New Study Finds Childhood Cancer Survivors Commonly Stay at Jobs to Keep Health Insurance

The results of a national cancer survey find a significant number of childhood cancer survivors are worried about keeping their health insurance, to the point of letting it affect their career decisions. The findings were published today in JAMA Oncology.

Anne Kirchhoff, PhD, an investigator at Huntsman Cancer Institute (HCI) and assistant professor of pediatrics at the University of Utah, led the study. Her goal was to examine the prevalence of job lock in full-time, employed childhood cancer survivors. Job lock is when an employee stays at a job in order to keep work-related health insurance.

The study found 23 percent of childhood cancer survivors reported job lock, compared to just under 17 percent of the survivors’ siblings who never had cancer.

“Even with protections and expansions of insurance coverage in the U.S., this study proves there is still quite a bit of worry about insurance,” says Kirchhoff, “and it’s affecting how people make decisions from a job standpoint. Employer-based insurance coverage is the most common way people get insurance in the U.S. If someone gets stuck in a certain job because they want to keep their insurance coverage, that could really affect their earning power across a lifetime. It could potentially stymie their ability to start a new company or take on a job that would allow them to have more career or income growth, all because of health insurance worries.”

The study found female survivors and survivors with chronic health conditions were more likely to report job lock. Researchers also determined survivors who had a history of problems paying medical bills and those with past health insurance denials were more likely to report feeling like they couldn’t change jobs because of insurance worries.

Kirchhoff says, “This information gives us a feel for high-risk groups of survivors who may need more information about insurance. Many people experience a gap in education and literacy around insurance, and it’s important for people to understand their options – even those who are employed and consistently had access to insurance through work. We want to know what their concerns are so we can help patients and survivors. Getting health care should not be a worry for cancer survivors.”

The study analyzed 394 pediatric cancer survivors from pediatric oncology institutions across the U.S., along with 128 of their siblings. All of the participants worked 35 hours or more per week. Eighty-eight percent of them had employer-sponsored health insurance. Only four percent of survivors (and just over six percent of siblings) were uninsured.

The cancer survivors were treated for cancer between birth and age 20, and all of the participants ranged in age at the time of the survey from their 20s to early 60s. They were asked to fill out surveys analyzing their insurance and work concerns.

Childhood cancer survivors were chosen to study because their life experiences are unique. Childhood cancer patients have seen tremendous growth in outcomes and survival over the years. But many times their strong treatments as children can lead to health problems as they get older. Certain chemotherapies can increase a patient’s risk of chronic health problems, such as cardiovascular disease, down the road. Treatments can cause infertility, and second cancers and lung issues can appear in some patients. About a third of pediatric survivors in this survey reported a severe, disabling or life-threatening chronic condition. The study showed the patients’ past cancer diagnosis can often shape their insurance and health care decisions later in life.

“Survivors have been through a lot when they were younger and understand the importance of making sure they can get health care when they need it,” explains Kirchhoff. “I think a lot of them also saw what their parents and families went through in terms of the financial stress and burden of dealing with a health crisis. So they’re just primed to understand the importance of health insurance.”

This study was conducted as the Affordable Care Act was rolling out. Kirchhoff says she would like to do a follow-up study to see if the insurance exchanges and Medicaid expansion have lessened job-related insurance worries. Kirchhoff also believes the study demonstrates what the country could expect if the ACA was dismantled.

The survey was funded by the National Institutes of Health/National Cancer Institute P30 CA042014 and U24 CA55727, the LIVESTRONG Foundation, and the Huntsman Cancer Foundation. Researchers from Massachusetts General Hospital and St. Jude Children’s Research Hospital also served as investigators on the study.

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Suicide and Social Media

Suicide is a serious problem among American teens. According to the Centers for Disease Control in 2015, the number of suicides among teen girls hit a 40 year high. And among teen boys the number of suicides rose by 30% between 2007 and 2015. Why? Some are wondering if it has to do with social media.

Almost every teen now has an account on at least one social media platform. They use it to reach out to friends, to share experiences, and to tell the world about themselves. However, they also may be making themselves vulnerable.

“Teens may struggle with how much information they put out there making them a target for bullying or harassment,” said Tori M Yeates LCSW, MBA, Crisis Line Supervisor for the University Neuropsychiatric Institute. “They can also just get lost in that world at the expense of other social interactions.”

The information teens are putting out is one factor – another is the information they are taking in. Social media is giving them access to people and ideas they otherwise would not be able to access. And not all of that is good. Some are actually designed specifically to harm. “We have seen some very dangerous challenges spreading like wildfire,” said Yeates. “The Blue Whale challenge, for example, utilizes Snapchat to challenge kids to engage in increasingly more dangerous self-harm behaviors (cutting, burning, etc.) culminating in the individual killing him/herself.”

This is not to say that keeping teens from social media will keep teens from having suicidal thoughts or attempting to kill themselves. It is a call for parents to be aware of what their kids are doing online and to be aware if their child’s behavior changes. “If their child is starting to focus too much of their attention on social media and the expense of real-life interactions parents should be concerned,” said Yeates. “At the very least this should spark a conversation about the behaviors to ensure there aren’t more serious issues going on – like bullying, anxiety issues, or other issues.”

Parents should also look for behaviors not necessarily related to social media that may signal a problem. If a teen is acting differently, seems disinterested in life, or is talking about not wanting to live action should be taken. It can be a hard conversation to have – but it might save their life. “Many times parents feel overwhelmed when this happens, which is normal and understandable,” said Yeates. “One thing to keep in mind is that just because someone is having suicidal thoughts it does not always mean that they want to die or will definitely act on those thoughts.”

Parents aren’t the only ones who should be on alert. Friends also should be aware when it appears someone is in trouble. They may even have more insight into the situation. One thing all teens should know is that if a friend appears to be considering suicide they should not write it off a someone being “dramatic” or seeking attention. “All suicidal behavior should be taken seriously, period, said Yeates. “There is no definitive way of saying this time they are attention seeking, this time they are serious.”

Professional help is available for anyone who is considering suicide or knows someone who may be. The UNI crisis line is available 24/7 at 801-587-3000, and nationwide the National Suicide Prevention Hotline can be reached at 800-273-TALK. Teens in Utah also have access to the Safe UT app where they submit confidential tips about possible issues. “Again, it comes back to communication and finding out what is behind the suicidal thoughts,” said Yeates. “Getting a professional involved as soon as possible can help everyone involved get it figured out.”

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Breast Cancer Screening: What Women Need to Know

 

Some types of cancers can be found before they cause any symptoms. The process of checking for cancer, before it causes symptoms, is called a cancer screening. Cancer screenings can help find cancer in the earlier stages when the cancer is most often easier to treat. For this reason, there are screening recommendations. Unfortunately, no single test can detect all types of cancers, and some cancers don’t have any type of screening.

Breast cancer is one of the types of cancer women can be screened for. Most women should follow the general recommendations for breast cancer screening listed below. If you have a family history of breast cancer or have the BRCA1 or BRCA2 gene, you may need to get screenings at a younger age or more often. Talk with your health-care provider about the best time to start breast cancer screening.

Types of Breast Cancer Screenings

There are two types of breast cancer screenings:

  1. Mammograms. Mammograms can find cancers that may be too small to feel during a breast exam. If the mammogram shows anything of concern, the doctor may recommend a follow-up exam.
  2. Breast exams. Breast exams, whether done by a health-care provider or by yourself, can be another form of breast cancer screening. It is important to know your body so you can recognize changes that may occur. If you do notice changes, talk with a health-care provider. Please keep in mind, not all breast lumps or changes are cancer. But it is best to share any concerns with a health-care provider.

Screening Recommendations
Huntsman Cancer Institute experts recommend the following breast cancer screenings for these age groups:

Women age 40 and older:

  • A mammogram each year
  • A breast exam by a health-care provider each year
  • Women ages 20-39:
  • A breast exam by a health-care provider every 2-3 years
  • Remember, always talk with your doctor about the cancer screenings that are right for you based on your age, family medical history, and personal medical history.

 

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Understanding Seasonal Affective Disorder: Are You SAD?

About 10 to 20 percent may have mild SAD(seasonal affective disorder). SAD is four times more common in women than in men. Although some children and teenagers get SAD, it usually doesn’t start in people younger than age 20.Your chance of getting SAD goes down as you get older.

Tanning beds shouldn’t be used to treat SAD. The light sources in tanning beds are high in ultraviolet (UV) rays, which harm your eyes and your skin.

“Winter blues is a general term, not a medical diagnosis. It’s fairly common, and it’s more mild than serious. It usually clears up on its own in a fairly short amount of time,” says Dr. Matthew Rudorfer, a mental health expert at NIH. The so-called winter blues are often linked to something specific, such as stressful holidays or reminders of absent loved ones.

“Seasonal affective disorder, though, is different. It’s a well-defined clinical diagnosis that’s related to the shortening of daylight hours,” says Rudorfer. “It interferes with daily functioning over a significant period of time.” A key feature of SAD is that it follows a regular pattern. It appears each year as the seasons change, and it goes away several months later, usually during spring and summer.

Many studies have shown that people with seasonal affective disorder feel better after exposure to bright light. It seems simple enough: In higher latitudes, winter days are shorter, so you get less exposure to sunlight. Replace lost sunlight with bright artificial light, and your mood improves. But it’s actually far more complex.

Alfred Lewy, MD, a seasonal affective disorder researcher at the Oregon Health & Science University, says it’s not only a matter of getting light, but also getting it at the right time. “The most important time to get light is in the morning,” he says.

 

Symptoms of SAD:

  • Irritability
  • Tiredness or low energy
  • Problems getting along with other people
  • Hypersensitivity to rejection
  • Heavy, “leaden” feeling in the arms or legs
  • Oversleeping
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Weight gain

When to see a doctor

It’s normal to have some days when you feel down. But if you feel down for days at a time and you can’t get motivated to do activities you normally enjoy, see your doctor. This is especially important if your sleep patterns and appetite have changed or if you feel hopeless, think about suicide, or turn to alcohol for comfort or relaxation.

winter blues, seasonal affective disorder, SAD

SAD is four times more common in women than in men. Make sure you are getting the treatment you need.

 

Lift Your Mood

These “self-care” tips might help with seasonal depression. See a mental health professional if sadness doesn’t go away or interferes with your daily life:

  1. Go to a movie, take a walk, go ice-skating or do other activities you normally enjoy.
  2. Get out in the sunlight or brightly lit spaces, especially early in the day.
  3. Try to spend time with other people and confide in a trusted friend or relative.
  4. Eat nutritious foods, and avoid overloading on carbohydrates like cookies and candies.
  5. Be patient. You won’t suddenly “snap out of” depression. Your mood will improve gradually.

Self-Care

  • Monitor your mood and energy level
  • Take advantage of available sunlight
  • Plan pleasurable activities for the winter season
  • Plan physical activities
  • Approach the winter season with a positive attitude
  • When symptoms develop, seek help sooner rather than later
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Do Cell Phones Cause Cancer?

The radiation emitted by cell phones is regulated by the Federal Communications Commission (FCC). Many Americans use cell phones and wonder if there are any health risks.

The only consistently recognized biological effect of radiofrequency energy is heating. The ability of microwave ovens to heat food is one example of this effect of radiofrequency energy.

Radiofrequency exposure from cell phone use does cause heating to the area of the body where a cell phone or other device is held (ear, head, etc.). However, it is not sufficient to measurably increase body temperature, and there are no other clearly established effects on the body from radiofrequency energy.

Cell phones do heat up but not enough to have an effect on the human body. 

People who say cell phones are safe reference statements by the FCC and Food and Drug Administration (FDA) and point to peer-reviewed studies which conclude that cell phone use is not associated with an increased risk of brain tumors or the onset of other health problems. They contend there has been no increase in brain tumor rates despite hundreds of millions of people now using cell phones.

People who say cell phones are not safe cite peer-reviewed studies showing an association between cell phone use and tumor growth, DNA damage, and decreased fertility. They say cancers take 20-30 years to develop and cell phone studies have monitored periods of 10 years or less.

 

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