Real Race in Cancer Is Finding Its Cause

By SUSAN LOVE, M.D. Published: February 6, 2012

A decision by the nations leading breast cancer advocacy group, Susan G. Komen for the Cure, to largely cut off financing for breast cancer screenings at Planned Parenthood set off howls of outrage last week. Once again, it seemed, political gamesmanship was jeopardizing womens health. The widespread anger forced Komen to reverse its decision, and it has certainly reinvigorated the womens health movement. But the furor misses an important fact: Women have been led to believe that screening is the best prevention. In reality, we still do not know what causes breast cancer, which means we really do not know how to prevent it, either. That has pushed us to focus on looking for cancers that are already there, a practice long based on the assumption that all cancers were the same, grew at a similar rate and were visible in the breast for a period of time before spreading. It made sense: If you could find cancers earlier, you could save lives. Indeed, the original screening study done in the 1950s on postmenopausal women in New York demonstrated a 30-percent decrease in deaths from breast cancer. It also led to the conjecture that if we just carried out more screening at a younger age, and more often, we could improve these statistics and win the war on breast cancer. But decades later, the success rate of screening remains nearly the same, even with much better imaging: routine mammography screening results in a 15- to 20-percent decrease in mortality in women over age 50. Why hasnt the situation improved? It turns out that there are at least five, and probably more, different types of breast tumors, growing and spreading at different rates. Some are so aggressive that they have almost always spread before they are visible on mammogram. But other tumors, if left alone, may never spread at all and do not need to be found. This more complicated picture explains why mammography has not further decreased mortality. The X-rays find some cancers at a point that makes a lifesaving difference but not all of them. British researchers estimated last year that one death from breast cancer is prevented for every 400 women ages 50 to 70 who are screened regularly over a 10-year period. Does this mean we should stop screening? No, it is still the best tool we have. But we have to start looking for other approaches to decreasing deaths from breast cancer.

Consider cancer of the cervix. First, we screened for it with Pap smears; now, with the HPV vaccine we hope to prevent it altogether. This is where we need to be focusing our money and efforts in breast cancer: finding the cause, so that we can prevent it from happening in the first place.

At the Dr. Susan Love Research Foundation, for instance, we perform research on the breast looking for the cause, and we are encouraging scientists to recruit from over 360,000 women with and without breast cancer, our Army of Women, who have volunteered to help them in research to stop this disease. Other groups, including Breast Cancer Action and the Avon Foundation, are focusing on the potential environmental causes. The National Breast Cancer Coalition has set a deadline of 2020 to find a breast cancer vaccine. We should continue to speak up when we think health care services are in jeopardy, but we cannot be satisfied with the status quo. We must move breast cancer advocacy to the next level, beyond screening for cancers that are already there, even beyond the cure, to finding the cause. That is true prevention.

Mindful Eating as Food for Thought

TRY this: place a forkful of food in your mouth. It doesnt matter what the food is, but make it something you love lets say its that first nibble from three hot, fragrant, perfectly cooked ravioli. Now comes the hard part. Put the fork down. This could be a lot more challenging than you imagine, because that first bite was very good and another immediately beckons. Youre hungry. Todays experiment in eating, however, involves becoming aware of that reflexive urge to plow through your meal like Cookie Monster on a shortbread bender. Resist it. Leave the fork on the table. Chew slowly. Stop talking. Tune in to the texture of the pasta, the flavor of the cheese, the bright color of the sauce in the bowl, the aroma of the rising steam. Continue this way throughout the course of a meal, and youll experience the third-eye-opening pleasures and frustrations of a practice known as mindful eating. The concept has roots in Buddhist teachings. Just as there are forms of meditation that involve sitting, breathing, standing and walking, many Buddhist teachers encourage their students to meditate with food, expanding consciousness by paying close attention to the sensation and purpose of each morsel. In one common exercise, a student is given three raisins, or a tangerine, to spend 10 or 20 minutes gazing at, musing on, holding and patiently masticating. Lately, though, such experiments of the mouth and mind have begun to seep into a secular arena, from the Harvard School of Public Health to the California campus of Google. In the eyes of some experts, what seems like the simplest of acts eating slowly and genuinely relishing each bite could be the remedy for a fast-paced Paula Deen Nation in which an endless parade of new diets never seems to slow a stampede toward obesity. Mindful eating is not a diet, or about giving up anything at all. Its about experiencing food more intensely especially the pleasure of it. You can eat a cheeseburger mindfully, if you wish. You might enjoy it a lot more. Or you might decide, halfway through, that your body has had enough. Or that it really needs some salad.

Consider These O.K., so you dont happen to live in a Buddhist monastery. You can still give mindful eating a spin by incorporating a few chilled-out gestures and rituals into your regular calorie intake.

WHEN YOU EAT, JUST EAT. Unplug the electronica. For now, at least, focus on the food. CONSIDER SILENCE. Avoiding chatter for 30 minutes might be impossible in some families, especially with young children, but specialists suggest that greenhorns start with short periods of quiet. TRY IT WEEKLY. Sometimes theres no way to avoid wolfing down onion rings in your cubicle. But if you set aside one sit-down meal a week as an experiment in mindfulness, the insights may influence everything else you do. PLANT A GARDEN, AND COOK. Anything that reconnects you with the process of creating food will magnify your mindfulness. CHEW PATIENTLY. Its not easy, but try to slow down, aiming for 25 to 30 chews for each mouthful. USE FLOWERS AND CANDLES. Put them on the table before dinner. Rituals that create a serene environment help foster what one advocate calls that moment of gratitude.

Summer fashion 2012 will be in glorious techno colour

Saturday 28 January 2012

As hyper-real digital printing techniques spread to major fashion houses, British women have stopped resisting rainbow palettes

It is as reliable as the appearance of the first crocuses: every spring, fashion embraces colour. This year, however, colour will be different. The couture shows on the runways of Paris last month have made it clear that consumers are being invited to face up to a riot of layered, clashing, bright digital prints like nothing seen before. While fashion pages have already warned cautious British women to prepare for a palette of cheery pastels this Easter, it turns out that striking patterns and bold floral photographic images on fabrics are just as likely to mark out the look of 2012, both in home furnishings and on the rails of dress shops. The sudden flurry of colour and rapid spread of busy prints is largely the result of the new ease of computer printing in fabric design. Five years ago London-based Turkish designer Erdem was one of the first to set the trend rolling, with his distinctive blurred photographic fabric designs, many digitally printed. As the technology has become more and more affordable, the hyper-real digital look has spread not just to the famous design houses known for their vibrant patterns such as Italy's Missoni and London's Liberty but even to more restrained fashion houses such as Chanel and Armani, where customers are being urged to consider wearing contrasting prints in a rainbow of hues. "It has become easier to manipulate these images, particularly to do the sort of layering of images that is popular," said Devon-based international fabric designer and painter Kate Rowley. "So some of the new photographic look is down to the ease of new digital printing, or to its influence at least. Some fans of the technique are designers William Tempest and Peter Pilotto. Pilotto's spring 2012 collection was applauded in Vogue for using "images of mercury to digitally enhance the kaleidoscopic line of their prints". "That slight cyber distortion," the magazine went on, "made for an otherworldly, Avatar-like brilliance."

The new prints are also a reaction to the grim economic climate. Designers planning fabrics for 2012 have been able to calculate for some months on a new appetite for colour. "In a recession people want to be cheered up," said Rowley. "They want colour and they want recognizable images. I am a furnishings designer who pays attention to fashion and in furnishing you want designs you can recognise in a time of recession."

Coco Chanel once said: "Fashion is not something that exists in dresses only. Fashion is in the sky, in the street; fashion has to do with ideas, the way we live, what is happening." But for the British consumer making such a date with vibrant colour is perhaps a bigger ask than in other international markets. "The English people are quite afraid of colour," said Rowley. "There is a lower-middle-class timidity about attitudes to it. There have been times when wearing sombre colours was a way to seem like a serious and intellectual person."

A Bridge Built to Sway When the Earth Shakes

SAN FRANCISCO Venture deep inside the new skyway of the San Francisco-Oakland Bay Bridge, and it becomes clear that the bridges engineers have planned for the long term. At intervals inside the elevated roadways box girders which have the closed-in feel of a submarine, if a submarine were made of concrete are anchor blocks, called deadmen, cast into the structure. They are meant to be used decades from now, perhaps in the next century, when in their old age the concrete girders will start to sag. By running cables from deadman to deadman and tightening them, workers will be able to restore the girders to their original alignment. Say what you want about the project and as the construction timeline has lengthened past a decade and costs have soared over $6 billion, plenty has been said keeping the bridge intact in an earthquake has always been the engineers chief goal. That contrasts with another potential approach: making the bridge structures large enough, and rigid enough, to resist movement. Massive and stiff structures would look absolutely ugly and be very, very expensive, said Frieder Seible, dean of the Jacobs School of Engineering at the University of California, San Diego, who tested many elements of the bridge design. That design includes a 525-foot-tall suspension bridge tower made up of four steel shafts that should sway in a major earthquake, up to about five feet at the top. But the brunt of the force would be absorbed by connecting plates between the shafts, called shear links. Emergency vehicles and personnel, at the least, should be able to use the bridge within hours of a major earthquake, after crews inspect the structure and make temporary fixes, like placing steel plates over certain joints. Given that the Bay Areas two major airports would be expected to be out of service after such a disaster, this bridge and the Benicia-Martinez Bridge, another seismically secure span about 20 miles to the northeast, would be lifeline structures to bring assistance to the stricken region from an Air Force base inland, said Bart Ney, a spokesman for the California Department of Transportation. There is a strong likelihood of a large earthquake in the Bay Area about a 2-in-3 chance of magnitude 6.7 or larger before 2036, according to the United States Geological Survey and other institutions. But Mr. Nader and his colleagues were not so much concerned with magnitude measured at the epicenter as they were with ground motions at the bridge site. They planned for the largest motions expected to occur within 1,500 years.

They got one. Unlike more conventional suspension bridges, in which parallel cables are slung over towers and anchored at both ends in rock or concrete, the 2,047-foot suspension bridge has only a single tower and a single cable that is anchored to the road deck itself, looping from the eastern end to the western end and back again. (With a conventional design it would have been extremely difficult to create an anchorage on the eastern end, in the middle of the bay.) The new bridge is the longest self-anchored suspension bridge in the world, and it is asymmetrical, with one side of the span longer than the other. (Mr. Nader says it looks like half a conventional suspension bridge.) The choice of such a design raised the cost of the project significantly. In a conventional suspension bridge, the road deck is added last, hung from suspender cables attached to the main cables. In a self-anchored design, the deck has to be built first. You have a kind of chicken-and-egg situation, Mr. Nader said. You need the deck to carry the compression so that the cable anchors into it, but the deck cant carry itself until the cable is there to carry it. So you have to build a temporary system. That system, called falsework, is basically a bridge to hold up the road deck until the cable is in place an operation that began in late December and was expected to take up to six months. The falsework needs to be seismically secure as well, adding to the cost. The links are of a special grade of steel that deforms more easily than other grades, and they are placed at specific points along the length of the tower, which affects how the shafts will move in a quake. Based on where you place the shear links, you can tune the dynamic response of your tower, said Dr. Seible, of the University of California, San Diego. Under normal conditions, the shear links help to stiffen the four shafts against wind and other loads. But when you come to larger earthquake loads, these links start yielding, Mr. Nader said. Its taking the energy thats being pumped into the tower.