Do Cellphones Cause Cancer?

The question of whether cellphones can cause cancer became a popular one after the dramatic increase in cell phone use since the 1990s. Scientists’ main concern is that cell phones can increase the risk of brain tumors or other tumors in the head and neck area – and as of now, there doesn’t seem to be a clear answer.

Cell phones give off a form of energy known as radiofrequency (RF) waves. They are at the low-energy end of the electromagnetic spectrum – as opposed to the higher-energy end where X-rays exist – and they emit a type of non-ionizing radiation. In contrast to ionizing radiation, this type does not cause cancer by damaging DNA in cells, but there is still a concern that it could cause biological effects that result in some cancers.

However, the only consistently recognizable biological effect of RF energy is heat. The closer the phone is to the head, the greater the expected exposure is. If RF radiation is absorbed in large enough amounts by materials containing water, such as food, fluids, and body tissues, it produces this heat that can lead to burns and tissue damage. Still, it is unclear whether RF waves could result in cancer in some circumstances.

An iPhone.

Many factors affect the amount of RF energy a person is exposed to, such as the amount of time spent on the phone, the model of the phone, and if a hands-free device or speaker is being used. The distance and path to the nearest cell phone tower also play a role. The farther a way a person is from the tower, the more energy is required to get a good signal on the phone. The same is true of areas where many people are using their phones and excess energy is required to get a good signal.

RF radiation is so common in the environment that there is no way to completely avoid it. Most phone manufacturers post information about the amount of RF energy absorbed from the phone into the user’s body, called the specific absorption rate (SAR), on their website or user manual. Different phones have different SARs, so customers can reduce RF energy exposure by researching different models when shopping for a phone. The highest SAR in the U.S. is 1.6 watts/kg, but actual SAR values may vary based on certain factors.

Studies have been conducted to find a possible link between cell phone use and the development of tumors. They are fairly limited, however, due to low numbers of study participants and risk of recall bias. Recall bias can occur when individuals who develop brain tumors are more predisposed to recall heavier cell phone use than those who do not, despite lack of true difference. Also, tumors can take decades to develop, and given that cell phones have only been in use for about 20 years, these studies are unable to follow people for very long periods of time. Additionally, cell phone use is constantly changing.

Outside of direct studies on cell phone use, brain cancer incidence and death rates have changed little in the past decade, making it even more difficult to pinpoint if cell phone use plays a role in tumor development.



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Ten Things to Know About Young Women with Breast Cancer

Women who develop breast cancer when they’re relatively young – under age 45 – face a variety of issues unique to their stage of life. Questions about how the disease may affect their careers, relationships, sexual functioning, and ability to have and raise children often become pressing in the aftermath of a diagnosis.

Because breast cancer is relatively rare in young women – the average age at which the disease is diagnosed in the United States is 61 – there has been little research focused on young women, and such research is needed, ranging from the biology of the disease in younger patients to the particular challenges they encounter. To begin to fill in that gap, we launched the Young Women’s Breast Cancer Study in 2006, the first multi-institutional effort to track the medical and psychosocial issues faced by a large group of young women with breast cancer in the U.S.

The study enrolled more than 1,300 women across the country. Participants were surveyed at the time of their diagnosis and treatment, and continue to be surveyed post-treatment about issues such as fertility concerns, sexual functioning, body image, genetic testing, treatment decisions, and family planning. Participants were also asked to provide blood and tissue samples for analyses to better understand the biology of breast cancer in young women.

Meredith Faggen, MD, delivers care to Joyce White, a young woman with breast cancer.

Data collected by the study have significantly increased our understanding of the nature of the disease in younger women and how it impacts their lives. Research based on the data may help change not only the way breast cancer is treated in these patients, but also the support services they receive.

Here are some of the most intriguing findings to date from studies using the Young Women’s Breast Cancer Study data.*

  • A substantial portion of young women with hormone receptor-positive breast cancer had high grade, more aggressive tumors.
  • A higher percentage of breast tumors in young women were HER2-positive versus those in older women. The HER2 protein spurs cancer cell growth and is a target for some drugs.
  • There was no association between the age at which participants were last pregnant, or were ever pregnant, and the molecular subtype of cancer they developed.
  • Participants sought care in a timely fashion. The median period between detecting a suspicious breast lump, or other symptom, and seeking care from a physician was only two weeks.
  • Genetic testing rates are increasing. Seventy-seven percent of participants diagnosed with breast cancer in 2006 agreed to be tested for mutations in the BRCA genes, which increase the risk of future breast and/or ovarian cancer. By 2013, that figure had risen to 95 percent.
  • An increasing percentage of young women with cancer in one breast are choosing to have the unaffected breast removed. The vast majority of study participants who chose this option said they did so to decrease the chance of developing cancer in the second breast, but many believe it will improve their survival. Research has shown that for women with breast cancer on one side, having the other breast removed does not improve survival.
  • Thirty-eight percent of participants said that, prior to their diagnosis, they’d been interested in having children. At the time of diagnosis, twenty-six percent indicated such an interest. Although the percentage declined in succeeding years, it remained in the 25 percent range for the first three or four years after diagnosis.
  • 11 percent of participants had taken steps to preserve their fertility by freezing embryos, freezing eggs, or other techniques.
  • Other studies have sought to gauge young women’s fertility following breast cancer treatment, using menstrual periods as a marker of their ability to have children. Among patients under 30, 87 percent continued to have periods, as did 64 percent of those aged 36-40. All patients not treated with chemotherapy continued to have periods in the initial years after diagnosis, as did 60 percent of those who did receive chemotherapy.
  • Of the participants who tried to get pregnant following treatment, the vast majority succeeded.



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Brother’s Stem Cells Make Remission Possible for Pediatric Leukemia Patient

How do you repay someone who has given you the gift of life? Eight-year-old Emma Duffin of Enfield, Connecticut, started by giving a kiss and cuddle to her brother, Alexander, who donated his bone marrow stem cells to Emma to reboot her immune system and send her rare form of leukemia into remission.

Emma’s journey to a stem cell transplant began in April 2014, when her usual energetic demeanor began to change. “Emma was very vibrant, very active, and she did not like to rest,” says her father, Brian Duffin. But suddenly his go-go daughter was exhausted all the time. She was diagnosed with strep throat, then foot-and-mouth disease, but neither medication nor time brought any improvement.

During yet another trip to the emergency room, a blood draw revealed Emma had an alarmingly low level of hemoglobin – a 3 instead of the normal range for a juvenile of 11 or higher.

“For an adult, such low levels would have been fatal,” Brian says. Emma was rushed to Connecticut Children’s Medical Center (CCMC), where she was diagnosed a few days later with acute undifferentiated leukemia.

Most leukemias fall into two types: acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML). Each type is treated with a distinct protocol. Acute undifferentiated leukemia is a subset of the disease that shows markers of both types.

“As a result, part of the leukemia is often resistant to one protocol or the other,” explains Steven Margossian, MD, PhD, a senior physician of pediatric hematology and oncology at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. “In this circumstance, the best approach is often a bone marrow stem cell transplant. The bone marrow is the factory where leukemia cells are made. By using strong chemotherapy to destroy the existing bone marrow cells, you can then replace those with normal, healthy cells from a donor as closely matched to the patient as possible.”

In Emma’s case, Alexander ended up being her perfect match.

Emma’s oncologist at CCMC trained under Dr. Margossian and referred the family to her mentor.

“When your doctor tells you the number one pediatric stem cell transplant hospital in the world is only 90 minutes from your house, you don’t question it,” says Allyson Duffin, Emma’s mom.

After Emma completed three rounds of chemotherapy at CCMC, the Duffin family traveled to Boston to prepare for “zero day”: the day Dr. Margossian would perform the stem cell transplant. Prior to the transplant, Emma had one last round of high-dose chemotherapy and radiation – a typical pre-transplant treatment called conditioning therapy – to wipe out any remaining malignant stem cells. Then, on zero day, Margossian’s team harvested and processed Alexander’s stem cells and prepared Emma for the infusion. Brian had the privilege of pushing the button that began the infusion, transferring this gift of life from his son to his daughter.

Emma remained at Boston Children’s Hospital for about a month until engraftment, or the point at which the new stem cells produce enough neutrophils, a specific kind of white blood cell, to provide protection against bacterial infection.

“She was still energetic during that time; she has a zest for life that is unquestionable,” Brian says.

On Halloween, Emma dressed as Elsa and enjoyed “reverse trick-or-treating,” as doctors and nurses brought candy to her on their rounds.

Still, the month of recovery had its challenges. The conditioning therapy often causes the onset of mucositis, an extremely painful inflammation of the mucous membranes that line the digestive tract. Emma’s case was especially severe; she had to be fed through a nasal tube.

“For 95 percent of stem cell patients, the pain of mucositis is what they remember the most about their transplant,” Margossian says.

Emma also endured graft-versus-host disease (GVHD), another expected side effect of a stem cell transplant in which the donor’s white blood cells (the “graft”) attack the host’s cells, which can cause skin rashes and irritate the digestive system and liver.

“Emma’s nurses were very proactive about it,” Allyson says. “They gave her Benadryl and used every lotion known to man to soothe her skin.”

After Emma was released from the hospital, she remained in quarantine at home for nine months, allowing her fragile immune system to gradually rebuild itself without unnecessary exposure to germs in indoor public places. She entertained plenty of visitors on her front porch, relished rides around town with her family, and enjoyed the occasional meal on the outside patio at her favorite restaurant.

When Emma’s quarantine restrictions were lifted on June 1, 2015, “she celebrated by doing anything and everything,” Brian says with a laugh. “She shopped, she visited friends, she ate inside at her favorite restaurant – and she was excited to go back to school.”

Today, Emma remains healthy. “You would never know she had been so sick,” Allyson says. Now 11, Emma is in a dance troupe and involved in acting. She plays trumpet in her school band. And yes, she and Alexander are back to the usual sibling antics.

“Kids often bounce back more easily, physically and psychologically, because they are more resilient,” Margossian said. “Emma is spunky, and her energetic attitude went a long way in positively influencing her recovery.”



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Study reveals that many oncologists recommend medical marijuana clinically despite not feeling sufficiently knowledgeable to do so

  • Researchers identified a discrepancy between oncologists’ self-reported knowledge base and their clinical practices and beliefs regarding medical marijuana.
  • They conclude that critical gaps exist in research, education, and policy regarding medical marijuana.

While a wide majority of oncologists do not feel informed enough about medical marijuana’s utility to make clinical recommendations, most do in fact conduct discussions on medical marijuana in the clinic and nearly half recommend it to their patients, say researchers who surveyed a population-based sample of medical oncologists.

The study, published today in the Journal of ClinicalOncology, is the first nationally-representative survey of medical oncologists to examine attitudes, knowledge and practices regarding the agent since medical marijuana became legal on the state level in the U.S. Medical marijuana refers to the non-pharmaceutical cannabis products that healthcare providers recommend for therapeutic purposes. A significant proportion of medical marijuana products are whole-plant marijuana, which contains hundreds of active ingredients with complicated synergistic and inhibitory interactions. By contrast, cannabinoid pharmaceuticals, which are available with a prescription through a pharmacy, contain no more than a couple of active ingredients. While considerable research has gone into the development of cannabinoid pharmaceuticals, much less has been completed on medical marijuana’s utility in cancer and other diseases. The researchers speculate that the immature scientific evidence base poses challenges for oncologists.

“In this study, we identified a concerning discrepancy: although 80% of the oncologists we surveyed discussed medical marijuana with patients and nearly half recommended use of the agent clinically, less than 30% of the total sample actually consider themselves knowledgeable enough to make such recommendations,” said Ilana Braun, MD, chief of Dana-Farber Cancer Institute’s Division of Adult Psychosocial Oncology. “We can think of few other instances in which physicians would offer clinical advice about a topic on which they do not feel knowledgeable. We suspect that this is at least partly due to the uncomfortable spot in which oncologists find themselves.  Medical marijuana is legal in over half the states, with cancer as a qualifying condition in the vast majority of laws, yet the scientific evidence base supporting use of medical marijuana in oncology remains thin.”

The mailed survey queried medical oncologists’ attitudes toward medical marijuana’s efficacy and safety in comparison with standard treatments; their practices regarding medical marijuana, including holding discussions with patients and recommending medical marijuana clinically; and whether they considered themselves sufficiently informed regarding medical marijuana’s utility in oncology. Responses indicated significant differences in attitudes and practices based on non-clinical factors, for instance regional location in the U.S.

“Ensuring that physicians have a sufficient knowledge on which to base their medical recommendations is essential to providing high quality care, according to Eric G. Campbell, PhD, formerly a professor of medicine at the Massachusetts General Hospital, now a professor at the University of Colorado School of Medicine. “Our study suggests that there is clearly room for improvement when it comes to medical marijuana.”

To date, no randomized clinical trials have examined whole-plant medical marijuana’s effects in cancer patients, so oncologists are limited to relying on lower quality evidence, research on pharmaceutical cannabinoids or research on medical marijuana’s use in treating diseases other than cancer.

Of note, additional findings of the current study suggest that nearly two-thirds of oncologists believe medical marijuana to be an effective adjunct to standard pain treatment, and equally or more effective than the standard therapies for symptoms like nausea or lack of appetite, common side effects of cancer treatments such as chemotherapy.



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