Myelofibrosis is a rare type of blood cancer that causes scarring of the bone marrow — the soft, spongy tissue in the center of most of your bones.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bcc88a20-4c47-4251-a784-168cf75d0934 “The cancer’s name refers to this process,” explains Ruben Mesa, MD , vice dean for cancer programs and professor of medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina. “‘Myelo’ meaning bone marrow and ‘fibrosis’ meaning scarring.” As scar tissue grows, the bone marrow loses its ability to make enough healthy blood cells.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299283eb7d-a612-498a-aba5-1ef3e1375d78 Myelofibrosis is considered to be a type of chronic leukemia , which affects blood-forming tissues. It belongs to a family of related blood cancers called myeloproliferative neoplasms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629281859a0-e593-496c-937a-41a4e730c814 In about 12 percent of cases, myelofibrosis advances from a chronic leukemia to an acute leukemia in which symptoms worsen, often rapidly.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291d2006fe-4e6c-4cfc-86ed-465b6e704574 “This chronic disease is burdensome and progressive, and in a fraction of patients, can evolve into an acute myeloid leukemia that is uniformly fatal,” says John Mascarenhas, MD , professor of medicine, hematology, and medical oncology at Mount Sinai in New York City. Types of Myelofibrosis There are two types of myelofibrosis: primary and secondary.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b709fda8-56d0-485c-8a39-647358210886 If myelofibrosis occurs of its own accord, it’s known as primary myelofibrosis. Sometimes, however, another bone marrow disease, such as polycythemia vera (PV) or essential thrombocythemia (ET), transforms into myelofibrosis. When this happens, the disease is referred to as secondary myelofibrosis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a5ad273e-331e-44bd-9adf-b349852f6895 Between 10 and 15 percent of myelofibrosis cases start as either PV or ET.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292edf518f-2ba5-417a-b351-76d3ad9e26f1 Polycythemia vera is also a rare blood cancer that occurs when a person’s bone marrow makes too many red blood cells. Those extra cells can make the blood too thick, which can lead to blood clots, heart attacks, and strokes. PV usually develops slowly, and many people can live a long time with it.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299802b9f7-958f-4b18-ae8a-c0123192dadb If polycythemia vera turns into myelofibrosis, it doesn’t transform back to PV. And people who have primary myelofibrosis won’t develop PV later on.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b64c41c8-41fb-443a-bea0-855d6d6de135 Essential thrombocythemia is another rare blood cancer that happens when the bone marrow makes too many platelets. Like PV, ET can increase the risk of blood clots, heart attack , and stroke .e60dc2a1-f33c-4a05-9b50-8e3e8e5976296fd7ebe4-79d1-4d04-af30-6569f28f948e
Signs and Symptoms of Myelofibrosis Symptoms Signs and symptoms of myelofibrosis usually occur because the bone marrow can’t produce enough normal blood cells. These symptoms can include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629b9039174-48bb-46f8-8f61-7019a2a539cc Frequent infections (due to low white blood cell counts) Easy bleeding or bruising (due to low platelet counts) Fatigue, shortness of breath , weakness, or paleness (due to low red blood cell counts) A feeling of fullness, abdominal pain , weight loss, or decreased appetite (due to an enlarged spleen or liver) Portal hypertension (a spike in blood pressure in the vein that carries blood from the spleen to the liver)e60dc2a1-f33c-4a05-9b50-8e3e8e597629a1e9e487-fad1-4eef-bce0-58d39e65c256 Fever Night sweats Itchy skin Joint or bone pain Weight loss Blood clots Extramedullary hematopoiesis (an abnormal growth of blood-forming cells outside of the bone marrow)e60dc2a1-f33c-4a05-9b50-8e3e8e597629f027973f-2050-4026-bdf3-e0e5db9d4f27 About one-third of people with myelofibrosis don’t show symptoms during the early stages of the disease; problems only arise as the cancer progresses.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298a9d6b19-640f-42cf-933d-b356e6c379fc
Causes and Risk Factors of Myelofibrosis Causes Scientists have not yet pinpointed the underlying cause of myelofibrosis, but the consensus it that it is not inheritable.e60dc2a1-f33c-4a05-9b50-8e3e8e597629116089b3-b404-4b07-8f2e-662d1787f1d9 “We believe that myelofibrosis is driven by changes that occur in the genes that control how the bone marrow functions,” Dr. Mesa explains. These faulty genes make copies of themselves and pass along the defects to new cells.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ed0ae5fc-419d-4b15-a2e5-ee92b912e7e9 Special proteins in the body called Janus-associated kinases (JAKs) are thought to play a key role in the development of myelofibrosis. These proteins help regulate the creation of blood cells in the bone marrow by prompting cells to grow and divide. If JAKs become too active, blood cell production can get out of whack.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298d19d007-202b-4501-b995-e18542968a51 Between 60 and 65 percent of all people with myelofibrosis have a mutation, or defect, in the JAK2 gene.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f1f5ed98-da1a-4674-bf53-09811c8781b2 Another genetic mutation, in a gene called calreticulin (CALR), is present in about 20 to 25 percent of people with myelofibrosis.e60dc2a1-f33c-4a05-9b50-8e3e8e59762917d5350a-c11c-4b52-a888-bb5f7c9a7871 Between 5 and 10 percent of patients have a mutation in a gene called the myeloproliferative leukemia (MPL) gene.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e21175c2-7d90-4674-a55d-55c584b51dd2 And some people with myelofibrosis don’t have any known gene mutations.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eda84b67-dc6d-4095-9a8d-36948d63a657 Risk Factors for Myelofibrosis “We are still working hard to understand exactly why people develop myelofibrosis,” Dr. Mascarenhas says. Potential risk factors include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762944d1f4af-951b-428b-917f-cad0c622785a Having another blood cell disorder, such as polycythemia vera (PV) or essential thrombocythemia (ET) Exposure to certain industrial chemicals, such as toluene or benzene Exposure to ionizing radiation, such as the radiation from X-rays , computerized tomography (CT) scans , positron emission tomography (PET) scans, and radon, a natural radioactive gas found in some homese60dc2a1-f33c-4a05-9b50-8e3e8e597629abe6f202-86d9-4a17-a424-ba938b32f43d However, the biggest individual risk factor for blood cancers like myelofibrosis is likely due to aging, Mesa notes. Though anyone can develop myelofibrosis, it’s most common in people older than 50.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294987ffd5-4cb1-4e77-b260-ce3d89e6371e Scientists are now looking for ways to better recognize who is at risk for developing myelofibrosis, Mascarenhas says. For instance, researchers are studying whether identifying people with a certain mutation — called clonal hematopoiesis of indeterminate potential (CHIP) — has the potential to halt the disease from developing or allow for earlier intervention. “However, this research and potential application is still in its infancy,” he explains.
How Is Myelofibrosis Diagnosed? Diagnosis As with most cancers, getting an accurate and prompt diagnosis is important so you can start treatment when myelofibrosis is in its earlier stages. Sometimes it’s tricky to differentiate myelofibrosis from other related blood cancers, such as ET, PV, and chronic myelogenous leukemia. “It is imperative that one clearly distinguishes between these diagnoses as the prognoses and therapeutic approaches can vary widely,” says Mascarenhas. Your doctor will likely order several tests and procedures to help determine if you have myelofibrosis. These may include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976291da45fa8-771b-4fda-a29c-72280d664e07 Physical Exam This is done to check your vital signs (body temperature, pulse rate, respiration rate, and blood pressure ) and examine your lymph nodes, spleen, and abdomen. Blood Tests These can reveal if you have an abnormal level of platelets, red blood cells, or white blood cells. Certain blood tests also check for elevated levels of uric acid, lactic dehydrogenase, and bilirubin, which may indicate myelofibrosis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ab933367-1076-4d36-883e-b31e7a7828a2 Imaging Tests X-rays and magnetic resonance imaging (MRI) may be performed to help doctors learn more about your condition. Additionally, doctors may order an ultrasound to check if your spleen is enlarged.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292bab3459-2c2c-4f0d-8075-b9df87b46eed Bone Marrow Biopsy This involves using a small needle to remove a sample of bone marrow. Examining the sample under a microscope helps rule out or confirm a myelofibrosis diagnosis. Gene Mutation Tests Analyzing your blood or bone marrow for gene mutations, such as JAK2, MPL, or CALR, can assist in tailoring treatment options and assessing your prognosis. Which Types of Experts Diagnose and Treat Myelofibrosis? Hematologist-oncologists are experts who treat blood cancers, including myelofibrosis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cb069727-e0cc-4f66-ac14-99b2af9056bc Because myelofibrosis is rare, you may want to find a doctor who has experience with this specific type of blood cancer. “It is really important to seek consultation with an expert who has a focus in this area of malignant hematology. Ideally, this person can work with your local hematologist to help provide a personalized treatment approach with the most up-to-date and cutting-edge therapies,” says Mascarenhas.
Prognosis of Myelofibrosis The prognosis for someone with myelofibrosis varies depending on the patient’s overall health, age, how advanced the cancer is at diagnosis, treatments received, and other factors.e60dc2a1-f33c-4a05-9b50-8e3e8e59762989465900-6775-4731-bd26-15e39f5e7d71 “Life expectancy can range from a year or two in very aggressive cases to sometimes decades. The average being somewhere in the handful of years,” says Mesa. Newer therapies have extended survival odds for many patients, he adds.
Duration of Myelofibrosis Duration If you’re diagnosed with myelofibrosis, you’ll likely have it for the rest of your life. However, for a select number of patients, a stem cell transplant can wipe out the cancer for good.e60dc2a1-f33c-4a05-9b50-8e3e8e59762967b4b23b-830c-4388-9b13-75eaffdcfb59
Treatment and Medication Options for Myelofibrosis Treatment Your treatment approach will depend on how advanced your cancer is, your overall health, what genetic mutations you have, if any, and other factors. “Myelofibrosis is very heterogenous [diverse],” explains Mesa. “Plans need to be quite individualized because not everybody is the same.” For example, a small subset of people with myelofibrosis who are low risk and minimally affected by the disease may be candidates for the simplest treatment of all: observation. This means the doctor will watch the cancer carefully, but the patient isn’t on any active treatment. Medications for Myelofibrosis Currently, FDA-approved medicines to treat myelofibrosis include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762996ea558f-359d-4ab3-aab6-bffea584cb14 ruxolitinib (Jakafi) fedratinib (Inrebic) pacritinib (Vonjo) momelotinib (Ojjaara) e60dc2a1-f33c-4a05-9b50-8e3e8e597629185faa70-961e-4f42-a41c-dc2c0029ffe7 These medicines are all JAK-inhibitors, which work by blocking the processes of faulty genes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e8a7995d-d04f-4305-bb1c-bac2cefb9a3e Medications for Anemia Patients with myelofibrosis who develop anemia (a low red blood cell count) might be candidates for additional treatments, such as:e60dc2a1-f33c-4a05-9b50-8e3e8e597629601c54dc-3250-4290-bee3-89a7957d3bcc Chemotherapy Steroids Androgens (synthetic hormones) Immunomodulators, such as thalidomide or lenalidomide Interferon (specific proteins that help the body fight infections) A blood transfusion Erythropoietin stimulating agentse60dc2a1-f33c-4a05-9b50-8e3e8e59762945ca7af8-c90c-4125-b7f1-46efada58b8c momelotinib (Ojjaara)e60dc2a1-f33c-4a05-9b50-8e3e8e597629185faa70-961e-4f42-a41c-dc2c0029ffe7 Treatments for an Enlarged Spleen An enlarged spleen due to myelofibrosis might be treated with one or more of the following:e60dc2a1-f33c-4a05-9b50-8e3e8e597629795597d1-44c6-446c-b93e-1c28685fd75e A JAK inhibitor Chemotherapy Radiation Surgery to remove the spleen Interferon Stem Cell Transplant for Myelofibrosis A stem cell transplant, also called a bone marrow transplant, is an option for some people with myelofibrosis. This involves replacing diseased bone marrow with healthy blood stem cells from a donor.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295517cd1f-8681-43b1-8bdd-3d1aece0cd2e Candidates for a stem cell transplant are usually younger, healthy patients.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e1ab73d3-f9a0-4152-83c4-191b77a967b8 Before undergoing the transplant, the patient receives chemotherapy or radiation to destroy the diseased bone marrow. Stem cells from a compatible donor are then given via an infusion.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292657bae1-65bf-4481-a443-9bd6495bd548 A stem cell transplant has the potential to cure myelofibrosis, but the procedure can cause life-threatening risks.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297e7155eb-f5e3-44aa-960d-32314b4bbd73 Because of these risks, Mesa says stem cell transplants are performed in less than 10 percent of patients with myelofibrosis. “A stem cell transplant can, even in the best circumstances, have a 10 to 15 percent chance of fatal complications,” Mesa says. “To put that in perspective, open-heart surgery carries only a 1 percent risk.” Clinical Trials Participating in a clinical trial may be an option for some people with myelofibrosis. These studies might allow you to receive a therapy that isn’t yet available to the public. Mesa says there are several drugs being studied in clinical trials that could be beneficial for people with myelofibrosis. “Be hopeful. There are a lot of new medicines in development, a lot of things that are being discovered, and a lot of people out there rooting for you even though this is a rare cancer,” he says.
Prevention of Myelofibrosis There’s no way to prevent myelofibrosis, however, researchers are looking into ways to detect the disease sooner so therapies can be started quickly.e60dc2a1-f33c-4a05-9b50-8e3e8e597629605e6f6b-47ec-4041-986b-9620a7d80734
Complications of Myelofibrosis Complications Potential complications of myelofibrosis include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976293790da78-e534-466f-9afd-909b052c161d Acute Leukemia When myelofibrosis progresses to an acute state — in which symptoms worsen quickly — it becomes extremely aggressive. Pain An enlarged spleen can cause back and abdominal pain. Growths Sometimes blood cells form outside of the bone marrow and create tumors of developing blood cells in other parts of the body. These growths can cause gastrointestinal bleeding, coughing or spitting up blood, seizures, or spinal cord compression. Bleeding If your platelet counts drop, you may experience bleeding complications.
Research and Statistics: Who Has Myelofibrosis? Research and Statistics Myelofibrosis is a rare cancer, affecting an estimated 20,000 people in the United States.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fbfed27c-241f-4e25-9948-6250c4eaf62e “There clearly are more rare cancers, but myelofibrosis is not one of the common ones,” says Mesa. The cancer occurs in both men and women and is most common in people over age 50. However, children and younger adults can also develop myelofibrosis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629de56141a-ff82-4141-af2e-082693edca04
Related Conditions and Causes of Myelofibrosis Related Conditions Some conditions closely related to myelofibrosis include: Polycythemia vera (PV) Essential thrombocythemia (ET) Acute myeloid leukemia Chronic leukemia
Resources We Trust Cleveland Clinic: MyelofibrosisLeukemia & Lymphoma Society: MyelofibrosisNational Organization for Rare Disorders: Primary MyelofibrosisCancerCare: MyelofibrosisMPN Research Foundation: What Is Myelofibrosis (MF)?

Are you and your partner neglecting sex play? Learn how to add it back into your routine to boost your bond in and out of the bedroom. While “quickies” can be fun and spontaneous, skipping foreplay means missing out on a great way to connect emotionally and physically. According to Pepper Schwartz, PhD, a sexual health expert and researcher at the University of Minnesota in Minneapolis, foreplay is critical, elemental, and necessary.

Foreplay, also known as “outercourse,” is any sexual activity that occurs before intercourse. There is no single way to engage in foreplay, as it can mean different things to different people. It can involve kissing, caressing, cuddling, flirty texting or talking, massage, and oral sex. If you like it a little rough, biting, pinching, scratching, and spanking can be a turn-on. The goal is to increase sexual excitement, which can help prepare the body for intercourse. Foreplay is sometimes thought of as a warm-up for sex, but it doesn’t necessarily have to lead to intercourse. Some couples find foreplay itself to be sexually fulfilling as a main event.

The benefits of foreplay include lubrication of the vagina, an extended erection, and the prevention of premature ejaculation for people with penises. The female body pulls the uterus up when aroused, lengthening the vagina. This process, called uterine tenting, creates a pool area for semen, which is part of the reproductive sophistication of our machinery, according to Dr. Schwartz. As those muscles relax, the nerve endings start to get stimulated, paving the way for a more pleasurable experience. Research involving married couples has found that 1 to 10 minutes of foreplay was associated with 40% of women achieving orgasm during sex. That percentage rose to 50 with 12 to 20 minutes of foreplay and 60 with more than 20 minutes of foreplay.

If you want more action in bed, you have to let your partner know what you want. But talking about sex can be easier said than done for some. Dr. Lyndsey Harper, a clinical assistant professor of obstetrics and gynecology at Texas A&M School of Medicine in Bryan, Texas, recommends two sentence starters to try when expressing sexual desire to your partner: “I want you to…” and “It feels so good when you…”. If it makes you more comfortable, you can bring up your sexual needs outside of the bedroom. If you don’t know how to bring it up, she suggests starting the conversation with something like, “Our sex life is really important, and I’d love for us to feel open talking about things. Would it be okay for me to share with you some things I like?”

Communication comfort is closely linked to trust. To experience true intimacy and fun foreplay, trusting each other is essential, especially since our needs constantly change. Couples who find it difficult to communicate about their desires should consider seeing a couple’s counselor or sex therapist who can help them navigate these discussions.

Foreplay is just play. Couples can engage in it however they want. According to Dr. Harper, it generally takes about 20 minutes of arousal for women to become fully lubricated and ready for penetrative sex. However, it is best to abolish the idea of “foreplay” and the “main event” of penetrative sex and work together with your partner to create a fun and intimate sexual life where everyone’s needs are met.

https://www.everydayhealth.com/sexual-health/sexual-foreplay.aspx

The post What Is Myelofibrosis? Symptoms, Causes, Diagnosis, Treatment, and Prevention appeared first on Secretly Sexy.

Foreplay is just play. Couples can engage in it however they want. According to Dr. Harper, it generally takes about 20 minutes of arousal for women to become fully lubricated and ready for penetrative sex. However, it is best to abolish the idea of “foreplay” and the “main event” of penetrative sex and work together with your partner to create a fun and intimate sexual life where everyone’s needs are met.

https://www.everydayhealth.com/sexual-health/sexual-foreplay.aspx

The post What Is Myelofibrosis? Symptoms, Causes, Diagnosis, Treatment, and Prevention appeared first on Secretly Sexy.

Are you and your partner neglecting sex play? Learn how to add it back into your routine to boost your bond in and out of the bedroom. While "quickies" can be fun and spontaneous, skipping foreplay means missing out on a great way to connect emotionally and physically. According to Pepper Schwartz, PhD, a sexual health expert and researcher at the University of Minnesota in Minneapolis, foreplay is critical, elemental, and necessary. Foreplay, also known as "outercourse," is any sexual activity that occurs before intercourse. There is no single way to engage in foreplay, as it can mean different things to different people. It can involve kissing, caressing, cuddling, flirty texting or talking, massage, and oral sex. If you like it a little rough, biting, pinching, scratching, and spanking can be a turn-on. The goal is to increase sexual excitement, which can help prepare the body for intercourse. Foreplay is sometimes thought of as a warm-up for sex, but it doesn't necessarily have to lead to intercourse. Some couples find foreplay itself to be sexually fulfilling as a main event. The benefits of foreplay include lubrication of the vagina, an extended erection, and the prevention of premature ejaculation for people with penises. The female body pulls the uterus up when aroused, lengthening the vagina. This process, called uterine tenting, creates a pool area for semen, which is part of the reproductive sophistication of our machinery, according to Dr. Schwartz. As those muscles relax, the nerve endings start to get stimulated, paving the way for a more pleasurable experience. Research involving married couples has found that 1 to 10 minutes of foreplay was associated with 40% of women achieving orgasm during sex. That percentage rose to 50 with 12 to 20 minutes of foreplay and 60 with more than 20 minutes of foreplay. If you want more action in bed, you have to let your partner know what you want. But talking about sex can be easier said than done for some. Dr. Lyndsey Harper, a clinical assistant professor of obstetrics and gynecology at Texas A&M School of Medicine in Bryan, Texas, recommends two sentence starters to try when expressing sexual desire to your partner: "I want you to..." and "It feels so good when you...". If it makes you more comfortable, you can bring up your sexual needs outside of the bedroom. If you don't know how to bring it up, she suggests starting the conversation with something like, "Our sex life is really important, and I'd love for us to feel open talking about things. Would it be okay for me to share with you some things I like?" Communication comfort is closely linked to trust. To experience true intimacy and fun foreplay, trusting each other is essential, especially since our needs constantly change. Couples who find it difficult to communicate about their desires should consider seeing a couple's counselor or sex therapist who can help them navigate these discussions.

Foreplay is just play. Couples can engage in it however they want. According to Dr. Harper, it generally takes about 20 minutes of arousal for women to become fully lubricated and ready for penetrative sex. However, it is best to abolish the idea of "foreplay" and the "main event" of penetrative sex and work together with your partner to create a fun and intimate sexual life where everyone's needs are met.

https://www.everydayhealth.com/sexual-health/sexual-foreplay.aspx

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