How to Treat Migraine and Get Pain Relief

Acute migraine treatments relieve migraine attacks that are in progress, easing pain, nausea, and light sensitivity. These include over-the-counter pain relievers, triptans, ditans, gepants, dihydroergotamine, steroids (usually for attacks that don’t respond to other treatment) and antinausea medications.

Others are preventive, meaning that people taking them aim to reduce how many attacks they have and how severe they are. People who have frequent or severe migraine attacks that disrupt daily life may be candidates for preventive migraine medications.

Preventive medications include antiseizure medications, beta-blockers, calcium channel blockers, CGRP monoclonal antibodies, and certain antidepressants.

People may need to try different options to settle on a preventive drug that works for them, and it may take a few months to start reducing migraine attacks.

 Low doses can help people limit side effects while finding a treatment that works for them.

Over-the-Counter (OTC) Pain Relievers

This category includes nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin, as well as acetaminophen (Tylenol). A combination drug containing aspirin, acetaminophen, and caffeine (Excedrin Migraine) may be effective at reducing the pain associated with mild to moderate migraine. But it’s not as effective for severe attacks.

If your doctor recommends NSAIDs or products containing aspirin, these drugs have links to side effects such as ulcers and gastrointestinal bleeding. Daily use might lead to medication-overuse headaches.

Triptans

Triptans are also known as 5-HT1B/1D receptor agonists because they block the pain pathways in the brain by binding to specific serotonin receptors on neurons.

 Doctors often prescribe them if other migraine therapies haven’t been successful. Seven triptans are available, including:

  • eletriptan (Relpax)
  • rizatriptan (Maxalt)
  • zolmitriptan (Zomig)
  • frovatriptan (Frova)
  • naratriptan (Amerge)
  • sumatriptan (Imitrex)
  • almotriptan

According to Everyday Health network site Migriane Again, triptans come in many forms, including oral pills, nasal sprays, nasal powder, and injections. Non-oral methods (e.g., nasal sprays and injections) can be more effective for people experiencing the migraine symptom of nausea or vomiting as the digestive system tends to slow during an attack.

Common side effects of triptans include nausea, dizziness, drowsiness, and muscle tingling, numbness, and weakness. Because one of their actions is to constrict blood vessels, doctors don’t recommend triptans for people at high risk for a stroke or heart attack.

Ergots

Ergots interact with the same brain receptors as triptans. However, doctors often prescribe triptans instead of ergots, as more research supports the effectiveness of triptans for treating migraine attacks.

An ergot called dihydroergotamine (Migranal, Trudhesa) may be used when triptans aren’t having the desired effect on pain.

Dihydroergotamine is most effective when delivered intravenously (IV), which requires a medical professional to administer the dose. It’s also available as a self-injection and as a nasal spray.

Gepants

CGRP is a peptide (or short chain of amino acids) in the brain and nervous system that causes blood vessel dilation and plays a role in transmitting pain. Research shows that blood and saliva levels of CGRP increase during migraine attacks.

 CGRP antagonists, sometimes referred to as “gepants,” prevent CGRP from binding to receptors in various cell types in the brain.

FDA-approved gepants include:
  • atogepant (Qulipta)
  • rimegepant (Nurtec ODT)
  • ubrogepant (Ubrelvy)
  • zavegepant (Zavzpret)
Different drugs require different dosages. For example, atogepant is available in 10-milligram (mg), 30 mg, and 60 mg doses.

 Zavgepant is a nasal spray available as a single spray (10 mg) in one nostril, as needed. The maximum dose in 24 hours is one 10 mg spray.

In 2023, atogepant also received approval as a preventive treatment for chronic migraine based on a study in which participants had roughly seven fewer migraine days over 12 weeks on either 30 mg twice a day or 60 mg once a day compared with a placebo.

5-HT1F Receptor Agonists (Ditans)

Also known as ditans, 5-HT1F receptor agonists selectively bind to certain serotonin receptors on trigeminal neurons, blocking the transmission of pain in the trigeminal nerve system.

 The trigeminal nerve is a complex nerve responsible for sensation in the face and movement of the jaw muscles.

 Activation of the trigeminal nucleus, located in the brain stem, might be a key stage in a migraine attack’s development.

Lasmiditan (Reyvow) is the only drug in this class, and it has approval as an acute migraine treatment.

Antiemetics

If your migraine attacks include nausea and vomiting, your doctor may prescribe an oral antinausea drug, also known as an antiemetic, to take along with a pain-relieving medication. Antiemetics used for migraine relief include:

  • chlorpromazine
  • prochlorperazine (Compro)
  • metoclopramide (Reglan)
  • droperidol (Inapsine)
Metoclopramide increases muscle contractions in the upper digestive tract to speed up the rate at which food in the stomach moves to the small intestine.

Chlorpromazine,

droperidol,

 and prochlorperazine,

 in contrast, control nausea by blocking chemicals in the brain linked to vomiting.

Antihypertensive Medications

People typically use beta-blockers to manage high blood pressure and coronary artery disease, but doctors also commonly prescribe them to prevent migraine attacks.

 Examples of beta-blockers that may help treat migraine include:
  • propranolol (Inderal LA or Innopran XL)
  • metoprolol tartrate (Lopressor)
  • timolol (Betimol)
More research is necessary to understand how beta-blockers work for people with migraine.

Side effects might include depression, insomnia, nausea, and extreme tiredness.

Calcium channel blockers are another blood pressure medication that may help prevent migraine attacks.

One common example is verapamil (Calan, Verelan).

Antidepressants

Tricyclic antidepressants work by changing the levels of serotonin and other chemicals in your brain. To date, amitriptyline (Elavil) is the only tricyclic antidepressant proven to prevent migraine attacks. Side effects can include dry mouth, constipation, weight gain, sexual dysfunction, and others.

Antiseizure Drugs

Certain antiseizure or antiepileptic drugs, including divalproex sodium (Depakote) and topiramate (Topamax), have been shown to reduce the frequency of migraine attacks. They’re available as tablets, capsules, and sprinkle capsules, or capsules full of small beads of medication designed to be sprinkled over soft foods.

The exact way in which these medications prevent migraine attacks is unclear. You would take them as a daily or twice-daily dose.

Antiseizure drugs have significant side effects, including nausea, fatigue, unexpected weight changes, hair loss, dizziness, diarrhea, and concentration problems.

Doctors recommend against using them if you’re pregnant or plan to become pregnant.

Botox

The U.S. Food and Drug Administration (FDA) has approved onabotulinumtoxinA (Botox) to treat adults with chronic migraine. Doctors inject the drug into around 31 areas in the forehead and neck, where it reduces muscle contractions and blocks pain signals in the nerves for around 12 weeks.

Botox injections can reduce the number of migraine attacks by around half. They commonly cause neck soreness as a temporary side effect, which may feel better after applying an ice pack.

You’ll have injections about every three months, and you may not feel the benefits until your second or third treatment. In the meantime, you can take other migraine medications without the risk of harmful interactions.

CGRP Monoclonal Antibodies

CGRP monoclonal antibodies are lab-made proteins that specifically target CGRP in the body to reduce its effect on pain and inflammation.

CGRP antibody drugs include:

  • eptinezumab (Vyepti)
  • erenumab (Aimovig)
  • fremanezumab (Ajovy)
  • galcanezumab (Emgality)
CGRP monoclonal antibodies are a preventive migraine treatment.

 A review of data published in 2023 concluded that they reduced the number of migraine days compared with placebo in both episodic and chronic migraine.

 People receive CGRP antibodies either as an intravenous (IV) infusion once every three months, or as a monthly injection.

Each monoclonal antibody carries a risk of different side effects. For example, erenumab may lead to constipation, ulcers, higher blood pressure, and hair loss. Eptinezumab might cause a scratchy throat or stuffy nose.

Corticosteroids, or Steroids

Doctors may prescribe steroid medications, including methylprednisolone and dexamethasone, to treat a migraine headache that hasn’t responded to other treatments or that has lasted more than 72 hours, known as status migrainosus. Most studies on steroids for migraine relief have shown that these drugs are most useful for migraine prevention, leading to milder migraine attacks.

Doctors prescribe steroids, especially dexamethasone, in conjunction with other types of migraine drugs, such as triptans, to improve pain relief. They may administer steroids by IV in a hospital or clinic.

Steroids are only suitable for short-term use as they have a risk of side effects including insomnia and high blood sugar.

Nerve Blocks for Acute Migraine Pain Relief

A nerve block involves injecting small amounts of a numbing medicine such as lidocaine or bupivacaine into the base of the skull, over the eyes, or in the temple to block pain signals from the nerves. Nerve blocks can relieve pain within minutes, and the effects may last for days, weeks, or even months.

A doctor can also inject a nerve block into myofascial trigger points, which may relieve pain in these hypersensitive areas. Myofascial trigger points are nodules in skeletal muscle that are painful under pressure that can also cause pain in other areas of the body.

Pressing on myofascial trigger points may provoke a migraine attack in some people with migraine.

Emergency Medication for Intractable Migraine

Doctors usually refer to a severe migraine attack that lasts for more than 72 hours and doesn’t respond to a person’s usual acute therapies as an intractable migraine, or status migrainosus. It’s often necessary to seek additional treatment in the emergency department in those cases, where a number of drugs can be administered intravenously to help break the headache cycle.

Those drugs may include:

  • Antiepileptics
  • Triptans
  • NSAIDs
  • Steroids
  • Muscle relaxants
  • Antipsychotic medications
Intractable migraine can be debilitating and worrying, and you might not be able to think clearly when you get to the ER. Consider asking your regular doctor to write down and sign an emergency migraine treatment plan for you to bring with you to the hospital or urgent care center. This can help you access the medications that are most effective for you.

Ideally, your emergency migraine treatment plan should include:

  • Your diagnosis
  • Any relevant information about your medical history
  • Your doctor’s recommendations for the safest and most effective medications for you
  • Your doctor’s signature and contact information

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7 Plantar Fasciitis Stretches for Heel Pain Relief

Stretching is one of the fastest and most reliable pain relief methods for plantar fasciitis.

When you have plantar fasciitis, it’s common to have tightness in a number of places, says Schuyler Archambault, DPT, CSCS, a physical therapist and the owner of Arch Physical Therapy and Fitness in Boston.

Common tight spots include the plantar fascia (the thick band of tissue on the bottom of your foot that connects your heel to your toes), Achilles tendon (the tendon that connects your calf muscles to your heel), and calves, she notes.

Stretching loosens the plantar fascia and surrounding tissues, and this can reduce the inflammation that causes pain associated with plantar fasciitis, says Lori Addison Grant, a doctor of podiatric medicine and a board-certified foot and ankle surgeon at Orlando Health Physician Associates in Maitland, Florida.

In fact, research finds that more than 90 percent of people who include stretches in their plantar fasciitis treatment plan feel less heel pain.

But stretching is only one piece of a plantar fasciitis treatment plan, Dr. Archambault says, so it’s a good idea to see a podiatrist or physical therapist for plantar fasciitis. In addition to stretching and rest, they might recommend self-massage, over-the-counter pain relievers, and sleeping in a splint that keeps your foot stretched overnight, Dr. Grant says.

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15 Foods You Need in Any Emergency

Powdered milk dropped in popularity over the past few decades, but it has experienced a bit of a resurgence in recent years, especially during the early days of the COVID-19 pandemic. If your power is out, all you need to do is add the powder to water and mix.

You can also stock your shelves with liquid milk that has been treated with ultra-high temperature processing (UHT) to make it shelf-stable. Brands like Horizon offer this kind of milk in cardboard Tetra Pak packaging, but one study found that storage temperature may still affect the milk’s quality, so it’s best to keep it stored at around 68 degrees F or below.

Nutritionally, UHT milk is practically identical to other cow’s milk: It packs over 8 g of protein and is a good source of vitamins A and D as well as an excellent source of calcium, according to the USDA.

If you’re vegan or lactose-intolerant, look for a Tetra Pak shelf-stable dairy-free milk that matches dairy milk’s nutritional profile as closely as possible. Unsweetened soy milk, for instance, is a great alternative.

Shelf life: Dry milk, three to five years at cool temperatures; Tetra Pak milk boxes, six months

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Thoughts on Aging as a Woman’

Film, modeling, and TV icon Brooke Shields, 59, wants to redefine what aging looks like for women. In her new book, Brooke Shields Is Not Allowed to Get Old, the former child star takes an open and unapologetic approach to challenging society’s expectations of older women who are “past their prime.”

In the memoir, the mother of two shares her journey to empowerment and confidence — one not without humbling detours. Here are five key experiences she describes in her book.

She Battled Depression (and Tom Cruise)

Early in the book, Shields recounts the difficult decision to tell her fans about the postpartum depression she experienced after the birth of her first daughter, Rowan.

At first, she was reluctant to open up, afraid she would become a “sob story.”

“While I’ve learned to have no shame about experiencing postpartum depression (about 1 in 8 women experience symptoms), it was not exactly something I was proud of, especially in 2005, when it was far less openly discussed than it is today,” Shields writes.

The actor was “gobsmacked” a few months later when actor Tom Cruise publicly attacked her use of antidepressants and called her choice to open about it “dangerous.”

Shields admits that earlier in her life, she may have remained quiet — but the episode took place a month after her 40th birthday, and her thought process was shifting from “everyone knows better than I do” to “I know myself best.”

She clapped back with an op-ed in The New York Times defending herself and her choice, using data to refute the actor’s claim that she should have relied on vitamins and exercise to combat her depression, while pointing out that Cruise was criticizing her without having experienced the condition himself.

“Today, I know what is best for me, and I feel certain that trusting myself — and prioritizing myself — will only benefit me,” Shields concludes.

She Takes Hormone Therapy for Menopause Symptoms

When Shields began dripping in sweat in the middle of shooting a movie scene, it didn’t occur to her that it might be a hot flash, even though she had recently turned 50.

The film star “hadn’t given much thought to menopause before this moment,” she writes. Flash forward almost 10 years, and the conversation about menopause is picking up thanks to many celebrities and investments in menopause care.

Shields found relief from symptoms with low dose hormone replacement, a treatment she calls a “personal decision” and“incredibly helpful.”

What else can improve the experience of menopause? Sharing about it with other women, she says. And not only more talk, but more of a focus on the peace, emotional growth, and creativity that comes with age, and not just the unpleasant symptoms.

She Experienced Trauma at the Hands of a Doctor

After the birth of her daughters, Shields decided to have labial reduction surgery because of the painful chafing she had experienced since high school. “It hurt and it was in the way,” she writes.

Post-surgery, the surgeon informed her that, along with her scheduled surgery, he also “tightened her up a little bit,” and gave her vaginal rejuvenation surgery — without her consent.

Shields never took legal action against the doctor, but she was angry and unhappy with the results.

After a lifetime of believing that doctors knew best, the star now says her first instinct is, “I know myself better than you do. I’ve lived in this body for almost 60 years. … I know my body,” she writes.

She Prioritizes Well-Being Over Unrealistic Beauty Standards (Despite the Occasional Botox Shot)

We live in a world where unrealistic beauty standards are the cultural norm, writes Shields. And the actor has a unique perspective, given that she was labeled one of the world’s great beauties at a very young age.

“As I’ve gotten older, I’ve grown tired of being preoccupied with achieving a certain standard of beauty. It’s exhausting!” she says.

While it’s easy to get caught up in the pursuit of eternal youth, Shields encourages readers to focus on what truly matters: self-acceptance. But she admits she isn’t ready to sit back and embrace everything that comes with aging, and acknowledges turning to hair dye to cover her grays, the occasional Botox treatment, and Fraxels, which are laser treatments to improve skin tone.

“But I’ve begun to shift my focus to what I feel comfortable with rather than what I assume will please others,” she writes. Shields advocates for a balance of self-care and self-acceptance — one where women can prioritize their well-being while also learning to love themselves as they are.

She’s Learned to Take Risks and Tolerate Fear of Failure

Great opportunities are not reserved for the young, says Shields. New adventures, challenges, and successes can come at any age — but you may have to play a role in creating it.

In 2024, Shields started her own business, Commence, a line of haircare products for women over 40. This new role has required her to raise capital, learn the ropes of getting a startup off the ground, and open herself up to possible rejection or even failure.

“I’ve learned by now how to sit in that fear (of failure) and tolerate it, rather than let it drive me away from something I want. And if a new endeavor does go up in smoke … well, we’ve all lived through worse,” she writes.

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Tea Bags May Release Billions of Microplastic Particles

Drinking just one cup of tea brewed in a single-serving bag may expose you to billions of microplastic particles — substances that have been linked to a wide variety of health issues, like heart problems, fertility issues, and certain cancers.

Researchers tested disposable tea bags made from several common materials, including nylon-6, polypropylene, and cellulose. All of the tea bags made from these materials released microplastics, according to findings published in the journal Chemosphere.

Polypropylene was the worst offender, releasing about 1.2 billion particles of microplastics per milliliter (mL) of tea water, the study found. Cellulose released roughly 135 million particles per mL, and nylon-6 released about 8.2 million particles per mL.

“This is a lot, so if you drink a lot, you are exposed to a lot,” says Martha Gulati, MD, a professor and director of preventive cardiology at Cedars-Sinai in Los Angeles, who wasn’t involved in the new study.

Microplastics and nanoplastics are far too tiny to detect as you go about your daily life. Microplastics are less than 5 micrometers in size — thousands of times smaller than a grain of rice — and nanoplastics are below 1 micrometer. They are ubiquitous, too, and can be found in the food we eat, the water we drink, and the air we breathe.

How Worried Should You Be About Using Tea Bags?

“It is hard to know how worried people should be regarding exposure to microplastics in general, much less in their tea,” says Samantha Bear, a senior research scientist at SimpleLab, a water testing startup in Berkeley, California. Bear wasn’t involved in the new study.

She points out that this field of science is still new, and a lot of the evidence to date is based on findings from lab experiments and animal studies.

Still, “There is growing concern about the potential health impacts of ingesting microplastics because of their potential to cause effects in the gut microbiome and the hormonal system, inflammation, or increased cancer risk,” says Luz Claudio, PhD, a professor of environmental medicine and public health at the Icahn School of Medicine at Mount Sinai in New York City, who wasn’t involved in the new study.

“Even though this is a very active area of research and the full effects of microplastics in the body are not fully understood, we definitely don’t want to add to the already high exposure through regular tea consumption if we can avoid it, because this could lead to accumulation in the body over time,” Dr. Claudio says.

Dr. Gulati concurs: “I know we are at the earliest stages of understanding microplastics, but I recommend we avoid them as much as possible, given the data that is emerging,” she says.

How to Minimize Exposure to Microplastics in Tea

While it may be hard to completely avoid microplastics in your tea, there are steps you can take to limit your exposure, says senior study author Alba García-Rodríguez, PhD, an assistant professor at the Autonomous University of Barcelona in Spain.

“Loose-leaf tea is one of the most effective ways to minimize exposure to micro- and nanoplastics,” Dr. García-Rodríguez says. “By avoiding tea bags altogether, you eliminate the risk of plastic contamination from the bag itself.”

Your best bet to reduce exposure to microplastics with loose tea is by brewing it with stainless steel or glass infusers, García-Rodríguez advises. Another good option is brewing loose tea in a kettle and straining it afterwards to remove the leaves from your drink.

If you want to keep buying tea in disposable tea bags, look for plastic-free bags and don’t assume that organic tea is automatically risk-free, García-Rodríguez adds.

“While organic tea often refers to how the tea leaves are grown, it doesn’t necessarily guarantee that the tea bags are free of plastics,” García-Rodríguez says. “To avoid exposure, look for brands that specifically advertise plastic-free or biodegradable tea bags made from plant-based materials like paper, hemp, or cornstarch.”

You might also want to avoid microwaving hot water with a disposable tea bag in the cup. One recent study showed that microwaving nylon tea bags after steeping increased the release of microplastics.

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Natural Disasters and Mental Health: 9 Tips for Coping

Despite the physical and emotional strains of these events, most people will recover. That’s not to say they won’t be affected; just that they’ll be able to adapt and the short-term reactions they experience will subside over time, without treatment.

Others may develop trauma-related symptoms immediately after the disaster or years later.

 Research has shown there’s a link between natural disasters and generalized anxiety disorder, depression, substance use, adjustment disorder, and post-traumatic stress disorder (PTSD).

 Whether it develops into a diagnosable issue or not, you likely will experience stress, anxiety, and maybe even guilt in the aftermath of the natural disaster.

To help set yourself up to cope, acknowledge your mental health — and the emotions you’re feeling — even as you’re dealing with the situation. Simple coping mechanisms can shift your mindset to a more meditative state amidst the chaos and trigger the brain to release hormones that will help to regulate the nervous system, Rittenhouse says.

“Existing in a constant state of fight-or-flight causes exhaustion, anxiety, difficulty nourishing and sleeping properly, and impairs immune functioning, none of which will help coping and rebuilding in the weeks and months to come,” says Margot Rittenhouse, a licensed professional clinical counselor who treats patients with anxiety, generalized mental health issues, and eating disorders as director of clinical services with Alsana, and is based in Los Angeles.

In other words, taking care of your mental health now allows you to better deal with the challenges ahead.

Here are some ways you can cope when you’re living through a natural disaster.

1. Allow Yourself to Feel the Feelings

Expect to feel lots of emotions — there will be good days and there will be days when you’re moodier than usual and feeling stressed and overwhelmed.

 Be patient with yourself as you navigate through, and give yourself grace to feel the range of emotions when they come.

“Allow the brain and body to do the work to process what has happened,” Rittenhouse says. “This is part of the process of grieving and coping. It is uncomfortable, and it is necessary.”

2. Take Things One Step at a Time

Don’t try to tackle everything all at once — that’ll just leave you feeling overwhelmed and in a heightened state of stress, Yadush says. “Instead, prioritize safety and basic needs before long-term planning,” he says.

Tackle the physical stress you’re feeling as well. A helpful goal is to move from the fight-or-flight state into a more regulated one, Rittenhouse says.

When you’re within hours or days of experiencing a traumatic natural disaster, important skills to tap into are mindfulness, grounding, and deep breathing,” she says.

3. Lean on Others for Support

Following a natural disaster, there’s often an influx of people willing to help. Accept the help or ask for help if you need it, even if that feels uncomfortable to you.

“It’s a sign of strength rather than weakness,” Yadush says.

The support of those around you could protect your mental health. “It provides emotional validation, practical assistance, and a sense of belonging, which can be a buffer against feelings of isolation and helplessness,” Yadush says.

One study found having a strong social support system in place significantly lessened the risk of developing depressive symptoms after the 2011 Great East Japan earthquake and tsunami.

As weeks pass, volunteers and offers from loved ones may wane, but the need for support doesn’t necessarily go away. “Do not feel ashamed or hesitate to communicate your needs regardless of the time that has passed,” Rittenhouse says.

4. Limit News and Social Media Consumption

You don’t want to overdo your news and social media consumption as being overexposed to traumatic images and videos can increase the distress you’re feeling.

On the other hand, avoiding the news and updates all together can be unsafe if you are in a dangerous area. “Strike a balance between being informed and being inundated,” Rittenhouse says. And when you are consuming content, make sure it’s coming from a credible source and isn’t based on rumors.

5. Return to Your Routine

Once you’re able, try getting back to a routine that feels comfortable and productive.

“Reestablishing normal routines can restore a sense of stability, helping to alleviate powerlessness,” Yadush says.
Though your day-to-day may look nothing like it did before the disaster, getting back into simple habits, like sleeping and eating meals at regular times, can benefit your well-being.

 Start with these small things, and give yourself grace to adjust to your new normal, Rittenhouse says. “Be mindful of what is helping and what isn’t, and pivot as needed to build a new normal that helps you through,” she says.

6. Engage With the Community Around You

Once you have taken care of yourself, you may find it therapeutic to reach out to neighbors who are going through the same thing and share your experiences with one another. It can help you feel less alone.

 Taking part in your community’s recovery efforts can also help you feel better in return.

“Community engagement and acts of service can be incredibly healing as they offer connection and highlight the resilience of our humanity,” Yadush says.

7. Avoid Making Major Decisions

In the aftermath of a disaster, you’re likely not in the right headspace to make decisions you don’t necessarily need to make about switching careers, moving, or other major decisions.

 Avoid those decisions as much as possible until you stabilize your situation, Yadush says.

Of course, if you’ve been displaced, you may have no choice but to decide where to move or rebuild. In those instances, approach the decision carefully and seek input from your social circle when your decision-making abilities aren’t at their peak, Yadush says.

8. Be Honest With Little Ones

There’s an added layer of complication if you have children in your life. Talk to them about what happened (using words and concepts they can understand), answer their questions honestly, validate their feelings, and be patient as they may need the information repeated back to them to be reassured.

Limit exposure to disaster coverage, which can frighten children, and be careful not to make promises you can’t keep.

“You want to provide them with a sense of stability and normality amidst the uncertainty, but this can sometimes cause more harm than good if that promise turns out to be untrue,” Rittenhouse says. Saying “I hope our home or school will be okay” rather than “Our house or school will be fine” is a more helpful approach, Rittenhouse says.

9. Talk to a Professional

“Recovery doesn’t follow a straight line, and struggling months later is not ‘wrong’ or a sign of failure,” Yadush says. Allow yourself grace and space as you grieve and cope, Rittenhouse says.

If your trauma is lingering and you are feeling overwhelmed or cannot keep up with everyday life, reach out for professional help. A psychologist or other mental health professional can help you make a plan moving forward.

The Takeaway

  • Living through a hurricane, wildfire, flood, or other natural disaster can leave you feeling stressed, anxious, fearful, or guilty.
  • While there are plenty of immediate logistical to-dos, it’s important to take care of your mental health during the disaster rather than kicking it down the line.
  • There are several expert-suggested ways to cope, including giving yourself permission to feel the emotions that come up, getting back to your usual routine, and taking part in the community’s recovery efforts.

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Stage 4 Lymphoma

Lymphoma is a type of cancer that affects white blood cells called lymphocytes in the lymphatic system. Stage 4 lymphoma is the most advanced stage of lymphoma, occurring when the disease is widespread in the lymphatic system, bone marrow, and even other organs such as the lungs or liver.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e13c4c5c-d13b-43a6-99bf-9631cc44b2e9 Treatment of stage 4 lymphoma depends on the lymphoma type and may involve a combination of therapies, including chemotherapy, radiation therapy, stem cell transplantation, targeted therapy, immunotherapy, and surgery. Prognosis for stage 4 lymphoma also depends on the cancer type — along with patient age, overall health, and response to treatment.
Types of Stage 4 Lymphoma Types There are two main categories of lymphoma:e60dc2a1-f33c-4a05-9b50-8e3e8e59762931f5a282-894d-4aab-b63b-c93854b1737ce60dc2a1-f33c-4a05-9b50-8e3e8e597629b24b1a8f-061a-4560-ba08-94ea4ce68d50 Hodgkin lymphoma (formerly known as Hodgkin disease), which involves an abnormal type of lymphocyte called Reed-Sternberg cells Non-Hodgkin lymphoma, which does not contain Reed-Sternberg cells Both Hodgkin and non-Hodgkin lymphomas have a number of subtypes, which differ depending on the cells and tissues the cancer affects and how quickly they grow. Hodgkin Lymphoma Most Hodgkin lymphomas — 95 percent — are the “classic” types. There are four subtypes of classic Hodgkin lymphomas:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a7557d94-63d1-41b2-b564-da11f737ce18 Nodular Sclerosing Hodgkin Lymphoma This is the most common subtype of classic Hodgkin lymphoma, and it affects the lymph nodes in the central part of the chest. Mixed Cellularity Hodgkin Lymphoma This subtype is marked by lymph nodes carrying a mix of cell types, including many Reed-Sternberg cells. Lymphocyte-Rich Classic Hodgkin Lymphoma About 6 percent of Hodgkin lymphomas are of this subtype, which is characterized by a higher number of normal lymphocytes along with Reed-Sternberg cells. Lymphocyte-Depleted Hodgkin Lymphoma About 1 percent of people with Hodgkin lymphoma have this subtype, which is characterized by many abnormal lymphocytes in place of normal lymphocytes. The slow-growing nodular lymphocyte-predominant Hodgkin lymphoma makes up the other 5 percent of Hodgkin cases. This type grows more slowly and is more common in people in their twenties. Non-Hodgkin Lymphoma Non-Hodgkin lymphoma is far more common than Hodgkin lymphoma. It has dozens of subtypes that differ in terms of aggressiveness, response to treatment, and affected cell types. Common non-Hodgkin lymphomas include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629cb7977b0-c3bc-40e8-8756-3f024839b3d6e60dc2a1-f33c-4a05-9b50-8e3e8e59762948341ed7-002f-45ca-9cb2-cf793ab869d1 Diffuse large B-cell lymphoma, the most common type of non-Hodgkin lymphoma, which grows quickly in lymph nodes and often in other organs Follicular lymphoma, a slower-growing form that is characterized by enlarged lymph nodes and large cancel cells that may appear U-shapede60dc2a1-f33c-4a05-9b50-8e3e8e597629154bba87-f054-4796-9e14-9579fd233632 Mantle cell lymphoma , a rare and aggressive form that often affects the lymph nodes, bone marrow, spleen, and gastrointestinal tract Burkitt lymphoma, a highly aggressive form that primarily affects children and young adults Peripheral T-cell lymphomas, a diverse group of aggressive lymphomas that arise from mature T-cells in the thymus gland and travels to the lymph nodes, bone marrow, or spleen Small lymphocytic lymphoma, a slow-growing cancer that’s closely related to chronic lymphocytic leukemia and primarily involves the lymph nodes and spleen Lymphoma Staging Lymphoma is staged based on where in the body the cancer has spread. In stage 1, the cancer is limited to a single lymph node or a group of adjacent lymph nodes. Stage 2 involves two or more groups of lymph nodes on the same side of the diaphragm. In stage 3, the cancer has spread to lymph nodes on both sides of the diaphragm and may involve the spleen. Stage 4 involves widespread disease that includes other organs.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a8519240-7415-4ead-9e08-5ae0465aca41
Signs and Symptoms of Stage 4 Lymphoma Symptoms Symptoms can vary depending on the type of lymphoma, but common signs include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a0307efb-a78b-461b-8229-e73921abdad6 Enlarged lymph nodes in the neck, under the arm, or in the groin Persistent fatigue Unexplained weight loss Drenching night sweats Itchy skin Fever without an infection Stage 4 lymphoma can cause a range of other symptoms depending on the organs and parts of the body that are affected:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ccc2402e-6b80-409d-b1df-61f3a008100b Abdominal pain and swelling, loss of appetite, or feeling full after a small meal, if the cancer involves organs in the abdominal cavity Breathing difficulties, including coughing and chest pain, if lymphoma affects the mediastinum (the area between the lungs) Gastrointestinal issues such as nausea, vomiting, abdominal pain, or changes in bowel habits if the lymphoma affects the stomach or intestines Neurological symptoms such as headaches, trouble thinking, changes in vision, personality changes, seizures, facial numbness, or trouble speaking if lymphoma affects the central nervous system
How Is Stage 4 Lymphoma Diagnosed? Diagnosis Diagnosing lymphoma involves a combination of medical history review, physical examinations, blood tests, imaging tests, and biopsies (the process of removing a small tissue sample for viewing under a microscope):e60dc2a1-f33c-4a05-9b50-8e3e8e5976291d8492ff-b99a-4e1d-bc3d-fed498b8bd5ee60dc2a1-f33c-4a05-9b50-8e3e8e5976299e169125-089a-4747-b630-222479058a35 Medical History and Physical Examination Your healthcare provider will thoroughly review your medical history, including symptoms, previous illnesses, possible risk factors, and family history to understand the likelihood of you having lymphoma. They will then perform a physical exam to check for signs of lymphoma, such as swollen lymph nodes, enlarged spleen or liver, and other abnormalities. Biopsy To confirm suspected lymphoma, your provider will perform a biopsy by taking a sample of a lymph node or, in some cases, an entire lymph node, for examination. Though unlikely, your provider may perform a less invasive procedure, such as a core needle biopsy or fine-needle aspiration, which involves using a thin needle to extract a small sample of tissue from a suspicious lymph node. Biopsies can often determine the type of lymphoma you have, but additional lab tests on the samples, such as immunochemistry, may be needed. Blood Tests After confirming you have cancer, your provider may order certain blood tests to determine how advanced the lymphoma is, evaluate your overall health, and assess the function of various organs, such as the liver and kidneys. Your provider may also order a complete blood count to check for abnormalities in blood cell counts. Imaging Tests Along with the blood tests, your provider may also order imaging tests to understand where lymphoma is occurring in your body. These include CT (computerized tomography) and PET (positron emission tomography) scans to visualize enlarged lymph nodes and other organs to see if they contain cancerous cells.e60dc2a1-f33c-4a05-9b50-8e3e8e597629443dd0b3-a45d-4fd2-80f7-d4b9b72e90d4 MRI scans aren’t used as often for lymphoma, but they can help determine if lymphoma is affecting the spinal cord or brain. Your provider will order additional tests to determine the extent of the disease and whether it’s in stage 4 (whether it has spread to the spleen, liver, or other organs). These may include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762970ad4cab-5658-4a80-b2ae-508700f8862d Bone marrow aspiration and biopsy to see if the lymphoma affects your bone marrow Lumbar puncture (spinal tap) to see if lymphoma has spread to your central nervous system Pleural or peritoneal fluid sampling to see if lymphoma is in your chest or abdomen and causing a buildup of fluid
Treatment Options for Stage 4 Lymphoma Treatment Treatment for stage 4 lymphoma often involves a combination of therapies, including chemotherapy, radiation therapy, stem cell transplantation, and more. Chemotherapy Chemotherapy is the use of powerful drugs to kill or inhibit the growth of cancer cells throughout the body. These medicines are usually given as an IV infusion or in pill form. A number of different drug combinations may be used to treat stage 4 Hodgkin lymphoma, such as:e60dc2a1-f33c-4a05-9b50-8e3e8e59762906b1cf86-3496-4e98-a4ba-c3ec5bffba62 ABVD, made up of doxorubicin hydrochloride (Adriamycin), bleomycin, vinblastine sulfate, and dacarbazinee60dc2a1-f33c-4a05-9b50-8e3e8e5976297a00dc80-8ec9-431e-bc0d-9f06b2da4313 BEACOPP, made up of bleomycin, etoposide phosphate, doxorubicin hydrochloride (Adriamycin), cyclophosphamide, vincristine sulfate (Oncovin), procarbazine hydrochloride, and prednisonee60dc2a1-f33c-4a05-9b50-8e3e8e597629249b5477-ba29-4014-8333-52525c6d8d8c EPOCH, made up of etoposide phosphate, prednisone, vincristine sulfate (Oncovin), cyclophosphamide, and doxorubicin hydrochloride (hydroxydaunomycin)e60dc2a1-f33c-4a05-9b50-8e3e8e5976292c95a5cd-6dfb-4914-9969-32c60e241238 Researchers are still learning more about which chemotherapy regimens are most effective for specific types of lymphoma. Side effects of these medications may include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629a94a1270-25f6-461b-abad-1bd775f67b7de60dc2a1-f33c-4a05-9b50-8e3e8e5976293aa9ba32-8abc-44b0-b5fb-c6475b347c50 Anemia Breathlessness Bruising, bleeding gums, or nosebleeds Chills Constipation Diarrhea Hair loss Fatigue Fever Increased risk of infection Loss of appetite Mouth sores Nausea Risk of blood clots Skin problems, such as a rash or blistering, thickening, or itching of the skin. Weight gain or loss Heart, liver, or lung changes Radiation Therapy Radiation therapy uses high-dose X-rays or other forms of radiation to target and destroy cancer cells and keep them from growing. Your doctor may use radiation therapy to either attempt to cure the cancer or to help treat symptoms of lymphoma.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296bdf2d7d-3894-40cf-8e1f-504fd7c83fbc Curative radiation therapy is given with the aim of achieving remission (no evidence of the disease in your body). It’s used to treat localized disease or to shrink tumors before, during, or after chemotherapy. When radiation therapy is used to control symptoms of lymphoma, such as pain, this is called palliative radiotherapy.e60dc2a1-f33c-4a05-9b50-8e3e8e59762936617c82-38b7-4435-abeb-18ad096f98c6 Common side effects include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629048c9988-e674-4369-9f68-5acfa57dead9e60dc2a1-f33c-4a05-9b50-8e3e8e59762937ace7eb-4842-489a-8b1b-ebb312965dc0 Redness, blistering, or peeling of the skin where radiation is given Fatigue Nausea Dizziness More serious side effects include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629048c9988-e674-4369-9f68-5acfa57dead9e60dc2a1-f33c-4a05-9b50-8e3e8e59762937ace7eb-4842-489a-8b1b-ebb312965dc0 Lung or heart damage from radiation to the chest Thyroid problems from radiation to the neck Headache, memory loss, and personality changes from radiation to the brain Formation of other cancers Targeted Therapy Targeted therapy fights cancer by specifically targeting certain molecules involved in cancer growth. Some types of targeted therapies include the following: Monoclonal Antibodies These are immune system proteins made in the laboratory to target and kill cancer cells, block their growth, or keep them from spreading. Sometimes a monoclonal antibody is linked to a chemotherapy drug (called an antibody-drug conjugate), allowing the drug to be delivered directly to the cancer cell.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ee8bd1e7-4266-41ec-b149-35b132d095f5 Proteasome Inhibitors These medications block the activity of proteins called proteasomes that remove proteins in cells that are no longer needed. Blocking proteasomes allows proteins to build up in cells, potentially killing cancer cells. Kinase Inhibitors These drugs block certain enzymes that control cell growth, helping to keep lymphoma cells from growing.e60dc2a1-f33c-4a05-9b50-8e3e8e59762987898c5e-0f2d-4091-8edf-36e3647409a2 Examples of targeted therapies used to treat stage 4 lymphoma include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f8690d0a-49ee-4323-a582-1cfc53a3d666 brentuximab vedotin (Adcetris) copanlisib (Aliqopa) crizotinib (Xalkori) ibrutinib (Imbruvica) idelalisib (Zydelig) mogamulizumab (Poteligeo) polatuzumab vedotin (Polivy) rituximab (Rituxan) Targeted therapy drugs may have side effects. The types of side effects experienced will depend on the type of drug and what it targets.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e0a47bfa-7ec4-4394-ac6a-0521643601ab Some common side effects include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762960dc7c78-a28b-4bc4-9dbc-e476afe6c14ce60dc2a1-f33c-4a05-9b50-8e3e8e597629ea937a72-63d2-4050-bbfd-d161a8a365f9 Cough Diarrhea or constipation Flu-like symptoms such as fever and chills Fatigue Headache Heart problems Infection Kidney problems Liver problems Loss of appetite and weight loss Low blood cell counts Nausea and vomiting Nerve damage Joint pain Skin rashes, redness, itching, or dryness Allergic reaction to the medication Immunotherapy Immunotherapy aims to enhance the body’s immune system to recognize and attack cancer cells. Types of immunotherapy used to treat stage 4 lymphoma include: CAR T-Cell Therapy This is a type of immunotherapy where your doctor will remove some of your T cells, add special receptors to their surfaces in a laboratory, and then return the modified cells back to your body to bind to and kill cancer cells.e60dc2a1-f33c-4a05-9b50-8e3e8e597629afb4529d-1849-407f-807a-f601671000da Researchers are getting better at determining which lymphoma patients will respond well to CAR T-cell therapy before beginning treatment.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293ef5f834-3d4f-48cd-aa22-f66e6b6287f0e60dc2a1-f33c-4a05-9b50-8e3e8e5976293c8ec31e-aeb3-4c97-b33b-87b06265b087 Checkpoint Inhibitors PD-1 is a type of checkpoint protein on cell surfaces that helps prevent the body’s immune system from attacking normal, healthy cells. Some cancer cells also have these proteins and can therefore “hide” from the immune system. PD-1 inhibitors such as nivolumab (Opdivo) and pembrolizumab (Keytruda) block this checkpoint protein and allow the body’s immune system to better attack cancer cells.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298a30e35d-58b1-451b-9941-36475c59f5a9 Immunomodulating Drugs Medications such as thalidomide (Thalomid) and lenalidomide (Revlimid) are a type of immunotherapy called immunomodulating drugs. They are given to patients with lymphoma who have not responded to other treatments. It’s not yet clear to researchers exactly how these drugs work, but they are thought to work against cancer by affecting parts of the immune system.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292288fabe-d28b-41a5-ba7f-1433d5f36df8 Stem Cell Transplantation Stem cell transplantation involves the infusion of healthy stem cells (immature blood cells) to replace damaged or destroyed bone marrow. Also known as a bone marrow transplant, it’s typically used after high-dose chemotherapy or radiation therapy to restore the bone marrow’s ability to produce blood cells.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297295caa3-7295-4c64-9abc-6afe79cd5b87 Stem cells are removed from the blood or bone marrow of the patient or a donor, and then frozen and stored. After chemotherapy or radiation, these stem cells are thawed and infused back into the patient, where they grow into healthy blood cells.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297295caa3-7295-4c64-9abc-6afe79cd5b87 Surgery For certain lymphomas that are either aggressive or very slow-growing, surgery may be used to remove the cancer. The type of surgery depends on the type of lymphoma and where it has formed in the body.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297295caa3-7295-4c64-9abc-6afe79cd5b87 Clinical Trials Clinical trials for lymphoma are studies aiming to improve current treatments or test new ones. Patients who participate in a clinical trial may have access to new treatments that are not otherwise available. Eligibility is different for each trial, with some only enrolling patients who haven’t received treatment yet while others might only include patients for whom other treatments have not worked. Speak to your doctor to learn more about joining a clinical trial, or you can search for trials online at ClinicalTrials.gov .e60dc2a1-f33c-4a05-9b50-8e3e8e5976297295caa3-7295-4c64-9abc-6afe79cd5b87
Stage 4 Lymphoma Prognosis Prognosis and Outlook The prognosis for stage 4 lymphoma varies based on factors such as lymphoma type, age, overall health, and response to treatment. Advances in medical research and treatment options have significantly improved survival rates in recent years. The overall five-year relative survival rate (the percentage of people who will live five years or more after being diagnosed with the disease compared with people without the disease) for Hodgkin lymphoma is 89 percent. For stage 4 Hodgkin lymphoma, the five-year relative survival rate is reduced to 81 percent.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c7b265bd-5f63-45e7-99ba-9e67a6e64c00 Non-Hodgkin lymphoma is typically more aggressive and therefore has a poorer prognosis. The overall five-year relative survival rate for non-Hodgkin lymphoma is 74 percent. For stage 4 non-Hodgkin lymphoma, the relative five-year relative survival rate is 64 percent.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e0875ef7-4b18-4baa-bf44-0b6223e9cdb4 Factors that affect survival include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762940504917-e2ce-49f6-a489-456fb925533a Lymphoma Subtype Patients with indolent or slow-growing subtypes such as follicular lymphoma may live with the disease for many years. Some subtypes such as diffuse large B-cell lymphoma may respond better to treatment. Age, Sex, and General Health Patients who are healthy, under 60 years old, and female have a better prognosis. Lactate Dehydrogenase (LDH) Levels Higher LDH levels in the blood indicate poorer survival. Extent of the Disease Survival is reduced at higher stages with more widespread disease and more organs affected.
Complications of Stage 4 Lymphoma Complications Some people with stage 4 lymphoma experience other health problems as a result of the disease or from treatment side effects. These may include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762913c46b25-3395-493d-9e3b-0c2593479435e60dc2a1-f33c-4a05-9b50-8e3e8e597629b6e83942-f1fc-4c4b-972a-19afded39258 A weakened immune system Infertility Heart disease Lung disease Stroke Thyroid problems A second cancer
How Many People Have Stage 4 Lymphoma? Statistics The American Cancer Society estimates that in 2024, there were more than 8,500 new cases of Hodgkin lymphoma, with about 900 deaths.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297f6d9766-7de1-4f56-8122-0198f95fceaf For non-Hodgkin lymphoma, there were about 80,000 new cases in both adults and children, with about 20,000 deaths.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295ca04f81-82be-4e77-9ee8-adee64b6d80c According to a national database of people with lymphoma in the United States, about 23 percent of patients with Hodgkin lymphoma have stage 4 disease.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299c3e4af5-18a4-4d61-a82f-4dead1446993 For non-Hodgkin lymphoma, 36 percent of patients have stage 4 disease.e60dc2a1-f33c-4a05-9b50-8e3e8e59762952e7d112-c442-4e3f-ab34-c125928d3a6c The Takeaway Stage 4 lymphoma is the most advanced stage of the disease, characterized by its spread to other areas of the body like the lungs or liver. Many advanced treatment options are available to manage stage 4 lymphoma and improve survival, although the response to treatment depends on a variety of factors, including the type of lymphoma, age, and overall health. It’s important for individuals with symptoms that may suggest stage 4 lymphoma — such as unexplained weight loss, persistent fatigue, fever without an infection, or swollen lymph nodes — to seek immediate evaluation from a healthcare professional for accurate diagnosis and prompt treatment.
Resources We Trust Mayo Clinic: Hodgkin Lymphoma (Hodgkin Disease)Cleveland Clinic: Non-Hodgkin LymphomaAmerican Cancer Society: Stem Cell or Bone Marrow TransplantMoffitt Cancer Center: What Are the Different Stages of Lymphoma?Get Palliative Care: Leukemia, Lymphoma, and Palliative Care

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What Is Organic Food? Definition, Benefits, How to Buy, and More

The “organic” designation isn’t necessarily a measure of how healthy or nutritious a food is. Instead, it’s about the farming and processing practices used.

”The USDA sets the rules for what is organic — everything from what you feed your livestock to what kinds of pesticides you are allowed to use to what kind of records you have to keep,” says Neva Hassanein, PhD, a professor of environmental studies at the University of Montana in Missoula.

For plant foods like fruits, vegetables, beans, and grains to be labeled organic or use the USDA Organic Seal, they must be grown in soil that hasn’t been treated with prohibited substances, which includes most, but not all, synthetic fertilizers and pesticides, as outlined in the National List of Allowed and Prohibited Substances (the USDA’s official list of which products may be used in organic farming). In addition, these foods can’t undergo genetic modification.

In organic farming, natural products like compost and manure are used to help plant growth and soil health instead of chemical fertilizers, and certain crops that won’t be sold are planted in between harvests to enrich the soil, explains Melissa Bell, a research coordinator at North Carolina State Extension’s Center for Environmental Farming Systems.

Instead of using synthetic pesticides, organic farmers protect their crops from pests by regularly checking for them, growing different crops in different seasons to disrupt the pests, and using certain organic pesticides when absolutely needed, Bell adds.

For meat and poultry to be labeled organic, the animals must be raised on organic land using the same standards as plant foods; fed organic feed; given year-round access to the outdoors (except in inclement weather); and not given antibiotics, hormones, or other prohibited substances. Grazing animals like sheep and cattle must also have access to pasture during the grazing season.

Processed foods that contain multiple ingredients (such as chips, crackers, cookies, or frozen meals) can qualify for one of four organic claims, depending on their contents:

  • “100 Percent Organic” This label is for foods that are made up entirely of organic ingredients.

  • “Organic” To use this label, foods may contain up to 5 percent of certain non-organic ingredients on the National List of Allowed and Prohibited Substances.

  • “Made With Organic Ingredients” A food with this label must be made up of at least 70 percent certified organic ingredients, and any non-agricultural products used (like enzymes and acids) must be on the National List of Allowed and Prohibited Substances.

  • Specific Organic Ingredients If a food doesn’t specify a percentage of certified organic ingredients, it can’t use the word “organic” in its packaging, except in the ingredients list, to designate specific organic ingredients.

How to Get Organic Certification

To get organic certification, a producer or handler must submit an application to the USDA that describes in detail how they will abide by the organic requirements, including substances from the National List of Allowed and Prohibited Substances and how they’ll keep records.

Then, a USDA-certified agent comes to their farm or facility for a thorough inspection. Once a farm or facility is approved, the producer or handler must submit annual records detailing their practices. A certified agent comes back once a year for an inspection.

Organic vs. Non-GMO Food

“Non-GMO means the food in question has not been genetically modified in any way,” says Stacey Woodson, RD, a registered dietitian based in Philadelphia. A food cannot be labeled organic if it’s genetically modified. “Therefore, organic food is automatically non-GMO, but non-GMO is not necessarily organic,” Woodson says.

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What Is Metastatic Cancer?

Although cancer that has metastasized, or stage 4 cancer, is not curable, it can be treated. These options depend on the type of cancer, its severity, and the patient’s wishes, Shatsky says.

“The treatment focus for stage 4 solid cancers is controlling the cancer, prolonging life and controlling symptoms caused by the cancer,” she says.

For example, if a patient has metastatic breast cancer, the provider will treat the cancer that has spread in the same way as the original cancer in the breast. Treatments could include chemotherapy, hormone therapy, immunotherapy, radiation therapy, and targeted therapy.

Doctors call this type of treatment “palliative intent treatment.” The goal is “to control the cancer with the least toxic therapies to maintain quality of life for as long as possible,” she says. The treatment is generally lifelong, because most cancers will start growing again if treatment stops.

It’s possible for patients to live for many years with metastasized cancer. A few types of metastases can be cured, including melanoma and colon cancer.

The survival rate depends on many factors, including the type of cancer and where it has metastasized.

When evaluating medical information online, Shatsky says to be an informed consumer.

“It’s extremely important to go to evidence-based resources for information on cancer in general, as there is an enormous amount of misinformation about cancer out there,” Shatsky says.

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10 Food Allergy Safety Tips for Kids at Home, School, or While Traveling

7. Pack Your Child’s Epinephrine Injectors in Your Carry-On

If you’re traveling by air, make sure your child’s epinephrine auto-injector is stored in your carry-on, so you have easy access to it in an emergency. Pratt recommends storing it in a clear plastic bag to make it easier to go through security. “You usually have to separate it from your other items, since it does have a needle,” she notes.

8. Choose the Right Restaurant

Depending on your child’s food allergy, some restaurants will be riskier to eat at than others. For example, if your child has a peanut allergy, it’s wise to avoid certain Asian restaurants, such as those serving Thai, Chinese, or Indian cuisine, because nuts are frequently used in their dishes.

Buffet-style restaurants and bakeries should also be avoided. The risk of cross contact and accidental exposure is high at these eateries.

9. Review the Menu Ahead of Time

Many restaurants have their menus online, so you can take a look and figure out which foods will be on the safer side, Codispoti notes.

If you’re traveling within the United States, consider dining at chain restaurants where you know which foods are safe for your child. (The ingredients and preparation at chain restaurants are usually the same at every location.)

10. Talk to the Waitstaff

Nowadays, many restaurants ask if anyone has a food allergy. But if they don’t, it’s important to let them know. “Be really clear with the waitstaff or even the manager about your child’s particular allergy,” says Pratt.

Don’t be afraid to emphasize how important it is to avoid cross contamination. And be sure to ask for a list of all of the ingredients in the dish and exactly how it’s prepared. If you don’t feel satisfied or comfortable with their answers, find another restaurant.

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