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New way to identify telltale markers for breast cancer tumors

An imaging technique that takes advantage of machine learning technology allows scientists to obtain results quickly, in contrast to traditional, more expensive methods that could take weeks.

Credit: Image courtesy of Rishi Rabat

 

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New way to identify telltale markers for breast cancer tumors

 

A research team led by USC scientists has developed a new way to identify molecular markers of breast cancer tumors, a potentially life-saving breakthrough that could lead to better treatment for millions of women.

Aided by machine learning, the researchers taught a computer to rapidly sort images of breast tumors to identify which ones had estrogen receptors, a key to determining prognosis and treatment options. That's a big step forward from microscopes and cell biopsies in use for more than a century, according to the scientists.

The work opens a new pathway for breast cancer treatment that promises faster results for less cost for more people worldwide, said David B. Agus, professor at the Keck School of Medicine of USC and the USC Viterbi School of Engineering. He is also CEO of the Lawrence J. Ellison Institute for Transformative Medicine of USC.

The findings appear this week in Nature Partner Journals Breast Cancer.

"It's the beginning of a revolution to use machine learning to get new information about breast cancer to the physician," Agus said. "We can use it to detect better treatments, get information to patients faster and help more people. We're unleashing this power to give new information to physicians and help treat cancer."

Except for skin cancer, breast cancer is the most common cancer in women in the United States. While deaths have declined, it remains the second-leading cause of cancer death among women and the leading cause of cancer death among Hispanic women.

About 237,000 cases of breast cancer are diagnosed in U.S. women and about 41,000 die from the disease each year, according to the U.S. Centers for Disease Control and Prevention.

The key to identifying and treating cancer is knowing the nature of the tumor. Cancer cells that contain receptors for estrogen and other hormones respond differently to cancer drugs that target these mechanisms. While doctors use these characteristics to classify tumors and select treatments, testing for markers is a slow and inefficient process.

For example, assays can be inconsistent depending on the laboratory doing the testing. They're also expensive, take weeks to do and are unavailable in many developing countries.

"If you're diagnosed with cancer, it'll be a few weeks before you get a call from the doctor saying they've identified a marker," said Dan Ruderman, one of the study authors and assistant professor of research medicine at the Keck School of Medicine. "With machine learning technology, we can tell you the same day, so there's less delay, less stress and potentially better outcomes. It's going to enable us to identify the right drug and dose more quickly. It's a big step toward personalized medicine."

While machine learning has been used before for cancer detection, the USC study adapted the technology to more clearly focus on telltale markers of a cell's nucleus. The key was to extract parameters describing the shape of nuclei, and feeding these into a large neural network that could learn relationships between nucleus shape and molecular markers.

The scientists used publicly available hematoxylin-eosin (H&E) stained histopathology images. the cell-stained slides doctors have been using for more than a century. Next, they ascertained clinical status for 113 cancer patients, then split the patients into two groups, using one group to train a convolutional neural network algorithm, which is used to enhance visual imagery, and another to test the machine. When they compared the two sets, they found a strong correlation, providing high confidence that an algorithm can predict the estrogen receptor status of the tumor.

"We can use this technology to identify the molecular markers of the tumor and in the future will identify which therapeutics the tumor will respond to. Machine learning helps us get this information to patients sooner and may transform cancer care in the developing world where precise breast cancer marker assessment is in short supply," said Rishi Rawat, a graduate student in the Keck School of Medicine and first author of the study.

So far, the research findings demonstrate that the new technology has the potential to improve clinical care. Validation studies are under way -- an important step before it's ready for use in the doctor's office

The study authors are Agus, Rawat and Ruderman of the Lawrence J. Ellison Institute for Transformative Medicine of USC; Paul Macklin of Intelligent Systems Engineering at Indiana University; and David L. Rimm of the Department of Pathology at the Yale University School of Medicine.

The research was supported by a grant from the Breast Cancer Research Foundation (BCRF-16-103).

 

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How to Manage Paying for Retirement Housing

 

Assisted- and independent-living communities are expensive, but there are smart ways to find the funding

 

By

Robyn A. Friedman

Oct. 10, 2018 10:30 a.m. ET

Many older adults worry about the cost of senior housing—and with good reason.

Seniors who want to want to move out of their existing homes to communities with more services have several options—but they can be pricey. The average monthly rent for independent living—for relatively healthy seniors who want some support such as meals, light housekeeping and transportation—was $3,304 in the third quarter of this year, according to the nonprofit National Investment Center for Seniors Housing & Care.

The rent for assisted living, a greater level of care that offers assistance with activities such as dressing, bathing and medication management, was $4,947. And many facilities cost much more.

How people pay for senior care depends on their finances and the level of services they need. Many seniors draw on several sources of funds, including personal savings, home equity, long-term-care insurance and government benefits.

Typically, the first source of funding for senior housing is selling an existing home. The proceeds can be used to pay the entrance fee at a retirement community, or to help cover monthly payments. “For most Americans, their house is their largest asset,” says Jamie Hopkins, director of the Retirement Income Program at the American College of Financial Services, based in Bryn Mawr, Pa. “Selling it will be the biggest pool of funds they’ll have.”

Long-term-care insurance can help pay for assisted living. It pays benefits when policyholders need assistance with two or more activities of daily living, such as bathing, dressing or feeding. But it won’t help cover the cost of independent living, because seniors in those facilities generally don’t need help with two or more daily activities.

How to Manage Paying for Retirement Housing

PHOTO: ALEX NABAUM

The average cost of a long-term-care policy is about $2,600 a year, says William R. Dyess, president of Dyess Insurance Services in Boca Raton, Fla. Rates vary based on an applicant’s age and medical history. Hybrid products combining life insurance or annuities with long-term-care coverage are available as well.

Government-sponsored programs such as Medicaid and benefits provided by the U.S. Department of Veterans Affairs may also be available to help pay for independent and assisted living. Medicaid traditionally has covered nursing-home expenses but some states have enacted waiver programs that allow residents of assisted-living facilities to qualify for benefits as well, says Patrick Simasko, an elder-law attorney in Mount Clemens, Mich. But Medicaid only provides benefits to people whose total assets fall beneath certain levels.

 

Medicare, meanwhile, pays some medical costs for people age 65 and older and covers short nursing-home stays or hospice care, but not independent- or assisted-living costs.

The VA offers wartime veterans and their spouses extra income under the Aid and Attendance benefit that can help pay for assisted-living care as well, Mr. Simasko says. There are asset and income caps on eligibility.

Affluent individuals who plan to pay for independent or assisted living by liquidating investments or other assets should consult a financial adviser to determine which asset to dip into first. Mr. Hopkins suggests using taxable investments first. After that, he recommends tapping assets in the following order: required minimum distributions on retirement plans, withdrawals from traditional IRAs and, then, funds from Roth IRAs.

Here are some things to consider if you’re planning for future health care needs for yourself or aging relatives.

Start early. Make a list of your assets, and develop a plan on how and when to spend them down. Mr. Hopkins recommends starting to plan in your early 50s. “We don’t see many people buy long-term-care policies or make retirement housing decisions any time before that,” he says. “But that’s a reasonable time—if you’re 10 to 15 years out from retirement, all the options are still on the table for products and services at that point.”

Seek professional help. Consult an attorney or financial planner specializing in elder care. An elder-law attorney knowledgeable about government programs can be particularly helpful if you think you may qualify for Medicaid or VA benefits.

Run the numbers. Compare the expenses of homeownership—including the mortgage payment, taxes, insurance, utilities, maintenance and repair—with the monthly expenses of independent or assisted living. “Sometimes when you first start looking, you may be a little shocked by the price, but when you compare your home expenses to all that’s included in either independent or assisted living, you may be actually surprised,” says Mary Sue Patchett, executive vice president of community operations for Brookdale Senior Living, which operates over 900 communities in 47 states. Many communities include meals, transportation, entertainment and additional services in the monthly fee.

How to Divest

When spending down assets, consider divesting in this order, suggests Jamie Hopkins, director of the retirement income program at the American College of Financial Services. Consult a financial adviser for a strategy that suits your finances.

1. Taxable investments, such as dividends

2. Required minimum distributions on retirement plans

3. Traditional IRAs

4. Roth IRAs

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Microwave Popcorn Causes Cancer: Fact or Fiction?

 

microwave popcorn cancer

What’s the link between microwave popcorn and cancer?

Popcorn is a ritual part of watching movies. You don’t need to go to the theater to indulge in a bucket of popcorn. Simply stick a bag in the microwave and wait a minute or so for those fluffy buds to pop open.

Popcorn is also low in fat and high in fiber.

Yet a couple of chemicals in microwave popcorn and its packaging have been linked to negative health effects, including cancer and a dangerous lung condition.

Read on to learn the real story behind the claims about microwave popcorn and your health.

Does microwave popcorn cause cancer?

The possible link between microwave popcorn and cancer isn’t from the popcorn itself, but from chemicals called perfluorinated compounds (PFCs) that are in the bags. PFCs resist grease, making them ideal for preventing oil from seeping through popcorn bags.

PFCs have also been used in:

  • pizza boxes

  • sandwich wrappers

  • Teflon pans

  • other types of food packaging

 

The trouble with PFCs is that they break down into perfluorooctanoic acid (PFOA), a chemical that’s suspected to cause cancer.

These chemicals make their way into the popcorn when you heat them up. When you eat the popcorn, they get into your bloodstream and can remain in your body for a long time.

PFCs have been so widely used that about 98 percent of Americans already have this chemical in their blood. That’s why health experts have been trying to figure out whether PFCs are related to cancer or other diseases.

To find out how these chemicals might affect people, a group of researchers known as the C8 Science Panel studied the effects of PFOA exposure on residents who lived near DuPont’s Washington Works manufacturing plant in West Virginia.

The plant had been releasing PFOA into the environment since the 1950s.

After several years of research, the C8 researchers linked PFOA exposure to several health conditions in humans, including kidney cancer and testicular cancer.

The U.S. Food and Drug Administration (FDA) conducted its own review of PFOA from a range of sources, including microwave popcorn bags and nonstick food pans. It found that microwave popcorn could account for more than 20 percent of the average PFOA levels in Americans’ blood.

As a result of the research, food manufacturers voluntarily stopped using PFOA in their product bags in 2011. Five years later, the FDA went even further, banning the use of three other PFCs in food packaging. That means the popcorn you buy today shouldn’t contain these chemicals.

However, since the FDA’s review, dozens of new packaging chemicals have been introduced. According to the Environmental Working Group, little is known about the safety of these chemicals.

Is microwave popcorn linked to other health problems?

Microwave popcorn has also been linked to a serious lung disease called popcorn lung. Diacetyl, a chemical used to give microwave popcorn its buttery flavor and aroma, is linked to severe and irreversible lung damage when inhaled in large amounts.

Popcorn lung makes the small airways in the lungs (bronchioles) become scarred and narrowed to the point where they can’t let in enough air. The disease causes shortness of breath, wheezing, and other symptoms similar to those of chronic obstructive pulmonary disease (COPD).

Two decades ago the risk for popcorn lung was mainly among workers in microwave popcorn plants or other manufacturing plants who breathed in large amounts of diacetyl for long periods of time. Hundreds of workers were diagnosed with this disease, and many died.

The National Institute for Occupational Safety and Health studied the effects of diacetyl exposure at six microwave popcorn plants. The researchers found a link between long-term exposure and lung damage.

Popcorn lung wasn’t considered a risk to consumers of microwave popcorn. Yet one Colorado man reportedly developed the condition after eating two bags of microwave popcorn a day for 10 years.

In 2007, major popcorn manufacturers removed diacetyl from their products.

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How can you reduce your risk?

Chemicals linked to cancer and popcorn lung have been removed from microwave popcorn in recent years. Even though some chemicals that remain in the packaging of these products may be questionable, eating microwave popcorn from time to time shouldn’t pose any health risks.

But if you’re still worried or consume a lot of popcorn, there’s no need to give it up as a snack.

Try air-popping popcorn

Invest in an air popper, like this one, and make your own version of movie-theater popcorn. Three cups of air-popped popcorn contains only 90 calories and less than 1 gram of fat.

Make stovetop popcorn

Make popcorn on the stovetop using a lidded pot and some olive, coconut, or avocado oil. Use about 2 tablespoons of oil for every half cup of popcorn kernels.

Add your own flavors

Boost the flavor of air-popped or stovetop popcorn without any potentially harmful chemicals or excessive salt by adding your own toppings. Spray it with olive oil or freshly grated Parmesan cheese. Experiment with different seasonings, such as cinnamon, oregano, or rosemary.

The bottom line

A couple of chemicals that were once in microwave popcorn and its packaging have been linked to cancer and lung disease. But these ingredients have since been removed from most commercial brands.

If you’re still concerned about the chemicals in microwave popcorn, make your own popcorn at home using the stove or an air popper.

 

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