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From eye exams to blood tests and surgery: how doctors use light to diagnose disease

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/matthew-griffith-1539353">Matthew Griffith</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> You’re not feeling well. You’ve had a pounding headache all week, dizzy spells and have vomited up your past few meals. You visit your GP to get some answers and sit while they shine a light in your eyes, order a blood test and request some medical imaging. Everything your GP just did relies on light. These are just some of the optical technologies that have had an enormous impact in how we diagnose disease. <h2>1. On-the-spot tests</h2> Point-of-care diagnostics allow doctors to test patients on the spot and get answers in minutes, rather than sending samples to a lab for analysis. The “flashlight” your GP uses to view the inside of your eye (known as an <a href="https://medlineplus.gov/ency/article/003881.htm">ophthalmoscope</a>) is a great example. This allows doctors to detect abnormal blood flow in the eye, deformations of the cornea (the outermost clear layer of the eye), or swollen optical discs (a round section at the back of the eye where the nerve link to the brain begins). Swollen discs are a sign of elevated pressure inside your head (or in the worst case, a brain tumour) that could be <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/increased-intracranial-pressure-icp-headache">causing your headaches</a>. The invention of <a href="https://openmedscience.com/lighting-the-way-in-healthcare-the-transformative-role-of-lasers-in-medicine/">lasers and LEDs</a> has enabled many other miniaturised technologies to be provided at the bedside or clinic rather than in the lab. <a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">Pulse oximetry</a> is a famous example, where a clip attached to your finger reports how well your blood is oxygenated. It does this by <a href="https://www.howequipmentworks.com/pulse_oximeter/">measuring</a> the different responses of oxygenated and de-oxygenated blood to different colours of light. Pulse oximetry is used at hospitals (and <a href="https://theconversation.com/whats-a-pulse-oximeter-should-i-buy-one-to-monitor-covid-at-home-174457">sometimes at home</a>) to monitor your respiratory and heart health. In hospitals, it is also a valuable tool for detecting <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60107-X/fulltext">heart defects in babies</a>. <h2>2. Looking at molecules</h2> Now, back to that blood test. Analysing a small amount of your blood can diagnose <a href="https://theconversation.com/blood-tests-and-diagnosing-illness-what-can-blood-tell-us-about-whats-happening-in-our-body-80327">many different diseases</a>. A machine called an automated “full blood count analyser” tests for general markers of your health. This machine directs focused beams of light through blood samples held in small glass tubes. It counts the number of blood cells, determines their specific type, and reports the level of haemoglobin (the protein in red blood cells that distributes oxygen around your body). In minutes, this machine can provide a <a href="https://www.nuffieldhealth.com/article/inside-the-pathology-lab-what-happens-to-my-blood">snapshot</a> of your overall health. For more specific disease markers, blood serum is separated from the heavier cells by spinning in a rotating instrument called a centrifuge. The serum is then exposed to special chemical stains and enzyme assays that change colour depending on whether specific molecules, which may be the sign of a disease, are present. These colour changes can’t be detected with the naked eye. However, a light beam from an instrument called a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476943/#R88">spectrometer</a> can detect tiny amounts of these substances in the blood and determine if the biomarkers for diseases are present, and at what levels. <h2>3. Medical imaging</h2> Let’s re-visit those medical images your GP ordered. The development of fibre-optic technology, made famous for transforming high-speed digital communications (such as the NBN), allows light to get inside the body. The result? High-resolution optical imaging. A common example is an <a href="https://www.medicalnewstoday.com/articles/153737#risks-and-side-effects">endoscope</a>, where fibres with a tiny camera on the end are inserted into the body’s natural openings (such as your mouth or anus) to examine your gut or respiratory tracts. Surgeons can insert the same technology through tiny cuts to view the inside of the body on a video screen during <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553337/">laparoscopic surgery</a> (also known as keyhole surgery) to diagnose and treat disease. <h2>How about the future?</h2> Progress in nanotechnology and a better understanding of the interactions of light with our tissues are leading to new light-based tools to help diagnose disease. These include: <ul> <li> <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/advs.201903441">nanomaterials</a> (materials on an extremely small scale, many thousands of times smaller than the width of a human hair). These are being used in next-generation sensors and new diagnostic tests </li> <li> <a href="https://www.nature.com/articles/s41587-019-0045-y">wearable optical biosensors</a> the size of your fingernail can be included in devices such as watches, contact lenses or finger wraps. These devices allow non-invasive measurements of sweat, tears and saliva, in real time </li> <li> AI tools to analyse how blood serum scatters infrared light. This has allowed researchers to build a <a href="https://www.advancedsciencenews.com/powerful-diagnostic-approach-uses-light-to-detect-virtually-all-forms-of-cancer/">comprehensive database</a> of scatter patterns to detect <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/aisy.202300006">any cancer</a> </li> <li> a type of non-invasive imaging called <a href="https://www.ncbi.nlm.nih.gov/books/NBK554044/">optical coherence tomography</a> for more detailed imaging of the eye, heart and skin </li> <li> fibre optic technology to deliver a tiny microscope into the body on the <a href="https://www.uwa.edu.au/projects/microscope-in-a-needle">tip of a needle</a>. </li> </ul> So the next time you’re at the GP and they perform (or order) some tests, chances are that at least one of those tests depend on light to help diagnose disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231379/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/matthew-griffith-1539353">Matthew Griffith</a>, Associate Professor and ARC Future Fellow and Director, UniSA Microscopy and Microanalysis Facilities, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-eye-exams-to-blood-tests-and-surgery-how-doctors-use-light-to-diagnose-disease-231379">original article</a>. </div>

Body

Scurvy is largely a historical disease but there are signs it’s making a comeback

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Scurvy is often considered a historical ailment, conjuring images of sailors on long sea voyages suffering from a lack of fresh fruit and vegetables. Yet doctors in developed countries have recently reported treating cases of scurvy, including Australian doctors who <a href="https://casereports.bmj.com/lookup/doi/10.1136//bcr-2024-261082">reported their findings</a> today in the journal <a href="https://casereports.bmj.com/">BMJ Case Reports</a>. <h2>What is scurvy?</h2> Scurvy is a disease caused by a severe deficiency of vitamin C (ascorbic acid), which is essential for the production of collagen. This protein helps maintain the health of skin, blood vessels, bones and connective tissue. Without enough vitamin C, the body cannot properly repair tissues, heal wounds, or fight infections. This can lead to a range of <a href="https://www.degruyter.com/document/doi/10.1515/9781400884544/html">symptoms</a> including: <ul> <li>fatigue and weakness</li> <li>swollen, bleeding gums or loose teeth</li> <li>joint and muscle pain and tenderness</li> <li>bruising easily</li> <li>dry, rough or discoloured skin (reddish or purple spots due to bleeding under the skin)</li> <li>cuts and sores take longer to heal</li> <li>anaemia (a shortage of red blood cells, leading to further fatigue and weakness)</li> <li>increased susceptibility to infections.</li> </ul> <h2>It historically affected sailors</h2> Scurvy was <a href="https://pubmed.ncbi.nlm.nih.gov/23183299/">common</a> from the 15th to 18th centuries, when naval sailors and other explorers lived on rations or went without fresh food for long periods. You might have heard some of these milestones in the history of the disease: <ul> <li> in 1497-1499, Vasco da Gama’s crew <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)13131-5/fulltext#:%7E:text=After%205%20weeks%20at%20sea,lemons%2C%20clearing%20up%20the%20condition">suffered severely from scurvy</a> during their expedition to India, with a large portion of the crew dying from it </li> <li> from the 16th to 18th centuries, scurvy was rampant among European navies and explorers, affecting notable figures such as <a href="https://www.jstor.org/stable/26305889">Ferdinand Magellan and Sir Francis Drake</a>. It was considered one of the greatest threats to sailors’ health during long voyages </li> <li> in 1747, British naval surgeon <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3536506/">James Lind</a> is thought to have conducted one of the first clinical trials, demonstrating that citrus fruit could prevent and cure scurvy. However, it took several decades for his findings to be widely implemented </li> <li> in 1795, the British Royal Navy officially adopted the <a href="https://journals.sagepub.com/doi/pdf/10.1177/003591572601902602">practice of providing lemon or lime juice to sailors</a>, dramatically reducing the number of scurvy cases. </li> </ul> <h2>Evidence of scurvy re-emerging</h2> In the new case report, doctors in Western Australia <a href="https://casereports.bmj.com/lookup/doi/10.1136//bcr-2024-261082">reported</a> treating a middle-aged man with the condition. In a separate case report, doctors in Canada <a href="https://www.cmaj.ca/content/196/33/E1144">reported</a> treating a 65-year old woman. Both patients presented with leg weakness and compromised skin, yet the doctors didn’t initially consider scurvy. This was based on the <a href="https://www.mdpi.com/2072-6643/12/7/1963">premise</a> that there is abundant vitamin C in our modern food supply, so deficiency should not occur. On both occasions, treatment with high doses of vitamin C (1,000mg per day for at least seven days) resulted in improvements in symptoms and eventually a full recovery. The authors of both case reports are concerned that if scurvy is left untreated, it could lead to inflamed blood vessels (<a href="https://www.mayoclinic.org/diseases-conditions/vasculitis/symptoms-causes/syc-20363435">vasculitis</a>) and potentially <a href="https://www.sciencedirect.com/science/article/pii/S2211419X11001625">cause fatal bleeding</a>. Last year, a major New South Wales hospital undertook a <a href="https://www.mja.com.au/journal/2023/219/10/serum-vitamin-c-status-people-new-south-wales-retrospective-analysis-findings">chart review</a>, where patient records are reviewed to answer research questions. This found vitamin C deficiency was common. More than 50% of patients who had their vitamin C levels tested had either a modest deficiency (29.9%) or significant deficiency (24.5%). Deficiencies were more common among patients from rural and lower socioeconomic areas. Now clinicians are <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.52146">urged to</a> consider vitamin C deficiency and scurvy as a potential diagnosis and involve the support of a dietitian. <h2>Why might scurvy be re-emerging?</h2> Sourcing and consuming nutritious foods with sufficient vitamin C is unfortunately <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10260575/">still an issue</a> for some people. Factors that increase the risk of vitamin C deficiency include: <ul> <li> poor diet. People with restricted diets – due to poverty, food insecurity or dietary choices – <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10296835/">may not get enough</a> vitamin C. This includes those who rely heavily on processed, nutrient-poor foods rather than fresh produce </li> <li> food deserts. In areas where access to fresh, affordable fruits and vegetables is limited (often referred to as food deserts), people may <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9587807/">unintentionally suffer from a vitamin C deficiency</a>. In some parts of developing countries such as India, lack of access to fresh food is <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10296835/">recognised as a risk</a> for scurvy </li> <li> the cost-of-living crisis. With greater numbers of people <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10935407/">unable to pay for fresh produce</a>, people who limit their intake of fruits and vegetables may develop nutrient deficiencies, including scurvy </li> </ul> <ul> <li> weight loss procedures and medications. Restricted dietary intake due to weight loss surgery or weight loss medications may <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/oby.24067">lead to nutrient deficiencies</a>, such as in this <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3320124/">case report of scurvy</a> from Denmark </li> <li> mental illness and eating disorders. Conditions such as depression and anorexia nervosa can lead to severely restricted diets, increasing the risk of scurvy, such as in this <a href="https://pubmed.ncbi.nlm.nih.gov/32291151/">case report</a> from 2020 in Canada </li> <li> isolation. Older adults, especially those who live alone or in nursing homes, may have <a href="https://doi.org/10.1136//bcr-2024-261082">difficulty</a> preparing balanced meals with sufficient vitamin C </li> <li> certain medical conditions. People with digestive disorders, malabsorption issues, or those on restrictive medical diets (due to severe allergies or intolerances) can develop scurvy if they are <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8248877/">unable to absorb or consume enough vitamin C</a>. </li> </ul> <h2>How much vitamin C do we need?</h2> Australia’s dietary guidelines <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-c">recommend</a> adults consume 45mg of vitamin C (higher if pregnant or breastfeeding) each day. This is roughly the amount found in half an orange or half a cup of strawberries. When more vitamin C is <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/australian-health-survey-usual-nutrient-intakes/latest-release">consumed</a> than required, excess amounts leave the body through urine. Signs of scurvy can appear as early as a month after a daily intake of less than 10 mg of vitamin C. Eating vitamin C-rich foods – such as oranges, strawberries, kiwifruit, plums, pineapple, mango, capsicum, broccoli and Brussels sprouts – can resolve symptoms within a few weeks. Vitamin C is also readily available as a supplement if there are reasons why intake through food may be compromised. Typically, the supplements contain 1,000mg per tablet, and the <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/vitamin-c">recommended upper limit</a> for daily Vitamin C intake is 2,000mg.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/scurvy-is-largely-a-historical-disease-but-there-are-signs-its-making-a-comeback-241894">original article</a>. </div>

Body

"Absolute breakthrough": New hope in search for Motor Neurone Disease cure

Melbourne researchers are one step closer to finding a cure for Motor Neurone Disease, with the help technology and stem cell research. Scientists at The Florey Institute of Neuroscience and Mental Health have developed a world-first technology that will speed up the drug testing process to help find an effective treatment and maybe even a cure for the disease. New machines at the institute can now help determine whether drugs on the market could be used to treat MND in just weeks, a process which previously took decades. "This is an absolute breakthrough, it's at the cutting edge of technology," Florey MND researcher Professor Brad Turner said. Animal cells were previously used to test the efficacy of MND drugs, but now thanks to more than 100 MND patients who donated their skin cells to the institute, researchers have a library of stem cells to work with. The human stem cells can provide scientists with the full scope of the disease, something that they were previously unable to do with just animal cells. "This is really a game-changer in that we can use their own cells, and we can test drugs directly on their own cells," Florey MND researcher and neurologist Dr Thanuja Dharmadasa said. Large scale screening will commence thanks to a $5 million grant from the Australian Medical Research Future Fund. The research is expected to help people like Phil Camden who has been living with the disease for 10 years. "That's the key to all of us living with MND... we want to do what we can while we can," Camden said. "We know we're not doing it to find a cure for us. We're doing it for those in the future, my grandkids and their children." Scientists believe that medication or a cocktail of drugs tailored specifically to a patient is the way forward when it comes to treating the disease. "Therefore your drug treatments are tailed back to the clinical makeup in the dish and we call that personalised medical treatment," Turner said. Image: Nine News

Caring

Millions warned as dangerous disease spreads in Melbourne

Health authorities have issued an urgent warning to Victorians after multiple people have been admitted to hospital with severe symptoms. Victoria's Department of Health has revealed it is investigating an outbreak of Legionnaires disease after a "significant increase" in cases across Melbourne since Friday. Over just three days, 22 cases of the disease have been confirmed with another six cases suspected. Most of the cases are in adults aged over 40, with many of them requiring hospitalisation and intensive care for severe pneumonia. Health authorities are now searching for the source of the outbreak, as the health department said in a statement, "Legionnaires' disease can cause a chest infection with symptoms of fever, chills, cough, headache and muscle aches and pains. Other atypical symptoms may include nausea, vomiting, diarrhoea and confusion." "All cases have visited or reside in metropolitan Melbourne. Those most at risk are adults aged over 40 years, especially people with other medical conditions or immune compromise, or who smoke." The source of the outbreak is not yet known but investigations are underway to determine where it has come from. Legionnaires' disease is spread by breathing in fine droplets of water that contain legionella bacteria, and is not commonly spread from person-to-person or by drinking contaminated water. The <a href="https://www.health.vic.gov.au/health-alerts/outbreak-of-legionnaires-disease-in-metropolitan-melbourne" target="_blank" rel="noopener">Department of Health</a> is urging anyone who lives in, works in or has visited metropolitan Melbourne and surrounding areas to seek urgent medical care if they develop symptoms. Image credits: Shutterstock

Caring

Mysterious leg pain that’s quietly killing older Australians

Peripheral Artery Disease (PAD) has long been overshadowed by its more widely recognised counterparts, such as heart attacks and strokes. Often referred to as the “poor cousin” or “Cinderella” of cardiovascular diseases, PAD affects one in five older Australians, yet it remains largely under-diagnosed and misunderstood. However, a wave of optimism is sweeping through the medical community with the launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a>, an Australian-first facility dedicated to pioneering research and improving patient outcomes. Spearheaded by the Heart Research Institute, the Centre for Peripheral Artery Disease, marks a significant step forward in addressing the challenges posed by PAD. The centre aims to fill critical gaps in our understanding of the disease, which is responsible for a limb amputation in Australia every two hours. This initiative promises to enhance diagnosis, transform patient care, and raise awareness about PAD. Associate Professor Mary Kavurma, the Centre Lead, is at the forefront of this ground-breaking effort. “We’re supercharging research into PAD because there are still many unknowns about the disease’s biology that could unlock new methods for early detection and better management,” she explains. This research is particularly urgent given the prevalence of PAD among women and First Nations Australians, groups that remain disproportionately affected by this condition. The centre’s mission is to develop a simple blood test for early diagnosis and explore novel therapies that could reduce the need for limb amputations and significantly improve patients’ quality of life. Unlike current treatments that primarily focus on symptom management, this new approach seeks to prevent the disease from progressing. One of the most inspiring aspects of the centre is its commitment to involving patients and their families in the research process. At the inaugural consumer meeting, nearly 20 patients and their carers shared their personal experiences with PAD. Take the story of Simon Josephson, a renowned advertising guru – who famously designed the Solo logo. PAD almost cost him his life after taking more than five years to diagnose. He woke up one morning with a sore leg, thinking he’d overdone it exercising but the 73-year-old – who was otherwise healthy and active – unknowingly had Peripheral Artery Disease, caused by a build-up of plaque in his arteries causing them to narrow and stiffen. It wasn’t until a trip to the hospital emergency department years later that doctors would discover his aorta had expanded to more than twice the usual size and was at risk of rupturing. He immediately underwent open heart surgery and has faced a lengthy recovery. The launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a> heralds a new era of hope and progress in the fight against PAD. Through world-leading research, community engagement, and a commitment to patient-centred care, the CPAD is poised to make a profound impact on the lives of many Australians. As Assoc Prof Kavurma aptly put it, “By understanding more about this debilitating condition, we are paving the way for better health outcomes and a brighter future for all those affected by PAD.” Images: CPAD

Caring

Is it really possible to have Alzheimer’s yet no symptoms?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/michael-hornberger-1507154">Michael Hornberger</a>, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a> Some people seem to be more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003087/#:%7E:text=Some%20individuals%20are%20able%20to,into%20a%20widely%20debated%20concept.">resilient</a> to developing Alzheimer’s diseases, despite having the biological hallmarks of the devastating disease. For obvious reasons, scientists are very interested in studying this special group of people. Alzheimer’s disease, the most common form of dementia, is thought to start because of a build-up of two proteins in the brain: amyloid and tau. Once these proteins accumulate, for yet-to-be-determined reasons, they become toxic to brain cells (neurons) and these cells start dying. As a result, people develop symptoms such as memory loss because the brain can’t function properly with all these dead neurons. This cascade of events has been known for many years and is how the disease progresses in most people with Alzheimer’s. Most people, except a special group who are more resilient. But why are they resilient? A recent study in the journal <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-024-01760-9">Acta Neuropathologica Communications</a> investigated whether our genes might influence how resilient we are against Alzheimer’s disease symptoms when there are high levels of amyloid in our brain. The scientists conducted a study on the brains of three groups of people. The first group comprised people who had died with Alzheimer’s disease. The second were healthy people who died of natural causes. And the third comprised people who had high levels of Alzheimer’s proteins in the brain but never developed symptoms of the disease during their lifetime – or at least never had a diagnosis of Alzheimer’s disease. The last group, they considered as being resilient to Alzheimer’s disease since they had the proteins in their brains but did not have the symptoms or a diagnosis of Alzheimer’s disease during their lifetime. The scientists found that genes related to the activity of the immune system seem to have been more active in the Alzheimer’s resilient group. This would make sense as it is well established that the immune system helps clear the excess proteins from the brain, so genes that help this process might make us more resilient to developing symptoms of the disease. <h2>How to become resilient – even if you don’t have the genes</h2> This is great if you have inherited these genes from your parents, but what does it mean for the rest of us who do not have those genes? Is there a way we can make ourselves more resilient to developing Alzheimer’s disease regardless of our genes? “Yes” is the short answer. There is now good scientific evidence that <a href="https://theconversation.com/can-alzheimers-really-be-reversed-as-a-new-documentary-claims-230705">lifestyle changes</a> and drugs allow us to reduce our risk of developing Alzheimer’s disease in the future. In particular, physical activity has been shown to reduce our risk of developing Alzheimer’s, probably because it has a well-known beneficial effect on our immune system and hence helps clear those rogue proteins accumulating in our brains. This means that being more physically active might have the same effect on our Alzheimer’s resilience as those lucky people who have the “right” genes. Interestingly, we do not know how physically active the resilient people in the study were and how this might have influenced their resilience to Alzheimer’s disease. As so often in science, it is not clear whether nature (genes) or nurture (lifestyle) contributed to their resilience. The other interesting aspect is that the resilient people in the study died of another cause than Alzheimer’s disease, but they might have developed Alzheimer’s disease eventually if they had lived longer.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230334/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-hornberger-1507154">Michael Hornberger</a>, Professor of Applied Dementia Research, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-it-really-possible-to-have-alzheimers-yet-no-symptoms-230334">original article</a>. </div>

Mind

"Rest in love": All Blacks legend and Dancing with the Stars winner dies at 55

The sports and entertainment communities are mourning the loss of former All Blacks hooker and Dancing with the Stars winner Norm Hewitt, who has passed away at the age of 55. Hewitt, a beloved figure both on and off the rugby field, succumbed to a lengthy battle with motor neurone disease, as confirmed by his family in a heartfelt statement. "Although rugby dominated his early life, he established a thriving human relations consultancy after retirement, and his services were much in demand both nationally and internationally," his family shared. "He walked confidently in both Māori and Pākehā worlds and was a particular role model for troubled youth, citing his own background, and offering inspirational teachings that one’s present life need not be one’s future." Hewitt leaves behind his wife Arlene and their two children, Elizabeth and Alexander. Born and raised in Pōrangahau, southern Hawke’s Bay, Hewitt's rugby career was nothing short of illustrious. Over 13 seasons, he played 296 representative matches for Hawke’s Bay, Southland and Wellington, earning 23 caps for the All Blacks. Hewitt was also a pivotal member of the Hurricanes during the formative years of Super Rugby, missing only one match in the first five years. The rugby community has been profoundly affected by Hewitt's passing. Former teammate Ofisa Tonu’u posted a touching tribute on Facebook: "I’m just devastated finding out the news today. I will never forget how you always stuck up for me during the Black Tracker days when no one else would, you always look after all the players and we always followed you into battle. No more pain, brother, you can now rest in Love. Fa’afetai tele lava my uso for having my back as I did yours. I know the other boys will be welcoming you with open arms at the gates. Rest in Love, Normy." Beyond his rugby career, Hewitt transitioned into a public speaker and mentor, focusing heavily on violence prevention programmes and advocacy. He worked with the SPCA as an animal cruelty and anti-violence publicity officer, visiting schools to spread his message. In 2005, Hewitt showcased his versatility by winning the first season of Dancing with the Stars alongside professional dancer Carol-Ann Hickmore. Hewitt's life was not without its struggles. In 1999, he made a public apology for a drunken incident in Queenstown, marking a turning point as he renounced alcohol and dedicated himself to helping others facing similar challenges. The outpouring of tributes was immediate, with The All Blacks expressing their sorrow: “We are saddened by the loss of All Black #938 Norm Hewitt who passed away yesterday in Wellington. Hewitt played 9 Tests and 14 Games between 1993 and 1998. Our thoughts are with Norm’s family and loved ones at this time.” Podcaster Martin Devlin shared his personal experience: “RIP Norm Hewitt. Not a lot of people know how kind & generous this man was. A truly wonderful person. Reached out to me and helped me considerably a long time ago when things were very rough. Love & respect.” Richard Hills echoed the sentiments of many: “This is bloody sad. A sad way to lose a kiwi icon so young. He had a really rough childhood and upbringing and faced it and turned his life around to become not only a rugby legend but also helped others who’d been through similar issues.” Norm Hewitt’s legacy will endure through the lives he touched and the positive change he inspired. His story is a testament to the strength of the human spirit and the profound impact one individual can have on the world. Image: Radio New Zealand

Caring

1 in 5 deaths are caused by heart disease, but what else are Australians dying from?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/garry-jennings-5307">Garry Jennings</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Nobody dies in good health, at least in their final moments. But to think the causes of death are easy to count or that there is generally a single reason somebody passes is an oversimplification. In fact, in 2022, four out of five Australians had multiple conditions at the time of death listed on their death certificate, and almost one-quarter had five or more recorded. This is one of many key findings from a <a href="https://pp.aihw.gov.au/reports/life-expectancy-deaths/what-do-australians-die-from/contents/about">new report</a> from the Australian Institute of Health and Welfare (AIHW). The report distinguishes between three types of causes of death – underlying, direct, and contributory. An underlying cause is the condition that initiates the chain of events leading to death, such as having coronary heart disease. The direct cause of death is what the person died from (rather than with), like a heart attack. Contributory causes are things that significantly contributed to the chain of events leading to death but are not directly involved, like having high blood pressure. The report also tracks how these three types of causes can overlap in deaths involving multiple causes. In 2022 the top five conditions involved in deaths in Australia were coronary heart disease (20% of deaths), dementia (18%), hypertension, or high blood pressure (12%), cerebrovascular disease such as stroke (11.5%), and diabetes (11.4%). <hr /> <iframe id="MzQHA" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/MzQHA/" width="100%" height="400px" frameborder="0"></iframe> <hr /> When the underlying cause of death was examined, the list was similar (coronary heart disease 10%, dementia 9%, cerebrovascular disease 5%, followed by COVID and lung cancer, each 5%). This means coronary heart disease was not just lurking at the time of death but also the major underlying cause. The direct cause of death however was most often a lower respiratory condition (8%), cardiac or respiratory arrest (6.5%), sepsis (6%), pneumonitis, or lung inflammation (4%) or hypertension (4%). <h2>Why is this important?</h2> Without looking at all the contributing causes of death, the role of important factors such as coronary heart disease, sepsis, depression, high blood pressure and alcohol use can be underestimated. Even more importantly, the various causes draw attention to the areas where we should be focusing public health prevention. The report also helps us understand which groups to focus on for prevention and health care. For example, the number one cause of death in women was dementia, whereas in men it was coronary heart disease. <hr /> <iframe id="NosVz" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/NosVz/" width="100%" height="400px" frameborder="0"></iframe> <hr /> People aged under 55 tended to die from external events such as accidents and violence, whereas older people died against a background of chronic disease. <hr /> <iframe id="1l3OS" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/1l3OS/" width="100%" height="400px" frameborder="0"></iframe> <hr /> We cannot prevent death, but we can prevent many diseases and injuries. And this report highlights that many of these causes of death, both for younger Australians and older, are preventable. The top five conditions involved in death (coronary heart disease, dementia, hypertension, cerebrovascular disease and diabetes) all share common risk factors such as tobacco use, high cholesterol, poor nutrition, physical inactivity, or are risk factors themselves, like hypertension or diabetes. <hr /> <iframe id="7Eb8O" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/7Eb8O/" width="100%" height="400px" frameborder="0"></iframe> <hr /> Tobacco use, high blood pressure, being overweight or obese and poor diet were attributable to a combined 44% of all deaths in this report. This suggests a comprehensive approach to health promotion, disease prevention and management is needed. <hr /> <iframe id="2MmGg" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/2MmGg/" width="100%" height="400px" frameborder="0"></iframe> <hr /> This should include strategies and programs encouraging eating a healthy diet, participating in regular physical activity, limiting or eliminating alcohol consumption, quitting smoking, and seeing a doctor for regular health screenings, such as the Medicare-funded <a href="https://www.heartfoundation.org.au/your-heart/heart-health-checks">Heart Health Checks</a>. Programs directed at accident prevention, mental health and violence, especially gender-related violence, will address untimely deaths in the young.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231598/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/garry-jennings-5307">Garry Jennings</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/1-in-5-deaths-are-caused-by-heart-disease-but-what-else-are-australians-dying-from-231598">original article</a>. </div>

Body

"I'm a prisoner in my own body": Rob Burrow's heartbreaking last message

An emotional final message from rugby legend Rob Burrow has been released in the days after his death. The former footballer <a href="https://oversixty.com.au/health/caring/rugby-league-hero-dies-at-just-41" target="_blank" rel="noopener">died</a> at the age of 41 on Sunday after a lengthy battle with motor neurone disease, with his former club, the Leeds Rhinos, sharing the news of his passing. Before he died, Burrow was involved in the making of a documentary about his life by the BBC, titled There's Only One Burrow, only agreeing to appear in the program on the condition it only be used after his death. In the documentary, Burrow spoke of how the cruel disease impacted his life and how he hoped to raise awareness for MND research. "I want to live in a world free of MND. By the time you watch this I will no longer be here," he said in the video. "In a world full of adversity, we must still dare to dream. I'm just a lad from Yorkshire who got to live out his dream of playing rugby league." <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C7xPgSxM6lY/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by BBC SPORT (@bbcsport)</a> </div> </blockquote> His pre-recorded final words were shown to his friends and family on screen, reacting to his words. "I'm a fighter, to be honest. I might not be able to tackle MND but I'll certainly be swinging, I'm not going to give in, not until my last breath," he said. "I'm a prisoner in my own body, that's the way MND gets you. The lights are on but no one is home." Recalling his diagnosis, he said, "My family told me I was slurring my speech a bit but I didn't take notice or believe them." In an emotional segment of the widow, Burrow's wife Lindsey spoke of how she learnt of her husband's devastating disease. "I remember that moment being told it's not good news. Asking how long and them saying two years. Rob said 'thank god it's me and not the kids'. That's all he was bothered about," she recalled. When asked about his children, Burrow became emotional, saying, "I had no idea how my family would cope. They've become a beacon of hope for families in the same situation as ours." "I have had such a great life. I have been gifted with the most incredible wife and three children. I hope they know how much I love them." Burrows finishes the piece, saying. "As a father of three young children, I would never want someone to go through this." "I hope I have left a mark on this disease. I hope you choose to live in the moment. I hope you find inspiration." "My final message to you is whatever your personal battle to be brave and face it." "Every single day is precious. Don't waste a moment. In a world full of adversity we must still dare to dream. Rob Burrow over and out." Image credits: BBC

Caring

Rugby League hero dies at just 41

Rugby League legend Rob Burrow has passed away at the age of 41 after a lengthy battle with motor neurone disease. The British footballer spent his career with the Leeds Rhinos and helped them win eight Super League titles, and while he never played in Australia, he won the World Club Challenge over NRL opponents three times. Just two years after his retirement in 2017, Burrows was diagnosed with MND. Despite his rapidly progressing condition, Burrows stayed in the public eye to raise money and awareness for MND, and soon became the face of the fight against the disease in the UK. He worked with former teammate Kevin Sinfield to raise millions for a new care centre for MND patients, as the pair competed in <a href="https://oversixty.com.au/health/caring/terminally-ill-rugby-player-carried-across-marathon-finish-line-by-his-best-mate" target="_blank" rel="noopener">marathons</a> today, with Sinfield often pushing Burrow the entire way. His former football club announced Burrow’s death on Sunday, just one day before the groundbreaking of the new Rob Burrow Centre for MND at Seacroft Hospital, which will go ahead at his request. “It is with deep sadness that we announce the death of our beloved son, husband, father, brother and friend,” the club said. “Rob has always been a true inspiration throughout his life whether that was on the rugby league field or during his battle with MND. He never allowed others to define what he could achieve and believed in his own ability to do more." “The outpouring of love and support that Rob and the whole Burrow family have received over the last four and a half years meant so much to Rob." “For those who knew Rob throughout his life, his determination and spirit in the face of MND over the last four and a half years came as no surprise. Rob never accepted that he couldn’t do something. He just found his way of doing it better than anyone else." “He will continue to inspire us all every day. In a world full of adversity. We must dare to dream.” Prince William, who awarded Burrow with a Commander of the British Empire (CBE) honour in January 2024, was among those to mourn his death on social media. “A legend of rugby league, Rob Burrow had a huge heart,” he wrote. “He taught us ‘in a world full of adversity, we must dare to dream’. Catherine and I send our love." Burrow is survived by wife Lindsey and their three children Macy, Maya and Jackson. Image credits: SplashNews.com/Matt West/BPI/Phil Noble-Reuters/POOL supplied by Splash News/Shutterstock Editorial

Caring

Major TV star's 7-year-old undergoes third open heart surgery

Jimmy Kimmel's seven-year-old son has undergone his third, and hopefully final open heart surgery after being born with congenital heart disease. In 2017, Jimmy <a href="https://www.youtube.com/watch?v=MmWWoMcGmo0" target="_blank" rel="noopener">revealed</a> that Billy was only three days old when had to undergo his first open heart surgery, after doctors found “a hole in the wall of the left and right side of his heart” that was preventing enough oxygen from reaching his blood. Billy was only seven months old when he had to undergo his second open heart surgery, and over the weekend he had to undergo his third major surgery at the Children's Hospital Los Angeles. A few days later, the TV host took to Instagram to share an update following his son's successful surgery. "We went into this experience with a lot of optimism and nearly as much fear and came out with a new valve inside a happy, healthy kid," Kimmel wrote, alongside a picture of his youngest son smiling in a hospital bed. He then thanked all the surgeons, doctors and other medical staff who "came through for us with immeasurable kindness and expertise." "Walking around this hospital, meeting parents at their most vulnerable, children in pain and the miracle workers who do everything in their considerable power to save them is a humbling experience," Kimmel continued. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C7fE-p4S7YN/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jimmy Kimmel (@jimmykimmel)</a> </div> </blockquote> He then highlighted the hospital's dedication to providing help to families "regardless of their ability to pay". Jimmy then extended his thanks to his family and friends and the "loving strangers who took time to pray for and send positive energy to our baby". He gave a special shout out to his wife Molly – for "being stronger than is reasonable for any Mum to be". The pair also share daughter Jane, nine. The late night TV host then praised his son for being "the toughest (and funniest) 7 year-old we know." "There are so many parents and children who aren't fortunate enough to go home after five days," he added and encouraged his followers to send their thoughts and prayers to these families. Image: Instagram/ X

Caring

Amanda Keller's emotional family update

Amanda Keller has shared an emotional family update while live on-air on the Jonesy and Amanda show on Monday. The radio star has shared an update on how her husband's battle with Parkinson's disease has affected them, as they try to plan their son's 21st birthday party. “It was a hard week for me leading up to it because I wanted to put a slide show together to play throughout the night,” she told her co-host Jonesy. “And normally that is Harley’s domain. He has been the guy who will make the kid’s birthday invitations. He’s very creative. He will work on the computer to do this funky stuff. Normally, he would have done all of that. And with the way things are with Harley at the moment, he’s got Parkinson’s disease and things are just hard.” Keller, who has been married to her husband since 1989, revealed that he had been <a href="https://www.oversixty.com.au/health/caring/amanda-keller-shares-heartbreaking-family-news" target="_blank" rel="noopener">privately battling</a> with the disease for seven years, on October 2023. She then went on to share how the disease has affected her husband's ability to perform tasks that he was once good at. “So that kind of skill set isn’t with him anymore. He doesn’t have dementia or any of that stuff, but that stuff’s hard for him to do now. "And so I was going through a whole lot of photos on my phone and seeing photos of when he was well, and it was a very emotional week leading up to the 21st.” She then went on to confess that the situation had made her feel “lonely” and that her heart broke for her husband, who she thought couldn't attend the birthday party. “Leaving the house to go to Jack’s party, I thought, you know, it’s not right that Harley can’t come. Yeah, I really felt lonely thinking it’s our son’s 21st, but how hard it is for Harley and how much he would have loved to have been there,” she continued. But her husband surprised her, and managed to attend the event despite his ill health. “So there we are, having a great time. The speeches are about to start and my friend Kate said to me, There’s Harley. And I looked over. And I know what it cost him to be there. "He and our friend Pam and our driver friend Cole had conspired to get Harley there for the speeches. And it was so moving.” Keller, who was tearing up at this moment, proudly added: “And a lot of people were shocked because they hadn’t seen Harley for a while. But I know what it cost him to get there. And he said to me, how could I not be here?” Image: Jonesy and Amanda show/ news.com.au

Caring

Allan Border's desperate plea to PM

Allan Border has joined Parkinson’s Australia chief executive Olivia Nassaris in a plea for the Federal Government to provide more funding and research into the condition. The 68-year-old cricket legend is one of over 150,000 Australians living with Parkinson’s, after being diagnosed with the neurodegenerative disorder back in 2016. A new report from the organisation revealed that there are 19,500 new cases every year, with one Australian diagnosed with the condition every 27 minutes. “A lot of people know the disease but they don’t know the impact that it has — 150,000 people in Australia have the disease, it does present in different ways,” Border said. “When I was told I was suffering, my first image was of (boxer) Muhammad Ali and the Olympic torch, I just thought people suffered from a tremor. “But there’s about 100,000 different ways of it presenting.” Border joined the Parkinson’s Australia chief executive on April 11 to raise awareness for World Parkinson’s Day. Nassaris estimated that the number of Australians impacted by Parkinson’s would almost triple by 2050. “At the moment we don’t have a cause or cure, so it is frightening that a disease like this is going to almost triple in numbers,” she said. Responding to the cricketer’s plea, the Prime Minister described Border as a “great Australian” and hinted at a potential boost to government support in providing more resources into the condition. “Our heart goes out to him,” the PM said on Thursday. “I will have a word with the Health Minister about what more we can do. We have contributed over $100m to research into Parkinson’s. “There’s also a pilot program for nurses about people suffering from Parkinson’s at the moment. There’s some $6.5m being used for that pilot program. We want to wait and see what the assessment of that is.” Images: Getty

Caring

Princess of Wales and King Charles: one in two people develop cancer during their lives – the diseases and treatments explained

<a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> The Princess of Wales released a <a href="https://x.com/KensingtonRoyal/status/1771235267837321694?s=20">moving video message</a> on March 22 to address speculation about her health. In it, the future queen disclosed that she’d been <a href="https://www.bbc.co.uk/news/health-68641710">diagnosed with cancer</a> following tests conducted after she underwent major abdominal surgery at a clinic in London in January. Catherine explained that she was undergoing “preventative chemotherapy” – but emphasised that her surgery had been successful, and that she was “well” and “getting stronger every day”. The message was the <a href="https://www.theguardian.com/uk-news/2024/mar/22/princess-kate-cancer-royal-family-health-annus-horribilis">second announcement</a> of a royal family cancer diagnosis in recent weeks. On February 5, Buckingham Palace <a href="https://www.royal.uk/a-statement-from-buckingham-palace-5Feb24">published a statement</a> that King Charles III had been diagnosed with an undisclosed form of <a href="https://www.bbc.co.uk/news/uk-68208157">cancer, unrelated</a> to the treatment he had been receiving for an enlarged prostate. <figure><iframe src="https://www.youtube.com/embed/3xzKooCaRXU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The statement said that he had begun “regular treatments”. The king postponed all public-facing duties during his treatment, but <a href="https://www.bbc.co.uk/news/uk-68213383">reportedly continued</a> with his “constitutional role as head of state, including completing paperwork and holding private meetings”. Cancer is the <a href="https://www.who.int/news-room/fact-sheets/detail/cancer">leading cause of death</a> worldwide. <a href="https://www.nhs.uk/conditions/cancer/#:%7E:text=The%20cancerous%20cells%20can%20invade,of%20cancer%20during%20their%20lifetime.">One in two</a> people will develop some form of cancer in their lifetime – so the condition will affect almost every family. However, many cancers can be cured if, as appears to be the case with the king, the condition is <a href="https://www.bbc.co.uk/news/uk-68213383">detected early</a> and treated effectively. <h2>What is cancer?</h2> Our bodies are made up of more than 100 billion cells, and cancer typically starts with changes in a small group of cells – or even a single one. We have different cell types depending upon where in the body they are and the function that the cell has. The size, amount and function of each of these cells is normally tightly regulated by genes – groups of codes held within our DNA – that instruct cells how to grow and divide. However, changes (mutations) to DNA can alter the way cells grow and multiply – often forming a lump, or solid tumour. Cancers can also develop in blood cells, such as white blood cell cancer which is known as leukaemia. This type of cancer does not form solid tumours; instead, the cancer builds up in the blood or sometimes the marrow in the core of bones, where blood cells are produced. In all, there are <a href="https://www.cancerresearchuk.org/about-cancer/what-is-cancer/how-cancer-starts/types-of-cancer#:%7E:text=For%20example%2C%20nerves%20and%20muscles,of%20cell%20they%20start%20in.">more than 200</a> types of cancer, but all start with mutations in the DNA contained within each and every cell. <h2>What exactly are mutations?</h2> Think of your DNA as a big recipe book, and your genes as individual recipes for making different dishes. Mutations are smudges or missing words from this recipe that can result in key ingredients not being added into the mix. <figure><iframe src="https://www.youtube.com/embed/8BJ8_5Gyhg8?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Regardless of the type of cancer or the cells from which it develops, mutations in our genes can result in a cell no longer understanding its instructions. These mutations can happen by chance when dividing, but can also be the result of lifestyle choices such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141049/">smoking</a>, <a href="https://www.ndph.ox.ac.uk/news/new-genetic-study-confirms-that-alcohol-is-a-direct-cause-of-cancer#:%7E:text=These%20mutations%20both%20disrupt%20the,aldehyde%20dehydrogenase%202%20(ALDH2).">drinking</a>, and <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet">inactivity</a>. Research has found that in order for a normal cell to turn into a cancerous cell, anywhere from <a href="https://www.sanger.ac.uk/news_item/1-10-mutations-are-needed-drive-cancer-scientists-find/">one to ten different mutations</a> are normally required. <h2>How is cancer treated?</h2> Treatment options for cancer depend on a variety of factors, including where your cancer is, how large it is, and whether it has spread to other parts of the body. The main treatments for cancer include surgery, chemotherapy, and radiotherapy. Chemotherapy uses drugs to target and kill cells that are rapidly dividing in our bodies. This approach is effective at targeting fast-growing cells in various cancers – but also has negative side effects. It also targets healthy cells that rapidly divide, such as hair and the cells lining our digestive system. This can lead to commonly reported <a href="https://www.nhs.uk/conditions/chemotherapy/side-effects/">side-effects</a> such as hair loss, nausea and diarrhoea. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/chemotherapy?gad_source=1&gclid=Cj0KCQjw-_mvBhDwARIsAA-Q0Q6tyQxTuBzU7vVD7SHjQ5dF-fRdqnL7S74-k5LXyTqODydsrPfJVsoaAkgyEALw_wcB&gclsrc=aw.ds">Chemotherapy</a> can be used both preventatively – as in the case of the princess – and therapeutically. <figure><iframe src="https://www.youtube.com/embed/FkZn5u3MIiY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Preventative chemotherapy, also known as <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/adjuvant-therapy">adjuvant chemotherapy</a>, is given after surgery or other primary treatments to eliminate any remaining cancer cells in the body. It aims to reduce the risk of the cancer returning (known as recurrence). Therapeutic chemotherapy is used as a treatment option for cancer that has spread or is well established, such as advanced-stage cancers. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/surgery/about">Surgery</a> involves the physical removal of cancerous tissues as well as nearby lymph nodes – small glands which act as filters in your body that cancers can spread through – to eliminate the tumour. Surgery is often used to remove localised cancers that haven’t spread throughout the body. <a href="https://www.cancerresearchuk.org/about-cancer/treatment/radiotherapy">Radiotherapy</a> uses high-energy radiation beams that are able to target specific areas where tumour cells are located to destroy or shrink the tumour. Radiotherapy can be applied externally or internally. Chemotherapy, surgery, and radiotherapy are often combined in cancer treatment to improve outcomes for patients. Thanks to developments in cancer research over the last 50 years, survival rates have improved greatly – although the rate of improvement has <a href="https://news.cancerresearchuk.org/2024/02/02/world-cancer-day-2024/#:%7E:text=Improvements%20in%20cancer%20survival%20have%20slowed%20in%20recent%20years&text=Survival%20increased%20three%20to%20five,consistently%20lags%20behind%20comparable%20countries.">slowed recently</a>. Cancer survival depends on various factors such as age – people under 40 have a <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/age">greater chance</a> of survival – overall health and fitness, as well as family history. <h2>What you should do</h2> Particular changes in your body or warning symptoms could indicate the presence of cancer. These include, but are not limited to: <ul> <li>Unexplained weight loss;</li> <li>Fatigue that doesn’t improve with rest;</li> <li>Changes in bowel or bladder habits;</li> <li>Persistent cough or coughing up blood;</li> <li>Difficulty swallowing;</li> <li>Persistent pain;</li> <li>Noticing lumps, such as in a breast or testicle.</li> </ul> The symptoms may not necessarily be the result of cancer. But it is important to get checked by a doctor if you notice anything out of the ordinary or have had persistent symptoms that don’t ease. Early detection and treatment can <a href="https://www.science.org/doi/full/10.1126/science.aay9040">significantly improve</a> outcomes for many types of cancer.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gavin-metcalf-1340598">Gavin Metcalf</a>, Cancer Biologist and Lecturer in Biomedical Science, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/princess-of-wales-and-king-charles-one-in-two-people-develop-cancer-during-their-lives-the-diseases-and-treatments-explained-226456">original article</a>.

Caring

Victorian man rides lawn mower for 800km to speak to the PM

You know the saying: mow big or mow home. And one man risked it all in hopes of scoring a meeting with Prime Minister Anthony Albanese. In an incredible 11-day journey Warren "Woz" Acott made the 800km journey from Central Victoria to Canberra to try and speak with the Prime Minister about motor neurone disease (MND). He left his home in Toolleen in Central Victoria on March 11, with no guarantee that anyone was going to meet him at the end of his journey. But his efforts have been fruitful, because by the time he arrived in Canberra this morning, he had a booking with the PM. "I've shuffled my schedule around to fit him in. I'd better go see him," Woz joked when he was told he had a meeting with the PM Albanese met met Woz in the Prime Minister's courtyard, and a crowd of families affected by MND were also waiting outside parliament to welcome Woz. "I'm overwhelmed. But it's not about me. It's about MND and the families and the carers and everybody else," Woz told A Current Affair. Woz, who lives with MND, wants the condition to be added to the National Notifiable Disease Surveillance System (NNDSS). This is because NNDSS conditions "a threat to public health in Australia" and are given additional funding for research." "We'll give consideration to all these things. You're a champion, mate," Albanese said. "It's all over my head. I mean, I'm a truck driver at the end of the day. But I know that if (MND is added to the NNDSS), it's more trackable, more funding, and everything else," Woz said. Robyn Sneddon, who lost her husband Ian to MND, praised Woz for his effort. "The effort he has made has been incredible. He is just a champion," she told A Current Affair. "I'm very proud of him," Snedden added. Images: A Current Affair

Caring

"What a legend": Michael J Fox receives emotional standing ovation

Michael J Fox, who has Parkinson's disease, made a surprise appearance at the BAFTA Awards in London. The Back to the Future actor came onstage in a wheelchair, but he insisted on standing up at the podium to present the Best Film award. The star-studded audience all rose to their feet and gave the actor a standing ovation. When presenting the award, Fox described cinema as "magic" which can "change your life". "Five films were nominated in this category tonight and all five have something in common. They are the best of what we do," he said. He added that films can bring people together "no matter who you are or where you're from". "There's a reason why they say movies are magic because movies can change your day. "It can change your outlook. Sometimes it can change your life." Fox, who was diagnosed with Parkinson's in the 1990s, rarely makes public appearances. Many fans were pleasantly surprised at his appearance as he presented the night’s biggest award, Best Film, to Oppenheimer. "I was in tears the moment Michael J Fox came on the stage," one fan wrote on X, formerly known as Twitter. "THE MAN IS A LEGEND" <blockquote class="twitter-tweet"> i was in tears the moment Michael J Fox came on the stage 😥😥😥 THE MAN IS A LEGEND <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://twitter.com/hashtag/BAFTA2024?src=hash&ref_src=twsrc%5Etfw">#BAFTA2024</a> <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a> <a href="https://t.co/Uud368S9gb">pic.twitter.com/Uud368S9gb</a> — RanaJi🏹 (@RanaTells) <a href="https://twitter.com/RanaTells/status/1759323180060299726?ref_src=twsrc%5Etfw">February 18, 2024</a></blockquote> "Michael J Fox. Absolute hero. What a legend," wrote another. <blockquote class="twitter-tweet"> Michael J Fox. Absolute hero. What a legend. <a href="https://twitter.com/hashtag/BAFTAs?src=hash&ref_src=twsrc%5Etfw">#BAFTAs</a> <a href="https://t.co/62lxpCy3mn">pic.twitter.com/62lxpCy3mn</a> — Jules 🌼 (@JulesItsjules) <a href="https://twitter.com/JulesItsjules/status/1759320058583568638?ref_src=twsrc%5Etfw">February 18, 2024</a></blockquote> "All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend," added a third. <blockquote class="twitter-tweet"> All those stars in the room, and still the biggest and most affectionate reaction is for Michael J Fox, because the man is a legend. <a href="https://twitter.com/hashtag/EEBAFTAs?src=hash&ref_src=twsrc%5Etfw">#EEBAFTAs</a> — Declan Cashin (@Tweet_Dec) <a href="https://twitter.com/Tweet_Dec/status/1759319831696855281?ref_src=twsrc%5Etfw">February 18, 2024</a></blockquote> "He's a total legend and wonderful human," wrote a fourth. The actor has spoken <a href="https://www.oversixty.com.au/health/caring/i-m-not-gonna-be-80-michael-j-fox-s-tragic-admission" target="_blank" rel="noopener">candidly</a> about his experience with Parkinson's over the years, and has said that he has made peace with the degenerative nature of the disease. In a previous interview with AARP magazine profile, the actor admitted that he did not fear death. “I am genuinely a happy guy. I don’t have a morbid thought in my head — I don’t fear death. At all," he told the publication. Images: Getty

What happens to your liver when you quit alcohol

<a href="https://theconversation.com/profiles/ashwin-dhanda-1359529">Ashwin Dhanda</a>, <a href="https://theconversation.com/institutions/university-of-plymouth-717">University of Plymouth</a> According to Greek mythology, Zeus punished Prometheus for giving fire to humans. He chained Prometheus up and set an eagle to feast on his liver. Each night, the liver grew back and each day, the eagle returned for his feast. In reality, can a liver really grow back? The liver is the largest internal organ in the human body. It is needed for hundreds of bodily processes, including breaking down toxins such as alcohol. As it is the first organ to “see” alcohol that has been drunk, it is not surprising that it is the most susceptible to alcohol’s effects. However, other organs, including the brain and heart, can also be damaged by long-term heavy alcohol use. As a liver specialist, I meet people with alcohol-related liver disease every day. It is a <a href="https://britishlivertrust.org.uk/information-and-support/liver-conditions/alcohol-related-liver-disease/">spectrum of disease</a> ranging from laying down of fat in the liver (fatty liver) to scar formation (cirrhosis) and it usually doesn’t cause any symptoms until the very late stages of damage. At first, alcohol makes the liver fatty. This fat causes the liver to become inflamed. In response, it tries to heal itself, producing scar tissue. If this carries on unchecked, the whole liver can become a mesh of scars with small islands of “good” liver in between – cirrhosis. In the late stages of cirrhosis, when the liver fails, people can turn yellow (jaundice), swell with fluid and become sleepy and confused. This is serious and can be fatal. Most people who regularly drink more than the recommended limit of 14 units of alcohol per week (about six pints of normal strength beer [4% ABV] or about six average [175ml] glasses of wine [14% ABV]) will have a fatty liver. Long-term and heavy alcohol use increases the risk of developing <a href="https://www.nhs.uk/conditions/alcohol-related-liver-disease-arld/">scarring and cirrhosis</a>. <h2>Good news</h2> Fortunately, there is good news. In people with fatty liver, after only two to three weeks of giving up alcohol, the liver can heal and looks and functions <a href="https://arcr.niaaa.nih.gov/volume/41/1/natural-recovery-liver-and-other-organs-after-chronic-alcohol-use">as good as new</a>. In people with liver inflammation or mild scarring, even within seven days of giving up alcohol, there are noticeable reductions in liver <a href="https://www.mdpi.com/2072-6643/13/5/1659">fat, inflammation and scarring</a>. Stopping alcohol use for several months lets the liver heal and return to normal. In heavy drinkers with more severe scarring or liver failure, giving up alcohol for several years reduces their chance of <a href="https://www.cghjournal.org/article/S1542-3565(22)01113-2/fulltext">worsening liver failure and death</a>. However, people who drink heavily can be physically dependent on alcohol and stopping suddenly can cause alcohol withdrawal. In its mild form, it causes shaking and sweating. But if severe, it can cause hallucinations, fits and even death. Going “cold turkey” is never recommended for heavy drinkers, who should seek medical advice about how to safely give up alcohol. <h2>Other benefits</h2> Giving up drinking also has positive effects on <a href="https://alcoholchange.org.uk/blog/benefits-of-dry-january-and-when-you-can-expect-to-see-them">sleep, brain function and blood pressure</a>. Avoiding alcohol for long periods also reduces the risk of several types of <a href="https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/alcohol-and-cancer">cancer</a> (including liver, pancreas and colon) and the risk of <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/effects-of-alcohol-on-your-heart">heart disease and stroke</a>. However, alcohol is not the only cause of ill health. Giving it up has many health benefits, but it is not a panacea. It should be seen as part of a healthy lifestyle, including a balanced diet and regular physical exercise. So, to answer the question posed by the myth of Prometheus, the liver has an amazing power to repair itself after it has been damaged. But it cannot grow back as new if it was already severely scarred. If you stop drinking and only have a fatty liver, it can quickly turn back to normal. If you had a scarred liver (cirrhosis) to start with, stopping alcohol will allow some healing and improved function but can’t undo all the damage that has already been done. If you want to look after your liver, drink in moderation and have two to three alcohol-free days each week. That way, you won’t have to rely on the liver’s magical self-healing power to stay healthy.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/220490/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ashwin-dhanda-1359529">Ashwin Dhanda</a>, Associate Professor of Hepatology, <a href="https://theconversation.com/institutions/university-of-plymouth-717">University of Plymouth</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-to-your-liver-when-you-quit-alcohol-220490">original article</a>.

Body

"I’m not going to be cured". How breast cancer awareness and support sidelines people with metastatic disease

<a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> There have been incredible <a href="https://www.cancer.gov/types/breast/research">advances</a> in breast cancer diagnosis and treatment in recent years. And stories about celebrities who have “beaten” breast cancer continue to be a source of inspiration for many people. However, this emphasis on fighting, beating and surviving cancer shuts out the voices of those who will not survive. That is, the many people diagnosed with incurable, life-limiting metastatic breast cancer, <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">which kills nine Australians every day</a> or nearly <a href="https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia">3,300 people</a> a year. Yet an <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">estimated 10,000</a> Australians are living with the diagnosis. Being diagnosed with metastatic breast cancer, as one of the authors has been, means ongoing treatment to live as long, and as well, as possible. It also means an ongoing need for emotional and practical support. However, society, health-care professionals, cancer advocacy organisations, even a patient’s closest family and friends, can struggle to understand what it is like to live with an incurable and life-limiting cancer and how best to provide support. <h2>Why is there so little awareness?</h2> <a href="https://www.breastcancer.org/types/metastatic">Metastatic breast cancer</a>, also called stage four breast cancer, is the most serious form of breast cancer. Unlike early breast cancer that is contained within the breast or nearby lymph nodes, metastatic breast cancer has spread to other parts of the body, most often the bones, lungs, liver, or brain. There is no cure for metastatic breast cancer despite decades of advocacy, funding and research. Treatment continues for as long as it helps to control the cancer and is tolerated by the patient. Median survival is <a href="https://onlinelibrary.wiley.com/doi/10.5694/mja2.51687">two to three years</a>, although newer, novel treatments mean some patients are living much longer. As a society, we can be uncomfortable <a href="https://theconversation.com/before-you-go-are-you-in-denial-about-death-34056">talking about and facing death</a>. When it comes to cancer, we usually prefer focusing on good news stories. These narratives are often perceived to be better for fundraising and are reassuring for people newly diagnosed. But they fail to <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">represent</a> the diversity and reality of cancer experiences. Despite considerable research into people with non-metastatic breast cancer, <a href="https://www.bcna.org.au/latest-news/bcna-news/making-metastatic-breast-cancer-count/">relatively little</a> is known about Australians with metastatic breast cancer. <h2>Feeling silenced and unsupported</h2> Through our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13704">research</a> we wanted to better understand people’s experiences of metastatic breast cancer. We interviewed 38 participants from around Australia with diverse experiences of metastatic breast cancer. Participants were recruited through breast cancer and community organisations. We found messages and public campaigns about cancer survivorship, which emphasise hope and positivity, drowned out the voices of those with metastatic breast cancer. The focus on “success stories” about surviving breast cancer made some people feel like it was their responsibility to “beat” cancer. If they didn’t, it was their own fault. As one interviewee told us: "I react quite badly to all the, ‘we’ve had breast cancer and we beat it and we’ve survived. Aren’t we fantastic.’ There’s almost a feeling if you haven’t beaten your breast cancer you haven’t tried hard enough." Silence around metastatic breast cancer was common in research participants’ experiences. It prevented many from connecting with others and to the support they needed. It even affected relationships with those closest to them leaving them feeling misunderstood: "They don’t realise I’ve got to be on treatment forever. I’m not going to be cured. I think society thinks everything can be fixed; metastatic breast cancer actually can’t be fixed." Sharing deep fears and worries about their life expectancy can leave people with metastatic breast cancer feeling drained rather than supported. Many participants reported having to support and shield family, friends, acquaintances and work colleagues from the reality of their terminal diagnosis. "You hide how you feel because you don’t want to be avoided […] You put on that big, happy face. But like an onion if you peeled the layers away, you’d find out what’s going on." While many participants wanted to join a community of people with metastatic breast cancer, they struggled to know how to find one. Those who did, emphasised how invaluable it had been: "Being able to identify with and know that these people really get me is a huge relief and it reduces the isolation." These findings echo <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">previous research</a> demonstrating people with metastatic breast cancer have higher support needs than those with non-metastatic breast cancer. And these needs are <a href="https://www.bcna.org.au/media/alcjjmm2/bcna_member-survey-report_2017.pdf">less likely to be met</a> by <a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08269-8">health care, support services</a>, family or friends. <h2>A new path</h2> Being diagnosed with metastatic breast cancer can be terrifying, lonely and create significant support needs. It is essential people with metastatic breast cancer have their <a href="https://ascopubs.org/doi/10.1200/OP.20.00183">voices listened to</a> and their needs met. Next steps should include: <ul> <li> <a href="https://bcna-dxp.azureedge.net/media/d32bhdzf/bcna_making-metastatic-breast-cancer-count_2022.pdf">improving data collection by cancer registries</a> so we know exactly how many people in Australia have metastatic breast cancer </li> <li> increasing representation of people with metastatic breast cancer in advocacy, support organisations and research </li> <li> nationwide access to peer-to-peer programs and professionally led metastatic breast cancer support groups. </li> </ul> We must ensure people with metastatic breast cancer are the ones to speak to their experience and needs. As a colleague with metastatic breast cancer said: "I read an article written by an early-stage breast cancer ‘survivor’. It felt like someone describing winter when they had only ever experienced autumn." If you or someone you know has metastatic breast cancer, these organisations may be able to support you or connect you with others with the same diagnosis: <ul> <li> <a href="https://www.bcna.org.au">Breast Cancer Network Australia</a> for information and support </li> <li> <a href="https://www.mcgrathfoundation.com.au/">McGrath Foundation</a> for information about access to metastatic breast care nurses. </li> </ul> <hr /> The authors would like to thank the members of Breast Cancer Network Australia’s Metastatic Breast Cancer Lived Experience Reference Group for their review of this article.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215458/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sophie-lewis-111177">Sophie Lewis</a>, Senior Lecturer, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/andrea-smith-15431">Andrea Smith</a>, Research fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/katherine-kenny-318175">Katherine Kenny</a>, ARC DECRA Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-not-going-to-be-cured-how-breast-cancer-awareness-and-support-sidelines-people-with-metastatic-disease-215458">original article</a>.

Caring

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>. Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease. Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link? <h2>What the study did and found</h2> This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period. Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia. During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. <h2>Important considerations</h2> In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk. Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively. These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable. Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves. This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association. <h2>What does other evidence say?</h2> <a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both. High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too. For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life. <h2>Why the link?</h2> There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia. Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline. Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>. We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.

Mind

Demands for "killer product" to be dropped from Bunnings over fatal disease links

Bunnings Warehouse is being urged in the strongest possible terms to pull a popular item off their shelves amid concerns it could be linked to a fatal disease. A particular range of trendy kitchen countertops have been linked to an incurable disease that the national construction union says has been harming tradies. The Construction, Forestry, Maritime, Mining and Energy Union (CFMMEU) have taken their demands for the recall directly to the hardware giant’s chief executive Michael Schneider, warning it was “unconscionable” to keep the engineered stone benchtops on Bunnings’ product line up. “Bunnings has unique market power and a unique place in Australian society. If you were to remove this killer product from your shelves, it would send a powerful message,” CFMEU boss Zach Smith wrote. The engineered benchtops, which have become a feature in many modern day Australian kitchens and bathrooms, contain a high concentration of crystalline silica. When cutting the benchtops, silica dust is released into the air, which can lead to the potentially deadly and incurable disease of silicosis, as well as lung cancer. In his letter, Mr Smith called for the product to be removed “effective immediately”. “I am disappointed that, despite all this information being in the public sphere, Bunnings is still advertising and selling high-silica engineered stone products in your stores nationwide,” he said. “Conversely, it is unconscionable for Bunnings to continue promoting and selling this killer product when there is no need to do so." “There are many, many alternatives to engineered stone as a benchtop material. The business costs of removing these products are insignificant when we are faced with the prospect of more deaths.” It has been estimated that up to 103,000 tradies will be diagnosed in their lifetime with silicosis as a result of exposure to silica dust at work, while more than 10,000 will develop lung cancer. In response to the concerns raised, Jen Tucker, the Director of Merchandise at Bunnings, acknowledged that the hardware giant is aware of the issue at hand and emphasised their commitment to keeping a close watch on and adhering to guidance from regulatory authorities. However, Ms. Tucker did not explicitly endorse the request made by the CFMEU. She went on to clarify that the majority of benchtops available in their stores are made from laminate or timber materials. However, for the engineered stone benchtops that they offer, these are pre-cut to precise dimensions before reaching a customer's location. Furthermore, these engineered stone benchtops are exclusively supplied and installed by specialist providers who hold valid engineered stone licenses. These providers strictly adhere to rigorous safety standards, prioritising the well-being of their production and installation teams, all in accordance with the stipulations of their licenses. Ms Tucker underscored Bunnings' unwavering commitment to the safety of their staff and customers, underscoring its profound importance to the company. She also acknowledged that safety is a broader concern within the industry and noted that the federal government is presently conducting a review on this matter. In this regard, Bunnings expressed its support for new legislation and the establishment of consistent standards and licensing procedures across various states and territories, all in pursuit of enhancing safety within the industry. Image credits: Getty Images

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