Migraine Sufferers Appear to Have Reduced Risk of Breast Cancer

Almost everyone gets headaches at one time or another, but for millions of Americans who have migraines, they are more than just an occasional annoyance; they are often disruptive and debilitating. The pain is a severe throbbing on one or both sides of the head that can last for hours, or even days, and is often accompanied by nausea, dizziness, and sensitivity to light, sound or smells. But scientists say there is a bright spot for women who suffer these disabling headaches, and it’s not an aura.

A new study, led by Dr. Christopher I. Li of Fred Hutchinson Cancer Research Center in Seattle, comparing data on more than 9,000 women revealed that women with a history of migraines have a 26 percent reduced risk of breast cancer. This held true regardless of the woman’s menopausal status, age when she was first diagnosed with migraines, whether she used prescription medications for her headaches, or what triggers she might have been avoiding. These findings confirm a previous study reported last November, also by Li and his team, which found a 33 percent lower breast cancer risk among women with migraines. “This research suggests that women with migraine may have a lower risk of breast cancer,” said Li, adding that it could lead to a new way of understanding how breast cancer works. “If we can better understand what the biological mechanisms are, that could open new avenues for research into breast cancer prevention.”

While the researchers aren’t sure exactly why women who get migraines appear to have a reduced breast cancer risk, they suspect that hormones, estrogen in particular, are a likely explanation. “It’s pretty clear that migraine, like breast cancer, is a hormonally related disease,” Li said. “Many triggers for migraine are also things that reduce estrogen levels.” On the other hand, increased levels of estrogen are known to boost the risk for breast cancer, therefore it’s “biologically plausible” that migraine sufferers would be less prone to breast cancer.

The researchers say increased use of non-steroidal anti-inflammatory drugs (NSAIDS), such aspirin, ibuprofen and naproxen, by migraine sufferers could also explain some, but probably not all, of the reduction in breast cancer risk. A recent analysis of several studies showed a link between NSAID use and a 12 percent lower breast cancer risk. “Further work is needed to resolve what accounts for this relationship,” the researchers concluded.

Li added that women with migraines should “still have the same breast cancer screenings and follow-up,” and recommendation echoed by Dr. Michael Kraut, director of oncology at Providence Hospital in Southfield, Michigan. “The reduction in breast cancer risk in this study was about one-quarter, but it doesn’t eliminate the risk, so women still need to be on the lookout.”

Kraut also agrees that the link between migraines and breast cancer risk is likely a hormonal one. “The theory they propose here is that women who have migraines may have drops in estrogen levels that trigger migraines. And women who have sustained, increased levels of estrogen have a higher risk of breast cancer,” he said “This looks like one more piece of evidence that prolonged high levels of estrogen are dangerous.”

Li and team are now onto the next step—they are contacting women from the previous studies in hopes of learning more about the effects of different kinds of migraines. “We’re trying to understand what are the types of migraine that are most related to reduction in breast cancer risk,” Li says.

The study appears in the July issue of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

H1N1 Flu Vaccinations Could Begin in October

Since the H1N1 flu emerged in March in Mexico and Southern California, the virus has infected an estimated 1 million Americans, killing 170, and is still spreading, despite the summer’s heat and humidity, which influenza usually cannot tolerate. This persistence makes the virus’ resurgence in the fall all but certain and leaves little time to prepare. “We have a little bit more than a month ... to get our acts together,” Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention said during a summit at the National Institutes of Health in Bethesda, Maryland on Thursday, where officials announced their game plan to deal with the threat, including the vaccination schedule and the target populations. About 500 state and local health officials were in attendance, as was President Barack Obama, who took time from his G-8 summit in Italy to join by teleconference.

Health and Human Services Secretary Kathleen Sebelius said if all goes well, H1N1 vaccinations could begin by mid-October, and while officials have not yet decided exactly which age groups will be recommended to get the vaccine, school-age children, young adults with risky conditions such as asthma, pregnant women, and health workers are likely to be among the first in line. But the timetable is largely dependent on the outcome of studies with experimental vaccine batches that are set to begin the first week of August. Sebelius said that as soon as the vaccines were approved and available, the federal government would purchase them from the manufacturers and share them free among the states, which must then “try and get this in the arms of the targeted population as soon as possible.”

Sebelius acknowledged that this fall is likely to be a confusing season, with doctors’ offices, clinics, grocery stores and drug stores dispensing doses of regular seasonal flu vaccine as well as the H1N1 vaccine, which will probably have to be given in two separate inoculations. Schools and day care centers may also be utilized to mount a mass vaccination program against the H1N1 virus. “Since the population that seems to be most affected is younger folks, school-aged kids, kids in day care centers, we may well partner with the schools, looking at those as possible sites for a vaccination program,” said Sebelius.

Sebelius urged the summit attendees to go home and get schools, mayors and other community leaders to spread that message. “The last thing we want is millions of parents to be surprised” when the get-your-child-vaccinated-at-school note comes home. She also warned against complacency. “What we can’t do is wait until October and then suddenly decide that we have a very serious situation on our hands,” she said.

Sebelius said the federal government will provide $350 million by the end of July to help states develop specific plans for combating the pandemic and to help hospitals brace for a surge of demand. “We want to make sure we are not promoting panic but we are promoting vigilance and preparation,” Obama told the gathering. “We may end up averting a crisis. That’s our hope.”

Many other issues have yet to be hammered out, such as guidelines for closing schools where infected students are found, and how to keep students learning if schools are closed for extended periods. And an even bigger problem: When schools close and working parents must stay home, or when workers get sick and don’t get paid for time off. Usually, they go to work despite their illness, spreading infection to co-workers. “How are we going to assist people who don’t have benefits?” asked Paul Jarris of the Association of State and Territorial Health Officials.

Homeland Security Secretary Janet Napolitano said she is currently working with the Labor Department to address that question, and she urged employers to make other provisions, such as telecommuting, should H1N1invade their workplaces this fall.

“Trojan Horse” Used to Terminate Cancer Cells

Scientists have long been looking for a better way to fight the battle of cancer, rather than the traditional radiation and chemotherapy treatments, both of which damage healthy cells instead of just the cancerous ones. Now, they might have found the answer with a new treatment they call the “Trojan horse” therapy.

A team of researchers in Australia have developed the new “Trojan horse” therapy to help combat cancer by using a bacterially-derived nano cell to help penetrate and disarm the cell that is cancerous before a second nano cell kills it with the chemotherapy drugs. The “Trojan horse” therapy has the potential to target the cancer cells directly with chemotherapy, rather than the current treatment where drugs are injected into the cancer patient and end up attacking both the healthy and the cancer cells.

The scientists in Sydney, Dr. Jennifer MacDiarmid and Dr. Himanshu Barhmbhatt who formed EnGenelC Pty Ltd in 2001, stated that they have achieved a 100 percent rate of survival in mice with human cancer cells by using the “Trojan horse” therapy over the past two years. They plan to start the clinical trials on humans within the coming months. However, the human trials of the cell delivery system will begin next week at The Austin located at the University of Melbourne and the Peter MacCullum Cancer Center at the Royal Melbourne Hospital.

The therapy, which was published in the latest Nature Biotechnology journal, sees the mini-cells that are called EDVs (EnGenelc Delivery Vehicle) attach and then enter the cancer cell. The first wave of these mini-cells release ribonucleic acid molecules, which are called siRNA, that are used to switch off the production of proteins that make the cancer cell resistant to the chemotherapy treatment. Then, a second wave of the EDV cells are accepted by the cancer cells and release the chemotherapy drugs, in turn, killing the cancer cell.

MacDiarmid stated, “The beauty is that our EDVs operate like ‘Trojan horses’. They arrive at the gates of the affected cells and are always allowed in. We are playing the rogue cells at their own game. They switch-on the gene to produce the protein to resist drugs, an we are switching-off the gene which, in turn, enables the drugs to enter.”

RNA interference, also known as RNAi, is designed to help silence the genes that are responsible for producing disease-causing proteins and is considered one of the hottest areas of biotechnology research. The subject of RNA was the basis of the 2006 Nobel Prize in medicine. Dozen of biotechnology companies are already looking for way that they can manipulate RNA to help block the genes that produce disease-causing proteins that are involved in blindness, cancer or AIDS.

Brahmbhatt said that after the treatment with the conventional drug therapy, a high number of the cancer cells are terminated, however, a small percentage of the cells can produce the proteins that make cancer cells resistant to the chemotherapeutic medications. “Consequently, follow-up drug treatments can fail. The tumors thus become untreatable and continue to flourish, ultimately killing the patient. We want to be part of moving toward a time when cancers can be managed as a chronic disease rather than being regarded as a death sentence,” he stated.

The Nature report said that the mini-cells were well tolerated by the animals that were actively treated with no adverse side effects or deaths, despite the repeated dosing. MacDiarmid said, “Significantly, our methodology does not damage the normal cells and is applicable to a wide spectrum of solid cancer types. The hope is that the benign nature of this EDV technology should enable cancer sufferers to get on with their lives and operate normally using outpatient therapy.”

Study Links ADHD Drugs To Sudden Death In Children

A new study by researchers in the US suggests there may be a link between the use of stimulant drugs for attention-deficit hyperactivity disorder (ADHD) and sudden cardiac death in healthy children, but the US Food and Drug Administration (FDA), who funded the study with the National Institute of Mental Health, said because of its limitations, parents and carers should not stop giving children such medication on the basis of this study but should discuss any concerns with their prescribing doctor.

The study was the work of lead author Dr Madelyn S Gould of Columbia University, New York, New York, and colleagues, and is published in the 15 June issue of the American Journal of Psychiatry.

In the case-control study, using state-based mortality data from 1985 to 1996, Gould and colleagues compared the use of stimulant drugs in 564 healthy children aged 7 to 19 from across the US who died suddenly and most likely due to sudden cardiac disturbance with a matched group of 564 young people who died as passengers in motor vehicle traffic accidents.

The primary measure of exposure was the presence of stimulant medication as noted in the medical examiner records, toxicology reports and death certificates. The stimulants involved were amphetamine, dextroamphetamine, methamphetamine, and methylphenidate.

The results showed that out of the 564 healthy children who died suddenly, 10 (1.8 per cent) were taking stimulants, specifically methylphenidate (better known in the US under its brand name of Ritalin). This compared with only 2 children (0.4 per cent) in motor vehicle accident comparison group, only one of whom was taking Ritalin (methylphenidate).

Logistical regression, a tool commonly used by epidemiologists, showed a statistically significant link between stimulant use and sudden unexplained death in a primary analysis. This result was supported qualitatively in a further "comprehensive series of sensitivity analyses", wrote the authors, who concluded that:

"This case-control study provides support for an association between the use of stimulants and sudden unexplained death among children and adolescents."

"Although sudden unexplained death is a rare event, this finding should be considered in the context of other data about the risk and benefit of stimulants in medical treatment," they added.

In a Safety Communication released on 15 June, the FDA said that:

"The FDA can not conclude that the data in the study affect the overall risk-benefit profile of stimulant medications used to treat ADHD in children."

What they are saying is they are not going to change their advice about the risks versus the benefits of the medication because of the study's limitations, which they say include:

* The significant time lag between when the deaths occurred and when the data was collected.

* The different circumstances around each death that may have affected how well family members and/or carers may have remembered details of any medication the deceased child had been using.

* Sudden unexplained death in a child would be more likely to initiate a post-mortem inquiry than a death due to blunt force trauma in a motor vehicle accident.

* The low frequency of stimulant medication use by the children in both the study and the control groups.

When scientists highlight a study's limitations they are in effect saying that another study looking at the same things might reach a different result if it didn't have those limitations.

With subjects as serious as this, and with parents and carers rightly concerned about what to do about any ADHD medication their children have been prescribed, it is important that research in the service of public health produces results that are robust and reliable, so a small study like this one really needs to be confirmed by more research, preferably with a larger study, especially if there are concerns about its limitations.

In fact, the FDA is already co-sponsoring another larger study that is looking at the link between increased risk of heart attack, stroke and other cardiovascular problems and use of stimulant medication by children, the results of which are expected to come out later this year.

Dr Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research told the press:

"The FDA continues to review drug safety information for stimulant medications used to treat ADHD so that we can give health care professionals and families the most up-to-date drug safety information available."

The federal agency urged doctors to follow the current prescribing information that accompanies the product label, which recommends that young and adult patients being considered for ADHD treatment:

"Work with their health care professional to develop a treatment plan that includes a careful health history for cardiovascular disease in the child and his or her family."

Such preparation should include a physical exam that pays particular attention to the cardiovascular system, and should consider screening tests such as electrocardiogram and echocardiogram, depending on the patient's history and whether it suggests possible risk factors for heart disease.

"Sudden Death and Use of Stimulant Medications in Youths."
Gould, Madelyn S., Walsh, B. Timothy, Munfakh, Jimmie Lou, Kleinman, Marjorie, Duan, Naihua, Olfson, Mark, Greenhill, Laurence, Cooper, Thomas.
Am J Psychiatry, Published online 15 June 2009.
doi: 10.1176/appi.ajp.2009.09040472

Chemotherapy Drug May Improve Appearance Of Sun Damaged Skin, Study

Researchers in the US found that the chemotherapy drug fluorouracil appeared to reduce the appearance of sun-damaged and aging skin as well as the number of potentially pre-cancerous skin patches.

The study was the work of Dr Dana L Sachs, associate professor in the Department of Dermatology at the University of Michigan, Ann Arbor, and colleagues, and is published in the 6 June issue of Archives of Dermatology, one of the Journal of the American Medical Association/Archives journals.

Fluorouracil, which is used in chemotherapy treatment of cancers of the colon, head and neck, pancreas and other organs, stops the body being able to make thymine, a building block of DNA. Researchers studying cancer patients having treatments with fluorouracil have noticed changes in skin appearance and as a result of this the drug was developed as a skin cream to treat potentially pre-cancerous skin patches.

For this study, Sachs and colleagues asked 21 healthy volunteers with sun-damaged skin and lesions to apply 5 per cent fluorouracil cream to the face twice a day for two weeks and regularly examined their skin for molecular and clinical changes during this time and also for another 22 weeks afterwards.

This included taking biopsies, taking photographs and doing clinical evaluations at the start and then at intervals during the treatment period.

19 of the volunteers completed all parts of the study and 20 filled in questionnaires at week 10.

Three dermatologists who were not part of the research team who examined the volunteers during the study were invited to evaluate the photographs which were taken at the end of week 1, 2, 4, 6, 10 and 24 of the study.

The results showed that:

* The number of lesions at the end of treatment was significantly lower than the number at the start of treatment.

* This went down from an average of 11.6 lesions per volunteer to an average of 1.5.

* The clinical evaluation identified overall improvements in aging-related damage.

* This included reductions in wrinkling, dark skin spots, skin that has become darker (hyperpigmentation) and sallowness (when the skin tone goes yellow).

* Skin biopsies taken just after the end of treatment showed an increase in the compounds that are produced when skin is injured and inflamed and when the non-living tissue that acts like a "scaffold" for living skin cells, the extracellular matrix, breaks down.

* After this stage, levels of a collagen precursor called procollagen, appeared to increase (collagen is the main protein in skin and tends to lessen when skin is photo-damaged, also it fragments and degrades as skin ages).

* The treatment was well tolerated and according to the questionnaire they filled in during week 10, 95 per cent of the volunteers rated their skin as improved while 89 per cent said they would be willing to have the treatment again.

The authors concluded that:

"Topical fluorouracil causes epidermal injury, which stimulates wound healing and dermal remodeling resulting in improved appearance. The mechanism of topical fluorouracil in photoaged skin follows a predictable wound healing pattern of events reminiscent of that seen with laser treatment of photoaging."

They noted that patients who receive fluorouracil treatment for skin lesions are likely also to benefit from a reduction in sun-damage, a side-effect that may motivate them to persevere with the "rigorous" treatment. It is also possible that for some patients the drug could have an important role against photo-aging, they commented.

But some patients may not be prepared to endure two or three weeks with the cream on their face or other part of their skin, and then the rather unsightly after effects for several more weeks, while others may be prepared to do it if the cost proves to be much lower than ablative laser resurfacing. For the typical patient the skin gets dry, it itches and peels for several weeks before it recovers and gets softer.

The study was sponsored by Valeant Pharmaceuticals International who make Efudex, the cream that was used.

"Topical Fluorouracil for Actinic Keratoses and Photoaging: A Clinical and Molecular Analysis."
Dana L. Sachs; Sewon Kang; Craig Hammerberg; Yolanda Helfrich; Darius Karimipour; Jeffrey Orringer; Timothy Johnson; Ted A. Hamilton; Gary Fisher; John J. Voorhees.

'You've got to find what you love,' Jobs says

This is the text of the Commencement address by Steve Jobs, CEO of Apple Computer and of Pixar Animation Studios, delivered on June 12, 2005.

I am honored to be with you today at your commencement from one of the finest universities in the world. I never graduated from college. Truth be told, this is the closest I've ever gotten to a college graduation. Today I want to tell you three stories from my life. That's it. No big deal. Just three stories.

The first story is about connecting the dots.

I dropped out of Reed College after the first 6 months, but then stayed around as a drop-in for another 18 months or so before I really quit. So why did I drop out?

It started before I was born. My biological mother was a young, unwed college graduate student, and she decided to put me up for adoption. She felt very strongly that I should be adopted by college graduates, so everything was all set for me to be adopted at birth by a lawyer and his wife. Except that when I popped out they decided at the last minute that they really wanted a girl. So my parents, who were on a waiting list, got a call in the middle of the night asking: "We have an unexpected baby boy; do you want him?" They said: "Of course." My biological mother later found out that my mother had never graduated from college and that my father had never graduated from high school. She refused to sign the final adoption papers. She only relented a few months later when my parents promised that I would someday go to college.

And 17 years later I did go to college. But I naively chose a college that was almost as expensive as Stanford, and all of my working-class parents' savings were being spent on my college tuition. After six months, I couldn't see the value in it. I had no idea what I wanted to do with my life and no idea how college was going to help me figure it out. And here I was spending all of the money my parents had saved their entire life. So I decided to drop out and trust that it would all work out OK. It was pretty scary at the time, but looking back it was one of the best decisions I ever made. The minute I dropped out I could stop taking the required classes that didn't interest me, and begin dropping in on the ones that looked interesting.

It wasn't all romantic. I didn't have a dorm room, so I slept on the floor in friends' rooms, I returned coke bottles for the 5¢ deposits to buy food with, and I would walk the 7 miles across town every Sunday night to get one good meal a week at the Hare Krishna temple. I loved it. And much of what I stumbled into by following my curiosity and intuition turned out to be priceless later on. Let me give you one example:

Reed College at that time offered perhaps the best calligraphy instruction in the country. Throughout the campus every poster, every label on every drawer, was beautifully hand calligraphed. Because I had dropped out and didn't have to take the normal classes, I decided to take a calligraphy class to learn how to do this. I learned about serif and san serif typefaces, about varying the amount of space between different letter combinations, about what makes great typography great. It was beautiful, historical, artistically subtle in a way that science can't capture, and I found it fascinating.

None of this had even a hope of any practical application in my life. But ten years later, when we were designing the first Macintosh computer, it all came back to me. And we designed it all into the Mac. It was the first computer with beautiful typography. If I had never dropped in on that single course in college, the Mac would have never had multiple typefaces or proportionally spaced fonts. And since Windows just copied the Mac, its likely that no personal computer would have them. If I had never dropped out, I would have never dropped in on this calligraphy class, and personal computers might not have the wonderful typography that they do. Of course it was impossible to connect the dots looking forward when I was in college. But it was very, very clear looking backwards ten years later.

Again, you can't connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something — your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.

My second story is about love and loss.

I was lucky — I found what I loved to do early in life. Woz and I started Apple in my parents garage when I was 20. We worked hard, and in 10 years Apple had grown from just the two of us in a garage into a $2 billion company with over 4000 employees. We had just released our finest creation — the Macintosh — a year earlier, and I had just turned 30. And then I got fired. How can you get fired from a company you started? Well, as Apple grew we hired someone who I thought was very talented to run the company with me, and for the first year or so things went well. But then our visions of the future began to diverge and eventually we had a falling out. When we did, our Board of Directors sided with him. So at 30 I was out. And very publicly out. What had been the focus of my entire adult life was gone, and it was devastating.

I really didn't know what to do for a few months. I felt that I had let the previous generation of entrepreneurs down - that I had dropped the baton as it was being passed to me. I met with David Packard and Bob Noyce and tried to apologize for screwing up so badly. I was a very public failure, and I even thought about running away from the valley. But something slowly began to dawn on me — I still loved what I did. The turn of events at Apple had not changed that one bit. I had been rejected, but I was still in love. And so I decided to start over.

I didn't see it then, but it turned out that getting fired from Apple was the best thing that could have ever happened to me. The heaviness of being successful was replaced by the lightness of being a beginner again, less sure about everything. It freed me to enter one of the most creative periods of my life.

During the next five years, I started a company named NeXT, another company named Pixar, and fell in love with an amazing woman who would become my wife. Pixar went on to create the worlds first computer animated feature film, Toy Story, and is now the most successful animation studio in the world. In a remarkable turn of events, Apple bought NeXT, I returned to Apple, and the technology we developed at NeXT is at the heart of Apple's current renaissance. And Laurene and I have a wonderful family together.

I'm pretty sure none of this would have happened if I hadn't been fired from Apple. It was awful tasting medicine, but I guess the patient needed it. Sometimes life hits you in the head with a brick. Don't lose faith. I'm convinced that the only thing that kept me going was that I loved what I did. You've got to find what you love. And that is as true for your work as it is for your lovers. Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do. If you haven't found it yet, keep looking. Don't settle. As with all matters of the heart, you'll know when you find it. And, like any great relationship, it just gets better and better as the years roll on. So keep looking until you find it. Don't settle.

My third story is about death.

When I was 17, I read a quote that went something like: "If you live each day as if it was your last, someday you'll most certainly be right." It made an impression on me, and since then, for the past 33 years, I have looked in the mirror every morning and asked myself: "If today were the last day of my life, would I want to do what I am about to do today?" And whenever the answer has been "No" for too many days in a row, I know I need to change something.

Remembering that I'll be dead soon is the most important tool I've ever encountered to help me make the big choices in life. Because almost everything — all external expectations, all pride, all fear of embarrassment or failure - these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.

About a year ago I was diagnosed with cancer. I had a scan at 7:30 in the morning, and it clearly showed a tumor on my pancreas. I didn't even know what a pancreas was. The doctors told me this was almost certainly a type of cancer that is incurable, and that I should expect to live no longer than three to six months. My doctor advised me to go home and get my affairs in order, which is doctor's code for prepare to die. It means to try to tell your kids everything you thought you'd have the next 10 years to tell them in just a few months. It means to make sure everything is buttoned up so that it will be as easy as possible for your family. It means to say your goodbyes.

I lived with that diagnosis all day. Later that evening I had a biopsy, where they stuck an endoscope down my throat, through my stomach and into my intestines, put a needle into my pancreas and got a few cells from the tumor. I was sedated, but my wife, who was there, told me that when they viewed the cells under a microscope the doctors started crying because it turned out to be a very rare form of pancreatic cancer that is curable with surgery. I had the surgery and I'm fine now.

This was the closest I've been to facing death, and I hope its the closest I get for a few more decades. Having lived through it, I can now say this to you with a bit more certainty than when death was a useful but purely intellectual concept:

No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life's change agent. It clears out the old to make way for the new. Right now the new is you, but someday not too long from now, you will gradually become the old and be cleared away. Sorry to be so dramatic, but it is quite true.

Your time is limited, so don't waste it living someone else's life. Don't be trapped by dogma — which is living with the results of other people's thinking. Don't let the noise of others' opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.

When I was young, there was an amazing publication called The Whole Earth Catalog, which was one of the bibles of my generation. It was created by a fellow named Stewart Brand not far from here in Menlo Park, and he brought it to life with his poetic touch. This was in the late 1960's, before personal computers and desktop publishing, so it was all made with typewriters, scissors, and polaroid cameras. It was sort of like Google in paperback form, 35 years before Google came along: it was idealistic, and overflowing with neat tools and great notions.

Stewart and his team put out several issues of The Whole Earth Catalog, and then when it had run its course, they put out a final issue. It was the mid-1970s, and I was your age. On the back cover of their final issue was a photograph of an early morning country road, the kind you might find yourself hitchhiking on if you were so adventurous. Beneath it were the words: "Stay Hungry. Stay Foolish." It was their farewell message as they signed off. Stay Hungry. Stay Foolish. And I have always wished that for myself. And now, as you graduate to begin anew, I wish that for you.

Stay Hungry. Stay Foolish.

Thank you all very much.

Avastin (bevacizumab) Approved By FDA For Treatment Of Aggressive Brain Cancer

The FDA (Food and Drug Administration, USA) approved Avastin (bevacizumab) for patients with GBM (glioblastoma multiforme) whose cancer carries on progressing after standard therapy. GBM is a rapidly progressing cancer - it invades brain tissue and can may have a significant effect on a patient´s mental abilities and physical activities. Approximately 6,700 people each year in the USA are affected by GBM.

Unfortunately, the cancer nearly always comes back, even when treated with surgery, radiation and/or chemotherapy.

Richard Pazdur, M.D., director of the Office of Oncology Drug Products in the FDA's Center for Drug Evaluation and Research, said "This type of cancer is very resistant to therapy and thus challenging to treat. Avastin provides a therapy for patients with progressive GBM who have not responded to other medications."

Avastin is a monoclonal antibody that is produced in the laboratory. It mimics the antibodies our immune system produces to combat harmful substances. Avastin reduces the action of vascular endothelial growth factor that helps in the development of new blood vessels which can nourish a tumor and help it grow. The new blood vessels may also become a pathway for the cancer cells to spread around the body.

Avastin was first approved in 2004 by the FDA for the treatment of metastatic cancer of the colon or rectum. It has subsequently been approved to treat non-squamous, non-small cell lung cancer and metastatic breast cancer.

Two clinical trials showed that approximately one quarter of all patients with GBM responded to Avastin with an average duration of response of about 4 months.

Avastin´s most serious side effects include, gastrointestinal perforation, wound healing complications, hemorrhage, and blood clots - some of these side effects can be fatal. Other side effects include severe hypertension (high blood pressure), nervous system and vision disturbances, lower white blood cell counts, infection, myocardial infarction, stroke, and kidney problems. Common side effects include nosebleeds, hypertension, runny nose, headache, excess urine protein, alteration of taste, rectal bleeding, excessive tearing, dry skin, and skin peeling.