Even three years after finishing treatment for breast cancer, almost 50 percent of women report long-term pain, a new Danish study finds.

The research, published in the Nov. 11 issue of the Journal of the American Medical Association, strengthens earlier findings, said study senior author Dr. Henrik Kehlet, a professor of perioperative therapy at Rigshospitalet at Copenhagen University. But this work indicates which women are most likely to experience persistent pain.

“Several previous scientific reports have shown a risk of chronic pain after breast cancer surgery,” said Kehlet. The strength of this study, he noted, is the large number of participants — more than 3,000 — and the evaluation of many types of treatments.
Kehlet’s team reviewed questionnaires filled out by 3,253 women who had undergone breast cancer treatment in Denmark between 2005 and 2006. Their treatments varied and included breast-conserving surgery, mastectomy, radiation, chemotherapy and dissection of the lymph nodes.

The women were asked whether they experienced pain, in what areas of the body, how bad it was and how often they experienced it.
In all, 1,543 — 47 percent — reported pain in one or more areas. Of those, 52 percent reported severe or moderate pain.
Among those who had severe pain, 77 percent said they had it daily. For those who reported their pain as light, 36 percent had it every day. Pain was reported in the breast area, the armpit, the arm and the side of the body.
The research was funded by the Danish Cancer Society, Breast Friends and a private organization that funds science research, the Lundbeck Foundation.
Women under 40 were more than three times more likely to have chronic pain than older women, the researchers found. Those having radiation therapy were more likely to have pain than those who had chemotherapy. Dissection of the axillary (under arm) lymph node was associated with increased likelihood of pain compared to dissection of the sentinel lymph node (the first node to which the cancer is likely to spread).

Why does the pain linger?
“There are multiple mechanisms to explain the risk of chronic pain,” Kehlet said, “such as young age, risk of nerve damage during axillary dissection, radiation therapy or a general pain hyper-responsiveness in some patients.”
More research is needed on the pain mechanism in those who experience high levels of discomfort, he said. The focus for now should be on identifying patients at high risk for pain and providing preventive treatment and nerve-sparing treatment when possible.

The results do not surprise Dr. Robert H. Dworkin, a pain specialist and professor of anesthesiology, neurology, oncology and psychiatry at the University of Rochester School of Medicine and Dentistry in New York, who has also published on lingering cancer pain.
But the findings may come as a surprise to oncologists and others who treat cancer patients, he said. “Women tend not to tell their surgeons about this continuing pain,” he said, citing clinical experience. Why? “They fear that the fact they are in pain might mean a recurrence, and they don’t want to deal with it,” he said. Or, “they don’t want to hurt the oncologist’s feelings.”
A third reason is “they don’t want to distract the physician from thinking about the cancer,” he said.
Even pain specialists can’t say for sure why the pain lingers. “We have little understanding of what causes this kind of pain,” Dworkin said.
A woman in pain after breast cancer treatment “should not be shy in talking to her physician about it,” Dworkin said. He advises such women to ask for a referral to a pain specialist.

If you know someone who is at risk for a stroke you will want to make sure that you understand exactly what a stroke is.

It is very important that you recognize all of the warning signs of a stroke.

You will see that many of the symptoms will occur quickly so you will want to call 999 in the UK [or 911 if you're US based] or get your loved one to the hospital as quickly as possible. Even thought some of the people who have the symptoms are not just having a stroke. It is important to recognize all of the symptoms, but you should also try to act quickly so that you can minimize the damage.

Symptoms of a stroke
1. You will want to get immediate attention if there is a sudden numbness in the face, arm and leg. It can occur on both sides of the body or it may just be one side. It all depends what affects the brain. There are times when the body is only affected on one side of the body.

2. You will also notice that the person will struggle with their speech and may have difficulty understanding others.

3. Also, you will see things like confusion, dizziness, tiredness, and loss of coordination as a sign too.

You will want to get emergency care immediately so that your friend can have a better chance of getting through without damage.

That’s what it is very important that you take the time to write down all valuable information and leave it next to a phone.

Make sure you have all the numbers that you could possibly ever need to help you for emergency problems.

You may also want to carry a cell phone with the same information in your pocket, purse, or wallet for any occasion that you might be out and need to get emergency help.

Every stroke will and should be treated as an emergency. It is very important you think about getting help as if you new someone was taking a heart attack.

You will also find that timing is very important. Early treatment can help you save your friend’s life.

You will want to make sure that get treated within three hours of showing signs. You will be given medications to dissolve blood clots and you will also find that your doctor or the hospital will try to do all that they can to minimize the damage.

Time for recovery
After a stroke you will need to give the person some time for rehabilitation. They may need to take several months off and lean the basics all over again. Most people are unable to do things like walking, talking, or even associating with those that they love. Sometimes it is best that you spend as much time with a person who has had a stroke so that they know that they loved and make a good recovery.

The Government has announced that patients who wait too long on the NHS will have the right to free private care for the first time,
The new legal right will apply to all those forced to wait more than 18 weeks for treatment and cancer sufferers not seen by a specialist within a fortnight.

Ministers plan to launch a consultation on the finer details of the scheme but insist that the new laws will come into force by the start of April next year.
The Government will also consult on other potential new rights, such as the right to die at home or to access NHS dentistry

Around 400,000 people wait more than 18 weeks for treatment every year in Britain, although ministers insist that many of these delay their own treatment for a wide variety of reasons.

The new waiting times rights will be announced by Gordon Brown during his monthly press conference.
Andy Burnham, the Health Secretary, has already declared that the legal right will be a “key battleground” for the next general election.
He said: “Turning targets into legal rights will empower patients and guarantee them the same high standards of care, regardless of where they live.”

But doctors’ leaders have warned that some patients could be forced to wait longer for treatment because of the new right.
Opposition parties also accused the Government of making an “unaffordable and uncosted pledge” that had more to do with the prospect of an upcoming General Election than with improving the health service.

The NHS has seen substantial cuts in waiting times in recent years and 93.7 per cent of hospital patients are now treated within 18 weeks.
That figure is even higher for urgent cancer referrals, with 94.1 per cent being seen by a specialist within two weeks.

Some NHS organisations already outsource some patients to private health care providers but this will be the first time that patients have the right to demand the treatment.

The Government insists that it can bring in the new right under the Health Bill already going through parliament, which will also enshrine the NHS constitution in law, and will not have to bring forward any extra legislation.

Opposition politicians accused the Government of not knowing how much the move would cost.
Andrew Lansley, the Shadow Health Secretary, said: “This is the latest in a series of unaffordable and uncosted pledges that have more to do with electioneering than improving the NHS.”

Dr Mark Porter, chairman of the British Medical Association’s consultants committee, said: “Many doctors remain frustrated by examples of political targets being prioritised over the needs of individual patients.
“If one group of patients gains a legal right by virtue of how long they have waited, there is a risk that others with more serious conditions will wait longer.”
A spokesman for the Department of Health insisted that the proposals would be “largely cost-neutral”, and that increased costs would be offset by efficient use of extra capacity.

In this article we’ll just explain basic facts your need to know if you’re going to do weight lifting.

Why should I lift weights?
There are a lot of good reasons, especially if you’re a woman. Between the ages of 35 and 40, most women start losing bone mass, which can result in osteoporosis , the “brittle bone” disease. Weight training can help prevent that loss, or even reverse it. It also has more immediate benefits. Lifting weights can improve your balance and range of movement, help prevent exercise-related injuries, and help you lose weight and keep it off. After the first several months of training, you can also expect to see a 20 to 40 percent increase in your muscle strength, which translates into a lot less huffing and puffing when you carry the groceries, mow the lawn, or play sports.

What does a typical weight-training workout involve?
A good routine takes about 30 minutes, working all your muscle groups for a few minutes apiece. Begin with a 5- to 10-minute warm-up activity, such as walking, jogging, or cycling; that gets the blood pumping to both your upper and lower body. Do a few light stretches as well.

The main portion of the workout is a series of exercises called repetitions. These exercises may vary depending on your strength and lifting power, but a good workout will include all ten of your body’s major muscle groups:

•abdominals
•back
•biceps
•butt
•calves
•chest
•hamstrings
•quadriceps
•shoulders
•triceps

Should I use weight machines or free weights?
Either one is fine — or try both. Weight machines position your body specifically to work one muscle or muscle group. Machines are considered the most foolproof method for beginners, almost guaranteeing that you use the correct form, which helps prevent injuries.

Free weights are hand-held weights such as barbells and dumbbells. They allow you a greater variety of exercises and — when you learn to do them right — can give you an even better workout than machines. If you think about it, a machine keeps the weight in balance, while it’s up to you to stabilize a barbell while you’re lifting it. That means you use more muscles and get a more thorough workout. A good weight-lifting plan will usually incorporate both weight machines and free weights.

What’s the best weight-lifting technique?
It depends on your goals, but the key word for a safe and beneficial weight-training program is moderation. The most common mistake that beginners make is trying to lift too much too soon.

Beginners should start by lifting less weight for 10 to 15 repetitions, then progress to lifting more weight for 8 to 12 reps. Don’t hold the weight aloft for more than a few seconds. A good rule of thumb is to hold the weight in position for two counts, then slowly lower it for three to four counts. For most exercises, exhale when you lift, and inhale while you lower the weight. Generally, you’ll want to do three sets of repetitions for each muscle group.

When lifting, always bend from your knees. Move in slow, controlled movements; bouncing or jerking can hurt you. So can going too fast or trying to hold a weight too long. Rest in between sets, or if you’ve been working your chest muscles, do a leg exercise while your pectorals get a break. In general, you should exercise to the point of fatigue but not pain. If you notice any swelling or inflammation in your muscles or joints after lifting, ease up.

Work larger muscle groups, such as the back and chest, before moving on to smaller groups such as biceps. Smaller groups support larger ones and will fatigue earlier if they are exercised first, not giving the larger groups an effective workout. For the same reason, it’s smarter to work muscle groups first before performing any muscle-isolating exercises (do leg presses before you do specific hamstring exercises).

How often should I lift weights?
Plan to lift two or three times a week, giving your muscles at least 48 hours rest between workouts. Don’t work the same set of muscles on consecutive days; your body needs time to rebuild between weight-lifting sessions. For the most complete workout, you should run, walk, or swim on days you don’t lift.

Do I need a trainer or should I lift on my own?
If you’re new at weight training, it’s a good idea to hire a trainer for at least one or two sessions. Rates vary between $25 and $100 per hour, but the money is worth it. A one-time investment gives you access to a professionally recommended, safe, and effective lifting program.

Look for a trainer who is certified through an agency such as the American Council on Exercise or the American College of Sports Medicine. Make sure you and the trainer are compatible and that he or she has experience working with any special needs you have. If you decide not to hire a trainer, you may want to invest in a good instructional video or book that can illustrate lifting techniques for you. One good bet: Body Shaping With Free Weights: Easy Routines for Your Home Workout by Stephenie Karony and Anthony L. Ranken.

Will weight lifting make me look like a he-man?
It’s unlikely. Women can’t produce the testosterone necessary for that kind of bulk, and men have to work out for hours every day to get a body like Arnold Schwarzenegger’s. How much muscle you build, and where, is largely a matter of genetics and body type. If you have concerns about how weight training will change your body’s shape, consult a trainer about which weight-lifting exercises will best meet your goals.