Archive for October, 2020

Editor's Note: We at POPSUGAR recognize that people of many genders and identities have vaginas and uteruses, not just those who are women. For this particular story, we interviewed experts who generally referred to people with vaginas and uteruses as women.

When I was first introduced to the world of intrauterine devices (IUDs), I had decided that I no longer wanted to take birth-control pills and had began looking for alternative birth-control methods that were not susceptible to human error. In my search, I came across the copper IUD called ParaGard: a hormone-free birth-control option that would be implanted in my uterus and stay there for many years, reliably blocking the fertilization of eggs without any further work on my end.

After a few years of having the ParaGard, however, I noticed that my menstrual flow changed to a heavier period with more painful cramps, and although I loved this form of birth control for its efficiency I personally needed to try another option. After talking to my gynecologist, it was decided that the best option for me would be a hormonal IUD (in my case, the Mirena). I had initially avoided the hormonal IUD, thinking that the hormones would change my body in the same the way my birth control pills did. But, due to my family's medical history and my lifelong experience with heavy periods, my doctor highly suggested that I make the switch. So, I did. After doing so, my body experienced much milder side effects than it did with the copper IUD, which solidified the fact that I had finally found the right birth control option for me.

But, it made me wonder what makes these two palm-sized "T" devices different from one another. In my experience, the side effects of each one differ significantly. So, how do we know which one is the right one for us, if at all? I talked to two gynecologists about the copper and hormonal IUDs to uncover more about how and why exactly they differ, and the many similarities they share as well.

According to the experts that spoke to POPSUGAR, the ParaGard (copper IUD) and the Mirena (hormonal IUD) are both intrauterine contraceptive devices that differ mainly in their contraceptive agents. The "ParaGard is a nonhormonal, long-acting reversible contraception (LARC), and the Mirena is a hormonal LARC," said board-Certified OBGYN Dr. Kameelah Phillips, MD IBCLC. According to Planned Parenthood, LARCs (a family of contraceptives that also includes the hormonal contraceptive implant) prevent unwanted pregnancy up to 20 times more effectively than birth control pills, patches, and vaginal rings. "LARCs are the most effective forms of reversible contraception," adds board-certified OBGYN Dr. Kiarra King, MD FACOG.

While the ParaGard's contraceptive agent is the thin copper coil wrapped around the device, the Mirena prevents pregnancy by emitting a small amount of the hormone progestin (similar to the body's naturally occuring hormone, progesterone) slowly overtime. According to Dr. Phillips, "both LARCs offer contraception for several years. The ParaGard for up to 10 years, and the Mirena for up to five years."

"The mechanism used for inserting the devices is slightly different for the physician simply due to the design of each product," explained Dr. King. Although the design of the insertion tool differs slightly, Dr. King assured us that "the patient wouldn't notice any difference."

"Both IUDS are 99 percent effective in preventing unplanned pregnancy," said Dr. Phillips. Our experts shared that both devices have a failure (or unintended pregnancy) rate of less than 1 percent, but differ slightly within that threshold. "The copper IUD's [failure rate] is around 0.8 percent, while the hormonal IUD is around 0.2 percent," explained Dr. King, making the hormonal IUD slightly more effective.

Dr. Phillips said that the ParaGard "is the longest-acting reversible contraception," which makes this particular device a good option for those who want to prevent pregnancy without having to replace the IUD after a few years. Planned Parenthood states that the copper IUD works by making it nearly impossible for the sperm to reach an egg because "sperm doesn't like copper." Dr. Phillips explained that "there is no hormone [in the ParaGard] to alter periods or ovulation," which means that "it can be used by almost anyone, regardless of medical conditions except of course if you have an allergy to copper."

"Outside of the contraceptive benefit," added Dr. King, "the copper IUD is good for 10 years, so there is less need for removal and reinsertion. It also has no hormones, which makes it a great option for women who can't use a hormonal method." Interestingly, a copper IUD can also be used as emergency contraception (in place of the morning-after pill) and is more than 99.9 percent effective if it's put in within 120 hours (five days) of having unprotected sex. Of course, there are other factors to consider when having an IUD inserted, as outlined in this article.

Both experts agree that the primary con of the ParaGard is the potential for it to change one's menstrual flow. "Some women will notice that their periods are heavier and more painful with the copper IUD," shared Dr. King. "This may not happen to everyone," added Dr. Phillips, "but it is important to know that it is possible. Also, sometimes the period can become a little crampy, so it is important to be open to taking pain medication as needed."

Like the ParaGard, the Mirena's primary benefit is its effectiveness in preventing pregnancy, according to our experts. In addition to its long-acting contraceptive benefits, "the levonorgestrel IUD is associated with less painful periods, decreased menstrual flow and, for some women, amenorrhea, which is the complete cessation of menstrual periods," explained Dr. King.

For some, this easing of periods may just be a handy side effect, but for others, it can feel life changing. "The hormonal component of the Mirena can offer women with heavy or painful periods some meaningful relief," said Dr. Phillips. Along with lighter or no periods, "women can notice painful periods and pelvic pain also improve."

At this point, the Mirena probably sounds like the dream contraceptive but, like anything else, there are potental side effects. "The downsides can include occasional spotting and benign cysts on the ovaries," shared Dr. Phillips. Negative side effects may also include "irregular bleeding in the first several weeks to months after insertion, mood changes, breast tenderness, headaches, or skin changes such as acne," added Dr. King.

In addition to the potential side effects for each listed above, Dr. Phillips shared that "all IUDs carry the risk of making a small hole in the uterus and/or getting stuck in the uterus. The risk is very small," Dr. Phillips assured us, but nonetheless, it is important information to know when deciding which birth control option is best for you.

According to Dr. King, "it is very common for women to notice changes in menstrual patterns and flow after an IUD insertion." She added that "generally, with a hormonal device, bleeding may be irregular initially after insertion, but will often become lighter as time goes on, simply due to the effect of the hormone on the uterine lining." On the other hand, since periods can become heavier with the ParaGard, "it is important to monitor your periods if they become heavier with ParaGard," explained Dr. Phillips, as "heavier periods over time can cause anemia."

According to our experts, the main reason why the ParaGard and Mirena differ in duration of effectiveness is because of their contraceptive ingredients. "The Mirena has the hormone essentially infused into the device which is released daily, but will eventually run out," said Dr. King, explaining this is why it's FDA-approved for a maximum of five years after its insertion. The action of the ParaGard's copper coil, on the other hand, "lasts longer than the slow release progesterone that is present in the Mirena," according to Dr. Phillips.

"There is no problem with switching between ParaGard and Mirena," Dr. Phillips said. "Either can be used at different times in your reproductive lifespan." Dr. King seconded this, adding that "it is all dependent on what is best for a woman at a particular point in her life. Some women get their IUD removed and another one reinserted on the same day."

Dr. Phillips said it is first important to "explain to your doctor that you are looking for a long-acting, reversible contraception. From here, they can lead you through the pros and cons of each to see which option may fit you best." During this discussion with your doctor, you should "talk openly and candidly about your goals, health history, and desire for future pregnancy," advised Dr. King.

As far as deciding which option is best for you, "it is important to know all of your contraceptive options to make sure a long-acting reversible option is right for you," said Dr. Phillips. "The next decision point is if you desire a nonhormonal or hormonal option." It's impossible to say which option is best without first knowing your specific medical history. "If you have a history of heavy periods, a levonorgestrel-based IUD system may be ideal for you," said Dr. King. "If you have contraindications to hormonal devices, a copper device may be a better option. Each woman will have reasons as to why a device is best for her, and that's OK."

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My Body Reacted Differently to the Copper vs. the Hormonal IUD, So I Asked 2 Doctors Why - POPSUGAR

Over the past decade, breast surgeon Deanna Attai, MD, has built a reputation as a physician whos active in online patient groups. So its not surprising that she got her idea for her latest study from Twitter. She frequently observed patients with breast cancer posting about their frustrations talking to their oncologists about the downside of taking endocrine therapy. I saw multiple comments along the lines of My oncologist is great, but when it comes to endocrine therapy, every time I try to talk about side effects, the conversation just stops, said Dr Attai, who is assistant clinical professor in the department of surgery at UCLA Health at the David Geffen School of Medicine.

Or patients complained that their doctors had advised them to simply accept common symptoms of weight gain, joint pain, loss of libido, vaginal dryness, or impotence because there werent treatment alternatives. It struck me that this was a topic I hadnt seen written about in this way that addressed this frustration among patients, she said.

So Dr Attai and her team tapped 9 patients who were active in breast cancer social media communities to create a survey for hormone receptorpositive patients about their experiences with endocrine therapy and communication with their health care providers. Whos better qualified to design the questions than the people who are living with the side effects? she said, adding that conventional quality-of-life studies usually dont measure whats meaningful to patients.

Researchers received responses to the anonymous online survey from 2353 women and 54 men. The results, which were published in August 2020 in the Journal of Cancer Survivorship, found that 91% experienced side effects, which prompted about one-third of patients to discontinue therapy. Nearly one-third of respondents reported that they felt their concerns were dismissed or minimized in discussions with their cancer care team. I was surprised that 30 percent felt they were brushed off, said Dr Attai. I thought it would be lower.

This study is important because it gives voice to our experiences, says breast cancer survivor and patient advocacy leader Sue Friedman. Most clinicians are trained to tell patients whats in their best interest and arent always listening to patients concerns, said Friedman, who is executive director of the national nonprofit organization Facing Our Risk of Cancer Empowered (FORCE), which is based in Tampa, Florida. Yet for patients, these side effects can be a big deal. Hormone therapy affects your libido, energy levels, and weight. These are things that are essential to your very well-being, she said, adding that the results send a critical message to drug researchers about the need for new therapies.

Friedman said she hopes the research will prompt oncologists to dedicate more time to discussing side effects with patients as well as take the initiative to broach the topic. Some patients might not feel comfortable bringing us these conversations, especially related to sexual concerns, she said.

Dr Attai added that such empathy could ultimately improve patients drug compliance. I want physicians to understand that our patients might be struggling with these medicines more than they let on, and theyre also struggling with worry about recurrence if they stop early, she said. More than half of respondents suggested that doctors set aside extra time during office visits or perhaps a separate visit via telehealth to educate patients about expected side effects and discuss strategies to manage them. (In the survey, 40% reported that diet and exercise were helpful.) This survey helps us appreciate what a challenging position our patients are in, Dr Attai said.

Reference

Berkowitz MJ, Thompson CK, Zibecchi LT, et al. How patients experience endocrine therapy for breast cancer: an online survey of side effects, adherence, and medical team support. J Cancer Surviv. Published online August 17, 2020. doi:10.1007/s11764-020-00908-5

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How Breast Cancer Patients Really Feel About Endocrine Therapy - Cancer Therapy Advisor

Provided by Prince William County

Christine Doering is an Inova contractor working as an employee wellness coordinator for the Prince William County Office of Risk & Wellness Services, Breast cancer is the second leading cause of death among women in the United States with 250,000 new cases diagnosed every year. Additionally, 2,300 men are diagnosed annually with breast cancer.*

October is Breast Cancer Awareness Month, and the emphasis this year is prevention. For this month what were highlighting is the fact that prevention is getting in and getting your annual mammogram and thats the best prevention, says Doering.**

There are a few additional practices that can help women prevent breast cancer. Doering said, The best ways to avoid getting breast cancer for women are to get regular exercise and keep a healthy weight. Limit your alcohol. Talk to your physician. They might recommend taking hormone replacement as you get into your 50s. You might want to talk about family history before you start taking that. Breastfeed your children if you can. That helps limit the chance of getting breast cancer as you get older.*

In past years, Sentara Health Care sent out mobile testing sites to screen women for breast cancer; however, the mobile testing sites have been preempted this year. According to Doering, With Sentara helping out with the COVID-19 pandemic, Sentara wont be setting up mobile testing sites So were just promoting through Inovas Breast Cancer Center in Fairfax.

Appointments can be madeonline.

Sources:* CDC, Mayo Clinic** CDC, National Breast Cancer Organization

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October is Breast Cancer Awareness Month - Prince William Living

Laurie Wang, Staff Illustrator

For remote Yale students, dealing with sleep disruptions due to time zone differences can be a learning challenge.

Meir Kryger, a Yale sleep expert and Yale School of Medicine physician, and Suman Baddam, Assistant Professor of Clinical Child Psychiatry, co-instruct the course The Mystery of Sleep, which explores the relationship between sleep and well-being. Disruptions to sleep schedules can negatively impact attention, memory and cognitive awareness. Kryger said that there are a number of students in his class who study remotely and must battle time differences.

When my class starts, which is 4 oclock in the afternoon, in Taiwan its like 4 oclock in the morning, Kryger said. And the student is actually there wide awake and alert, participating in the class They seem to be asking questions when its appropriate. Even though the schedule is crazy.

Alongside the ways that inconsistent sleep schedules can harm students well-being, Baddam also said blue light can impact circadian rhythms, which raises another concern for Yalies taking virtual classes at late hours. He cited a study that showed that the light from a Kindle is enough to disrupt ones sleep patterns in the evenings.

According to Healthline, circadian rhythms are changes in physical and behavioral patterns that follow a 24-hour cycle. These include the release of hormone melatonin, which makes people sleepy.

Remote students Mehmed Can Olgac 22 and Sena Sugiono 24 are located in Turkey and Indonesia, respectively. Because of the large time difference, Olgac and Sugiono must go to extreme measures to adjust.

I have one class that ends at 1 a.m. in the morning on Mondays, so like by the end of that class Im very exhausted, Olgac said. I dont usually remember the second half of the class.

Not only has Olgac faced difficulty staying awake for classes, he said his home responsibilities also make it more challenging to keep up with schoolwork and remember the commitments he has made. Yet despite the downsides of studying remotely, Sugiono said in an interview with the News that there are also some benefits. Since his schedule is reversed, he can work with no distractions.

Now, Im actually enjoying it because I get to concentrate on my studies in a very quiet and tranquil situation, Sugiono wrote in a text message to the News. Just [because] no one is up [from] 2-4 a.m.

He told the News that he sleeps from 2 p.m. to 8 p.m. local time, while juggling extracurriculars in addition to classes.

As a piece of advice to undergraduates abroad studying remotely, Baddam suggested creating a consistent schedule for oneself to avoid sporadic sleep disturbances.

They should basically have their sleep time for their biological day as a shift worker and just stay up all night for the whole week, he told the News, adding that while its still bad, it is less harmful than constantly changing ones sleep schedule.

He also noted that regularly getting seven to nine hours of sleep a night is something that any undergraduate can do to enhance their learning, even if they think they are doing fine, as its hard to recognize how tired we are.

Kyrger and Baddam teach their Cognitive Science course on Tuesday and Thursday afternoons.

Anna Xu | anna.xu@yale.edu

Simisola Fagbemi | simi.fagbemi@yale.edu

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The schedule is crazy: Sleep science and the impact of online classes - Yale Daily News

By CAPITAL NEWS SERVICE

LANSING Fresh from what was conceivably the most important exam of his life, aspiring physician Sevar Yaldo sat on a Bailey Park bench for some fresh air in East Lansing.

Having spent the majority of the pandemic indoors preparing for the Medical College Admission Test, Yaldo understands and literally studied the psychological importance of getting outdoors during quarantine.

The slightest bit of fresh air can go such a long way in improving his thoughts, relationships and self-esteem, Yaldo said. Whenever I have a chance to not be inside, I will be outside, whether Im walking or running.

We often hear about how crucial it is to eat our greens. But rarely do we talk about the importance of seeing green.

Relationships with nature have diminished in an increasingly artificial world. Depression and obesity are reaching unprecedented levels.

While there are a host of treatments including medication and therapy regimens mitigating such problems may be simpler.

I encourage patients with all kinds of mental health conditions be it anxiety, depression, or whatever else to get outside. Ill suggest that they walk to my office rather than driving there, said Okemos psychologist Pamella Montgomery. By the time they arrive, they always report feeling significantly better.

Montgomery has long advocated spending time outdoors.

I worked and went to graduate school full time with a 30-hour-a week internship on the side, but I still managed to run outdoors. To this day, regardless of the weather, I run outside, Montgomery said. Being outdoors and in nature is crucial to our being. Were creatures that need to interact with nature.

Psychologically, she said, Going outside gets you out of your indoor rut. It makes you stop and think about things, which you dont do sitting in front of the TV or computer.

Paul Smith of Ann Arbor drove about 1 hours to go rock-climbing at Oak Park in Grand Ledge.

This is a sport you cant really do by yourself, which I know is very insane during our COVID times, said Smith, who was with a group of people at the Ledges.

Since the start of the pandemic, Smith said hes spent less time outside. With winter coming, hes trying to get outside more.

In addition to it being physically healthy, being outdoors has a good mental impact, he said. If youre just inside all the time, I definitely find it causes a lot of drain and wear on your emotions.

In the age of COVID-19, getting fresh air takes on new meaning.

Those fortunate enough to be near parks and trails can safely socially distance.

When Craig Dennis needs to kill time, he hits a nature trail in East Lansings Harrison Meadows Park. It gave me a purpose to go out and exercise and feel good, he said.

Outdoor activities are bustling as people have taken to hiking, walking dogs, biking and running because indoor activities remain limited. Dennis said hes seen coronavirus-wary older neighbors get outside more.

Speaking of dogs, one chilly morning in Westland, Kobe, with tongue hanging low was out for a walk with owner Jacquis Smith.

I shortened the time of how much time I spend outside. Ive noticed people arent wearing their mask when they are walking their dogs, but I always have mine on, Smith said,

Michigan State University education professor David Stroupe walks a trail alongside the Red Cedar River on campus.

I try to go in the woods and hear the birds, Stroupe said.

Stroupe was already going on regular walks before COVID 19 but has noticed more animals since the pandemic began. I think theyre more bold.

He doesnt bring technology. Being unplugged makes the walk more enjoyable. Since were on computers a lot now, I try and leave my phone at home, he said.

Green, leafy environments can boost a persons mood, speed up brain activity and improve overall health, according to research from the Department of Psychology at Ottawas Carleton University.

And like an all-natural ventilation system, trees and plants encountered on nature walks produce oxygen and scrub carbon dioxide from the atmosphere.

More sunshine helps. Direct sunlight isnt enough to wipe out COVID-19, the Centers for Disease Control and Prevention says, but can help produce vitamin D to gear up the immune system to fight infectious disease.

Sunlight also causes the brain to produce the hormone serotonin, which can heighten happiness.

On a rainy recent evening, the weather and COVID-19 didnt stop the daily busy world, especially not for Lansing resident Driscilla Tettey, whod been running errands all day.

Ive been spending more time outside now during the pandemicbecause we were social distancing and in isolation. We had to be indoors all the time, and that can take a toll on your mental health, so definitely spending more time outside helped boost my mental health and my overall well-being, Tettey said.

Anne Breton, who has been coming to the Harris Nature Center in Okemos for more than 20 years, said its been a gift to have parks in Meridian Township during this COVID-19 era.

We can walk with friends at a social distance,she said after finishing a birdwatching trip in the park.

Shes seen an uptick in the number of people of all ages using the park and said she hopes some who hadnt been enjoying the outdoors will make that a part of their lives, even after they can again go to movies.

Mckenzie Dickens walks barefoot through rows of plants in the MSU Botanical Gardens. Sitting on the grass, crossing his legs and tucking his dreadlocks into a bandana, he said time outdoors is precious, especially in the face of COVID-19.

Theres a point when watching Netflix gets tiresome.Thankfully, though, Gov. (Gretchen) Whitmer kept state parks open so people can visit them, Dickens said of Michigans early lockdown.

For all the harm this pandemic has caused, maybe it has a silver lining. Maybe it can teach everyone how to be outside again, he said.

And its not only people in Michigan who see a silver lining.

Before the pandemic, getting outdoors wasnt easy for Bernard Crawford, an advertising student at Florida Atlantic University. With more time on his hands, being outside is the new highlight of his day.

On an afternoon stroll in the 90-degree weather along Boca Raton streets, Crawford said hes felt a greater sense of connection with nature and is outdoors much of the day.

Being a full-time student, I never had the chance to get out and enjoy Gods beautiful creation. Im upset I was always inside playing video games before, he said.

This story was reported and written by Kathleen Fitch, Kalah Harris, Anne Hooper, Yue Jiang, Chioma Lewis, Lea Mitchell, Claire Moore, Audrey Porter and Lillian Young, and edited by Jiang and Lewis.

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Engaging with nature and just getting outside help in the age of COVID-19 - Spartan Newsroom

- Study in over 500 patients with node-negative or node-positive disease highlights impact of the test on treatment decisions, reducing potential over- and under-treatment and leading to a 23.5% net reduction in chemotherapy recommendations

- Publication shows that Recurrence Scoreresults do not correlate with clinical pathologic parameters

GENEVA, Oct. 2, 2020 /PRNewswire/ -- Exact Sciences today announced results from a prospective decision impact study1 presented at the virtual European Breast Cancer Conference (EBCC-12), being held October 2-3. The findings are consistent with previous studies and further support the clinical utility of the Oncotype DX Breast Recurrence Score test to optimise chemotherapy recommendations in patients with early-stage, hormone-receptor positive, HER-2 negative breast cancer with or without lymph node involvement.

The study was conducted between 2016 and 2019 in 15 certified breast cancer centers across Germany. The analysis presented at EBCC-12 includes 567 patients 403 with node-negative (N0) disease and 167 with one to three positive nodes. Results showed that treatment recommendations changed for 33.5% of patients based on their Recurrence Score results, and that using the test to guide treatment decisions resulted in a net reduction in chemotherapy recommendations of 23.5%. These changes in treatment recommendations could well have been greater in patients with N0 disease if the decision-making criteria (Recurrence Score groups) based on results from the landmark TAILORx study, which was published2in 2018, had been applied at the time of the study.

"These important results show the value of the Oncotype DX test to best select patients for chemotherapy and to avoid potential over- as well as under-treatment by adding genomic information and not relying only on traditional clinical parameters," said Prof. Dr Marc Thill, lead study author and chief physician of the Clinic for Gynecology and Gynecological Oncology at the Agaplesion Markus Krankenhaus in Frankfurt, Germany. "The use of this test allows us to tailor treatment plans more accurately to suit the needs of individual patients, and to use resources more effectively."

Importantly, the analysis presented at EBCC-12 also revealed a weak correlation between centrally and locally performed Ki67 (a classic prognostic factor) and showed a broad range of Recurrence Score results for patients with grade 2 tumours, suggesting that grade does not predict the Recurrence Score result and that the test can provide relevant information for all patients. These findings are consistent with results from a subset analysis3 of the TAILORx study, which showed that only the Oncotype DX test can assess the expected benefit of chemotherapy, and that clinical and pathological features generally provide only prognostic information.

Evidence from routine clinical practice shows that Recurrence Score results do not correlate with clinical pathologic factors

In addition to the results presented at EBCC-12, a recently published retrospective analysis compared the Recurrence Score result with clinical parameters in 4,695 patients with node-negative or node-positive early-stage breast cancer for whom testing with the Oncotype DX test was performed in routine clinical practice in Germany.4 In this group of patients, 84% had a Recurrence Score result of 0-25, consistent with data from TAILORx.2 The findings highlighted an overall high discordance of 45% between Ki67 and the Recurrence Score result classifications, and showed that a large proportion of patients with clinically high-risk features,such as high Ki-67 or high tumour grade, had low Recurrence Score results, suggesting they would not benefit from additional chemotherapy.

These latest results add to the substantial real-world evidence available for the Oncotype DX test, which reflects its growing adoption, particularly since the publication of TAILORx. This landmark study has positively influenced treatment guidelines and is having an important impact on global reimbursement and standard use of the test. More than 1 million patients around the world have used the test to inform their treatment decision.

About Oncotype DXThe Oncotype DX portfolio of breast, colon and prostate cancer tests applies advanced genomic science to reveal the unique biology of a tumour in order to optimise cancer treatment decisions. In breast cancer, the Oncotype DX Breast Recurrence Score test is the only test that has been shown to predict the likelihood of chemotherapy benefit as well as recurrence in invasive breast cancer. Additionally, the Oncotype DX Breast DCIS Score test predicts the likelihood of recurrence in a pre-invasive form of breast cancer called DCIS. In prostate cancer, the Oncotype DX Genomic Prostate Score test predicts disease aggressiveness and further clarifies the current and future risk of the cancer prior to treatment intervention. With more than 1 million patients tested in more than 90 countries, the Oncotype DX tests have redefined personalised medicine by making genomics a critical part of cancer diagnosis and treatment. To learn more about Oncotype DX tests, visit http://www.OncotypeIQ.com/en

AboutExact Sciences Corp.A leading provider of cancer screening and diagnostic tests, Exact Sciences relentlessly pursues smarter solutions providing the clarity to take life-changing action, earlier. Building on the success of the Cologuardand Oncotype DXtests, Exact Sciences is investing in its product pipeline to take on some of the deadliest cancers and improve patient care. Exact Sciences unites visionary collaborators to help advance the fight against cancer. For more information, please visit the company's website at http://www.exactsciences.com, follow Exact Sciences on Twitter @ExactSciences, or find Exact Scienceson Facebook.

NOTE: Oncotype DX, Breast Recurrence Score, and Recurrence Score are trademarks or registered trademarks of Genomic Health, Inc. Exact Sciences is a trademark or registered trademark of Exact Sciences Corporation. All other trademarks and service marks are the property of their respective owners.

Forward-Looking Statements This news release contains forward-looking statements within the meaning of Section27A of the Securities Act of 1933, as amended, and Section21E of the Securities Exchange Act of 1934, as amended, that are intended to be covered by the "safe harbor" created by those sections. Forward-looking statements, which are based on certain assumptions and describe our future plans, strategies and expectations, can generally be identified by the use of forward-looking terms such as "believe," "expect," "may," "will," "should," "would," "could," "seek," "intend," "plan," "goal," "project," "estimate," "anticipate" or other comparable terms. All statements other than statements of historical facts included in this news release regarding our strategies, prospects, expectations, financial condition, operations, costs, plans and objectives are forward-looking statements. Examples of forward-looking statements include, among others, statements we make regarding expected future operating results, anticipated results of our sales, marketing and patient adherence efforts, expectations concerning payer reimbursement, and the anticipated results of our product development efforts.Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based only on our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, anticipated events and trends, the economy and other future conditions. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Actual results, conditions and events may differ materially from those indicated in the forward-looking statements. Therefore, you should not rely on any of these forward-looking statements. Important factors that could cause actual results, conditions and events to differ materially from those indicated in the forward-looking statements include, among others, the following: uncertainties associated with the coronavirus (COVID-19) pandemic, including its possible effects on our operations and the demand for our products and services; our ability to efficiently and flexibly manage our business amid uncertainties related to COVID-19; our ability to successfully and profitably market our products and services; the acceptance of our products and services by patients and healthcare providers; our ability to meet demand for our products and services; the willingness of healthcare payers to cover our products and services and adequately reimburse us for such products and services; the amount and nature of competition for our products and services; the effects of the adoption, modification or repeal of any law, rule, order, interpretation or policy relating to the healthcare system, including without limitation as a result of any judicial, executive or legislative action; data protection laws and rules affecting our performance of diagnostic tests, including the Oncotype DX test; the effects of changes in pricing, coverage and reimbursement for our products and services; recommendations, guidelines and quality metrics issued by various organizations such as the American Society of Clinical Oncology, the National Cancer Care Network, the European Society of Medical Oncology, the St Gallen Consensus, and national health technology assessment bodies regarding our products and services; our ability to successfully develop new products and services and assess potential market opportunities; our success establishing and maintaining collaborative, licensing and supplier arrangements; our ability to maintain regulatory approvals and comply with applicable regulations; our ability to manage an international business and our expectations regarding our international expansion and opportunities; the potential effects of foreign currency exchange rate fluctuations and our efforts to hedge such effects; the possibility that the anticipated benefits from our combination with Genomic Health cannot be realized in full or at all or may take longer to realize than expected; the possibility that costs or difficulties related to the integration of Genomic Health's operations will be greater than expected and the possibility of disruptions to our business during integration efforts and strain on management time and resources; the outcome of any litigation, government investigations, enforcement actions or other legal proceedings; and the other risks and uncertainties described in the Risk Factors and in Management's Discussion and Analysis of Financial Condition and Results of Operations sections of our most recently filed Annual Report on Form 10-K and our subsequently filed Quarterly Reports on Form 10-Q. We undertake no obligation to publicly update any forward-looking statement, whether written or oral, that may be made from time to time, whether as a result of new information, future developments or otherwise.

1 Thill M, et al. [The REMAR (Rhein-Main-Registry)-Study: Prospective Evaluation of Oncotype DX Assay in Addition to Ki-67 For Adjuvant Treatment Decisions in Early Breast Cancer]. Presented at EBCC-12; October 2, 2020.

2 Sparano JA, Gray RJ, Makower DF, et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. New Engl J Med. 2018;379:111-121.

3 Sparano JA, Gray RJ, Ravdin PM, et al. Clinical and genomic risk to guide the use of adjuvant therapy for breast cancer. New Engl J Med. 2019;380:2395-2405

4Walter VP, Taran F-A, Wallwiener M, et al. Distribution of the 21-gene breast recurrence score in patients with primary breast cancer in germany. Geburtshilfe und Frauenheilkunde.2020;80:619-627.

Media Contact:

Federico Maiardi+41 79 138 1326fmaiardi@exactsciences.com

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New Real-World Evidence Further Demonstrates the Clinical Utility of the Oncotype DX Breast Recurrence Score Test, Beyond Clinical Risk Factors, in...

The American Medical Spa Association (AmSpa) has announced the release of a comprehensive new package of forms and consents designed to help medical aesthetic practices prepare for any eventuality and create a culture of safety and compliance.

CHICAGO (PRWEB) October 01, 2020

The American Medical Spa Association (AmSpa) has announced the release of a comprehensive new package of forms and consents designed to help medical aesthetic practices prepare for any eventuality and create a culture of safety and compliance.

"We're so excited to offer a full package of compliance documents to the industry," says AmSpa CEO, Alex R. Thiersch, JD. "We have been working on these documents in conjunction with several of our physician members, as well as our attorney partners at ByrdAdatto. Our goal is to help encourage the industry to become and remain safe and compliant, and this package goes a long way toward accomplishing that. As we say at AmSpa, compliance is cool,' but in order to be compliant, practitioners need access to high-quality, affordable resources that they can use in their practices right away. AmSpa's Forms and Consents Package aims to do precisely that."

Although these forms are very thorough, they must be used only after consulting with both a qualified health care attorney and the practice's medical director. Every practice and every location are different, so there cannot be a "one size fits all" approach to compliance.

The following packages are now available from AmSpa's store:

These packages can be purchased from the AmSpa store (https://www.americanmedspa.org/page/Store).

"We believe that being compliant should not be cost-prohibitive, and we have worked hard to ensure that our members and partners have easy and affordable access to resources that help them operate safely and compliantly," says Thiersch.

For the original version on PRWeb visit: https://www.prweb.com/releases/amspa_releases_comprehensive_forms_and_consents_for_medical_spas/prweb17402211.htm

Originally posted here:
AmSpa Releases Comprehensive Forms and Consents for Medical Spas - Benzinga

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Every year millions of adults in the United States try to lose weight (1).

Along with exercise, dieting is one of the most common methods used to promote weight loss.

However, not all diets are created equal, which can make it challenging to find a weight loss program thats safe, sustainable, and effective.

The programs featured in this article were selected based on the following criteria:

This article looks at 16 of the best weight loss programs in 2020.

The Mediterranean diet is inspired by the eating patterns of countries like Italy, Spain, and Greece.

A well-rounded Mediterranean diet should include plenty of fruits, vegetables, whole grains, nuts, seeds, proteins, and healthy fats.

Meanwhile, added sugars and foods that have been heavily processed or refined are restricted (2).

Although the diet isnt specifically designed for weight loss, many studies have demonstrated that following the Mediterranean Diet could lead to weight loss (3, 4, 5).

For example, one analysis of 16 studies showed that those who paired the Mediterranean diet with physical activity and calorie restriction lost significantly more weight than those in a control group (6).

Plus, other research suggests that the Mediterranean Diet may help prevent chronic conditions like type 2 diabetes and heart disease (5, 7).

For an easy resource to help get you started on the Mediterranean diet, check out The Complete Mediterranean Cookbook, which features a variety of delicious recipes and in-depth information about the diet.

Shop for The Complete Mediterranean Cookbook online.

Plant-based diets encourage you to eat foods from plants, including fruits, vegetables, nuts, seeds, oils, and legumes.

Unlike vegan or vegetarian diets, most plant-based diets dont eliminate meat or animal products entirely. However, these foods are only enjoyed in moderation and not generally considered to be the main focus of the diet (8).

Plant-based diets are particularly rich in fiber the parts of plant-based foods like fruits, vegetables, and whole grains that are resistant to digestion. Fiber helps keep you full between meals to promote weight loss (9, 10, 11).

According to one review of 12 studies, people who followed a plant-based vegetarian diet lost an average of 4.5 pounds (2 kg) more than those who followed a non-vegetarian diet over 18 weeks (12).

Another review of 32 studies found that plant-based diets were more effective for weight loss, compared with conventional diets, and even led to greater improvements in blood sugar control, cholesterol levels, and inflammation (13).

To learn more about plant-based diets, check out the book The Plant-Based Diet for Beginners by Gabriel Miller, which offers a variety of resources, including recipes and shopping lists.

Shop for The Plant-Based Diet for Beginners by Gabriel Miller online.

Carb-restricted diets are often recommended to help support blood sugar control and increase weight loss among those with type 2 diabetes (14).

There are many types of carb-restricted diets, but most of them involve limiting the consumption of foods that are high in sugar or carbs, such as desserts, candy, bread, and pasta.

Although some carb-restricted diets, such as the Atkins or ketogenic diet, also require significantly reducing your carb consumption to 2050 grams per day, low carb diets are defined as any diet comprising less than 130 grams of carbs per day (15, 16).

One study in 49 people with type 2 diabetes found that a low carb diet was more effective at improving blood sugar levels than a low fat diet. Whats more, it led to reductions in cholesterol and body mass index (BMI) after 3 months (17).

Another study in 124 people with type 2 diabetes found that following a low carb, high fat diet was linked to improved blood sugar control and increased weight loss, compared with a control group (18).

If you want to learn more about carb-restricted diets, you can find valuable resources online, or check out this article to get you started.

Shop for books on carb-restricted diets online.

The Mayo Clinic diet is an eating plan originally developed by experts at the Mayo Clinic, a nonprofit hospital system thats considered to be a leader in medical research.

The Mayo Clinic diet is focused on developing healthy habits like eating breakfast every day, exercising daily, and keeping a food journal.

It also promotes nutritious ingredients, such as fruits, vegetables, whole grains, and healthy fats, while limiting added sugars and saturated fat from full fat dairy and high fat meats.

Although there arent any peer-reviewed studies on the Mayo Clinic diet specifically, studies show that following a diet high in fiber and low in saturated fat may aid weight loss and blood sugar control (19, 20).

Other research suggests that reducing your intake of saturated fat or added sugars may also enhance your bodys ability to use insulin, the hormone thats responsible for carrying sugar from your bloodstream into your cells (21, 22, 23, 24).

You can learn more about the Mayo Clinic diet on the Mayo Clinics website, or find valuable information in books on the topic.

Shop for books on the Mayo Clinic diet online.

Low carb diets involve restricting your intake of carbs, including high carb foods like bread, pasta, and sweets.

Some research suggests that reduced sensitivity to insulin may play a role in the development of polycystic ovary syndrome (PCOS) (25).

As such, low carb diets are often recommended to improve insulin sensitivity and help manage symptoms of PCOS.

One review of eight studies showed that following a low carb diet could help increase weight loss and improve hormone levels in women with PCOS (26).

Whats more, another review of seven studies showed that low carb diets could help balance hormones and improve fertility in women with PCOS (27).

Shop for books on the low carb diet online.

Anti-inflammatory diets emphasize foods rich in nutrients that have been shown to fight inflammation, including antioxidants and omega-3 fatty acids (28).

These diets are rich in foods like fruits, vegetables, nuts, seeds, and fatty fish. They also typically limit processed products, fried foods, and sugar-sweetened beverages.

Studies show that increasing your intake of anti-inflammatory foods like fruits, vegetables, and nuts may be beneficial for weight loss (29, 30, 31).

In addition to promoting weight loss, following an anti-inflammatory diet may help alleviate symptoms of PCOS.

In fact, high levels of inflammation are thought to contribute to symptoms of PCOS and may be associated with increased levels of androgens, or male sex hormones (32).

One study in 100 women with PCOS found that pairing a calorie-restricted, anti-inflammatory diet with regular physical activity for 12 weeks significantly increased weight loss and improved hormone levels, menstrual cycle regularity, blood sugar control, and fertility (33).

Dorothy Calimeris and Lulu Cooks book The Complete Anti-Inflammatory Diet for Beginners is an excellent resource for more information on the anti-inflammatory diet.

Shop for The Complete Anti-Inflammatory Diet for Beginners by Dorothy Calimeris and Lulu Cook online.

The Dietary Approaches to Stop Hypertension (DASH) diet is an eating plan intended to promote weight loss, reduce blood pressure levels, and protect against heart disease (34).

The diet promotes nutritious foods like fruits, vegetables, lean proteins, and whole grains.

Meanwhile, red meat and foods high in added sugar, salt, or fat are limited.

According to one review of 13 studies, participants who followed the DASH diet lost more weight and belly fat than those following other calorie-restricted diets for 824 weeks (35).

The DASH diet has likewise been shown to decrease levels of blood pressure, total cholesterol, and LDL (bad) cholesterol all of which are risk factors for heart disease (36, 37).

There are a variety of books and resources on the DASH diet, or you can check out this article to get you started.

Shop for books on the DASH diet online.

The Therapeutic Lifestyle Changes (TLC) diet is a plan developed by the National Cholesterol Education Program to support healthy cholesterol levels.

On the TLC diet, foods high in fat and dietary cholesterol are limited, while foods high in soluble fiber a type of fiber that dissolves in water are encouraged.

The diet also recommends aiming for at least 30 minutes of moderate-intensity exercise daily.

Increasing your intake of soluble fiber and adding more physical activity into your routine are two common strategies for promoting weight loss (38, 39, 40).

Plus, several older studies have even found that the TLC diet can decrease levels of LDL (bad) cholesterol, reduce blood pressure, and enhance immune function (41, 42, 43).

Check out this free guide to the TLC diet online, which is provided by the U.S. Department of Health and Human Services.

Although there are many styles and variations of intermittent fasting, most involve restricting food intake for 1424 hours at a time.

Some research suggests that intermittent fasting may be particularly beneficial for women during menopause (44).

It has been shown to increase weight loss to a similar extent as cutting calories, and it may also help boost fat-burning (45, 46).

Intermittent fasting may likewise reduce insulin resistance and help stabilize blood sugar levels, both of which can be especially beneficial during menopause (47, 48).

Whats more, other research suggests that intermittent fasting may help support mental health during menopause by enhancing self-esteem, as well as reducing stress levels and symptoms of anxiety and depression (44).

Some studies have found that intermittent fasting could affect men and women differently, indicating that women may be more sensitive to the effects of fasting (49, 50).

Therefore, women may benefit from a more relaxed approach to fasting, which could include intermittent fasting just a few times per week, consuming a small number of calories during fasts, or limiting fasting periods to 1416 hours at a time.

Be sure to also follow a healthy and balanced diet during non-fasting periods to maximize the potential benefits.

To learn more about intermittent fasting and how to incorporate it into your daily routine, check out Fast. Feast. Repeat. by Gin Stephens.

Shop for Fast. Feast. Repeat. by Gin Stephens online.

The pescatarian diet is a mostly plant-based diet that includes fish and seafood.

There are several variations of pescatarian diets, but most of them exclude meat and poultry from the diet but include other animal products like fish, eggs, dairy, and honey.

Studies suggest that pescatarians tend to have a lower BMI and improved diet quality, compared with non-vegetarians (51, 52, 53).

The diet may also be particularly beneficial for those with thyroid issues like hypothyroidism, as it encourages the consumption of seafood thats rich in selenium, a mineral thats essential for the production of thyroid hormones (54).

Plus, fish like cod and tuna can help protect against iodine deficiency, another factor that can contribute to thyroid issues (55, 56).

However, keep in mind that this diet may not necessarily be suitable for all thyroid conditions, and those with conditions like Hashimotos or Graves disease may benefit from an individualized dietary pattern tailored to their needs.

Many books can provide more information on the pescatarian diet, along with meal plans and recipes to get you started.

Shop for books on the pescatarian diet online.

The Ornish Diet is a low fat, plant-based eating pattern that promotes nutritious ingredients like fruits, vegetables, whole grains, and legumes.

While weight control is not the primary goal of the Ornish Diet, multiple studies have found that it may be effective for long-term weight loss.

For example, one study in 311 women showed that participants who followed the Ornish Diet for 12 months lost an average of 5 pounds (2.2 kg) (57).

Another small study found that the Ornish Diet was more effective for weight loss than other popular diet plans like Atkins and the ZONE Diet, resulting in 7.5 pounds (3.3 kg) of weight loss after 1 year (58).

Keep in mind that the Ornish Diet restricts fat intake quite a bit and limits the consumption of several healthy foods like nuts, seeds, and oils. Thus, careful planning is necessary to ensure that youre meeting your nutritional needs while following the Ornish Diet.

For more information about the diet, check out UnDo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases by Dean and Annie Ornish.

Shop for UnDo It! How Simple Lifestyle Changes Can Reverse Most Chronic Diseases by Dean and Annie Ornish online.

Jenny Craig is a popular program that delivers prepackaged, portion-controlled meals to help simplify weight loss.

Jenny Craig may be an especially good fit for many older adults, as its simple, easy to follow, and doesnt require extensive planning or preparation.

Plans are tailored to your specific weight loss goals but typically provide 1,2002,300 calories per day.

One massive review of 39 studies found that Jenny Craig participants experienced nearly 5% more weight loss after 1 year, compared with those in a control group and people who underwent behavioral counseling (59).

In another study in 133 women with overweight, participants who followed Jenny Craig lost an average of 11.5 pounds (5.3 kg) over 12 weeks (60).

You can find more information about Jenny Craig and can get started on the program directly on their website.

The Mediterranean-DASH Intervention for Neurodegenerative Delay, or MIND diet, combines certain aspects of the Mediterranean and DASH diets to help combat mental decline.

On the MIND diet, foods like fruits, vegetables, healthy fats, and whole grains are encouraged, while foods high in saturated or trans fats are limited.

Although research on the effects of the MIND diet for weight control specifically is limited, both the Mediterranean and DASH diets have been associated with increased weight loss (6, 35).

Additionally, studies show that the MIND diet may help preserve brain function with aging and be linked to a lower risk of neurodegenerative disorders like Alzheimers disease (61, 62).

To get started, check out The MIND Diet Plan and Cookbook by Julie Andrews, which provides shopping lists, meal plans, and recipes aimed at promoting better brain health.

Shop for The MIND Diet Plan and Cookbook by Julie Andrews online.

WW, formerly Weight Watchers, is a diet program that uses a points-based system to promote long-lasting, sustainable weight loss.

More here:
The 16 Best Weight Loss Programs of 2020 - Healthline

The US President and the First Lady had announced that they were quarantining themselves after senior adviser Hope Hicks tested positive.

United States President Donald Trump and First Lady Melania Trump have tested positive for coronavirus. "We will begin our quarantine and recovery process immediately. We will get through this TOGETHER!" the US President tweeted on Friday.

Donald Trump had announced about putting himself in quarantine in a tweet late Thursday night after his close aide Hope Hicks was tested positive with COVID-19. Hicks, 31, is the closest aid of the president to have tested positive with coronavirus. She had travelled with the president on Air Force One early this week.

"Hope Hicks, who has been working so hard without even taking a small break, has just tested positive for COVID-19. Terrible! The First Lady and I are waiting for our test results. In the meantime, we will begin our quarantine process!" Trump said in his tweet.

Trump, in an interview to Fox News, on Thursday night said he and the First Lady spend a lot of time with her.

In the middle of the election campaign, Trump has been travelling a lot in particular in the battleground States. "I just went out with a test and the First Lady just went out with a test also. So, whether we quarantine or whether we have it, I don't know," he said.

In a statement, Judd Deere, the Deputy White House Press Secretary said that the President takes the health and safety of himself and everyone who works in support of him and the American people very seriously.

White House Operations collaborates with the Physician to the President and the White House Military Office to ensure all plans and procedures incorporate current CDC guidance and best practices for limiting COVID-19 exposure to the greatest extent possible both on complex and when the President is travelling," Deere said.

Several White House staffers have tested positive with COVID-19 in recent months, including the National Security Advisor Robert O'Brien and Katie Miller, Vice President Mike Pence's press secretary.

With PTI inputs

Read the original:
Donald Trump and Melania test positive for coronavirus - The News Minute