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No one would choose to be diagnosed with cancer or any other disease. However, it is not uncommon for participants in our programs to remark that having cancer \"was the best thing that happened\" to their relationship. Often, the simple human act of caring, and a changed \"perspective\" (the meaning of the Hebrew word tishkofet), can alter the experience from what has now been documented to increase the risk of depression and other negative sequellae to one of greater fulfillment in life. (Information on Life's Door-Tishkofet services and upcoming couple's retreats can be found @ www.tishkofet.co.il or call 02-631- 0803). To begin with, Resolution 242 does not require Israel to return to the Green Line (essentially the 1949 armistice line). The resolution, with which its drafters struggled long and hard, calls for Israel to withdraw from \"territories occupied in the recent conflict.\" It deliberately avoids reference to \"the territories\" or \"all territories\" because it was not the intention of the drafters that this would be required. For the other sense of the resolution is that every state in the area has the \"right to live in peace within secure and recognized boundaries,\" and it was broadly recognized that the Green Line would not provide Israel with secure borders. Resolution 242 addresses only the relationship between Israel and surrounding Arab states. There is no reference to either a \"Palestinian people\" or a \"Palestinian state\" - nor to direct negotiations. Such negotiations were anathema to the Arab states, which had declared three \"Noes\" - no recognition of Israel, no peace, no negotiations.

Sir, - As long as President Obama is in office there is no possibility whatsoever of the US using its military to destroy Iran's nuclear program, no matter how much it insists that \"all options are on the table\" and how many threats it makes (\"PM to Biden: Only credible military threat will stop Iran's race for nuclear arms,\" November 8). Sir, - The British foreign secretary, on his recent visit to Israel, was questioned about the continued threat of arrest for \"war crimes\" hanging over the head of any Israeli government or military personage visiting the UK, and when his government would take steps to cancel or defuse this ridiculous law. The minister replied with noticeable irritation that \"...we will continue to do it to our own timetable. We do not need any intervention by other foreign ministers in that process, including the Israeli one\" (\"We'll amend universal jurisdiction within a year, Hague promises,\" November 5). The Holocaust Educational Trust is an independent UK-based charity that has received funding for its \"Lessons from Auschwitz\" project from successive British governments (\"Because hearing is not seeing,\" November 9). It is not a government organization.(c) Copyright Jerusalem Post. All rights reserved.

Sir, - A few years ago I watched Nicolas Sarkozy demolish Tariq Ramadan on French TV and thought: finally a French politician who gets it. But once in power, European politicians seem forced to say things which make no sense - at least not to readers of The Jerusalem Post who absorbed Sam Ser's cover story on the \"simmering hatred\" in Islam in last Friday's UpFront magazine (\"A radical rethink,\" June 20) notably the interview with Ali Sina. Sir, - Larry Pfeffer was 100 percent correct in criticizing Yad Vashem's refusal to recognize the \"righteous Jews\" who planned, plotted and fought in every way possible to save fellow Jews from the Holocaust (\"Rescue, expurgated,\" Letters, June 24). Sir, - As a fan of Amy Winehouse who stands in awe of her phenomenal voice and talent, I plead: Amy, defeat your demons of drugs and cigarettes while you still can. Emphysema is a living hell. Don't follow those other great talents who lived too hard and died too young, to the music world's great detriment (\"Winehouse denies illness report,\" June 25).

PurposePost-operative radiation therapy for brain metastases (BM) has become standard treatment. Concerns regarding the deleterious cognitive effects of Whole Brain Radiation Therapy spurred a trend to use focal therapies such as stereotactic radiosurgery (SRS). The purpose of this study was to prospectively evaluate the neuropsychological effects following post-resection SRS treatment since limited data exist in this context.MethodsWe conducted a prospective single arm cohort study of patients with 1–2 BM, who underwent resection of a single BM between May 2015 to December 2016. Patients were evaluated for cognitive functions (NeuroTrax computerized neuropsychological battery; Modiin, Israel) and quality of life (QOL; QLQ-30, QLQ-BN20) before and 3 months following post-resection SRS.ResultsTwelve out of 14 patients completed pre- and post-SRS neurocognitive assessments. Overall, we did not detect significant neurocognitive or QOL changes 3 months following SRS. In a subgroup analysis among patients younger than 60 years, median global cognitive score increased from a pre-treatment score of 88 (72–102) to 95 (79–108), 3 months following SRS treatment, p = 0.042; Wilcoxon paired non-parametric test. Immediate verbal memory and executive functions scores increased from 86 (72–98) to 98 (92–112) and 86 (60–101) to 100 (80–126), respectively, p = 0.043. No significant cognitive changes were discovered among patients at the age of 60 or older.ConclusionsPost-resection radiosurgery has a safe neuro-cognitive profile and is associated with preservation of nearly all quality of life parameters. Patients younger than 60 years benefit most and may even regain some cognitive functions within a few months after treatment.

Blood oxygenation level dependence (BOLD) imaging under either hypercapnia or hyperoxia has been used to study neuronal activation and for assessment of various brain pathologies. We evaluated the benefit of a combined protocol of BOLD imaging during both hyperoxic and hypercapnic challenges (termed hemodynamic response imaging (HRI)). Nineteen healthy controls and seven patients with primary brain tumors were included: six with glioblastoma (two newly diagnosed and four with recurrent tumors) and one with atypical-meningioma. Maps of percent signal intensity changes (ΔS) during hyperoxia (carbogen; 95%O2+5%CO2) and hypercapnia (95%air+5%CO2) challenges and vascular reactivity mismatch maps (VRM; voxels that responded to carbogen with reduced/absent response to CO2) were calculated. VRM values were measured in white matter (WM) and gray matter (GM) areas of healthy subjects and used as threshold values in patients. Significantly higher response to carbogen was detected in healthy subjects, compared to hypercapnia, with a GM/WM ratio of 3.8 during both challenges. In patients with newly diagnosed/treatment-naive tumors (n = 3), increased response to carbogen was detected with substantially increased VRM response (compared to threshold values) within and around the tumors. In patients with recurrent tumors, reduced/absent response during both challenges was demonstrated. An additional finding in 2 of 4 patients with recurrent glioblastoma was a negative response during carbogen, distant from tumor location, which may indicate steal effect. In conclusion, the HRI method enables the assessment of blood vessel functionality and reactivity. Reference values from healthy subjects are presented and preliminary results demonstrate the potential of this method to complement perfusion imaging for the detection and follow up of angiogenesis in patients with brain tumors.

Risk-reducing mastectomy (RRM) is often advocated for BRCA1/2 mutation carriers who face a heightened lifetime risk of breast cancer. However, many carrier patients seek alternative risk-reducing measures. In a phase II nonrandomized trial, we previously reported that prophylactic irradiation to the contralateral breast among BRCA carriers undergoing breast-conserving treatment significantly reduced subsequent contralateral breast cancer. Herein, we report the outcome of salvage mastectomy and reconstruction in 11 patients that suffered reoccurrences of breast cancer in either the ipsilateral or contralateral breast or elected to have the procedure for risk reduction during the eight-year follow-up period. Patients’ satisfaction with the procedure and physicians’ assessment of the cosmetic outcome were not inferior for previously irradiated compared to non-irradiated breasts. Although the numbers are small, the results are encouraging and sustain hope in a challenging population. Our findings support continuing research as well as a discussion of risk-reduction alternatives besides mastectomy, including prophylactic breast irradiation, in BRCA1/2 mutation carriers.

Advanced MR imaging methods have an essential role in classification, grading, follow-up and therapeutic management in patients with brain tumors. With the introduction of new therapeutic options, the challenge for better tissue characterization and diagnosis increase, calling for new reliable non-invasive imaging methods. In the current study we evaluated the added value of a combined protocol of blood oxygen level dependent (BOLD) imaging during hyperoxic challenge (termed hemodynamic response imaging (HRI)) in an orthotopic mouse model for glioblastoma under anti-angiogenic treatment with B20-4.1.1, an anti-VEGF antibody. In glioblastoma tumors, the elevated HRI indicated progressive angiogenesis as further confirmed by histology. In the current glioblastoma model, B20-treatment caused delayed tumor progression with no significant changes in HRI yet with slightly reduced tumor vascularity as indicated by histology. Furthermore, fewer apoptotic cells and higher proliferation index were detected in the B20-treated tumors compared to control-treated tumors. In conclusion, HRI provides an easy, safe and contrast agent free method for the assessment of the brain hemodynamic function, an additionally important clinical information.

Calcification is a rare phenomenon in high grade glioma (HGG). CT scans are sensitive to mineralization but used infrequently for tumor assessment in the MRI era. The presence of calcification can be overlooked on routine MRI. Calcification may reflect chronicity and natural changes in the tumor or its milieu over time and may be accelerated by certain treatments. Calcification may have clinical significance which could signal potential risk for stroke or hemorrhage related to particular therapies; or it may be a positive prognostic factor for treatment response. The true incidence and relevance of calcification in HGG and relation to therapy is unclear. During treatment of HGG patients with bevacizumab (BVZ) we observed significant tumor calcification on brain CT. We performed a retrospective review of HGG patients treated with BVZ to quantitate the incidence of calcification in this group compared to those treated with cytotoxic therapy alone. Sixty-two patients with progressive HGG were treated with BVZ and a cytotoxic agent. Among 19 patients treated for 6+ months, 12 had a CT scan performed. We observed an unexpected phenomenon of calcification in the CT scans of several patients. We were also able to comparatively quantitate the incidence of calcification in a control group of primary glioblastoma (GB) patients not exposed to BVZ therapy. The incidence of calcification in the general GB population is increased with longer survival. The phenomenon is increased with anti-angiogenic therapy for brain tumors. Calcification may have significance as a predictor for treatment response.