How does cancer spread to other parts of the body?
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All cancers begin in a single organ or tissue, such as the lungs or skin. When these cancers are confined in their original organ or tissue, they are generally more treatable.
But a cancer that spreads is much more dangerous, as the organs it spreads to may be vital organs. A skin cancer, for example, might spread to the brain.
This new growth makes the cancer much more challenging to treat, as it can be difficult to find all the new tumours. If a cancer can invade different organs or tissues, it can quickly become lethal.
When cancer spreads in this way, it’s called metastasis. Metastasis is responsible for the majority (67%) of cancer deaths.
Cells are supposed to stick to surrounding tissue
Our bodies are made up of trillions of tiny cells. To keep us healthy, our bodies are constantly replacing old or damaged cells.
Each cell has a specific job and a set of instructions (DNA) that tells it what to do. However, sometimes DNA can get damaged.
This damage might change the instructions. A cell might now multiply uncontrollably, or lose a property known as adherence. This refers to how sticky a cell is, and how well it can cling to other surrounding cells and stay where it’s supposed to be.
If a cancer cell loses its adherence, it can break off from the original tumour and travel through the bloodstream or lymphatic system to almost anywhere. This is how metastasis happens.
Many of these travelling cancer cells will die, but some will settle in a new location and begin to form new cancers.
Scipro/Shutterstock
Particular cancers are more likely to metastasise to particular organs that help support their growth. Breast cancers commonly metastasise to the bones, liver, and lungs, while skin cancers like melanomas are more likely to end up in the brain and heart.
Unlike cancers which form in solid organs or tissues, blood cancers like leukaemia already move freely through the bloodstream, but can escape to settle in other organs like the liver or brain.
When do cancers metastasise?
The longer a cancer grows, the more likely it is to metastasise. If not caught early, a patient’s cancer may have metastasised even before it’s initially diagnosed.
Metastasis can also occur after cancer treatment. This happens when cancer cells are dormant during treatment – drugs may not “see” those cells. These invisible cells can remain hidden in the body, only to wake up and begin growing into a new cancer months or even years later.
For patients who already have cancer metastases at diagnosis, identifying the location of the original tumour – called the “primary site” – is important. A cancer that began in the breast but has spread to the liver will probably still behave like a breast cancer, and so will respond best to an anti-breast cancer therapy, and not anti-liver cancer therapy.
As metastases can sometimes grow faster than the original tumour, it’s not always easy to tell which tumour came first. These cancers are called “cancers of unknown primary” and are the 11th most commonly diagnosed cancers in Australia.
One way to improve the treatment of metastatic cancer is to improve our ways of detecting and identifying cancers, to ensure patients receive the most effective drugs for their cancer type.
What increases the chances of metastasis and how can it be prevented?
If left untreated, most cancers will eventually acquire the ability to metastasise.
While there are currently no interventions that specifically prevent metastasis, cancer patients who have their tumours surgically removed may also be given chemotherapy (or other drugs) to try and weed out any hidden cancer cells still floating around.
The best way to prevent metastasis is to diagnose and treat cancers early. Cancer screening initiatives such as Australia’s cervical, bowel, and breast cancer screening programs are excellent ways to detect cancers early and reduce the chances of metastasis.
Peakstock/Shutterstock
New screening programs to detect cancers early are being researched for many types of cancer. Some of these are simple: CT scans of the body to look for any potential tumours, such as in England’s new lung cancer screening program.
Using artificial intelligence (AI) to help examine patient scans is also possible, which might identify new patterns that suggest a cancer is present, and improve cancer detection from these programs.
More advanced screening methods are also in development. The United States government’s Cancer Moonshot program is currently funding research into blood tests that could detect many types of cancer at early stages.
One day there might even be a RAT-type test for cancer, like there is for COVID.
Will we be able to prevent metastasis in the future?
Understanding how metastasis occurs allows us to figure out new ways to prevent it. One idea is to target dormant cancer cells and prevent them from waking up.
Directly preventing metastasis with drugs is not yet possible. But there is hope that as research efforts continue to improve cancer therapies, they will also be more effective at treating metastatic cancers.
For now, early detection is the best way to ensure a patient can beat their cancer.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and John (Eddie) La Marca, Senior Resarch Officer, Walter and Eliza Hall Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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5 Things You Can Change About Your Personality (But: Should You?)
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There are many personality-typing systems that, with varying degrees of validity*, aim to describe a person’s personality.
*and often pseudoscience:
- sometimes obviously so like astrology
- sometimes dressed up in clinical words like the Meyers-Briggs
- sometimes openly, per “this is not science but you may find it useful to frame things this way”, like the Enneagram
There is currently one kind of personality-typing system (with some minor variations) that is used in the actual field of clinical psychology, specifically under the umbrella of “trait theory”, and that is…
The “Big Five” personality traits
Also called the OCEAN or CANOE model, based on its 5 components:
- openness to experience: inventive/curious rather than consistent/cautious
- conscientiousness: efficient/organized rather than extravagant/careless
- extroversion: outgoing/energetic rather than solitary/reserved
- agreeableness: friendly/compassionate rather than critical/judgmental
- neuroticism: sensitive/nervous rather than resilient/confident
The latter (neuroticism) is not to be confused with neurosis, which is very different and beyond the scope of today’s article.
Note that some of these seem more positive/negative than others at a glance, but really, any of these could be a virtue or a vice depending on specifics or extremity.
For scientific reference, here’s an example paper:
The Big Five Personality Factors and Personal Values
Quick self-assessment
There are of course many lengthy questionnaires for this, but in the interests of expediency:
Take a moment to rate yourself as honestly as you can, on a scale of 1–10, for each of those components, with 10 being highest for the named trait.
For example, this writer gives herself: O7, C6, E3, A8, N2 (in other words I’d say I’m fairly open, moderately conscientious, on the reserved side, quite agreeable, and quite resilient)
Now, put your rating aside (in your phone’s notes app is fine, if you hadn’t written it down already) and forget about it for the moment, because we want you to do the next exercise from scratch.
Who would you be, at your best?
Now imagine your perfect idealized self, the best you could ever be, with no constraints.
Take a moment to rate your idealized self’s personality, on a scale of 1–10, for each of those components, with 10 being highest for the named trait.
For example, this writer picks: O9, C10, E5, A8, N1.
Maybe this, or maybe your own idealized self’s personality, will surprise you. That some traits might already be perfect for you already; others might just be nudged a little here or there; maybe there’s some big change you’d like. Chances are you didn’t go for a string of 10s or 1s (though if you did, you do you; there are no wrong answers here as this one is about your preferences).
We become who we practice being
There are some aspects of personality that can naturally change with age. For example:
- confidence/resilience will usually gradually increase with age due to life experience (politely overlook teenagers’ bravado; they are usually a bundle of nerves inside, resulting in the overcompensatory displays of confidence)
- openness to experience may decrease with age, as we can get into a rut of thinking/acting a certain way, and/or simply consciously decide that our position on something is already complete and does not need revision.
But, we can decide for ourselves how to nudge our “Big Five” traits, for example:
- We can make a point of seeking out new experiences, and considering new ideas, or develop strategies for reining ourselves in
- We can use systems to improve our organization, or go out of our way to introduce a little well-placed chaos
- We can “put ourselves out there” socially, or make the decision to decline more social invitations because we simply don’t want to
- We can make a habit of thinking kindly of others and ourselves, or we can consciously detach ourselves and look on the cynical side more
- We can build on our strengths and eliminate our weaknesses, or lean into uncomfortable emotions
Some of those may provoke a “why would anyone want to…?” response, but the truth is we are all different. An artist and a police officer may have very different goals for who they want to be as a person, for example.
Interventions to change personality can and do work:
A systematic review of personality trait change through intervention
There are many ways to go about “being the change we want to see” in ourselves, and yes there can be a degree of “fake it until you make it” if that works for you, but it doesn’t have to be so. It can also simply be a matter of setting yourself reminders about the things that are most important to you.
Writer’s example: pinned above my digital workspace I have a note from my late beloved, written just under a week before death. The final line reads, “keep being the good person that you are” (on a human level, the whole note is uplifting and soothing to me and makes me smile and remember the love we shared; or to put it in clinical terms, it promotes high agreeableness, low neuroticism).
Other examples could be a daily practice of gratitude (promotes lower neuroticism), or going out of your way to speak to your neighbors (promotes higher extraversion), signing up for a new educational course (promotes higher openness) or downloading a budgeting app (promotes higher conscientiousness).
In short: be the person you want to be, and be that person deliberately, because you can.
Some resources that may help for each of the 5 traits:
- Curiosity Kills The Neurodegeneration
- How (And Why) To Train Your Pre-Frontal Cortex
- How To Beat Loneliness & Isolation
- Optimism Seriously Increases Longevity!
- Building Psychological Resilience (Without Undue Hardship)
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Chaat Masala Spiced Potato Salad With Beans
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This is an especially gut-healthy dish; the cooked-and-cooled potatoes are not rich with resistant starches (that’s good), the beans bring protein (as well as more fiber and micronutrients), and many of the spices bring their own benefits. A flavorful addition to your table!
You will need
- 1 lb new potatoes, boiled or steamed, with skin on, quartered, cooled ← this is a bit of a “mini recipe”, but we expect you can handle it
- 5 oz blanched broad beans
- 2 oz sun-dried tomatoes, chopped
- ¼ bulb garlic, crushed
- 1 tbsp extra virgin olive oil
- 2 tsp amchoor
- 2 tsp ground cumin
- 2 tsp ground coriander
- 1 tsp ground ginger
- 1 tsp ground asafoetida
- 1 tsp black pepper, coarse ground
- 1 tsp red chili powder
- 1 tsp ground turmeric
- ½ tsp MSG or 1 tsp low-sodium salt
- Juice of ½ lemon
And then…
- To garnish: finely chopped cilantro, or if you have the “cilantro tastes like soap” gene, then substitute with parsley
- To serve: a nice chutney; you can use our Spiced Fruit & Nut Chutney recipe
Method
(we suggest you read everything at least once before doing anything)
1) Mix all the ingredients from the main section, ensuring an even distribution on the spices.
2) Add the garnish, and serve with the chutney. That’s it. There was more work in the prep (and potentially, finding all the ingredients) today.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we scored all five today!
- Lycopene’s Benefits For The Gut, Heart, Brain, & More ← don’t underestimate those sun-dried tomatoes, either!
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6 Daily Habits To Keep Your Brain Young & Sharp
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Without brain health, we do not have health. So here are six ways to keep it in order:
Food for thought
The six areas to focus on are as follows:
- Physical exercise: as we at 10almonds sometimes say, what’s good for the heart is good for the brain (because the brain is only as healthy as the circulation feeding it). For this reason, the recommendation here is for physical exercise that improves heart health—so, walking, running, swimming, dancing, etc.
- Healthy diet: shocking nobody, this is important too. Specifically, a diet rich in fruits, vegetables, and healthy proteins and fats is important—partly for the heart benefits that give indirect benefits to the brain, and partly because the brain is built of stuff and so we have to consume that stuff in order to rebuild it (omega-3s features strongly here, for instance). Remember to hydrate, too! The body can’t do anything without water.
- Good sleep: yes, the famous 7–9 hours sleep per night, and yes, even at your age, whatever that might be. This is important for memory consolidation, cell repair, toxin removal, and more. Sleep deprivation, on the other hand, leads to cognitive decline and brain shrinkage.
- Mental stimulation: ideally, engaging those parts of the brain you most wish to protect (e.g. language, memory, or whatever is most important to you).
- Social interaction: this one gets underestimated a lot, but it’s important to have meaningful conversations (not just polite smalltalk from a small menu of stock phrases), and that these should be two-way, i.e. involving both listening/reading and speaking/writing. Ideally, all four of those, which for most people means online and offline social interactions.
- Stress management: because chronic stress damages brain cells and accelerates cognitive decline, it’s important to manage that; practices like mindfulness meditation go a very long way and make a big difference.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Physical Exercises That Build Your Brain ← this is different from just exercising for one’s heart and thus the brain by extension, and rather, is specific exercises that strengthen specific parts of the brain.
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Food and exercise can treat depression as well as a psychologist, our study found. And it’s cheaper
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Around 3.2 million Australians live with depression.
At the same time, few Australians meet recommended dietary or physical activity guidelines. What has one got to do with the other?
Our world-first trial, published this week, shows improving diet and doing more physical activity can be as effective as therapy with a psychologist for treating low-grade depression.
Previous studies (including our own) have found “lifestyle” therapies are effective for depression. But they have never been directly compared with psychological therapies – until now.
Amid a nation-wide shortage of mental health professionals, our research points to a potential solution. As we found lifestyle counselling was as effective as psychological therapy, our findings suggest dietitians and exercise physiologists may one day play a role in managing depression.
Alexander Raths/shutterstock What did our study measure?
During the prolonged COVID lockdowns, Victorians’ distress levels were high and widespread. Face-to-face mental health services were limited.
Our trial targeted people living in Victoria with elevated distress, meaning at least mild depression but not necessarily a diagnosed mental disorder. Typical symptoms included feeling down, hopeless, irritable or tearful.
We partnered with our local mental health service to recruit 182 adults and provided group-based sessions on Zoom. All participants took part in up to six sessions over eight weeks, facilitated by health professionals.
Half were randomly assigned to participate in a program co-facilitated by an accredited practising dietitian and an exercise physiologist. That group – called the lifestyle program – developed nutrition and movement goals:
Lifestyle therapy aims to improve diet. Jonathan Borba/Pexels - eating a wide variety of foods
- choosing high-fibre plant foods
- including high quality fats
- limiting discretionary foods, such as those high in saturated fats and added sugars
- doing enjoyable physical activity.
The second group took part in psychotherapy sessions convened by two psychologists. The psychotherapy program used cognitive behavioural therapy (CBT), the gold standard for treating depression in groups and when delivered remotely.
In both groups, participants could continue existing treatments (such as taking antidepressant medication). We gave both groups workbooks and hampers. The lifestyle group received a food hamper, while the psychotherapy group received items such as a colouring book, stress ball and head massager.
Lifestyle therapies just as effective
We found similar results in each program.
At the trial’s beginning we gave each participant a score based on their self-reported mental health. We measured them again at the end of the program.
Over eight weeks, those scores showed symptoms of depression reduced for participants in the lifestyle program (42%) and the psychotherapy program (37%). That difference was not statistically or clinically meaningful so we could conclude both treatments were as good as each other.
There were some differences between groups. People in the lifestyle program improved their diet, while those in the psychotherapy program felt they had increased their social support – meaning how connected they felt to other people – compared to at the start of the treatment.
Participants in both programs increased their physical activity. While this was expected for those in the lifestyle program, it was less expected for those in the psychotherapy program. It may be because they knew they were enrolled in a research study about lifestyle and subconsciously changed their activity patterns, or it could be a positive by-product of doing psychotherapy.
People in both groups reported doing more physical activity. fongbeerredhot/Shutterstock There was also not much difference in cost. The lifestyle program was slightly cheaper to deliver: A$482 per participant, versus $503 for psychotherapy. That’s because hourly rates differ between dietitians and exercise physiologists, and psychologists.
What does this mean for mental health workforce shortages?
Demand for mental health services is increasing in Australia, while at the same time the workforce faces worsening nation-wide shortages.
Psychologists, who provide about half of all mental health services, can have long wait times. Our results suggest that, with the appropriate training and guidelines, allied health professionals who specialise in diet and exercise could help address this gap.
Lifestyle therapies can be combined with psychology sessions for multi-disciplinary care. But diet and exercise therapies could prove particularly effective for those on waitlists to see a psychologists, who may be receiving no other professional support while they wait.
Many dietitians and exercise physiologists already have advanced skills and expertise in motivating behaviour change. Most accredited practising dietitians are trained in managing eating disorders or gastrointestinal conditions, which commonly overlap with depression.
There is also a cost argument. It is overall cheaper to train a dietitian ($153,039) than a psychologist ($189,063) – and it takes less time.
Potential barriers
Australians with chronic conditions (such as diabetes) can access subsidised dietitian and exercise physiologist appointments under various Medicare treatment plans. Those with eating disorders can also access subsidised dietitian appointments. But mental health care plans for people with depression do not support subsidised sessions with dietitians or exercise physiologists, despite peak bodies urging them to do so.
Increased training, upskilling and Medicare subsidies would be needed to support dietitians and exercise physiologists to be involved in treating mental health issues.
Our training and clinical guidelines are intended to help clinicians practising lifestyle-based mental health care within their scope of practice (activities a health care provider can undertake).
Future directions
Our trial took place during COVID lockdowns and examined people with at least mild symptoms of depression who did not necessarily have a mental disorder. We are seeking to replicate these findings and are now running a study open to Australians with mental health conditions such as major depression or bipolar disorder.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Adrienne O’Neil, Professor, Food & Mood Centre, Deakin University and Sophie Mahoney, Associate Research Fellow, Food and Mood Centre, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Strategic Wellness
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Strategic Wellness: planning ahead for a better life!
This is Dr. Michael Roizen. With hundreds of peer-reviewed publications and 14 US patents, his work has been focused on the importance of lifestyle factors in healthy living. He’s the Chief Wellness Officer at the world-famous Cleveland Clinic, and is known for his “RealAge” test and related personalized healthcare services.
If you’re curious about that, you can take the RealAge test here.
(they will require you inputting your email address if you do, though)
What’s his thing?
Dr. Roizen is all about optimizing health through lifestyle factors—most notably, diet and exercise. Of those, he is particularly keen on optimizing nutritional habits.
Is this just the Mediterranean Diet again?
Nope! Although: he does also advocate for that. But there’s more, he makes the case for what he calls “circadian eating”, optimally timing what we eat and when.
Is that just Intermittent Fasting again?
Nope! Although: he does also advocate for that. But there’s more:
Dr. Roizen takes a more scientific approach. Which isn’t to say that intermittent fasting is unscientific—on the contrary, there’s mountains of evidence for it being a healthful practice for most people. But while people tend to organize their intermittent fasting purely according to convenience, he notes some additional factors to take into account, including:
- We are evolved to eat when the sun is up
- We are evolved to be active before eating (think: hunting and gathering)
- Our insulin resistance increases as the day goes on
Now, if you’ve a quick mind about you, you’ll have noticed that this means:
- We should keep our eating to a particular time window (classic intermittent fasting), and/but that time window should be while the sun is up
- We should not roll out of bed and immediately breakfast; we need to be active for a bit first (moderate exercise is fine—this writer does her daily grocery-shopping trip on foot before breakfast, for instance… getting out there and hunting and gathering those groceries!)
- We should not, however, eat too much later in the day (so, dinner should be the smallest meal of the day)
The latter item is the one that’s perhaps biggest change for most people. His tips for making this as easy as possible include:
- Over-cater for dinner, but eat only one portion of it, and save the rest for an early-afternoon lunch
- First, however, enjoy a nutrient-dense protein-centric breakfast with at least some fibrous vegetation, for example:
- Salmon and asparagus
- Scrambled tofu and kale
- Yogurt and blueberries
Enjoy!
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Plant-Based Healthy Cream Cheese
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Cream cheese is a delicious food, and having a plant-based diet isn’t a reason to miss out. Here we have a protein-forward nuts-based cream cheese that we’re sure you’ll love (unless you’re allergic to nuts, in which case, maybe skip this one).
You will need
- 1½ cups raw cashews, soaked in warm water and then drained
- ½ cup water
- ½ cup coconut cream
- Juice of ½ lemon
- 3 tbsp nutritional yeast
- ½ tsp onion powder
- ½ tsp garlic powder
- ½ tsp black pepper
- ½ tsp cayenne pepper
- ¼ tsp MSG, or ½ tsp low-sodium salt
- Optional: ⅓ cup fresh basil
Method
(we suggest you read everything at least once before doing anything)
1) Blend all of the ingredients until creamy.
2) Optional: leave on the countertop, covered, for 1–2 hours, if you want a more fermented (effectively: cheesy) taste.
3) Refrigerate, ideally overnight, before serving. Serving on bagels is a classic, but you can also enjoy with the Healthy Homemade Flatbreads we made yesterday
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Pistachios vs Cashews – Which is Healthier? ← Pistachios actually won here, but cashews are also great and are better (from a culinary perspective) for making cream cheese
- Why You Should Diversify Your Nuts!
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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