Helpful Hints for Healthy Teeth

Remember how your mother used to tell you almost everything you did was "bad for your teeth?" You may have forgotten some of her warnings. And some things she said might not be as bad as you think. Read on.

"The function of teeth is to chew food -- and to some extent, help you talk and form words," Richard H. Price, DMD, retired dentist and former faculty member of the Boston University School of Dentistry, tells WebMD. He is also a spokesman for the American Dental Association.

Teeth, Price says, are not to be used for:

• Pliers
• Coat hangers
• Ice crushers
• Potato chip bag openers
• Knot looseners
• Fork tine straighteners
• Chomping frozen candy bars full of caramel or frozen nuts

"Blenders have special blades to crush ice, for heaven's sakes," he laments.

            

Whiteners: Good or Bad?

Gregory L. Paskerian, DMD, a private dentist and former assistant professor at Tufts University, tells WebMD that the new whitening rage follows a continuum of products. "The strips and other over-the-counter whiteners do not damage teeth or burn gum tissue," he says. "The trays (to hold the peroxide solution) you can buy may can contain an acidic, unbuffered solution, which could damage enamel."

The best tray-type lightening, he says, is provided by the dentist, who can control the solution and timing.

"For the fastest and safest whitening," Paskerian says, "you need to get the high-intensity light systems. This light changes the molecular structure of the enamel for a time, but it goes back to normal and at a lighter shade."

He adds, though that whitening is not really a color change, but a brightness or value change.

Price says he wishes patients would concentrate more on keeping teeth healthy. "There are bleaching groupies," he says, "People who can't get enough. You can only get teeth so white."

Price also says these solutions can sometimes cause gum sensitivity, although it is usually short-lived.

                

Don't Overbrush Your Teeth

Price says it's hard to go wrong on paste or brush if you look for the American Dental Association (ADA) label of approval. "This means a brush is firm enough to remove plaque but not tear up gums," he says. "Choose a brush like you would a piece of silverware -- something that feels comfortable in your hand." The designation of "Soft" is preferred by most dentists.

"Don't use a brush more than three months," Price adds. "That is the limit."

If you use an electric brush, Paskerian recommends a rotary head type that you take from tooth to tooth rather than cruising across the teeth with it.

Water picks, both dentists say, can drive bacteria back up into the gums, which can lead to it lodging in other parts of the body, such as the heart. "The picks do not remove plaque," Paskerian says.

Price recommends them only for a gentle lavage before or after brushing. "Do not turn it on like a fire hose," he instructs.

Similarly, prebrush rinses, Price says, are no substitute for brushing. These methods should be used together.

Toothpaste is an abrasive, with some therapeutic additions, namely fluoride, which strengthens enamel and can shore up little breaches in it before cavities develop.

Brushing itself should be gentle, with the bristles at a 45-degree angle to the teeth, Paskerian says. Swish gently with an oval motion rather than raking the brush side to side across the teeth.

What about the ever-popular floss? Paskerian recommends the easy-glide type -- daily, of course. Since the dentin between teeth is not fully mineralized with hard enamel, don't saw away like mad. Paskerian is also skeptical of the new "paste" floss -- that means an abrasive is being pulled over the dentin, he says.

               

Dental Destroyers

Homemade drugs full of industrial chemicals, such as methamphetamine (meth), can ruin teeth in short order. There is even a term for the rottenness and missing teeth -- meth mouth. Muriatic acid, used to strip cement floors, is one ingredient. "These drugs also cause dry mouth, leaving the teeth open to plaque, Price says. "And the users tend to be tense and grind their teeth." (Not to mention not being too picky about brushing, flossing, and taking care of their teeth.)

But even some more respectable drugs, such as tetracycline and other full-spectrum antibotics, can cause discoloration in permanent teeth if kids take them before age 10 -- and now they are finding that adults can get color changes from some adult acne antibiotics, too, Price says.

"Discuss antibiotics with your dentist and doctor," he advises. "Sometimes, the dentist can prescribe a high-content fluoride rinse, which helps some."

Other drugs may cause dry mouth or bleeding gums.

Nicotine, of course, stains teeth, but there are also some chemicals in the burning paper that can cause discoloration, and the heat in a smoker's mouth can impede circulation and encourage gum disease.

Although it is not usually the first problem with bulimia that comes to mind, people who binge and vomit also eat away their teeth with acid.

Also -- lemon chewing is out! Both dentists mentioned this -- is there a lot of that going around?

Drinking bottled water exclusively can also be a problem. Check to see if it's fluoridated. If it doesn't say, call the company, Price advises.

And researchers have now found that obesity and insulin resistance may be linked to periodontal disease. So stick with your healthy eating to stay out of the dental chair.

         

What About Sugar?

What was Mom's biggest refrain about teeth? Sugar! "You will ruin those beautiful teeth!"

Sugar, both dentists say, is not the problem. How long the sugar stays on teeth is the problem. Given enough time, the bacteria in your mouth feed on the sugar and excrete damaging acid that can eat through enamel forming cavities.

So if you eat candy, brush afterward if you can.

Or chew some gum! Amazingly, even sugar gum is not a big no-no for teeth, the dentists say. It churns up lots of saliva, which carries off the sugar in short order.

Some sugarless gum, containing xylitol, is even a good decay-preventer. In fact, in California, researchers are trying to make Gummi Bears into a dental aid by making them with xylitol.

Soda, too, is not too much of a tooth problem, if you brush or drink water afterward. In fact, the diet kind contains more phosphates than can be acidic to enamel and may be a bigger threat to your choppers than regular.

Dark chocolate is not too bad for your teeth, either, Price notes.

Well, that makes it all worthwhile!

That -- and not having to crush all that ice anymore.

8 Tips to Treat Colds and Flu the 'Natural' Way

With no cure in sight for the cold or the flu, over-the-counter treatments can at best bring symptom relief or shorten the duration of those symptoms. Or you can take the natural approach. WebMD explores some home remedies that may help you feel better along the way.

No. 1: Blow Your Nose Often -- and the Right Way

It's important to blow your nose regularly when you have a cold rather than sniffling mucus back into your head. But when you blow hard, pressure can cause an earache. The best way to blow your nose: Press a finger over one nostril while you blow gently to clear the other. Wash your hands after blowing your nose.

No. 2: Stay Rested

Resting when you first come down with a cold or the flu helps your body direct its energy toward the immune battle. This battle taxes the body. So give it a little help by lying down under a blanket.

No. 3: Gargle

Gargling can moisten a sore throat and bring temporary relief. Try a teaspoon of salt dissolved in warm water, four times daily. To reduce the tickle in your throat, try an astringent gargle -- such as tea that contains tannin -- to tighten the membranes. Or use a thick, viscous gargle made with honey or a mixture of honey and apple cider vinegar, a popular folk remedy. Steep one tablespoon of raspberry leaves or lemon juice in two cups of hot water and mix in one teaspoon of honey. Let the mixture cool to room temperature before gargling. Honey should never be given to children under age 1.

 

No. 4: Drink Hot Liquids

Hot liquids relieve nasal congestion, help prevent dehydration, and soothe the uncomfortably inflamed membranes that line your nose and throat.

No. 5: Take a Steamy Shower

Steamy showers moisturize your nasal passages and relax you. If you're dizzy from the flu, run a steamy shower while you sit on a chair nearby and take a sponge bath.

No. 6: Apply Hot or Cold Packs Around Your Congested Sinuses

Either temperature may help you feel more comfortable. You can buy reusable hot or cold packs at a drugstore. Or make your own. Take a damp washcloth and heat it for 55 seconds in a microwave (test the temperature first to make sure it's not scalding). Or take a small bag of frozen peas to use as a cold pack.

No. 7: Sleep With an Extra Pillow Under Your Head

 

This will help with the drainage of nasal passages. If the angle is too awkward, try placing the pillows between the mattress and the box springs to create a more gradual slope.

No. 8: Don't Fly Unless Necessary

There's no point adding stress to your already stressed-out upper respiratory system, and that's what the change in air pressure will do. Flying with cold or flu congestion can hurt your eardrums as a result of pressure changes during takeoff and landing. If you must fly, use a decongestant and carry a nasal spray with you to use just before takeoff and landing. Chewing gum and swallowing frequently can also help relieve pressure.

Remember, serious conditions can masquerade as the common cold and a mild infection can evolve into something more serious. If you have severe symptoms or are feeling sicker with each passing day, see a doctor.

New prostate cancer test which studies the tumour to help determine how aggressive it is could save men's sex life

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John Murphy opted to pay privately for a new test (picture posed by model)

John Murphy was devastated to be diagnosed with prostate cancer last November. A routine blood test showed the 56-year-old builder had raised PSA (prostate specific antigen) levels, which can indicate a problem with the prostate.

An MRI (magnetic resonance imaging) scan and biopsy showed he had several tumours around his prostate, the walnut-shaped gland that surrounds the urethra, the tube which carries urine from the body.

'My first reaction was to have my prostate removed surgically as soon as possible, which my urologist said was the safest option because the prostate and cancer would be gone,' says John, who lives near Slough in Berkshire and is married with three children.

John was warned that surgery carried risks of incontinence and impotence, because it could damage nearby nerves that control sexual and bladder function.

Initially he was happy to take his chances, but three days before the operation, he changed his mind. 'I wanted more time to think,' he says. 'My wife Sue and I are very close, and I'm relatively young.'

Instead, John opted to pay privately for a new test that studies the genes in a tumour to help determine how aggressive the cancer is, and therefore whether surgery is necessary.

More than 40,000 men are diagnosed with prostate cancer each year in Britain, and over 10,000 die of it.

Around one in four with prostate cancer will have an aggressive form of it, says Dr Hayley Whitaker, lead scientist on the Cancer Research UK Biomarker (which develops new ways to diagnose cancer). This means their cancer is fast growing and likely to spread elsewhere, requiring some form of treatment. 'For the rest, the disease will come to nothing and grow very slowly and they don't need treatment - they will eventually succumb to something else,' she adds.

Those with low risk, slow growing cancers can be monitored quite safely, with several PSA tests a year, and MRI scans and biopsies every year or so, without the need for immediate treatment, adds Marc Laniado, a consultant urologist at Frimley Health NHS Foundation Trust and Windsor Urology.

The challenge is distinguishing slower growing tumours from the more dangerous ones. Until now this has been done by examining tissue samples taken during a biopsy to see how abnormal the cells look and how disrupted the tissue appears.

From this a Gleason score of between six and ten is given to indicate how aggressive the cancer is. However, this can be inaccurate because it gives only a partial picture, explains Mr Laniado.

'And until a few years ago men with small tumours and low Gleason scores were having treatment because knowing that these scores could be inaccurate, doctors were being cautious.'

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John paid around £1,200 and his results showed his cancer was not aggressive (picture posed by model)

Studies have since shown that low-risk tumours do not particularly benefit from treatment. And biopsies help doctors select patients suitable for monitoring (known as active surveillance).

Now a new test offers another way of predicting how aggressive a cancer is - and how urgent it is for men to go through potentially damaging surgery. Called Prolaris, the test is used with existing results from PSA tests, the Gleason score and the biopsy to give a clearer likely prognosis.

It uses tissue already taken in a biopsy. But rather than looking at the structure of the cells, it examines the cancer in greater detail, adding chemicals to break open the cells and extract the DNA.

Scientists then examine 31 genes and the proteins they produce, which are thought to trigger the abnormal cells to divide and grow quickly.

 Prolaris is very exciting because we are now in a better position to judge whether to proceed with treatment

By determining which of these genes are switched on and active, researchers can determine how aggressive a cancer is likely to be.

'Prolaris looks at the activity of the cancer cells, and is very exciting because we are now in a better position to judge whether to proceed with treatment,' says Mr Laniado.

The test - only available privately - costs around £1,200. John decided to pay for it himself and a week later his results showed his cancer was not aggressive and was slow growing.

'Many patients, like John, are in the middle range of risk because he had a low Gleason score but a large volume of tumour, on both sides of the prostate, so alongside the other evidence, Prolaris helped us make a decision about his treatment,' says Mr Laniado.

Dr Whitaker suggests more evidence is needed for the test.

There have been 11 studies worldwide, which examined old tissue samples using Prolaris to see if the test's prediction matched what actually happened to the patients. Dr Whitaker says these have been 'a mixed bunch'; some are too small to be meaningful.

'What is lacking is a large study involving thousands of patients that is prospective (rather than looking back at evidence that already exists) to confirm its utility in the UK and not just the U.S.' This is because in the UK men do not routinely have PSA screening so prostate cancer patients tend to have higher grade tumours and higher Gleason scores.

BREAST CANCER: CAUSES, SYMPTOMS, DIAGNOSIS AND TREATMENT

What is breast cancer? What causes breast cancer?

Last updated: 7 November 2014

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Breast cancer is a kind of cancer that develops from breast cells. Breast cancer usually starts off in the inner lining of milk ducts or the lobules that supply them with milk. A malignant tumor can spread to other parts of the body. A breast cancer that started off in the lobules is known as lobular carcinoma, while one that developed from the ducts is called ductal carcinoma.

The vast majority of breast cancer cases occur in females. This article focuses on breast cancer in women. Click here to read about breast cancer in men (male breast cancer).

Breast cancer is the most common invasive cancer in females worldwide. It accounts for 16% of all female cancers and 22.9% of invasive cancers in women. 18.2% of all cancer deaths worldwide, including both males and females, are from breast cancer.

Breast cancer rates are much higher in developed nations compared to developing ones. There are several reasons for this, with possibly life-expectancy being one of the key factors - breast cancer is more common in elderly women; women in the richest countries live much longer than those in the poorest nations. The different lifestyles and eating habits of females in rich and poor countries are also contributory factors, experts believe.

According to the National Cancer Institute, 232,340 female breast cancers and 2,240 male breast cancers are reported in the USA each year, as well as about 39,620 deaths caused by the disease.

The anatomy of a female breast

1. Chest wall. 2. Pectoralis muscles. 3. Lobules (glands that make milk). 4. Nipple surface. 5. Areola. 6. Lactiferous duct tube that carries milk to the nipple. 7. Fatty tissue. 8. Skin.


A mature human female's breast consists of fat, connective tissue and thousands of lobules - tiny glands which produce milk. The milk of a breastfeeding mother goes through tiny ducts (tubes) and is delivered through the nipple.



The breast, like any other part of the body, consists of billions of microscopic cells. These cells multiply in an orderly fashion - new cells are made to replace the ones that died. In cancer, the cells multiply uncontrollably, and there are too many cells, progressively more and more than there should be.

Cancer that begins in the lactiferous duct (milk duct), known as ductal carcinoma, is the most common type. Cancer that begins in the lobules, known as lobular carcinoma, is much less common.

Recent developments on diagnosing breast cancer from MNT news
Cancer detection rate improved with 3D breast imaging technique - A study published in JAMA has found that the addition of tomosynthesis, a 3D imaging technique, to digital mammography was linked to a reduction in the number of patients being called back for additional testing and a rise in the breast cancer detection rate.
Blood test to indicate breast cancer risk 'in development' - Researchers from University College London in the UK are developing a simple blood test to help predict the likelihood of a woman developing breast cancer. They publish their research in the open access journal Genome Medicine.

What is the difference between invasive and non-invasive breast cancer?

Invasive breast cancer - the cancer cells break out from inside the lobules or ducts and invade nearby tissue. With this type of cancer, the abnormal cells can reach the lymph nodes, and eventually make their way to other organs (metastasis), such as the bones, liver or lungs. The abnormal (cancer) cells can travel through the bloodstream or the lymphatic system to other parts of the body; either early on in the disease, or later.

Non-invasive breast cancer - this is when the cancer is still inside its place of origin and has not broken out. Lobular carcinoma in situ is when the cancer is still inside the lobules, while ductal carcinoma in situ is when they are still inside the milk ducts. "In situ" means "in its original place". Sometimes, this type of breast cancer is called "pre-cancerous"; this means that although the abnormal cells have not spread outside their place of origin, they can eventually develop into invasive breast cancer.

What are the signs and symptoms of breast cancer?

A symptom is only felt by the patient, and is described to the doctor or nurse, such as a headache or pain. A sign is something the patient and others can detect, for example, a rash or swelling.

The first symptoms of breast cancer are usually an area of thickened tissue in the woman's breast, or a lump. The majority of lumps are not cancerous; however, women should get them checked by a health care professional.

Some of the possible early signs of breast cancer

According to the National Health Service, UK, women who detect any of the following signs or symptoms should tell their doctor:

• A lump in a breast
• A pain in the armpits or breast that does not seem to be related to the woman's menstrual period
• Pitting or redness of the skin of the breast; like the skin of an orange
• A rash around (or on) one of the nipples
• A swelling (lump) in one of the armpits
• An area of thickened tissue in a breast
• One of the nipples has a discharge; sometimes it may contain blood
• The nipple changes in appearance; it may become sunken or inverted
• The size or the shape of the breast changes
• The nipple-skin or breast-skin may have started to peel, scale or flake.

What are the causes of breast cancer?

Experts are not sure what causes breast cancer. It is hard to say why one person develops the disease while another does not. We know that some risk factors can impact on a woman's likelihood of developing breast cancer.

• Getting older - the older a woman gets, the higher is her risk of developing breast cancer; age is a risk factor. Over 80% of all female breast cancers occur among women aged 50+ years (after the menopause).


• Genetics - women who have a close relative who has/had breast or ovarian cancer are more likely to develop breast cancer. If two close family members develop the disease, it does not necessarily mean they shared the genes that make them more vulnerable, because breast cancer is a relatively common cancer.
  
  The majority of breast cancers are not hereditary.
  
  Women who carry the BRCA1 and BRCA2 genes have a considerably higher risk of developing breast and/or ovarian cancer. These genes can be inherited. TP53, another gene, is also linked to greater breast cancer risk.


• A history of breast cancer - women who have had breast cancer, even non-invasive cancer, are more likely to develop the disease again, compared to women who have no history of the disease.


• Having had certain types of breast lumps - women who have had some types of benign (non-cancerous) breast lumps are more likely to develop cancer later on. Examples include atypical ductal hyperplasia or lobular carcinoma in situ.


• Dense breast tissue - women with more dense breast tissue have a greater chance of developing breast cancer.


• Estrogen exposure - women who started having periods earlier or entered menopause later than usual have a higher risk of developing breast cancer. This is because their bodies have been exposed to estrogen for longer. Estrogen exposure begins when periods start, and drops dramatically during the menopause.


• Obesity - post-menopausal obese and overweight women may have a higher risk of developing breast cancer. Experts say that there are higher levels of estrogen in obese menopausal women, which may be the cause of the higher risk.


• Height - taller-than-average women have a slightly greater likelihood of developing breast cancer than shorter-than-average women. Experts are not sure why.


• Alcohol consumption - the more alcohol a woman regularly drinks, the higher her risk of developing breast cancer is. The Mayo Clinic says that if a woman wants to drink, she should not exceed one alcoholic beverage per day.


• Radiation exposure - undergoing X-rays and CT scans may raise a woman's risk of developing breast cancer slightly. Scientists at the Memorial Sloan-Kettering Cancer Center found that women who had been treated with radiation to the chest for a childhood cancer have a higher risk of developing breast cancer.


• HRT (hormone replacement therapy) - both forms, combined and estrogen-only HRT therapies may increase a woman's risk of developing breast cancer slightly. Combined HRT causes a higher risk.


• Certain jobs - French researchers found that women who worked at night prior to a first pregnancy had a higher risk of eventually developing breast cancer.
  
  Canadian researchers found that certain jobs, especially those that bring the human body into contact with possible carcinogens and endocrine disruptors are linked to a higher risk of developing breast cancer. Examples include bar/gambling, automotive plastics manufacturing, metal-working, food canning and agriculture. They reported their findings in the November 2012 issue of Environmental Health.


• Cosmetic implants may undermine breast cancer survival - women who have cosmetic breast implants and develop breast cancer may have a higher risk of dying prematurely form the disease compared to other females, researchers from Canada reported in the BMJ (British Medical Journal) (May 2013 issue).
  
  The team looked at twelve peer-reviewed articles on observational studies which had been carried out in Europe, the USA and Canada.
  
  Experts had long-wondered whether cosmetic breast implants might make it harder to spot malignancy at an early stage, because they produce shadows on mammograms.
  
  In this latest study, the authors found that a woman with a cosmetic breast implant has a 25% higher risk of being diagnosed with breast cancer when the disease has already advanced, compared to those with no implants.
  
  Women with cosmetic breast implants who are diagnosed with breast cancer have a 38% higher risk of death from the disease, compared to other patients diagnosed with the same disease who have no implants, the researchers wrote.
  
  After warning that there were some limitations in the twelve studies they looked at, the authors concluded "Further investigations are warranted into the long term effects of cosmetic breast implants on the detection and prognosis of breast cancer, adjusting for potential confounders."

Recent developments on breast cancer causes from MNT news
Scientists identify 'high-priority' chemicals that may cause breast cancer - Past research has indicated that exposure to some chemicals may increase the risk of breast cancer. Now, a new study published in Environmental Health Perspectives - a journal from the National Institutes of Health (NIH) - has identified 17 "high-priority" chemicals women should avoid in order to reduce such risk and demonstrates how their presence can be detected.
Could red meat consumption increase breast cancer risk? - A study published in BMJ has found that higher red meat intake during early adulthood could a risk factor for developing breast cancer.
Can breast cancer risk be predicted by skin moles? - PLOS Medicine has published two studies finding that moles - or cutaneous nevi - may be a predictor of breast cancer. The two teams - from the US and France - find that women with a greater number of moles are more at risk of developing breast cancer.
Study links high cholesterol to increased risk of breast cancer - A new study recently presented at the Frontiers in Cardiovascular Biology meeting in Barcelona, Spain, suggests that women who have high cholesterol may be at higher risk of developing breast cancer.
Recent use of some oral contraceptives increases breast cancer risk - Numerous studies have suggested that birth control pills increase the risk of breast cancer. Now, a new study suggests that this increased risk may only apply to recent users and is dependent on the formulation of the pill.
Childhood cancer treatment could increase risk of breast cancer - In a study published in Cancer, researchers found that patients receiving chest radiation to treat Wilms tumor - a rare form of childhood kidney cancer - had an increased risk of future breast cancer.

Breast Cancer UK says that up to 1 in 8 women in the UK will experience breast cancer at some point in their lives. The charity says this figure cannot be attributed to genetic and lifestyle factors alone.

Diagnosing breast cancer

 

Women are usually diagnosed with breast cancer after a routine breast cancer screening, or after detecting certain signs and symptoms and seeing their doctor about them.

If a woman detects any of the breast cancer signs and symptoms described above, she should speak to her doctor immediately. The doctor, often a primary care physician (general practitioner, GP) initially, will carry out a physical exam, and then refer the patient to a specialist if he/she thinks further assessment is needed.

Below are examples of diagnostic tests and procedures for breast cancer:

• Breast exam - the physician will check both the patient's breasts, looking out for lumps and other possible abnormalities, such as inverted nipples, nipple discharge, or change in breast shape. The patient will be asked to sit/stand with her arms in different positions, such as above her head and by her sides.


• X-ray (mammogram) - commonly used for breast cancer screening. If anything unusual is found, the doctor may order a diagnostic mammogram.
  
  Breast cancer screening has become a controversial subject over the last few years. Experts, professional bodies, and patient groups cannot currently agree on when mammography screening should start and how often it should occur. Some say routine screening should start when the woman is 40 years old, others insist on 50 as the best age, and a few believe that only high-risk groups should have routine screening.
  
  In July, 2012, The American Medical Association said that women should be eligible for screening mammography from the age of 40, and it should be covered by insurance.
  
  In a Special Report in The Lancet (October 30th, 2012 issue), a panel of experts explained that breast cancer screening does reduce the risk of death from the disease. However, they added that it also creates more cases of false-positive results, where women end up having unnecessary biopsies and harmless tumors are surgically removed.
  
  Another study, carried out by scientists at the The Dartmouth Institute for Healthy Policy & Clinical Practice in Lebanon, N.H., and reported in the New England Journal of Medicine (November 2012 issue), found that mammograms do not reduce breast cancer death rates.
  
  A team from the University of Copenhagen reported that women who have false-positive mammogram outcomes may suffer long-lasting stress and anxiety, in some cases this can last up to three years. They published their findings in Annals of Family Medicine (March 2013 issue).
  
  Researchers from the Barbara Ann Karmanos Cancer Institute in Detroit, Michigan, found that breast cancer mortality was higher among older women whose time-lapses between their last mammogram and their breast cancer diagnosis were longer. They presented their findings at the American Association for Cancer Research (AACR) Annual Meeting 2013.
  
  Team leader, Michael S. Simon, M.D., M.P.H., said "We found that for women age 75 and older, a longer time interval between the last mammogram and the date of breast cancer diagnosis was associated with a greater chance for dying from breast cancer."


• 2D combined with 3D mammograms - 3D mammograms, when used in collaboration with regular 2D mammograms were found to reduce the incidence of false positives, researchers from the University of Sydney's School of Public Health, Australia, reported in The Lancet Oncology.
  
  The researchers screened 7,292 adult females, average age 58 years. Their initial screening was done using 2D mammograms, and then they underwent a combination of 2D and 3D mammograms.
  
  Professor Nehmat Houssami and team found 59 cancers in 57 patients. 66% of the cancers were detected in both 2D and combined 2D/3D screenings. However, 33% of them were only detected using the 2D plus 3D combination.
  
  The team also found that 2D plus 3D combination screenings were linked to a much lower number of false positives. When using just 2D screenings there were 141 false positives, compared to 73 using the 2D plus 3D combination.
  
  Prof. Houssami said "Although controversial, mammography screening is the only population-level early detection strategy that has been shown to reduce breast cancer mortality in randomized trials. Irrespective of which side of the mammography screening debate one supports, efforts should be made to investigate methods that enhance the quality of, and hence potential benefit from, mammography screening.
  
  We have shown that integrated 2D and 3D mammography in population breast-cancer screening increases detection of breast cancer and can reduce false-positive recalls depending on the recall strategy. Our results do not warrant an immediate change to breast-screening practice, instead, they show the urgent need for randomised controlled trials of integrated 2D and 3D versus 2D mammography."


• Breast ultrasound - this type of scan may help doctors decide whether a lump or abnormality is a solid mass or a fluid-filled cyst.


• Biopsy - a sample of tissue from an apparent abnormality, such as a lump, is surgically removed and sent to the lab for analysis. It the cells are found to be cancerous, the lab will also determine what type of breast cancer it is, and the grade of cancer (aggressiveness). Scientists from the Technical University of Munich found that for an accurate diagnosis, multiple tumor sites need to be taken.


• Breast MRI (magnetic resonance imaging) scan - a dye is injected into the patient. This type of scan helps the doctor determine the extent of the cancer. Researchers from the University of California in San Francisco found that MRI provides a useful indication of a breast tumor's response to pre-surgical chemotherapy much earlier than possible through clinical examination.

Staging describes the extent of the cancer in the patient's body and is based on whether it is invasive or non-invasive, how large the tumor is, whether lymph nodes are involved and how many, and whether it has metastasized (spread to other parts of the body).

A cancer's stage is a crucial factor in deciding what treatment options to recommend, and in determining the patient's prognosis.

Staging is done after cancer is diagnosed. To do the staging, the doctor may order several different tests, including blood tests, a mammogram, a chest X-ray, a bone scan, a CT scan, or a PET scan.

What are the treatment options for breast cancer?

 

A multidisciplinary team will be involved in a breast cancer patient's treatment. The team may consists of an oncologist, radiologist, specialist cancer surgeon, specialist nurse, pathologist, radiologist, radiographer, and reconstructive surgeon. Sometimes the team may also include an occupational therapist, psychologist, dietitian, and physical therapist.

The team will take into account several factors when deciding on the best treatment for the patient, including:

• The type of breast cancer


• The stage and grade of the breast cancer - how large the tumor is, whether or not it has spread, and if so how far


• Whether or not the cancer cells are sensitive to hormones


• The patient's overall health


• The age of the patient (has she been through the menopause?)


• The patient's own preferences.

The main breast cancer treatment options may include:

• Radiation therapy (radiotherapy)
• Surgery
• Biological therapy (targeted drug therapy)
• Hormone therapy
• Chemotherapy.

Surgery

• Lumpectomy - surgically removing the tumor and a small margin of healthy tissue around it. In breast cancer, this is often called breast-sparing surgery. This type of surgery may be recommended if the tumor is small and the surgeon believes it will be easy to separate from the tissue around it. British researchers reported that about one fifth of breast cancer patients who choose breast-conserving surgery instead of mastectomy eventually need a reoperation.


• Mastectomy - surgically removing the breast. Simple mastectomy involves removing the lobules, ducts, fatty tissue, nipple, areola, and some skin. Radical mastectomy means also removing muscle of the chest wall and the lymph nodes in the armpit.
  
  Many undergo pointless mastectomies due to fear - a study carried out at the Dana-Faber Cancer Institute and published in Annals of Internal Medicine found that many young women choose to have their healthy breast removed after being diagnosed with cancer in one breast. Unfortunately, doing so does not improve survival rates, the authors explained.


• Sentinel node biopsy - one lymph node is surgically removed. If the breast cancer has reached a lymph node it can spread further through the lymphatic system into other parts of the body.


• Axillary lymph node dissection - if the sentinel node was found to have cancer cells, the surgeon may recommend removing several nymph nodes in the armpit.


• Breast reconstruction surgery - a series of surgical procedures aimed at recreating a breast so that it looks as much as possible like the other breast. This procedure may be carried out at the same time as a mastectomy. The surgeon may use a breast implant, or tissue from another part of the patient's body.

Radiation therapy (radiotherapy)

Controlled doses of radiation are targeted at the tumor to destroy the cancer cells. Usually, radiotherapy is used after surgery, as well as chemotherapy to kill off any cancer cells that may still be around. Typically, radiation therapy occurs about one month after surgery or chemotherapy. Each session lasts a few minutes; the patient may require three to five sessions per week for three to six weeks.

The type of breast cancer the woman has will decide what type of radiation therapy she may have to undergo. In some cases, radiotherapy is not needed.

Radiation therapy types include:

• Breast radiation therapy - after a lumpectomy, radiation is administered to the remaining breast tissue


• Chest wall radiation therapy - this is applied after a mastectomy


• Breast boost - a high-dose of radiation therapy is applied to where the tumor was surgically removed. The appearance of the breast may be altered, especially if the patient's breasts are large.


• Lymph nodes radiation therapy - the radiation is aimed at the axilla (armpit) and surrounding area to destroy cancer cells that have reached the lymph nodes


• Breast brachytherapy - scientists at UC San Diego Moores Cancer Center revealed that patients with early-stage breast cancer in the milk ducts which has not spread, seem to benefit from undergoing breast brachytherapy with a strut-based applicator. This 5-day treatment is given to patients after they have undergone lumpectomy surgery. The researchers found that women who received strut-based breast brachytherapy had lower recurrence rates, as well as fewer and less severe side effects.

Shorter radiation therapy for early breast cancer? - scientists at The Institute of Cancer Research in England carried out a 10-year study to determine whether giving radiation therapy to women with early breast cancer might be as effective and safe as current standard treatment (with a higher overall dose).

In an article in The Lancet Oncology, John Yarnold and colleagues wrote that their findings confirmed this. Shorter radiation therapy is at least as safe and effective.

Professor Yarnold, said "These 10-year results reassure us that 3 weeks of radiotherapy is as good as the 5 weeks still used in many countries, with less damage to nearby healthy tissue, as well as being more convenient for women (shorter waiting lists and fewer hospital visits) and cheaper for health services."

The study authors added that the outcomes of the women given shorter radiation therapy were similar "irrespective of age, tumor grade, stage, chemotherapy use, or use of tumor bed boost."

Side effects of radiation therapy may include fatigue, lymphedema, darkening of the breast skin, and irritation of the breast skin.

Chemotherapy

Medications are used to kill the cancer cells - these are called cytotoxic drugs. The oncologist may recommend chemotherapy if there is a high risk of cancer recurrence, or the cancer spreading elsewhere in the body. This is called adjuvant chemotherapy.

If the tumors are large, chemotherapy may be administered before surgery. The aim is to shrink the tumor, making its removal easier. This is called neo-adjuvant chemotherapy.

Chemotherapy may also be administered if the cancer has metastasized - spread to other parts of the body. Chemotherapy is also useful in reducing some of the symptoms caused by cancer.

Chemotherapy may help stop estrogen production. Estrogen can encourage the growth of some breast cancers.

Side effects of chemotherapy may include nausea, vomiting, loss of appetite, fatigue, sore mouth, hair loss, and a slightly higher susceptibility to infections. Many of these side effects can be controlled with medications the doctor can prescribe. Women over 40 may enter early menopause.

Protecting female fertility - Scientists have designed a way of aggressively attacking cancer with an arsenic-based chemo medication, which is much gentler on the ovaries. The researchers, from Northwestern University Feinberg School of Medicine in Chicago, believe their novel method will help protect the fertility of female patients undergoing cancer treatment.

The scientists say they also developed a way of rapidly testing existing chemotherapy drugs for their effect on ovarian function, so that doctors and patients can make decisions regarding treatment that minimize damage to ovaries.

They reported their findings in the journal PLOS ONE (March 2013 issue). The authors claim that the new nanoparticle chemo medication they designed is the first cancer drug to be tested during development for its impact on fertility using the new rapid toxicity test.

Although more cancer patients are surviving today thanks to the advances in cancer therapies, a significant number of female patients still face fertility loss after undergoing traditional chemotherapy.

Co-principal study investigator Teresa Woodruff, said "Our overall goal is to create smart drugs that kill the cancer but don't cause sterility in young women."

Hormone therapy (hormone blocking therapy)

Used for breast cancers that are sensitive to hormones. These types of cancer are often referred to as ER positive (estrogen receptor positive) and PR positive (progesterone receptor positive) cancers. The aim is to prevent cancer recurrence. Hormone blocking therapy is usually used after surgery, but may sometimes be used beforehand to shrink the tumor.

If for health reasons, the patient cannot undergo surgery, chemotherapy or radiotherapy, hormone therapy may be the only treatment she receives.

Hormone therapy will have no effect on cancers that are not sensitive to hormones.

Hormone therapy usually lasts up to five years after surgery.

The following hormone therapy medications may be used:

• Tamoxifen - prevents estrogen from binding to ER-positive cancer cells. Side effects may include changes in periods, hot flashes, weight gain, headaches, nausea, vomiting, fatigue, and aching joints.
  
  A biomarker in breast cancer patients who do not respond, or who have become resistant to Tamoxifen has been discovered by researchers at the University of Manchester, England. They say that their discovery will help doctors decide which patients are suitable or not for adjuvant (complementary) hormone therapy with Tamoxifen.
  
  Biomarker may predict breast cancer recurrence after Tamoxifen - scientists from the Cancer Center and Department of Pathology at Massachusetts General Hospital, Boston, say that it may be possible to predict which women will have a higher risk of cancer recurrence after completing tamoxifen treatment. The biomarker measures the ratio of gene expression in the HOXB13 and IL17BR genes.


• Aromatase inhibitors - this type of medication may be offered to women who have been through the menopause. It blocks aromatase. Aromatase helps estrogen production after the menopause. Before the menopause, a woman's ovaries produce estrogen. Examples of aromatase inhibitors include letrozole, exemestane, and anastrozole. Side effects may include nausea, vomiting, fatigue, skin rashes, headaches, bone pain, aching joints, loss of libido, sweats, and hot flashes.

Ovarian ablation or suppression - pre-menopausal women produce estrogen in their ovaries. Ovarian ablation or suppression stop the ovaries from producing estrogen. Ablation is done either through surgery or radiation therapy - the woman's ovaries will never work again, and she will enter the menopause early.

A luteinising hormone-releasing hormone agonist (LHRHa) drug called Goserelin will suppress the ovaries. The patient's periods will stop during treatment, but will start again when she stops taking Goserelin. Women of menopausal age (about 50 years) will probably never start having periods again. Side effects may include mood changes, sleeping problems, sweats, and hot flashes.

Biological treatment (targeted drugs)

• Trastuzumab (Herceptin) - this monoclonal antibody targets and destroys cancer cells that are HER2-positive. Some breast cancer cells produce large amounts of HER2 (growth factor receptor 2); Herceptin targets this protein. Possible side effects may include skin rashes, headaches, and/or heart damage.


• Lapatinib (Tykerb) - this drug targets the HER2 protein. It is also used for the treatment of advanced metastatic breast cancer. Tykerb is used on patients who did not respond well to Herceptin. Side effects include painful hands, painful feet, skin rashes, mouth sores, extreme tiredness, diarrhea, vomiting, and nausea.


• Bevacizumab (Avastin) - stops the cancer cells from attracting new blood vessels, effectively causing the tumor to be starved of nutrients and oxygen. Side effects may include congestive heart failure, hypertension (high blood pressure), kidney damage, heart damage, blood clots, headaches, mouth sores. Although not approved by the FDA for this use, doctors may prescribe it "off-label". Using this drug for breast cancer is controversial. In 2011, the FDA said that Avastin is neither effective nor safe for breast cancer.
  
  Swiss researchers found that Avastin offers only a modest benefit regarding disease progression in women with advanced stage breast cancer. They added that it has no impact on survival.


• Low dose aspirin
  
  Research carried out on laboratory mice and test tubes suggests that regular low-dose aspirin may halt the growth and spread of breast cancer.
  
  Scientists from the Veterans Affairs Medical Center in Kansas City and the University of Kansas Medical Center explained that their tests on cancer lines and in mice showed that aspirin not only slowed the growth of cancer cells and shrank tumors considerably, but also stopped metastasis (cancer spreading to new sites).
  
  Their research involved assessing aspirin's effects on two types of cancer, including the aggressive "triple-negative" breast cancer which is resistant to most current treatments.
  
  Cancer campaigners cautioned that although the current results show great promise, this research is at a very early stage and has yet to be shown to be effective on humans.

Recent developments on breast cancer treatment from MNT news
Cholesterol-busting compound may halt breast cancer - A new study shows that a compound designed as a cholesterol-lowering drug can kill cancer cells and stop tumor progression in hormone-dependent breast cancers, which represent the majority of breast cancers in women.
Researchers at the University of Missouri (MU) led by Salman Hyder, professor of biomedical sciences in the College of Veterinary Medicine, describe their findings in the journal Breast Cancer Research and Treatment.
Potential new treatment for aggressive breast cancer - Researchers have discovered a "viable" new target for the treatment of a particularly aggressive form of breast cancer. The molecule, known as alpha-v-beta-6, could also be used to identify those women with HER2-positive breast cancer who have a higher risk of developing secondary tumors.
Gel tamoxifen effective for breast cancer, fewer side effects than oral form - Tamoxifen is a hormone drug that binds to estrogen receptors, blocking its actions so that cells - including cancer cells - needing estrogen to divide, stop growing and die. The drug is taken orally to prevent breast cancer in high-risk women and to treat advanced breast cancer. But a new study suggests a gel form of the drug, applied directly to the breast, is just as effective and produces fewer side effects.
Sea sponge-derived drug could extend life for breast cancer patients - Triple negative breast cancer is a subtype of the disease defined by the absence of hormone receptors for estrogen and progesterone, and lack of expression of a protein called HER2. This subtype is responsible for a disproportionate percentage of breast cancer deaths. Now, a cancer drug developed from a sea sponge could add an extra 5 months of life for women with an advanced form of the disease.

Exercise and cancer survival rates - an report published in the Journal of the National Cancer Institute explained that physical activity may lower rates of breast and colon cancer deaths.

Preventing breast cancer

Some lifestyle changes can help significantly reduce a woman's risk of developing breast cancer.

• Alcohol consumption - women who drink in moderation, or do not drink alcohol at all, are less likely to develop breast cancer compared to those who drink large amounts regularly. Moderation means no more than one alcoholic drink per day.


• Physical exercise - exercising five days a week has been shown to reduce a woman's risk of developing breast cancer. Researchers from the University of North Carolina Gillings School of Global Public Health in Chapel Hill reported that physical activity can lower breast cancer risk, whether it be either mild or intense, or before/after menopause. However, considerable weight gain may negate these benefits.


• Diet - some experts say that women who follow a healthy, well-balanced diet may reduce their risk of developing breast cancer.
  
  Fish oils help reduce breast cancer risk - a study published in BMJ (June 2013 issue) found that women who regularly consumed fish and marine n-3 polyunsaturated fatty acids had a 14% lower risk of developing breast cancer, compared to other women. The authors, from Zhejiang University, China, explained that a "regular consumer" should be eating at least 1 or 2 portions of oily fish per week (tuna, salmon, sardines, etc).


• Postmenopausal hormone therapy - limiting hormone therapy may help reduce the risk of developing breast cancer. It is important for the patient to discuss the pros and cons thoroughly with her doctor.


• Bodyweight - women who have a healthy bodyweight have a considerably lower chance of developing breast cancer compared to obese and overweight females.


• Women at high risk of breast cancer - the doctor may recommend estrogen-blocking drugs, including tamoxifen and raloxifene. Tamoxifen may raise the risk of uterine cancer. Preventive surgery is a possible option for women at very high risk.


• Breast cancer screening - patients should discuss with their doctor when to start breast cancer screening exams and tests.


• Breastfeeding - women who breastfeed run a lower risk of developing breast cancer compared to other women.
  
  A team of researchers from the University of Granada in Spain reported in the Journal of Clinical Nursing that breastfeeding for at least six months reduces the risk of early breast cancer. This only applies to non-smoking women, the team added. They found that mothers who breastfed for six months or more, if they developed breast cancer, did so on average ten years later than other women.

Survivors of breast cancer and diabetes risk

Postmenopausal women who survived breast cancer are more likely to develop diabetes, compared to other women of their age who did not have breast cancer, researchers from the Women's College Hospital, Women's College Research Institute, Toronto, reported in the journal Diabetologia.

The authors added that breast cancer survivors who had undergone chemotherapy were especially at risk of developing diabetes.

Over the last few years, scientists have become increasingly aware of a link between cancer and diabetes. The association works the other way round too - women with diabetes are 20% more likely to develop breast cancer after the menopause compared to their counterparts who are not diabetic.

More women are surviving breast cancer, experts say, making it much more important to understand what the long-term outcomes for survivors are as they grow older.

EBOLA VIRUS: Symptoms, Treatment and Prevention

Ebola Virus Infection

What is Ebola?

Ebola is a deadly disease caused by a virus. There are five strains, and four of them can make people sick. After entering the body, it kills cells, making some of them explode. It wrecks the immune system, causes heavy bleeding inside the body, and damages almost every organ.
The virus is scary, but it’s also rare. You can get it only from direct contact with an infected person’s body fluids.

Editor's note: This story was updated on Nov. 17, 2014, with the death of Martin Salia, a doctor brought to the U.S. from Sierra Leone for treatment.
 
Perhaps no virus strikes as much fear in people as Ebola, the cause of a deadly outbreak in West Africa.
The World Health Organization (WHO) reports more than 14,400 confirmed or suspected cases of Ebola, mostly in the countries of Guinea, Liberia, and Sierra Leone, as of Nov. 11. More than 5,100 people have died in the largest Ebola outbreak ever recorded.
Four confirmed or probable cases have been reported in Mali, along with three deaths, the WHO said.
A surgeon from Sierra Leone who lives in the United States died after being flown to the Nabraska Medical Center for treatment, the hospital said Nov. 17.

NIH's Dr. Fauci answers your questions about Ebola.

Martin Salia, who was reportedly working at a hospital in the Sierra Leone capital of Freetown, arrived in the U.S. Nov. 15 and was taken to the medical center.
He was in extremely critical condition, suffering from kidney and respiratory failure, when he arrived, the hospital said.“We used every possible treatment available to give Dr. Salia every possible opportunity for survival,” said Phil Smith, MD, medical director of the hospital’s biocontainment unit. That included giving him the experimental treatment ZMapp, also given to other Ebola patients, according to the hospital.
But Salia’s disease was “extremely advanced,” Smith said in a statement.
Salia was reportedly a permanent U.S. resident who lived in Maryland with his family.
Two other Americans – Rick Sacra, MD, and Ashoka Mukpo – recovered from Ebola after being treated in the Omaha isolation unit.

How Ebola Kills

A Doctors Without Borders physician who returned to the U.S. after treating Ebola patients in Guinea was the latest person in the U.S. to be diagnosed with Ebola. Craig Spencer, MD, recovered after getting treatment at New York’s Bellevue Hospital. He was released on Nov. 11.
Spencer, who returned to New York on Oct. 17, was taken to the hospital 6 days later after reporting a fever and vomiting

        

Two nurses at a Dallas hospital also caught Ebola after treating Thomas Eric Duncan, a Liberian man who later died. The nurses, Nina Pham, 26, and Amber Vinson, 29, both work at Texas Health Presbyterian Hospital. Duncan arrived in the U.S. on Sept. 20 to visit relatives and 10 days later became the first person to be diagnosed with Ebola in the U.S. He died Oct. 8.
Both Pham and Vinson recovered from the virus and have been released from hospitals. No one who had contact with them, including people on flights Vinson took from Cleveland to Dallas and back before being admitted to a hospital, caught Ebola.
In total, five Americans infected with the virus in Africa have been brought back to the U.S. for treatment. All have recovered. The five include aid workers Sacra, Kent Brantly, MD, and Nancy Writebol.
The fourth person was flown back to the U.S. on Sept. 9 for treatment at Atlanta’s Emory University Hospital, where Brantly and Writebol were also treated. This person's arrival came after the WHO said one of its doctors was being evacuated from Sierra Leone after getting Ebola. The man was released from the hospital Oct. 19. He wants  to remain anonymous, the hospital said.
Mukpo, a freelance cameraman for NBC News, was flown to Omaha on Oct. 6. He was part of a crew covering the outbreak in West Africa. He was released Oct. 22.

Ebola Outbreak Unfolds in Africa

On Aug. 8, the WHO declared the Ebola outbreak in West Africa to be a “public health emergency of international concern.” It said “a coordinated international response is deemed essential to stop and reverse the international spread” of the virus.
On Sept. 16, President Barack Obama announced a plan to scale up the nation’s response to the Ebola crisis in West Africa. Responding to a plea for help from the Liberian government, Obama said the Department of Defense will send personnel there to boost the international response to the outbreak. The U.S. will also build 17 100-bed units to treat Ebola patients.
Ebola was first identified in 1976, when it appeared in outbreaks in Sudan and the Democratic Republic of the Congo. It is named for the Ebola River, which runs near the Congolese village where one of the first outbreaks happened.
WebMD asked Amesh Adalja, MD, about the virus and efforts to contain it. Adalja is an infectious disease doctor at the University of Pittsburgh.
             

Q. How deadly is Ebola?
A. The Ebola strain in the current outbreak is the most lethal of the five known strains of the virus. It is called Ebola Zaire and usually kills up to 9 out of 10 infected people. But the high death rate might be due to a lack of modern medical care, Adalja says. “It’s hard to say exactly what the [death] rate would be in a modern hospital with all of its intensive care units.”
The CDC said in July the Ebola death rate in the West African outbreak is about 6 in 10, rather than 9 in 10. That shows that early treatment efforts have been effective, says Stephan Monroe, deputy director of the National Center for Emerging and Zoonotic Infectious Diseases at the CDC.
On July 31, the CDC issued a travel advisory recommending against non-essential travel to Guinea, Liberia, and Sierra Leone.
Q. What are the symptoms?
A. At first, the symptoms are like a bad case of the flu: high fever, muscle aches, headache, sore throat, and weakness. They are followed quickly by vomiting, diarrhea, and internal and external bleeding, which can spread the virus. The kidneys and liver begin to fail.
Ebola Zaire kills people quickly, typically 7 to 14 days after symptoms appear, Adalja says.
A person can have the virus but not show any symptoms for as long as 3 weeks, he says. People who survive can still have the virus in their system for weeks afterward.
The virus has been detected in semen up to 7 weeks after recovery, according to the WHO. But this is very rare, says Thomas Geisbert, PhD, a professor of microbiology and immunology at the University of Texas Medical Branch. Geisbert has been studying the Ebola virus since 1988.
                   

Q. How does the virus spread?
A. Ebola isn’t as contagious as more common viruses, such as colds, influenza, or measles, Adalja says. It spreads to people by close contact with skin and bodily fluids from infected animals, such as fruit bats and monkeys. Then it spreads from person to person the same way.
“The key message is to minimize bodily fluid exposures,” Adalja says.

           
Q. What precautions should people take if they’re concerned they might come in contact with someone infected with Ebola?
A. “Ebola is very hard to catch,” Adalja emphasizes. Infected people are contagious only after symptoms appear, by which time close contacts, such as health care workers and family members, would use “universal precautions.” That's an infection control approach in which all blood and certain body fluids are treated as if they are infectious for diseases that can be borne in them, Adalja says.
Even though the virus can be transmitted by kissing or sex, people with Ebola symptoms are so sick that they’re not typically taking part in those behaviors, he says.

               

Q. Is there a cure or a vaccine to protect against it?
A. No, but scientists are working on both. The National Institutes of Health is taking part in human testing of an experimental Ebola vaccine, which began in early September. Testing for that vaccine is also taking place in the U.K. and Mali.
The agency expects to have results of that trial by the end of 2014. The NIH is also testing several other potential vaccines.
There is no specific treatment for Ebola. The only treatments available are supportive kinds, such as IV fluids and medications to level out blood pressure, a breathing machine, and transfusions, Adalja says.
ZMapp was given to Brantly and Writebol, among others. But health officials don't know if it aided in their recovery. A trial of ZMapp in 18 Ebola-infected rhesus monkeys prompted recovery in all 18, researchers reported.
               
Sacra received a different treatment, called TKM-Ebola. He also received a blood transfusion from Brantly, a friend. Health officials don't know if any of these treatments helped with his recovery.
Duncan and Mukpo both received an experimental drug named brincidofovir. The drug is being tested for effectiveness against cytomegalovirus and adenovirus, but test-tube experiments done at the CDC and National Institutes of Health reveal it showed effectiveness against Ebola, according to its manufacturer, Chimerix Inc.
Mukpo and Pham also received blood transfusions from Brantly.
Spencer was reportedly given a range of treatments, including an experimental drug and a blood transfusion from Writebol. The experimental drug was not identified.
Q. Why do some people survive the virus?
A. That’s hard to say. Adalja thinks several things might play a role, such as a person's age and genetic makeup, and whether they have other medical conditions. Those aren't proven reasons, though.
Q. How can the outbreak be stopped?
A. Simple steps to control infection, such as gowns, gloves, and eye protection, can help halt the spread of Ebola, Adalja says. Public health officials will have to wait 6 weeks after the last case is reported before declaring the outbreak over, he says.
Keys to stopping Ebola include identifying patients; providing treatment, preventing the spread, and protecting health care workers, including following patients’ contacts and monitoring them for symptoms; and preventing future cases through education and urging people to avoid close contact with sick people or bodies, Frieden has said.
But, he said, turning the tide in Western Africa is “not going to be quick or easy. Even in a best-case scenario, it would take 3 to 6 months or more.”
Q. Could an Ebola outbreak happen in the United States?
Although concerns have grown since Sept. 30, when the first case was diagnosed in the U.S., health officials have continued to say they are well-prepared to deal with Ebola, and that the risk of an outbreak remains low.
        

“I have no doubt that we will control this importation or this case of Ebola so that it doesn’t spread widely in this country,” Frieden told reporters on Sept. 30.
The first case diagnosed in the U.S. was “not unexpected,” says William Schaffner, MD, an infectious disease specialist at Nashville’s Vanderbilt University Hospital. “There’s a lot of travel between West Africa and the United States, and we all anticipated that sooner or later there would be a traveler exposed.”

Measures are being taken to isolate members of the man’s family and track others he was in contact with. 

        

Because the virus isn't airborne, “it would take very close contact with someone who is at an advanced stage of illness to become infected,” Thomas Geisbert tells HealthDay.
One of the five Ebola virus strains caused an outbreak in laboratory monkeys in Reston, VA, outside Washington, DC, in 1989. People who were exposed to that strain of Ebola virus did not get sick. But they developed antibodies to it.

Reviewed by Michael W. Smith, MD on November 17, 2014