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Cards & Games
51st State Card Game$31.95
The world you know no longer exists. There is no government. No army. No civilization. The United States has collapsed. And now, 30 years after the war started, new powers finally try to take control over the ruined country. Try to establish a new order. Try to control others. Create a new country, a new State: the 51st State.

51st State, the critically acclaimed, post-apocalyptic multi-player card game which debuted at the 2010 Spiel Festival in Essen, Germany.

Players take control of one of four factions vying for control of the post-war remains of a devastated United States. These factions struggle to build their stockpiles of supplies through conquest, trade, and expansion of their territory, until they achieve the stability to become the 51st State – and provide the foundation of a new society.

51st State introduces a new idea – every card in the game can be put into play in three different ways. You can invade a location to gain many resources once, or you can sign a contract with this location to gain one resource every turn, or you can attach the location to your State so you can use its skill. One card, three possibilities. Lots of decisions and choices that matter.

Designed by internationally renowned designer Ignacy Trzewiczek, and set in the Neuroshima universe, 51st State features breathtaking artwork and innovative gameplay. Players will have to strategically plan the growth of their faction – Will you use force to gain large, short term benefits? Will you negotiate to gain an ongoing income? Or will you incorporate new locations into your territory? Difficult decisions await the players on every turn.
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Rattus$31.99
Europe, 1347. A disaster is about to strike. The Black Death reaches Europe, and during the next 4 - 5 years, the population of Europe will be halved. The players settle in the various regions of Europe, while the plague spreads throughout all of the continent. The players gain help from the various classes of the middle ages: The Peasants provide population growth, the wise Monks keep the rats away, the rich Merchants flee when the plague approaches, the warfare conducted by the Knights spreads the plague to new areas, the Witches control the spread through magic and witchcraft, whereas the Kings avoid the plague by staying in their fortified palaces. But the plague does not make any distinction: When the rats arrive, no one can feel safe. When the plague withdraws and the game ends, the player with the highest surviving population wins.

Contents: board, board, 49 rat tokens, 80 wooden cubes, 1 Plague pawn, 6 character cards, rules
No. of players: 2-4
Ages: 10+
Playing time: 45 minutes
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A Game of Thrones LCG: Core Set$34.50
A Game of Thrones LCG™ is a game of epic battles and intrigue for 2-4 players. Players vie for the Iron Throne as one of the six Great Houses of Westeros using their favorite characters from George R.R. Martin's A Song of Ice and Fire novels in military, intrigue and power challenges.

The Core Set is the best way to start playing it contains a game board, high-quality pieces and four playable out of the box decks.

By buying Chapter Packs, fixed 40 card supplements that feature 20 distinct cards, players will be able to customize their core decks, or create strategies and decks of their own.
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The Struggle for Catan$14.95
The Struggle for Catan™ is a fast-paced game between the 2-4 factions developing newly settled Catan. Manage your resources to build settlements, cities, city improvements, knights, and roads that generate victory points or special abilities. While your settlements, cities, and city expansions remain yours, valuable roads and knights change hands. Varied expensive city improvements give you additional victory points and lasting advantages, so they're generally key to victory.

As in The Settlers of Catan® board game, you win by being the first to acquire and play 10 victory points.

The Struggle for Catan™ is the perfect way for 2-4 players to swiftly and casually explore, settle, trade, and build on the beautiful and ever-changing island of Catan.
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Bloodsuckers$39.95
Bloodsuckers is a highly thematic strategy card game for 2 to 4 players ages 13 and up.

Play as either vampires or vampire hunters fighting to control the most locations within Blackwood. Unleash powerful card combos to attack your opponent but beware as your strength rises and falls with the time of day. Battle alone or alongside a teammate to recruit the innocent bystanders at the church, graveyard, nightclub, police station, and hospital.

Win the battles and claim the most locations to declare victory in the fight between the living and the undead!
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Inka$29.95
Four explorers, smitten by gold-fever, set off to find the legendary treasure of the Incas.

But when they finally arrive at their goal they are still confronted by a difficult task.

Lead your explorers through an old labyrinth which hides many obstacles. Lots of paths lead you to your goal -but only one will enable you to get your hands on the gold ahead of your fellow players.

On the hunt for the gold of the Inkas, each player not only wants to be the first to find the treasure, but also to be the first to return with the treasure.In order to overcome the dangerous abysses of the temple, the players must carefully move the rhombic floor tiles. Some of them allow the players to move walls, which can make the path to the treasures more difficultfor their opponents.
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Samurai: The Card Game$29.95Samurai: The Card Game simulates the board game by placing cities on the board and then allowing each player to play one of their 5 cards from their hands. A city is considered surrounded when 4 cards surround the sides. A new city is placed when two different players cards create a location for it to be placed. Learn More
Samurai$39.95The samurai -- for centuries, the name has represented unfailing courage, imperturbable loyalty and internal harmony. Today the name is no less respected and stories of the samurai myths and legends have become more and more popular. In Japan, there were three samurai forces: peasants, clergy, and nobility. The way to power in old Japan led through the peasants, the clergy, and the nobility. To becomea samurai, one had to be supported by one of these forces and have strong connections to the other two. Learn More
Race for the Galaxy$34.95In Race for the Galaxy, players build galactic civilizations by game cards that represent worlds or technical and social developments.Each round consists of one or more of five possible phases. In each round, each player secretly and simultaneously chooses one of seven different action cards and then reveals it. Only the selected phases occur. For these phases, every player performs the phase's action, while the selecting player(s) also get a bonus for that phase.For example, if at least one player chooses the Develop action, then the Develop phase will occur; otherwise it is skipped. In it, each player may simultaneously select a development from his hand of cards to build. After revealing the cards, each player adds his development to his tableau of cards on the table and then discards cards from his hand equal to its cost. Each player who chose Develop discards one card fewer as his bonus.Explore allows a player to draw cards and select which of them to add to his hand. Settle allows a player to place a world in his tableau. Some worlds produce goods, represented by face down cards, when Produce is selected. These goods can be discarded for victory points or sold to add cards to the player's hand by selecting Consume. With cards, players can settle new worlds and build more developments, gaining both victory points and card powers that provide advantages in certain phases.The player who best manages his cards, phase and bonus selections, and card powers to build the greatest space empire, wins.The winner is the player with the most victory points. Learn More
Arcana (Revised Edition)$34.95Are you ambitious and cunning enough to rule the city of Cadwallon?

In the revised edition of Arcana 2-4 guild leaders send their loyal Agents into the districts of Cadwallon to entice, bribe, or win over powerful citizens, buy precious treasures, and utilize locations. Whichever player earns the most victory points wins!

This vibrant game creates a fantastical atmosphere for players to enjoy while they attempt to best their opponents through strategic card play. Make your guild the most influential by winning Stake cards and strengthening your deck with impressive Personalities, advantageous Locations, or tempting Relics to use in bribery.

The revised edition of Arcana introduces two new guilds, and six new rule options for players to choose from, or play with them all for a more challenging experience. Will you customize your deck or call in the Militia?

The revised edition of Arcana includes:

6 Guild Crest cards

120 Guild cards

Over 60 cards for game variant play

1 rulebook

 Learn More


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Newell: Bear highlights need for wildlife control
May 2, 2013
PARKERSBURG — A bear found roaming in Parkersburg underscores the problem the city has with wildlife, the mayor said Wednesday....
if one lives in a rural state and lives in a city with woods one 3 sides, on occassion you will have wild animals in the city. They have a right to live on Gods green earth as well.
20 Agrees | 0 Disagrees | Report Abuse »
I live up from the City Park entrance. Have for about 25+ years. Until a few years ago. In the past 2 years I've seen maybe 25-30 deer roam my neighborhood. 3 Weeks ago as I was turning the corner off of Pearcy & 16th there was a deer eating berries off one of the trees. So, it's not just around the cemetery and the water towers. They are pretty much everywhere.
7 Agrees | 0 Disagrees | Report Abuse »
Disregard the sentence "Until a few years ago." I didn't go back an read/edit it before I hit post comment. I still live there.
0 Agrees | 0 Disagrees | Report Abuse »
Disregard the sentence "Until a few years ago." I didn't go back an read/edit it before I hit post comment. I still live there.
0 Agrees | 0 Disagrees | Report Abuse »
I have a house across from City Park on 23rd St. In spite of my yard being fenced, the deer come through it at will. I've had as many as six deer lying down in my backyard at once. They are dangerous...not just in rutting season, when the bucks might attack, but also year round when they collide with vehicles. On average, deer collisions cause about 200 HUMAN deaths per year, and about one BILLION in property damage. You can blame deer for a large part of your high car insurance rates. Then, let us not forget LYME disease. Deer are major carriers of the ticks which cause Lyme disease.
8 Agrees | 4 Disagrees | Report Abuse »
Who lets there kid out at midnight with a cell phone and a flashlight,looking for a bear?Parkersburg needs parent control more than bear control.Good Job PPD
9 Agrees | 2 Disagrees | Report Abuse »
Seems to me someone should implement a form of "Parkersburg City Government" control, starting with the mayor and police chief.
10 Agrees | 2 Disagrees | Report Abuse »
OMG! Deer eating shrubbery and berries! When will it all end. Folks stay inside, exit only at your own risk, Bambi might be watching for you.
8 Agrees | 0 Disagrees | Report Abuse »
As for the LION incident it was in the 1980's and was won in a poker game at a local (no longer existent) bar. The lion got loose while the bar owner was passed out. It was easily recaptured put in a carr and later driven around town letting people pet it. (he was actually pretty friendly until the fellows driving him around kept pouring booze down him)
2 Agrees | 1 Disagrees | Report Abuse »
Lets just kill everything!!!! Unbelieveable!!
2 Agrees | 2 Disagrees | Report Abuse »
I live close to the park too, and we have possum and skunks. We leave them alone.
If one can afford expensive shrubs, then one can afford to by deer resistant plants.
We are taking their land from them. Where else are they to go? Besides, they are all the Lord's creatures, and "dominion" over them does not mean to kill everything just because we want to.
Life is a gamble. Is it better to be killed in an accident because of mechanical failure than a deer? Your're just as gone, no matter the reason.
6 Agrees | 1 Disagrees | Report Abuse »
Showing 11 of 11 comments

subset: commoncrawl


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Phiten Titanium Air Necklace
The Phiten Titanium Air Necklace is an incredibly lightweight version of Phiten?s trademark necklace. You asked for something lighter that would reduce bounce and here it is! The Titanium Silica Foam Core reduces the overall weight while the fabric shell is a combination of highly elastic polyurethane and nylon, allowing for a design that easily stretches over your head.


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A fat-restricted diet limits the amount of fat you can eat each day.
This diet may be prescribed for people with medical conditions that make it difficult to digest fat. Examples include chronic pancreatitis and gallbladder disease. A fat-restricted diet will minimize the unpleasant side effects of fat malabsorption, such as diarrhea , gas, and cramping.
A fat-restricted diet typically limits fat intake to 50 grams per day. Fat contains nine calories per gram. So, if you need 2,000 calories per day, this means only about 22% of those calories can be from fat. The rest should be from carbohydrates and proteins.
For most people, it is possible to meet all nutrient requirements on this diet. However, a supplement may be recommended if fat is very limited or you are on the diet for a long time. Vitamins A , D , E , and K need fat to be absorbed. Your doctor or a dietitian may recommend supplements for these vitamins.
The following guide is broken down into categories based on the Choose My Plate website recommendations for healthy eating. It is recommended that you work with a dietitian to determine how many servings of each category you should eat. Here are some general recommendations:
|Food Category
|Foods Recommended
|Foods to Avoid
Fats and Sweets in moderation
Academy of Nutrition and Dietetics
Choose My Plate—US Department of Agriculture
Canadian Association of Gastroenterology
Dietitians of Canada
Daily Food Plans & Worksheets. Choose My Plate—US Department of Agriculture website. Available at: http://www.choosemyplate.gov/supertracker-tools/daily-food-plans.html. Accessed November 17, 2014.
Diets for weight loss. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 8, 2014. Accessed November 17, 2014.
Dietary guidelines for Americans 2010. US Department of Agriculture and US Department of Health and Human Services. Available at: http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Accessed November 17, 2014.
Last reviewed September 2013 by Dianne Scheinberg Rishikof MS, RD, LDN
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2012 EBSCO Publishing All rights reserved.
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SANTA CLARA -- As Donte Whitner left for his native Cleveland to help repair the Browns, the 49ers quickly replaced him with another veteran safety, Antoine Bethea.
But that isn't the only change in the 49ers' shifting secondary.
Carlos Rogers officially got released, joining three other 49ers cornerbacks who hit the free agent market Tuesday: Tarell Brown, Eric Wright and Perrish Cox.
Meanwhile, kicker Phil Dawson re-signed on a two-year deal and quarterback Blaine Gabbert was acquired in a trade with the Jacksonville Jaguars for a sixth-round draft pick.
Instead of returning for a fourth season, Whitner became the first player from last season's NFC runner-up team to sign elsewhere (four years, $28 million; per ESPN and NFL Media).
"My time in San Fran will always be cherished!" Whitner posted on Twitter. "I love everything about the place. I left my heart and soul out there each and every week."
Bethea, a two-time Pro Bowler in eight seasons with the Indianapolis Colts, becomes becomes the front-runner to pair with second-year safety Eric Reid. Bethea signed a four-year, $26 million deal, according to the Indianapolis Star.
"Glad to be a Niner!! Going to the Bay!!!" Bethea posted on Twitter.
Bethea, 29, totaled 14 interceptions in 123 career starts for the Colts. Like Whitner, he is a product of the 2006 draft, although he was a sixth-round pick out of Howard whereas Whitner went No. 6 overall out of Ohio State (to the Buffalo Bills).
Unlike Whitner, Bethea rarely has drawn penalties, and he wasn't called for any last season. Bethea has been penalized 13 times in eight seasons, and only three of those infractions were for unnecessary roughnes. Whitner got flagged a team-high five unnecessary-roughness last season, including in the NFC Championship game loss to the Seahawks.
"The business side to the league is never fun," Reid posted on Twitter. "Hate to see him go but happy for my man @DonteWhitner. Appreciate everything you did for me."
While Whitner's physical reputation prompted him to considered changing his name to "Hitner" during the season, though he ultimately withdraw his application in his native Cleveland.
Whitner started all but one game since joining the 49ers in 2011 as a free agent. He played his first five seasons with the Buffalo Bills, who drafted him in the first round out of Ohio State.
Starting alongside rookie safety Eric Reid last season, Whitner produced 103 tackles and two interceptions, as well as an interception in the NFC divisional-playoff win at Carolina. Whitner allowed only two touchdown catches in coverage last season, down drastically from the 12 he yielded through the 2012 Super Bowl run, according to ProFootballFocus.com.
Whitner earned his first Pro Bowl invitation in 2012, and he won the Garry Niver Award in 2011 and 2013 for his professionalism and cooperation with the 49ers media. He is the fifth Niver winner since 2003 to not return to the team the following season.
The Browns haven't made the playoffs since the 2002 season, when Whitner was a senior at Cleveland's Glenville High, where he was coached by Ted Ginn Sr. The Browns have won only four or five games each season since 2008.


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Welcome to Coffeecream Themes
We're Coffeecream Themes. Two guys with the same passion. One of us is a web designer and front end developer from Poland, responsible for a design, html, css and jQuery. The other one is a back end developer from Belarus – a dude doing Wordpress, php and stuff. Enjoy our themes.


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Ever wished you had your own personal boat? Ever wished you could carry it wherever you went? Well your wishes have finally come true!
Max Frommeld and Arno Mathies, design students at London's Royal College of Art, have created an origami-like boat that folds into a backpack-size package for easy storage and transportation. They call it the Foldboat.
The small plastic rowboat can be assembled by a single person in as little as two minutes and comes with collapsible oars and inflatable cushions. The [...] Read More >


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MyChart Login
Home > Health & Wellness > Health Library > Sexuality and Reproductive Issues (PDQ®): Supportive care - Patient Information [NCI]
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
Many types of cancer and treatments for cancer can cause sexual side effects.
Many types of cancer and cancer treatments can affect sexual function. These changes may be temporary or permanent. Sexual problems are common in patients with the following types of cancer:
Less is known about how other types of cancer affect sexuality.
Both sexual desire and ability can be affected.
The most common sexual problems for cancer patients include the following:
Less common problems in men include the following:
Less common problems in women include the following:
Unlike many other physical side effects of cancer treatment, sexual problems may not get better within the first year or two after cancer treatment. The problems may get worse over time and can get in the way of returning to normal life. That is why it is important to get help with learning to adapt to changes in sexual function.
You and your partner decide what is normal for you.
Sexuality involves both the body and the mind. "Normal" sexual functioning covers a wide range. You and your partner define what is normal for you. Your "normal" may be affected by the following:
Sexual function can be an important part of your quality of life. Talk with your doctor if you have problems or concerns about your sexual function. If your doctor cannot talk with you about sexual problems, ask for information from other places or for the name of a doctor who is comfortable talking with you about them.
Certain cancer treatments can affect sexual function.
Surgery for the following cancers can cause body changes that have sexual side effects:
For both men and women, chemotherapy is linked to loss of sexual desire and having intercourse less often. Common side effects of chemotherapy can affect your sexual self-image and make you feel unattractive. Side effects may include the following:
In women, chemotherapy can cause the following problems:
Older women who receive chemotherapy have an increased risk of ovarian cancer.
In men, chemotherapy can cause the following problems:
Radiation therapy
Radiation therapy can cause side effects that may decrease sexual desire. Side effects may include the following:
In women, radiation therapy to the pelvis can cause changes to the lining of the vagina. The vagina may become narrow and scar tissue may form, which can cause pain with intercourse, painful pelvic exams, infertility, and other long-term problems.
In men, radiation therapy can cause problems getting and keeping an erection. Sexual changes happen slowly over six months to one year after radiation therapy. Men who had problems with erectile dysfunction before getting cancer may be more likely to have sexual problems after being diagnosed and treated for cancer.
Other risk factors in men that cause sexual changes include the following:
Hormone therapy
Hormone therapy can stop or slow the growth of certain cancers, such as prostate and breast cancer. This is done by using hormones made in a laboratory or other drugs to block the body's natural hormones. However, lower hormone levels can cause sexual problems.
Men who get hormone therapy for prostate cancer may have the following problems:
Women older than 45 years who are treated with tamoxifen may have slightly more of the following problems:
Other drug therapy
Drug therapy, such as opioids for pain and drugs to treat depression, can cause sexual side effects. Cancer patients may get drug therapy that affects the nerves, blood vessels, and hormones that control normal sexual function. Drug therapy may also affect their alertness and moods.
Your thoughts and feelings can affect your sexual function.
Misbeliefs about cancer might make you confused or unsure about sex when you are recovering from cancer. Common misbeliefs about cancer include the following:
Misbeliefs like these can keep you from enjoying sex again. Talk with your doctor to find out the facts so that you can feel more comfortable.
Depression is more common in cancer patients than in people who do not have cancer. Common symptoms of depression include loss of sexual desire and a decrease in sexual pleasure. Treatment for depression may lessen your sexual problems. (See the PDQ summary on Depression for more information.)
Cancer and cancer treatment may cause physical changes, such as hair loss or weight gain from chemotherapy or body changes from surgery. You may not like how you look and you may not want to have sex. Let your health care team know your concerns. You can get help adjusting to body changes caused by cancer and its treatment.
Patients with colostomies or ileostomies need to find a sexual position that does not place weight on the ostomy. Information is available from national organizations related to sexual function.and ostomates.
The stress of cancer diagnosis and treatment can make relationship problems that you already have even worse. Your sexual relationship can also be affected. Patients who do not have a committed relationship may stop dating because they fear being rejected when a new partner finds out they have cancer. Your feelings about your sexuality before being diagnosed with cancer will affect adjustment after cancer treatment. If you had positive feelings about sex, you may be more likely to continue sex after cancer treatment. Cancer can be hard on any relationship. It is important to get help if stress is causing a problem for you.
Your doctor will talk with you to find out what may be causing your sexual problems and how these problems affect your life.
As part of the assessment, your doctor will talk with you alone or with both you and your partner. You may be asked the following questions:
Your doctor may ask questions about your relationship with your partner.
You may be asked the following questions if you have a partner:
You and your partner may have sexual problems and concerns and fears about your relationship. It is important that you and your partner talk about these things with a doctor you feel comfortable with.
Your doctor may also ask you about your lifestyle.
You may be asked the following questions about your lifestyle:
Sexual assessment may include a physical exam and other tests.
The following tests and procedures may be done:
Good communication can help you and your partner continue sex after cancer treatment.
You may be afraid or anxious about having sex after cancer treatment. Fear and anxiety can cause you to avoid intimacy, touch, and sexual activity. Your partner may also be afraid and anxious that starting sexual activity will make you feel pressured or cause you pain. Even when a couple has been together a long time, talking about these things is important. Honest communication of feelings, concerns, and preferences can help.
You can learn ways to adapt to changes in sexual function.
Health professionals who specialize in treating sexual problems can give you the names of organizations that offer support. They can also tell you about educational materials such as Internet sources, books, pamphlets, and DVDs. These resources can help you learn ways to adapt to changes in sexual function.
Counseling may make it easier for you to cope with changes in your body and your sex life after cancer.
Sexual counseling may help you. Counseling may be for you alone, with you and your partner, or in a group.
Medical treatments may help improve sexual function.
You may be helped by medical treatments such as hormone replacement, drugs, medical devices, or surgery.
Cancer treatments may cause infertility.
Radiation therapy and chemotherapy may cause infertility (being unable to have children). This may be temporary or permanent. The risk of infertility as a side effect of cancer treatment depends on the following:
Ask your doctor if your cancer or its treatment may cause infertility or sexual side effects. Your doctor can tell you what changes may happen. A child may be too young to understand issues about infertility or sexuality. Parents can decide what they want their child to know about these issues.
If you are concerned about your ability to have children, find out what you can do before treatment.
Talk to your doctor before treatment if you are concerned about the effects of cancer treatment on your ability to have children. Your doctor can recommend a counselor or fertility specialist who can tell you your options and help you and your partner make a decision. Options may include freezing sperm, eggs, or ovarian tissue before cancer treatment.
Chemotherapy can affect fertility.
The following chemotherapy agents have been shown to affect fertility:
Fertility is likely to get better the longer you have been off chemotherapy. If you are taking chemotherapy, your age is an important factor. In women older than 40 years, adjuvant hormone therapy increases the risk that chemotherapy will cause infertility.
Radiation therapy to the abdomen or pelvis can cause infertility.
A man's age and the amount of radiation given directly to the testicles affects his risk of infertility. Lower doses of radiation and using lead shields to protect the testicles can help men keep their fertility. Sperm counts usually take 10 to 24 months to return to the level they were before radiation therapy. Usually, the higher the radiation dose, the longer it takes to recover. If the body is not making hormones normally, hormone therapy may help restore fertility. Radiation given to boys who have not reached puberty can cause problems with fertility.
Radiation therapy to the ovaries may cause infertility in women of any age. High doses of radiation in women younger than 26 years may cause early menopause. Lower doses of radiation can cause infertility in women older than 40 years. Regaining fertility is more likely if radiation to the ovaries is given before puberty. Doctors are sometimes able to protect the ovaries during radiation therapy.
Check NCI's list of cancer clinical trials for U.S. supportive and palliative care trials about sexuality and reproductive issues, sexual dysfunction, fertility assessment and management and cryopreservation that are now accepting participants. The list of trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
This summary was completely reformatted and some content was added.
About PDQ
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about sexuality and reproductive issues that cancer patients may experience during or after treatment. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are listed in PDQ and can be found online at NCI's Web site. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."
The best way to cite this PDQ summary is:
National Cancer Institute: PDQ® Sexuality and Reproductive Issues. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/about-cancer/treatment/side-effects/sexuality-fertility-women/sexuality-pdq. Accessed <MM/DD/YYYY>.
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.
The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.
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More information about contacting us or receiving help with the Cancer.gov Web site can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the Web site's E-mail Us.
If you have questions or comments about this summary, please send them to Cancer.gov through the Web site's E-mail Us. We can respond only to email messages written in English.
Call 1-800-4-CANCER
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.
Chat online
The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.
Write to us
For more information from the NCI, please write to this address:
Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each Web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen Web pages that are most closely related to the search term entered.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
Find Publications
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).
Last Revised: 2013-12-09
If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.
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Staff writers
SAN FRANCISCO -- Firefighters struggled to reach an area still smoldering and hosed down hot spots on Wednesday after a massive five-alarm blaze destroyed a $227 million apartment development Tuesday in the Mission Bay neighborhood, authorities said.
The fire, which injured two firefighters, was contained to the 172-unit building but was not yet under control as of Wednesday afternoon, said San Francisco Fire Division Chief David Franklin.
The apartment complex had collapsed inward, he said, creating hazards that prevented crews from extinguishing a smoldering fire on the bottom floors. There were more concerns for potential collapse of walls on Wednesday.
View Mission Bay fire in a larger map
Fire Chief Joanne Hayes-White said one firefighter suffered first- and second-degree burns on his hands but continued to fight the fire for "a significant amount of time," despite the burns. A battalion chief working with the overnight crew suffered an ankle injury, she said.
Both are expected to recover fully, she said. No other injuries were reported.
Hayes-White said primary fire damage was contained to the apartment complex under construction. The project, known as MB360, was being developed by San Francisco-based BRE Properties Inc. and was slated to open later this year.
"It was a phenomenal display of teamwork" that kept the fire from spreading, Hayes-White said at a news conference Wednesday.
Officials said the building was intended to mirror a nearby apartment building on Fourth Street that is seven stories tall and includes a penthouse. BRE Properties issued a statement Tuesday that none of its workers was injured and thanked fire crews. A spokeswoman said BRE Properties would not have any more comment Wednesday about the fire.
San Francisco Fire spokeswoman Mindy Talmadge said the blaze may have been sparked by welding going on above ground. Workers completed doing welding work between 3:30 and 4 p.m. Tuesday, she said.
Four aerial ladders surrounded the four corners of the building on Wednesday afternoon, with firefighters dousing each section with hoses. A long-armed wrecker began pushing down sections of the complex's external walls just before 4 p.m.
Two nearby apartment buildings, the Strata at Mission Bay and the Venue, were evacuated Tuesday evening, San Francisco Fire Deputy Chief of Operations Mark Gonzales said. Both buildings have about 200 units, but the Venue is at only 40 percent capacity and may be used to temporarily house displaced residents.
San Francisco Mayor Ed Lee said about 30 units in other neighboring apartment buildings also were evacuated after windows blew out during the fire and that automatic sprinkler safety systems in those buildings were activated.
It was not known when any of the evacuated residents would be allowed to return. All found housing or were assisted by the Red Cross, Franklin said.
Steven Johnson, 27, stood outside the Venue on Wednesday morning with four suitcases, awaiting word on when he might be able to return. Johnson said he was in the process of moving into a second-floor apartment when the fire started; he added that "you could feel the heat through the window."
He stayed in a hotel near Union Square on Tuesday night and said he would do so again if need be Wednesday.
"I'm just waiting on word from the leasing office," he said. "It's not like they're going to be busy. I doubt they'll be showing many tours."
Fourth Street remained closed on Wednesday, as did all blocks surrounding the buildings. But San Francisco MUNI officials confirmed that trains were running on Third Street as scheduled.
About 60 firefighters remained at the scene Wednesday, Franklin said, down from the 150 that worked to extinguish the fire on Tuesday evening.
One building that was not evacuated was the Channel Mission Bay apartment complex, located diagonally across the way from the fire. That complex just opened in January.
"The apartment smelled like a campfire," resident Rachel Gilner, 29, said. "It's crazy, because it was so close. It was really scary."
A Block 11 site, which is also part of the MB360 development and contains 188 units under construction, was not affected by the fire.
"We are currently assessing the situation, including the cause of the fire, and we will be consulting with the appropriate authorities," the company said in a statement.
BRE Properties said the company has comprehensive insurance coverage for events such as the fire and believe any losses to the company caused by the fire will be covered by insurance.
Staff writers Katie Nelson, Eric Kurhi and Kristin J. Bender contributed to this story.


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The Hannibal Area Chapter #4610 of AARP, Inc. will meet at 11:30 a.m. Thursday, May 16, at the Quality Inn & Suites on U.S. 36 West in Hannibal.
The program will be presented by Mary Lynne Richards from the Hannibal Parks and Recreation Department. Reservations are necessary and must be made no later than Monday, May 13, by calling (573) 221-3114.
Location, ST | website.com


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BEVERLY HILLS -- When "Downton Abbey" returns for Season 4 on PBS, Lady Mary (Michelle Dockery) -- now a young widow and single mother -- will be "broken and bruised" as she mourns the shocking death of her husband Matthew (Dan Stevens).
Tuesday night, reporters attending the Television Critics Association press tour were treated to several fresh clips from the show, which featured some scenes in which various characters are trying to pull Mary out of her deep funk.
"You must choose either life or death," advises the wise Dowager Countess (Maggie Smith).
Like her character, Dockery was quite taken aback when Stevens decided to bolt the wildly popular costume drama (and then was abruptly killed off in a car crash).
"My first reaction was, 'Oh crap. what's going to happen? Where can the story go now?'" she said during a panel session featuring several female members of the 'Downton' cast, along with executive producer Gareth Neame. "We spent all this time having this on-off, will-they-won't-they relationship and suddenly it comes to an end."
But "Downton" writer/creator Julian Fellowes soon convinced Dockery that the show, and Lady Mary, would do just fine without Matthew.
"As much as I think it was sad to see Dan go, it does open up an opportunity for Julian to take the character in all new directions," she said.
And so Mary will have "more than one" love interest in the coming season, including Lord Gillingham, an old family friend of the Crawleys played by Tom Cullen.
"They've known each other since they were children and she hasn't seen him in a while," Dockery explained. "Eventually, Mary has to move on."
She'll also grow closer to her brother-in-law Tom, partly because they have a common bond after losing their spouses, and partly because they need to work together to run the Downton estate. But don't look for them to be anything more than friends.
"They become closer because of what they've been through," Dockery said. "But romantically I don't think it's going anywhere. I hope not."
As for taking care of her new baby, George, it's going to take some time for those maternal instincts to kick in. Mary is in mourning, after all, and she has nannies to handle the diapers and bottles.
"Besides," Dockery said, "she looks at him and sees Matthew."
Meanwhile, what's in store for Mary's lovelorn sister, Edith, played by Laura Carmichael? Is there any hope for her?
"It's a tricky thing," says Carmichael. "Julian always says some people in life are lucky and some people aren't, and Edith is one of those who aren't.
That said, the clips shown to critics had Edith getting out and about around London and "seeing the new trends." And Neame explained that Edith has a more active story line this season that is "dynamic and really engaging."
Season 4, Neame said, will pick up a few months after Matthew's death and cover from February 1922 to spring of '23.
As for the future of the series, Neame believes it has enough life in it to run for at least a few more years.
"The show is so popular around the world now. ... It's beloved," he said. "The fourth season is in extremely good health, and I'm already thinking about the fifth season. I will say we're not going to World War II, but that's 18 years away. We want to make the show and I think it's got a lot further to go. When we feel it's had its time, hopefully we'll know before you guys. But it's not any time soon."


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BOSTON - Professional football can evolve into a safer game without losing the physical play - or, some would say, violence - that has made it so popular, NFL commissioner Roger Goodell said in a speech on player safety at the Harvard School of Public Health on Thursday.
"Football has always evolved, and it always will," he told an overflow crowd of a few hundred. "Make no mistake: change does not inhibit the game; it improves it."
In a long-planned appearance that came a few days after three starting quarterbacks were knocked out with concussions, Goodell said that the NFL has already improved the way it has handled hits to the head. San Francisco's Alex Smith, Chicago's Jay Cutler and Philadelphia's Michael Vick were all diagnosed with concussions in Sunday's games, but Smith and Cutler kept playing for a short time after being injured.
Goodell said that all three were taken out "as soon as they showed symptoms," a claim that was challenged by a member of the audience during the period for questions.
"It was identified and they were taken out of the game," the commissioner said. "Even a few years ago, I'm not sure you would have seen that."
Listing some of the safety measures that have been incorporated into the sport both before and since he became commissioner, Goodell mentioned the elimination of the flying wedge that was first employed by Harvard in the 1800s and the change in kickoffs last season that he credited for a 40 percent reduction in concussions on returns. He said the league is looking into better helmets and sponsoring scientific research that could make the game still safer.
"Not long ago, the game allowed the head slap, tackling by the face mask, horse-collar tackles, dangerous blocks, and hits to the head of defenseless receivers and quarterbacks. All of that has changed," he said. "My commitment has been and will continue to be to change the culture of football to better protect players without changing the essence of what makes the game so popular. It has been done. And it will be done."
But the changes are coming too late for thousands of former players who are suing the NFL, claiming it withheld information on the damage concussions can do to their long-term health. Research has shown that repeated hits to the head, even those that do not cause concussions, can cause brain damage that leads to memory loss and depression and has been blamed for the suicides of several former players.
Goodell stressed that there is risk of injury in all sports.


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How To Buy General Camping Accessories
Sometimes it is the little things that make or break a trip. Here's a basic list to get you started on the right track.
Maps, compass and field guides
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Personal items checklist
Here are some key items to bring along on any trip lasting more than a day:
What you choose depends on what you'll be doing and where you'll be camping.
First aid kits
You can buy prepackaged kits or create your own. It is an essential on any trip. Items should include (but are not limited to):
Knives and tools
These will serve a variety of purposes, such as cutting a cloth into bandages, repairing eyeglasses and gear, and opening cans.
Sleeping pads
A sleeping pad will add comfort, help decrease heat loss between you and the ground, and protect your sleeping bag from extra wear. The two main types are inflatable and foam.
Emergency blankets
Useful if you get wet, lost, cold or the weather takes a turn for the worst.
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USC awarded NCAA regional; Clemson will start on road
Gamecocks will host NCAA baseball tournament games Friday-Monday; regional visitors to be announced Monday
Published: Sunday, May 26, 2013 at 10:46 p.m.
Last Modified: Sunday, May 26, 2013 at 10:46 p.m.
Home has been sweet during recent postseasons for South Carolina and Sunday it was officially announced the Gamecocks will host an NCAA baseball regional for a fourth consecutive year.
A limited number of ticket booklets for the Columbia Regional are now available to the general public. Booklets include tickets for all games held Friday through Monday and are available for $84 each and are sold on a first-come, first-serve basis. Fans purchasing the booklet will secure their actual seat locations at the time of the purchase.
Single game tickets will go on sale at 10 a.m. on Monday for $15, but there is no guarantee of their availability. To purchase tickets visit www.GamecocksOnline.com/tickets or call 803-777-4274 or 800-472-3267.
USC was one of four SEC teams and 16 overall selected as hosts for the four-team, double-elimination opening round of the NCAA championship with the remainder of the field and starting times to be announced at noon Monday on ESPNU.
SEC schools Vanderbilt, LSU and Mississippi State also were chosen and the Columbia Regional will take place Friday-Monday.
Clemson was not chosen as a host site for a second consecutive season.
The remaining sites were North Carolina, Virginia, Florida State, North Carolina State, Virginia Tech, Kansas State, Louisville, UCLA, Oregon, Cal State Fullerton, Oregon State and Indiana.
USC won consecutive national championships in 2010 and 2011 before losing to Arizona in last year's best-of-three championship series finale.
"I'm happy and excited for our players, coaches and Gamecock Nation that we have been invited to play in this year's NCAA tournament," South Carolina coach Chad Holbrook said in a release. "We look forward to playing at home at Carolina Stadium in front of the best fans in college baseball."
This is the 15th time the Gamecocks will host an NCAA regional, including nine since the current regional-super regional format was adopted in 1999. USC is making its 29th overall appearance in the NCAA tournament, including a current streak of 14 straight trips that's the longest among SEC schools, and has advanced 11 times to the College World Series in Omaha, Neb.
The Gamecocks (39-18) have lost four of their past five games and dropped both outings in last week's SEC tournament to Mississippi State and Vanderbilt. They have an RPI ranking of 13th with the nation's 17th-most difficult schedule, according to WarrenNolan.com.
Clemson (39-20) cost itself a chance to host after losing all three games at the ACC tournament to North Carolina State, North Carolina and Miami. The Tigers blew a five-run, ninth-inning lead to UNC before losing 7-0 to the Hurricanes on Saturday.
Clemson had won nine consecutive games and 23 of 27 before losing its past five overall to end the season. That poor stretch likely was the key in allowing red-hot Virginia Tech to secure the fifth ACC host site, most of any conference. The Hokies (38-20) defeated Virginia, Florida State and Georgia Tech in the ACC tourney before falling to UNC in the title game and won 16 of 19 to close out their season.
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.


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- Rock your soccer love!
$12.99Goal Club Members
$11.6939Goal Club Points
Show your passion and your pride for soccer and your team with these sweet dog tags. You can even get your own number engraved! (Available #'s 1-25).
Team pride number dog tag on 24 inch snake chain. Individually engraved with reverse hatch technology and featuring a hand polished luster finish. One inch wide, two inches in length, made from nickel and silver.
Cadena de 24 pulgadas de largo. Dije de 1 pulgada de ancho y 2 pulgadas de largo. Números 1-25 disponibles.


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New Grand Caillou school gets OK
Published: Wednesday, November 14, 2012 at 10:21 a.m.
Last Modified: Wednesday, November 14, 2012 at 10:21 a.m.
The students of the often-flooded Grand Caillou Middle School will get new building in a few years now that the School Board has approved more than $15.7 million for construction.
The board voted 7-2 Tuesday to approve the proposal; members Brenda Babin and Roosevelt Thomas objected.
The board also unveiled plans for what the building might look like — two stories tall, the school will be 57,953 square feet. It will include a joint cafeteria/auditorium and a 15,630-square-foot outdoor covered area for students.
The building will house about 450 students, grades five through eight.
The building will cost about $193.86 per square foot. It will be built by Thibodaux-based Thompson Construction Inc., which is also building the freshman expansion at H.L. Bourgeois High School.
Merlin Lirette, the school's architect, said the building will be built 10 feet above sea level. That should make the building less likely to flood and meet the latest height recommendations from FEMA and other agencies.
"It's going to take some serious floods for this school to take water," Lirette said.
If the school does flood, Lirette said the entire bottom floor will be made of material that can easily be cleaned afterward. Lirette said construction should start before the end of the year, and could be finished in about a year and a half.
The building will be paid for using money from special interest-free bonds the board sold with voters' approval. Superintendent Philip Martin said that means the district saved millions in the construction.
Those bonds will be paid back using money from the 1-cent sales tax the board levies. Voters approved re-dedicating part of that tax to construction two years ago.
Martin said the new building was one of the top priorities administrators had in mind when they asked for the construction money.
"This school has flooded seven times. It was built in the 1920s," Martin said. "It is long past time that these children get a better learning environment."
Before the proposal passed, several board members asked Lirette and Martin about decisions made in the bidding process.
Several questioned why Lirette's estimated price tag for the school jumped from $12 million to more than $15.7 million.
Lirette said the cost of materials jumped significantly since the H.L. Bourgeois expansion. He also said the process of elevating the school added significantly to the cost.
Babin said she objected to the proposal because she disapproved of the decision to re-route technology money to building projects.
"I did some quick calculations, and with the money we used for this project, we could have bought iPads for 7,500 kids," Babin said. "I think there are better things we could be spending money on."
Member Roosevelt Thomas objected because the proposal doesn't include a gym, though it does include space and infrastructure for one to be added later. Thomas made a substitute motion to use FEMA money the district hopes to earn to pay for a gym, but no other board members voted for it.
"It seems to me if we're going to build this school and spend this much money, we need to do it right," Thomas said. "We're going to be inconveniencing a lot of parents and kids with this."
Staff Writer Matthew Albright can be reached at 448-7635 or at email@example.com.
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.


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The Internship
Internship Objectives
A list of objectives has been determined for each internship period that corresponds with the preceding classroom learning objectives. This list includes the key activities the intern should experience during the internship at their sponsoring dealer. Each internship will vary as to the availability of all the specified objectives. However, this list of objectives should be the guide for planning each internship so that as many of the objectives as possible can be accomplished. A checkoff signature with the date for each objective accomplished with serve as a record of these experiences and will be used to ensure that the appropriate instruction has been achieved. The objectives not accomplished during the program can be used to plan for future training needs.
Dealer Internship
This paid internship allows students to apply what they have learned during their classroom/lab sessions, in a "real world" setting. In addition, students will become familiar with the dealership environment, its organizational structure, and the competencies that are expected of a professional service technician. Upon completion of eight weeks of classroom instruction at SJDC, student technicians will complete eight weeks of internship at their sponsoring dealership, earning four units of college credit. The internship requirements include:
Intern Logbook
The logbook will provide the intern with a record of his/her learning accomplishments and will be part of the final course grade for the internship. It will be used by the dealer program coordinator, dealer internship coordinator, and the dealer program instructor to assess the learning experiences of the intern, and will also help to ensure that the objectives of the internship have been satisfied. The Intern Log Book consists of:
Recording the intern's daily activities in a logbook helps keep track of his/her daily learning experiences during the dealership internship. This may include a short summary of activities performed, equipment used, system used, people contacted, training achieved or any other event that has significance relating to the internship. The service report should be considered as a tool to record anything that the intern feels is related to his/her learning experience. The intern should also fill out a regular service report for the work they perform at the dealership, when appropriate.
Internship Coordinator
The internship coordinator is responsible for ensuring that all students have equal opportunities to meet the program objectives and that all are progressing at the same rate. The internship coordinator will have input in evaluations and will be the main liaison between the college instructor and the dealership regarding student internships.
Internship Evaluations
In addition to the list of internship objectives, each intern will be given a minimum of two formal evaluations by their supervisor per internship period. An evaluation by the mentor should also be given, if available. The student will also complete an evaluation of the dealer at the conclusion of the eight-week period. Student evaluations are scheduled as follows:
Dealer Program Visits
A Caterpillar Dealer Service Technician Program Instructor will visit each student during his or her internship to check on learning objectives and needed areas of improvement. The program instructor will assign a grade to the student's internship worth four units of college credit based on the evaluations, dealer visits and the student's logbook.