Ovarian cancer facts

• Most ovarian growths in women under age 30 are benign, fluid-filled cysts.



• There are several types of ovarian cancer.



• The exact causes of ovarian cancer are unknown.



• Risk factors that increase the chance of developing ovarian cancer include a family history of cancer, being over 55 years of age, and never being pregnant.



• The ovarian cancer symptoms and signs can be vague but may include abdominal swelling, pressure, or pain, frequent urination or urinary urgency, back pain, leg pain, unusual vaginal bleeding, and feeling full quickly.



• There are no routine screening tests for ovarian cancer.



• A physical examination (including pelvic exam), ultrasound, X-rays, the CA 125 blood test, and biopsy of the ovary may be needed to detect and diagnose ovarian cancer and determine staging.



• The treatment, prognosis, and survival rate for ovarian cancer depend on the stage of the disease and the age and health of the woman.

The ovaries

The ovaries are part of a woman's reproductive system. They are in the pelvis. Each ovary is about the size of an almond.
The ovaries make the female hormones -- estrogen and progesterone. They also release eggs. An egg travels from an ovary through a fallopian tube to the womb (uterus).
When a woman goes through her "change of life" (menopause), her ovaries stop releasing eggs and make far lower levels of hormones.

Understanding ovarian cancer

Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.
Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.
Tumors can be benign or malignant:
Benign tumors are not cancer:

• Benign tumors are rarely life-threatening.



• Generally, benign tumors can be removed. They usually do not grow back.



• Benign tumors do not invade the tissues around them.



• Cells from benign tumors do not spread to other parts of the body.

Malignant tumors are cancer:

• Malignant tumors are generally more serious than benign tumors. They may be life-threatening.



• Malignant tumors often can be removed. But sometimes they grow back.



• Malignant tumors can invade and damage nearby tissues and organs.



• Cells from malignant tumors can spread to other parts of the body. Cancer cells spread by breaking away from the original (primary) tumor and entering the lymphatic system or bloodstream. The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis.

Benign and malignant cysts
An ovarian cyst may be found on the surface of an ovary or inside it. A cyst contains fluid. Sometimes it contains solid tissue too. Most ovarian cysts are benign (not cancer).
Most ovarian cysts go away with time. Sometimes, a doctor will find a cyst that does not go away or that gets larger. The doctor may order tests to make sure that the cyst is not cancer.
Ovarian cancer
Ovarian cancer can invade, shed, or spread to other organs:

• Invade: A malignant ovarian tumor can grow and invade organs next to the ovaries, such as the fallopian tubes and uterus.



• Shed: Cancer cells can shed (break off) from the main ovarian tumor. Shedding into the abdomen may lead to new tumors forming on the surface of nearby organs and tissues. The doctor may call these seeds or implants.



• Spread: Cancer cells can spread through the lymphatic system to lymph nodes in the pelvis, abdomen, and chest. Cancer cells may also spread through the bloodstream to organs such as the liver and lungs.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original tumor. For example, if ovarian cancer spreads to the liver, the cancer cells in the liver are actually ovarian cancer cells. The disease is metastatic ovarian cancer, not liver cancer. For that reason, it is treated as ovarian cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic disease.

What is the prostate gland?

The prostate gland is an organ that is located at the base or outlet (neck) of the urinary bladder. (See the diagram that follows.) The gland surrounds the first part of the urethra. The urethra is the passage through which urine drains from the bladder to exit from the penis. One function of the prostate gland is to help control urination by pressing directly against the part of the urethra that it surrounds. The main function of the prostate gland is to produce some of the substances that are found in normal semen, such as minerals and sugar. Semen is the fluid that transports the sperm to assist with reproduction. A man can manage quite well, however, without his prostate gland. (See the section on surgical treatment for prostate cancer.)
In a young man, the normal prostate gland is the size of a walnut (<30g). During normal aging, however, the gland usually grows larger. This hormone-related enlargement with aging is called benign prostatic hyperplasia (BPH), but this condition is not associated with prostate cancer. Both BPH and prostate cancer, however, can cause similar problems in older men. For example, an enlarged prostate gland can squeeze or impinge on the outlet of the bladder or the urethra, leading to difficulty with urination. The resulting symptoms commonly include slowing of the urinary stream and urinating more frequently, particularly at night. Patients should seek medical advice from their urologist or primary-care physician if these symptoms are present.

What is prostate cancer?

Prostate cancer is a malignant (cancerous) tumor (growth) that consists of cells from the prostate gland. Generally, the tumor usually grows slowly and remains confined to the gland for many years. During this time, the tumor produces little or no symptoms or outward signs (abnormalities on physical examination). However, all prostate cancers do not behave similarly. Some aggressive types of prostate cancer grow and spread more rapidly than others and can cause a significant shortening of life expectancy in men affected by them. A measure of prostate cancer aggressiveness is the Gleason score (discussed in more detail later in this article), which is calculated by a trained pathologist observing prostate biopsy specimens under the microscope.
As the cancer advances, however, it can spread beyond the prostate into the surrounding tissues (local spread). Moreover, the cancer also can metastasize (spread even farther) throughout other areas of the body, such as the bones, lungs, and liver. Symptoms and signs, therefore, are more often associated with advanced prostate cancer.

Why is prostate cancer important?

Prostate cancer is the most common malignancy in American men and the second leading cause of deaths from cancer, after lung cancer. According to the American Cancer Society's most recent estimates, 192,280 new cases of prostate cancer would be diagnosed in 2009 and 27,360 would die from the disease.
The estimated lifetime risk of being diagnosed with the disease is 17.6% for Caucasians and 20.6% for African Americans. The lifetime risk of death from prostate cancer similarly is 2.8% and 4.7% respectively. As reflected in these numbers, prostate cancer is likely to impact the lives of a significant proportion of men that are alive today.
Over the years, however, the death rate from this disease has shown a steady decline, and currently, more than 2 million men in the U.S. are still alive after being diagnosed with prostate cancer at some point in their lives.
Although it is subject to some controversy, many experts in this field, therefore, recommend that beginning at age 40, all men should undergo screening for prostate cancer.

What is prostate cancer?

The prostate

The prostate is a gland found only in men. As shown in the picture below, the prostate is just below the bladder and in front of the rectum. The size of the prostate varies with age. In younger men, it is the size of a walnut, but it can be much larger in older men. The tube that carries urine (the urethra) runs through the center of the prostate. The prostate contains cells that make some of the fluid (semen) that protects and nourishes the sperm.
The prostate begins to develop before birth and keeps on growing until a man reaches adulthood. Male hormones (called androgens) cause this growth. If male hormone levels are low, the prostate gland will not grow to full size. In older men, though, the part of the prostate around the urethra may keep on growing. This causes BPH (benign prostatic hyperplasia) which can lead to problems passing urine because the prostate can press on the urethra. BPH is a problem that often must be treated, but it is not cancer.

Prostate cancer

There are several types of cells in the prostate, but nearly all prostate cancers start in the gland cells. This kind of cancer is known as adenocarcinoma. The rest of the information here refers only to prostate adenocarcinoma.
Some prostate cancers can grow and spread quickly, but most of the time, prostate cancer grows slowly. Autopsy studies show that many older men (and even younger men) who died of other diseases also had prostate cancer that never caused a problem during their lives. These studies showed that as many as 7 to 9 out of 10 men had prostate cancer by age 80. But neither they nor their doctors even knew they had it.

Pre-cancerous changes of the prostate

Some doctors believe that prostate cancer begins with very small changes in the size and shape of the prostate gland cells. These changes are known as PIN (prostatic intraepithelial neoplasia). Almost half of all men have PIN by the time they reach age 50. In PIN, there are changes in how the prostate gland cells look under the microscope, but the cells are basically still in place -- they don't look like they've gone into other parts of the prostate (like cancer cells would). These changes can be either low-grade (almost normal) or high-grade (abnormal).
A prostate biopsy might also show a change called atypical small acinar proliferation (ASAP). It is sometimes just called atypia. In ASAP, the cells look like they might be cancer when seen under the microscope, but there are too few of them on the slide to be sure. If ASAP is found, there's a high chance that cancer is also present in the prostate.
If you have had a prostate biopsy that showed high-grade PIN, ASAP, or certain other changes, there is a greater chance that there are cancer cells in your prostate. For this reason, you will be watched carefully and may need another biopsy.

Children, ear infections and antibiotics

If you're a parent, there's a good chance you know about middle ear infections – infections in the space behind the eardrum. Or if you don't yet, you soon will.
The painful condition, known medically as "otitis media", strikes virtually all kids at some point in their childhood. But it is especially common in babies and toddlers, particularly those attending childcare. Peaking in the cooler months, it makes them unwell and irritable – often with a fever – and can affect their hearing.
Since the infection is usually caused by bacteria, antibiotics became the standard treatment.
In fact, acute middle ear infection (where the symptoms come on suddenly) is the most common reason antibiotics are prescribed for children, says Harvey Coates, clinical professor in ear, nose and throat medicine at the University of Western Australia.
But whether or not that's appropriate is controversial.
Over the past 30 years, expert opinion has swung against doctors giving antibiotics for this problem, and parents have been urged not to pressure GPs to prescribe them.
Now two papers published in a leading medical journal, the New England Journal of Medicine, have raised the issue once again.
An editorial commenting on the studies says they are high quality and provide "the best evidence yet" that toddlers who have been properly diagnosed with the condition recover more quickly when treated with antibiotics.
So what's a parent of a sick child to make of it all?

Watch and wait

When your toddler's ear infection makes them irritable and feverish – and keeps you awake at night – it's perhaps understandable you might see antibiotics as a "quick fix".
But concerns antibiotics might not be the most appropriate response have been enough to trigger education campaigns aimed at parents.
"Parents should not be concerned if the doctor does not prescribe antibiotics or suggests they wait and see what happens before having a script dispensed," stated a 2009 press release from the NPS, a government-funded organisation that aims to help people use medicines wisely.
"In some cases, such as babies, antibiotics will be necessary, but most ear infections will get better without specific treatment," the release said.
"Pain will usually subside within one or two days, in which case antibiotics would not be needed."
The advice reflects a treatment policy known as "watchful waiting", which was endorsed for selected children by the American Academy of Pediatrics in 2004 and also underlies treatment guidelines issued to Australian GPs. It involves treating symptoms with paracetamol while observing recovery from the infection before giving antibiotics.

Opinions divided

Watchful waiting stems from on a solid body of research dating back to the 1980s, says Dr Hasantha Gunasekera, a general paediatrician at the Sydney Children's Hospitals Network, Westmead.
This research clearly shows the benefit from antibiotics for most children with acute middle ear infections is "very small", Gunasekera says – around 12 to 24 hours less pain or fever. What's more this benefit is generally seen in only around one in 10 or so children treated with the drugs.
"It's not one of those conditions that has a very rapid response to treatment and if you don't treat it's catastrophic. It's a condition where antibiotics have a very weak effect," he says.
This weak benefit has to be balanced against the cost and inconvenience to the family of buying and administering antibiotics, as well as the side effects, which may include a rash, diarrhoea and vomiting, he says.
Research in the past has shown the benefits of antibiotics are slightly greater in very young children, in children with infections in both ears, and in children whose eardrums have burst from the infection. But, even then, they are still benefits Gunasekera describes as "modest".
His view is that the two studies published in January this year essentially confirm this modest benefit in younger children. They focused on children aged six to 23 months and six to 35 months, respectively.
In both studies, "most children given the placebo [non-active treatment] still got better, it just took a little longer," he said. Other experts like Boston University paediatrics professor Jerome Klein, however, have described the children who took antibiotics in the studies as "substantially improved" compared to those who did not.
The different perspectives may stem from what Gunasekera describes as "a disagreement in the medical fraternity".
"There's a group of doctors who are pro-antibiotics," he says.
"And then there are others who are not so much anti-antibiotics, but [they are] quite happy to just observe first before going down the antibiotic path".

The role of parents

What's this got to do with parents anyway? Isn't it doctors who decide how to treat sick children, not their parents?
Yes, but it's widely recognised parents play a significant role in influencing doctors' prescribing habits, Gunasekera says.
This is one reason prescribing rates are so high, despite what the treatment guidelines say.
"The argument [given by doctors who succumb to pressure from parents] is that if the child is sick and crying and irritable it's very hard to do nothing. But what we're recommending is not 'doing nothing'. We're recommending you treat the symptoms – the pain and the fever.
"What I say to parents when I'm managing the condition is: 'If I was to treat your child there's a chance they'd get better one day sooner but the trouble is there's also a very similar chance they'll get some problem like a rash or diarrhoea'."
If a discussion follows, some parents are also told there are broader benefits to limiting antibiotic use to cases that really need them. This is because overuse of antibiotics is known to lead to more bacteria becoming resistant to the drugs, making illnesses harder to treat – a major public health concern worldwide.
Gunasekera believes the message not to automatically expect antibiotics for a child with an acute middle ear infection is still valid.
"I think it's perfectly justified to still use the watchful waiting approach, even with this new research," he says.
Immediate treatment with antibiotics might be more warranted however, he says, if:

• Your child has a history of recurrent infections (more than six in six months) or severe infections (the ear drum bursts or there is ongoing release of fluid from the ear drum) that started before they were three months old. The risk of long term hearing problems is significantly greater in these children.
• Your family has difficulty accessing health care – say, because you live in a very remote area. If a child is not given antibiotics initially but does not seem to be getting better in a few days time, you need to be able to bring them back so a doctor can review them.

The bottom line

While experts disagree about whether or not it's necessary to treat middle ear infections, they do agree if you suspect your child has one, it's important to take them to a doctor.
The signs of a middle ear infection may include:

• fever
• earache (or pulling at the ears)
• irritability
• being generally unwell
• sometimes with diarrhoea and vomiting
• if the eardrum has burst there may be a discharge of fluid from the ear

Fight against parasite getting advanced

An Australian researcher is hoping his work sequencing the genome of a giant parasitic worm will lead to a more effective treatment for a condition that affects more than one billion people worldwide.

The worm hinders the development of children and kills tens of thousands of people, mainly in South East Asia, South America and parts of Africa.

Here's Simon Lauder.

SIMON LAUDER: For the past year and a half University of Melbourne parasitologist Dr Aaron Jex has been taking a very close look at one of the world's most troublesome parasites.

AARON JEX: It's a very big, big worm. It's about 30cm. I mean there are some people that would say nematodes are pretty, quite attractive. But you know I guess to each their own.

SIMON LAUDER: Dr Jex says the giant intestinal roundworm infects about a billion people and its impact can be compared with malaria and tuberculosis.

AARON JEX: The most significant effects tend to be in children where you can get chronic, from the affects of the parasite which is mainly malnutrition you can get chronic disease, effects on their physical and cognitive development. And that can last them through the rest of their life.

SIMON LAUDER: So really they're literally stunted by this parasite.

AARON JEX: Yeah absolutely, yep. The challenge with the parasite is that it tends to affect people in very impoverished communities. And so the amount of information that's available for those people is limited.

But tens of thousands or more would die from this parasite annually, yeah.

SIMON LAUDER: Can you explain how it's comparable with tuberculosis and malaria?

AARON JEX: Mainly in prevalence. In really heavily affected regions, in heavily endemic regions it might be up to 90 or in excess of 90 per cent of the population would have the parasite.

The effect in terms of overall comparison to malaria, tuberculosis, is the overall effect on quality of life because it affects so many individuals. And because that effect can start from childhood and last for the rest of their life the sum effect is quite substantial.

SIMON LAUDER: There are already treatments for the condition known as ascariasis but none that are lasting.

AARON JEX: You can treat someone for ascariasis and then because the environment is still contaminated they can become infected again. And so especially in young children you have to re-treat constantly for most of their school age.

But the challenge with that is if you are constantly re-treating you're breeding resistance to the drug and there will emerge populations of parasites that will not be affected by this drug.

And that's a problem because there are a limited number of drugs available and there are a limited number of new drugs.

SIMON LAUDER: Dr Jex is a part of a large international team of scientists who have just finished mapping the genome of Ascaris Suum which is very closely related to the one that infects humans but easier to study.

SIMON LAUDER: He says it will help find new treatments for ascariasis which has been identified by the World Health Organization as a key neglected disease.

AARON JEX: This has revealed a lot of new information about how the parasite interacts with the human host. And the hope is that by doing that we'll be on an avenue towards being able to develop vaccines against these parasites. But it's a very difficult feat.

But obviously when you think of a parasite that causes disease in roughly one in six on the planet and hugely affects children, particularly children between the ages of one to five, to be able to even in a small sense be able to develop a new drug that can replace the existing drugs if and when resistance emerges will be a massive thing.

About Diabetes Drugs

What do diabetes medicines do?

Over time, high levels of blood glucose, also called blood sugar, can cause health problems. These problems include heart disease, heart attacks, strokes, kidney disease, nerve damage, digestive problems, eye disease, and tooth and gum problems. You can help prevent health problems by keeping your blood glucose levels on target.

Everyone with diabetes needs to choose foods wisely and be physically active. If you can't reach your target blood glucose levels with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends on your type of diabetes, your schedule, and your other health conditions.

You may need diabetes medicines to reach your blood glucose targets.

Diabetes medicines help keep your blood glucose in your target range. The target range is suggested by diabetes experts and your doctor or diabetes educator.

What targets are recommended for blood glucose levels?

The National Diabetes Education Program uses blood glucose targets set by the American Diabetes Association (ADA) for most people with diabetes. To learn your daily blood glucose numbers, you'll check your blood glucose levels on your own using a blood glucose meter.

Target blood glucose levels for most people with diabetes		My targets
Before meals	70 to 130 mg/dL*
1 to 2 hours after the start of a meal	Less than 180 mg/dL

* Milligrams per deciliter.

Also, you should ask your doctor for a blood test called the A1C at least twice a year. The A1C will give you your average blood glucose for the past 3 months.

Target A1C result for people with diabetes	My targets
Less than 7 percent

Your personal A1C goal might be higher or lower than 7 percent. Keeping your A1C as close to normal as possible-below 6 percent without having frequent low blood glucose-can help prevent long-term diabetes problems. Doctors might recommend other goals for very young children, older people, people with other health problems, or those who often have low blood glucose.

Talk with your doctor or diabetes educator about whether the target blood glucose levels and A1C result listed in the charts above are best for you. Write your own target levels in the charts. Both ways of checking your blood glucose levels are important.

If your blood glucose levels are not on target, you might need a change in how you take care of your diabetes. The results of your A1C test and your daily blood glucose checks can help you and your doctor make decisions about

• what you eat
• when you eat
• how much you eat
• what kind of exercise you do
• how much exercise you do
• the type of diabetes medicines you take
• the amount of diabetes medicines you take

What happens to blood glucose levels in people with diabetes?

Blood glucose levels go up and down throughout the day and night in people with diabetes. High blood glucose levels over time can result in heart disease and other health problems. Low blood glucose levels can make you feel shaky or pass out. But you can learn how to make sure your blood glucose levels stay on target-not too high and not too low.

What makes blood glucose levels go too high?

Your blood glucose levels can go too high if

• you eat more than usual
• you're not physically active
• you're not taking enough diabetes medicine
• you're sick or under stress
• you exercise when your blood glucose level is already high

Some diabetes medicines can also lower your blood glucose too much. Ask your doctor whether your diabetes medicines can cause low blood glucose.
The results of your blood glucose checks can help you make decisions about your diabetes medicines, food choices, and physical activity.

Medicines for My Diabetes

Ask your doctor what type of diabetes you have and write down your answer.

I have

• type 1 diabetes
• type 2 diabetes
• gestational diabetes
• another type of diabetes: ____________________

Medicines for Type 1 Diabetes

Type 1 diabetes, once called juvenile diabetes or insulin-dependent diabetes, is usually first found in children, teenagers, or young adults. If you have type 1 diabetes, you must take insulin because your body no longer makes it. You also might need to take other types of diabetes medicines that work with insulin.

Medicines for Type 2 Diabetes

Type 2 diabetes, once called adult-onset diabetes or noninsulin-dependent diabetes, is the most common form of diabetes. It can start when the body doesn't use insulin as it should, a condition called insulin resistance. If the body can't keep up with the need for insulin, you may need diabetes medicines. Many choices are available. Your doctor might prescribe two or more medicines. The ADA recommends that most people start with metformin, a kind of diabetes pill.

Medicines for Gestational Diabetes

Gestational diabetes is diabetes that occurs for the first time during pregnancy. The hormones of pregnancy or a shortage of insulin can cause gestational diabetes. Most women with gestational diabetes control it with meal planning and physical activity. But some women need insulin to reach their target blood glucose levels.

Medicines for Other Types of Diabetes

If you have one of the rare forms of diabetes, such as diabetes caused by other medicines or monogenic diabetes, talk with your doctor about what kind of diabetes medicine would be best for you.

Types of Diabetes Medicines

Diabetes medicines come in several forms.

Insulin

If your body no longer makes enough insulin, you'll need to take it. Insulin is used for all types of diabetes. Your doctor can help you decide which way of taking insulin is best for you.

• Taking injections. You'll give yourself shots using a needle and syringe. The syringe is a hollow tube with a plunger. You will put your dose of insulin into the tube. Some people use an insulin pen, which looks like a pen but has a needle for its point.
• Using an insulin pump. An insulin pump is a small machine about the size of a cell phone, worn outside of your body on a belt or in a pocket or pouch. The pump connects to a small plastic tube and a very small needle. The needle is inserted under the skin and stays in for several days. Insulin is pumped from the machine through the tube into your body.
• Using an insulin jet injector. The jet injector, which looks like a large pen, sends a fine spray of insulin through the skin with high-pressure air instead of a needle.

If your body no longer makes enough insulin, you'll need to take it.

What does insulin do?

Insulin helps keep blood glucose levels on target by moving glucose from the blood into your body's cells. Your cells then use glucose for energy. In people who don't have diabetes, the body makes the right amount of insulin on its own. But when you have diabetes, you and your doctor must decide how much insulin you need throughout the day and night.

What are the possible side effects of insulin?

Possible side effects include

• low blood glucose, weight gain

How and when should I take my insulin?

Your plan for taking insulin will depend on your daily routine and your type of insulin. Some people with diabetes who use insulin need to take it two, three, or four times a day to reach their blood glucose targets. Others can take a single shot. Your doctor or diabetes educator will help you learn how and when to give yourself insulin.

Types of Insulin

Each type of insulin works at a different speed. For example, rapid-acting insulin starts to work right after you take it. Long-acting insulin works for many hours. Most people need two or more types of insulin to reach their blood glucose targets.

Diabetes Pills

Along with meal planning and physical activity, diabetes pills help people with type 2 diabetes or gestational diabetes keep their blood glucose levels on target. Several kinds of pills are available. Each works in a different way. Many people take two or three kinds of pills. Some people take combination pills. Combination pills contain two kinds of diabetes medicine in one tablet. Some people take pills and insulin.

Diabetes pills help people with type 2 diabetes or gestational diabetes keep their blood glucose levels on target.

Your doctor may ask you to try one kind of pill. If it doesn't help you reach your blood glucose targets, your doctor may ask you to

• take more of the same pill
• add another kind of pill
• change to another type of pill
• start taking insulin
• start taking another injected medicine

If your doctor suggests that you take insulin or another injected medicine, it doesn't mean your diabetes is getting worse. Instead, it means you need insulin or another type of medicine to reach your blood glucose targets. Everyone is different. What works best for you depends on your usual daily routine, eating habits, and activities, and your other health conditions.

Injections Other Than Insulin

In addition to insulin, two other types of injected medicines are now available. Both work with insulin-either the body's own or injected-to help keep your blood glucose from going too high after you eat. Neither is a substitute for insulin.

Talk with your doctor if you have questions about your diabetes medicines. Do not stop taking your diabetes medicines without checking with your doctor first.

What do I need to know about side effects of medicines?

A side effect is an unwanted problem caused by a medicine. For example, some diabetes medicines can cause nausea or an upset stomach when you first start taking them. Before you start a new medicine, ask your doctor about possible side effects and how you can avoid them. If the side effects of your medicine bother you, tell your doctor.

For More Information

To find diabetes educators-nurses, dietitians, and other health professionals-near you, call the American Association of Diabetes Educators toll-free at 1-800-TEAMUP4 (1-800-832-6874). Or go to www.diabeteseducator.org and see the "Find a Diabetes Educator" section.

jenifer lopez purchases $18million mansion

In late August, Jennifer Lopez, 42, purchased an $18 million mansion in the Water Mill area of The Hamptons, New York. The 14,000-square foot home features seven bedrooms and nine and half baths.

PHOTOS: Celebrity dream homes
Built in 2010 by architect Richard Perrillo of East End Builders, the shingle-style home sits on two acres of land and is surrounded by water.
Other amenities include heated marble floors in the master bath, several walk-in closets, a formal dining room, a library with white oak paneling, seven fireplaces, a media room, dockage on Mecox Bay and a pool.
PHOTOS: Look back at Jennifer and Marc in happier times
The property also boasts a first floor guest suite with garden views, an elevator and an attached three-car garage.
The American Idol judge -- currently shooting the movie Parker in Palm Beach, Florida -- won't be settling into her new digs with three-year-old twins Max and Emme just yet.
"She is moving in in a few months," a source tells Us Weekly.
PHOTOS: Jennifer's ghetto to glam style evolution
Though she's new to the neighborhood, Lopez has been visiting The Hamptons for years. Less than a month after announcing her split with hubby Marc Anthony, 41, in July, the "On the Floor" singer reunited with her ex at Sagg Main Beach in Southampton, New York.

Sir Paul McCartney and Nancy Shevell marries "Whats next"

Sir Paul McCartney and American heiress Nancy Shevell have married in London, on what would have been Beatle bandmate John Lennon's 71st birthday.
The couple spent around a minute posing for photographers after arriving at The Old Marylebone Town Hall in London shortly after 3.25pm.
The 69-year-old former Beatle wore a dark suit with a white shirt and pale blue tie while his bride chose a long-sleeved white dress for the ceremony.
Sir Paul's former band mate Ringo Starr posed for photographs and made a peace sign as he arrived at the register office.
After the ceremony the beaming couple waved to the gathering of around 200 cheering fans - some of whom had been waiting all day to catch a glimpse of the singer - before getting into their red Lexus to travel to the reception at Sir Paul's home.
Sir Paul and Nancy posed for pictures and kissed outside their home when they got back from the ceremony.
Asked how he felt, he said: "Terrific, thank you. I feel married." He added: "I feel absolutely wonderful."
The bride's second cousin, US broadcast journalist Barbara Walters, described the wedding as "beautiful and wonderful" as she left the register office.
Alison Cathcart, Westminster City Council's superintendent registrar said: "I am overjoyed to have played a part in bringing these two wonderful people together in marriage.
"Lots of couples get married at Marylebone Town Hall because of the venue's iconic status and reputation as the place to get married in central London. I wish them both great happiness as they further their lives together."

Latest story of the Forest Boy

A Swiss couple have said a boy who emerged from woodland in Germany claiming he had lived wild for the past five years is their grandson.
Now the pair are due to give a DNA test which will be matched with the teenager, Ray, who was dubbed "forest boy" after his story became public.
Berlin's BZ newspaper reported on Friday that Ray's photo was seen by the couple in Switzerland and that they then contacted police.
There was no official comment from authorities in the German capital and no further details in the newspaper report.
Police and social workers began suspecting two weeks ago that Ray's story was bogus and that his motives were suspect.
He is only 17 and now in the care of social workers after a legal guardian to represent his interests was appointed.
If it is found that he comes from Switzerland he will be deported back there.
The blond, blue-eyed boy claimed to remember few details about his life and where he had been when he pitched up on the steps of a town hall in the east of Berlin on September 5.
He spun a tale - in accented English - that gripped the imagination of the world: that he had been living in a tent in a forest for five years with his father, called Ryan, and that his mother Doreen had perished in a car crash five years previously.
He said he began walking towards Berlin after his father died suddenly in the woods a fortnight before his arrival. He said he had buried him among the trees.
"I'm all alone, please help me," he said.
He was taken into care at a cost to the German taxpayer of around £2,500 per month.
But the tale he wove began to appear to have more holes than a Swiss cheese.
A check of police computers in all 16 states of Germany showed up that no woman called Doreen had died in a car crash in Germany in the past decade.
No sign of a grave has been found in cursory searches of forests in the Harz Mountains, along the Bavarian-Czech border or in Thuringia.
He was unable to pinpoint the forest where he said he lived, he was also unable to say what nationality he was, although police soon suspected he was not British despite the words he spoke.
The tent he carried did not look like it had sustained five years of treatment in a German forest and he was well dressed and clean.
As Interpol was alerted to check with police forces for missing people in other European lands, Ray triggered more suspicion when he said he did not want to pose for photographs or make an appeal to try to find any of his family members.
"They're all dead," he said. "I just want to get on and make a new life for myself."
"Unfortunately it seems that the boy told his guardian that he wasn't interested in discovering who he was," said a police spokesman.
But now the Swiss link is the most promising development so far.
If true, Germany would be in a position to make a claim from Switzerland for money paid towards his upkeep.

Causes, incidence, and risk factors of cervical cancer

Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the routine use of Pap smears.

Cervical cancers start in the cells on the surface of the cervix. There are two types of cells on the cervix's surface: squamous and columnar. Most cervical cancers are from squamous cells.

Cervical cancer usually develops very slowly. It starts as a precancerous condition called dysplasia. This precancerous condition can be detected by a Pap smear and is 100% treatable. That is why it is so important for women to get regular Pap smears. Most women who are diagnosed with cervical cancer today have not had regular Pap smears or they have not followed up on abnormal Pap smear results.

Undetected precancerous changes can develop into cervical cancer and spread to the bladder, intestines, lungs, and liver. It can take years for precancerous changes to turn into cervical cancer. Patients with cervical cancer do not usually have problems until the cancer is advanced and has spread.

Almost all cervical cancers are caused by HPV (human papilloma virus). HPV is a common virus that is spread through sexual intercourse. There are many different types of HPV. Some strains lead to cervical cancer. (Other strains may cause genital warts, while others do not cause any problems at all.)

Risk factors for cervical cancer include:

• Having sex at an early age
• Multiple sexual partners
• Poor economic status (may not be able to afford regular Pap smears)
• Sexual partners who have multiple partners or who participate in high-risk sexual activities
• Women whose mothers took the drug DES (diethylstilbestrol) during pregnancy in the early 1960s to prevent miscarriage

• Weakened immune system

Symptoms

Most of the time, early cervical cancer has no symptoms. Symptoms that may occur can include:

• Abnormal vaginal bleeding between periods, after intercourse, or after menopause
• Any bleeding after menopause
• Continuous vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smelling
• Periods become heavier and last longer than usual

Symptoms of advanced cervical cancer may include:

• Back pain
• Bone fractures
• Fatigue
• Heavy bleeding from the vagina
• Leaking of urine or feces from the vagina
• Leg pain
• Loss of appetite
• Pelvic pain
• Single swollen leg
• Weight loss

Signs and tests

Precancerous changes of the cervix and cervical cancer cannot be seen with the naked eye. Special tests and tools are needed to spot such conditions.

• Pap smears screen for precancers and cancer, but do not make a final diagnosis.
• If abnormal changes are found, the cervix is usually examined under magnification. This is called colposcopy. Pieces of tissue are surgically removed (biopsied) during this procedure and sent to a laboratory for examination.

Other tests may include:

• Endocervical curettage (ECC) to examine the opening of the cervix
• Cone biopsy

If the woman is diagnosed with cervical cancer, the health care provider will order more tests to determine how far the cancer has spread. This is called staging. Tests may include:

• Chest x-ray
• CT scan
• Cystoscopy
• Intravenous pyelogram (IVP)
• MRI

Treatment

Treatment of cervical cancer depends on:

• The stage of the cancer
• The size and shape of the tumor
• The woman's age and general health
• Her desire to have children in the future

Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. There are various surgical ways to do this without removing the uterus or damaging the cervix, so that a woman can still have children in the future.

Types of surgery for early cervical cancer include:

• Loop electrosurgical excision procedure (LEEP) -- uses electricity to remove abnormal tissue
• Cryotherapy -- freezes abnormal cells
• Laser therapy -- uses light to burn abnormal tissue

A hysterectomy (removal of the uterus but not the ovaries) is not often performed for cervical cancer that has not spread. It may be done in women who have repeated LEEP procedures.

Treatment for more advanced cervical cancer may include:

• Radical hysterectomy, which removes the uterus and much of the surrounding tissues, including lymph nodes and the upper part of the vagina.
• Pelvic exenteration, an extreme type of surgery in which all of the organs of the pelvis, including the bladder and rectum, are removed.

Radiation may be used to treat cancer that has spread beyond the pelvis, or cancer that has returned. Radiation therapy is either external or internal.

• Internal radiation therapy uses a device filled with radioactive material, which is placed inside the woman's vagina next to the cervical cancer. The device is removed when she goes home.
• External radiation therapy beams radiation from a large machine onto the body where the cancer is located. It is similar to an x-ray.

Chemotherapy uses drugs to kill cancer. Some of the drugs used for cervical cancer chemotherapy include 5-FU, cisplatin, carboplatin, ifosfamide, paclitaxel, and cyclophosphamide. Sometimes radiation and chemotherapy are used before or after surgery.

Support Groups

National Cervical Cancer Coalition - http://www.nccc-online.org/

Expectations (prognosis)

Many factors influence the outcome of cervical cancer. These include:

• The type of cancer
• The stage of the disease
• The woman's age and general physical condition

Pre-cancerous conditions are completely curable when followed up and treated properly. The chance of being alive in 5 years (5-year survival rate) for cancer that has spread to the inside of the cervix walls but not outside the cervix area is 92%.

The 5-year survival rate falls steadily as the cancer spreads into other areas.

Complications

• Some types of cervical cancer do not respond well to treatment.
• The cancer may come back (recur) after treatment.
• Women who have treatment to save the uterus have a high risk of the cancer coming back (recurrence). 
• Surgery and radiation can cause problems with sexual, bowel, and bladder function.

Calling your health care provider

Call your health care provider if you:

• Are a sexually active woman who has not had a Pap smear in the past year
• Are at least 20 years old and have never had a pelvic examination and Pap smear
• Think your mother may have taken DES when she was pregnant with you
• Have not had regular Pap smears (ask your health care provider how often you should have one performed)

Prevention

A vaccine to prevent cervical cancer is now available. In June 2006, the U.S. Food and Drug Administration approved the vaccine called Gardasil, which prevents infection against the two types of HPV responsible for most cervical cancer cases.

Studies have shown that the vaccine appears to prevent early-stage cervical cancer and precancerous lesions. Gardasil is the first approved vaccine targeted specifically to prevent any type of cancer.

Practicing safe sex (using condoms) also reduces your risk of HPV and other sexually transmitted diseases. HPV infection causes genital warts. These may be barely visible or several inches wide. If a woman sees warts on her partner's genitals, she should avoid intercourse with that person.

To further reduce the risk of cervical cancer, women should limit their number of sexual partners and avoid partners who participate in high-risk sexual activities.

Getting regular Pap smears can help detect precancerous changes, which can be treated before they turn into cervical cancer. Pap smears effectively spot such changes, but they must be done regularly. Annual pelvic examinations, including a pap smear, should start when a woman becomes sexually active, or by the age of 20 in a nonsexually active woman.

See also: Physical exam frequency