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Breast cancer study finds survival increases when time between diagnosis and concluding treatments is limited

Research found a decrease in patient survival rates when treatment options – surgery, chemotherapy and radiation – are completed more than 38 weeks from the time of diagnosis.

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Research from Cleveland Clinic in the U.S. and Cleveland Clinic Abu Dhabi in the U.A.E. has found a decrease in patient survival rates when treatment options – surgery, chemotherapy and radiation – are completed more than 38 weeks from the time of diagnosis. 

The observational study, which included more than 28,000 breast cancer patients registered in the American National Cancer Database, is the largest of its kind to evaluate breast cancer survival and time to completion for all therapies. It found the treatment duration of less than 38 weeks was associated with a higher five-year survival –  89.9 percent compared to the 83.3 percent in the greater than 38 weeks treatment duration. This builds on previous research that noted poorer outcomes when there was a delay in time to treatment initiation, although time to treatment completion was not assessed in these studies.

The study’s authors point out it is important to identify the reasons for delays in treatment and where in the process they occur, and to design programs to measure and pursue optimization of time to treatment to decrease anxiety for patients and improve their chances of survival.

“The biggest difference in our study from others that have looked at time to treat was that we looked at the time from diagnosis to the completion of the multimodality treatment, not only at one individual part, to identify the 38-week window to improve survival rate for patients with breast cancer,” said Debra Pratt M.D., director of the Breast Center at Cleveland Clinic Fairview Hospital, and the lead author of the study.

“In breast and other cancers, patients don’t only get surgery, but may also require chemotherapy and radiation therapy,” Dr. Pratt said. “This becomes a complicated system to navigate and there are multiple reasons why delays arise in treatment being completed. This analysis helps us identify opportunities for improving care within the delivery systems.”

Other studies evaluating the time to treatment for breast cancer by individual treatment modality have concluded that the optimal time from diagnosis to first surgical treatment was less than 90 days from diagnosis; less than 120 days from diagnosis to adjuvant chemotherapy; and when chemo is administered, the radiation should start less than 365 days from date of diagnosis.  The last two are consistent with Commission on Cancer’s Cancer Central Clinical Participant Registry (C3PR) quality indicators.

“What we found is that the optimal time for treatment completion is 99 days shorter than C3PR quality indicators,” Dr. Pratt said. “We have so much more data now to reassess these quality indicators and determine what those metrics should be.”

The study did not allow researchers to gauge the causes for delays beyond 38 weeks, but Dr. Pratt said from experience, she can divide them into medical, personal and systemic factors.

“If patients have medical issues, they may have to go through other assessments, such as cardiac clearance, which are done as a precaution,” she explained. “These are the hardest to control. Other delays are personal, for example, where the patient does not want to be seen at the first appointment available because of financial reasons or chooses to prioritize a family event over surgery.”

She says medical facilities can, however, control some of the systemic factors to speed up the process. These include adequate staffing and improved systems to increase ease of access, such as making special reservations to schedule urgent assessments like metastatic surveys and breast MRI, as well as a reduction in insurance delays in approving tests required to complete pre-treatment assessments.  

Stephen Grobmyer M.D., chair of the Oncology Institute at Cleveland Clinic Abu Dhabi, an integral part of Mubadala Health, and a co-author on the study, says that care must be consolidated to help patients receive treatment on time.

“What we see happen traditionally in the U.S. and even in the U.A.E. is that the patient has to visit multiple specialists – first a surgeon, then a medical oncologist for chemotherapy followed by a radiation oncologist – all of which are scheduled weeks apart and in different places,” he said. “There is this phenomenon of ‘serial care,’ rather than coordinated and planned care.”

Dr. Grobmyer adds that Cleveland Clinic has tried to avoid this issue with their coordinated multidisciplinary cancer programing. For example, in preparation of the opening of its cancer tower, Cleveland Clinic Abu Dhabi opened its dedicated Breast Health Clinic last year. The facility offers targeted diagnostic testing, genetic counseling, innovative therapies and treatments, as well as reconstruction specialists and disease-specific experts to address all breast health issues, in one location and in the shortest time possible.

“We are trying to anticipate the needs of the patients and plan for all their treatment from the beginning so that it is seamless, efficient and reduces their anxiety,” he said. “We have also started measuring time to treatment as a quality measure.”

Dr. Pratt said further studies to determine which type of treatment has the most delays will aid their efforts in optimizing care.

“One of the data points missing in our study was the last day of chemotherapy for these patients, so we could not determine where the majority of delays occurred,” she said. “One of my hopes is to look at our patients’ data to know where the challenges lie and how we can fix them.”.

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Celebrating World School Milk Day by making milk safe and accessible to Filipino school children

Tetra Pak believes that attaining a sustainable future is anchored on initiatives protecting people and the planet. That is why alongside its efforts in ensuring safe nutrition for children, Tetra Pak is also helping promote sustainability in various communities by providing recycling training for teachers and students.

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In light of World Milk School Day, a global event celebrating the benefits and success of school milk programs, world-leading food processing and packaging solutions company, Tetra Pak, draws attention to the role of multi-stakeholder collaborations to sustainably address childhood nutrition by making fresh milk safe and accessible for everyone.

In the Philippines, Republic Act 11037 also known as an Act Institutionalizing a National Feeding Program for Undernourished Children in Public Day Care was a breakthrough development that mothered the School-Based Feeding Program (SBFP) of the Department of Education.

For the 2020-2021 School Year, it surpassed the target of providing nutritious food products and pasteurized or sterilized milk to 1.7 million beneficiaries from primary public school students in daycare, kindergarten, and elementary schools across the country. Despite the many challenges posed by the COVID-19 pandemic, DepEd SBFP recorded an achievement rate of 183.46% for the milk component and  198.15% for the Nutritious Food Products (NFP) component for the 2020-2021 School Year.  

As the SBFP aims to reach more schoolchildren and communities, RFM Corporation, a home-grown food and beverage leader, highlights the advantages of using UHT milk or milk that went through Ultra High-Temperature pasteurization, thus is safer and has a longer shelf life. This is an important feature considering infrastructure challenges and the lack of refrigeration to distribute the milk in far-flung areas.

Tetra Pak has been helping RFM Corporation deliver Selecta Kids Fortified Milk in Tetra Wedge® Aseptic 200ml Slim, a carton package that protects both the nutritional value and the taste of the milk for up to 12 months. Introduced in 2021, so that children in various parts of the country could have access to safe nutrition, Tetra Wedge® Aseptic Slim uses aseptic technology to ensure that the packaging materials and product inside it are free from harmful bacteria. Like all Tetra Pak carton packages, it’s made of renewable materials and recyclable paperboard, making it one of the best ways to feed the future sustainably.

According to Ms. Marie Concepcion-Young, Senior Vice President and General Manager, Consumer Group of RFM Corporation, “Milk help school kids reach their physical and cognitive potential. Aside from making it accessible, it is imperative that the milk stays fresh and safe even as we transport it to hard-to-reach areas or those with limited storage facilities.” 

During the first phase of SBFP Milk Component, Selecta Kids Fortified Milk in Tetra Wedge® Aseptic 200ml Slim was delivered to schools in Bicol, Davao, and Soccsksargen regions benefitting 359,557 school children. Tetra Pak together with Tetra Laval Food for Development is likewise providing practical support where they share best practices in school milk programs organization and implementation, as well as providing environmental education.

“For decades, we have been working with our customers and relevant stakeholders to support school feeding programs around the world because we believe these are effective in addressing poor health and nutrition in disadvantaged communities,” said Michael Wu, Managing Director, Tetra Pak Malaysia, Singapore, Philippines, and Indonesia.

He adds that “We are committed to making food safe and available, everywhere.  That is why we make sure that school children get all the goodness of milk to have the energy to stay in school and get that brain boost they need for learning.”

Tetra Pak believes that attaining a sustainable future is anchored on initiatives protecting people and the planet. That is why alongside its efforts in ensuring safe nutrition for children, Tetra Pak is also helping promote sustainability in various communities by providing recycling training for teachers and students.

“Whether it is addressing food availability or environmental concerns, we believe that real, lasting impact in society can be achieved if stakeholders work together,” Wu concludes.

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The Bellevue Resort leads international coastal cleanup #SeaTheChange in Bohol

The Bellevue Resort – Bohol is a two-time ASEAN Green Hotel awardee, proudly a leader for sustainability.

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More than half a thousand volunteers from local organizations and private sectors, including frontliners, professionals, employees, students, divers, and many more gathered together to collect and segregate an estimated 1,713 kg of non-biodegradable waste at the recently concluded 37th International Coastal Cleanup (ICC) day hosted by The Bellevue Resort in Doljo Beach, Panglao, Bohol.

The Bellevue Resort – Bohol is a two-time ASEAN Green Hotel awardee, proudly a leader for sustainability. This eco-friendly five-star hotel has consistently spearheaded meaningful initiatives for responsible tourism in Bohol since its opening in 2012. Today the resort continues to head and take part in various efforts to promote environmental protection and conservation in the Philippines.

To know more about the resort, visit www.thebellevuebohol.com.

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5 Affordable and simple ways everyone can be an eco warrior

Understanding that collective effort is the way to go, retail giant SM Supermalls is committed to helping all Filipinos make more environmentally friendly choices in every aspect of their life.

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From changing weather patterns to disease outbreaks, we are already feeling the effects of global warming. We need to act now and work together in protecting the planet.

Understanding that collective effort is the way to go, retail giant SM Supermalls is committed to helping all Filipinos make more environmentally friendly choices in every aspect of their life.

“Many people care about the planet but find it hard to create a green lifestyle because of limited time or budget. That’s why we have community programs that make it more convenient and affordable to be an eco-warrior,” says Jonjon San Agustin, SVP for Marketing, SM Supermalls.

Here are five easy ways on how you and your family can live greener.

Segregate your trash and Trash to Cash

Segregating your biodegradable and recyclable waste reduces the amount of trash that goes into landfills. Have separate containers for different kinds of trash: biodegradable for food and garden waste; recyclable for plastic, paper, and metal waste; residual waste for trash that can’t be recycled including used tissue or paper plates; electronic waste for old batteries or broken gadget which shouldn’t be mixed with other waste because they contain metals that can contaminate the soil.

You can bring your recyclable waste to SM Supermalls’ Trash to Cash Recycling Market, held 10 am to 2 pm on every first Friday and Saturday of the Month. Visit this link to find the kiosk locations near you.

Limit the use of plastic through Plastic Waste Collection

Did you know that it takes plastic over 1,000 years to decompose?

About 10% of plastic materials will end up in the ocean and can kill marine life. In the Philippines, plastic waste often congests sewage systems causing floods. You can avoid using single use plastic by bringing your own reusable containers or eco bags when going to the groceries.

You can also buy items in eco-friendly packaging.

Plastic cutlery and straws are optional during order delivery or takeout. For dine-in, you can have your own eco-kit which has a drinking bottle, a set of utensils, and a foldable eco bag. Go green anytime and anywhere!

You can also recycle your plastic waste through SM Supermalls’ Plastic Waste Collection programs. Make it a fun weekend and volunteer for SM by the Bay and SM Mall of Asia’s regular ocean clean-up drives.

Plant a garden

Plants help stop climate change by removing carbon dioxide from the air. If you don’t have a large yard for a garden, you can still get houseplants! There are many creative and beautiful ways to add more plants to a small home like using a backless bookshelf or installing vertical gardens.

Get plants, tools, and expert tips on how to take care of your home garden at SM Mall. You can also find beautiful containers like terrariums and plant hangers that are made by Filipino SMEs.

Buy eco-friendly products

Choose more environmentally friendly products to gradually create a sustainable lifestyle.

Environmentally friendly products can be reusable or biodegradable. They are usually made from sustainable materials with eco-friendly packaging. They also produced less toxic waste during manufacturing and after disposal.

You can find thousands of eco-friendly products within SM malls through the recently launched Green Finds pop-up stores. The selection of products can help go green in every aspect of your life.

Reuse as much as you can

Before you throw anything away, consider if the item can be either upcycled into something useful, or donated to someone who needs it. SM holds regular toy and book drives, where you can even get discount vouchers to use in the store.

Join the Green Movement

The SM Green Movement is a collective effort of SM, its customers, communities, and partners to promote green living, green culture and a green planet. For more information, visit this website.

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