Category: California

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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How Long Are Leftovers Good For?

You have about three or four days to safely eat most leftovers, says Bucknavage. Of course, this depends on the exact type of food, as well as other factors like refrigerator temperature, how much moisture is in the food, how long the food sat out after cooking, and sanitary practices used to prepare the food, he says.

Three to four days is a guideline, though some foods won’t be good for that long. “Cooked meals like casseroles, roasted veggies, and pizza usually hold up well for that timeframe, while delicate cold salads or seafood might spoil sooner,” says Alyssa Simpson, RDN, a digestive health dietitian in Phoenix, Arizona.

Eat cold salads that are dressed within one to two days, she recommends. Some salads, like romaine lettuce that’s been tossed in a vinaigrette, won’t hold up at all as leftovers — their taste and texture will be compromised (read: a soggy mess) — so you’re better off trying to make only what you plan on eating in one sitting, if possible.

If you’re going out to eat, stick to the three- or four-day rule for restaurant leftovers. But be advised that some experts, like Simpson, toss them sooner out of an abundance of caution. You don’t know how far in advance they were prepared at the restaurant, she says.

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Weight Loss Pills, Past and Present

The weight loss medications on the market today are generally approved for adults with obesity who have a body mass index (BMI) of 30 or higher, or adults with a BMI of 27 or greater who have at least one weight-related health problem such as high blood pressure, type 2 diabetes, or high cholesterol.

But until recently, very few patients who met those criteria took drugs to lose weight. One study collected prescription data from more than 2.2 million adults eligible for treatment with weight loss medications from 2009 to 2015.

Part of the problem came down to safety concerns, particularly because so many of the first drugs used for weight loss decades ago had potentially life-threatening side effects.

As far back as the 1940s, cocktails of appetite suppressants known as “rainbow pills” were heavily marketed to American women.

The brightly colored capsules often contained amphetamines, diuretics, laxatives, and thyroid hormones to maximize weight loss. They were typically mixed with drugs like benzodiazepines, barbiturates, and antidepressants. By the 1960s, after those potent cocktails of drugs had caused dozens of deaths, the U.S. Food and Drug Administration (FDA) removed them from the market.

“None of these medications were tested in long-term trials prior to repurposing them for the treatment of obesity. This raises the risk that they will have side effects not recognized in short-term therapy,” says Frank Greenway, MD, the chief medical officer and a professor at the Pennington Biomedical Research Center at Louisiana State University in Baton Rouge.

In the 1990s, another untested weight loss cocktail nicknamed fen-phen started taking off.

 This cocktail mixed the psychiatric drug fenfluramine, which boosts levels of the brain chemical serotonin and induces feelings of satiety, with the appetite suppressant phentermine. An older version of fenfluramine, marketed as Pondimin, was on the market for more than two decades, and a newer version called dexfenfluramine, marketed as Redux, was sold for about a year, before both were recalled in 1997 because of concerns that the products caused heart valve defects.
An appetite suppressant called sibutramine, marketed as Meridia, was recalled by the FDA in 2010 after more than a decade on the market, because of an increased risk of cardiovascular events and strokes.

 Next up, the prescription weight loss drug lorcaserin (Belviq) was recalled by the FDA over cancer concerns in 2020, after more than a decade on the market.

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6 Skin-Care Ingredient Combinations That Don’t Mix

Vitamin A derivatives like retinol and retinoids — and alpha hydroxy acids (AHAs) like glycolic acid — are a dermatologist’s go-to for anti-aging. They speed skin cell turnover and increase collagen production for glowy, fine line–free skin. Using them together, however, does not have the same effect. Because they both exfoliate the outer layer of skin, “they possess potentially irritating side effects, especially in combination,” says Elizabeth Bahar Houshmand, MD, a double-board-certified dermatologist in Dallas.

When skin shows signs of irritation (think: red, stingy, flaking, and peeling), you’re less likely to stick to the regimen. You don’t have to choose one or the other. She advises patients to use these topicals on alternate days (AHA on Monday, retinoid on Tuesday, and so on).

One exception? Products that have been specifically tested through clinical trials that combine retinoids and AHA, says Deirdre Hooper, MD, a board-certified dermatologist at Audubon Dermatology in New Orleans. One such is AlphaRet by Skinbetter Science. A study found that this combination retinoid cream performed as well as a prescription retinoid product in diminishing the signs of aging with fewer side effects like redness.

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Kate Middleton Says Her Cancer Is in Remission

Catherine, Princess of Wales, announced on Tuesday in a message posted on social media that she is in remission from an undisclosed type of cancer that was diagnosed last year.

Remission means a decrease in or disappearance of signs and symptoms of cancer.

“It is a relief to now be in remission and I remain focused on recovery,” the princess said in the message. “As anyone who has experienced a cancer diagnosis will know, it takes time to adjust to a new normal. I am, however, looking forward to a fulfilling year ahead.”

This is the first time the princess, formerly known as Kate Middleton, has shared information about her prognosis since announcing last year that she had cancer. She has not disclosed the type of cancer.

The Princess of Wales’s Cancer Journey

Catherine shared the news about her cancer diagnosis in March 2024. In a video statement distributed on social media, she revealed that she’d undergone abdominal surgery in January that detected the presence of cancer, and that she was receiving “preventative” chemotherapy as treatment.

Chemo is often considered once tumors start to grow or spread throughout the body. So-called preventive chemo, also called adjuvant chemotherapy, is often used to attack any cancer remaining after surgery to remove tumors.

In September 2024, the princess announced in a video posted on social media that she had completed chemotherapy.

Outlook for Cancer Has Improved Dramatically in the Past 50 Years

Remission is more common when patients are diagnosed with early-stage tumors, which are typically smaller and easier to treat, according to Cleveland Clinic. It happens less often, but is still possible, when patients are diagnosed with late-stage tumors that are larger or have spread further.

Today, roughly 7 in 10 cancer patients survive at least five years after their diagnosis, compared with only about half of patients in the 1970s, says Frank Penedo, PhD, a professor and the director of cancer survivorship and supportive care at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine in Florida. Dr. Penedo was not involved in the princess’s care, and spoke in general terms about cancer remission and recovery.

“Cancer is becoming more and more a chronic and manageable condition,” Penedo says. “Early detection and treatment advances account for much of this success, but much work remains to be done to address multiple challenges that come from the survivorship experience.”

What Is Remission in Cancer?

Generally speaking, cancer is in remission when the signs and symptoms of tumors are reduced by treatment, according to the National Cancer Institute (NCI). Remission can be partial, meaning cancer has decreased or stopped growing, or complete, meaning all signs of cancer have disappeared.

“There needs to be confirmation via various diagnostic tests that there is no evidence of disease, through a physical exam, blood work, or imaging tests,” Penedo says.

Can Cancer Be Cured?

Doctors sometimes say that patients who remain in complete remission for at least five years are cured because most cancers that reappear do so within this timeframe, according to the NCI. But cancer can still return after more time passes, making it difficult to say with certainty that cancer is cured, even when remission has persisted for many years, the NCI notes.

Doctors typically monitor patients for many years to test for signs that cancer has returned and to assess whether patients are experiencing any lingering side effects of treatment, according to the NCI.

Even in Remission, Side Effects of Chemotherapy Linger

Late effects of chemotherapy, according to Mayo Clinic, can include:

  • Dental problems
  • Early menopause
  • Hearing loss
  • Heart problems
  • Increased risk of other cancers
  • Infertility
  • Loss of taste
  • Lung disease
  • Nerve damage
  • Memory issues
  • Osteoporosis
  • Problems with digestion
  • Reduced lung capacity

Beyond these physical effects of cancer treatment, patients in remission can also experience a wide range of emotions, as they repeatedly undergo testing to see if cancer has come back, Penedo says.

“Understandably, this can lead to elevated levels of anxiety and fear,” Penedo says. “Managing the uncertainty of whether a cancer will or has returned can be emotionally distressing.”

How Cancer Survivors Can Protect Their Well-Being

These are some strategies Cleveland Clinic recommends to help cancer survivors manage their physical and mental health:

  • Talk to your doctor. Your oncologist can help you understand your prognosis and what to expect while you’re in remission, so you know how to monitor for potential signs that cancer is coming back.
  • Connect with survivors. Cancer survivorship programs can connect you with a support group of other people in recovery and help you talk through the challenges you experience.
  • See a nutritionist. A healthy, balanced diet that’s tailored to your specific needs during remission can be beneficial for both your physical and mental health.
  • Get some exercise. Physical activity after cancer treatment can relieve stress and build strength and endurance that may have been sapped during cancer treatment.
  • Get some rest. Cancer and treatment to attack tumors can be hard on your body. Sleep can aid recovery.

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