BBC presenter Rachael Bland reveals 'incurable' cancer

BBC presenter Rachael Bland, who blogs about having cancer, says her hopes now rest on clinical trials after being told her breast cancer was “incurable”.

The 40-year-old said she had become a “lab rat”, in her latest post, after starting her first trial last week.

She also revealed she was out with her young son when she received a call with the news that her cancer was incurable.

Bland, who also co-hosts the podcast You, Me and the Big C, was diagnosed with breast cancer in November 2016.

She had months of chemotherapy and radiotherapy in 2017 but required more surgery earlier this year after discovering cancer had spread to her lymph nodes.

The BBC Radio 5 live newsreader and presenter was with her two-year-old son Freddie and his friends at an ice cream farm when she received a call with the results of some biopsies.

On her blog ‘Big C little me’, she wrote: “My heart raced as I answered it, knowing a phone call did not bode well.

“Then came the words ‘I am so sorry, it’s bad news. The biopsies have come back showing the same cancer is back and is in the skin’.

“I watched my little Freddie innocently playing away in a tyre in the barn and my heart broke for him.

“I scooped him up and dashed home and then had to break (her husband) Steve’s heart with the news that my cancer was now metastatic and therefore incurable.”

Metastatic – or secondary – breast cancer occurs when cancer cells spread from the primary cancer in the breast through the lymphatic or blood system to other parts of the body.

Olympic medal winning sprinter Katharine Merry, four-time Olympic rowing champion Matthew Pinsent, and fellow BBC presenter Victoria Derbyshire – who has previously spoken about having treatment for breast cancer – were among those to send their support to Bland on social media.

Other people who have followed her progress since she started writing about her cancer diagnosis responded by saying what an inspiration she had been to them.

One Twitter follower, Tom Millen, said: “I couldn’t be more gutted for someone I’ve never met. May you continue to inspire others as you do me.”

Another, Tamsin Edwards, who is also living with cancer, said: “Your podcast has helped me more than I can say: fears about chemo, how to think about the future, effects on partners and the ways cancer affects other people than me.

“We’re all in the waiting game – I’m so sorry for your results and wish you well.”

Her husband, Steve Bland, said: “I hate that she has to write this so so much… but I’m so very very proud that she did.”

Bland told the BBC she had been “absolutely overwhelmed by all the wonderful messages”, adding that “whatever happens, I feel like I have such amazing support from everyone”.

After going through a strict screening process, Bland started immunotherapy – which works by harnessing the immune system to destroy cancer cells – at the Christie Hospital in Manchester last Wednesday.

She is taking a new trial drug that is designed to make immunotherapy – usually used for other cancers – more effective in treating breast cancer.

It was very early in the process, she said, but she felt “an odd sense of pride” that she was one of fewer than 150 people in the world to test it.

“If it doesn’t help me then I hope the data I provide will at some point in the future help others in the same position,” she added.

“I feel a bit like a grenade with the pin out… just waiting for some odd sensations to appear. Tick tock.”

She said she will stay on the trial if, when she has a scan in six weeks, the cancer is stable or has shrunk, or if it has grown by more than 20% she will be put on a different trial.

“We are waiting and hoping,” she said.

Deadly Nipah virus claims victims in India

Health officials in the south Indian state of Kerala say nine people have died in confirmed and suspected cases of the deadly Nipah virus.

Three victims tested positive for the virus in the last fortnight. The results of the remaining six samples will be available later on Monday.

Twenty five others have been hospitalised with symptoms of the infection in Kozhikode, officials said.

Nipah is an infection which can be transmitted to humans from animals.

There is no vaccination for the virus which has a mortality rate of 70%.

Nipah virus is also “top of the list” of 10 priority diseases that the WHO has identified as potentials for the next major outbreak.

Kerala’s health secretary Rajeev Sadanandan told the BBC that a nurse who treated the patients had also died.

“We have sent blood and body fluid samples of all suspected cases for confirmation to National Institute of Virology in Pune. So far, we got confirmation that three deaths were because of Nipah,” he said.

“We are now concentrating on precautions to prevent the spread of the disease since the treatment is limited to supportive care.”

Fruit bats are mainly considered to be the natural host of the virus.

Health officials say they have found mangoes bitten by bats in a home, where three people have died of the suspected infection.

What is Nipah virus?

  • Nipah virus (NiV) infection is a newly emerging disease which can be transmitted to humans from animals. The natural host of the virus are fruit bats.
  • The infection was first identified in 1999 during an outbreak of encephalitis and respiratory illness among pig farmers and people with close contact with pigs in Malaysia and Singapore.
  • Nearly 300 human cases with over 100 deaths were reported at the time. In order to stop the outbreak, more than a million pigs were euthanized, causing tremendous trade loss for Malaysia.
  • Nipah virus infection can be prevented by avoiding exposure to sick pigs and bats in endemic areas and not drinking raw date palm sap.
  • Symptom of the infection include fever, headache, drowsiness, respiratory illness, disorientation and mental confusion. These signs and symptoms can progress to coma within 24-48 hours.
  • There is no vaccine for either humans or animals.

(Source: WHO, Centers for Disease Control and Prevention)

Are we eating at the wrong time for our body clocks?

We’ve been warned repeatedly about the health perils of being out-of-sync with our body clocks. Are we eating in the right way for these circadian rhythms, and could changing our mealtime habits boost our health and help us lose weight?

‘Breakfast like a king’

What did you eat this morning for breakfast or lunch?

The chances are it wasn’t steak and chips, chickpea curry or anything else you might normally have for dinner.

Yet some scientists believe eating more of our daily calories earlier in the day – and shifting mealtimes earlier in general – could be good for our health.

One study found women who were trying to lose weight lost more when they had lunch earlier in the day, while another linked eating later breakfasts to having a higher body mass index.

“There’s already a very old saying, eat breakfast like a king, lunch like a prince and dinner like a pauper, and I think there’s some truth in that,” says Dr Gerda Pot, a visiting lecturer in nutritional sciences at King’s College London.

Now scientists are trying to find out more about what’s driving those results and are looking at the relationship between eating and our body clocks, dubbed “chrono-nutrition” by some, for answers.

When you eat

You may think of the body clock as being something that determines when we sleep.

But in fact there are clocks in virtually every cell in the body.

They help prime us for the day’s tasks, such as waking up in the morning, by regulating blood pressure, body temperature and hormone levels, among other things.

Experts are now looking at whether our eating habits – including irregular mealtimes and eating too late – are far from optimal for our internal rhythms.

Dr Pot, who studies chrono-nutrition, said: “We have a body clock that determines that every 24 hours each metabolic process has an optimal time when something should happen.

“That suggests that having a large meal in the evening is actually, metabolically speaking, not the right thing to do because your body is already winding down for the night.”

Dr Jonathan Johnston, reader in chronobiology and integrative physiology at the University of Surrey, said although studies suggest our bodies are less good at processing food in the evening it was not yet understood why this is.

One theory is that it’s linked to the body’s’ ability to expend energy.

“There’s a little bit of preliminary evidence to suggest that the energy you use to process a meal – you use more of it in the morning compared with if you eat in the evening.”

Properly understanding the link between when we eat and our health is important, Dr Johnston says, because it could have big implications for helping to tackle the obesity epidemic.

“If we can come up with advice to say, ‘Well actually you don’t necessarily have to change so much what you eat, but if you just change when you eat,’ that little subtle modification might in itself be a really important part of how people can improve health across society,” he says.

Beyond this, the timings of our meals could also have implications for people with disrupted body clocks, such as shift workers, who are estimated to make up about 20% of the workforce, Dr Johnston says.

Animal studies have shown that eating at certain times can help re-set circadian rhythms, and now research is looking at if this applies to people too.

In a study of 10 men, Dr Johnston found that delaying their mealtimes by five hours clearly shifted a biological marker of their body clocks.

While it was a small study, Dr Johnston said it suggested that eating at specific times could form part of a strategy to help people cope with a disrupted body clock, something that has been shown to be particularly harmful for health.

More questions

So should we all start eating earlier?

Experts say there are a lot of questions that need answering.

For example, what are the optimum times to eat and avoid food?

How is this affected by our own individual body clock types – be it morning lark, night owl or something in between?

And are there foods that are particularly bad to eat at certain times?

Both Dr Johnston and Dr Pot said the evidence suggested we should be consuming more of our calories earlier in the day, for example by making lunch the biggest meal.

However, Prof Alexandra Johnstone, a nutritionist who is now starting to study in the field of chrono-nutrition, is slightly more cautious.

She says that while there are studies showing that shifting our mealtimes earlier might boost our health, she’d like to see a clearer explanation of what’s causing this.

But she hopes forthcoming research can show this and lead to clear guidance for people around when to eat.

Follow Alex on Twitter.

What do people want to happen at life's end?

Scientists are expecting a spike in deaths in the coming years. As life expectancies increased, the number of people dying fell – but those deaths were merely delayed.

With people living longer, and often spending more time in ill-health, the Dying Matters Coalition wants to encourage people to talk about their wishes towards the end of their life, including where they want to die.

“Talking about dying makes it more likely that you, or your loved one, will die as you might have wished. And it will make it easier for your loved ones if they know you have had a ‘good death’,” the group of end-of-life-care charities said.

Where to die?

Surveys repeatedly find most people want to die at home. But in reality the most common place to die is in hospital.

Almost half of the deaths in England last year were in hospital, less than a quarter at home, with most of the remainder in a care home or hospice.

What happens to human remains?

Dying wishes don’t just extend to where you die but to what happens to your body after death too.

Cremation overtook burial in the UK in the late-1960s as the most popular way to dispose of human remains, and more than doubled in popularity between 1960 and 1990.

Since then it has remained fairly stable at about three-quarters of the deceased being cremated, although it has been creeping up gradually year on year – in 2017 it hit 77%.

Although cremation is thought to be more environmentally friendly, it is not without its own costs. The process requires energy. And burning bodies releases carbon dioxide into the atmosphere.

There are hundreds of “green” burial grounds in Britain where coffins must be biodegradable and no embalming fluid or headstone markers are permitted. Instead, loved ones of the deceased often plant trees as a memorial.

The Association of Natural Burial Grounds says: “Many people nowadays are conscious of our impact on the environment and wish to be as careful in death as they have been during their lives to be as environmentally friendly as possible.”

At natural burial grounds, bodies are generally buried in shallow graves to help them degrade quickly and release less methane – a greenhouse gas.

Some people want to go further than this.

A form of “water cremation” is currently available in parts of the US and Canada, and could come to the UK.

This eco-friendly method uses an alkaline solution made with potassium hydroxide to dissolve the body, leaving just the skeleton, which is then dried and pulverised to a powder.

Sandwell Council, in the West Midlands, was granted planning permission to introduce a water cremation service, but these plans are currently on hold because of environmental concerns.

In December 2017, water providers membership body Water UK intervened and said it feared “liquefied remains of the dead going into the water system”.

Cremation by fire or burial remain the two options for most people, but those that want to do something a bit different could opt to have their ashes turned into a diamond or vinyl record, displayed in paperweight, exploded in a firework or shot into space.

The cost of death

Traditional cremation is cheaper than burial, particularly as space is short, driving up the cost of grave plots. But the cost of funerals in general has been rising.

Insurance firm SunLife, which produces an annual report on the cost of funerals, says prices have risen 70% in a decade.

It put this down to lack of space and the rising cost of land as well as fuel prices and cuts to local authority budgets leading to reduced subsidies for burials and crematoria.

A survey of 45 counties, conducted by the Society of Local Council Clerks, found half of respondents’ local council run cemeteries would be full in 10 years and half of Church of England graveyards surveyed had already been formally closed to new burials.

The same problem faces Islamic burial sites.

Mohamed Omer, of the Gardens of Peace cemetery in north-east London, says the problem is compounded by a growing population and by the fact that Muslims do not cremate their dead.

The Jewish community also do not traditionally practise cremation. David Leibling, chairman of the Joint Jewish Burial Society, says all of the four largest Jewish burial organisations have acquired extra space in recent years.

However, he says it’s not such a problem for the community since synagogue members pay for their burial plots through their membership. This means the organisation can predict how many people it is going to have to bury.

“As we serve defined membership we can make accurate estimates of the space we need,” he says.

What about our digital legacy?

There are growing concerns over what will happen to people’s social media profiles after they die.

The Digital Legacy Association is working with lawyers to produce guidelines on creating a digital will, setting out people’s wishes for what happens to social media profiles – and “digital assets” such as music libraries – after death.

Three-quarters of respondents to the DLA’s annual survey say it’s important to them to be able to view a loved one’s social media profile after their death.

But almost no-one responding to the survey had used a function to nominate a digital next of kin, such as Facebook’s legacy contact or Google’s inactive account manager functions.

Both Facebook and Instagram allow family and friends to request the deceased’s account is turned into a memorial page, while Twitter says loved ones can request the deactivation of a “deceased or incapacitated person’s account”.

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