potential drug interactions, and as such have little place in the management of hay fever.</p> <p>The newer less-sedating antihistamines are <a href="https://australianprescriber.tg.org.au/articles/antihistamines-and-allergy.html#:%7E:text=Less%20sedating%20antihistamines%20are%20equally,an%20ongoing%20good%20safety%20profile">equally effective</a> as the older sedating ones.</p> <p>Antihistamines are usually taken orally (as a tablet or solution) but there are also topical preparations such as nasal sprays (azelastine) and eye drops. Antihistamine nasal sprays have <a href="https://www.sciencedirect.com/science/article/abs/pii/S108112061000743X">equal to or better efficacy</a> than oral antihistamines.</p> <p>The individual response to antihistamines varies widely. For this reason, you may need to trial several different types of antihistamines to see which one works best for you.</p> <p>Increasing the dose of an antihistamine, or combining an oral and topical antihistamine, does not provide any additional benefit. Paying extra for a brand name doesn’t offer any more or less effect than the generic (both have the same active ingredient and are <a href="https://www.tga.gov.au/news/news/generic-prescription-medicines-fact-sheet">bioequivalent</a>, which means they have the same outcomes for patients).</p> <h2>Steroid nasal sprays</h2> <p>If your symptoms don’t improve from antihistamines alone, a nasal spray containing a corticosteroid is often recommended.</p> <p>Corticosteroids prevent the release of several key chemicals that cause inflammation. How they work is complex: in part, corticosteroids “turn off” the production of late phase inflammatory mediators (cytokines and chemokines). This reduces the future release of more inflammatory mediators, which reduces inflammation.</p> <p>Corticosteroids and antihistamines have different mechanisms of action. Research shows corticosteroid nasal sprays are <a href="https://journals.sagepub.com/doi/full/10.2500/ajra.2016.30.4397">more effective</a> than antihistamines in controlling an itchy, runny, congested nose. But when instilled into the nose, corticosteroids <a href="https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1016/j.otohns.2007.10.027">also reduce</a> the eye symptoms of hay fever.</p> <p>There are also nasal sprays that contain both an antihistamine and corticosteroid.</p> <p>While there are a range of corticosteroid nasal sprays containing different active ingredients, a large study published this year shows they are all <a href="https://www.frontiersin.org/articles/10.3389/fphar.2023.1184552/full">about as effective as each other</a>, and work best when they have been taken for several days.</p> <h2>Sodium cromoglycate</h2> <p>Another medicine used to treat hay fever symptoms is sodium cromoglycate, which is available as an eye drop and over-the-counter in pharmacies.</p> <p>This medicine is known as a mast cell stabiliser. As the name suggests, it stabilises or prevents mast cells from breaking down. When mast cells break down, they release histamine and other chemicals that cause inflammation.</p> <p>This eye drop is both a preventative and treatment medicine, usually used before allergies strike. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9375451/">Evidence shows</a> it is effective at reducing the symptoms of allergic conjunctivitis (eye inflammation from allergies).</p> <h2>Decongestants</h2> <p>Decongestants constrict blood vessels. They can be taken orally, administered as a nasal spray, or instilled into the eyes. When administered into the eyes it will reduce redness, and when administered into the nose, it will stop it from running.</p> <p>However, decongestants should be used for a short duration only and are not for long term use. In fact, if a nasal spray decongestant is used for more than five days, you can experience something called “rebound congestion”: a severe stuffy nose.</p> <h2>Saline</h2> <p>Saline (saltwater) nasal sprays or irrigation products are also available to flush out the allergens and provide hay fever relief. While there are not many studies in the area, there is evidence that saline irrigation <a href="https://www.cochrane.org/CD012597/ENT_nasal-saline-allergic-rhinitis#:%7E:text=Saline%20irrigation%20may%20reduce%20patient,any%20outcomes%20beyond%20three%20months">may reduce hay fever symptoms</a>. Saline is safe and is not associated with adverse effects.</p> <p>If you’re suffering from hay fever symptoms and unsure what to try, talk to your prescriber or pharmacist, who can guide you through the options and identify the best one for your symptoms, medical conditions and medicines.</p> <p>Allergen immunotherapy (or allergen shots) is another option hay fever sufferers <a href="https://www.allergy.org.au/patients/allergy-treatments/allergen-immunotherapy-faqs">may discuss</a> with their doctors. However it’s not a quick fix, with therapy taking three to five years.<!-- 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/213071/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/mary-bushell-919262">Mary Bushell</a>, Clinical Assistant Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</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/how-do-hay-fever-treatments-actually-work-and-whats-best-for-my-symptoms-213071">original article</a>.</em></p>

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Taking an antidepressant? Mixing it with other medicines – including some cold and flu treatments – can be dangerous

<p><em><a href="https://theconversation.com/profiles/treasure-mcguire-135225">Treasure McGuire</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>In the depths of winter we are more at risk of succumbing to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522168/">viral respiratory infections</a> – from annoying sore throat, common cold and sinusitis, to the current resurgence of respiratory syncytial virus (RSV), influenza and COVID.</p> <p>Symptoms of upper respiratory tract infection range in severity. They can include fever, chills, muscle or body aches, cough, sore throat, runny or stuffy nose, earache, headache, and fatigue. Most antibiotics target bacteria so are <a href="https://pubmed.ncbi.nlm.nih.gov/32495003/">not effective</a> for viral infections. Many people seek relief with over-the-counter medicines.</p> <p>While evidence varies, guidelines suggest medicines taken by mouth (such as cough syrups or cold and flu tablets) have a <a href="https://pubmed.ncbi.nlm.nih.gov/25420096/">limited but potentially positive</a> short-term role for managing upper respiratory infection symptoms in adults and children older than 12. These include:</p> <ul> <li>paracetamol or ibuprofen for pain or fever</li> <li>decongestants such as phenylephrine or pseudoephedrine</li> <li>expectorants and mucolytics to thin and clear mucus from upper airways</li> <li>dry cough suppressants such as dextromethorphan</li> <li>sedating or non-sedating antihistamines for runny noses or watery eyes.</li> </ul> <p>But what if you have been prescribed an antidepressant? What do you need to know before going to the pharmacy for respiratory relief?</p> <h2>Avoiding harm</h2> <p>An audit of more than 5,000 cough-and-cold consumer enquiries to an Australian national medicine call centre found questions frequently related to drug-drug interactions (29%). An 18-month analysis showed 20% of calls <a href="https://pubmed.ncbi.nlm.nih.gov/26590496/">concerned</a> potentially significant interactions, particularly with antidepressants.</p> <p>Australia remains in the “<a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-%20prescriptions#Prescriptionsbytype">top ten</a>” antidepressant users in the <a href="https://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_PHMC">OECD</a>. More than <a href="https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions">32 million</a> antidepressant prescriptions are dispensed on the Pharmaceutical Benefits Scheme each year.</p> <p>Antidepressants are commonly prescribed to manage symptoms of anxiety or depression but are also used in chronic pain and incontinence. They are classified primarily by how they affect chemical messengers in the nervous system.</p> <p>These classes are:</p> <ul> <li><strong>selective serotonin reuptake inhibitors (SSRI)</strong> such as fluoxetine, escitalopram, paroxetine and sertraline</li> <li><strong>serotonin and noradrenaline reuptake inhibitors (SNRI)</strong> such as desvenlafaxine, duloxetine and venlafaxine</li> <li><strong>tricyclic antidepressants (TCA)</strong> such as amitriptyline, doxepin and imipramine</li> <li><strong>monoamine oxidase inhibitors (MAOI)</strong> such as tranylcypromine</li> <li><strong>atypical medicines</strong> such as agomelatine, mianserin, mirtazapine, moclobemide, reboxetine and vortioxetine</li> <li><strong>complementary medicines</strong> including St John’s wort, S-adenosyl methionine (SAMe) and L-tryptophan</li> </ul> <p>Medicines within the same class of antidepressants have similar actions and side-effect profiles. But the molecular differences of individual antidepressants mean they may have different interactions with medicines taken at the same time.</p> <h2>Types of drug interactions</h2> <p>Drug interactions can be:</p> <ul> <li><strong>pharmacokinetic</strong> – what the body does to a drug as it moves into, through and out of the body. When drugs are taken together, one may affect the absorption, distribution, metabolism or elimination of the other</li> <li><strong>pharmacodynamic</strong> – what a drug does to the body. When drugs are taken together, one may affect the action of the other. Two drugs that independently cause sedation, for example, may result in excessive drowsiness if taken together.</li> </ul> <p>There are many <a href="https://wchh.onlinelibrary.wiley.com/doi/pdf/10.1002/pnp.429">potential interactions</a> between medications and antidepressants. These include interactions between over-the-counter medicines for upper respiratory symptoms and antidepressants, especially those taken orally.</p> <p>Concentrations of nasal sprays or inhaled medicines are generally lower in the blood stream. That means they are less likely to interact with other medicines.</p> <h2>What to watch for</h2> <p>It’s important to get advice from a pharmacist before taking any medications on top of your antidepressant.</p> <p>Two symptoms antidepressant users should monitor for shortly after commencing a cough or cold medicine are central nervous system effects (irritability, insomnia or drowsiness) and effects on blood pressure.</p> <p>For example, taking a selective SSRI antidepressant and an oral decongestant (such as pseudoephedrine or phenylephrine) can cause irritability, insomnia and affect blood pressure.</p> <p>Serotonin is a potent chemical compound produced naturally for brain and nerve function that can also constrict blood vessels. Medicines that affect serotonin are common and include most antidepressant classes, but also decongestants, dextromethorphan, St John’s wort, L-tryptophan, antimigraine agents, diet pills and amphetamines.</p> <p><a href="https://reference.medscape.com/drug-interactionchecker">Combining drugs</a> such as antidepressants and decongestants that both elevate serotonin levels can cause irritability, headache, insomnia, diarrhoea and blood pressure effects – usually increased blood pressure. But some people experience orthostatic hypotension (low blood pressure on standing up) and dizziness.</p> <p>For example, taking both a serotonin and SNRI antidepressant and dextromethorphan (a cough suppressant) can add up to high serotonin levels. This can also occur with a combination of the complementary medicine St John’s Wort and an oral decongestant.</p> <p>Where serotonin levels are too high, <a href="https://pubmed.ncbi.nlm.nih.gov/15666281/">severe symptoms</a> such as confusion, muscle rigidity, fever, seizures and even death have been reported. Such symptoms are rare but if you notice any of these you should stop taking the cold and flu medication straight away and seek medical attention.</p> <h2>Ways to avoid antidepressant drug interactions</h2> <p>There are a few things we can do to prevent potentially dangerous interactions between antidepressants and cold and flu treatments.</p> <p><strong>1. Better information</strong></p> <p>Firstly, there should be more targeted, consumer-friendly, <a href="https://www.webmd.com/interaction-checker/default.htm">online drug interaction information</a> available for antidepressant users.</p> <p><strong>2. Prevent the spread of viral infections as much as possible</strong></p> <p>Use the non-drug strategies that have worked well for COVID: regular hand washing, good personal hygiene, social distancing, and facemasks. Ensure adults and children are up to date with immunisations.</p> <p><strong>3. Avoid potential drug interactions with strategies to safely manage symptoms</strong></p> <p>Consult your pharmacist for strategies most appropriate for you and only use cold and flu medications while symptoms persist:</p> <ul> <li>treat muscle aches, pain, or a raised temperature with analgesics such as paracetamol or ibuprofen</li> <li>relieve congestion with a nasal spray decongestant</li> <li>clear mucus from upper airways with expectorants or mucolytics</li> <li>dry up a runny nose or watery eyes with a non-sedating antihistamine.</li> </ul> <p>Avoid over-the-counter cough suppressants for an irritating dry cough. Use a simple alternative such as honey, steam inhalation with a few drops of eucalyptus oil or a non-medicated lozenge instead.</p> <p><strong>4. Ask whether your symptoms could be more than the common cold</strong></p> <p>Could it be influenza or COVID? Seek medical attention if you are concerned or your symptoms are not improving. <!-- 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/208662/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/treasure-mcguire-135225">Treasure McGuire</a>, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/taking-an-antidepressant-mixing-it-with-other-medicines-including-some-cold-and-flu-treatments-can-be-dangerous-208662">original article</a>.</em></p>

Body

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Promising Alzheimer’s drug offers hope for a bright future in treatment

<p>A remarkable and significant breakthrough in the fight against Alzheimer’s disease is ushering in a new era of hope and possibilities for patients grappling with early onset dementia.</p> <p>Scientists and researchers are celebrating this groundbreaking development, viewing it as a tremendous opportunity to transform the landscape of Alzheimer's treatment.</p> <p>The drug in question, donanemab, developed by Eli Lilly, has shown remarkable success in clinical trials and is anticipated to receive approval from the Food and Drug Administration later this year, according to a report in the <a href="https://nypost.com/2023/07/17/alzheimers-drug-donanemab-lowers-risk-of-dementia/" target="_blank" rel="noopener"><em>New York Post</em></a>.</p> <p>Individuals who participated in the donanemab trials experienced a remarkable 40% reduction in the risk of transitioning from mild cognitive impairment to mild or moderate dementia. This is an extraordinary advancement that brings renewed optimism to those affected by this devastating condition.</p> <p>Donanemab would be the third Alzheimer’s drug to emerge in recent months, following the introduction of Leqembi and Aduhelm. This is just the beginning of an exciting new chapter in the realm of molecular therapies for Alzheimer's, as expressed by Dr. Gil Rabinovici, director of the University of California San Francisco’s Memory and Ageing Centre, in an editorial for <em>JAMA</em>.</p> <p>Dr. Daniel Skovronsky, the chief scientific and medical officer at Lilly, has emphasised the significance of this breakthrough. He states, "This will be a very important and meaningful drug," as quoted in <em>Fierce Biotech</em>. Skovronsky further adds, "[T]here’s a huge opportunity here for patients." Such resolute optimism is inspiring, reflecting the tremendous potential this drug holds for transforming lives.</p> <p>Similar to Leqembi and Aduhelm, donanemab is a monoclonal antibody designed to target plaque in the brain, specifically the amyloid protein. These amyloid plaques are responsible for the propagation of another protein called tau, which contributes to the development of Alzheimer's disease.</p> <p>Notably, the donanemab trial also revealed that the drug slowed cognitive decline by an impressive 35% compared to a placebo in individuals with low to intermediate levels of tau protein in the brain. In fact, donanemab demonstrated superior efficacy in clearing amyloid plaques when compared to Aduhelm and Leqembi.</p> <p>Moreover, unlike Leqembi, which necessitates long-term usage, patients taking donanemab may follow a fixed-duration dosing schedule, potentially allowing some individuals to discontinue the treatment after a certain period. "I expect that many patients will be able to stop dosing even as soon as 12 months," Skovronsky affirmed. This stands as a significant departure from being prescribed a lifelong medication, providing an exciting and meaningful prospect for patients.</p> <p>While it is important to note that these new Alzheimer’s drugs do carry limitations and risks, medical experts remain cautiously optimistic. Donanemab, along with the other emerging drugs, has been associated with brain swelling and bleeding. Tragically, three individuals in the donanemab clinical trial lost their lives due to these side effects.</p> <p>The risk of brain swelling and bleeding is heightened among those carrying the APOE4 gene, which is associated with an increased susceptibility to Alzheimer’s. Furthermore, individuals with more advanced stages of the disease showed minimal to no benefit compared to those who received a placebo.</p> <p>As a result, it is possible that donanemab will be recommended primarily for individuals with low to intermediate levels of tau proteins, indicating milder forms of the disease.</p> <p>Nevertheless, Skovronsky and other medical experts maintain their optimism regarding the FDA's approval, expressing the urgent need for it to come to fruition. Skovronsky highlights, "Every day that goes by, there are some patients who pass through this early stage of Alzheimer’s disease and become more advanced, and they won’t benefit from treatment. That’s a very pressing sense of urgency."</p> <p>While challenges and risks remain, the emergence of donanemab and its potential approval by the FDA represents a beacon of hope for the millions of individuals and families affected by Alzheimer's disease. It symbolises the start of a new chapter in the fight against this debilitating condition, offering renewed prospects for a brighter future filled with effective treatments and improved quality of life.</p> <p><em>Image: Shutterstock</em></p> <p> </p>

Mind

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Fans fume as classic film undergoes censorship treatment

<p>Film fanatics are in outrage after discovering an unannounced edit in William Friedkin’s 1971 classic movie, The French Connection.</p> <p>The scene causing the trouble comes just 10 minutes into the drama, when two characters - Gene Hackman’s ‘Popeye’ Doyle and Roy Scheider’s Buddy ‘Cloudy’ Russo - are having a conversation, and one of them uses a racial slur. </p> <p>The sequence was removed, and the new edited version cuts to the latest in the conversation, omitting the part with the slur. </p> <p>Disney has been the subject of blame for the move - as the company took over Fox in 2019 and subsequently the rights to the film - with fans accusing them of censoring the scene in the United States, while in the United Kingdom and Canada, the unedited version of the film is still available for streaming on Disney+.</p> <p>Most took to social media to share their complaints, with the majority in agreement that Disney had missed the mark, and The Film Magazine’s Joseph Wade even calling it “corporate vandalism”.</p> <p>“In cases such as this, ‘Censor’ takes the place of ‘Vandalise’,” he tweeted. “They have vandalised a piece of art.”</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Disney Censor 'The French Connection' (1971)</p> <p>In cases such as this, "Censor" takes the place of "Vandalise".</p> <p>They have vandalised a piece of art. This is corporate vandalism no matter how said corporation spins the language. <a href="https://t.co/yxl1o2RsMU">pic.twitter.com/yxl1o2RsMU</a></p> <p>— Joseph Wade (@JoeTFM) <a href="https://twitter.com/JoeTFM/status/1666327940072722434?ref_src=twsrc%5Etfw">June 7, 2023</a></p></blockquote> <p>“At the risk of being like ‘nooo, my precious n-word,’ the uncensored FRENCH CONNECTION should be the only one in circulation, whether on TV or in theatres,” one user said. “I don't think it's a stretch to say that Friedkin knew exactly what having his detective protagonist use it said about him.”</p> <p>One user went on to share a clip of Hackman discussing the scene - and slur - in question, in which the actor claimed he “protested somewhat”, before sharing his belief that it was part of “who the guy is”. </p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Gene Hackman speaking in 2012 about the controversial line from French Connection. <a href="https://t.co/l45DBP9DvD">pic.twitter.com/l45DBP9DvD</a></p> <p>— oneilla (@oneilla828) <a href="https://twitter.com/oneilla828/status/1666439477403811840?ref_src=twsrc%5Etfw">June 7, 2023</a></p></blockquote> <p>“The censorship of The French Connection is shameful if true,” another agreed.</p> <p>“Thank God,” a frustrated - and sarcastic - fan added, “now I can finally show my 6 year old child The French Connection without any worries”.</p> <p>One Twitter user wrote of how “it speaks badly for film preservation that even a Best Picture winner isn't immune from the clutches of Disney”, and how they’d prefer to watch the film “the way it was intended to be watched, thank you very much.”</p> <p><em>Images: Twentieth Century Fox</em></p>

Movies

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Music and mental health: the parallels between Victorian asylum treatments and modern social prescribing

<p>Music has a powerful effect on the listener. It is linked to <a href="https://www.nature.com/articles/s41398-021-01483-8">better mental health</a>, and it has been shown to <a href="https://journals.sagepub.com/doi/abs/10.1177/0305735617703811?journalCode=poma">alleviate loneliness, pain, anxiety and depression</a>. </p> <p>For this reason, it is increasingly being prescribed by doctors as a form of medicine. This practice – where patients are referred to various activities such as running groups, art classes and choirs – is known as <a href="https://www.england.nhs.uk/personalisedcare/social-prescribing/">social prescribing</a>.</p> <p>Music-based activities may be prescribed to <a href="https://link.springer.com/article/10.1186/s13612-016-0048-0">help support</a> patients’ <a href="https://www.tandfonline.com/doi/abs/10.1080/08098131.2018.1432676">mental health</a>, <a href="https://link.springer.com/chapter/10.1007/978-3-319-76240-1_9">combat isolation</a>, encourage <a href="https://www.tandfonline.com/doi/full/10.1080/17482631.2020.1732526">physical activity</a>, and <a href="https://www.frontiersin.org/articles/10.3389/fnagi.2021.693791/full">keep an active brain</a>.</p> <p>While social prescribing is a relatively new practice, the use of music as a therapeutic tool is not. The first widespread use of music as a therapeutic tool can be traced back to the 19th century, where it was used in Victorian asylums to support patients’ treatment. </p> <h2>Music in asylums</h2> <p>Victorian asylums are usually associated with poor sanitation, overcrowding, <a href="https://www.tandfonline.com/doi/abs/10.1179/0308018813Z.00000000063">danger</a> and patients held against their will. Indeed, the Victorians had little understanding of mental illness and the brain, which meant <a href="https://journals.sagepub.com/doi/10.1177/030802269005301009">many treatments </a>considered barbaric today were used on patients – including bleeding, leeching, shaving the head and bathing in ice.</p> <p>From the end of the 18th century, however, practitioners moved away from the worst types of physical restraint. A new practice emerged, known as “<a href="https://www.sciencemuseum.org.uk/objects-and-stories/medicine/victorian-mental-asylum#:%7E:text=The%20Victorian%20mental%20asylum%20has,humane%20attitude%20towards%20mental%20healthcare.">moral management</a>”, which placed a focus on using employment, diet, surroundings and recreational activities as <a href="https://historicengland.org.uk/research/inclusive-heritage/disability-history/1832-1914/daily-life-in-the-asylum/">forms of therapy</a>.</p> <p>When state-run asylums were first introduced in Britain in the <a href="https://www.bloomsbury.com/uk/cure-comfort-and-safe-custody-9780718500948/">early 19th century</a>, music soon became included as a <a href="https://link.springer.com/book/10.1007/978-3-030-78525-3">form of moral management</a> to distract patients outside of working hours and keep them occupied. Both music and dance were efficient ways of entertaining large numbers of patients. </p> <p>By the middle of the 19th century, almost all the larger asylums in the UK had their own band and would often organise dances, attended by over a hundred patients. Asylums also hosted concerts by travelling performers, from comic sketches to solo singers and amateur choirs. Dances and concerts were usually the only opportunities for patients to meet in a large group, providing important social interaction.</p> <p>Among the <a href="https://www.cambridge.org/core/journals/royal-musical-association-research-chronicle/article/music-as-therapy-for-the-exceptionally-wealthy-at-the-nineteenthcentury-ticehurst-asylum/CBB82DA05DAB7A9D47636BCE2DF9DBB7">smaller asylums</a>, chiefly catering for wealthier patients, patients had more options to create music as part of their treatment. They would often bring instruments with them. And small concerts put on by patients and staff were common.</p> <h2>The benefits of music</h2> <p>Much of the therapeutic value of music was attached to its social function. Accounts suggest that patients benefited from the anticipation of these social engagements and that events were used to reward good behaviour. Music was also used to break up the monotony of asylum life.</p> <p>For example, <a href="https://link.springer.com/chapter/10.1007/978-3-030-78525-3_11">at one private asylum</a>, Dr Alfred Wood, wrote, "These entertainments involved a great amount of trouble in their preparation and arrangement and, I may add, considerable expense; but they are invaluable as a relief to the monotony of life in an Asylum. The pleasure they afford as well in anticipation as in reality, is ample to compensate for the efforts made to present them …"</p> <p>Dances, in particular, offered exercise and enjoyment, and even patients who were unable to dance enjoyed the music and watching fellow patients. </p> <p>Musical events also carried strict expectations of behaviour. Patients needed a good deal of self-control to participate and behave appropriately. It was this process of conforming to expectations that formed an important part of rehabilitation. William A.F. Browne, one of the most noteworthy asylum doctors of the era, wrote in 1841 about the <a href="https://wellcomecollection.org/works/dkxnvx35/items?canvas=91">self-control</a> needed before, during and after amusements. </p> <p>Others suggested that music would help <a href="https://wellcomecollection.org/works/vmmq4wv8/items?canvas=216">remind patients of happier days</a> and give them hope and pleasure during their treatment. Browne also cited the “powers of music to soothe, enliven, rouse, or melt”. He suggested that even difficult patients may benefit from music, <a href="https://wellcomecollection.org/works/far6jdph/items?canvas=26">writing</a>: “There is or may be a hidden life within him which may be reached by harmony.”</p> <p>The writer James Webster <a href="https://www.bmj.com/content/s1-5/114/197.2">recorded in 1842</a> that: “In many, the effect produced by the music upon their countenances and behaviour was often quite apparent.” Records include many stories of patients seemingly cured by music. </p> <p>Webster cites the example of a young girl, previously “morose” and “stupefied”, who under the influence of music, seemed “pleased” and “cheerful” – appearing “altogether a changed creature”. Browne also wrote in one of his books of the <a href="https://wellcomecollection.org/works/far6jdph/items?canvas=26">miraculous effect</a> music had on one patient who awoke, cured, the morning after listening to a performance of Scottish traditional melodies. </p> <h2>Music as treatment</h2> <p>In the 1890s, many doctors carried out experiments on the relationship between music and mental illness. Herbert Hayes Newington, medical superintendent of one of the era’s most prestigious asylums, used music to diagnose patients and <a href="https://www.cambridge.org/core/journals/journal-of-mental-science/article/abs/some-mental-aspects-of-music/A87C190163A86070D4445A830E656557">help develop theories</a> on how the brain works. Reverend Frederick Kill Harford, who campaigned to provide music in public hospitals during the early 1890s, believed music could <a href="https://www.bmj.com/content/2/1603/667">treat depression</a>, alleviate physical pain and help with sleep. </p> <p>Although music remained in asylums as a form of <a href="https://theconversation.com/what-life-was-like-in-mental-hospitals-in-the-early-20th-century-119949">therapy</a>, interest in it as a large-scale treatment waned as innovations such as <a href="https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp-rj.2020.160103">electroconvulsive therapy</a> emerged in the 20th century.</p> <p>For patients in Victorian asylums, therefore, music was an important part of mental health treatment – not only providing an opportunity for creative engagement but also fulfilling a range of social, emotional and intellectual needs. Given what we know now about the <a href="https://www.nature.com/articles/s41398-021-01483-8">benefit of music on mental health</a>, it’s no wonder doctors are making use of it again.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/music-and-mental-health-the-parallels-between-victorian-asylum-treatments-and-modern-social-prescribing-200576" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Music

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Could mobile phones revolutionise chronic wound treatment?

<p>Australian researchers are developing a contactless, thermal imaging system that uses artificial intelligence to help nurses determine the best way to treat leg ulcers without waiting to see if the wound is going to heal properly.</p> <p>It’s estimated that 450,000 thousand Australians currently live with a chronic wound.</p> <p>Being able to predict early on which wounds will become chronic could improve outcomes by enabling nurses to start specialised therapy as soon as possible. But current techniques rely on physically monitoring the wound area over several weeks.</p> <p>New research from RMIT in Melbourne paired thermal imaging with AI.</p> <p>The software was able to accurately identify unhealing ulcers 78% of the time, and healing ulcers 60% of the time, according to the new study <a href="https://www.nature.com/articles/s41598-022-20835-y" target="_blank" rel="noreferrer noopener">published</a> in <em>Scientific Reports</em>.</p> <p>“Our new work that identifies chronic leg wounds during the first visit is a world-first achievement,” says lead researcher Professor Dinesh Kumar, from RMIT’s School of Engineering.</p> <p>“This means specialised treatment for slow-healing leg ulcers can begin up to four weeks earlier than the current gold standard.”</p> <p><strong>How do you normally assess wound healing?</strong></p> <p>The work builds on <a href="https://www.nature.com/articles/s41598-021-92828-2.epdf?sharing_token=7SIEmbOksKOou2TGQ5qPWdRgN0jAjWel9jnR3ZoTv0NntGTf8gfSMhoDjLAz58SefUeGL0aP2A-0mDVnZaiZTcBjNNpA4cvP9FgK6-aoPzyk4oQ0OSbPh83HNS_AwGDQVMg43K4WmG60QDoQohtsdkaRv70YSxfPg4Dn0qa_CUs%3D" target="_blank" rel="noreferrer noopener">previous research</a> by the same team, which found that this method could be used to predict wound healing by week 3 after initial assessment. But they wanted to know whether healing could be predicted from the first wound assessment only, reducing any delay in treatment.</p> <p>If a wound is healing normally it’s area would reduce by 50% within four weeks, but more than 20% of ulcers don’t heal in this expected trajectory and may need specialist interventions.</p> <p>Venous leg ulcers (VLUs) are the <a href="https://treasury.gov.au/sites/default/files/2022-03/258735_wounds_australia.pdf" target="_blank" rel="noreferrer noopener">most common</a> chronic wound seen in Australia and currently, the gold standard for predicting their healing– conventional digital planimetry – requires physical contact. Regular wound photography is also less accurate because there can be variations between images due to lighting, image quality, and differences in camera angle.</p> <p>But a non-contact method like thermal imaging could overcome this.</p> <p>The thermal profile of wounds changes over the healing trajectory, with higher temperatures signalling potential inflammation or infection and lower temperatures indicating a slower healing rate due to decreased oxygen in the region. So, taking thermal images of wounds can provide important information for predicting how they will heal.</p> <p><strong>What did they do?</strong></p> <p>The study collected VLU data from 56 older participants collected over 12 weeks, including thermal images of their wounds at initial assessment and information on their status at the 12<sup>th</sup> week follow-up.</p> <p>“Our innovation is not sensitive to changes in ambient temperature and light, so it is effective for nurses to use during their regular visits to people’s homes,” says co-author Dr Quoc Cuong Ngo, from RMIT’s School of Engineering.</p> <p>“It is also effective in tropical environments, not just here in Melbourne.”</p> <p>“Clinical care is provided in many different locations, including specialist clinics, general practices and in people’s homes,” says co-author Dr Rajna Ogrin, a Senior Research Fellow at Bolton Clarke Research Institute.</p> <p>“This method provides a quick, objective, non-invasive way to determine the wound-healing potential of chronic leg wounds that can be used by healthcare providers, irrespective of the setting.”</p> <p><strong><strong>So, what’s next?</strong></strong></p> <p>There are a few limitations to this study. First, the number of healed wounds in the dataset was relatively small compared to unhealed wounds, and the study only investigated older people.</p> <p>The authors recommend that “future research should focus on improving the predictive accuracy and customising this method to incorporate this assessment into clinical practice on a wider pool of participants and in a variety of settings.”</p> <p>Kumar says that they are hoping to adapt the method for use with mobile phones.</p> <p>“With the funding we have received from the Medical Research Future Fund, we are now working towards that,” he says. “We are keen to work with prospective partners with different expertise to help us achieve this goal within the next few years.”</p> <p><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --></p> <p><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=222978&amp;title=Could+mobile+phones+revolutionise+chronic+wound+treatment%3F" width="1" height="1" /></p> <p><!-- End of tracking content syndication --></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/health/revolutionise-chronic-wounds-treatment/" target="_blank" rel="noopener">This article</a> was originally published on Cosmos Magazine and was written by Imma Perfetto.</em></p> <p><em>Image: RMIT University</em></p> </div>

Technology

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Disabled woman slams Jetstar for “extremely humiliating” treatment

<p dir="ltr">A woman has said she was humiliated at the end of her flight after Jetstar staff couldn’t provide her with a wheelchair for her, forcing her to leave the plane by crawling.</p> <p dir="ltr">Natalie Curtis has been in a wheelchair since high school but said she has never been as humiliated as she was left to crawl to her wheelchair after flying from Singapore to Bangkok.</p> <p dir="ltr">While she was provided a standard “aisle” wheelchair to board the plane, Ms Curtis was told she would have to pay to use another chair to get off the plane - a service which is usually free.</p> <p dir="ltr">“I didn’t really comprehend it and I was like, ‘No, I’m not paying to be able to get off this plane’,” Ms Curtis told <em>Sunrise</em>.</p> <p dir="ltr">With her friend Natasha Elford unable to carry her due to a knee injury, Ms Curtis crawled on the floor past eight rows until she could reach her chair.</p> <p dir="ltr">“It was extremely humiliating,” she said.</p> <p dir="ltr">Ms Elford said she was in shock while watching the ordeal and that she was “absolutely gutted”.</p> <p dir="ltr">“I was like, ‘Is this actually happening?’” she told the program on Monday.</p> <p dir="ltr">“I couldn’t physically lift her so I felt really hopeless and I couldn’t believe this was really happening.”</p> <p><span id="docs-internal-guid-5074d5cf-7fff-8dbb-d33e-bba54635ce43"></span></p> <p dir="ltr">She added that she tried to find out if a wheelchair could be fast tracked to Ms Curtis, but said the flight attendants “didn’t really try to do anything”.</p> <p dir="ltr"><iframe style="border: none; overflow: hidden;" src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2Fnatalie.hodges.50%2Fposts%2Fpfbid0ewJHd3156WaV46vd8LHJWCwLrxBQraSgSfAP1dZqcfPc47oo4WkNmCj7VWjda6Rl&amp;show_text=true&amp;width=500" width="500" height="393" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></p> <p dir="ltr">A spokesperson for the budget airline said Jetstar had sincerely apologised to Ms Curtis and had offered her a refund and additional compensation.</p> <p dir="ltr">“We unreservedly apologise to Ms Curtis for her recent experience while travelling with us,” they said.</p> <p dir="ltr">“We are committed to providing a safe and comfortable travel experience for all our customers, including those requiring specific assistance.”</p> <p dir="ltr">The spokesperson added that Jetstar staff don’t charge for using a wheelchair, and that an inquiry into the incident had found a language barrier led to the miscommunication of a fee.</p> <p dir="ltr">“At no point was an aisle chair withheld due to a request for payment,” they said.</p> <p dir="ltr">Ms Curtis isn’t the only person to have experienced such an incident over wheelchair use, and her experience comes as disability advocates call for a complete overhaul of the treatment of passengers by airlines.</p> <p dir="ltr">In August, Brad Wszola had to be carried by his wife and a staff member over the gap between the air bridge and the Jetstar plane he was trying to board to fly from Darwin to Cairns, per <em><a href="https://www.theguardian.com/society/2022/oct/06/second-class-citizen-man-lifted-on-to-plane-as-darwin-airport-had-no-ramp-for-wheelchair-users" target="_blank" rel="noopener">The Guardian</a></em>.</p> <p dir="ltr">“Watching these people having to lift me, to bend down, Jen had to bend down below the level of the floor of the plane, bend over and grab the bottom of the aisle chair to lift me … That put myself at risk, also the staff at risk and Jenny at risk,” Mr Wszola said. </p> <p dir="ltr">“She was the one helping lift me into the plane.”</p> <p dir="ltr">Mr Wszola even encountered issues prior to leaving Darwin, with his wheelchair being sent to the baggage carousel rather than the air bridge on his arrival.</p> <p dir="ltr"><span id="docs-internal-guid-959917b9-7fff-c8f5-f194-0fd6a3ef5a8c"></span></p> <p dir="ltr">After his wife made multiple requests via email to Darwin airport and Jetstar, she was told a ramp wasn’t provided to bridge the gap as it was a low-cost airline - but a ramp has since been provided to the airport after <em>The Guardian</em> contacted Jetstar.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Just made a cute little video about how <a href="https://twitter.com/Qantas?ref_src=twsrc%5Etfw">@Qantas</a> broke my wheelchair and won’t fix it 🙃🙃🙃🙃 <a href="https://t.co/CnFXazJ1ox">pic.twitter.com/CnFXazJ1ox</a></p> <p>— Zoe Simmons | she/her (@ItbeginswithZ) <a href="https://twitter.com/ItbeginswithZ/status/1577502974796247041?ref_src=twsrc%5Etfw">October 5, 2022</a></p></blockquote> <p dir="ltr">Earlier this month, Qantas reversed its decision not to refund Zoe Simmons, whose wheelchair was damaged on a flight from Sydney to Canberaa, after she took her complaints to social media.</p> <p dir="ltr">In a column for <em><a href="https://www.news.com.au/travel/travel-advice/flights/disability-advocate-lashes-qantas-over-broken-wheelchair/news-story/72ae759ca7960ab607610c5ebd6c8bca" target="_blank" rel="noopener">news.com.au</a></em>, Simmons explained that damage to her chair brakes had left it “unusable” and was initially told Qantas wouldn’t reimburse her or repair her chair, which she needs as someone living with the nerve disorder fibromyalgia.</p> <p dir="ltr">“I am so angry that this is how wheelchair users are treated by airlines, over and over. And it’s not just Qantas: it’s a systemic issue, because the system is so very broken,” she wrote.</p> <p dir="ltr">With the airline reaching out to apologise and offering to pay for her wheelchair repairs, Simmons questioned whether she would have received such a response if she hadn’t taken matters into her own hands.</p> <p dir="ltr">“I wonder: would this resolution have occurred, had I not made a fuss about it?” she wrote.</p> <p dir="ltr">“I shouldn’t have to hope to be an exception to the norm. The norm should be that disabled people are looked after, treated well, and able to get the same resolution I’ve been able to get here.”</p> <p dir="ltr"><span id="docs-internal-guid-650b6358-7fff-1acf-83b2-095ff2b36a84"></span></p> <p dir="ltr"><em>Image: Sunrise</em></p>

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"She's been amazing": The friendship helping Johnny Ruffo through cancer treatment

<p dir="ltr">Johnny Ruffo said he owes everything to his girlfriend Tahnee Sims for constantly being by his side as he battles through his terminal brain cancer. </p> <p dir="ltr">But behind-the-scenes is one more person that the former <em>Home and Away</em> star has to thank for her support.</p> <p dir="ltr">Lynne McGranger, who plays Irene Roberts, has also been a rock in Johnny’s life as he pushes through his chemotherapy. </p> <p dir="ltr">"She's been amazing," the former <em>X-Factor</em> star told TV Week.</p> <p dir="ltr">"She constantly checks in and asks how I'm doing. She always wants to go out for dinner.</p> <p dir="ltr">"I can't stress enough how people like her help get through tough times. She's just a wonderful person. Having people like that to say 'Oh, how are you feeling this week?' and little sweet things like that make all the difference. It's a great support network."</p> <p dir="ltr">When it comes to Tahnee, Johnny admits that he wouldn’t have been able to go through his diagnosis without her. </p> <p dir="ltr">"Having Tahnee by my side every step of the way, literally and metaphorically, she's incredible. I couldn't do it without her,” he previously said.</p> <p dir="ltr">"She does it just as hard as I do. She's having to deal with all the doctors and what they're saying, and then she has to deal with me once we get home as well.”</p> <p dir="ltr">The singer is going through chemotherapy once every three weeks and said he wanted to give gave as the holiday season creeps up. </p> <p dir="ltr">Ruffo partnered with Amazon Australia to help twelve superhero children from the Starlight Children’s Foundation to become official toy testers for the festive season.</p> <p dir="ltr">"It brings such joy to me. It's a privilege to be able to know that you are helping them forget about everything that they're going through," he said in the Starlight Children's Foundation campaign.</p> <p dir="ltr">"I feel like I get as much out of it as the kids. It's quite cathartic for me to be able to bring joy to these children who are somewhat in a similar position."</p> <p dir="ltr">The 34-year-old was first diagnosed with brain cancer in 2017 after struggling with multiple headaches.</p> <p dir="ltr">Ruffo then announced in 2019 that he was in remission, but by November 2020 the cancer had returned, before confirming in 2022 that his illness is terminal.</p> <p dir="ltr">He has also recently released a memoir called No Finish Line, dedicated to his girlfriend, in which he details his experiences recording music, acting, his family and loved ones.</p> <p dir="ltr">The title, he explains, is that “it wasn’t the end”.</p> <p dir="ltr"><em>Images: Instagram</em></p>

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"It's a miracle": Aussie hospital rolls out cancer treatment

<p dir="ltr">Two years ago, Tony Jiang was told he had advanced, terminal lung cancer. Today, he is fighting fit thanks to a new treatment requiring the pop of just one pill per day.</p> <p dir="ltr">"It's a miracle. Sometimes I don't feel like I'm a patient," Jiang said.</p> <p dir="ltr">He reports that this a dramatic turnaround from the day he was diagnosed. Prior to diagnosis he suffered two months of a persistent cough which eventually landed him in hospital.</p> <p dir="ltr">"They didn't think about cancer because of my age, I never smoked, I had a pretty much healthy lifestyle."</p> <p dir="ltr">Doctor Vanessa Chin at St Vincent's Hospital Medical Oncologist said Jiang's right lung was filled with fluid.</p> <p dir="ltr">"By the time I'd met him he already had a tube inserted into that lung to drain off the fluid and a biopsy had been performed," Chin said.</p> <p dir="ltr">A tissue biopsy of Jiang's lung was sent off for genetic sequencing. Alterations in his cancer cells meant that he was eligible for a subsidised treatment, and no longer needed chemotherapy or radiation.</p> <p dir="ltr">"Just taking a tablet, one tablet every day and I'm just back to my normal life," Jiang said.</p> <p dir="ltr">Jiang's doctor Chin said the tumours on his scans virtually disappeared and that he experienced very few side effects.</p> <p dir="ltr">"When we do scans it's actually hard to tell that he has anything wrong," she said.</p> <p dir="ltr">New technology now allows pathologists at Sydney's St Vincent's Hospital to test hundreds of genes in one go – a task that just two years ago was impossible.</p> <p dir="ltr">Anatomical pathologist Dr Tao Yang from St Vincent's Hospital said the technology used can load 24 patient samples at once and deliver results overnight.</p> <p dir="ltr"><em>Image: Nine News</em></p>

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A new treatment could help tackle this common, embarrassing problem

<p id="docs-internal-guid-83339339-7fff-abbf-daac-7a8379011434" dir="ltr">Our bathroom habits aren’t usually the kind of topic we like to discuss, but its taboo nature could be stopping us from reaching out for help with an incredibly common problem: incontinence.</p> <p dir="ltr">With <a href="https://www.continence.org.au/about-us/our-work/key-statistics-incontinence" target="_blank" rel="noopener">one in four Australians</a> affected by incontinence - including an estimated 1.17 million over the age of 65 as of 2010 - it’s a topic that, though embarrassing, is important to talk about and seek treatment for.</p> <p dir="ltr">For women alone, leading GP obstetrician Dr Elizabeth Golez says 70 percent of women with urinary leakage don’t seek advice, with embarrassment and perceptions of its taboo nature acting as roadblocks.</p> <p dir="ltr">“Those who have sought help have only had limited options, such as invasive surgery and painful laser but this is changing,” Dr Golez says.</p> <p dir="ltr">EmpowerRF, a new kind of treatment which uses radiofrequency technology, is promising to improve the lives of Australian women who suffer from a range of pelvic health disorders, including bladder dysfunction, genitourinary syndrome of menopause, sexual dysfunction, and pelvic aesthetic indications.</p> <p dir="ltr">“EmpowerRF platform, popular in America, Israel and the UK, is designed to provide three complementary energies:  submucosal fractional radiofrequency (Fractional RF micro-needling), intravaginal electrical muscle stimulation (EMS) and bipolar radiofrequency to re-educate and rehabilitate weak pelvic floor muscles for the treatment of stress, urge, and mixed urinary incontinence (SUI) in women,” Dr Golez explains.</p> <p dir="ltr">“The Empower RF platform is equipped with applicators Morpheus 8V, Vtone, and FormaV to treat bladder control, strengthen pelvic floor muscles and return collagen liquidity back into vaginal walls with additional modalities in Morpheus Body, Tone and Aviva.”</p> <p dir="ltr">Using separate attachments, the Empower RF platform can also be used to tighten skin on the face and body and has been the secret weapon for many celebrities’ youthful looks.</p> <p dir="ltr">“There are so many women suffering in silence but they no longer need to, EmpowerRF restores patient self-confidence and quality of life without surgery or prolonged downtime,” Dennis Cronje, the Managing Director of InMode Australia which provides the EmpowerRF Technology, says. </p> <p dir="ltr">“Radio frequency (RF) treatments use electrical energy to generate heat and trigger skin tightening and the heat can be controlled ensuring no risk of burning.”</p> <p dir="ltr"><em>Image: Getty Images</em></p>

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Famous ‘Napalm Girl’ receives final burns treatment

<p dir="ltr">The woman known around the globe as “Napalm Girl” has received her final round of treatment for the burns she received as a child when her village in Vietnam was hit by a napalm bomb.</p> <p dir="ltr">Kim Phuc was just nine years old when South Vietnamese planes dropped the bomb on the village of Trảng Bàng in 1972 and she was photographed running naked from her home, covered in third-degree burns after her clothes caught on fire.</p> <p dir="ltr">The iconic photo, taken by Vietnamese-American photographer Nick Ut before he rushed Ms Phuc to a hospital, won a Pulitzer Prize and became a symbol of the awful consequences of war.</p> <p dir="ltr">Ms Phuc, who has since become a Canadian citizen, has lived with the pain and scars from the attack ever since.</p> <p><span id="docs-internal-guid-592e9620-7fff-cb30-c831-53f262c58d99"></span></p> <p dir="ltr">On Tuesday, she underwent a 12-hour medical procedure in Miami, with local media reporting it was the final course of laser therapy for her scars.</p> <p dir="ltr"><img src="https://oversixtydev.blob.core.windows.net/media/2022/07/kim-phuc1.jpg" alt="" width="1280" height="720" /></p> <p dir="ltr"><em>Kim Phuc underwent the last of her laser therapy treatments for the burns across her body, 50 years after she received them. Image: Getty Images</em></p> <p dir="ltr">Now 59, Ms Phuc also reunited with Mr Ut and recalled the distressing moment when they first met.</p> <p dir="ltr">“I heard the noise, bup-bup bup-bup, and then suddenly there was fire everywhere around me and I saw the fire all over my arm,” Ms Phuc said of the moment the bomb landed, per NBC 6 South Florida.</p> <p dir="ltr">“[Ut] told me after he took my pic that he saw me burned so severely, he put down his camera and he rushed me to [the] nearest hospital.”</p> <p dir="ltr">Mr Ut also recalled how terribly injured Ms Phuc was.</p> <p dir="ltr">“I saw her burning, her body burning so badly,” he said.</p> <p dir="ltr">But when he took her to a local hospital, staff initially refused to treat her and told him to take her to another hospital two hours away.</p> <p dir="ltr">“I get upset, I hold my media pass, I say, ‘I’m media, if she dies, my picture’s on the front page of every newspaper tomorrow’ … they took her right away inside,” he said.</p> <p dir="ltr">During her decades-long recovery, Dr Jill Waibel has been helping her, using laser therapy to heal and remove scar tissue.</p> <p dir="ltr"><span id="docs-internal-guid-f7f833b3-7fff-f32a-9f73-40919640df43"></span></p> <p dir="ltr">“It used to be that everyone with an injury like Kim’s would pass away and so we are blessed now that we can keep people alive but we really have to help them thrive and live,” Dr Waibel said.</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/CfR-zFYPGjV/?utm_source=ig_embed&amp;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/CfR-zFYPGjV/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Nick Ut (@utnicky)</a></p> </div> </blockquote> <p dir="ltr">Ms Phuc now lives in Toronto and is the founder of the Kim Foundation International, which provides aid to child victims of war.</p> <p dir="ltr">On the 50th anniversary of the attack, Ms Phuc penned an essay for <em><a href="https://www.nytimes.com/2022/06/06/opinion/kim-phuc-vietnam-napalm-girl-photograph.html" target="_blank" rel="noopener">The New York Times</a></em>, revealing she hated the photo for a long time as she struggled to heal amid the photo’s growing popularity.</p> <p dir="ltr">“You don’t grow out of the scars, physically or mentally,” she wrote. “I am grateful now for the power of that photograph of me as a 9-year-old, as I am of the journey I have taken as a person.</p> <p dir="ltr">“I’m proud that, in time, I have become a symbol of peace. It took me a long time to embrace that as a person. I can say, 50 years later, that I’m glad Nick captured that moment, even with all the difficulties that image created for me.</p> <p dir="ltr">“That picture will always serve as a reminder of the unspeakable evil of which humanity is capable. Still, I believe that peace, love, hope and forgiveness will always be more powerful than any kind of weapon.”</p> <p dir="ltr"><span id="docs-internal-guid-800ccc89-7fff-32a8-334c-fe72a34f8c93"></span></p> <p dir="ltr"><em>Image: Nick Ut / Canapress</em></p>

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