Many supposed breast cancer risk genes don’t raise risk, studies find

https://www.inquirer.com/health/which-breast-cancer-genes-really-matter-penn-mayo-clinic-study-surprises-20210210.html

In the quarter century since the watershed discovery of BRCA1 and BRCA2, dozens of other genes have been implicated in hereditary breast cancer.

A slew of commercial tests are now available that look for mutations in those breast cancer “predisposition genes” to help guide health-care decisions.

The thing is, some of the genes barely nudge cancer risk. Even BRCA1/2, dreaded as time bombs, can have harmless DNA variations, or variants that haven’t been studied enough to be classified.

Two ambitious analyses of breast cancer risk genes — a U.S. study that included the University of Pennsylvania, and a British-led international study — help to clarify which ones warrant risk-management strategies, such as increased screening or preventive surgeries, and which ones are probably inconsequential.

» READ MORE: With BRCA genetic testing on rise, insurers balk

Both analyses, published last month in the New England Journal of Medicine, used previous population-based studies to figure out which faulty genes confer a susceptibility, and how common the flaws are in women in general. The U.S. study looked for changes in 28 genes in 32,000 women with breast cancer diagnoses and an equally large “control” group without cancer. The international study evaluated 34 genes in 60,500 breast cancer cases and an equal number of women without cancer.

But the results for a much bigger alphabet soup of genes were ambiguous, or insignificant. Sixteen genes in the U.S. study and 22 in the international study were not tied to susceptibility to the disease.

The U.S. study detected harmful genetic variants in 5% of breast cancer cases and 1.6% of women in the control group. Studies of high-risk women have estimated that 7% to 10% of all breast cancers are due to inherited mutations.

The work “shows us a clearer picture of risk and genetic drivers for women in the general population who don’t fall under the high-risk category,” said Susan M. Domchek, executive director of Penn’s Basser Center for BRCA and an author of the U.S. study, led by the Mayo Clinic.

Ellen Matloff, a certified genetic counselor and founder of My Gene Counsel, which provides programs to increase access to counseling, said the new research illustrates the complexity of interpreting genetic test results, especially as test panels add genes for which evidence is scant.

“A lot of practitioners think ‘the more genes in the panel, the better,’ ” Matloff said. “This paper shows more genes can add to confusion. People can be advised to have unnecessary surgeries and screening. We’ve had patients with late diagnoses because they were told they were not at risk when they were.”

Indeed, in a recent case study published by Precision Oncology News in collaboration with My Gene Counsel, a 42-year-old woman received incorrect advice about two breast cancer risk genes both of them part of the new population-based studies.

The woman’s case began with a suspicious mammogram, followed by a breast biopsy that found no sign of cancer. Despite the good news, her breast surgeon ordered genetic testing because three members of her extended family died of pancreatic cancer.

Her PALB2 gene had a “variant of unknown significance” — meaning more study is needed to classify it as harmless or disease-related. Her surgeon told her not to worry about it.

PALB2 mutations were linked to a moderately increased risk of breast cancer in the new studies.

She also had an alteration in RAD50, a gene with such a limited breast cancer link that expert guidelines do not recommend considering extra screening or preventive surgeries.

The new population-based studies found RAD50 was not linked at all to increased breast cancer risk.

The surgeon, however, advised his patient to remove both healthy breasts because of the RAD50 variant.

That drastic elective surgery was scuttled because of the pandemic, giving her time to consult a genetic counselor. The patient ultimately opted for increased screening — because of the PALB2 variant her surgeon had brushed aside.

Matloff acknowledges her bias, but having written journal articles compiling such cases, she believes patients must have access, at least by phone or video, to professionals who can advise them and their families.

“There are calls by some prominent scientists that we should be testing all women for breast cancer genes. But data shows breast surgeons and others really struggle to interpret very straightforward results. Now, there are test results that are very nuanced.

“Doctors are very busy and the field is changing rapidly,” she continued. “Insurance companies should and must cover genetic counseling.”

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Israeli COVID cure? Researchers hope peptide treatment could slow disease

https://www.jpost.com/health-science/israeli-covid-cure-researchers-hope-peptide-treatment-could-slow-disease-658380

The trial is being run by Ziv and Rambam medical centers with researchers from Bar-Ilan University and Technion Institute of Science.

By MAAYAN JAFFE-HOFFMAN

FEBRUARY 10, 2021 19:29

A pulmonary alveolus

(photo credit: CREATIVE COMMONS)

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I tried to verify this media source but this is all I could find  https://en.wikipedia.org/wiki/The_Post_Millennial  and they are based in Canada.  One of the links in this article is to a EO issued by Biden about reversing the easing the ability of prescribers to prescribe/treat substance abuser/addicts with Suboxone type product, but does not mention anything about cutting Rx opiates to pts that have a valid medical necessity. 

I have often stated that the worse thing for the community is a “person of power” that has a friend/relative that has OD’d or has a substance abuse issue and President’s Biden son Hunter Biden just release a book  Beautiful Things: A Memoir

“These hardships were compounded by the collapse of his marriage and a years-long battle with drug and alcohol addiction.”

So now we have someone in the White House – the most powerful person on the planet – that sort of matches that description of someone who would/could do something … so that “.. no one should ever have to deal with what they had to deal with.

Joe Biden’s new EO denies patients in pain the medication they need

https://thepostmillennial.com/joe-bidens-new-eo-that-denies-patients-in-pain-the-medication-they-need

While campaigning, then-candidate Joe Biden proposed to make life much harder for pain patients, the disabled, and addicts. As President, he has lived up to his word.

While campaigning, then-candidate Joe Biden proposed to make life much harder for pain patients, the disabled, and addicts. As President, he has lived up to his word.

The US Drug Enforcement Administration, led by Democrats, is enacting a plan to expand patient surveillance massively, circumventing HIPPA protections and codifying the unofficial regulations that make up the prescription opioid prohibition. In the face

of a worsening opioid crisis, regulators and federal and state governments hope to make getting pain treatment more impossible.

Even as millions of patients cry out for help and scientific institutions put out studies advocating sheer barbarism, the age of Biden will mean not only a weakened economy, a government-run amuck but a medical surveillance state.

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A new day and another video of pain to bring you. This video is important. It was after this pain episode that this doctor tried to stop us recording these episodes. Even Social Services tried to stop us recording at the Doctors request. The Doctor even went to the carers agency to stop the carers recording too. But the carers were employed by me. If that’s not a guilty conscience then what is??

But we carried on recording as much as we could. We just got clever about it, hiding our phones so the nurses couldn’t see. This pain episode was also the episode that prompted the nurses to start pulling the curtains around melody so other parents couldn’t witness her pleas for help, her desperation, her begging eyes. And no one coming to help. This episode went on for a couple of hours, until a doctor that was covering the ward that didn’t know melody witnessed it and gave her morphine. It took two doses of Morphine to get it under control due to how severe it was and how long it was left. This episode is important. This episode was the start of the hospital cover up. Parents were crying witnessing it. My carers were crying. The day after, I tried to show Melody’s liver consultant. He REFUSED to watch it!!!!!!!!!! He has twin girls the same age as Melody and he refused to acknowledge it. He just simply carried on the other doctors request of weaning down and taking away Melody’s medications

Melody needs Justice. She should never of been put through this!

Please keep Donating and Sharing as much as you can. Every penny counts

JUSTICE FOR MELODY

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High Levels of Toxic Heavy Metals Found in Some Baby Foods: Report

https://www.medscape.com/viewarticle/945289

WASHINGTON (Reuters) – U.S. congressional investigators found “dangerous levels of toxic heavy metals” in certain baby foods that could cause neurological damage, a House Oversight subcommittee said in a report released on Thursday.

The panel examined baby foods made by Nurture Inc, Hain Celestial Group Inc, Beech-Nut Nutrition and Gerber, a unit of Nestle, it said, adding that it was “greatly concerned” that Walmart Inc, Campbell Soup Co and Sprout Organic Foods refused to cooperate with the investigation.

The report said internal company standards “permit dangerously high levels of toxic heavy metals, and documents revealed that the manufacturers have often sold foods that exceeded those levels” and it called on U.S. regulators to set maximum levels of toxic heavy metals permitted in baby foods and require manufacturers to test finished products for heavy metals, not just ingredients.

Representative Raja Krishnamoorthi, a Democrat who chairs the panel that released the report, said it found “these manufacturers knowingly sell baby food containing high levels of toxic heavy metals … It’s time that we develop much better standards for the sake of future generations.”

A Food and Drug Administration (FDA) spokesman said it was reviewing the report.

The agency noted toxic elements are present in the environment and enter the food supply through soil, water or air. “Because they cannot be completely removed, our goal is to reduce exposure to toxic elements in foods to the greatest extent feasible,” the FDA said.

Campbell said in a statement on its website that its products are safe and cited the lack of a current FDA standard for heavy metals in baby food. The company said it thought it had been “full partners” in the study with congressional researchers.

Walmart said it submitted information to the committee in February 2020 and never received any subsequent inquiries. The retail giant requires private label product suppliers to hew to its own internal specifications, “which for baby and toddler food means the levels must meet or fall below the limits established by the FDA.”

Hain Celestial, which makes Earth’s Best, said it had not seen the report and did not have a chance to review it.

A Gerber representative said the elements in question occur naturally in the soil and water in which crops are grown and added it takes multiple steps “to minimize their presence.”

The report was critical also of the administration of former President Donald Trump, saying it “ignored a secret industry presentation to federal regulators revealing increased risks of toxic heavy metals in baby foods.”

The report said “in 100% of the Hain baby foods tested, inorganic arsenic levels were higher in the finished baby food than the company estimated they would be based on individual ingredient testing.”

It said that in August 2019 the FDA received a secret slide presentation from Hain that said “corporate policies to test only ingredients, not final products, underrepresent the levels of toxic heavy metals in baby foods.”

The report said the FDA took no new action in response. “To this day, baby foods containing toxic heavy metals bear no label or warning to parents. Manufacturers are free to test only ingredients, or, for the vast majority of baby foods, to conduct no testing at all,” the report said.

The FDA has declared that inorganic arsenic, lead, cadmium, and mercury are dangerous, particularly to infants and children, the report noted.

The FDA in August finalized guidance to industry, setting an action level of 100 parts per billion inorganic arsenic in infant rice cereal.

“We acknowledge that there is more work to be done, but the FDA reiterates its strong commitment to continue to reduce consumer exposure to toxic elements and other contaminants from food,” the FDA said Thursday.

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The National Pain Council is a citizens and professional group with the goal to suspend the CDC Guidelines now that the AMA has declared the guidelines as having “harmed many patients”. We will work to suspend these dangerous informal “guidelines” written by people without the clinical experience to write medical guidelines, and with noticeable bias toward pain nihilism. Look over our goals at www.Nationalpaincouncil.org and donate! We need money for lobbyists, for lawyers to file lawsuits against those who have harmed us.

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https://youtu.be/bMPDE8u2biM

Narcan is a drug that is is given to heroin addicts who Overdose. Only 5% of people who Overdose do so on prescribe prescription drug. Most of these people are dying from the underlying disease, not the medicines. Tax-papers fund these follies. 10 million w painful disease who will never use x $150 is 5 billion wasted.

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JATH educational contortion continuing to research the origins of why pres drugs have become the focus of the opioid epidemic, present since the end of the civil war. We have found the watershed paper, published by Lenard palazzi, a supporter of the PROP, a small group of radial ideologists, who believe no one should have access. The Palazzi 2006 article switched because of the opioid crisis from heroin to prescription drugs, inciting docs instead of heroin drug dealers. This paper is severely flawed and was presented in its flawed status, to the Joe Biden senate committee in 2008, it has remained invalid since that time.

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https://makeamericansfreeagain.com/

Lawsuit Update: This Will Make Your Day!

The truth about CDC’s Covid-19 death rate — and the conspiracies undermining it

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Abrupt Cessation of Long-Term Opioid Prescribing Common

Most Medicare patients stopping long-term opioids experienced ‘falling off a cliff’ drug changes

https://www.medpagetoday.com/neurology/opioids/91060

Medicare beneficiaries were increasingly likely to have long-term opioid therapy stopped in recent years and medication changes often were abrupt, not tapered, an observational study showed. This blog also shows how to get Suboxone online for treating opioid addiction.

Long-term opioid discontinuations among Medicare Part D beneficiaries increased by 49% from 2012 to 2017 and most were rapid, “falling off a cliff” drug changes, reported Michael Barnett, MD, MS, of Harvard T. H. Chan School of Public Health and Brigham and Women’s Hospital in Boston, and co-authors.

The proportion of abrupt opioid discontinuations increased over time, from 70.1% in 2012 to 81.2% in 2017 (P<0.001), they wrote in the Journal of General Internal Medicine.

Patients on long-term opioid therapy “face significant stigma and misunderstanding in the current healthcare system,” Barnett said. “There are many reports of patients being indiscriminately discontinued from their medications, but little data to investigate these concerning reports,” he told MedPage Today.

“The vast majority of long-term opioid users whose therapy was discontinued had an extremely rapid, abrupt taper that was far outside of guideline recommendations,” Barnett added. “It would have been concerning to find that, say, one in four long-term opioid users had abrupt cessation of their therapy but we found that it was most, even among those with very high daily doses of opioids.”

The CDC and FDA have published cautions against abrupt tapering, citing it as dangerous to patient health, noted Beth Darnall, PhD, director of the Stanford University Pain Relief Innovations Lab, who wasn’t involved with the research.

This study highlights the pervasiveness of poor tapering practices occurring from 2012-2017 and the extent of pain care disparities, she observed. “As of 2017, these alarming trends continued to increase,” Darnall told MedPage Today. “There is a desperate need for improved healthcare and safety measures for people with chronic pain taking prescribed opioids so they are not subjected to unethical and dangerous practices.”

The CDC’s 2016 guideline for chronic pain opioid prescribing prompted a big focus to reduce overprescribing. Some state agencies and insurance companies used the guideline to push hard dose limits and abrupt tapering, which the CDC later said was inconsistent with its recommendations.

“In 2018, a group of us authored a letter to HHS calling for urgent action against forced and abrupt opioid tapering,” Darnall said. “In 2019, HHS issued guidance for patient-centered opioid tapering that promotes consensual tapering practices.”

In their study, Barnett and co-authors looked at claims for a 20% sample of Medicare beneficiaries on long-term opioid therapy for at least 1 year, defined as four or more consecutive quarters with more than 60 days of opioids supplied in each quarter from January 2011 through December 2017. People with a cancer diagnosis besides skin cancer and hospice patients were excluded, as were people on an average daily dose of 25 morphine milligram equivalents (MME) or less during their initial 12-month long-term opioid therapy period.

Most (70.3%) long-term opioid users in the study were eligible for Medicare due to disability. Mean age was 60 and 58% were women.

Long-term opioid discontinuation was defined as at least 60 consecutive days without opioids supplied. The researchers evaluated whether discontinuation was tapered or abrupt by comparing patients’ daily MME dose in the last month of therapy to their average daily dose in a baseline period of 7 to 12 months before discontinuation. By the last month of therapy, patients with abrupt discontinuation had at least a 50% reduction in their baseline average daily dose.

The study identified 258,988 long-term opioid therapy users; of these, 17,617 (6.8%) discontinued therapy. Adjusted rates of discontinuation increased from 5.7% of users in 2012 to 8.5% in 2017. Increases in annual discontinuation rates were similar for people on lower (26-90 MME, 5.8% to 8.7%) and higher (more than 90 MME, 5.3% to 7.7%) doses.

People eligible for Medicare because of disability had a greater increase in the probability of discontinuing opioids from 2012-2017 (adjusted rates 5.9% to 9.2%, 56% relative increase) compared with people not eligible due to disability (5.2% to 7.0%, 35% relative increase, P<0.001 for interaction).

While it was common for patients on lower daily MME doses to have long-term opioids stopped rapidly, the majority of patients on very high doses — even over 200 MME — who stopped also had an abrupt discontinuation, Barnett and co-authors reported.

“We need more education and support for patients on long-term opioid therapy to taper in a clinically rational way and maintain excellent continuity of care with their pain management team,” Barnett said.

The study had several limitations, the researchers noted. Data represent Medicare beneficiaries only, predominantly the disabled Medicare population, and may not apply to other people. The intended tapering strategy for these patients wasn’t known and it’s possible the data reflect a bias toward abrupt discontinuation.

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