The New Old Age Blog: A Son Lost, a Mother Found

My friend Yvonne was already at the front door when I woke, so at first I didn’t realize that my mother was missing.

It was less than a week after my son Spencer died. Since that day, a constant stream of friends had been coming and going, bringing casseroles and soup, love, support and chatter. Mom hated it.

My 94-year-old mother, who has vascular dementia, has been living in my home in upstate New York for the past few years. Like many with dementia, mom is courteous but, underneath, irascible. Pride defines her, especially pride in her Phi Beta Kappa intellect. She hates to be confronted with how she has become, as she calls it, “stupid.”

The parade of strangers confused her. She had to be polite, field solicitous questions, endure mundane comments. She could not remember what was going on or why people were there. It must have been stressful and annoying.

That night, like every night since the state troopers brought the news, I woke hourly, tumbling in panic. As if it were not too late to save my son. Mom knew something was wrong, but she could not remember what. As I overslept that morning, she must have decided enough was enough. She was going home.

In a cold sky, the sun blazed over tall pines. As I opened the door, the dogs raced out to greet Yvonne and her two housecleaners. Yvonne often brags about her cleaning duo. They were her gift to me. They were going to clean my house before the funeral reception, which was scheduled for later that week. This was a very big gift because, like my mother before me, I am a very bad housekeeper.

Mom’s door was shut. I cautioned the housecleaners to avoid her room as I showed them around. Yvonne went to the kitchen to listen to the 37 unheard messages on my answering machine; the housecleaners went out to their van to get their instruments of dirt removal.

I ducked into Mom’s room to warn her about the upcoming noise. The bed was unmade; the floor was littered with crumpled tissues; the room was empty.

Normally, I would have freaked out right then. I knew Mom was not in the house, because I had just shown the whole house to the cleaners. Although Mom doesn’t wander like some dementia patients, she does on occasion run away. But I could not muster a shred of anxiety.

“Yvonne,” I called, “did you see my mother outside?”

Yvonne popped her head into the living room, eyebrows raised.“Outside? No!” She was alarmed. “Is she missing?”

“Yeah,” I said wearily, “I’ll look.” I stepped out onto the front porch, tightening the belt of my bathrobe and turning up the collar. Maybe she had walked off into the woods. The dogs danced around my legs, wanting breakfast.

I had no space left in my body to care. Either we would find her, or we would not. Either she was alive, or she was not. My child was gone. How could I care about anything ever again?

Then I saw my car was missing. My mouth fell open and my eyeballs rolled up to the right, gazing blindly at the abandoned bird’s nest on top of the porch light: What had I done with the keys?

Mom likes to run away in the car when she is angry. She used to do it a lot when my father was still alive — every time they fought. Since Mom took off in my car almost a year ago, after we had had a fight, I’d kept the keys hidden. Except for this week; this week, I had forgotten.

I was reverting to old habits. I had left the doors unlocked and the keys in the cupholder next to the driver’s seat. Exactly like Mom used to do.

“Uh-oh,” I said aloud. Mom was still capable of driving, even though she did not know where she was going. I just really, really hoped that she didn’t hurt anybody on the road. I pulled out my cellphone, about to call the police.

“Celia!” Yvonne shouted from the kitchen. She hurried up behind me, excited. “They found your mother. There are two messages on your machine.”

At that very moment, Mom was holed up at the College Diner in New Paltz, a 20-minute drive over the mountain, through the fields, left over the Wallkill River and away down Main Street.

Yvonne called the diner. They promised to keep the car keys until someone arrived. By that time, Yvonne had to go to work. She drove my friend Elizabeth to the diner, and Elizabeth drove Mom home in my car.

Half an hour later, they walked in the front door. Mom’s cheeks were rouged by the chill air and her eyes sparkled, her white hair riffing with static electricity. “Hello, hello,” she sang out. “Here we are.” She was wearing the flannel nightgown and robe I had dressed her in the night before. It was covered by her oversized purple parka, and her bare feet were shoved into sneakers.

I started laughing as soon as I saw her. I couldn’t help it. Elizabeth and Mom started laughing too. “You had a big adventure,” I said, hugging them both. “How are you?”

“I’m just marvelous,” said my mother. Mom always feels great after doing something rakish. We settled her on the sofa with her feet on the ottoman. By the time I got her blanket tucked in around her shoulders, she had fallen asleep.

Elizabeth couldn’t stop laughing as she described the scene. “Your mother was holding court in this big booth. She was sitting there in her nightgown and her parka, talking to everybody, with this plate of toast and coffee and, like, three of the staff hovering around her.”

The waitress said Mom seemed “a little disoriented” when she got there. Mom said she was meeting a friend for breakfast, but since she was wearing a nightgown and didn’t know whom she was meeting or where she lived, the staff thought there might be a problem. They convinced Mom to let them look in the glove compartment of the car, where they found my name and number.

It was then that I realized I was laughing – something I’d thought I would never be able to do again. “Elizabeth, Elizabeth, I’m laughing,” I said.

“Ha, ha, ha,” laughed Elizabeth, holding her belly.

“Ha, ha, ha,” I laughed, rolling on the floor.

And she who gave me life, who had suffered the death of my child and the extinction of her own intellect, snoozed on: oblivious, jubilant, still herself, still mine.

Read More..

Off the Charts: European Banks Thriving as Investor Fears Ease





THE European bank crisis was one of the major worries of 2012. There were forecasts that the euro zone would break up, that various countries would default on their debts and that undercapitalized banks would fail because national governments could not afford to keep them alive.




The bank crisis is not yet resolved, but it “appears to have been put on the back burner of investor concerns,” Jeffrey Yale Rubin and Kevin Pleines of Birinyi Associates said in a research bulletin sent to clients this week.


The accompanying charts show what has happened to the share prices of an index of euro zone bank stocks, and to each of the 28 members in the index, since June 30. In early July, the index kept falling, but by late in the month it turned around. Anyone who bought all the banks at the end of June is up by about 25 percent. Anyone with the good fortune to buy at the exact bottom has a profit of about half the money invested.


The bank stocks have outperformed other European stocks and they have outperformed American bank stocks, although the shares of most American banks also have risen.


The reasons for the relaxation of investor fears are simple enough. There is a growing confidence that euro zone institutions will succeed in their support efforts. Finance ministers are still arguing about the details of a single regulator for banks throughout the zone, but the European Central Bank’s promise to lend money to banks that need it is widely accepted, and investors believe that Germany will put up whatever money is needed to keep the euro zone from breaking up.


Troubled governments like Italy and Spain are still paying much more than Germany to borrow, but their rates have fallen. Costs have declined even in Portugal, which is in the weakest position of countries other than Greece. The French banks led the way up in late 2012, but even the price of Banco Espirito, a Portuguese bank, has soared by about half since midyear. There are still major concerns about troubled Spanish banks, and two of those join an Italian institution in being the only stock market losers over the period. But the National Bank of Greece managed a small gain.


None of this means that those banks have served long-term shareholders well. Only one of them, a Finnish institution, has a share price higher than it did at the end of 2007, before the financial crisis.


But, for now at least, investors seem to have growing confidence that the banks will survive. Given the fears of a few months ago, that is reason for celebration.


Floyd Norris comments on finance and the economy at nytimes.com/economix.



Read More..

IHT Rendezvous: Trust Women Conference: A Delegate's Reflections

LONDON — The first Trust Women conference, hosted by Thomson Reuters Foundation and the International Herald Tribune in London this week, boasted an impressive line up of speakers — from Melanne Verveer, the U.S. ambassador-at-large for global women’s issues to Christy Turlington Burns of Every Mother Counts to Queen Noor of Jordan, to name a few.

The conference confronted difficult subjects like modern-day slavery, the role of women after the Arab Spring, child marriage, corruption and development. The opening speech was delivered by Daw Aung San Suu Kyi by video.

When she was small, she said, growing up with her widowed mother, she thought women ruled the world. The Burmese politician, the second woman in history to be awarded the Nobel Peace Prize, said she couldn’t empathize more with the title of the conference “Trust Women.” “We women have to learn to trust ourselves much more than society has perhaps allowed us to do,” she said.

Sessions on how to change laws, enforce existing laws and change mindsets to empower women led inevitably to discussion of the role women themselves play in passing their predicament on to future generations. Shirin Ebadi, the Iranian lawyer and human rights activist featured in my film “Lili’s Journey,” said, “Men are children of women, they are raised by women, and often these notions of patriarchy are carried from generation to generation even more fiercely by the women themselves.”

Dr. Ebadi, also a Nobel Peace Prize laureate, has set out with volunteers to collect one million signatures in Iran to address the gender discrimination laws in the country’s constitution. “The aim is not to simply gather these million signatures, but to engage the entire society so that they themselves can be the change from within.”

“We tell them useful facts, unbeknownst to many like: Did you know that in an accident, the law dictates that compensation for your male counterpart will be twice the amount of yours?”

Nazir Afzal, Britain’s chief crown prosecutor for the northwest, told the conference that he was on a drive to bring those guilty of “the organized crime that is honor killing” to justice.

Most shockingly, he explained to the audience that a missing underage girl in Britain who is forced into marriage and sent back to her parents’ native country is not protected by the laws of the Western country in which she was born.

He noted of such girls, “Nobody looks for them when they go missing. When your own family is at the origin of the harm that is being done to you, there is no one else to ring the alarm bell for them.”

Home-grown grass-roots action and leadership is needed to change some of these vast issues in different cultures, which are intrinsically linked to strong traditions.
And while the concept of the “white savior complex” crossed a few minds at the conference, it was very obvious that the activists represented today need support but are deemed best placed to know how far to stretch their own communities, challenging their own specific circumstances and heritage.

They are not expecting anybody else to do it for them. Mabel van Oranje, senior adviser to the group of global leaders known as The Elders, said, for instance, that “in the African countries where we are active, we are often told to keep our nose out, but the word of Desmond Tutu, the word of Kofi Annan is highly respected … to
them, it is the voice that comes from within” Africa.

The panel on the role of women and the Arab Spring brought out some of these perspectives. When the journalist Katrin Bennhold of the International Herald Tribune asked the panel of women from Tunisia, Saudi Arabia, Libya, Yemen, Bahrain and Egypt whether they perceive Western women to be charging around with notions of what is best for them, the answer was rather candid.

“We are not here to import Western laws,” said Alaa Murabit, the founder of Voice of Libyan Women. Then she added, “We need a more accurate interpretation of the Shariah law to establish our new constitution.”

The comment upset an Iranian delegate who begged for clarification on what exactly it meant for women to be subjected to Shariah. What is the provision for women in a correct interpretation of Shariah law when it comes to gender equality, access to your children and to financial independence? The outburst threw a lot of questions into the air. They remained unanswered.

Personally, since producing my film, “Lili’s Journey,” on women’s empowerment, I am compelled by the topic of public-private partnerships to achieve some of the important development goals broached during the conference.

At the end of a two-day meeting that created dozens of new connections, fresh stories and much determination to act, Emma Bonino took the stage — epitomizing all that energy, and vowing to take it to Yangon, where she plans to spend time over the Christmas holidays with Aung San Suu Kyi. Who knows, she speculated, perhaps we can go there next year?

Noting that much of the conference had dwelled on how to empower women and get things moving in Africa, Asia or the Middle East, Emma reminded everyone in no uncertain fashion that ”we in Europe still have a very, very long way to go.”

The latest example, she said, was the failure to get a woman on to the board of the European Central Bank. Comparing the many struggles faced by women today to one of her first campaigns — to legalize abortion in Italy in the 1970s — she urged everyone present to stay focused, and to fight for laws because they do make a difference. They are the first step to ensuring that achievements are ”set in stone,” so ”that there is no going back,” she insisted, recalling the joy she had felt when abortion was allowed in Italy, that she was no longer someone campaigning for something illegal, but working to make something that was legal work well.

Activists should remember, she added, that it is important to ask governments, politicians and other individuals and institutions to do their social duty. ”We must pretend that institutions are capable of reacting to the needs of people,” she said. ”We must mob them….The more we leave them alone, the happier they are!”


Laetitia Belmadani is a Paris-based writer and film director.

Read More..

Zynga moves to enter US gambling market












NEW YORK (AP) — Online games company Zynga said it has asked Nevada gambling regulators for a decision that could pave the way for it to enter the U.S. gambling market.


This follows Zynga’s October disclosure that it has signed a deal to offer online poker and casino games, played with real money, in the U.K. It plans to launch those games in the first half of 2013.












Zynga Inc. said in an email late Wednesday that it is seeking an “application for a preliminary finding of suitability” from the Nevada Gaming Control Board. This, the company says, is part of its plan to enter regulated “real-money gaming,” that is, gambling markets.


Zynga has not said what it plans to do with a gaming license. But the company, whose games are played primarily on Facebook, has faltered in recent months and is looking for additional revenue sources beyond online games such as “FarmVille 2″ and “Words With Friends.”


The San Francisco-based company says the process with Nevada regulators should take 12 to 18 months. If Zynga passes the first regulatory hurdle, it can then apply for a gaming license in the state. That, the company said, takes two to three months.


Zynga’s stock rose 17 cents, or 7.1 percent, to close Thursday at $ 2.49. The company went public about a year ago, when its stock priced at $ 10 per share.


Gaming News Headlines – Yahoo! News


Read More..

NHL labor talks break off after 1 hour


NEW YORK (AP) — Talks in the NHL labor fight broke down after just one hour Thursday night, and it isn't known when the league and the players' association would get back together.


After several hours of waiting for discussions to resume for a third straight day, the conversations didn't go well and had none of the momentum that existed Tuesday and Wednesday.


NHL deputy commissioner Bill Daly left the site of the negotiations and headed to the league's office.


The union held internal discussions most of the day, while keeping in contact with the NHL, and the sides finally reconvened around 5 p.m.


Players' association executive director Donald Fehr was expected to address reporters to give an update. Fehr rejoined the negotiations Thursday after sitting out the previous two days. NHL Commissioner Gary Bettman stayed out for the third consecutive day.


Read More..

Extended Use of Breast Cancer Drug Suggested


The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.


In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.


“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.


Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs might be taken for a longer duration as well.


“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”


Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.


Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.


About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them are in premenopausal women with estrogen receptor-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.


The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.


In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing 10 years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.


About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.


There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.


Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.


“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.


Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.


Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.


“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.


Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.


“They don’t feel well on them, but it’s their safety net,” said Dr. Garber, who added that the news would be welcomed by many patients who would like to stay on the drug. “I have patients who agonize about this, people who are coming to the end of their tamoxifen.”


Emily Behrend, who is a few months from finishing her five years on tamoxifen, said she would definitely consider another five years. “If it can keep the cancer away, I’m all for it,” said Ms. Behrend, 39, a single mother in Tomball, Tex. She is taking the antidepressant Effexor to help control the night sweats and hot flashes caused by tamoxifen.


Cost is not considered a huge barrier to taking tamoxifen longer because the drug can be obtained for less than $200 a year.


The results, while answering one question, raise many new ones, including whether even more than 10 years of treatment would be better still.


Perhaps the most important question is what the results mean for postmenopausal women. Even many women who are premenopausal at the time of diagnosis will pass through menopause by the time they finish their first five years of tamoxifen, or will have been pushed into menopause by chemotherapy.


Postmenopausal patients tend to take aromatase inhibitors like anastrozole or letrozole, which are more effective than tamoxifen at preventing breast cancer recurrence, though they do not work for premenopausal women.


Mr. Peto said he thought the results of the Atlas study would “apply to endocrine therapy in general,” meaning that 10 years of an aromatase inhibitor would be better than five years. Other doctors were not so sure.


The Atlas study was paid for by various organizations including the United States Army, the British government and AstraZeneca, which makes the brand-name version of tamoxifen.


Read More..

Jobless Claims Drop as Storm’s Effects Fade





WASHINGTON (AP) — The number of people applying for unemployment benefits fell sharply last week as a temporary spike caused by Hurricane Sandy faded. Weekly first-time jobless claims have fallen back to a level consistent with modest hiring.




The Labor Department said Thursday that applications for unemployment benefits dropped 25,000 last week to a seasonally adjusted 370,000.


New unemployment claims surged a month ago after the storm forced businesses to close in the Northeast. Applications jumped to 451,000 in the week that ended Nov. 10. People can claim unemployment benefits if their workplaces are forced to close and they are not paid.


Some analysts were encouraged by how quickly new jobless claims returned to pre-storm levels. Pierre Ellis, an economist at Decision Economics, said the rapid drop suggested that companies were quickly rehiring workers displaced by the storm. Rebuilding and repair efforts could also be creating jobs, he said.


The early impact of Hurricane Sandy could still be seen in the four-week average of new unemployment applications. It rose to 408,000 last week.


Before the storm hit on Oct. 29, new jobless claims had fluctuated this year from 360,000 to 390,000. They were above 400,000 for most of last year. That has coincided with only modest declines in the unemployment rate.


The impact of Hurricane Sandy is also likely to depress November’s employment figures, which the government will report on Friday. And fears over looming tax increases and government spending cuts also may have dragged on job gains last month.


Economists were forecasting on average that employers added 110,000 jobs in November, according to FactSet. And they predicted that the unemployment rate would remain at 7.9 percent. But some analysts expected much lower job gains, roughly 25,000 to 50,000, because of the storm and anxiety over the fiscal crisis.


Read More..

The Lede Blog: Clashes in Cairo After Morsi Supporters Attack Palace Sit-In

Video, said to show a Morsi supporter firing a shotgun in the direction of protesters in Cairo on Wednesday night, was posted on YouTube by the Mosireen film collective.

Last Updated, 6:55 p.m. Street battles erupted in Cairo on Wednesday night, after Islamist supporters of President Mohamed Morsi attacked protesters camped outside the gates of the presidential palace, according to journalists and activists who witnessed the raid.

Morsi supporters reportedly attempted to stifle coverage by attacking journalists and bloggers, but activists from the Mosireen film collective managed to record video of tents being ripped down, which was quickly posted on YouTube.

Raw footage of an attack on a sit-in outside the presidential palace in Cairo on Wednesday posted on YouTube by Mosireen, a collective of activist filmmakers.

Egypt’s ON TV, which posted a live stream of the scene outside the palace on YouTube, also broadcast video of the president’s supporters clearing the sit-in and putting up barriers to block the return of protesters to the area.

Video from Egypt’s ON TV showed Islamists driving away protesters camped outside the presidential palace in Cairo on Wednesday

Activists and journalists posted images on Twitter showing the president’s supporters dispersing the sit-in and taking control of the area outside the palace, with the apparent acquiescence of the police.

The attack on the sit-in came one day after tens of thousands of protesters rallied outside the gates of the palace to protest the president’s decree granting himself unchecked power to help push through a new constitution written by Islamists.

Before the attack, a message posted on the Muslim Brotherhood’s official @Ikhwanweb Twitter account called for a million-man counter-demonstration at the same location.

As several journalists noted, the Morsi supporters cleared the sit-in just as the vice president told reporters that the crisis could be resolved by allowing a referendum on the draft constitution to proceed and then passing amendments to the document after a new Parliament convenes.

While Muslim Brotherhood officials denied that they were responsible for the violence, claiming that “both sides” engaged in attacks, opposition activists blamed the Islamist president for the escalation and compared the use of force by civilian supporters of the Islamist movement to the tactics of the Mubarak regime and the way Iran’s government deploys members of the Basij militia to attack protesters there.

After the Morsi supporters cleared the small number of protesters who had camped outside the palace walls following Tuesday night’s protest, they moved on to erasing graffiti left by the revolutionaries, including a portrait of Jika Gaber, a young man who was killed at the start of the protests against the president’s decree.

As opposition protesters rallied nearby in response to the attack, activists reported that the president’s supporters remained on the offensive. Video streamed live from the scene to the video-sharing site Bambuser by the activist blogger Tarek Shalaby seemed to capture the sound of shots being fired.

Raw footage posted online later by the activist filmmakers from Mosireen appeared to show clear images of one of the Morsi supporters firing a shotgun in the direction of the protesters.

Later, a researcher for the Egyptian Initiative for Personal Rights reported that Morsi supporters were firing shotgun pellets at the protesters on the other side, and one blogger took cover under a car to avoid being attacked.

After reports of serious casualties accompanied by graphic images began to circulate online, the journalists Sharif Kouddous and Sarah Carr reported on clashes between supporters and opponents of the president from the front line between the two groups.

More footage of the street battle posted online late in the evening by Mosireen appeared to show a police officer firing at protesters from the Morsi supporters’ side of the barricades.

Mosireen video of the street battles on Wednesday night in Cairo.

Late in the evening, the blogger who writes as @Egyptocracy on Twitter drew attention to video that appeared to show a protester who had been captured by the president’s supporters. Refusing to give into the demands of his captors to confess to having been paid to take part in the demonstration, the man shouted instead, “I will voice my opinion.”

After the violence escalated, Brotherhood officials, including Essam el-Erian, a senior leader of the group’s political party, and the young, Islamist bloggers running the official Twitter account tried to blame opposition politicians, and were met with jeers from activists.

Read More..

Chiefs players head to Belcher memorial service


KANSAS CITY, Mo. (AP) — Several players for the Kansas City Chiefs attended a memorial service for teammate Jovan Belcher, who killed his girlfriend and then fatally shot himself in the head.


Belcher killed 22-year-old Kasandra Perkins on Saturday at the home they shared in Kansas City with their 3-month-old daughter. He then drove to the Chiefs practice facility at Arrowhead Stadium, where he killed himself in front of team officials, who pleaded with him to put down his gun.


Retired Chiefs Hall of Famer Bobby Bell said after the private hour-long service that general manager Scott Pioli, who witnessed Belcher's suicide, spoke during the service. Bell said an uncle of Belcher also spoke.


The service was held at a church that Belcher and Perkins attended.


Several other Chiefs players declined comment after the service.


Read More..

Extended Use of Breast Cancer Drug Suggested


The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.


In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.


“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.


Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs as well might be taken for a longer duration.


“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”


Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.


Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.


About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them would be in premenopausal women with ER-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.


The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.


In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing ten years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.


About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.


There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.


Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.


“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.


Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.


Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.


“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.


Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.


Read More..