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Sex Games For Couples And Love Making Advice To Spice Up Your Sex Life!
Welcome to the number one destination for love making advice, sex games for couples and sex help for men and women. Keep reading below to begin mastering the art of love making and learn new couples sex games to spice up life under the sheets. But first…
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Mastering The Art Of Love Making
Sex may still be a tabu, even in western societies. That doesn't seem to stop couples from trying to improve their love making skill, learn new tricks and find sex games to play in order to spice up their lives under the sheet. Why wouldn't they? Sex is a very important aspect of our lives and sexual health is just as important as any…
Mastering the art of love making should be a common dream. I bet everyone would like to live in a world where more and more people would seem like they've slept with a hanger in their mouth last night. I just love that smile, that overwhelming sense of satisfaction and fulfillment. Don't you?
Is that something to feel shame for? To apologize to the neighbor maybe?
So, lesson number one. Let your self go free of superstitions and social conventions, at least while you're in the bedroom with your other half. Your bedroom is your realm, a place to forget who you can't be and start being who you can be. Who you really want to be… Realize your own and your partner's fantasies. Just… do it.
Is There Such Thing As A Love Making Secret
Well, yes and no. I mean, there's a lot you can do to spice things up, learn new sex games for couples, improve your overall love making skill and even come up with your very own, unique ideas. But every individual is different, unique in nature. Carries own fantasies and own superstitions.
Some people are way ahead their superstitions of course. They are ready to discuss and bring their fantasies to life. Others, well, not so much. Should you find yourself in the first situation, the job is half done. Just keep on learning and trying new things, following your instincts. Should you encounter the latter, the only thing you can do is challenge your partner's instincts and hope that in time, he or she will come around.
A Love Making Secret That Shouldn't Be A Secret
Prolonging your foreplay. I wouldn't call it a secret if it hadn't been for so many people neglecting the importance of foreplay in their lovemaking. A prolonged foreplay is definitely one of the best ways to intensify orgasms and the overall sensation during sex. That's because it gives you plenty of time to build up sexual anticipation. So, the next time you find yourself in the bedroom, take the time to explore and leave a trail of soft but passionate kisses on your partner's body. Gaze into their eyes, work with your fingers along their skin and enjoy the thrill.
You should always keep in mind that trying new things with a bit of your own twist and creativity added will make your experiences even more enjoyable and fulfilling.
Try a change of scenery to spice things up a little and no matter the place, provided you find a private spot, who knows what might end up happening? Let's go over some sex games you can add to your portfolio now, shall we?
Try These Sex Games For Couples As A Start
Sex games are a great way for couples to intensify their sex lives. Not only are they fun and thrilling, but they incorporate everything we've talked about so far. Sex games offer diversity and variety, a change of scenery if you will. They're also great bringing the love making secret of prolonged foreplay to life. Doesn't matter which games you end up playing, if they consist of familiar moves or not, simply unleash your imagination and creativity and everything will feel new and exciting. Sex games offer a lot of replay value, especially if you apply your own twist every now and then.
1. Dices
Dice related games are probably the most famous of sex games for couples. Dices come in various versions; some have words on their sides that form phrases challenging you to do a task such as "suck" + "nipple" or "lick" + "ears". Others are simply challenging you to adopt a certain position depending on the outcome of your rolling of the dice, others are dedicated to oral sex games etc.
Playing with dices is simple enough; all you have to do is buy a pair or more of your liking and agree with your partner to actually DO what the dice says no matter how bizarre that is or how uncomfortable it makes you feel. You can buy dices and other sex games for couples ONLINE to ensure your purchase stays under the radar. They are extremely cheap so price shouldn't be a problem at all.
2. The Unseen And The Unknown
This one works wonders for both men and women. One should use a scarf, a blindfold or a necktie to blindfold the other. Being unable to see what your partner is doing or is about to do dramatically increases psychological vulnerability which is very powerful an emotion. At the same time, you become more and more sensitive to your partner's touch; nature's way to compensate for your inability to see. Combining the two, you have an aphrodisiac manifest.
3. You Can't Go Anywhere, You Can't Do Anything
All time classic. You've seen it in films, you always imagined of doing it but probably never did. Tying up your partner in the bedposts shall be an easy, first sex game you can play. You can use any form of restrain such as a necktie or a pair of fur handcuffs to tie their wrists around the bedposts or behind their back. The lack of power to resist or reply to whatever it is they're doing to you will be a thrilling experience.
You can also mix and match this game with blindfolding your partner. You can also change roles in order for both to experience being the "victim".
4. The Mirror
Most couples fantasize being able to watch themselves "on duty". If there's a mirror in your bedroom or anywhere inside the house that you can play in front of, make sure you give it a try sometime. If there's not a comfortable spot that's adjutant to a mirror at the same time, you can use a hand or portable mirror instead. During oral sex for example. That will give your partner a different angle to watch from.
If you are still think you are running out of things to try in the bedroom, I highly recommend you get a copy of Michael Webb' s 100 Sex Games For Couples. I believe you will be pleasantly surprised by the originality and the fun this book has to offer, just as I was when I first read it. Oprah Love Expert Michael Webb (the author) describes the book as a set, "full of ways to spice up your lovemaking, adding more passion and intimacy to your experience". Michael is one of the world's best known romance experts. He has written over a dozen books on relationships and has appeared on over 500 TV and radio shows. 100 Sex Games For Couples is instantly available as a download and comes with several other e-books as bonuses. Great deal in my opinion.
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FREE BONUS: 101 Romantic Ideas to surprise your other half!


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Special Issue of the NCI Cancer Bulletin on Survivorship
Treating the Whole Person: Meeting the Emotional and Social Needs of Cancer Patients and Their Families
Drs. Elizabeth H. Blackburn of the University of California, San Francisco; Carol W. Greider of Johns Hopkins University School of Medicine; and Jack W. Szostak of Harvard Medical School have won the Nobel Prize in Physiology or Medicine for the discovery of how chromosomes are protected by telomeres and the enzyme telomerase. Telomeres limit the number of times a cell can divide and therefore play an important role in aging and cancer.
During a visit to the NIH campus last week, President Barack Obama announced that NIH will spend $275 million over the next 2 years to catalogue the genetic changes driving more than 20 types of cancer. Read more > >
At NCI, we clearly recognize cancer as a global health crisis, and one for which the worldwide impact—both personal and economic—is rapidly expanding. A recent study reported that in the past 30 years the global burden of cancer, based on the incidence of new cancer cases and annual deaths, has doubled. Read more > >
The NCI Cancer Bulletin is produced by the National Cancer Institute (NCI), which was established in 1937. Through basic, clinical, and population-based biomedical research and training, NCI conducts and supports research that will lead to a future in which we can identify the environmental and genetic causes of cancer, prevent cancer before it starts, identify cancers that do develop at the earliest stage, eliminate cancers through innovative treatment interventions, and biologically control those cancers that we cannot eliminate so they become manageable, chronic diseases.
For more information about cancer, call 1-800-4-CANCER or visit http://www.cancer.gov.
NCI Cancer Bulletin staff can be reached at email@example.com.
During a visit to the NIH campus last week, President Barack Obama announced that NIH will spend $275 million over the next 2 years to catalogue the genetic changes driving more than 20 types of cancer.
The grant, which includes $175 million in Recovery Act funds, will support the second phase of The Cancer Genome Atlas (TCGA) project. This collaborative effort led by NCI and the National Human Genome Research Institute (NHGRI) aims to discover the molecular alterations that occur in major types and subtypes of cancer.
Leaders of the project said that the TCGA pilot study, launched in 2006, has demonstrated the feasibility of using integrated genomic strategies to characterize the molecular alterations in cancer. The first three cancers profiled were brain, lung, and ovarian.
"The pilot project showed not only that we could build the infrastructure for a large-scale genome mapping project, but also that a very large team of scientists could come together and do work that benefits the entire community," said NCI Deputy Director Dr. Anna Barker, who co-leads the research program.
More than 150 researchers at some 18 centers around the country will use various genomic technologies, including next-generation DNA sequencing machines, to produce the data. As has happened during the pilot project, the information will be deposited in public databases, where the scientific community can use the results for many purposes, including searching for vulnerabilities in tumors that could be exploited by therapies.
The project aims to complete in-depth genomic analyses of 10 cancer types using approximately 500 samples of both tumor and matched normal tissue of each type, while also sequencing and characterizing at least 100 tumors for each of the additional cancers in the next 2 years, officials said.
The TCGA research network will broaden its mapping efforts and generate more in-depth analyses of all of the cancers in the following 3 years. Dr. Barker noted that the development of new bioinformatic tools to analyze large amounts of genomic data will be critical to the project's success.
NCI and NHGRI will each commit $50 million in non-Recovery Act funds to TCGA over the initial 2-year period. The two institutes have also committed to funding the remaining 3 years of the project, and the details will be finalized shortly, officials said.
The 20 cancer types have not been announced, but the criteria include relatively high incidence, substantial lethality, and the availability of high-quality biological samples for analysis. A type of kidney cancer called clear cell renal cell carcinoma and a type of breast cancer called invasive ductal carcinoma are examples of cancers likely to be priorities.
"This ambitious effort promises to open new windows into the biology of all cancers, transform approaches to cancer research, and raise the curtain on a more personalized era of cancer care," NIH Director Dr. Francis Collins said in a news release.
For example, TCGA data could accelerate the discovery of biological markers associated with specific subtypes of cancer. Even before new drugs or diagnostic tools are developed for patients with these subtypes, physicians could use biomarkers to assign patients to the most appropriate clinical trials, Dr. Barker noted.
The project also collects detailed information about each participant's clinical course and outcomes, so researchers can identify associations between genomic changes and treatment responses. For example, TCGA investigators reported recently that certain genetic alterations in patients with glioblastoma (a form of brain cancer) are associated with the development of resistance to a drug that is commonly used to treat the disease.
In his speech at the NIH Clinical Center on September 30, President Obama announced that $5 billion in 2009 Recovery Act funding for NIH would support more than 12,000 grants. Calling the Recovery Act grants the "single largest boost to biomedical research in history," he said that the investment would drive cutting-edge research across America, unlocking treatments to diseases such as cancer "that have long plagued humanity."
After attending a scientific meeting on brain cancer last week, Dr. Barker said that TCGA was already making a difference in the field. Many presentations included TCGA data, and clinicians were discussing the issue of drug resistance uncovered by project investigators. Some researchers at the meeting had begun to work on glioblastoma largely because reliable genomic data on the tumor type were available, she noted.
"This project has transformed our view of glioblastoma, first and foremost, by providing new therapeutic points of attack," Dr. Ronald DePinho of the Dana-Farber Cancer Institute, who was also at the meeting, said in an email message. "It is an extraordinary resource for all of cancer science, not just glioblastoma."
"What is particularly helpful for the field," he continued, "is that investigators can now conduct a comprehensive analysis of pathways and their interactions across all dimensions of the genome space—RNA, splicing, microRNA, copy number, mutations, and epigenetics."
As the project's next phase gets under way, Dr. Barker predicted that the scientific community would continue to use the data to develop new insights into the biology of cancer.
"I think the TCGA approach has enormous promise to change the face of cancer research as we roll out the genomic profiles on these various tumors in the next 5 years," she said.
—Edward R. Winstead
The largest study of its kind indicates that hormone treatments used to block the effects of testosterone on prostate tumors can increase the risk of cardiac events and cardiac death. The retrospective study reviewed the health records of more than 30,000 Swedish men and found that the risk was highest in those men taking gonadotropin-releasing hormone (GnRH) agonists, the most commonly used hormone treatment in the United States. The results were reported at the ECCO 15-ESMO 34 conference in Germany.
The researchers looked at all men with prostate cancer in Sweden who were treated with hormone therapy between 1997 and 2006 and assessed their incidence of cardiac problems for 3 years after receiving the hormone treatment. The majority of patients received either GnRH agonists (which reduce testosterone production) or GnRH agonists plus anti-androgen drugs (which block testosterone from attaching to prostate cells). The remaining patients received anti-androgen therapy or orchiectomy (removal of the testicles).
According to study author Ms. Mieke Van Hemelrijck, treatment with any hormone therapy was associated with a 24 percent increase in the risk of a nonfatal heart attack and a 28 percent increase in risk of a fatal heart attack. The risks of heart failure, arrhythmia (irregular heart beat), and ischemic heart disease also increased, as did the risk of death from these cardiac problems. The lowest risk was associated with anti-androgen therapy, whereas GnRH agonists were associated with the highest risk.
The findings, stated Ms. Van Hemelrijck in a news release, "may have implications for treatment choice."
Other studies have pointed to a potential increased risk for cardiac events associated with hormone therapy, explained Dr. Eric Horwitz, a radiation oncologist at Fox Chase Cancer Center. But that finding has not been consistent, he cautioned. "It's hard to separate out this risk from patients' other underlying health issues," he said. For patients with aggressive disease, hormone therapy is very effective in conjunction with other therapies including radiation therapy and surgery. "But it's a real risk," he said. "It's a discussion we're now having every day with our patients."
An NCI-sponsored phase III clinical trial for women with high-risk breast cancer has temporarily suspended accrual while researchers study the incidence of congestive heart failure among participants. The E5103 trial is comparing bevacizumab (Avastin) combined with standard adjuvant chemotherapy versus adjuvant chemotherapy alone for women with lymph node-positive or high-risk lymph node-negative breast cancer who have undergone lumpectomy or mastectomy. As a preplanned safety measure, the investigators suspended accrual after 6 of the first 200 women enrolled in the trial developed clinical congestive heart failure. In the cases where follow-up data were available, the symptoms of congestive heart failure resolved with treatment. More than 3,300 women are currently participating in the study.
NCI and the Eastern Cooperative Oncology Group suspended recruitment of new patients on September 24. Women currently participating in the trial will be notified of these adverse events and may choose to continue receiving their assigned treatment or withdraw from the study.
In two studies published in the September 24 New England Journal of Medicine, a high dose of daunorubicin given as part of initial treatment for acute myeloid leukemia (AML) increased the rate of complete remission and, in one study, improved overall survival compared with the standard dose given in the clinic. These beneficial effects of high-dose daunorubicin appeared to be confined to patients aged 65 or younger.
One clinical trial, designed by the Eastern Cooperative Oncology Group, randomly assigned 657 patients aged 17 to 60 to either high-dose or standard-dose daunorubicin; all patients also received the drug cytarabine. If a complete remission was not observed after the first course of the drugs, patients received a second course of cytarabine and standard-dose daunorubicin.
Significantly more patients in the high-dose daunorubicin group had a complete remission compared with those in the standard-dose group (70.6 percent versus 57.3 percent). The median overall survival was 15.7 months for patients in the standard-dose group and 23.7 months for patients in the high-dose group.
The second trial, performed by several European cooperative research groups, enrolled 813 patients between ages 60 and 83. Patients were randomly assigned to receive a first course of either standard-dose or high-dose daunorubicin, along with cytarabine. All patients received a second cycle of treatment with cytarabine alone.
Significantly more patients in the high-dose daunorubicin group had a complete remission (64 percent versus 54 percent in the standard-dose group). However, unlike in the American study, the two groups did not have significant differences in survival. An analysis showed that patients aged 60 to 65 had an increase in survival with high-dose daunorubicin; however, explained the authors, "these differences could be due to chance findings," since the trial was not designed to analyze the results by age group.
Neither trial saw an increase in serious side effects from the higher dose of daunorubicin. "The lack of an increase in toxic effects and the benefit in overall survival strongly argue for incorporating high-dose daunorubicin into the initial treatment of younger patients with AML," concluded the authors of an accompanying editorial.
Most people who are treated for cancer as children or adolescents and go on to have children of their own are just as likely as other parents to have healthy babies, according to two studies in the October Archives of Pediatrics & Adolescent Medicine. After examining birth records of nearly 2,400 childhood cancer survivors and 18,000 comparison subjects, female survivors overall were not more likely to have major complications during pregnancy, to have babies with birth defects, or to experience infant death compared with other women, one study found. The other study found no major differences in birth outcomes between the offspring of male childhood cancer survivors and a matched comparison group.
The results are "very reassuring," said Dr. Eric Chow of Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, an author of both studies. "People who have childhood cancers who then go on to have children of their own should be reassured that most likely their children will be fine."
Concerns have been raised about the potential for birth defects and complicated pregnancies as a result of treatments such as radiation and chemotherapy. And some studies suggest that the offspring of childhood cancer survivors may have more health problems than other children. The new studies did find that among female survivors of childhood cancers, there was an increased risk of infants born prematurely or with a low birth weight. While premature birth and low birth weight are not insignificant, they do not necessarily predict health problems later in life, the researchers noted.
Women who survive cancer and intend to become pregnant should alert their health care providers so they can be monitored more closely to minimize the chances and consequences of having a low birth weight or premature baby, Dr. Chow said. He also cautioned that some of the survivors in the study were treated several decades ago and that more research is needed to follow more recent survivors who may have received different treatments.
"The most important take-home message is that for childhood and adolescent cancer survivors who go on to have families, the prospect for having healthy offspring is excellent," said Dr. Julia Rowland, director of NCI's Office of Cancer Survivorship.
An investigational agent called PLX4032 that targets a specific genetic mutation effectively shrunk tumors in an ongoing phase I clinical trial involving patients with metastatic melanoma, U.S. researchers reported on September 23 at the ECCO 15-ESMO 34 conference in Germany. Metastatic melanoma has proven particularly resistant to most treatments, and 5-year survival rates are below 20 percent. Based on the trial results, the company that developed the drug has begun enrolling patients in a phase II trial, and a phase III clinical trial is expected to begin enrolling patients by the end of the year.
Presenting the results, Dr. Paul Chapman of Memorial Sloan-Kettering Cancer Center reported that nearly two-thirds of the 22 patients for whom data were available had at least a partial response to the drug—that is, tumor shrinkage of at least 30 percent. Some patients' tumors have regrown after initially responding to the drug, and several patients have developed nonmelanoma skin cancers, he said.
Most of the patients in the trial had previously had their disease progress after receiving other treatments, including chemotherapy and interleukin 2. All trial participants have a specific mutation in a gene called BRAF, which is mutated in approximately half of advanced melanoma cases. The data presented at the conference came from a 30-patient extension of the original phase I trial, which involved 55 patients and was intended to find the best dose to use in future trials. The patients being treated in the extension trial are all receiving the same dose of PLX4032. Overall, 20 of 22 patients have had some level of tumor shrinkage following treatment.
"Right now we are seeing dramatic responses," Dr. Chapman said in a news release, although he stressed that it's too early to draw conclusions about patients' long-term outcomes. The phase II trial of PLX4032 will enroll 100 patients with metastatic melanoma whose tumors have BRAF mutations that did not respond to previous treatment, whereas the phase III trial will test the drug as a front-line therapy in previously untreated patients with the mutation.
How breast cancer cells acquire the ability to break off from a tumor and travel to other parts of the body is poorly understood, but researchers have now identified a critical player in the process. In some breast cancer cells, increased levels of a protein called 14-3-3ζ (zeta) appears to trigger a molecular cascade that leads to the loss of molecular "glue" (E-cadherin) that binds cells together, allowing the cells to break free of the main tumor and spread to other tissues.
"We have discovered a key molecular mechanism for the deadly transition of non-invasive breast cancer into invasive disease," lead investigator Dr. Dihua Yu of the University of Texas M.D. Anderson Cancer Center said in a press release. This transition was observed in cells that produced increased levels of both 14-3-3ζ and another cancer-related protein, ErbB2/HER2, the researchers reported in the September 8 issue of Cancer Cell.
Women with advanced breast cancer commonly have their levels of ErbB2/HER2 tested to determine whether they should be treated with trastuzumab (Herceptin), but little has been known about the role of this protein in early stage disease. It now appears that ErbB2/HER2 and 14-3-3ζ may cooperate in transitioning some abnormal breast cells known as ductal carcinoma in situ (DCIS) into invasive breast cancer and metastasis.
Although it may be impractical to block the activity of 14-3-3ζ because it has many roles in normal cells, it is possible that the protein could be used to identify those women with DCIS who are at high risk of progressing to invasive cancer. It may also be possible to target the pathways and partners of 14-3-3ζ, including the growth factor TGF-β, the researchers said.
"This is a seminal paper," commented Dr. Suresh Mohla of NCI's Division of Cancer Biology. He noted that 14-3-3ζ is overexpressed in many human epithelial cancers, and the findings therefore could potentially be relevant to lung, liver, pancreatic, ovarian, and prostate cancers.
At NCI, we clearly recognize cancer as a global health crisis, and one for which the worldwide impact—both personal and economic—is rapidly expanding. A recent study reported that in the past 30 years the global burden of cancer, based on the incidence of new cancer cases and annual deaths, has doubled. The burden of cancer, however, is not equally distributed, and this represents a major concern. Today, 63 percent of cancer cases occur in countries less developed than ours. It has been estimated that across the globe there will be 12.9 million new cases diagnosed this year, and the worldwide toll is predicted to rise to 27 million new cancer cases and 17 million deaths by the year 2030, unless we take more pressing action.
In the United States, lung cancer is a major health problem, and in Mexico, cancers of the lung, bronchus, and trachea are also highly lethal, with a recently reported crude mortality rate of 6.5 per 100,000 people. However, cervical and uterine cancers in Mexico have an even higher crude mortality rate (recently reported at 7.6 deaths per 100,000 women), which is probably the result of inadequate screening and thus diagnosis of cancer at advanced, and more likely fatal, stages.
In Chile, the leading cause of cancer death in women is not breast or lung cancer, but cancer of the gallbladder. Both examples above, from Mexico and Chile, suggest differences in genetic susceptibility and environmental risk factors.
In China, smoking rates have skyrocketed, with an estimated 350 million current smokers. Two thirds of men in China smoke. That staggering statistic means that the rates of lung cancer and other tobacco-related cancers, such as pancreatic and bladder cancer, will increase markedly in the coming decades. An August 2009 report commissioned by the Lance Armstrong Foundation and conducted by staff at The Economist stated that, "It takes about 40 years for the increase in smoking rates to be fully reflected in cancer epidemiology statistics. As a result, the number of deaths in the developing world will continue to rise based on past activities as well as the projected increase in new lung cancer cases."
For the United States, cancer in other countries is clearly a humanitarian and diplomatic challenge, but also a tremendous opportunity to learn through studies of genetic drivers of risk and interactions between genes and the environment. Indeed, NIH Director Dr. Francis Collins has made improving global health one of the five pillars of his directorship. Our country, he said during a recent town hall meeting with NIH employees, has been viewed of late as a "soldier to the world." Using our scientific and medical expertise to improve global health would be a welcome display of "soft power," he said, demonstrating that the United States can be a "doctor to the world."
NCI's international cancer efforts are a response to these challenges. The global economic cost in 2009 of new cancer cases—factoring medical and nonmedical costs, along with productivity losses and the cost of cancer research—is currently estimated to be at least $286 billion, according to the The Economist report, "Breakaway: The Global Burden of Cancer—Challenges and Opportunities." A steep rise in cancer cases will only drive this economic burden higher. Such data become tangible, though, when you take a more personal perspective. In the United States, adjuvant use of the breast cancer drug tamoxifen for 5 years often costs $4,000. Meanwhile, the annual per capita income in Bangladesh is just under $600; in sub-Saharan Africa, it is about $1,100. Many of the therapies that Americans with health insurance expect to be available for their care cost at least 10 times the annual per capita income of developing nations. Yet only 5 percent of global resources for cancer are spent in that part of the world, less than $1 to $2 per day, according to the World Health Organization.
As populations move, as governments change, as environmental toxins affect great land areas, what happens to one region of the world is clearly felt in another. I believe NCI's international duty must be, in part, to study patterns of population movement. We must also understand the impact of poverty on health and cancer rates, and we must continue to study and attempt to drive down global smoking rates. We must contemplate infectious agents as the causes of greater numbers of cancers, and we must never lose vigilance in studying the malignancies that are so often a consequence of HIV/AIDS. In short, we must employ our international research efforts to better understand the biology of cancer around the world.
Consider Bangladesh, one of the world's poorest countries, where 162 million people live in an area the size of Iowa. With support from NCI and other organizations, Dr. Richard Love of Ohio State University is attempting to break through political and cultural barriers to save women's lives. Dr. Love has worked with the Bangladeshi government to open free breast cancer clinics that treat hundreds of breast cancer cases, almost all of which present in late stages. In that country, where more than 30 percent of the population lives on less than $1 per day, Dr. Love is not only helping patients, he is studying populations, looking for differences in individual tumors, in the reactions of patients to medicines and treatments, in cultural traditions, and in health care systems. Dr. Love is even conducting a study in a small village to determine whether it is possible to educate women and men about breast health and breast cancer by employing a type of traditional song often performed as street theater.
Last week, I met with top health and diplomatic officials from Argentina, Brazil, Mexico, and Uruguay, who came to the NIH campus to sign letters of intent formally bringing them into the U.S.-Latin America Cancer Research Network, joining Chile, which signed a letter of intent earlier this year. For a pilot project in breast cancer, researchers from the five countries will perform molecular profiling of tumor samples from women to help identify the most common breast cancer subtypes and to improve both diagnosis and treatment. Given the growing Hispanic population in the United States, this work promises significant benefits for all of the partner countries.
In our own country, we have considerable evidence that the incidence of cancer has two principal drivers: a population that is rapidly aging, and one that is increasing in number and ethnic heterogeneity. This presents opportunities to apply what we are learning from global research programs to changing U.S. demographics.
NCI also has a long history of international population-based studies, specifically in Russia and China, to identify environmental and genetic determinants of cancer.
Healthcare, many argue, is a basic human right. The United Nations' Universal Declaration of Human Rights from 1948 says, "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family." When it comes to NCI and the rest of the world, I would suggest a simpler way of thinking: It is our duty to reduce cancer's great burden for all people.
Dr. John E. Niederhuber
Director, National Cancer Institute
NCI and France Sign Letter of Intent to Collaborate on Cancer Research
On September 16, NCI signed a letter of intent to collaborate with the Institut National du Cancer (INCa) of France. As the leading government agencies for cancer research in France and the United States, the two Institutes share an interest in fostering collaborative biomedical research in oncology and a common goal in educating and training the next generation of cancer research scientists and clinicians. Through this partnership, INCa and NCI seek to enhance the discovery and development of new anticancer agents and to enhance the process of phase III and other cancer treatment trials. INCa and NCI partnership activities will include collaborations in early phase I-II clinical cancer trials of new agents and associated translational research, collaborations in phase III and other definitive cancer treatment trials, and planning meetings, conferences, workshops, and informational exchanges. This letter of intent is expected to result in new and wider areas of partnership and cooperation, as well as expanded research collaborations.
One of the controversies in oncology today concerns how to treat ductal carcinoma in situ (DCIS), a common pre-cancer of the breast that accounts for at least 20 percent of all breast cancer diagnoses. Nearly 100 percent of patients with DCIS achieve long-term disease-free survival with current therapies. NCI and NIH's Office of Medical Applications of Research convened a state-of-the-science conference titled, "Diagnosis and Management of Ductal Carcinoma In Situ" 2 weeks ago, which brought together researchers, clinicians, advocates, and policymakers to discuss some key questions about this condition.
The draft conference statement, produced by a panel of 14 experts and delivered by chair Dr. Carmen Allegra of the University of Florida Shands Cancer Center at Gainesville, was intended "to provide health care providers, patients, and the general public with a responsible assessment of currently available data." The statement addressed most of the dilemmas and included the panelists' recommendations about how they should be handled. Questions addressed by the panel were prompted by an evidence-based report compiled by the Agency for Healthcare Research and Quality.
Perhaps the most animated discussions at the meeting were about whether the condition should be called something other than DCIS, since the fear and stigma associated with breast cancer can compromise a health provider's efforts to explain the diagnosis and guide patients to an informed decision about treatment choices. Despite dramatically higher cure rates than invasive breast cancer (IBC) and excellent prognoses after treatment, women with DCIS experience psychological responses (e.g., anxiety and worry) similar to those experienced by women diagnosed with invasive disease.
The panel concluded that "strong consideration should be given to elimination of the use of the anxiety-producing term 'carcinoma' from the description of DCIS," though Dr. Allegra emphasized it was not their charge to suggest an actual change of nomenclature and felt that pathologists would be an important constituency to consult on this issue.
The heart of the DCIS dilemma stems from the rise of screening mammography; in the 1970s, DCIS accounted for less than 5 percent of cancer diagnoses. With the addition of mammography and magnetic resonance imaging (MRI), much more disease is being detected today, and the incidence of DCIS is growing faster than that of any other breast cancer subtype.
While the natural history of DCIS is poorly understood, low-grade disease can persist for more than 4 decades without progressing, said Dr. D. Craig Allred, director of breast pathology at the Washington University School of Medicine in St. Louis. Left untreated, however, "the few studies that have been done suggest that about 35 percent of DCIS cases will progress to IBC within 30 years, and there's actually reason to think that the real incidence of DCIS that progresses to IBC is even higher."
The panel acknowledged that the majority of treated DCIS lesions will not progress to IBC, but Dr. Allred points out that "unless you know which ones those are, all are potentially threatening." In addition to routine mammorgraphy, MRI is used increasingly to screen for breast cancer, and in terms of DCIS the panel asked, "To what degree does breast MRI in this setting result in overdetection, meaning the detection of biologically insignificant lesions?"
Most women with DCIS elect to have some form of surgery, given the risk of progression and their fear of invasive disease. Approximately one in three patients elect to have a mastectomy and some also have the other breast removed as a preventive measure (prophylactic mastectomy). The alternative is a local excision (lumpectomy), often followed by radiation therapy and, in estrogen receptor-positive DCIS, tamoxifen or aromatase inhibitor therapy to prevent recurrence.
Currently, it is unclear whether all patients "uniformly benefit from these interventions [and] important therapeutic questions remain unanswered," wrote the panel. "[R]esearch efforts should focus on the identification of patients who are at high risk for developing recurrence." They added that "the appropriate investigation of biomarkers could be helpful in guiding both systemic and local treatment decisions."
The panel also called for better decision-making tools, which will help address patient anxiety related to the diagnosis of DCIS, the complex choice of treatment options, and "misperceptions regarding outcomes and risks of therapy."
––Addison Greenwood
This is the third article in a series of stories highlighting cancer technology. Look for the symbol on the left in an upcoming issue for the next article in the series.
The Agency for Healthcare Research and Quality recommends colorectal cancer screening for average-risk adults between the ages of 50 and 75 with one of the following methods: annual fecal occult blood testing, sigmoidoscopy every 5 years, or colonoscopy every 10 years. However, as of 2005, only 59 percent of people aged 50 or older had been screened according to these recommendations, and only 50 percent had had a colorectal endoscopy procedure (either sigmoidoscopy or colonoscopy, screening techniques that can both visualize cancer in the colon and rectum and remove precancerous polyps) within the past 10 years.
Many factors contribute to this low rate of screening endoscopy, including a shortage of medical professionals trained to perform the techniques, disparities in access, and people's reluctance to undergo an invasive screening procedure.
"Having a tube placed for a colonoscopy is something that's uncomfortable for a lot of people to think about," said Dr. Stephen Taplin, senior scientist in NCI's Division of Cancer Control and Population Sciences' Applied Research Program (ARP).
One way to boost colorectal cancer screening rates may be to develop new screening technologies that are simpler, more accessible, and more acceptable to participants. A tiny, futuristic device smaller than the tip of one's finger called the capsule endoscope is currently being tested and improved for what its developers hope will be a place in the cancer screening armamentarium.
Visualizing the "Black Box" of the Body
Originally developed to explore the small intestines, the small-bowel capsule endoscope (CE) is a tiny device about the size of a large vitamin pill, containing a light, a miniature camera, and a transmitter that sends images to a recording device worn by the patient during the procedure. A patient swallows the CE just like a pill, and the capsule is propelled through the digestive system by the normal movement of the intestines, transmitting pictures of the intestinal walls throughout its passage.
Approved by the FDA for the diagnosis of small bowel diseases in 2001, CE revolutionized small bowel medicine by allowing noninvasive imaging of part of the body that had been previously inaccessible except through surgical exploration.
One of the three companies that manufacture small-bowel CEs has now developed a version for the colon, in the hope of producing a less invasive alternative to traditional endoscopy for colorectal cancer screening. The colon CE has not been approved by the FDA for use in the United States, but it is being tested in clinical trials and explored by researchers interested in its potential applications.
Unmet Hopes in First Large Trial
The new colon CE—which contains two video imagers, one at each end of the capsule, and captures pictures at a rate of four frames per second—was recently tested in an international clinical trial led by researchers from the Université Libre de Bruxelles in Belgium and the manufacturer, Given Imaging, from Yoqneam, Israel. The researchers enrolled 332 patients with known or suspected colon disease into the trial. Each patient underwent both CE and standard colonoscopy on either the same or successive days.
Although the capsule was found to be safe, the preparation regimen that was required to cleanse the gut (including a clear liquid diet and laxatives) was more involved than the regimen for a standard colonoscopy, and the sensitivity of the capsule was not as high as colonoscopy (which is thought to have a maximum sensitivity of just over 90 percent). Advanced adenomas of any size were detected in 52 patients by colonoscopy, but in only 44 patients by CE. Nineteen cancers were detected by colonoscopy, but only 14 of those were visualized by the capsule.
"With the capsule's relatively low sensitivity for the detection of colorectal lesions, [and] its requirement for more extensive bowel-cleansing regimens as compared with colonoscopy and CT colonography…colon capsule endoscopy cannot be recommended at this time," concluded Dr. Michael Bretthauer of Oslo University Hospital Rikshospitalet in an editorial that accompanied the trial's publication in the July 16 New England Journal of Medicine.
Challenges and Promises
A number of challenges lie in the way of colon CE being ready for the clinic, including improving sensitivity, which is related to the amount of data that can be captured by the imaging device, and the human error that can arise in analyzing large amounts of captured video. Reducing the cost per procedure will also be necessary.
Dr. Ram Sriram, a group leader with the National Institute of Standards and Technology Manufacturing Engineering Laboratory, and his colleagues in the Information Technology Laboratory, with input from the Asian Institute of Gastroenterology, are designing software to help automate image analysis for the small-bowel CE to speed analysis time (and thereby decrease cost) and reduce the likelihood of human error. Similar software could potentially help reduce the cost and increase the accuracy of colon CE, as well, but first the capsule must be able to capture enough data for the software engineers to analyze.
The colon is much wider than the small bowel, making it more challenging to develop a sufficiently sensitive colon CE. Even with a slightly larger size, "the capsule tends to move around a lot and doesn't have a focus area, so you're not getting all the pictures that you need," explained Dr. Sriram. "Once they can take enough pictures, engineers can do image processing to make the technology more sensitive."
The issue of simplifying the complicated bowel preparation currently required for colon CE is also "not trivial—it's a huge issue, because the preparation is another aspect of colonoscopy that a lot of people don't like," said Dr. Taplin.
But the potential advantages of colon CE will likely keep researchers focused on improving the technology. For example, CE holds promise for telemedicine applications, explained Dr. Sriram, such as helping patients in remote areas who cannot travel to see a specialist for screening or diagnosis.
Also, if an improved, lower-cost colon CE could be administered by a primary care physician instead of a specialist, "that could remove the barrier of the scheduling process, and make it easier for patients to get access," said Dr. Taplin. "Improving any kind of screening process is not just about improving the technology; it's about streamlining the whole process to make it work."
—Sharon Reynolds
Name of the Trial
Phase III Randomized Study of Radiotherapy with Versus without Trastuzumab (Herceptin) in Women with HER2-Positive Ductal Carcinoma In Situ Who Underwent Lumpectomy (NSABP-B-43). See the protocol summary.
Principal Investigators
Dr. Melody Cobleigh, Dr. Douglas Arthur, and Dr. Thomas Julian, National Surgical Adjuvant Breast and Bowel Project
Why This Trial Is Important
Ductal carcinoma in situ (DCIS), a condition in which abnormal cells are confined entirely to the milk duct of the breast, is a risk factor for the development of invasive breast cancer. The standard treatment for DCIS is surgery, which produces excellent long-term disease-free results. Although most patients can be treated with lumpectomy (breast-conserving surgery, in which only part of the breast is removed) and radiation therapy, patients with larger tumors or tumors with high-grade features may undergo mastectomy (removal of as much of the breast as possible).
One high-grade feature seen in some DCIS tumors is overexpression of the HER2 protein. When there is too much of this human epidermal growth factor receptor, tumors tend to grow faster and are also more likely to recur after initial treatment. Trastuzumab (Herceptin) is a monoclonal antibody that binds to the HER2 receptor and interferes with the growth of HER2-expressing tumors. It is approved by the FDA to be used with chemotherapy to treat HER2-positive invasive breast cancer. In addition, laboratory and animal studies have suggested that trastuzumab can increase the effectiveness of radiation therapy.
In this clinical trial, women with HER2-positive DCIS will be treated with lumpectomy followed by whole-breast radiation therapy; half of the women will also receive two doses of trastuzumab during their radiation treatment. The researchers will then monitor the women in both groups to see whether trastuzumab prevents or delays the development of invasive breast cancer or the recurrence of DCIS in the breast, among other outcomes, such as breast cancer in the opposite breast. Trastuzumab is administered for a short period of time with radiation and without chemotherapy, so the side effects from trastuzumab are expected to be minimal.
"We are looking for ways to extend the option of breast-conserving surgery to women whose more aggressive or advanced DCIS would normally indicate a mastectomy," said Dr. Cobleigh. "We have seen that radiation therapy can significantly improve protection after lumpectomy.
"Trastuzumab has been proven safe and effective in the treatment of both early and metastatic breast cancer, and we want to see if it can make HER2-expressing tumor cells more sensitive to radiation. These women are more likely to have aggressive DCIS, and they should have an alternative to mastectomy," she said. "This is a targeted approach that could make a real difference for women in that group."
For More Information
See the lists of entry criteria and trial contact information or call NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). The toll-free call is confidential.
This is the second article in a series of stories related to cancer survivorship. Look for the next article in our survivorship series in an upcoming issue.
A headwind slowed the riders all the way from Indianapolis to Pittsburgh, and then the hills began. For Cindi Hart, a "flatlander" from Indiana and two-time cancer survivor, the gentle hills started to feel more like mountains.
"We were climbing 15 percent grades that seemed to go on forever," recalled Hart, who organized the ride to raise awareness of cancer and advocate for research. "But this was not a race, and when people dropped back, we would stop and wait for them. Just as in the journey through cancer, no one should have to do it alone."
The riders were from Cyclists Combating Cancer, an international support group of people touched by cancer who share a passion for cycling. This online community had been Hart's primary support group during her illness, and last month more than 100 members rode in a series of regional rides around the United States that included visits to several NCI-designated cancer centers. About a dozen riders met in Washington, DC, on September 16, including some who had started in Indiana or joined along the way.
"I've never seen so much compassion and support and love and hope as on this ride," said Christopher States of San Francisco, a two-time cancer survivor who flew in to join the ride from Pittsburgh to DC. At the cancer centers, he and others shared their stories of coming back from multiple cancers and drew inspiration from patients who are still battling the disease.
These patients and their caregivers joined the tour by signing banners that traveled with the cyclists to Capitol Hill, where the group met with Senator Richard Lugar (R-IN) and other lawmakers, including Rep. Steven Rothman (D-NJ), who sponsored their visit. In what the cyclists described as fruitful discussions, they talked about the challenges facing cancer survivors and their caregivers.
Turning Negatives into Positives
The cyclists were frequently overcome with emotion by the stories of the remarkable patients they met. In Pittsburgh, the riders met Michelle, a 22-year-old mother who had undergone a bone marrow transplant for leukemia. Because her immune system had been suppressed, she had not been able to see her 3-year-old son for 3 months. But at the urging of her nurses, she spent about an hour talking with the cyclists.
"We told her our stories and that we'd been in the chemo chair, that we'd been hairless," Hart said. "We'd been where she was, and now we were on the bike ride trying to make a difference in this cancer fight. We encouraged her to stay active and said that every step she took down that hallway would put her one step closer to her son."
The cyclists did lots of listening, as well. As they got up to leave, the young mother embraced one of the riders, Jeffrey Rowe of Knoxville, TN. "She just wept and thanked us all for giving her the courage and the hope to go forward in her treatment. Attitude is everything—it's one of the Lance Armstrong Foundation manifests," Hart recalled.
Special Issue of the NCI Cancer Bulletin on Survivorship
Treating the Whole Person: Meeting the Emotional and Social Needs of Cancer Patients and Their Families
Rowe is a professional speaker who survived brain cancer at age 17. When he signed on to the tour last spring, he was excited to mark his upcoming 20th anniversary as a cancer survivor on the ride. But in July doctors found two new tumors. For Rowe, the meaning of the ride changed, and he focused more than ever on turning negatives into positives. He was hopeful that by sharing his own experiences with cancer he could help patients like Michelle avoid some of the struggles he had endured.
Focusing on Survivors
Hart was in the midst of chemotherapy when she came up with the idea for the Spokes of Hope tour. A former nurse who had raced bikes for nearly 3 decades and also coached, she was looking ahead to the day when she'd be back riding. She approached members of Cyclists Combating Cancer at a gathering for cancer survivors and advocates sponsored by the Lance Armstrong Foundation in July 2008.
More than a year later, as a final stop before reaching the Capitol, the cyclists visited the NIH campus in Bethesda, MD, where they toured the Clinical Center and gave a presentation to NCI officials. They also heard about the latest research on the complex health and psychosocial issues facing some 11.4 million cancer survivors in the United States.
"Being cancer-free does not mean being free of cancer," Dr. Julia Rowland, director of NCI's Office of Cancer Survivorship, told the cyclists. "It's not over when it's over." Cancer treatments can have long-term and late-occurring side effects, and survivors need to have their health monitored over time. The goal, she added, is not just to live longer but to ensure that a person has a high quality of life after a cancer diagnosis. She praised the cyclists as shining examples of the remarkable resilience of cancer survivors.
Researchers have not quantified the benefits of cycling after a cancer diagnosis, but the riders in the room did not need a study to validate their experiences.
"I have no doubt that I'm alive today because of cycling," said Dr. Kenneth Youner, a retired gastroenterologist from New Jersey who was diagnosed with kidney cancer in 2003. He was taking sunitinib (Sutent) for a recurrence during the tour. A former marathon runner and longtime cyclist, he said that regular exercise had helped him come back from aggressive treatments that left him unable to get out of bed. He was riding in honor of his wife, Cecile, who died of cancer last year.
Online Tool for Creating Survivorship Care Plans Evaluated
A new survey has found that cancer survivors and health care providers were willing to use an online decision-making tool called OncoLife to create survivorship care plans and were satisfied with the information provided, according to a report in the Journal of Medical Internet Research. The Institute of Medicine recommends survivorship care plans for all cancer survivors.
"You Are My Sunshine"
With bright yellow jerseys and Livestrong wristbands, the cyclists were often stopped on the street. Upon learning about the ride, a woman in Pennsylvania asked the cyclists to visit a friend who had just come home after a bone marrow transplant and was despondent.
When the cyclists arrived at the woman's house, she came to the door wearing an isolation mask. As she looked out at the people and bikes assembled on her lawn, the friend said, "I have brought you a gift." With that, the cyclists started to sing, "You Are My Sunshine." Everyone then held up three fingers and shouted "three," because that was the friend's symbol for I Love You.
"The woman smiled and cried, and we could tell by her eyes that she had been touched," said Hart. After the woman went inside, her friend turned toward the cyclists and went from being almost giddy to breaking down and sobbing. Hart embraced her and realized that the song was also a gift for the friend.
"Friends and family feel so helpless when a loved one is faced with cancer, and they often don't know what they can do," Hart said. "Sometimes even the smallest gift—even just to see a loved one smile—is the most precious gift anyone could give."
A Final Ride
The song and "3" became themes of the trip. When the group reached the Capitol, they carried armloads of signed banners into the building along with several bikes.
After clearing the security checkpoint, Dr. Youner hopped on his bike and rode down the hallway. He may not have been the first citizen to ride a bike in the Capitol, but he certainly was the first to do so in socks with the words "Cancer Stinks" written across the bottom.
Afterward, he said with a smile, "I couldn't resist."
—Edward R. Winstead
The White House has issued a presidential proclamation designating October National Breast Cancer Awareness Month. As the federal government's leading funding institution for cancer research, NCI supports a wide range of research to improve breast cancer prevention, detection, and treatment. NCI also funds research on follow-up care for the growing number of breast cancer survivors. Learn more about recent advances and selected resources on NCI's Web site.
NCI's Division of Cancer Control and Population Sciences (DCCPS) has launched CC Publications, a searchable database that includes information on publications authored by the division's staff, grantees, and contract-funded investigators. The database, which currently includes publications from 2005 to 2007, demonstrates the depth and breadth of recent research funded by DCCPS. CC Publications was developed to facilitate literature reviews, share information on the state of the science, communicate the return on investment to NCI stakeholders and constituents, and help researchers identify gaps in knowledge in order to write novel grant applications.
The Health Disparities Calculator (HD*Calc) is a new statistical software program designed to generate data summaries to evaluate and monitor health disparities (HD). HD*Calc can be used as an extension of SEER*Stat, which allows users to easily import Surveillance, Epidemiology, and End Results (SEER) incidence data and National Center for Health Statistics mortality data. Alternatively, on its own, it can be used with other population-based health data. HD*Calc allows researchers to use a range of HD measures and tests them in different situations.
Cross-sectional and trend data (e.g., cancer rates, survival, stage at diagnosis) categorized by disparity group (including socioeconomic status, race, ethnicity, and geographic area) can be used with HD*Calc to generate 11 summary measures of disparity. Several of these measures are not commonly used to evaluate cancer-related health disparities. The output is presented in both tabular and graphic formats allowing users to specify different conditions and formats, and the tables and graphs can be exported from the program. In addition to summary measures, HD*Calc also allows users to explore underlying trends in the data. Tutorials available on the Web site allow users to gain experience with the software.
The application extends the work published in the NCI Cancer Surveillance Monograph Series entitled Methods for Measuring Cancer Disparities, which evaluates measures of health disparities included in HD*Calc.
NCI has announced the recipients of its new Cancer Clinical Investigator Team Leadership Award:
Dr. Jordan Berlin, Vanderbilt-Ingram Cancer Center
Dr. Jeffrey Clark, Dana-Farber/Harvard Cancer Center
Dr. Steven Devine, Ohio State University Comprehensive Cancer Center
Dr. Jeffrey Lancet, H. Lee Moffitt Cancer Center & Research Institute
Dr. Robert Maki, Memorial Sloan-Kettering Cancer Center
Dr. Wells Messersmith, University of Colorado Cancer Center
Dr. Julian Molina, Mayo Clinic
Dr. Melanie Royce, University of New Mexico Cancer Center
Dr. Christopher Ryan, Oregon Health & Science University
Dr. Melanie Thomas, Hollings Cancer Center
Dr. Antonio Wolff, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Designed for midlevel clinical investigators, the awards provide recognition and funding for those who lead cancer research programs at academic cancer centers. Eleven clinical investigators are being recognized for their exceptional contributions to the advancement of effective new therapies through their collaborative team science approach within NCI-funded clinical trials. The 2-year award provides investigators with partial salary support for their leadership roles in clinical trials at NCI-designated cancer centers.
The awards are the result of one of the recommendations of NCI's Clinical Trials Working Group (CTWG), which was established to advise the institute on methods to improve and enhance the publicly funded clinical trials enterprise. The goals of the awards are to offer support and provide academic recognition to investigators who promote collaborative team science. The broad clinical trials community, including the Clinical Trials and Translational Research Advisory Committee and the American Society of Clinical Oncology, provided input into the development of this award.
"We are truly excited to be able to recognize these key clinical investigators without whom we couldn't conduct clinical trials," said Dr. Sheila Prindiville, director of NCI's Coordinating Center for Clinical Trials, the office that oversees implementation of the CTWG's recommendations. "These recipients have exceptional leadership skills in cancer clinical trial activities and have demonstrated a commitment to conducting cancer clinical trials that promise to advance care for patients."
The initial phase of the program funds 11 awards of $50,000 in each of the next 2 years. The funding is provided to the recipient's institution and can be applied toward the investigator's salary, fringe benefits, and associated facilities and administrative costs. Recipients are expected to devote 10 to 15 percent of their time to the activities associated with the award.
The awards are a new source of funding to support clinical research for those leading NCI-sponsored clinical trials who are not principal investigators, a group that tends to be overlooked by funding opportunities and recognition.
The awards, available to investigators at all NCI-designated cancer centers participating in NCI-funded collaborative clinical trials, ultimately support a shared culture in which investigators collaborate freely across disciplines, institutions, and programs to most expeditiously advance the design and conduct of cancer clinical trials.
Learn more about how NCI is restructuring the national cancer clinical trials enterprise online.
Last week, NCI Director Dr. John E. Niederhuber announced plans to use funds from the American Recovery and Reinvestment Act to support the NCI Community Cancer Centers Program (NCCCP). A Request for Proposals (RFP) has been posted online to add approximately 14 new sites and another RFP will be posted on FedBizOpps later this week to enhance work at existing NCCCP sites.
The NCCCP is a pilot program that has formed a national network of community cancer centers to expand cancer research and deliver the most advanced cancer care to people in the communities where they live. Started in 2007, the NCCCP involves 16 community hospitals located primarily in rural, small-town, and underserved urban areas in 14 states.
To explore how NCI-designated cancer centers can implement partnerships with hospital-based community cancer centers using the NCCCP model, approximately half of the awards will be made to NCI-designated cancer centers in partnership with freestanding community hospital cancer centers; the remaining awards will be made to freestanding facilities. NCI will also allocate funds to current NCCCP hospitals for 2 years for 18 specific projects encompassing clinical trials, disparities, community outreach, biospecimen collection, electronic health records, quality of care, partnerships with state cancer plans, communications, survivorship, and palliative care.
Questions about the RFPs should be addressed to Roger Lewis.
Dr. Lin He, a cancer researcher at the University of California, Berkeley, received a 2009 MacArthur Fellowship for her work studying how microRNAs are involved in converting normal cells into cancer cells by interrupting the p53 tumor suppressor mechanism, which normally stops replication or induces suicide in cancer cells.
Dr. He earned her Ph.D. at Stanford University in 2003, completed her postdoctoral fellowship at Cold Spring Harbor Laboratory in 2007, and joined the faculty at UC Berkeley in 2008.
MacArthur Fellowships are awarded each year to approximately 20 or 30 people "who have shown extraordinary originality and dedication in their creative pursuits and a marked capacity for self-direction," according to the fellowship program Web site.
MacArthur Fellows receive unrestricted quarterly research subsidies totaling $500,000 over the course of 5 years—money that is viewed as "an investment in [the recipient's] originality, insight, and potential," rather than a reward for past accomplishments. Fellows are nominated by peers in their respective research fields and selected by a committee comprising leaders in the arts, sciences, humanities, and for-profit and non-profit sectors.
Dr. Thomas Waldmann, chief of the Metabolism Branch in NCI's Center for Cancer Research, was one of nine public servants who received a Service to America Medal on September 23. Dr. Waldmann received the Career Achievement Medal for cutting-edge discoveries made during his 52-year career. He joined NCI in 1956 and has been chief of the Metabolism Branch since 1973. Dr. Waldmann studies the IL-2/IL-2 receptor system in the growth of normal and neoplastic cells. His work has led to effective treatments for previously fatal forms of T-cell leukemia, Hodgkin lymphoma, and multiple sclerosis.
The Service to America Medals program honors the best in the federal workforce and works to inspire a new generation to consider public service careers by sharing recipients' stories with the general public. Winners were nominated by colleagues familiar with their work and selected by a committee that included members of Congress, journalists, a university president, and leaders of several prominent philanthropic organizations. Nearly 400 nominations were submitted for medal consideration this year.
The Fellows Award for Research Excellence (FARE) awards ceremony was held this afternoon to recognize outstanding scientific research by intramural fellows at NIH. Seventy-one of this year's 236 winners are fellows from NCI's Center for Cancer Research, Division of Cancer Control and Population Sciences, and Division of Cancer Epidemiology and Genetics.
Each winner received a $1,000 travel award to present their research at a scientific meeting during FY 2010 and was asked to serve as a judge for the following year's competition. FARE winners will present posters on their research during the NIH Research Festival, being held October 6–9 on the NIH main campus.
The annual NIH-wide FARE competition is sponsored by the NIH Fellows Committee, Scientific Directors, NIH Office of Research on Women's Health, and NIH Office of Intramural Training and Education.
A complete list of the 2010 FARE award recipients can be found online.
The President's Cancer Panel held the first meeting of its 2009–2010 series, "America's Demographic and Cultural Transformation: Implications for the Cancer Enterprise," on September 22 in Seattle, WA. The panel heard testimony from a variety of experts in health demography, biostatistics, and social justice, including public health professionals, research scientists, physicians, and community advocates.
The panel explored the effects of a rapidly changing population on cancer care in the United States. Growing minority populations, particularly in Hispanic groups, and the disappearance of a majority group were widely predicted by experts. The speakers focused particularly on health disparities that exist across race, socioeconomic status, and education level, and noted that underserved populations are disproportionately minority, impoverished, and undereducated. They also acknowledged that health disparities will persist as long as underlying social injustices of poverty and racism continue. The panel will consider speaker recommendations in writing their 2009–2010 report to the President. The panel will continue to hear testimony on the effects of the changing U.S. population on cancer care and research at three future meetings:
October 27, 2009 - Los Angeles, CA
December 9, 2009 - Wilmington, DE
February 2, 2010 - Miami, FL
NCI's Small Business Innovation Research (SBIR) Development Center will sponsor the first NCI SBIR Investor Forum on November 5 at Boston University. The event is designed to connect investors and strategic partners with the most promising SBIR companies developing breakthrough discoveries that are primed for commercialization. These innovative developments will be the next generation of cancer therapeutic, imaging, diagnostic, and other important technologies in the fight against cancer.
This full-day conference will feature the top 10 to 15 NCI SBIR companies focused on innovative research in cancer-related technologies, private breakout sessions to explore prospective partnerships, opportunities to discuss upcoming funding and opportunities with NCI SBIR Development Center staff, and a networking reception with leaders in the life sciences and medical technology arena to foster new collaborations.
Registration is free, but seating is limited. For more information, go online or contact Deepa Narayanan or Patti Weber.

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Diamonds, and a New GC, Are Tiffany's Best Friend
The luxury goods company promotes from within an associate GC who came from Cravath in 2012.
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A new face will welcome students at Harper Elementary when school opens for the 2012-2013 school year.
Janene Ashley was named Harper Elementary school's principal at the Webster Parish School Board meeting last night.
"Janene Ashley is a fantastic person," WPSB superintendant Steve Dozier said. "She is extremely friendly and competent. Everything she has done has been of the highest quality and she is of exceptional character."


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In pure crisp linen, this smart 2 button blazer jacket is the perfect pick for formal occasions. Part of Kids' Autograph, a luxurious collection of beautifully designed clothing in high quality fabrics with superior finishing details. Kids' Autograph gives a stylish well-dressed look.
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This report highlights the impact of shale-based natural gas on the North American plastics market and features an in-depth analysis of production trends in the United States during 2013 and a forecast for 2014 and beyond.Learn more
This in-depth report analyzes economic and market trends, legislative/regulatory activity impacting supply and demand, business opportunities and threats, materials pricing, manufacturing technology, as well as growth strategies being implemented by thermoformed packaging companies.Learn more
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Plastic pipe will post the strongest gains through 2018, continuing to take market share from competing materials in a range of markets.
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- Polly Bergen Dies at 84; Emmy-Winning Actress
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- The TV Watch: 'Madam Secretary' and 'The Good Wife,' TV's Mighty Women
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- ArtsBeat: Moyers Says Show Really Is Ending This Time
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(RNN) - The National Rifle Association released a new commercial calling President Obama an "elitist hypocrite" for being resistant in the placement of armed guards in schools when his daughters have U.S. Secret Service protection at theirs.
"Are the president's kids more important than yours?" a narrator asks. "Then why is he skeptical about putting armed security in our schools when his kids are protected by armed guards at their schools? Mr. Obama demands the wealthy pay their fair share of taxes, but he's just another elitist hypocrite when it comes to a fair share of security."
The 35-second ad, released Tuesday night, is being aired on the Sportsman Channel and is also posted on the NRA's "Stand and Fight" website.
"Stand and fight sums up what Americans need to do to preserve our Second Amendment freedom," NRA spokesman Andrew Arulanandam told CNN.
According to CNN, The NRA is not ruling out expanding to air the commercial elsewhere.
The president unveiled his new gun control proposals Wednesday.
He is calling to ban assault weapons, ban high-capacity magazines, background checks to be done on all buyers, more funds for mental health care and more support for school security.
Obama issued a total of 23 executive actions to prevent gun violence that do not require congressional approval.
The move comes after the Dec. 14 massacre at Sandy Hook Elementary School in Connecticut that killed 20 children and six teachers.
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Clarion University Libraries Reserve Policy
Library reserves provide faculty with an opportunity to make supplementary course materials available to students. The Libraries offer both traditional in-library and electronic reserve options. Faculty members are encouraged to use E-Reserve services (when possible) using the E-Reserve Guidelines.
E-Reserves provide convenient access to reserve materials regardless of user location or time of day. For books, as well as some types of media, traditional course reserves may be the most appropriate option.
Clarion University Libraries use the Fair Use Doctrine (17 USCS § 107/108 of the U.S. Copyright Law) as the guiding principle for library reserves copyright compliance. The Libraries will evaluate requests for additions to the reserves system in terms of compliance with fair use. In the event that compliance is unclear, it may be necessary to acquire copyright permission prior to adding materials to the reserve file.
Placing Materials On Reserve
Traditional Reserves
Complete a Library Reserves Request form for each item and include it with the material to be placed on reserve. You will be asked to include complete bibliographic information as well as copyright information for each request.
Please keep in mind that for E-Reserves, the quality of the scanned copy will depend largely upon the quality of the original document. Please provide clean, legible photocopies.
Digital copies may be forwarded as e-mail attachments or submitted on CD, DVD, or USB media. Links to e-books and database articles licensed by the University can also be added to E-Reserve lists in compliance with vendor licensing agreements.
In compliance with copyright guidelines, E-Reserves are password-protected and access is available only to students in the class for which the materials have been placed on reserve. Reserve staff will provide the faculty member with a password to share only with members of the designated class.
Please submit reserve materials at least two weeks before your class needs access to the resources to ensure availability.
Semester End Process
At the end of each semester, all photocopied materials are removed from reserve, library materials are returned to the collection, and personal copies are returned to the professor.
E-Reserve materials are deactivated at the end of the semester, but may remain on the server for future use for up to two years. It may be necessary to obtain copyright permission before materials can be reactivated for another semester.
Materials That May Be Placed On Reserve
• Circulating copies of materials owned by the library (books, DVDs, videos).
• Photocopies of journal articles, book chapters, essays, and graphs provided that...
...the photocopied portion constitutes a small part of the overall work. (Generally this is interpreted as one book chapter or essay, and no more than one article per journal issue.)
...a copy of the title page and page displaying copyright information is included with each photocopy.
...copyright permission has been received for materials placed on reserve in previous semesters. Photocopies used more than one semester require copyright permission. The Library will assist with securing permissions; however, it may be necessary to remove materials from reserve if the cost of permission is prohibitive.
• Digital materials and links to database articles licensed by the University in compliance with publishers' licensing agreements.
• Personal copies of books and media* supplied by the faculty member that satisfy copyright guidelines.
• Lecture notes or assignments supplied by the faculty member. (Note: Work completed by students must meet both copyright and privacy guidelines. Submitted materials must not include the student's name. A release statement signed by the student must accompany the materials.)
• Public Domain works (works created before 1923 or published without a copyright notice for 1923-1977).
*The library cannot assume responsibility
for loss or damage to personal materials placed on reserve.
Materials Generally Not Appropriate for Reserve
· Bound volumes of periodicals
· Reference collection materials
· Books or media obtained via Interlibrary Loan
· Course packs
· Consumables (workbooks, standardized tests, etc.)
Last Updated: October, 2010
Send your comments about this page to the Libraries.


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Everywhere is Easy
Learn more about our free apps
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This culturally vibrant city has much to offer for the visitor, either long term or tourist. Kansas City shines in arts, upscale shopping and local cuisine. With plenty of pet friendly Kansas City hotels, traveling couldn't be easier with your four-legged friend.
Start out your visit with one of Kansas City's main attractions: its fountains. With more than 40 public water works, ranging from classical to modern, minimalist to ornate, get lost in these public venues spread out all over town. Pick up a map and discover hidden fountains scattered around downtown and in the shopping district of Country Club Plaza.
If you are looking for a vast array of entertainment, head over to the historic 18th and Vine Jazz District, where history buffs can get their fill. Known throughout the world as the birthplace of jazz, this district has hosted legendary performers such as Ella Fitzgerald and Joe Turner. It is home to The American Jazz Museum and The Blue Room Jazz Club, where regular performances are hosted. But make sure to come hungry and have a bite (or two) of Kansas City's famous spicy barbecue at various restaurants within the same district.
Take a walking tour around Westport located in the heart of Kansas City. This historical walk can be done by yourself with a map and in the company of your four-legged friend. This tour highlights historical cemeteries, Civil War sites and other KC buildings.
End the day with a peaceful stroll at Penn Valley Off-Leash Park around their 2.7 acres double-gated dog park. This park also offers a 130-acre recreation area suited with an exercise trail, playing fields and photo opportunities by the lake.
Whatever your itinerary holds, Kansas City awaits you. IHG's Kansas City pet friendly hotels will make sure you are comfortable and equipped with all the amenities you and your companion have come to rely on.
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To book more than 9 rooms for one stay or request a quote, please use our Easy Meetings tool or call 1-800-MEETING (in United States, Mexico and Canada).


text: I've never dealt with constipation during pregnancy before or really ever (except after morphine). This might be from the Zofran I started a few days ago but I can't stop taking that. What have you all done? What can I take before things get really bad? I do plan on upping my fiber but that could take a week before impacting anything.


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Welcome to MySmartBuy.com, the home of great value, practical products all designed to make your life easier. We understand that some tasks and pastimes, whether they are in the garden, home or on the move can cause issues. But with the right products, it is possible to complete these tasks with the minimum amount of hassle, giving you more free time to enjoy. At MySmartyBuy.com we only source products that solve real world problems. No matter how big or small, you can be certain that our products will be the best solution to your needs and will always be great value for money. Read More
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(The same applies if you have arrived by another mode of public transport though getting onto Shotover Street will vary depending on where you are dropped off. It will almost always be a central locaion.)
Driving from the airport:
Head southeast onto Frankton Rd/State Highway 6A signposted Queenstown. Continue to follow signs to the Town Centre. Continue straight along Shotover Street (the main street through Queenstown) until the road bends round to the right and becomes Lake Esplanade. A few hundred metres along the lake you will see Lakeside Backpackers on the right hand side.
Bumbles Backpackers Queenstown
Queenstown, New Zealand Youth Hostels
If you are looking for a small, relaxed & friendly place to stay in Queenstown with spectacular views and a waterfront location, this is it! There's free Wi-Fi, free use of our cruiser bikes & a friendly team to welcome you....
Starting at 32 Per Night
Hippo Lodge
Queenstown, New Zealand Youth Hostels
Our small, friendly hostel with fabulous views can transform your stay from a good one to a great one!...
$25 Per Night
Haka Lodge Queenstown
Queenstown, New Zealand Youth Hostels
Come and stay at true backpacker luxury. Everything at our Backpacker Lodge is up market from flat-screen...
$24 Per Night
Absoloot Value Accommodation
Queenstown, New Zealand Youth Hostels
Absoloot Value Accommodation is spectacularly located on the lakefront right in the heart of Queenstown....
$23 Per Night
Adventure Queenstown Hostel
Queenstown, New Zealand Youth Hostels
Located in the heart of Queenstown with fantastic sunny balconies, comfy beds and plenty to do!...
$23 Per Night
Nomads Queenstown
Queenstown, New Zealand Youth Hostels
Brand new Nomads Queenstown is backpacking in Style. This fantastic new property is newly open, receiving rave reviews and will be the best hostel in New Zealand with a fantastic location just meters away from the lake in central Queestown....
$23 Per Night
Southern Laughter
Queenstown, New Zealand Youth Hostels
Welcome to Southern Laughter Lodge, Queenstown New Zealand, warm and friendly backpacker accommodation in the heart of the adventure capital of New Zealand....
$23 Per Night
Bumbles Backpackers Queenstown
Queenstown, New Zealand Youth Hostels
If you are looking for an affordable, relaxed & friendly place to stay in Queenstown with spectacular mountain views & a waterfront location, this is it! We're only 300m from the buzz of downtown Queenstown, just far enough away for some peace and qu...
$26 Per Night
Yha Queenstown Lakefront
Queenstown, New Zealand Youth Hostels
YHA Queenstown is a modern, fully equipped hostel with magnificent views across Lake Wakatipu to the Southern Alps......
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Base Queenstown
Queenstown, New Zealand Youth Hostels
Welcome to Queenstown - the adventure capital of the world! Base Queenstown sets the standard in Queenstown's budget accommodation with amazing alpine and lake views....
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AJ Hackett Bungy Queenstown
Queenstown, New Zealand Bungee Jumping
AJ Hackett Bungy is the world pioneer of commercial Bungy Jumping. It all started in Queenstown, New Zealand in 1988, and since then they have become an established World Leader in the Tourism Industry. Bungy jumping is a must do in NZ!...
Starting at 150 Per Person
Mountain bike Heli bike-Fat Tyre New Zealand
Queenstown, New Zealand Bike Tours
Heli bike and Mountain biking. Over twenty trails. Free ride, Single track and Cross country, late model full suspension bikes. Single and Multi day trips, Real New Zealand Mountain Biking experience. Heli-bike options include a 5 day Heli everyday...
$134 Per Night
Hang gliding and Paragliding
Queenstown, New Zealand Paragliding
Learn to fly with Extreme Air Queenstown, paragliding & hang gliding school. We run day course through to full pilot license course. We operate in Queenstown, New Zealand. Please check out Extreme Airs web page, email as for booking on our web page...
Starting at 250 Per Trip
Kiwi Dundee Adventures Ltd. New Zealand
Coromandel, New Zealand Eco Tours
Doug & Jan are two fun loving genuine 'Kiwi' Guides.Doug Johansen is regarded as one of NZ's foremost guides with a wealth of knowledge on the natural world. His feats earned him the 'Kiwi Dundee' title in 1988, the Queens medal for services to Natur...
Starting at $230 Per Person
Queen Charlotte Wilderness Park
Marlborough, New Zealand Eco Tours
Private native wildlife sanctuary and island in the beautiful Marlborough Sounds. Miles of private walking tracks, beaches, gold mines, scuba, snorkelling, fishing, wilderness, nature....
$100 Per Night
Bush & Beyond guided conservation walks
Kahurangi Park, New Zealand Wildlife & Safari Tours
The original operator in Kahurangi National Park. New Zealand's most diverse wilderness park. Largest variety of plant species, rare birds and scenery from alpine to coastal. Trips 1 to 8 days, all ages and fitness levels....
$105 Per Trip
Queenstown Wine Trail - wine tours New Zealand
Queenstown, New Zealand Wine Tasting
First time tasters or wine connoisseurs join us for a full afternoon of wine tasting, just a short journey from Queenstown this relaxed personalised tour takes in a selection of our finest boutique wineries. Operating daily deparures at 12.30pm....
Starting at 129 Per Person
Study English in New Zealand
Hamilton, New Zealand Language Schools
Study English in New Zealand at Waikato Institute of Education. A wide range of quality courses and programmes including General English at 6 levels (academic and general), IELTS Preparation, English for High School, Summer & holiday programmes...
Starting at 340 Per Week
Rainforest, Nature Retreat, Unique accomodation
Bay of Plenty, New Zealand Health Spas & Retreats
In Native Rainforest, Mount Tutu Eco-Sanctuary is Eco-Lodge, Nature Retreat/Bird Sanctuary-has 3 cosy whare/ensuite. Guests receive Glow-Worm tour, enjoy Bush Walks, feed unique Mount Tutu Sheep, & enjoy expansive woodland/water gardens. Full B/fast...
Starting at 150 Per Night
Exclusive helicopter excursions in New Zealand
Queenstown, New Zealand Scenic Flight Tours
"An experience of a lifetime" Over The Top specialises in exclusive and personalised helicopter tours from Queenstown throughout Fiordland and New Zealand. The company operate an exclusive fleet of helicopters in unique and remote locations....
$100 Per Person
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Alpha Protocol PC DRM Explained, Will Be Removed EventuallyPublisher Sega has explained the ins and outs of the 'Uniloc: SoftAnchor' DRM scheme chosen for Obsidian Entertainment's espionage RPG Alpha Protocol, covering what it means for players and revealing plans to eventually remove the DRM altogether.
Uniloc: SoftAnchor will allow five active installations of Alpha Protocol at any given time, which can be deactivated either by uninstalling them or via a website. Online activation will be required only when the game is first installed, with the option to activate by "saving a file and transporting it to the computer that does have web access."
"We take your rights as a consumer very seriously, so we will provide a version of the game without license management (available as a patch) in around 18-24 months after release," assures Sega. "We can't be specific about the exact date due to business factors, but rest assured that we will provide an unprotected patch."
Alpha Protocol is slated for a PC, Xbox 360 and PlayStation 3 release on June 1 in North America, after hitting Australia on May 27 then Europe on May 28. As ever, retailers are offering their own exclusive pre-order bonuses, including in-game weapons and items.
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By Hollywood.com Staff, Hollywood Staff
As Blockbuster announced on Wednesday that it would be closing down its remaining 300 stores, we are brought to memories of our evenings strolling through those vaguely damp aisles, considering which backup VHS to rent because, somehow, they still haven't gotten that copy of *batteries not included back yet. Blockbuster was a special thing to many of us who grew up in the '90s, offering unique experiences and ushering us into new kinds of movies. Here are a few of our recollections...
Julia EmmanueleI went on my first sleepover when I was in the fifth grade. My mother wasn't a big fan of them - she claimed that it was because she never experienced one growing up, and therefore didn't see the point, but I always suspected it was because she thought I would embarrass her if left to my own devices - and so it was a big deal for her to allow me to spend the night at my friend's house. As we waited for the pizza to be delivered, we stopped at our local Blockbuster to pick out some movies to watch, and as we combed the aisles for something we could agree on, she came across the first Scary Movie.
My friend had older brothers who had seen and loved the film, and so she was determined to see it too. She picked it up, along with two or three other, more age appropriate films, and told me that her father would never notice when he went to check them out. It didn't take much for her to convince me to go along with her plan, and she was proved right when her father wordlessly handed over the stack of movies to the clerk, along with his own picks. We waited until her parents went to bed to break out the film, which was filled with jokes we didn't understand because we were far too young. But we had a great time anyway, feeling like rebels for eating candy and watching and R-rated movie at midnight. (I was a very uncool child.) However, my joy was short-lived because when I returned home, I promptly told my older brother all about the movie I had seen the night before in an attempt to show off. Of course, my mother eventually found out about my tiny act of rebellion, and promptly banned me from any more sleepovers, on the basis that she couldn't trust that I wouldn't do the same thing again. So, thank you Blockbuster, for teaching me to think twice before I brag about breaking the rules.


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"My sister ran into the room, and she's like get in the bathroom," said Anthony Clousurdo, who was asleep inside his home. "Once I came into the bathroom, we heard the whole house shake. I guess the trees fell on, and then we looked out the bathroom door and we could just see outside and it was nuts."Huddling in the bathroom, somehow Clousurdo and his family were not crushed by four massive trees that came crashing down and smashed their mobile home like a tin can.A strong storm blew through Chesterfield's Fairchild Lake mobile home community off 22 Mile in the blink of an eye."I can't believe there was no sirens or anything. We didn't hear nothing," Clousurdo said."I was on the phone and, all of a sudden, I hung up and I heard a crash and everything came off of my walls, all the pictures, glass shattered all over, and then the whole paneling came off inside and scared the heck out of me," said Joann Awe.It didn't take long for a Macomb Township couple, who usually watch storms from their garage on Birch Crest Drive, to run for cover."The winds picked up to unbelievable speeds. The tree came down on the car. The tree over here went down and shingles off the roof flying across the street, and it was time for us to get downstairs," said Greg Nakoneczny.There was no rhyme or reason to the wicked waves of storms that kept coming Tuesday evening. Macomb County was hit the hardest. Several houses were hit by lightening, power lines down leaving thousands without electricity and flash flooding.Now the cleanup begins, and its helpful residents like Al Pauli with his tractor working with his neighbors to clear the debris."It's fun. I like doing it and it's the Good Samaritan thing and just the right thing to do," he said.As for the Clousurdo family, we're told the leasing office has moved them to another mobile home in the community.
WJBK-TV | Fox 2 16550 West Nine Mile Rd.Southfield, MI 48075Main Station: (248) 557-2000Newsroom: (248) 552-5103


text: Information contained on this page is provided by NewsUSA, an independent third-party content provider. WorldNow and this Station make no warranties or representations in connection therewith.(NewsUSA) - The vast majority of the 65 million Americans who live in condominiums and homeowners associations are satisfied with their communities, according to a national survey conducted by Public Opinion Strategies for the Foundation for Community Association Research.