Fast Five Quiz: Metastatic Breast Cancer Treatment Issues
Breast cancer care has made remarkable strides in recent years, with advancements in imaging, targeted therapies, minimally invasive surgical techniques, and personalized medicine leading to improved survival rates. Despite these innovations, the management of metastatic and advanced breast cancer remains complex, with treatment-related complications posing significant challenges. From cardiotoxicity to issues such as fatigue, neuropathy, and bone loss, understanding these potential effects is essential for optimizing patient care. As survival rates improve, addressing these challenges becomes even more critical in ensuring long-term well-being.
How well do you understand the treatment complications of metastatic and advanced breast cancer? Take this quick quiz and test your knowledge.
Human epidermal growth factor receptor-2 (HER2) targeted therapies are associated with a higher risk for treatment-related cardiovascular toxicity, particularly in causing cancer therapy–related cardiac dysfunction during and after treatment. Anthracycline-based and HER2-targeted therapies pose significant risks of cardiovascular toxicity, including heart failure, making them a major concern for long-term breast cancer survivors.
Although antibody-drug conjugates and immune checkpoint inhibitors are being rapidly developed and used alongside traditional chemotherapy, their cardiovascular toxicity risks remain less well understood and appear to be lower compared with HER2-targeted treatments. Additionally, sodium glucose cotransporter-2 inhibitors have shown promise in cardioprotection rather than contributing to cardiovascular toxicity.
Learn more about HER2-targeted therapies.
A key complication associated with whole-brain radiotherapy is neurocognitive decline. Whole-brain radiotherapy can cause long-term impairments in verbal learning, memory, executive function, and verbal fluency, primarily due to hippocampal dysfunction. Stereotactic radiosurgery can affect verbal learning, memory, fine motor coordination, and executive function.
Meningitis, seizures, and hemorrhage are complications more commonly associated with surgical treatment of brain metastases, not whole-brain radiotherapy.
Learn more about brain metastasis in metastatic breast cancer.
According to a comprehensive analysis, non-Hispanic Black patients with late-stage breast cancer had higher rates of chemotherapy-related complications compared with non-Hispanic White patients. This includes higher rates of cardiomyopathy, diarrhea/enteritis, fatigue, nausea/vomiting, neuropathy, lung disease, pain, dehydration/hypovolemia, rash, and infusion reactions. Non-Hispanic Black patients also had higher rates of cardiovascular toxicities such as acute myocardial infarction and pneumonitis. Non-Hispanic White patients had higher rates of being diagnosed with psychological issues, although non-Hispanic Black patients had higher rates of cognitive decline and dementia.
There were no significant differences in overall immune-related toxicities between non-Hispanic Black and non-Hispanic White patients. These racial disparities in breast cancer treatment-related adverse events might be due to non-Hispanic Black and non-Hispanic White patients receiving different treatments. Non-Hispanic Black patients have a higher probability of receiving adjuvant therapy, whereas non-Hispanic White patients have a higher probability of undergoing curative-intent breast cancer surgery and being prescribed endocrine therapy.
Learn more about breast cancer treatment protocols.
A systematic review and meta-analysis indicated that although various postoperative complications can occur, seroma is the most frequently reported. It involves the accumulation of fluid at the surgical site, which can lead to discomfort, delayed wound healing, and, in some cases, infection. Other complications, such as hematoma, surgical-site infection, and chronic neuropathic postoperative pain, are also recognized but occur less frequently.
Learn more about surgical treatment of breast cancer.
Calcium channel blockers are preferred for managing cancer therapy-related cardiac dysfunction in patients with advanced breast cancer and hypertension, due to their cardiovascular benefits. Calcium channel blockers, particularly in combination with renin-angiotensin system inhibitors, provide superior cardiovascular outcomes compared with beta-blockers and diuretics in hypertensive patients undergoing cardiotoxic chemotherapy. They effectively reduce blood pressure variability and arterial stiffness, contributing to improved cardiovascular health.
Although diuretics are commonly used to manage hypertension and heart failure, they do not provide the same protective cardiovascular benefits as calcium channels blockers or renin-angiotensin system inhibitors in this specific patient population. Although statins might reduce oxidative stress and inflammation, their efficacy in preventing cancer therapy-related cardiac dysfunction remains controversial due to conflicting results from major clinical trials. Beta-blockers are used for heart failure management but are not the preferred antihypertensive agents in patients undergoing cardiotoxic chemotherapy.
Learn more about signs and symptoms of hypertension.
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3 hours ago
- Yahoo
Are Pesticides in Your Food Harmful?
Credit - iStockphoto—Getty Images Various chemicals, from those in plastics to food additives, have made headlines lately for their potential roles in triggering diseases. Pesticides are unique among chemicals, though, says Melissa Perry, an environmental epidemiologist and dean of George Mason's College of Public Health. 'They're deliberately manufactured to kill things.' By poisoning weeds, pesticides clear the way for farmers' crops to thrive. But their deadly design may undermine human health, too. A recent report by a new federal advisory board, the Make America Healthy Again (MAHA) Commission chaired by Health Secretary Robert F. Kennedy Jr., calls for further investigation of pesticides' effects to determine if their use should be limited. Some evidence does suggest that long-term exposure could lead to cancer and several other serious health problems. More research is needed to better understand these risks, but in the meantime, experts recommend simple, practical steps to reduce intake. Here's what we know about the risks of pesticides and how to lower your exposure. The MAHA report assesses 'root causes' of poor health in U.S. children. It describes pesticides as one of eight types of chemicals giving rise to chronic diseases. The report specifically takes issue with two weed killers, glyphosate and atrazine. They're the most commonly used pesticides by American farmers, and research has focused on them in lab experiments on animals, with several concerning findings. Other studies have drawn links between glyphosate exposure—mainly by consuming trace amounts in food—and health problems, including earlier death. In 2019, a large research review identified a 'compelling link' between glyphosate intake and non-Hodgkin lymphoma in humans, though in 2024 a federal judge criticized this study's design and approach. Additional research points to a range of diseases potentially related to glyphosate, but a recent review by Italian researchers on glyphosate was inconclusive and called for further research. Read More: Seed Oils Don't Deserve Their Bad Reputation Based on the evidence, the World Health Organization (WHO) has described glyphosate as 'probably carcinogenic to humans,' whereas the U.S. Environmental Protection Agency (EPA) found 'no evidence that glyphosate causes cancer in humans,' citing a dataset the agency considered more thorough than WHO's. The second widespread pesticide highlighted by the MAHA report is atrazine. Like glyphosate, it's been used by farmers since the 1960s, but research on animals in the 1990s began to show it could disrupt reproductive health and hormone regulation. Tyrone B. Hayes, a biologist at the University of California, Berkeley, found that atrazine interfered with the sexual development of frogs. Subsequent studies showed similar effects, as well as weight gain, in mice. Researchers have also observed that women in certain agricultural communities experience higher rates of abnormal menstrual cycles, compared to places with fewer farms. Other human studies show increases in several kinds of birth defects. Still more research links atrazine to breast cancer, but researchers at the National Institutes of Health have concluded 'no evidence of an association' with cancer. The EPA estimated that atrazine adversely affects 54% of all species and 50% of all critical habitats. 'I don't know how an Environmental Protection Agency can make a statement like that and then re-register the chemical,' Hayes says. In 2023, U.S. Department of Agriculture (USDA) data showed that 99% of food samples tested below the EPA's safety limit for pesticides. However, U.S. limits are considerably higher than what's allowed in the European Union, where atrazine has been effectively banned. Read More: The Best Longevity Habit You're Not Thinking About Pesticides called organophosphates have been studied by the EPA and others for links to neurological disorders such as ADHD. 'Research clearly shows that children exposed to higher levels did have more neurobehavioral problems,' says Jason Richardson, professor of physiology and pharmacology at the University of Georgia's Isakson Center for Neurological Disease Research. Overall, uncertainty and debate about pesticides continues partly due to research challenges. People are typically exposed to multiple types of chemicals, so it's 'hard to attribute disease to one pesticide or pinpoint the definitive dose or exposure time' that makes people sick, Perry says. 'Just because a chemical is present doesn't mean it's doing anything bad, but in combination with other chemicals, it may be,' Richardson says. 'Efforts are underway to measure these combinations.' 'The country's agricultural policy follows science, not fear, speculation, and fringe narratives,' says Becky Langer-Curry, director of innovation at the National Corn Growers Association. The Corn Growers were 'perplexed' by the MAHA report, she adds. 'We need faith in the EPA's regulatory system to review the science. They're ensuring our food is safe, well below human risk.' In an email to EPA spokesperson Mike Bastasch said the EPA'typically regulates pesticides at least 100 times lower than where no adverse effects are seen in safety studies.' The agency is 'confident that the fruits and vegetables our children are eating are safer than ever,' Bastasch wrote. However, he added that the EPA is updating its evaluation of glyphosate's cancer-causing potential, and it's currently working on an Updated Mitigation Proposal for atrazine. In the meantime, researchers including Perry, Richardson, and Hayes think pesticides are dangerous enough that people should take precautions—but especially young kids, people who are pregnant, those who live close to farms, agricultural workers, and seniors. The first step is to become aware of pesticides in your environment. They're more common than people think, Perry says. 'Exposures happen routinely for most members of the American public.' Experts recommend contacting the environmental office of your county or city to learn whether you're close to a food production facility that uses pesticides. In 2017, kids and teachers at a Hawaii middle school reported unusual throat irritation and dizziness. They suspected the symptoms were caused by pesticides applied in nearby fields, and researchers found residues in the school's indoor and outdoor air samples. Read More: What to Do If Fluoride Is Removed From Your Water The detected levels were deemed below concerning thresholds. Bastasch says that, for communities near farms, the EPA studies potential exposure through the air and other pathways to make sure safety levels are based on sound science. Still, Hayes worries about the long-term effects of pesticide contact and absorption. 'For someone living in a farming community that's constantly exposed to estrogen mimics like atrazine, you're more likely to develop adverse effects,' he says. People take in atrazine mainly through their drinking water, after farm runoff carries the pesticide into local water systems. But some utilities are more effective than others at removing pesticide residues. The Environmental Working Group rates local water utilities. For people on well water, the federal government provides guidelines for testing it. Pesticide use is widespread enough—and disperses at such distances—that everyone should probably use a high-quality water filter, experts say. Atrazine can travel as far as 600 miles, Hayes says. As far back as 1999, USGS noticed that pesticides, including atrazine, were detected in places where farmers hadn't applied them. Even for residents of areas where a water treatment plant removes the chemicals, buying a filter certified to the NSF/ANSI Standards 42 and 53 provides some additional assurance of water safety. Look for filters in refrigerators and water pitchers that meet this certification. Eating organic foods can also help to reduce intake of pesticides, especially glyphosate. About 90% of pregnant women have detectable amounts of glyphosate in their bodies, according to one study. 'But when you put people on organic diets, you start to see that they no longer have pesticides in their urine,' Perry says. Research in 2020 found that eating an organic diet dropped glyphosate levels by 70% in children and their parents. In 2023, researchers put pregnant women on an organic diet for one week. Those who went all-organic decreased glyphosate in their urine by 43%. A 2019 study found a 95% reduction in organophosphates. Richardson calls these studies on organic foods 'intriguing' while noting that natural compounds used in organic farming may also be toxic beyond certain thresholds. Even when eating organic, 'make sure you wash your fruits and vegetables very well,' he says. Read More: Dermatologists Have a Dirty Little Secret One study found that soaking apples in baking soda mixed with water for 12-15 minutes eliminated more residue than water alone. However, according to another study, washing produce with running water is superior to baking soda, sitting water, and vinegar. Other research shows a gentle rubbing action during washing is effective. Aim for 20-30 seconds or longer if you have time. Peeling the skin and outer pulp will get rid of additional residue that penetrates into some produce. There's a major downside, though: you lose a portion of the beneficial nutrients and compounds, like fiber and vitamins, that help protect against pesticide toxicity. Some research suggests that replacing processed foods with diverse whole foods can reduce how many pesticides you ingest (but some research suggests there may be fewer benefits if they're not organic). Aside from nutrition, other lifestyle behaviors such as exercise, stress management, and good sleep may build a baseline of health that helps thwart the cumulative effects of pesticides and other pollutants. Overall, they influence how someone's body responds to their 'exposome,' Richardson explains—your total environmental exposures and how they interact with lifestyle behaviors and risk factors like age and genetics. Bastasch says the EPA assesses the combined risks of groups of pesticides that affect the body in similar ways, adding that the agency is continuing to advance research in this area. The exposome probably matters more than any one chemical type, but 'we're really just breaking the surface of understanding these interactions,' Richardson says. Until more definitive science emerges, maintain smart practices like scrubbing produce and striving for a healthy lifestyle. Contact us at letters@
Time Magazine
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Are Pesticides in Your Food Harmful?
Various chemicals, from those in plastics to food additives, have made headlines lately for their potential roles in triggering diseases. Pesticides are unique among chemicals, though, says Melissa Perry, an environmental epidemiologist and dean of George Mason's College of Public Health. 'They're deliberately manufactured to kill things.' By poisoning weeds, pesticides clear the way for farmers' crops to thrive. But their deadly design may undermine human health, too. A recent report by a new federal advisory board, the Make America Healthy Again (MAHA) Commission chaired by Health Secretary Robert F. Kennedy Jr., calls for further investigation of pesticides' effects to determine if their use should be limited. Some evidence does suggest that long-term exposure could lead to cancer and several other serious health problems. More research is needed to better understand these risks, but in the meantime, experts recommend simple, practical steps to reduce intake. Here's what we know about the risks of pesticides and how to lower your exposure. Research on pesticide risks The MAHA report assesses 'root causes' of poor health in U.S. children. It describes pesticides as one of eight types of chemicals giving rise to chronic diseases. The report specifically takes issue with two weed killers, glyphosate and atrazine. They're the most commonly used pesticides by American farmers, and research has focused on them in lab experiments on animals, with several concerning findings. Other studies have drawn links between glyphosate exposure—mainly by consuming trace amounts in food—and health problems, including earlier death. In 2019, a large research review identified a 'compelling link' between glyphosate intake and non-Hodgkin lymphoma in humans, though in 2024 a federal judge criticized this study's design and approach. Additional research points to a range of diseases potentially related to glyphosate, but a recent review by Italian researchers on glyphosate was inconclusive and called for further research. Based on the evidence, the World Health Organization (WHO) has described glyphosate as 'probably carcinogenic to humans,' whereas the U.S. Environmental Protection Agency (EPA) found 'no evidence that glyphosate causes cancer in humans,' citing a dataset the agency considered more thorough than WHO's. The second widespread pesticide highlighted by the MAHA report is atrazine. Like glyphosate, it's been used by farmers since the 1960s, but research on animals in the 1990s began to show it could disrupt reproductive health and hormone regulation. Tyrone B. Hayes, a biologist at the University of California, Berkeley, found that atrazine interfered with the sexual development of frogs. Subsequent studies showed similar effects, as well as weight gain, in mice. Researchers have also observed that women in certain agricultural communities experience higher rates of abnormal menstrual cycles, compared to places with fewer farms. Other human studies show increases in several kinds of birth defects. Still more research links atrazine to breast cancer, but researchers at the National Institutes of Health have concluded 'no evidence of an association' with cancer. The EPA estimated that atrazine adversely affects 54% of all species and 50% of all critical habitats. 'I don't know how an Environmental Protection Agency can make a statement like that and then re-register the chemical,' Hayes says. In 2023, U.S. Department of Agriculture (USDA) data showed that 99% of food samples tested below the EPA's safety limit for pesticides. However, U.S. limits are considerably higher than what's allowed in the European Union, where atrazine has been effectively banned. Pesticides called organophosphates have been studied by the EPA and others for links to neurological disorders such as ADHD. 'Research clearly shows that children exposed to higher levels did have more neurobehavioral problems,' says Jason Richardson, professor of physiology and pharmacology at the University of Georgia's Isakson Center for Neurological Disease Research. Overall, uncertainty and debate about pesticides continues partly due to research challenges. People are typically exposed to multiple types of chemicals, so it's 'hard to attribute disease to one pesticide or pinpoint the definitive dose or exposure time' that makes people sick, Perry says. 'Just because a chemical is present doesn't mean it's doing anything bad, but in combination with other chemicals, it may be,' Richardson says. 'Efforts are underway to measure these combinations.' 'The country's agricultural policy follows science, not fear, speculation, and fringe narratives,' says Becky Langer-Curry, director of innovation at the National Corn Growers Association. The Corn Growers were 'perplexed' by the MAHA report, she adds. 'We need faith in the EPA's regulatory system to review the science. They're ensuring our food is safe, well below human risk.' In an email to EPA spokesperson Mike Bastasch said the EPA'typically regulates pesticides at least 100 times lower than where no adverse effects are seen in safety studies.' The agency is 'confident that the fruits and vegetables our children are eating are safer than ever,' Bastasch wrote. However, he added that the EPA is updating its evaluation of glyphosate's cancer-causing potential, and it's currently working on an Updated Mitigation Proposal for atrazine. In the meantime, researchers including Perry, Richardson, and Hayes think pesticides are dangerous enough that people should take precautions—but especially young kids, people who are pregnant, those who live close to farms, agricultural workers, and seniors. How to learn more about your exposure The first step is to become aware of pesticides in your environment. They're more common than people think, Perry says. 'Exposures happen routinely for most members of the American public.' Experts recommend contacting the environmental office of your county or city to learn whether you're close to a food production facility that uses pesticides. In 2017, kids and teachers at a Hawaii middle school reported unusual throat irritation and dizziness. They suspected the symptoms were caused by pesticides applied in nearby fields, and researchers found residues in the school's indoor and outdoor air samples. The detected levels were deemed below concerning thresholds. Bastasch says that, for communities near farms, the EPA studies potential exposure through the air and other pathways to make sure safety levels are based on sound science. Still, Hayes worries about the long-term effects of pesticide contact and absorption. 'For someone living in a farming community that's constantly exposed to estrogen mimics like atrazine, you're more likely to develop adverse effects,' he says. People take in atrazine mainly through their drinking water, after farm runoff carries the pesticide into local water systems. But some utilities are more effective than others at removing pesticide residues. The Environmental Working Group rates local water utilities. For people on well water, the federal government provides guidelines for testing it. Use a water filter Pesticide use is widespread enough—and disperses at such distances—that everyone should probably use a high-quality water filter, experts say. Atrazine can travel as far as 600 miles, Hayes says. As far back as 1999, USGS noticed that pesticides, including atrazine, were detected in places where farmers hadn't applied them. Even for residents of areas where a water treatment plant removes the chemicals, buying a filter certified to the NSF/ANSI Standards 42 and 53 provides some additional assurance of water safety. Look for filters in refrigerators and water pitchers that meet this certification. Buy organic Eating organic foods can also help to reduce intake of pesticides, especially glyphosate. About 90% of pregnant women have detectable amounts of glyphosate in their bodies, according to one study. 'But when you put people on organic diets, you start to see that they no longer have pesticides in their urine,' Perry says. Research in 2020 found that eating an organic diet dropped glyphosate levels by 70% in children and their parents. In 2023, researchers put pregnant women on an organic diet for one week. Those who went all-organic decreased glyphosate in their urine by 43%. A 2019 study found a 95% reduction in organophosphates. Wash and peel Richardson calls these studies on organic foods 'intriguing' while noting that natural compounds used in organic farming may also be toxic beyond certain thresholds. Even when eating organic, 'make sure you wash your fruits and vegetables very well,' he says. One study found that soaking apples in baking soda mixed with water for 12-15 minutes eliminated more residue than water alone. However, according to another study, washing produce with running water is superior to baking soda, sitting water, and vinegar. Other research shows a gentle rubbing action during washing is effective. Aim for 20-30 seconds or longer if you have time. Peeling the skin and outer pulp will get rid of additional residue that penetrates into some produce. There's a major downside, though: you lose a portion of the beneficial nutrients and compounds, like fiber and vitamins, that help protect against pesticide toxicity. Some research suggests that replacing processed foods with diverse whole foods can reduce how many pesticides you ingest (but some research suggests there may be fewer benefits if they're not organic). Exercise and manage stress Aside from nutrition, other lifestyle behaviors such as exercise, stress management, and good sleep may build a baseline of health that helps thwart the cumulative effects of pesticides and other pollutants. Overall, they influence how someone's body responds to their ' exposome,' Richardson explains—your total environmental exposures and how they interact with lifestyle behaviors and risk factors like age and genetics. Bastasch says the EPA assesses the combined risks of groups of pesticides that affect the body in similar ways, adding that the agency is continuing to advance research in this area. The exposome probably matters more than any one chemical type, but 'we're really just breaking the surface of understanding these interactions,' Richardson says. Until more definitive science emerges, maintain smart practices like scrubbing produce and striving for a healthy lifestyle.
Yahoo
6 hours ago
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Texas Girl, 17, Thought She Had a Swollen Lymph Node from a Cold. It Turned Out to Be Cancer
Texas teen Makaila Chenier has shared how what she thought was a swollen lymph node from a lingering cold turned out to be cancer The 17-year-old was diagnosed with stage 2 Hodgkin lymphoma earlier this year 'It was just a little lump ... It was very hard because it was like everything changed literally overnight," Mikaila told the outletA teen from Texas is opening up about the moment she found out what she thought was a lump from a lingering cold was actually cancer. Makaila Chenier, 17, found a 'little lump' in her neck in January and thought it was a swollen lymph node, but after it 'got progressively bigger' and she had 'trouble breathing' when she was lying down, she ended visiting her doctor, according to She was referred to an ear, nose and throat doctor who told her to go to the emergency room, where she underwent a series of tests, including an ultrasound, X-ray and CT scan. 'There was definitely a sense of urgency that we picked up on very quickly in the appointments,' Mikaila's mom, Christina Chenier, told 'We knew something wasn't quite right.' It was there that doctors told Makaila they suspected she had lymphoma. 'Doctor said, 'It looks like it might be some sort of lymphoma,' ' Christina told the outlet. 'Hearing your kid may have cancer … it was a gut punch … All of a sudden we were playing a completely different game and everything was completely upside down.' From the ER, Makaila was transferred to Texas Children's Hospital in downtown Houston where she was diagnosed with stage 2 Hodgkin lymphoma the very next day, beginning her first round of chemotherapy just over a week after visiting the ER. 'It was very hard because it was like everything changed literally overnight,' Mikaila, who undergoes chemotherapy every two weeks, told the outlet. 'It was just a little lump.' According to the Mayo Clinic, Lymphoma is 'a cancer of the lymphatic system. The lymphatic system is part of the body's germ-fighting and disease-fighting immune system. Lymphoma begins when healthy cells in the lymphatic system change and grow out of control.' There are two types of lymphoma, Hodgkin lymphoma (formerly called Hodgkin disease) and Non-Hodgkin lymphoma, and symptoms include a fever, night sweats and 'painless swelling of lymph nodes in the belly, neck, armpits or groin.' Never miss a story — sign up for to stay up-to-date on the best of what PEOPLE has to offer, from celebrity news to compelling human interest stories. Mikaila is now homeschooled and has had to miss special occasions like prom. However, there was one milestone the teen didn't want to miss out on. 'They let me do graduation because that's once in a lifetime,' she told the outlet. She is expected to complete her treatment in August and plans to take a gap year before going to college. 'I've been staying really positive through it all and I've learned that really helps get through it because they say time flies when you're having fun,' Makaila said. 'I try to have as much fun as I can and make the best out of it, which has really helped.' Read the original article on People
