A cancer survivor and a clinical researcher tell about taking part in an immunotherapy clinical trial at NCI's Center for Cancer Research. Breast cancer is one of a few cancers for which an effective screening test, mammography, is available. Unlike most hospitals, to be seen at the Clinical Center you must have an illness that is being studied and be eligible for a clinical trial that is accepting people. In 2020, the FDA approved the use of  the drug tucatinib (Tukysa) combined with trastuzumab and capecitabine (Xeloda) for HER2-positive breast cancer that either can't be removed with surgery or has spread to other parts of the body. The mainstays of breast cancer treatment are surgery, radiation, chemotherapy, hormone therapy, and targeted therapy. Given the increasing burden of breast cancer in Uganda and elsewhere in sub-Saharan Africa (SSA) and driven by the limited availability of immunohistochemistry (IHC), we launched a clinical trial … But scientists continue to study novel treatments and drugs, along with new combinations of existing treatments. The goal of the programs is to give physicians a better idea whether regular monitoring is sufficient or if early treatment is warranted. The study, which included patients with ER-positive, lymph node-negative breast cancer, found that a test that looks at the expression of certain genes can predict which women can safely avoid chemotherapy. Improving Treatments for Patients with Metastatic Breast Cancer Using Genomic Profiling 27/08/2020 A polyploid giant cancer cell (PGCC) from triple-negative breast cancer. Explore 364,793 research studies in all 50 states and in 219 countries. See listed clinical studies related to the coronavirus disease (COVID-19) ClinicalTrials.gov is a resource provided by the U.S. National Library of Medicine. Two concerns in breast cancer screening, as in all cancer screening, are the potential for diagnosing tumors that will not become life-threatening (overdiagnosis) and the possibility of receiving false-positive test results. Any time you or a loved one need treatment for cancer, clinical trials are an option to think about. Conclusion. Most of the trials that take place here are phase 1 and 2. Complementary & Alternative Medicine (CAM), Coping with Your Feelings During Advanced Cancer, Emotional Support for Young People with Cancer, Young People Facing End-of-Life Care Decisions, Late Effects of Childhood Cancer Treatment, Tech Transfer & Small Business Partnerships, Frederick National Laboratory for Cancer Research, Milestones in Cancer Research and Discovery, Step 1: Application Development & Submission, Tomosynthesis Mammographic Imaging Screening Trial (TMIST), Women Informed to Screen Depending on Measures of Risk (WISDOM), lived longer both without their disease progressing and overall, Breast Specialized Programs of Research Excellence (Breast SPOREs), Cancer Intervention and Surveillance Modeling Network (CISNET), Division of Cancer Epidemiology and Genetics, Breast Cancer Surveillance Consortium (BCSC), Consortium for Imaging and Biomarkers (CIB), Consortium for Molecular Characterization of Screen-Detected Lesions, Breast Cancer Genetic Study in African-Ancestry Populations, Detroit Research on Cancer Survivors (Detroit ROCS), Trial Tests Abemaciclib as New Option for Early-Stage Breast Cancer, Fertility Preservation Safe for Young Women with Breast Cancer, Some Postmenopausal Women with Breast Cancer May Forgo Chemotherapy, Having a Heart Attack May Make Breast Cancer Grow Faster, Sacituzumab Govitecan Approved for Metastatic Triple-Negative Breast Cancer, For Women with Breast Cancer, Regular Exercise May Improve Survival, Breast Cancer Research Results and Study Updates, U.S. Department of Health and Human Services, Scientists are also studying whether combining a variety of drugs with immunotherapy will work better than immunotherapy alone. PURPOSE: This randomized clinical trial is studying vitamin D and breast cancer biomarkers in female patients. HER2-targeted drugs that can cross the blood-brain barrier are being studied for the treatment and prevention of brain metastases. ... Advances in Breast Cancer Research (National Cancer Institute) Clinical Trials ClinicalTrials.gov: Breast Neoplasms, Male (National Institutes of Health) Journal Articles References and abstracts from MEDLINE/PubMed (National Library of Medicine) Article: Male Breast Cancer… EDRN is a network of NCI-funded institutions that are collaborating to discover and validate early detection biomarkers. Once you have finished the clinical trial, you will return to your local doctor to continue your medical care. A Phase 1b Trial of Sequential Combinations of BN-Brachyury, Entinostat, ado-trastuzuamb emtansine and M7824 in Advanced Stage Breast Cancer (BrEAsT) Open - Recruiting NCI Protocol ID NCI-20-C-0056 Referring health care providers are welcome to call the NCI research team conducting the trial at any time to discuss patient treatment plans and care. by the National Cancer Institute (NCI) to bring researchers, cancer centers, and doctors together to: – identify important questions in cancer research, and – design and conduct clinical trials to answer these questions. Therefore, chemotherapy is the mainstay for treatment of TNBC. 2011 Jun;10(6):755-74. doi: 10.1586/erv.11.59. Over the years, DCEG research on breast cancer has made a significant impact in the following areas: DCEG studies in hereditary breast and ovarian cancer uncovered the value of risk reducing salpingo-oophorectomy , now considered a standard-of-care treatment option in the management of women in high-risk families (Tobacman et al., 1982; Struewing et al., 1995; Kramer et al., … Many NCI-funded researchers working at the NIH campus, as well as across the United States and world, are seeking ways to address breast cancer more effectively. A cluster randomized controlled trial was initiated in the Trivandrum district (Kerala, India) on January 1, 2006, to evaluate whether three rounds of triennial clinical breast examination (CBE) can reduce the incidence rate of advanced disease incidence and breast cancer mortality. You can: If you search for trials yourself, first review the trial information and eligibility criteria for each trial and discuss with your doctor. A randomized trial of antiestrogen therapy versus combined antiestrogen and octreotide LAR therapy in the adjuvant treatment of breast cancer in postmenopausal women. Explore the links on this page to learn more about breast cancer prevention, screening, treatment, statistics, research, clinical trials, and more. Have your diagnosis confirmed by your own doctor. Trials are available for breast cancer prevention, screening, and treatment. Trials of immunotherapy approaches are currently underway for all three major breast cancer subtypes (ER-positive, HER2-positive, and triple-negative). A national government agency working to reduce the impact of cancer on all Australians. NCIC CTG Trial MA.14 A phase III randomized double blind study of letrozole versus placebo in women with primary breast cancer completing five or more years of adjuvant tamoxifen. Meet the requirements for a clinical trial that is accepting patients. In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “Advances in Breast Cancer Research was originally published by the National Cancer Institute.”. The NCI Cancer Intervention and Surveillance Modeling Network (CISNET) focuses on using modeling to improve our understanding of how prevention, early detection, screening, and treatment affect breast cancer outcomes. Edit profile . It is now known that breast cancer can be divided into subtypes that respond differently to various types of treatment. Clinical trials add to the progress that is being made against cancer in many ways: A clinical trial can answer important questions about the best treatment for a type of cancer. You will not receive long-term care at the Clinical Center. Need help finding a trial? Triple-negative breast cancers (TNBC) are the hardest to treat because they lack both hormone receptors and HER2 overexpression, so they do not respond to therapies directed at these targets. All trials on the list are supported by NCI. Have an illness that is being studied in a clinical trial that is accepting patients. Receiving cancer care and treatment at the Stefanie Spielman Comprehensive Breast Center? Medical records need to be in English or a certified English translation. And some are more clinical, seeking to translate this basic information into improving patient outcomes. Mammograms can detect breast cancer early, possibly before it has spread. CCR’s teams are made up of compassionate doctors, nurses, and care specialists who conduct clinical trials that are testing new treatments. Center for Cancer Research (CCR) The Center for Cancer Research … Learn more. Other studies focus on financial impacts, the effects on caregivers, models of care for survivors, and issues such as racial disparities and communication. Want to use this content on your website or other digital platform? Staff . The Confluence Project, from NCI's Division of Cancer Epidemiology and Genetics, will develop a research resource that includes data from thousands of breast cancer patients and controls of different races and ethnicities. The immunotherapy drug. Examples of studies funded include the impact of cancer and its treatment on physical functioning, emotional well-being, cognitive impairment, sleep disturbances, and cardiovascular health. Search. November 1, 2007—NCI sponsored a symposium, HIV/AIDS Research at the National Cancer Institute: ... NCORP conducts multi-site cancer clinical trials and studies in diverse populations in community-based healthcare systems across the United States and Puerto Rico with a goal of NCORP bringing cancer clinical trials and cancer care delivery research to individuals in their … A breast cancer clinical trial, on the other hand, is an approved research study that some doctors believe has a strong potential to improve standard treatments. Learning all you can about clinical trials can help you talk with your doctor and decide what is right for you. In this section you can learn about clinical trials in general, find tools to help you decide if a clinical trial may be right for you, and search for specific studies you may be eligible for. Clinical trials are research studies that involve people. The study, SWOG S1007, known as RxPONDER, was supported by the National Cancer Institute (NCI), part of the National Institutes of Health; designed and led by SWOG Cancer Research Network; and conducted by the NCI National Clinical Trials Network. CCR Central; Login; Search Toggle . Technological advances in imaging are creating new opportunities for improvements in both screening and early detection. Our syndication services page shows you how. The Consortium for Imaging and Biomarkers (CIB) and the Consortium for Molecular Characterization of Screen-Detected Lesions are programs that research which screen-detected lesions are areas of concern and which can be left alone. NIH is the largest funder of research in biology and medicine in the country. NCI's Center for Cancer Research (CCR) conducts more than 150 cancer and HIV clinical trials at the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland. Depending on the results from the screening visit, you may be invited to enroll in a clinical trial. NCI-funded researchers are working to advance our understanding of how to prevent, detect, and treat breast cancer. You should also review the Clinical Center’s Visa and Immigration Information to become familiar with all requirements. Trials in the clinic use the scientific resources of the DCTD to provide better understanding of techniques of treatment, selection of patients, and combinations of agents. Provide all necessary medical records in English. Data Sources. Cancer and HIV clinical trials at the NIH Clinical Center are open to patients with cancer or HIV, regardless of where they live in the United States. This approach fosters communication and teamwork among doctors and researchers. Cancer Clinical Trials at the NIH Clinical Center Cancer research at the NIH Clinical Center takes place within the Center for Cancer Research (CCR) and the Developmental Therapeutics Clinic. For contact information for the Clinical Research Referral Coordinators and a copy of the Patient Self-Referral Form, see their Referrals–Contacts for Patients page. We hypothesized that this platform would provide the most expedient approach to … Log out. If you are not eligible for a screening visit, the research team will let you know. In some cases, people from other countries can enroll in clinical trials at the Clinical Center if they meet the trial’s eligibility requirements and the trial accepts international participants. Cancer Institute NSW. Other languages; Log in; My Profile My saved pages. Site . Early Detection of Breast Cancer. This includes women whose cancer had spread to the brain. Duke Cancer Institute; Our Research; Clinical Trials. Cancer Institute NSW NSW cancer control agency eviQ Cancer treatments protocols eviQ Education Learning resources for cancer care staff Canrefer Find a cancer specialist iCanQuit Learn how to quit smoking BreastScreen NSW Detect breast cancer early. Remember, all our current standards were clinical trials at one time. MRI (magnetic … The NCI Center for Cancer Research is dedicated to solving important, challenging and neglected problems in cancer research and patient care. Even though most costs are covered, it is important for you to maintain health insurance while receiving treatment at the Clinical Center because you many need coverage for medical care that is required outside of the trial or that is provided away from the Clinical Center. This procedure takes images from different angles around the breast and builds them into a 3-D-like image. Manuscripts, government publications, websites, and professional communications. The current trials are looking for patients with early, advanced-stage breast cancer and patients that are undergoing breast cancer surgery. All NCI Center for Cancer Research (CCR) clinical trials take place at the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland. There are ongoing programs at NCI that support prevention and early detection research in different cancers, including breast cancer. NCI Experts Discuss Challenges in Breast Cancer Research. Search site or phonebook: COVID-19 is an emerging, rapidly … For questions regarding cancer trials at Duke, please contact the Duke Recruitment Innovation Center via email or call 919.681.5698. Some trials may not be listed below. These treatments could prolong the time until chemotherapy is needed and ideally, extend survival. The three main clinical subtypes of breast cancer are: As we learn more about the subtypes of breast cancer and their behavior, we can use this information to guide treatment decisions. The Uganda Cancer Institute, the sole national comprehensive cancer center in Uganda, has a long and rich history of clinical investigation and locally relevant cancer research. If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. To see current clinical trials that are offered through the Developmental Therapeutics Clinic, visit the list of open DTC trials. ClinicalTrials.gov is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world. Within the EDRN, the Breast and Gynecologic Cancers Collaborative Group conducts research on breast and ovarian cancers. The people who take part in clinical trials at the Clinical Center are active partners in medical research and discovery. Search. Article: Area Deprivation Index and Rurality in Relation to Lung Cancer Prevalence and Mortality in a Rural State Article: Penetrance of Breast and Ovarian Cancer in Women Who Carry a BRCA1/2 Mutation and Do Not Use Risk-Reducing Salpingo-Oophorectomy: An Updated Meta-Analysis Breast cancer is the second most common cancer in women after skin cancer. Depending on the results of this review, they may invite you to the Clinical Center for a screening visit. Overview. This page highlights some of the latest research in breast cancer, including clinical advances that may soon translate into improved care, NCI-supported programs that are fueling progress, and research findings from recent studies. There is a new focus on adding targeted therapies to hormone therapy for advanced or metastatic HR-positive breast cancer. All trials are held at The Kinghorn Cancer Centre, Darlinghurst NSW. In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “Cancer Clinical Trials at the National Institutes of Health Clinical Center was originally published by the National Cancer Institute.”. Although breast cancer is much more common in women, men can get it too. If you and your doctor find a trial you may be eligible for, your doctor should call the phone number listed under “Locations and Contacts” for instructions on which medical records to send and where to send them. Phase I/II Study of the Anti-programmed Death Ligand-1 Antibody MEDI4736 in Combination with Olaparib or Cediranib for Advanced Solid Tumors and Advanced or Recurrent Ovarian, Triple Negative Breast, Lung, Prostate and Colorectal Cancers Some trials pose scientific questions that help us understand cancer better or understand what works best for people with the disease. Clinical trials at the NIH Clinical Center are open to patients with cancer, HIV, or immunodeficiency disorders, regardless of where they live in the United States. Although this technology is increasingly available in the clinic, it isn’t known whether it is better than standard 2-D mammography, for detecting cancer at a less advanced stage. Targeted therapy uses drugs or other substances to attack cancer cells with less harm to normal cells. In one study, women who received tucatinib in addition to the other two drugs lived longer both without their disease progressing and overall than women receiving only trastuzumab and capecitabine. Authors Elizabeth A Mittendorf 1 , Gheath Alatrash, Haile Xiao, G Travis Clifton, James L Murray, George E Peoples. Our experts across all cancer specialties participate in national clinical trials and perform the most advanced treatment methods using … … Read new research from the Open Access sister title to JNCI.. The clinical trials on this list are for breast cancer. The Developmental Therapeutics Clinic is an NCI clinic that supports the work of the Division of Cancer Treatment and Diagnosis (DCTD). The Breast Specialized Programs of Research Excellence (Breast SPOREs) are designed to quickly move basic scientific findings into clinical settings. If traveling from another country to take part in a research study at the Clinical Center, you must pay for your own travel to the states and have a place to stay while you are here. National Cancer Institute Center for Cancer Research. To gain an understanding of these disparities, NCI is funding a multi-institution project, the Breast Cancer Genetic Study in African-Ancestry Populations. Some research is basic, exploring questions as diverse as the biological underpinnings of cancer and the social factors that affect cancer risk. A total of 275 clusters that included 115 652 healthy women, aged 30–69 … NCI encourages health care providers to continue open communication with their patients throughout the clinical trial. Long-term follow-up of the IBIS-II DCIS clinical trial has found that Anastrozole and Tamoxifen are both effective in preventing breast cancer and DCIS, providing more treatment options for postmenopausal women with an early form of breast cancer. MRI (magnetic resonance imaging), ultrasound, and clinical breast exams are also used to detect breast cancer, but not as routine screening tools. The National Institutes of Health Clinical Center. • Cancer Cooperative Groups are located throughout North America, Europe, Australia, and New Zealand. Often, the treatments under study are being used for the first time in people. The Clinical Center at the National Institutes of Health (NIH) in Bethesda, Maryland, is America’s largest hospital devoted entirely to research with people. That knowledge, in turn, may lead to the development of therapies that target the genetic alterations that drive those cancer subtypes. Ongoing studies are looking at ways to enhance current breast cancer screening options. Doctors use clinical trials to develop new treatments for serious diseases such as cancer. Skip to main content. Once you are enrolled in a trial, the principal investigator will send regular updates and test results to your doctor back home. Black women are more likely to be diagnosed with aggressive subtypes of breast cancer, and they are more likely to die of their disease than white women. Once you are enrolled in a clinical trial at the Clinical Center, medical care is free. For example, the Women Informed to Screen Depending on Measures of Risk (WISDOM) study aims to determine if risk-based screening—that is, screening at intervals that are based on each woman’s risk as determined by her genetic makeup, family history, and other risk factors—is as safe, effective, and accepted as standard annual screening mammography. Cancer research at the NIH Clinical Center takes place within the Center for Cancer Research (CCR) and the Developmental Therapeutics Clinic. Provides information on the disease, research and clinical trials. However, due to limited resources and funding, United States citizens and lawful permanent residents have priority. The goal of the Breast Cancer Surveillance Consortium (BCSC), an NCI-funded program launched in 1994, is to enhance the understanding of breast cancer screening practices in the United States and their impact on the breast cancer's stage at diagnosis, survival rates, and mortality. They are also looking at how to address disparities and improve quality of life for survivors of the disease. In order to take part in a clinical trial at the Clinical Center, you must: The research team for the trial you are interested in will review your records. Breast cancer vaccines: ongoing National Cancer Institute-registered clinical trials Expert Rev Vaccines. … Clinical trials look at new ways to prevent, detect, or treat disease. NCI’s Office of Cancer Survivorship, part of the Division of Cancer Control and Population Sciences (DCCPS), supports research projects throughout the country that study many issues related to breast cancer survivorship. One new technology is 3-D mammography, also called breast tomosynthesis. If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. Breast cancer clinical trials Our researchers are conducting a number of clinical trials for breast cancer at the Kinghorn Cancer Centre. The Center for Cancer Research is NCI’s in-house cancer center. Get directions, find out where to park and more. The genes of black women with and without breast cancer will be compared to each other, as well as to those of white women who have breast cancer. The following are some of our latest news articles on breast cancer research and study updates: View the full list of Breast Cancer Research Results and Study Updates. The New Onset Diabetes Study (NOD) will include … It conducts clinical trials of novel cancer treatment agents for patients with advanced cancer who may have no other standard treatment options. The National Cancer Institute is leading a project to create a cohort of people who are newly diagnosed with diabetes in the hopes that this group, who are at increased risk of developing pancreatic cancer, provide the clues in their blood and tissues to unravel some of the unknowns about this highly fatal cancer. They are studying screening methods that are appropriate for each woman’s level of risk and limit the possibility of overdiagnosis. Want to use this content on your website or other digital platform? Clinical Trials . One example is the Cancer Biomarkers Research Group, which promotes research in cancer biomarkers and manages the Early Detection Research Network (EDRN). NCI funds and oversees both early- and late-phase clinical trials to develop new treatments and improve patient care. Genomic analyses, such as those carried out through The Cancer Genome Atlas (TCGA), have helped reveal the molecular diversity of breast cancer and eventually could help identify even more breast cancer subtypes. The Breast SPOREs support the development of new therapies and technologies, and studies to better understand tumor resistance, diagnosis, prognosis, screening, prevention, and treatment of breast cancer. Phonebook . The Clinical Center is arranged so that patient care units are close to the labs where related research is taking place. However, you are responsible for any travel, lodging, and food costs related to your initial screening visit. Patients are encouraged to share their clinical trial experience with their health care providers. Immunotherapy Clinical Trials: Sue Scott’s Story of Survival. If you do not live locally, you will also receive help paying for travel, as well as food and lodging expenses if you are being treated as an outpatient. Here, doctors and researchers seek new ways to diagnose, treat, and prevent disease. RxPONDER was an international effort, conducted at 632 sites in nine countries — the United States, Canada, … One example of this is the NCI-sponsored TAILORx clinical trial. Change is inevitable … Its mission is to improve the lives of people with cancer by solving important, challenging, and neglected problems in cancer research and patient care. The members of these families have been invited to participate in other CGB protocols, including the Breast Imaging/Breast Duct Lavage study, the National Ovarian Cancer Prevention and Early Detection study, and a Phase I PARP-inhibitor trial targeting women at increased genetic risk of ovarian cancer being run by investigators in NCI's Center for Cancer Research (CCR). When clinical trials demonstrate better results than the standard, that new treatment becomes the standard. Approved drugs include: The FDA has approved a number of targeted therapies to treat HER2-positive breast cancer, including: Crossing the blood-brain barrier. As cancer treatment is becoming more individualized, researchers are looking at ways to personalize breast cancer screening. Our syndication services page shows you how. The programs listed below are a small sampling of NCI’s research efforts in breast cancer. HER2-positive metastatic breast cancer is more likely to spread to the brain than other types of breast cancer. We have … Cancer Clinical Trials at the NIH Clinical Center, How to Take Part in a Clinical Trial at the NIH Clinical Center, Once Enrolled in a Clinical Trial, Care at the Clinical Center Is Free. Detroit ROCS will examine medical, emotional, social, environmental, and other factors that may affect cancer survival. Search CCR Central . The National Cancer Institute–Molecular Analysis for Therapy Choice (NCI-MATCH) trial was the first national-scale trial in the United States incorporating centralized diagnostic testing and geographically distributed clinical investigation of dozens of treatment options in parallel. Ibrance, Kisquali, or Verzenio). Clinical trials lead to future research. This resource will be used to identify genes that are associated with breast cancer risk, prognosis, subtypes, response to treatment, and second breast cancers. Hear about challenges in breast cancer research in this excerpt from a Facebook Live event with Dr. Stan Lipkowitz and Dr Alexandra Zimmer of NCI’s Center for Cancer Research. This page highlights some of the latest research in breast cancer, including clinical advances that may soon translate into improved care, NCI-supported programs that are fueling progress, and research findings from recent studies. ER-positive breast cancer is typically treated with a combination of hormonal therapy with a targeted treatment, such as a CDK4/6 inhibitor (e.g. Breast cancer is one of a few cancers for which an effective screening test, mammography, is available. NCI is funding a large-scale randomized breast screening trial, the Tomosynthesis Mammographic Imaging Screening Trial (TMIST), to compare the number of advanced cancers detected in women screened for 5 years with 3-D mammography with the number detected in women screened with 2-D mammography. Complementary & Alternative Medicine (CAM), Coping with Your Feelings During Advanced Cancer, Emotional Support for Young People with Cancer, Young People Facing End-of-Life Care Decisions, Late Effects of Childhood Cancer Treatment, Tech Transfer & Small Business Partnerships, Frederick National Laboratory for Cancer Research, Milestones in Cancer Research and Discovery, Step 1: Application Development & Submission, How to Work With Your Health Insurance Plan, Questions to Ask about Treatment Clinical Trials, Drugs Approved for Different Types of Cancer, Drugs Approved for Conditions Related to Cancer, Clinical Center at the National Institutes of Health (NIH), NCI’s clinical trials advanced search form, Clinical Center’s Visa and Immigration Information, Taking Part in Cancer Treatment Research Studies, Clinical Trials Information for Patients and Caregivers, U.S. Department of Health and Human Services. NCI’s basic information about clinical trials explains the types and phases of trials and how they are carried out. It is part of the United States Department of Health and Human Services. Call the Patient Recruitment and Liaison Office at 1-800-411-1222. Call the CCR referral coordinator at 1-888-NCI-1937 (1-888-624-1937). Impact of cancer on all Australians trials look at new ways to personalize breast cancer research that! ( e.g trials explains the types and phases of trials and how they are looking!, find out where to park and more they are studying screening methods that undergoing! S Visa and Immigration information to become familiar with all requirements National agency... Enroll in a clinical trial, you will return to your initial screening visit by NCI, doctors researchers. Are phase 1 and 2 focus on adding targeted therapies to hormone therapy, and communications. Or treat disease help you talk with your doctor and decide what is for. 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