Manchester United stars Paul Pogba, Alexis Sanchez and David De Gea host youngsters for dream day

  • Manchester United hosted their dream day at the Aon Complex training ground
  • David De Gea, Alexis Sanchez, Paul Pogba and Romelu Lukaku were all present
  • United are gearing up for Sunday’s Premier League clash at home to Arsenal 

Robert Cottingham For Mailonline

Manchester United welcomed youngsters to their Aon Complex training ground as they celebrated their foundation’s dream day on Thursday. 

Seriously ill children and adults met with Red Devils stars including Paul Pogba, David De Gea, Alexis Sanchez and Romelu Lukaku at Carrington. 

The event takes place twice a season and sees United stars meet and pose with supporters who are suffering from life-limiting illnesses. 

Manchester United No 1 David De Gea with nine-year-old Caitlin

Manchester United No 1 David De Gea with nine-year-old Caitlin

Alexis Sanchez and Romelu Lukaku with fan Jacob

Alexis Sanchez and Romelu Lukaku with fan Jacob

David De Gea, Alexis Sanchez and Romelu Lukaku pose with young supporters on Thursday

Youth products Marcus Rashford and Jesse Lingard were also in attendance while the likes of Antonio Valencia, Juan Mata and Chris Smalling to make it a memorable day for United supporters. 

United are currently gearing up for Sunday afternoon’s home clash with Arsenal, the first meeting between the two sides since Arsene Wenger announced he would be stepping down as Gunners boss at the end of the season. 

Wenger and former Sir Alex Ferguson held a long-standing rivalry around the early 2000s when Arsenal and United were consistently competing for league titles. 

Paul Pogba was another Manchester United in attendance for the foundation's dream day

Paul Pogba was another Manchester United in attendance for the foundation's dream day

Paul Pogba was another Manchester United in attendance for the foundation’s dream day

Juan Mata poses with nine-year-old George and 10-year-old Jake at the Aon Complex 

Juan Mata poses with nine-year-old George and 10-year-old Jake at the Aon Complex 

Juan Mata poses with nine-year-old George and 10-year-old Jake at the Aon Complex 

And Wenger will come up against another familiar adversary in Jose Mourinho on Sunday, in what will be the final meeting between the rival managers. 

Sanchez, who joined United from Arsenal in the January transfer window, spoke ahead of Sunday’s match about the differences between the two clubs.  

‘It is very different here,’ Alexis told MUTV as he prepared to face the Gunners for the first time since leaving. ‘I think United is a club with more history and we want to win trophies next year.

Defender Antonio Valencia smiles alongside Scott as United hosted their bi-annual dream day

Defender Antonio Valencia smiles alongside Scott as United hosted their bi-annual dream day

Defender Antonio Valencia smiles alongside Scott as United hosted their bi-annual dream day

Youth product Marcus Rashford was present during the heart-warming day at Carrington

Youth product Marcus Rashford was present during the heart-warming day at Carrington

Youth product Marcus Rashford was present during the heart-warming day at Carrington

‘We need to keep progressing; United is a big club, to which I am still adapting, and I am looking forward to giving everything I’ve got next year and aiming to win everything there is to win.’ 

United then face Premier League matches against Brighton, West Ham and Watford before the FA Cup final clash with Chelsea to round off the campaign.

Mourinho’s men conceded the Premier League title to rivals Manchester City this month with a shock 1-0 home defeat by West Brom. 

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Keith Curle to leave Carlisle at the end of the season

  • Keith Curle took over at Carlisle back in September 2014
  • The ex-Manchester City captain led them to the play-off last season
  • But Carlisle are guaranteed to finish outside League Two’s top seven 

Press Association Sport Staff

Keith Curle will leave his role as Carlisle manager at the end of the season, the club have announced.

The 54-year-old took over the Cumbrians in September 2014, replacing Graham Kavanagh with the club bottom of League Two.

Curle guided the club to safety with a 20th-placed finish before leading them to 10th the following season.

Keith Curle could not repeat last season's play-off finish at Carlisle

Keith Curle could not repeat last season's play-off finish at Carlisle

Keith Curle could not repeat last season’s play-off finish at Carlisle

The former England international then took Carlisle into the League Two play-off semi-final where they suffered a 6-5 aggregate defeat by Exeter having led the fourth tier for the majority of the season.

A Carlisle statement announcing Curle’s departure read: ‘Following a meeting with club directors yesterday, Keith Curle has decided to move on and further his career elsewhere and will therefore leave the club at the end of the current season.

‘He will manage the last two games and will assist the club with its retained list for the 2018-19 season.

‘The directors and staff would like to thank Keith for his contribution over the last three-and-three-quarter years and wish him well for the future.’

Carlisle currently sit 10th in League Two, eight points adrift of the play-off places with two matches remaining.

Curle captained Manchester City in the 1990s during a lengthy playing career

Curle captained Manchester City in the 1990s during a lengthy playing career

Curle captained Manchester City in the 1990s during a lengthy playing career

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Two million Britons take medicine that may increase dementia risk

Medicines taken by up to two million Britons may increase the chance of dementia.

A study highlighted a 30 per cent higher risk from some drugs prescribed for depression, bladder problems and Parkinson’s.

The medicines – anticholinergics – have already been linked to falls, confusion and memory problems in the elderly. The latest research found they were more likely to cause dementia – if taken for at least a year.

New research by the University of East Anglia suggests that anticholinergics may have triggered some 20,000 cases out of 850,000 in the UK 

New research by the University of East Anglia suggests that anticholinergics may have triggered some 20,000 cases out of 850,000 in the UK 

New research by the University of East Anglia suggests that anticholinergics may have triggered some 20,000 cases out of 850,000 in the UK 

It suggests anticholinergics may have triggered around 20,000 cases of dementia – out of a national total of 850,000.

The researchers said their results did not prove that some anticholinergics caused the illness.

But they warned that doctors should consider the long-term effects when prescribing them.

The chance of a random individual developing dementia is roughly 10 per cent. But taking anticholinergics was found to increase the risk to 13 per cent.

Published in the British Medical Journal, the study was the largest of its kind to look at the link between the drugs and dementia.

Anticholinergics work by blocking a chemical messenger in the brain called acetylcholine, which can affect moods, movement and the bladder.

One in five people on anti-depressants are prescribed anticholinergics – the most common being amitriptyline. Others include dosulepin and paroxetine. The extra dementia risk was also found for medications prescribed for bladder conditions – such as tolterodine, oxybutynin and solifenacin and Parkinson’s drugs, such as procyclidine. The study looked at the medical records of 300,000 patients over 65 – of whom 40,770 had a dementia diagnosis.

Dr George Savva, who led the research at the University of East Anglia’s school of health sciences, said: ‘We found that people who had been diagnosed with dementia were up to 30 per cent more likely to have been prescribed specific classes of anticholinergic medications.

The research was published in the British Medical Journal and looked at the effects of drugs used to control moods, movement and even the bladder

The research was published in the British Medical Journal and looked at the effects of drugs used to control moods, movement and even the bladder

The research was published in the British Medical Journal and looked at the effects of drugs used to control moods, movement and even the bladder

‘And the association with dementia increases with greater exposure to these types of medication.’ Doug Brown of the Alzheimer’s Society, which sponsored the research, said: ‘Guidelines for doctors say that anticholinergic drugs should be avoided for frail older people because of their impact on memory and thinking, but doctors should consider these new findings for all over-65s as long-term use could raise the risk of dementia.’

Dr Noll Campbell, a study co-author, said the results suggested doctors should prioritise alternatives to anticholinergic medications long before symptoms of dementia appear.

Chris Fox, a UEA professor and consultant psychiatrist, said: ‘While the associations are moderate, given the high incidence of dementia, they reflect a potentially important risk to patients.

‘Doctors and patients should therefore be vigilant about using anticholinergic medications.

‘They need to consider the risk of long-term cognitive effects, as well as short-term effects, associated with specific drugs when weighing up risks and benefits.’

Separately, the study gave a clean bill of health to antihistamines. Previous research has suggested anticholinergics, which include hayfever medications, could also increase the risk of dementia.

But the study said there was no higher risk. 

But no reason to panic, say doctors  

Dr Carol Routledge of Alzheimer's Research UK warned patients against stopping taking the drugs

Dr Carol Routledge of Alzheimer's Research UK warned patients against stopping taking the drugs

Dr Carol Routledge of Alzheimer’s Research UK warned patients against stopping taking the drugs

Doctors yesterday warned patients against coming off the drugs linked to higher dementia risk.

They said anyone concerned should talk to their GP first. ‘Anticholinergics can have many beneficial effects which doctors need to weigh against any potential side effects,’ said Dr Carol Routledge of Alzheimer’s Research UK.

‘Anybody concerned about their current medication should speak to a doctor before stopping a course of treatment.’

Clive Ballard, who is professor of age-related diseases at the University of Exeter, warned that some patients might be taking more than one anticholinergic drug.

The Medicines and Healthcare Products Regulatory Agency said in a statement: ‘Patient safety is our highest priority and we continuously monitor the safety of all medicines on the UK market. These findings will be carefully evaluated, as with any study, to determine whether they have any implications for the safe use of anticholinergic medicines.’

Decoded: Enzyme that could stop ageing

An enzyme thought to halt ageing in plants, animals and humans has finally been decoded by scientists after a 20-year plight.

Unravelling the structure of the complex enzyme, called telomerase, could lead to drugs that slow or block the ageing process, along with new treatments for cancer, they reported in the journal Nature.

Elated scientists announced Wednesday the completion of a 20-year quest to map the enzyme thought to forestall ageing by repairing the tips of chromosomes.

‘It has been a long time coming,’ lead investigator Kathleen Collins, a molecular biologist at the University of California in Berkeley, said in a statement.

‘Our findings provide a structural framework for understanding human telomerase disease mutations, and represent an important step towards telomerase-related clinical therapeutics.’

Decoding the architecture of the enzyme, called telomerase, could lead to drugs that slow or block the ageing process, along with new treatments for cancer

Decoding the architecture of the enzyme, called telomerase, could lead to drugs that slow or block the ageing process, along with new treatments for cancer

Decoding the architecture of the enzyme, called telomerase, could lead to drugs that slow or block the ageing process, along with new treatments for cancer

Part protein and part RNA (genetic material that relays instructions for building proteins) telomerase acts on microscopic sheaths, known as telomeres, that cover the tips of the chromosomes found inside all cells.

In humans, each cell contains 23 pairs of chromosomes, including one pair of sex chromosomes – the ‘X’ and ‘Y’ – that differ between males and females.

Australian-American biologist Elizabeth Blackburn, who shared the 2009 Nobel Prize in Medicine for discovering telomeres and their protective function in the 1970s, likened them to the tiny plastic caps that keep shoelaces from fraying.

Eventually, however, shoelace tips and telomeres do break down: every time a cell divides the telomeres get worn a little bit more, until the cell stops dividing and dies. This, biologists agree, is probably central to the natural ageing process.

But there is a twist.

In 1985, Blackburn discovered telomerase and its remarkable capacity to extend a cell’s lifespan by essentially rebuilding telomeres with extra bits of DNA, much in the same way that retreading a tyre can make it nearly as good as new.

The enzyme telomerase, in other words, was revealed to be a key agent in longevity.

It can also be linked to disease.

‘Inherited genetic mutations that compromise telomerase function cause disorders,’ said Michael Stone, a professor at the Center for Molecular Biology or RNA at the University of California, Santa Cruz.

A deficiency of the enzyme could accelerate cell death.

At the other extreme, too much telomerase ‘supports unbridled cell growth in most human cancers,’ he wrote in a commentary, also in Nature.

But early efforts to develop drugs that could control the enzyme’s functioning ‘were hampered by an incomplete understanding of the structure and organisation of the telomerase complex,’ Stone added.

Telomerase complex: The enzyme's protein structure was a tough code to crack, despite telomerase being discovered in 1985

Telomerase complex: The enzyme's protein structure was a tough code to crack, despite telomerase being discovered in 1985

Telomerase complex: The enzyme’s protein structure was a tough code to crack, despite telomerase being discovered in 1985

To crack the telomerase code, Collins and her team used a state-of-the-art cryoelectron microscope (Cryo-EM) to see the enzyme in action at unprecedented resolutions of seven or eight’angstroms, a device which won its developers the 2017 Nobel Prize in Chemistry.

An angstrom is one ten-billionth of a metre long.

‘When I got to the point where I could see all the subunits – we had 11 proteins in total – it was a moment of ‘Wow! Wow! This is how they all fit together’,’ said lead author Thi Hoang Duong Nguyen, a post-doc at UC Berkeley’s Miller Institute for Basic Research in Science.

A 2010 study showed that ageing could be reversed in mice that were treated with telomerase.

And in 2011, scientists found a way to transform age-worn cells from people over 90 into rejuvenated stem cells indistinguishable from those found in embryos.

In lab experiments, several critical markers of ageing in cells were ‘reset’, including the size of telomeres.

 

Fitness experts weigh in on the perfect temperature to work out in

For decades fitness fans have been under the impression that working out is pointless if you don’t break a sweat. 

But a new fitness studio in New York is suggesting that turning up the temperature isn’t essential, and advises that working out in colder temperatures can be more beneficial to your body. 

Speaking to Yahoo Lifestyle, Johnny Adamic, who has recently founded Brrrn, a fitness studio opening in Manhattan’s Flatiron district next week with Jimmy T. Martin, explained why they will hold classes at 45, 55, and 60 degrees only.

Conflicting views: Three fitness experts have each argued the case for working out in extreme heat, extreme cold and a moderate temperature

Conflicting views: Three fitness experts have each argued the case for working out in extreme heat, extreme cold and a moderate temperature

Conflicting views: Three fitness experts have each argued the case for working out in extreme heat, extreme cold and a moderate temperature

Stay cool: Johnny Adamic, the founder of Brrrn in New York City believes cooler temperatures boost metabolism, and reduce inflammation and dehydration

Stay cool: Johnny Adamic, the founder of Brrrn in New York City believes cooler temperatures boost metabolism, and reduce inflammation and dehydration

Stay cool: Johnny Adamic, the founder of Brrrn in New York City believes cooler temperatures boost metabolism, and reduce inflammation and dehydration

Stay cool: Johnny Adamic, the founder of Brrrn in New York City believes cooler temperatures boost metabolism, and reduce inflammation and dehydration

Stay cool: Johnny Adamic, the founder of Brrrn in New York City believes cooler temperatures boost metabolism, and reduce inflammation and dehydration

‘Exercise and heat dissipation, aka sweating, place competing demands on the cardiovascular system,’ he explained. 

 ‘It’s like trying to talk to your mom on the phone while having an in-person conversation with your best friend. Both are lacking your full, undivided attention.’

Johnny and his team also believe that exercising at lower temperatures keeps the body from overheating and wasting energy, hydration and electrolytes on sweat.

The also suggest working out in cooler temperatures can help boost metabolism and reduce inflammation. 

However, Bethany Lyons, owner at Lions Den Power Yoga in New York City proposes the complete opposite is true, and keeps her workout spaces set to a balmy 90 to 95 degrees with 60 per cent humidity. 

‘It supports what we’re trying to do from the get-go, which is warm up the body and make the muscles pliable,’ she said. 

‘We don’t just rely on that, though. It’s still important that you’re creating contractions in the body and all of that. You still need to move.’

A former dancer, Bethany explained that she used to wear ‘leg warmers on top of leg warmers on top of leg warmers’ to keep her muscles warm and limber, and is a big fan of getting her sweat on so she can ‘fully rinse’ before getting into the shower. 

‘There’s such a sense of satisfaction from leaving and wringing out your clothes,’ she added. 

Hot to trot: Former dancer and yogi Bethany Lyons of the Lions Den Power Yoga group believes keeping muscles warm is key - her studios are set to a balmy 90-95 degrees

Hot to trot: Former dancer and yogi Bethany Lyons of the Lions Den Power Yoga group believes keeping muscles warm is key - her studios are set to a balmy 90-95 degrees

Hot to trot: Former dancer and yogi Bethany Lyons of the Lions Den Power Yoga group believes keeping muscles warm is key - her studios are set to a balmy 90-95 degrees

Hot to trot: Former dancer and yogi Bethany Lyons of the Lions Den Power Yoga group believes keeping muscles warm is key - her studios are set to a balmy 90-95 degrees

Hot to trot: Former dancer and yogi Bethany Lyons of the Lions Den Power Yoga group believes keeping muscles warm is key – her studios are set to a balmy 90-95 degrees

Meet me in the middle: Alonzo Wilson, founder of Tone House, keeps his gyms at 68 degrees so his clients break a 'real sweat', a theory backed up by Heather Milton, an exercise physiologist

Meet me in the middle: Alonzo Wilson, founder of Tone House, keeps his gyms at 68 degrees so his clients break a 'real sweat', a theory backed up by Heather Milton, an exercise physiologist

Meet me in the middle: Alonzo Wilson, founder of Tone House, keeps his gyms at 68 degrees so his clients break a 'real sweat', a theory backed up by Heather Milton, an exercise physiologist

Meet me in the middle: Alonzo Wilson, founder of Tone House, keeps his gyms at 68 degrees so his clients break a 'real sweat', a theory backed up by Heather Milton, an exercise physiologist

Meet me in the middle: Alonzo Wilson, founder of Tone House, keeps his gyms at 68 degrees so his clients break a ‘real sweat’, a theory backed up by Heather Milton, an exercise physiologist

Contradicting both schools of thought, Alonzo Wilson, founder of NYC-based chain Tone House, keeps his gyms at 68 degrees. 

A former college football player, Alonzo has chosen 68 degrees as it’s the temperature basketball courts and NFL weight trainer rooms are set to. 

‘When you work out here, you get what you call real sweat, which is when your body works to heat itself up, and then once you’re warmed up it works to stay cool,’ he says.

‘If it’s extremely cold, you’re not going to be able to move enough to get the benefit of the workout. If it’s too hot, you’re not going to be able to move enough, either.’

A belief shared by Heather Milton, a clinical specialist exercise physiologist at New York University’s Langone Sports Performance Center.

She suggested that while hot and cold workouts may make your body feel like it’s doing more work, they’re most likely distracting your muscles.   

‘Our bodies are very smart, and they basically have their own thermostat — they regulate themselves,’ she explained. 

‘If you’re in a hot environment, your body tries to cool itself, so you’re shunting blood away from working muscles and toward the surface of the skin.’

However, she’s not a fan of cold temperatures either: You’re pulling more blood flow away from the periphery because you’re trying to keep your core warmer. Your survival technique kicks in.’ 

Nearly 80% of hair products aimed at black women contain chemicals linked to cancer

Nearly 80 percent of hair products aimed at black women contain chemicals linked to cancer, infertility and obesity, new research suggests. 

Up to 78 percent of relaxers, which are used to permanently straighten hair, contain hormone-disrupting chemicals, known as parabens, a US study found.

Past studies suggest parabens, which are used as preservatives, mimic oestrogen and may cause cancer, weight gain and reduced muscle mass.

Up to 78 percent of hair products, including leave-in conditioners, also contain phthalates, the research adds.

Phthalates are added to prolong products’ shelf lives and have been linked to breast and ovarian cancer, as well as early menopause.

Out of the 18 products analysed, 11 contain chemicals that are banned under the EU cosmetic regulations due to their links to cancer and female infertility.

Previous research suggests black women are more likely to use straightening and moisturising hair products to try and meet social beauty norms.

Nearly 80 percent of hair products aimed at black women contain cancerous chemicals (stock)

Nearly 80 percent of hair products aimed at black women contain cancerous chemicals (stock)

Nearly 80 percent of hair products aimed at black women contain cancerous chemicals (stock)

MORE THAN 90% OF RECEIPTS CONTAIN CHEMICALS LINKED TO INFERTILITY, AUTISM AND TYPE 2 DIABETES 

More than 90 percent of receipts contain chemicals linked to infertility, autism and type 2 diabetes, research suggested in January 2018.

The so-called ‘gender-bending’ chemical Bisphenol A (BPA) and its ‘healthier alternative’ Bisphenol S (BPS) are added to 93 percent of receipts given out in stores, with just two percent having no chemical coating at all, a study by the Michigan-based non-profit organisation The Ecology Center found.

Cashiers and waiting staff, who frequently handle receipts, are particularly vulnerable to the chemicals’ effects, the research adds.

BPA, which reacts with estrogen and thyroid-hormone receptors, has been linked to infertility, autism, ADHD, obesity, type 2 diabetes, premature births and early onset of puberty.

Health fears prompted BPA to be replaced with BPS, however, evidence suggests this disrupts babies’ development in the womb.

BPA and BPS, which are added to receipts to make their writing darker without using ink, are also often found in plastic water bottles and food containers.

The US Food and Drug Administration has banned BPA from baby bottles, while The European Commission prohibits the chemical from being added to receipts from 2020. 

Past research reveals cashiers and waiting staff can handle as many as 30 receipts an hour.

After a shift, such workers have significantly higher BPA and BPS levels in their blood and urine than the average person.

Previous studies suggest BPS can be found in the urine of 81 percent of people living in the US, of which 90 percent can be traced to receipts. 

Past research also reveals even briefly handling receipts causes a significant amount of BPA or BPS to be absorbed into the body, which increases up to 10 times if the person has greasy or moist fingers, or has recently applied hand sanitizer or lotion. 

‘Black women are over-exposed and under-protected’

Results further suggest that hair products aimed at black women contain up to 45 hormone-disrupting chemicals, which are not generally listed on their labels.

All of the products contain at least one fragrance, which have previously been described as ‘gender benders’ due to them encouraging male-breast growth. 

The worst offenders were found in hair lotions, root stimulators and relaxers.

Lotions claim moisturise, while root stimulators are thought to encourage hair growth and strength.

Lead author Dr Jessica Helm, from the Silent Spring Institute, Massachusetts, said: ‘Chemicals in hair products, and beauty products in general, are mostly untested and largely unregulated.  

Janette Robinson Flint, from the nonprofit organisation Black Women for Wellness, added: ‘Black women are over-exposed and under-protected from toxic chemicals.’

‘This study is evidence that hair products are an important source of toxic chemicals and that we need to remove these risks to protect black women’s lives and prevent harm.’

Use natural, organic products

The researchers hope their findings will lead to clearer ingredient labeling on products.

They also encourage hair-product manufacturers to make safer cosmetics.

In the meantime, the scientists advise people reduce their chemical exposure by looking for products that are paraben and fragrance free.

People should also choose plant-based or organic products, they add.  

How the research was carried out  

The researchers analysed 18 hair products marketed towards black women.

These products were made up of hot-oil treatments, anti-frizz polishes, leave-in conditioners, root stimulators, hair lotions and relaxers.

The aforementioned products were chosen based on a 2005 survey of 301 women living in New York. The survey’s black participants, which made up more than half of the total, used these six products most frequently.  

The researchers tested the products for 66 chemicals. 

The findings were published in the journal Environmental Research. 

Batangas student who battled cancer had to have her arm amputated

An agonising five-year cancer battle left a student with a giant arm that resembled the cartoon sailor Popeye.

Joy Arcilla, 21, first noticed a tiny lump on her left bicep in October 2012, which she initially dismissed as a mosquito bite.

After the mark continued to grow, Ms Arcilla, from Batangas, Philippines, was diagnosed with Ewing’s Sarcoma, which is cancer of the bone or soft tissue, at just 16 years old.

She underwent surgery in April 2013, with doctors assuring her the cancer was cured, only for it to return a year later, forcing her to face 17 rounds of grueling chemotherapy.

Unable to cope with chemo’s crippling side effects, Ms Arcilla stopped treatment, which caused the mass to grow bigger than ever.

After trying ‘every alternative medicine’, only for the tumour to return four times, Ms Arcilla made the drastic decision to have her entire left arm amputated in December 2017. 

Student Joy Arcilla's five-year cancer battle left her with a giant left arm

Student Joy Arcilla’s five-year cancer battle left her with a giant left arm

Ms Arcilla had the limb amputated when the cancer returned for a fourth time 

Ms Arcilla had the limb amputated when the cancer returned for a fourth time 

Ms Arcilla made the drastic decision after the tumour continued to grow despite treatment 

Ms Arcilla made the drastic decision after the tumour continued to grow despite treatment 

WHAT IS EWING’S SARCOMA?

Ewing’s Sarcoma is a cancer of the bone, which usually affects the ribs, pelvis and spine. In rare cases, it also occurs in the soft tissues.

The condition affects less than 30 children a year in the UK. 

Around 225 young people are diagnosed annually in the US.

Ewing’s Sarcoma cause is unclear but may relate to the timing of rapid bone growth.

The most common symptom is pain, which is usually worse at night.

Others may include:

  • Swelling
  • Tenderness
  • Fever
  • Weight loss

Treatment depends on the size and position of the tumour but usually involves chemotherapy, surgery and radiotherapy.  

Amputation may be unavoidable if the cancer affects the surrounding blood vessels and nerves. 

However, this may be avoidable by replacing the bone with a prosthesis or a bone from elsewhere in the body.

Source: Macmillan  

Cancer returned four times 

Ms Arcilla was diagnosed after the initial tiny lump developed into several raised pimples under her skin within months.

She said: ‘I noticed that there was a lump in my left arm but he just thought I was just a bite of mosquito so I ignored it, but after weeks and months I noticed that it was not gone and it seems like it was getting bigger. It was hard but not painful.

‘I found out that I had cancer, I was scared, crying. I thought about the future, everything. I stopped studying so I could focus on my treatment.’ 

During her first attempt at chemotherapy, Ms Arcilla only made it through five rounds before having to stop due to extreme weakness.   

She said: ‘In five cycles or six cycles of my chemo I was upset because it was so physically, emotionally and mentally painful.’ 

This caused the lump to come back in 2015, forcing Ms Arcilla to endure more surgery and chemotherapy.

It then returned for a fourth time in 2017. 

Ms Arcilla initially had surgery to lump the growth, however, it returned just one year later 

Ms Arcilla initially had surgery to lump the growth, however, it returned just one year later 

She faced 17 rounds of chemotherapy, however, extreme weakness left her unable to cope

She faced 17 rounds of chemotherapy, however, extreme weakness left her unable to cope

Ms Arcilla, who lost her hair during chemotherapy, was too upset to continue treatment 

Ms Arcilla, who lost her hair during chemotherapy, was too upset to continue treatment 

She added chemotherapy was 'so physically, emotionally and mentally painful'

She added chemotherapy was ‘so physically, emotionally and mentally painful’

Ms Arcilla then had a second operation, with the growth appearing to have gone (pictured)

Ms Arcilla then had a second operation, with the growth appearing to have gone (pictured)

Despite having surgery, Ms Arcilla's cancer returned for a third time in 2015 (pictured)

Despite having surgery, Ms Arcilla’s cancer returned for a third time in 2015 (pictured)

She also underwent an additional operation (picture shows her scar after the third procedure)  

She also underwent an additional operation (picture shows her scar after the third procedure)  

‘It had to be done to stop the cancer spreading’ 

Speaking of her decision to amputate, Ms Arcilla said: ‘I tried every alternative medicine, I became super strict on my diet then, I changed my lifestyle, ate vegetables and fruits.

‘Again the cancer came back and it was so aggressive. 

‘I realised that my left arm would have to be cut off, which we did last year. 

‘Yes, I was sad but this had to be done to stop the cancer spreading to other parts of my body. 

Ms Arcilla dropped out of school during her treatment but is now studying a Bachelor of Science in Business Administration. She says she can finally put the illness behind her.

She said: ‘There were times when I was depressed. But with the love and support of family I made it through.

‘The inspiration for me was seeing other children at the hospital, still happy and laughing with smiles on their faces.’

Ms Arcilla (pictured when she was healthy) dismissed the mark as a mosquito bite 

Ms Arcilla (pictured when she was healthy) dismissed the mark as a mosquito bite 

Ms Arcilla (pictured after her third operation) says the amputation allowed her to move on 

Ms Arcilla (pictured after her third operation) says the amputation allowed her to move on 

She was forced to drop out of school but has since returned (pictured after the third surgery)

She was forced to drop out of school but has since returned (pictured after the third surgery)

Ms Arcilla (pictured after the third surgery) says at times her condition left her depressed 

Ms Arcilla (pictured after the third surgery) says at times her condition left her depressed 

She adds that the love and support of her family has seen her through (after the third surgery)

She adds that the love and support of her family has seen her through (after the third surgery)

Ms Arcilla was motivated to recover by other patients in the hospital (after the third surgery)

Ms Arcilla was motivated to recover by other patients in the hospital (after the third surgery)

E. coli-infected salad saga rages on: 31 more sickened, bringing the total to 84

The E. coli outbreak linked to tainted romaine lettuce has grown and sickened 84 people from 19 states, US officials say. 

The US Centers for Disease Control said Wednesday that at least another 31 cases are believed to be tied to romaine lettuce grown in Yuma, Arizona.

The agency says those infected range in age from 1 to 88. More than half of are female.

Forty-two people have been hospitalized, including nine battling kidney failure as the agency scrambles to sniff out the source of the E. coli outbreak. 

Scientist Karen Xavier holds a petri dish containing a stool sample of small bacteria colonies in Denver. Samples like this one are examined to try to find the source of the E. coli outbreak 

Scientist Karen Xavier holds a petri dish containing a stool sample of small bacteria colonies in Denver. Samples like this one are examined to try to find the source of the E. coli outbreak 

Scientist Karen Xavier holds a petri dish containing a stool sample of small bacteria colonies in Denver. Samples like this one are examined to try to find the source of the E. coli outbreak 

Centers for Disease Control and Prevention (CDC) officials say the illnesses started between March 13 and April 12.

The agency and the US Food and Drug Administration last week issued a warning against eating all romaine lettuce.

Officials have not yet identified the source of the tainted lettuce except to say it came from the Yuma region. 

Disease hunters are using genetic sequencing in their investigation of the ongoing food poisoning outbreak linked to romaine lettuce, a technique that is revolutionizing the detection of germs in food.

The genetic analysis is being used to bolster investigations and – in some cases – connect the dots between what were once seemingly unrelated illnesses. 

The investigation is also uncovering previously unfathomed sources of food poisoning, including one outbreak from apples dipped in caramel.

So far, most of the work has largely focused on one germ, listeria. But it is expanding. 

Scientists used the genome sequencing technique in their investigation of the romaine lettuce outbreak, though other methods have so far been largely responsible for their ability to trace the contamination to Arizona. 

Hopefully, continued DNA analysis will help officials narrow the source to particular farms.  

By the end of this year, labs in all 50 states are expected to also be using genetic sequencing for much more common causes of food poisoning outbreaks, including salmonella and the E. coli bacteria linked to recent lettuce outbreak.

That means the number of identifiable outbreaks are likely to explode even if the number of illnesses don’t.

‘There are a lot of outbreaks where they don’t connect the dots. Now they’re going to be connected,’ said Michael Doyle, a retired University of Georgia professor who is an expert on foodborne illness.

The new DNA testing is enabling disease detectives to spot food contamination before anyone is aware of a resulting human illness.

‘It’s turning around how outbreaks are figured out,’ said Bill Marler, a prominent Seattle lawyer who has made a business of suing companies whose products sicken people.

Marler added that the program is in its early stages and it’s too early to call it a success. But he said the new approach has the potential to transform how and when outbreaks come to light.

The Centers for Disease Control and Prevention is driving the program. It estimates that 48 million Americans get sick – and 3,000 die – from food poisoning each year.

Lab technician extracts DNA for whole genome sequencing at the Colorado Department of Public Health & Environment's Molecular Science Laboratory in Denver

Lab technician extracts DNA for whole genome sequencing at the Colorado Department of Public Health & Environment's Molecular Science Laboratory in Denver

Lab technician extracts DNA for whole genome sequencing at the Colorado Department of Public Health & Environment’s Molecular Science Laboratory in Denver

The new technique relies on whole genome sequencing, which has been used in biology for more than two decades. 

The laboratory process determines nearly all of an organism’s DNA, the genetic material needed to build and maintain an organism. And scientists use software to compare the DNA of specimens to see if they are the same strain and how resistant they are to current medicines.

The technique allows the analysis to become faster, cheaper and more automated, said Dr Robert Tauxe, one of the CDC’s leading experts on food poisoning.

Plans are to use the technology against several germs that cause food poisoning, but so far all the work has concentrated on listeria. 

The bacteria cause around 1,600 illnesses each year, a tiny fraction of US foodborne disease diagnoses. But it is a particularly lethal infection, killing nearly one in five people who get it.

Historically, listeria-caused outbreaks were known as ‘the graveyard of epidemiology.’ It could take weeks for people to develop symptoms, meaning food evidence was discarded – and some of the patients were dead – by the time officials began to sort things out.

From 1983 to 1997, only five listeria outbreaks were identified in the United States. They were obvious and large – with a median of 54 cases per outbreak.

That’s how it was with other food poisoning outbreaks, too.

‘Most foodborne outbreaks were detected because it happened in one place,’ like in a town where a popular restaurant’s customers grew ill, Dr Tauxe said.

Outbreaks were investigated by asking people what they ate before they got sick, and then comparing notes to see what patients had in common.

The field took a big step in the 1990s, after a frightening outbreak erupted in the Seattle area. Four deaths and more than 700 illnesses in four states eventually were traced to undercooked Jack in the Box restaurant hamburgers contaminated with E. coli.

The outbreak prodded the CDC to develop a program that relied on a technique called pulsed-field gel electrophoresis that helped health officials more easily link illnesses, but it was imperfect: it couldn’t make exact matches and sometimes missed when cases were related.

Then came whole genome sequencing.

The CDC began using the technique in food poisoning investigations in 2013. Initially state labs sent samples to a CDC lab in Atlanta for testing. Now, the CDC is working to get labs in all 50 states up and running.

Last year, the federal agency awarded about $32 million to state and city health departments to work on foodborne, waterborne and fungal disease outbreaks. That included $12 million to help them set up whole genome sequencing technology.

Since whole genome sequencing began, the CDC says it’s catching more listeria outbreaks with a food source identified. 

By that measure, the number rose from about two per year to an average of more than six per year from 2014 to 2016.

One of the first success stories came a couple of weeks after Halloween in 2014, when listeria cases began popping up in Arizona, New Mexico and the Midwest. Through whole genome sequencing, investigators discovered about three dozen people had been sickened.

In interviews, patients and their families didn’t mention foods commonly associated with listeria. But most did say they had eaten packaged caramel apples.

This 2002 electron microscope image made available by the Centers for Disease Control and Prevention shows the kind of listeria bacteria that is behind some food poisoning outbreaks

This 2002 electron microscope image made available by the Centers for Disease Control and Prevention shows the kind of listeria bacteria that is behind some food poisoning outbreaks

This 2002 electron microscope image made available by the Centers for Disease Control and Prevention shows the kind of listeria bacteria that is behind some food poisoning outbreaks

Scientists hadn’t considered them a threat, because apples and caramel aren’t hospitable to listeria individually. But it turns out that putting a stick in a caramel-covered apple gives germs a door into tiny spaces between caramel and the apple’s skin.

Besides fingering foods previously seen as unthreatening, whole genome sequencing has the potential to turn investigations around: In several outbreaks recently, germs found in food plant inspections prompted product recalls before anyone knew about an outbreak. 

Then whole genome sequencing helped find and confirm illnesses.

Whole genome sequencing is becoming increasingly important, but it’s not yet the basis of outbreak solving. 

It was used in the current investigation of E. coli bacteria found in romaine lettuce grown in Arizona, which has sickened at least 84 people in 19 states, according to a CDC update released Wednesday. 

But ‘that’s not how we first detected the outbreak,’ said Matthew Wise, a CDC food poisoning investigator.

It was more crucial in an investigation last year of a 21-state salmonella outbreak that ultimately was linked to ground beef. Whole genome sequencing allowed health officials to wade through a wave of cases to parse out the illnesses that were most closely matched and then look for a common origin, Wise said.

‘Using our previous technology,’ Wise said, ‘we would have had a really difficult time solving that one.’

Air pollution in big cities increases levels of crime

Air pollution is a major driver of crime in big cities.

That’s the claim of researchers who looked at connections between crime and air quality in London.

Researchers found that high levels of air pollution increase the rate of minor offences such as shop lifting and pick-pocketing.

However, air pollution does not seem to have a significant impact on the most serious crimes – such as murder, assault causing severe bodily harm and rape. 

Researchers say crime may increase when smog levels are high because toxic air can increase the levels of stress hormone cortisol in the body.  

The research has implications for other major cities, such as Chicago and New York, which also suffer from high levels of pollution and crime, researchers say.

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Air pollution is a major driver of crime in big cities, suggests a new study that examined connections between offending and air quality in London. This was found to be particularly true of lower level offences, such as shop lifting and pickpocketing

Air pollution is a major driver of crime in big cities, suggests a new study that examined connections between offending and air quality in London. This was found to be particularly true of lower level offences, such as shop lifting and pickpocketing

Researchers from the London School of Economics and Political Science found that a ten point rise of the Air Quality Index score, correlated with an increase in the crime rate of 0.9 per cent. The research has implications for other major cities, such as Chicago and New York

Researchers from the London School of Economics and Political Science found that a ten point rise of the Air Quality Index score, correlated with an increase in the crime rate of 0.9 per cent. The research has implications for other major cities, such as Chicago and New York

Experts from the London School of Economics and Political Science found that a ten point rise of the air pollution measure, the Air Quality Index (AQI), correlated with an increase in the crime rate of 0.9 per cent.

This means that the crime rate in London is 8.4 per cent higher on the most polluted day, with an AQI of 103.6, compared to the days with the lowest level of pollution, an AQI of 9.3. 

An AQI of over 35, which happens in one out of four days on average, leads to 2.8 per cent more crimes – equivalent to a nine per cent reduction in policing, researchers say.

Dr Sefi Roth, assistant professor of environmental economics and co-author of the paper, said: ‘Our research suggests that reducing air pollution in urban areas could be a cost effective way to reduce crime, in addition to the health benefits it would bring.

‘We did not find that London’s ongoing spate of knife crime would be affected by improved air quality. 

‘However, if the number of less serious crimes could be reduced, the police could potentially be freed up to allocate more resources to these types of very serious incidents.

‘The effect of air pollution on crime occurs at levels which are well below current regulatory standards in the UK and the US which suggests that it could be beneficial to lower these existing guidelines.’ 

Crime data covered 455,520 observations of daily crime all of greater London's 624 wards, excluding the City of London, and 96 AURN/MIDAS monitoring stations.

Crime data covered 455,520 observations of daily crime counts  across all of greater London’s 624 wards (divided by black lines), excluding the City of London. Pollution data was taken from 96 AURN Midas monitoring stations (blue specks)

London’s wealthiest neighbourhoods, which are also its most polluted, were most heavily affected by the link.

The poorest neighbourhoods, although less polluted, were also affected, which scientists say suggests that those that live in them are more sensitive to poor air quality.

A similar sensitivity to poor air quality on health has already been established by other research.

Researchers looked at 1.8 million crimes over two years and compared them with pollution data within boroughs and wards over time, to ensure like was compared with like. 

WHAT IS THE AIR QUALITY INDEX?

The Air Quality Index (AQI) is a measure used by environmental agencies and other public bodies around the world to measure how clean the air is.

The lower the index is, the better the quality of the air.

The AQI provides a number which is easy to compare between different pollutants, locations, and time periods.

Exactly how this score is categorised varies from country to country, but each category in the AQI corresponds to a different level of health risk.

The daily results of the index are used to convey to the public an estimate of air pollution level. 

The AQI provides a number which is easy to compare between different pollutants, locations, and time periods. Exactly how this score is categorised varies from country to country, but each category in the AQI corresponds to a different level of health risk

The AQI provides a number which is easy to compare between different pollutants, locations, and time periods. Exactly how this score is categorised varies from country to country, but each category in the AQI corresponds to a different level of health risk

An increase in air quality index signifies increased air pollution and severe threats to human health. 

The AQI centres on the health effects that may be experienced within a few days or hours after breathing polluted air.

AQI calculations focus on major air pollutants including: particulate matter, ground-level ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide.

Particulate matter and ozone pollutants pose the highest risks to human health and the environment. 

For each of these air pollutant categories, different countries have their own established air quality indices in relation to other nationally set air quality standards for public health protection.

Their findings took account of factors such as temperature, humidity and rainfall, days of the week and different seasons.

The researchers also used wind direction, which blows pollution in and out of areas randomly, as a ‘natural experiment’ to exclude any other factor from being the cause of the link they observed between crime and air pollution.

The researchers suggest their findings may be linked to the increases in the stress hormone cortisol, which can occur in people exposed to higher levels of pollution.

However, not everyone is ready to take the research at face value. 

Professor Kevin McConway, emeritus professor of applied statistics at The Open University, said: ‘This is an interesting paper, but there are several points to bear in mind.

Air pollution was not found to have a significant impact on the most serious crimes - such as murder, assault causing severe bodily harm and rape (falling on or near the purple line)

Air pollution was not found to have a significant impact on the most serious crimes – such as murder, assault causing severe bodily harm and rape (falling on or near the purple line)

‘First, the researchers’ suggestion that reducing air pollution could reduce crime makes sense only if the increased crime rate that they observed at time of high pollution is actually caused by the pollution. 

‘The observational design of the study makes it impossible to be sure about that.  Maybe there is some other factor that causes air pollution to be high on some days, and completely independently causes the crime rate to increase. 

‘If that’s the case, then reducing the pollution would have no effect on crime.

‘Another point to make is that this is a paper in a discussion paper series, published by an institute with which the authors are associated, and I believe it has not yet been subject to scientific peer review.

‘A proper peer review, which would go much further into the details than I have had time to do, might or might not find more serious issues with these research findings.’ 

The full findings of the study were published by the Institute of Labor Economics.

Mother says her baby son’s ‘hidden’ unborn twin caused her cancer

Leanne Crawley, 38, was diagnosed with a rare and fast-growing cancer

Leanne Crawley, 38, was diagnosed with a rare and fast-growing cancer

A mother-of-four has revealed how she was left fighting for life after she developed cancer – from her baby son’s hidden unborn twin.

Leanne Crawley, 38, had no idea she was carrying twins until she was rushed to hospital six weeks after baby Louee was born.

Doctors discovered he had been ‘hiding’ a second molar pregnancy, which was then removed – but left behind a rare and fast growing cancer.

The cells spread to her lungs forcing her to endure five months of super-strength chemotherapy, 20 blood transfusions and an entire month in hospital.

Ms Crawley, from Orpington, Kent, who is now cancer free, said: ‘As odd as that sounds, Louee’s twin very nearly killed us both.

‘I was basically pregnant with my tumour. The twin caused the cancer, and the cancer nearly killed us both.

‘I have never really thought of it like that – but then I still can’t believe I had cancer.

‘It was a huge ordeal trying to deal with a newborn, the other children, then finding out I had been pregnant with twins, and then the cancer.

‘I’m just glad I was able to fight it and it was all picked up and I can plan a future with Louee and my family.’

Giving birth to Louee 

Ms Crawley became pregnant with Louee just months after giving birth to daughter Francesca, now two, with her long term partner Andrew Smith, 28.

The scans all appeared normal, but he was born ‘grey and lifeless’ in December 2016 and tests revealed he had lost a lot of blood.

‘They don’t know exactly what happened but they think he bled through me and while we didn’t know it at the time, they think it was down to the cancer,’ she said.

Doctors discovered baby Louee had been 'hiding' a second molar pregnancy, which was then removed - but left behind a rare and fast growing cancer

Doctors discovered baby Louee had been ‘hiding’ a second molar pregnancy, which was then removed – but left behind a rare and fast growing cancer

The cells spread to her lungs forcing her to endure five months of super-strength chemo, 20 blood transfusions and an entire month in hospital (scan of Louee)

The cells spread to her lungs forcing her to endure five months of super-strength chemo, 20 blood transfusions and an entire month in hospital (scan of Louee)

WHAT IS A MOLAR PREGNANCY?

A molar pregnancy occurs when a lump of abnormal cells grows in the womb instead of a healthy foetus.

A ‘complete mole’ is when there is no foetus, while a ‘partial’ occurs when a foetus starts to form but cannot develop into a baby.

Around one in 590 pregnancies in the UK, and one in 1,000 in the US, are molar. 

Many women have no symptoms and are unaware they are having molar pregnancies until routine ultrasound scans.

Some may experience:

  • Vaginal bleeding or dark discharge
  • Severe morning sickness
  • An unusually swollen abdomen

Treatment often involves removing the abnormal cells via suction.

Medication may also be necessary.

Treatment may also be required to remove any leftover abnormal cells, which can turn cancerous.

Molar pregnancies do not affect women’s chances of conceiving in the future.

Source: NHS Choices 

Louee spent more than three weeks in hospital, on life support, in a cooling machine and in an incubator.

His organs had started to shut down due to losing 80 per cent of his blood and he was put in an induced coma and given donor blood to bring him back to health.

Rushed back to hospital 

Two days after he came home, Ms Crawley was still bleeding heavily and was rushed to hospital where medics operated to remove what they thought was part of Louee’s placenta.

But after another two weeks of heavy bleeding, she was admitted to hospital again.

A second operation revealed she had been carrying a molar pregnancy, and surgeons removed the remains left from the first op.

The abnormal form of pregnancy happens when a non-viable fertilized egg implants in the uterus, and hers was around the size of a three-month-old foetus.

Ms Crawley, from Kent, who is now cancer free, said: 'As odd as that sounds, Louee's twin very nearly killed us both'

Ms Crawley, from Kent, who is now cancer free, said: ‘As odd as that sounds, Louee’s twin very nearly killed us both’

Ms Crawley became pregnant with Louee just months after giving birth to daughter Francesca, now two, with her long term partner Andrew Smith, 28 (pictured after her cancer diagnosis)

Ms Crawley became pregnant with Louee just months after giving birth to daughter Francesca, now two, with her long term partner Andrew Smith, 28 (pictured after her cancer diagnosis)

In very rare occasions, twins are conceived and one develops normally – like Louee – from a second healthy egg, but usually the healthy baby is consumed by the growth.

Around half of women who have a molar-type pregnancy go on to develop a very rare womb cancer called choriocarcinoma, due to the growth of the abnormal cells.

What cancer did she have? 

Ms Crawley was diagnosed with the fast-growing cancer a week after the molar pregnancy was discovered and removed, when Louee was three months old. 

She said: ‘After the operation to remove the molar pregnancy they asked me if I wanted a funeral and things like that for the twin.

‘It was a lot to take in and I was just like “what is going on”. They never knew there were two in there.

‘All you could see on the scan was Louee and it all looked normal. It turned out Louee had been hiding it all along, protecting me.

The scans all appeared normal, but he was born 'grey and lifeless' in December 2016 and tests revealed he had lost a lot of blood (pictured with a filter)

The scans all appeared normal, but he was born ‘grey and lifeless’ in December 2016 and tests revealed he had lost a lot of blood (pictured with a filter)

Louee spent more than three weeks in hospital, on life support, in a cooling machine and in an incubator (pictured with his mother)

Louee spent more than three weeks in hospital, on life support, in a cooling machine and in an incubator (pictured with his mother)

His organs had started to shut down due to losing 80 per cent of his blood and he was put in an induced coma and given donor blood to bring him back to health (pictured in hospital)

His organs had started to shut down due to losing 80 per cent of his blood and he was put in an induced coma and given donor blood to bring him back to health (pictured in hospital)

Two days after he came home, Ms Crawley was still bleeding heavily and was rushed to hospital where medics operated to remove what they thought was part of Louee's placenta (pictured recently, after cancer treatment)

Two days after he came home, Ms Crawley was still bleeding heavily and was rushed to hospital where medics operated to remove what they thought was part of Louee’s placenta (pictured recently, after cancer treatment)

‘The molar pregnancy had caused the cancer and it had already spread to my lungs.

‘They said they didn’t want it to get to my brain and I started chemo into my veins that night.’

Cancer treatment 

She had 15 hours of chemotherapy each week and 20 blood transfusions, and also nearly died when a blood clot traveled to her lung during her four-week hospital admission.

Ms Crawley, who also has daughters Olivia, 12, and Charlotte, nine, said: ‘That in itself is even rarer than the cancer.’

Doctors gave her the all clear last September, but she is still fighting back to fitness, due to the intense chemotherapy.  

She said: ‘The whole experience nearly destroyed us all, but I had so much support from my friends and family.

‘I wouldn’t wish the experience on anyone, but obviously I would take it all again if it was a choice between me and Louee.’ 

But after another two weeks of heavy bleeding, she was admitted to hospital again. A second operation revealed she had been carrying a molar pregnancy, and surgeons removed the remains left from the first operation (Louee is pictured)

But after another two weeks of heavy bleeding, she was admitted to hospital again. A second operation revealed she had been carrying a molar pregnancy, and surgeons removed the remains left from the first operation (Louee is pictured)

Ms Crawley was diagnosed with choriocarcinoma a week after the molar pregnancy was discovered and removed, when Louee was three months old 

Ms Crawley was diagnosed with choriocarcinoma a week after the molar pregnancy was discovered and removed, when Louee was three months old 

Ms Crawley said: 'After the operation to remove the molar pregnancy they asked me if I wanted a funeral and things like that for the twin' (pictured in hospital)

Ms Crawley said: ‘After the operation to remove the molar pregnancy they asked me if I wanted a funeral and things like that for the twin’ (pictured in hospital)

Doctors gave her the all clear last September, but she is still fighting back to fitness, due to the intense chemotherapy (pictured with her daughter Francesca and son Louee in hospital)

Doctors gave her the all clear last September, but she is still fighting back to fitness, due to the intense chemotherapy (pictured with her daughter Francesca and son Louee in hospital)