E.U. Panel to Pressure Google on Privacy Rules

BERLIN — European data protection officials are drafting plans to censure Google over its online privacy policy if the company does not eventually meet regulators’ demands to revise it.

In a two-day closed-door meeting this week in Brussels of the European Union’s 27 national data protection officials, the group mapped a preliminary strategy, including the possibility of testing Google's compliance with national privacy laws in countries like Ireland, Belgium and Finland, where the company operates data centers. That was the word from a person close to the discussions, who was not authorized to speak publicly.

The group may issue a public statement next week on the matter.

New guidelines that Google adopted earlier this year for collecting information on individuals have come under sharp criticism in Europe.

In mid-October the French regulator, C.N.I.L., which had been asked by the group to study the matter, released a report criticizing Google’s privacy guidelines as allowing an “uncontrolled combination of data.”

C.N.I.L. said the method of combining information from Google’s search engine, YouTube, Google+ social network and other services “suggests the absence of any limit concerning the scope of collection and the potential uses of the personal data.”

When C.N.I.L. released its report, Google said it would study the analysis. But the company also asserted that its method of handling consumer data was legal under European Union rules. So far the company, which also ran afoul of European regulators in 2010 for its collection of personal data from home Wi-Fi routers, has not responded formally to the C.N.I.L. report.

On Friday, a Google spokesman in Brussels, Alistair Verney, referred to the company’s previous statement in October, which said Google was reviewing the French recommendations.

“Our new privacy policy demonstrates our longstanding commitment to protecting our users’ information and creating great products,” the Google statement said at the time. “We are confident that our privacy notices respect European law.”

When C.N.I.L. presented its analysis in October, the chairwoman of the French regulator, Isabelle Falque-Pierrotin, gave the search engine “three to four months” — roughly until mid-February — to respond to its recommendations.

Among other things, C.N.I.L. asked Google to heed European restrictions on mixing certain data and to heed Europe’s rules for obtaining prior consent from consumers before collecting personal data.

Google users in Europe cannot use the search engine’s services unless they agree to accept the company’s privacy policy.

But C.N.I.L. argued in its review that the opt-in disclaimer, which is legal under United States law, was too broad. It also said consumers should be given clearer information and be allowed to individually authorize or reject the collection of certain kinds of data.

Google announced its new policy, which applies globally and was presented as a way to simplify the user experience, earlier this year.

The company made nearly all of its $37.9 billion in sales revenue in 2011 from Internet advertising, which relies in part on the collection and analysis of user data to produce ads aimed at individual consumers.

While European lawmakers coordinate European Union data protection from Brussels, privacy law is enforced on the national level.

That decentralization is the reason why regulators are considering taking action within a few nations — most likely in countries where Google has physical operations and where national courts could be asked to enforce penalties.

But whether any actions, if they do eventually take place, result in anything other minor sanctions remains to be seen. In general, European national regulators are limited to only a few hundred thousand euros in the privacy-violation fines they can assess against companies or individuals.

A proposed update to European Union data protection law would give regulators the ability to assess much larger fines of as much as 2 percent of a company’s annual sales — which based on Google’s financial performance would equate to $760 million, based on 2011 revenue of $37.9 billion.

But it is unclear how soon, if ever, those higher penalties will be adopted.

Another person with knowledge of the regulators’ discussion this week emphasized that the group was still hoping Google would heed its recommendations and adapt its rules in Europe to conform with the Continent’s restrictions on data mining.

“We still have a lot of time left before we come to this juncture,” said another person with knowledge of the group’s discussions, citing the spring deadline for Google’s formal response. “Let’s wait and see what happens.”

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The New Old Age Blog: A Son Lost, a Mother Found

My friend Yvonne was already at the front door when I woke, so at first I didn’t realize that my mother was missing.

It was less than a week after my son Spencer died. Since that day, a constant stream of friends had been coming and going, bringing casseroles and soup, love, support and chatter. Mom hated it.

My 94-year-old mother, who has vascular dementia, has been living in my home in upstate New York for the past few years. Like many with dementia, mom is courteous but, underneath, irascible. Pride defines her, especially pride in her Phi Beta Kappa intellect. She hates to be confronted with how she has become, as she calls it, “stupid.”

The parade of strangers confused her. She had to be polite, field solicitous questions, endure mundane comments. She could not remember what was going on or why people were there. It must have been stressful and annoying.

That night, like every night since the state troopers brought the news, I woke hourly, tumbling in panic. As if it were not too late to save my son. Mom knew something was wrong, but she could not remember what. As I overslept that morning, she must have decided enough was enough. She was going home.

In a cold sky, the sun blazed over tall pines. As I opened the door, the dogs raced out to greet Yvonne and her two housecleaners. Yvonne often brags about her cleaning duo. They were her gift to me. They were going to clean my house before the funeral reception, which was scheduled for later that week. This was a very big gift because, like my mother before me, I am a very bad housekeeper.

Mom’s door was shut. I cautioned the housecleaners to avoid her room as I showed them around. Yvonne went to the kitchen to listen to the 37 unheard messages on my answering machine; the housecleaners went out to their van to get their instruments of dirt removal.

I ducked into Mom’s room to warn her about the upcoming noise. The bed was unmade; the floor was littered with crumpled tissues; the room was empty.

Normally, I would have freaked out right then. I knew Mom was not in the house, because I had just shown the whole house to the cleaners. Although Mom doesn’t wander like some dementia patients, she does on occasion run away. But I could not muster a shred of anxiety.

“Yvonne,” I called, “did you see my mother outside?”

Yvonne popped her head into the living room, eyebrows raised.“Outside? No!” She was alarmed. “Is she missing?”

“Yeah,” I said wearily, “I’ll look.” I stepped out onto the front porch, tightening the belt of my bathrobe and turning up the collar. Maybe she had walked off into the woods. The dogs danced around my legs, wanting breakfast.

I had no space left in my body to care. Either we would find her, or we would not. Either she was alive, or she was not. My child was gone. How could I care about anything ever again?

Then I saw my car was missing. My mouth fell open and my eyeballs rolled up to the right, gazing blindly at the abandoned bird’s nest on top of the porch light: What had I done with the keys?

Mom likes to run away in the car when she is angry. She used to do it a lot when my father was still alive — every time they fought. Since Mom took off in my car almost a year ago, after we had had a fight, I’d kept the keys hidden. Except for this week; this week, I had forgotten.

I was reverting to old habits. I had left the doors unlocked and the keys in the cupholder next to the driver’s seat. Exactly like Mom used to do.

“Uh-oh,” I said aloud. Mom was still capable of driving, even though she did not know where she was going. I just really, really hoped that she didn’t hurt anybody on the road. I pulled out my cellphone, about to call the police.

“Celia!” Yvonne shouted from the kitchen. She hurried up behind me, excited. “They found your mother. There are two messages on your machine.”

At that very moment, Mom was holed up at the College Diner in New Paltz, a 20-minute drive over the mountain, through the fields, left over the Wallkill River and away down Main Street.

Yvonne called the diner. They promised to keep the car keys until someone arrived. By that time, Yvonne had to go to work. She drove my friend Elizabeth to the diner, and Elizabeth drove Mom home in my car.

Half an hour later, they walked in the front door. Mom’s cheeks were rouged by the chill air and her eyes sparkled, her white hair riffing with static electricity. “Hello, hello,” she sang out. “Here we are.” She was wearing the flannel nightgown and robe I had dressed her in the night before. It was covered by her oversized purple parka, and her bare feet were shoved into sneakers.

I started laughing as soon as I saw her. I couldn’t help it. Elizabeth and Mom started laughing too. “You had a big adventure,” I said, hugging them both. “How are you?”

“I’m just marvelous,” said my mother. Mom always feels great after doing something rakish. We settled her on the sofa with her feet on the ottoman. By the time I got her blanket tucked in around her shoulders, she had fallen asleep.

Elizabeth couldn’t stop laughing as she described the scene. “Your mother was holding court in this big booth. She was sitting there in her nightgown and her parka, talking to everybody, with this plate of toast and coffee and, like, three of the staff hovering around her.”

The waitress said Mom seemed “a little disoriented” when she got there. Mom said she was meeting a friend for breakfast, but since she was wearing a nightgown and didn’t know whom she was meeting or where she lived, the staff thought there might be a problem. They convinced Mom to let them look in the glove compartment of the car, where they found my name and number.

It was then that I realized I was laughing – something I’d thought I would never be able to do again. “Elizabeth, Elizabeth, I’m laughing,” I said.

“Ha, ha, ha,” laughed Elizabeth, holding her belly.

“Ha, ha, ha,” I laughed, rolling on the floor.

And she who gave me life, who had suffered the death of my child and the extinction of her own intellect, snoozed on: oblivious, jubilant, still herself, still mine.

Read More..

The New Old Age Blog: A Son Lost, a Mother Found

My friend Yvonne was already at the front door when I woke, so at first I didn’t realize that my mother was missing.

It was less than a week after my son Spencer died. Since that day, a constant stream of friends had been coming and going, bringing casseroles and soup, love, support and chatter. Mom hated it.

My 94-year-old mother, who has vascular dementia, has been living in my home in upstate New York for the past few years. Like many with dementia, mom is courteous but, underneath, irascible. Pride defines her, especially pride in her Phi Beta Kappa intellect. She hates to be confronted with how she has become, as she calls it, “stupid.”

The parade of strangers confused her. She had to be polite, field solicitous questions, endure mundane comments. She could not remember what was going on or why people were there. It must have been stressful and annoying.

That night, like every night since the state troopers brought the news, I woke hourly, tumbling in panic. As if it were not too late to save my son. Mom knew something was wrong, but she could not remember what. As I overslept that morning, she must have decided enough was enough. She was going home.

In a cold sky, the sun blazed over tall pines. As I opened the door, the dogs raced out to greet Yvonne and her two housecleaners. Yvonne often brags about her cleaning duo. They were her gift to me. They were going to clean my house before the funeral reception, which was scheduled for later that week. This was a very big gift because, like my mother before me, I am a very bad housekeeper.

Mom’s door was shut. I cautioned the housecleaners to avoid her room as I showed them around. Yvonne went to the kitchen to listen to the 37 unheard messages on my answering machine; the housecleaners went out to their van to get their instruments of dirt removal.

I ducked into Mom’s room to warn her about the upcoming noise. The bed was unmade; the floor was littered with crumpled tissues; the room was empty.

Normally, I would have freaked out right then. I knew Mom was not in the house, because I had just shown the whole house to the cleaners. Although Mom doesn’t wander like some dementia patients, she does on occasion run away. But I could not muster a shred of anxiety.

“Yvonne,” I called, “did you see my mother outside?”

Yvonne popped her head into the living room, eyebrows raised.“Outside? No!” She was alarmed. “Is she missing?”

“Yeah,” I said wearily, “I’ll look.” I stepped out onto the front porch, tightening the belt of my bathrobe and turning up the collar. Maybe she had walked off into the woods. The dogs danced around my legs, wanting breakfast.

I had no space left in my body to care. Either we would find her, or we would not. Either she was alive, or she was not. My child was gone. How could I care about anything ever again?

Then I saw my car was missing. My mouth fell open and my eyeballs rolled up to the right, gazing blindly at the abandoned bird’s nest on top of the porch light: What had I done with the keys?

Mom likes to run away in the car when she is angry. She used to do it a lot when my father was still alive — every time they fought. Since Mom took off in my car almost a year ago, after we had had a fight, I’d kept the keys hidden. Except for this week; this week, I had forgotten.

I was reverting to old habits. I had left the doors unlocked and the keys in the cupholder next to the driver’s seat. Exactly like Mom used to do.

“Uh-oh,” I said aloud. Mom was still capable of driving, even though she did not know where she was going. I just really, really hoped that she didn’t hurt anybody on the road. I pulled out my cellphone, about to call the police.

“Celia!” Yvonne shouted from the kitchen. She hurried up behind me, excited. “They found your mother. There are two messages on your machine.”

At that very moment, Mom was holed up at the College Diner in New Paltz, a 20-minute drive over the mountain, through the fields, left over the Wallkill River and away down Main Street.

Yvonne called the diner. They promised to keep the car keys until someone arrived. By that time, Yvonne had to go to work. She drove my friend Elizabeth to the diner, and Elizabeth drove Mom home in my car.

Half an hour later, they walked in the front door. Mom’s cheeks were rouged by the chill air and her eyes sparkled, her white hair riffing with static electricity. “Hello, hello,” she sang out. “Here we are.” She was wearing the flannel nightgown and robe I had dressed her in the night before. It was covered by her oversized purple parka, and her bare feet were shoved into sneakers.

I started laughing as soon as I saw her. I couldn’t help it. Elizabeth and Mom started laughing too. “You had a big adventure,” I said, hugging them both. “How are you?”

“I’m just marvelous,” said my mother. Mom always feels great after doing something rakish. We settled her on the sofa with her feet on the ottoman. By the time I got her blanket tucked in around her shoulders, she had fallen asleep.

Elizabeth couldn’t stop laughing as she described the scene. “Your mother was holding court in this big booth. She was sitting there in her nightgown and her parka, talking to everybody, with this plate of toast and coffee and, like, three of the staff hovering around her.”

The waitress said Mom seemed “a little disoriented” when she got there. Mom said she was meeting a friend for breakfast, but since she was wearing a nightgown and didn’t know whom she was meeting or where she lived, the staff thought there might be a problem. They convinced Mom to let them look in the glove compartment of the car, where they found my name and number.

It was then that I realized I was laughing – something I’d thought I would never be able to do again. “Elizabeth, Elizabeth, I’m laughing,” I said.

“Ha, ha, ha,” laughed Elizabeth, holding her belly.

“Ha, ha, ha,” I laughed, rolling on the floor.

And she who gave me life, who had suffered the death of my child and the extinction of her own intellect, snoozed on: oblivious, jubilant, still herself, still mine.

Read More..

Wider Chaos Feared as Syrian Rebels and Kurds Clash

Lynsey Addario for The New York Times

Syrian Kurds in Ras al-Ain are seeking refuge across the border in Ceylanpinar, Turkey.

CEYLANPINAR, Turkey — In plain view of the patrons at an outdoor cafe here in this border town, the convoy of gun trucks waving the flag of the Syrian rebels whizzed through the Syrian village of Ras al-Ain. They had not come to fight their primary enemy, the soldiers of Bashar al-Assad’s government. They had rushed in to battle the ethnic Kurds.

The confrontation spoke not only to the violence that has enveloped Syria, but also to what awaits if the government falls. The fear — already materializing in these hills — is that Syria’s ethnic groups will take up arms against one another in a bloody, post-Assad contest for power.

The Kurdish militias in northern Syria had hoped to stay out of the civil war raging in Syria. They were focused on preparing to secure an autonomous enclave for themselves within Syria should the rebels succeed in toppling the government. But slowly, inexorably, they have been dragged into the fighting and now have one goal in mind, their autonomy, which also means the balkanization of the state.

“We want to have a Kurdish nation,” said Divly Fadal Ali, 18, who fled the fighting and was recently staying in a local community center here for Kurdish refugees. “We want our own schools, our own hospitals. We want the government to admit our existence. We want recognition of our Kurdish identity.”

These skirmishes between Kurds and Arabs take on a darker meaning for Syria as the rebels appear each day to gain momentum, and the government appears less and less able to restore control. The rebels have taken over military bases, laid siege to Damascus and forced the shutdown of the airport.

But the rebels are largely Sunni Arabs, and the most effective among them are extremists aligned with Al Qaeda, a prospect that worries not only the West, but the Christians, Shiites, Druze — and Kurds — of Syria.

The fighting in Ras al-Ain, which came after a fierce battle between rebel and government forces last month, demonstrated the complexity of a bloody civil war that has already claimed more than 40,000 lives. Like the sectarian battles in Iraq after the American invasion, the recent violence between Arabs and Kurds in Syria indicates the further unraveling of a society whose mix of sects, identities and traditions were held together by the yoke of a dictator.

Analysts fear this combustible environment could presage a bloody ethnic and sectarian conflict that will resonate far beyond Syria’s borders, especially if it involves the Kurds. There is concern that Iraq’s Kurds, who are already training Syrian Kurds to fight, may jump into the Syria fight to protect their ethnic brethren. That could also pull in Turkey, which fears that an autonomous Kurdish region in Syria would become a haven for Kurdish militants to carry out cross-border attacks in the Kurdish areas in southeastern Turkey.

“The fear that an Arab-Kurdish confrontation has been ignited might lead the Kurds to ask for additional security forces to protect their lands,” said Maria Fantappie, Iraq analyst at the International Crisis Group, who is helping to prepare a report on the Syrian Kurds.

She said that the Syrian Kurdish fighters being trained in northern Iraq were on standby and could be sent to Syria, which would escalate the situation.

Before the uprising in Syria, the Kurds in Ras al-Ain lived peacefully with their Arab neighbors, they say. But the war has shredded those old bonds just as surely as the revolutions in the region have prompted the Kurds to dream of an independent nation uniting the Kurds in Syria, Iraq, Turkey and Iran, and put their own stamp on the great contest for power under way in the Middle East.

“Our time has come after so much suffering and persecution,” said Barham Salih, the former prime minister of Iraq’s regional Kurdish government. “The 20th century was cruel to the Kurds. Our rights, identity and culture were brutally suppressed.”

Sebnem Arsu contributed reporting from Ceylanpinar, and an employee of The New York Times contributed reporting from Ras al-Ain, Syria.

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Software Founder John McAfee Is Denied Asylum

GUATEMALA CITY (AP) — Software company founder John McAfee was hospitalized Thursday after being denied political asylum in Guatemala and his lawyers said they were making a last-ditch effort to keep him from being flown back to Belize for questioning about the killing of a fellow American expatriate.

McAfee told The Associated Press that he suffered chest pains overnight but didn't believe he had a heart attack. A government doctor who examined him agreed, saying that McAfee's heart rhythm and blood pressure were normal and that he appeared to be suffering from high stress.

McAfee was moved from an immigration center to a police-run hospital Thursday afternoon after Guatemalan authorities said McAfee's request for asylum had been denied. They did not explain why. Shortly after the decision was announced, McAfee issued a plea on his blog for the public to petition Guatemalan President Otto Perez Molina to let him stay.

"Please email the President of Guatemala and beg him to allow the court system to proceed, to determine my status in Guatemala, and please support the political asylum that I am asking for," the post read.

McAfee's legal team said they were preparing to appeal the denial of asylum to the country's constitutional court, a process that could give McAfee perhaps another day or two in Guatemala. The court would have to issue a decision within 48 hours.

McAfee's complaints of chest pain prompted authorities to move him from the immigration center where he had been held overnight. He had been taken to the center after his arrest for illegally entering the country after a bizarre weekslong journey as a self-styled fugitive with an active blog and constant contact with the press.

During an exclusive interview with the AP Thursday morning from inside his private room at the center, McAfee said he was refusing to travel to a hospital because he had been using Chinese herbal medicine since suffering a heart attack in 1993.

"Last night I had a little bit of pain, but I am fine this morning," he said. "I don't like Western medicine ... if the people around me are kind and compassionate, that's all that matters in life. The people of Guatemala are very kind people, so I have no complaints."

A couple of hours later, an AP reporter returned to McAfee's room and found him changed into a suit but lying on the floor as he was examined by a doctor. Shortly after, he was taken to the police hospital.

Belizean police spokesman Raphael Martinez said officials expected McAfee to be flown back to his country's capital. Police want to question him about the fatal shooting of killing of Gregory Viant Faull, who was shot to death in early November on the Belize island where both men lived.

There is no warrant for McAfee's arrest, so it is possible his self-initiated flight from Belizean authority could end up with him free to roam the Caribbean island where he lived for years, often clashing with neighbors and authorities over allegations he kept aggressive dogs, weapons and drug paraphernalia on his property.

The Faull family has said through a representative that the murder of their loved one on Ambergris Caye has gotten lost in the media frenzy provoked by McAfee's manipulation of the media through phone calls, emails and blog posts detailing his life on the lam.

McAfee updated his blog Thursday after being given a computer by the warden at the immigration center in Guatemala City, a three-story building with mesh-covered windows and barbed-wire on the roof.

McAfee said U.S. Embassy officials had said they couldn't help him with a request to be returned to the United States instead of Belize. McAfee said he had formally requested asylum in Guatemala because he fears for his safety in Belize because he has sensitive information about official corruption and refused to donate to local politicians.

Guerra warned Wednesday night that the 67-yeard-old McAfee's life would be in danger if he is sent back to Belize.

"He will be in danger if he is returned to Belize, where he has denounced authorities," Guerra said. "From the moment he asked for asylum he has to have the protection of the Guatemalan government."

Police in Belize deny they are persecuting McAfee and say there is no warrant for his arrest. The country's prime minister has questioned McAfee's mental state.

McAfee went on the run last month after officials tried to question him about the killing of Faull, who was shot to death in early November.

McAfee acknowledges that his dogs were bothersome and that Faull had complained about them, but denies killing Faull. Faull's home was a couple of houses down from McAfee's compound.

McAfee, the creator of the McAfee antivirus program, has led an eccentric life since he sold his stake in the anti-virus software company that is named after him in the early 1990s and moved to Belize about three years ago to lower his taxes.

He told The New York Times in 2009 that he had lost all but $4 million of his $100 million fortune in the U.S. financial crisis. However, a story on the Gizmodo website quoted him as calling that claim "not very accurate at all." He has dabbled in yoga, ultra-light aircraft and producing herbal medications.

___

Associated Press writers Patrick E. Jones in Belize City and Michael Weissenstein in Mexico City contributed to this report.

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Extended Use of Breast Cancer Drug Suggested

The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.

In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.

“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.

Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs might be taken for a longer duration as well.

“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”

Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.

Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.

About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them are in premenopausal women with estrogen receptor-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.

The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.

In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing 10 years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.

About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.

There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.

Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.

“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.

Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.

Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.

“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.

Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.

“They don’t feel well on them, but it’s their safety net,” said Dr. Garber, who added that the news would be welcomed by many patients who would like to stay on the drug. “I have patients who agonize about this, people who are coming to the end of their tamoxifen.”

Emily Behrend, who is a few months from finishing her five years on tamoxifen, said she would definitely consider another five years. “If it can keep the cancer away, I’m all for it,” said Ms. Behrend, 39, a single mother in Tomball, Tex. She is taking the antidepressant Effexor to help control the night sweats and hot flashes caused by tamoxifen.

Cost is not considered a huge barrier to taking tamoxifen longer because the drug can be obtained for less than $200 a year.

The results, while answering one question, raise many new ones, including whether even more than 10 years of treatment would be better still.

Perhaps the most important question is what the results mean for postmenopausal women. Even many women who are premenopausal at the time of diagnosis will pass through menopause by the time they finish their first five years of tamoxifen, or will have been pushed into menopause by chemotherapy.

Postmenopausal patients tend to take aromatase inhibitors like anastrozole or letrozole, which are more effective than tamoxifen at preventing breast cancer recurrence, though they do not work for premenopausal women.

Mr. Peto said he thought the results of the Atlas study would “apply to endocrine therapy in general,” meaning that 10 years of an aromatase inhibitor would be better than five years. Other doctors were not so sure.

The Atlas study was paid for by various organizations including the United States Army, the British government and AstraZeneca, which makes the brand-name version of tamoxifen.

Read More..

Extended Use of Breast Cancer Drug Suggested

The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.

In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.

“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.

Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs might be taken for a longer duration as well.

“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”

Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.

Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.

About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them are in premenopausal women with estrogen receptor-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.

The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.

In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing 10 years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.

About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.

There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.

Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.

“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.

Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.

Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.

“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.

Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.

“They don’t feel well on them, but it’s their safety net,” said Dr. Garber, who added that the news would be welcomed by many patients who would like to stay on the drug. “I have patients who agonize about this, people who are coming to the end of their tamoxifen.”

Emily Behrend, who is a few months from finishing her five years on tamoxifen, said she would definitely consider another five years. “If it can keep the cancer away, I’m all for it,” said Ms. Behrend, 39, a single mother in Tomball, Tex. She is taking the antidepressant Effexor to help control the night sweats and hot flashes caused by tamoxifen.

Cost is not considered a huge barrier to taking tamoxifen longer because the drug can be obtained for less than $200 a year.

The results, while answering one question, raise many new ones, including whether even more than 10 years of treatment would be better still.

Perhaps the most important question is what the results mean for postmenopausal women. Even many women who are premenopausal at the time of diagnosis will pass through menopause by the time they finish their first five years of tamoxifen, or will have been pushed into menopause by chemotherapy.

Postmenopausal patients tend to take aromatase inhibitors like anastrozole or letrozole, which are more effective than tamoxifen at preventing breast cancer recurrence, though they do not work for premenopausal women.

Mr. Peto said he thought the results of the Atlas study would “apply to endocrine therapy in general,” meaning that 10 years of an aromatase inhibitor would be better than five years. Other doctors were not so sure.

The Atlas study was paid for by various organizations including the United States Army, the British government and AstraZeneca, which makes the brand-name version of tamoxifen.

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Software Founder John McAfee Is Denied Asylum

GUATEMALA CITY (AP) — Software company founder John McAfee was hospitalized Thursday after being denied political asylum in Guatemala and his lawyers said they were making a last-ditch effort to keep him from being flown back to Belize for questioning about the killing of a fellow American expatriate.

McAfee told The Associated Press that he suffered chest pains overnight but didn't believe he had a heart attack. A government doctor who examined him agreed, saying that McAfee's heart rhythm and blood pressure were normal and that he appeared to be suffering from high stress.

McAfee was moved from an immigration center to a police-run hospital Thursday afternoon after Guatemalan authorities said McAfee's request for asylum had been denied. They did not explain why. Shortly after the decision was announced, McAfee issued a plea on his blog for the public to petition Guatemalan President Otto Perez Molina to let him stay.

"Please email the President of Guatemala and beg him to allow the court system to proceed, to determine my status in Guatemala, and please support the political asylum that I am asking for," the post read.

McAfee's legal team said they were preparing to appeal the denial of asylum to the country's constitutional court, a process that could give McAfee perhaps another day or two in Guatemala. The court would have to issue a decision within 48 hours.

McAfee's complaints of chest pain prompted authorities to move him from the immigration center where he had been held overnight. He had been taken to the center after his arrest for illegally entering the country after a bizarre weekslong journey as a self-styled fugitive with an active blog and constant contact with the press.

During an exclusive interview with the AP Thursday morning from inside his private room at the center, McAfee said he was refusing to travel to a hospital because he had been using Chinese herbal medicine since suffering a heart attack in 1993.

"Last night I had a little bit of pain, but I am fine this morning," he said. "I don't like Western medicine ... if the people around me are kind and compassionate, that's all that matters in life. The people of Guatemala are very kind people, so I have no complaints."

A couple of hours later, an AP reporter returned to McAfee's room and found him changed into a suit but lying on the floor as he was examined by a doctor. Shortly after, he was taken to the police hospital.

Belizean police spokesman Raphael Martinez said officials expected McAfee to be flown back to his country's capital. Police want to question him about the fatal shooting of killing of Gregory Viant Faull, who was shot to death in early November on the Belize island where both men lived.

There is no warrant for McAfee's arrest, so it is possible his self-initiated flight from Belizean authority could end up with him free to roam the Caribbean island where he lived for years, often clashing with neighbors and authorities over allegations he kept aggressive dogs, weapons and drug paraphernalia on his property.

The Faull family has said through a representative that the murder of their loved one on Ambergris Caye has gotten lost in the media frenzy provoked by McAfee's manipulation of the media through phone calls, emails and blog posts detailing his life on the lam.

McAfee updated his blog Thursday after being given a computer by the warden at the immigration center in Guatemala City, a three-story building with mesh-covered windows and barbed-wire on the roof.

McAfee said U.S. Embassy officials had said they couldn't help him with a request to be returned to the United States instead of Belize. McAfee said he had formally requested asylum in Guatemala because he fears for his safety in Belize because he has sensitive information about official corruption and refused to donate to local politicians.

Guerra warned Wednesday night that the 67-yeard-old McAfee's life would be in danger if he is sent back to Belize.

"He will be in danger if he is returned to Belize, where he has denounced authorities," Guerra said. "From the moment he asked for asylum he has to have the protection of the Guatemalan government."

Police in Belize deny they are persecuting McAfee and say there is no warrant for his arrest. The country's prime minister has questioned McAfee's mental state.

McAfee went on the run last month after officials tried to question him about the killing of Faull, who was shot to death in early November.

McAfee acknowledges that his dogs were bothersome and that Faull had complained about them, but denies killing Faull. Faull's home was a couple of houses down from McAfee's compound.

McAfee, the creator of the McAfee antivirus program, has led an eccentric life since he sold his stake in the anti-virus software company that is named after him in the early 1990s and moved to Belize about three years ago to lower his taxes.

He told The New York Times in 2009 that he had lost all but $4 million of his $100 million fortune in the U.S. financial crisis. However, a story on the Gizmodo website quoted him as calling that claim "not very accurate at all." He has dabbled in yoga, ultra-light aircraft and producing herbal medications.

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Associated Press writers Patrick E. Jones in Belize City and Michael Weissenstein in Mexico City contributed to this report.

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Typhoon Bopha Kills Hundreds in Philippines

Bullit Marquez/Associated Press

A resident hung clothing amid fallen trees and debris on Wednesday, a day after Typhoon Bopha made landfall in the village of Andap, in southern Philippines. More Photos »

MANILA — With many roads and bridges washed away, rescue teams struggled Wednesday to reach isolated villages in the southern Philippines after a powerful out-of-season typhoon tore through the region, leaving more than 270 people dead and hundreds more missing, officials said.

Typhoon Bopha packed winds of up to 100 miles per hour when it struck Tuesday, bringing torrential rains that washed away villages and left thousands homeless.

The deaths were concentrated in the province of Compostela Valley, a mountainous gold mining area, and the neighboring province of Davao Oriental, on the eastern coast of the southern Philippine island of Mindanao, Lt. Col. Lyndon Paniza, a military spokesman, said in a telephone interview late Wednesday afternoon.

A national disaster official, Benito Ramos, said at a news conference on Wednesday afternoon that 274 people had died, 339 were injured and 279 were missing. Those figures were likely to rise, he suggested, since rescue workers had not yet reached several villages in the hardest-hit areas and the casualties there were not known.

Most of the dead appeared to have drowned or been hit by falling trees or flying debris, officials said.

“There is debris in the road, so our soldiers are moving by foot,” Colonel Paniza said. “They are crossing rivers and landslides. I don’t want to speculate, but we don’t know what they will find when they reach those cut off areas.”

Three soldiers are known to have died, and eight are missing, he said. Some of the soldiers died when a landslide washed out their patrol base, and others disappeared while on search-and-rescue operations.

Local television crews broadcast grisly footage of mud-covered bodies being loaded into trucks in villages that appeared flattened by the storm. In some areas, not a single structure could be seen standing.

In areas where roads were washed out, the government sent seagoing vessels to take relief goods to remote coastal areas from the provincial capital of Davao Oriental, Mati.

“I have thus authorized the local government of Mati, its mayor and the provincial governor to use their calamity funds to hire all available large, local fishing boats for an immediate sea-lift transfer of goods to the affected areas,” Manuel Roxas, the interior secretary, said in a statement.

The eastern coast of Mindanao, which was the area hardest hit by the storm, is a remote, impoverished agricultural area. Mr. Roxas told reporters on Wednesday that during his visit to the area, he had seen tens of thousands of fallen coconut trees and many acres of destroyed banana plantations.

In New Bataan, the town hit hardest by the storm, Virgilia Babaag had been waiting nervously in her home before dawn on Tuesday as hard rain from the approaching typhoon pounded her small village.

“My neighbors started yelling, ‘The water is coming fast! Run! Run!’ ” she said Wednesday by telephone.

Ms. Babaag gathered up her three young nieces staying with her and ran through the night toward high ground. There she stayed with dozens of others as winds ripped through the town.

“When I came back, my roof was gone,” she said from her devastated home. “The houses around my place are destroyed. There are so many who have died here. The soldiers are still finding more.”

The Philippines is hit by as many as 20 powerful tropical storms each year, but this one struck remote communities south of the usual typhoon path.

“This is the first time that the people in this area have experienced a storm like this,” Colonel Paniza said. “They aren’t accustomed to big storms.”

Last December, Tropical Storm Washi — another out-of-season storm that hit south of the usual Philippine typhoon belt — killed more than 1,200 people and left hundreds of thousands homeless.

This year, officials put out strong warnings days in advance and carried out mandatory early evacuations of vulnerable communities.

President Benigno S. Aquino III, stung by criticism last year that the national government had not done enough to prepare for Tropical Storm Washi, went on television the day before the storm hit and pleaded with people to follow the instructions of local government officials.

“I am facing you now because the incoming storm is no laughing matter,” Mr. Aquino said, adding later, “We expect the cooperation of everyone so that nobody gets in harm’s way.”

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State of the Art: Reviewing All-in-One Luxury PCs From Vizio, H.P. and Apple - State of the Art

Try this simple test at home: What’s the name of Dell’s best-selling PC? Anybody? Anybody?

Right. Nobody knows.

And nobody cares. Today, it’s all about phones and tablets, baby. Nobody buzzes about the PC anymore. Innovation is dead. Sales are down, right?

Actually, there’s one pocket of surging sales and innovation in PC land: the luxury all-in-one computer, of the type made famous by the iMac.

I took a look at three silver, high-design, screen-on-a-stalk competitors: Apple’s new iMac ($1,300 and up), Hewlett-Packard’s SpectreOne ($1,300 and up), and the Vizio All-in-One Touch PC ($1,000 and up). (Lenovo, Dell, Samsung and Acer also offer, or soon will offer, very similar all-in-ones.)

What characterizes these computers? First, a tremendous emphasis on looks. They’re shiny, sleek, futuristic, uncluttered and cordless (they come with Bluetooth wireless keyboard and trackpad or mouse). They’re sculpture. In your kitchen or on your desk, they contribute to the décor even when they’re turned off.

The usual box of innards is missing. In the iMac, the guts are concealed behind the screen. In the Vizio, they’re in the foot of the monitor. In the H.P., they’re inside the stalk that supports the screen.

The second common trait is state-of-the-art components. These computers offer gorgeous, vivid, high-definition screens. And they’re fast; they’re powered by the latest Intel chips and lots of memory.

Third characteristic: no DVD drive.

What? Do these companies really think that the era of the disc is over? That nobody will ever again want to digitize music from a CD? Or burn some files to a disc to hand to a colleague? Or borrow a DVD from the library?

Apple, H.P. and Vizio seem to believe that everything is online now. Well, it’s not. Want to rent an Indiana Jones movie, “Jurassic Park” or “Schindler’s List”? How about “Star Wars,” “A Beautiful Mind,” “Bridget Jones’s Diary,” or “My Big Fat Greek Wedding”? Too bad; they’re not available to rent online.

You can, of course, buy an external DVD drive. But aren’t these called “all in ones”? An external drive just looks stupid.

Now, on a laptop, eliminating the DVD drive is understandable. You carry laptops. Weight matters. Bulk matters. But why eliminate DVD drives on computers that stay in one place?

All right, end of rant.

The new iMac, clad in its traditional aluminum, is stunning. The stand is still a thin, curved L of metal — but now, the screen appears to be just as thin (0. 2 inches). Where are the guts?

Turns out it’s a trick — an illusion. Behind the screen, you see a substantial bulge; Apple tapered the aluminum as it approaches the screen, so that from front angles it seems that the whole screen is razor thin.

Apple has also eliminated much of the glare that has long dogged today’s glossy screens. Viewed side-by-side with its rivals, the iMac is a lot less reflective.

There are two iMac sizes: 21.5 and 27 inches. The $1,300 and $1,800 base models come with a 1-terabyte hard drive, 8 gigabytes of memory and an i5 Intel processor. Each has four USB 3.0 jacks, two Thunderbolt jacks (for video input or output or external hard drives), and camera memory-card slot, awkwardly positioned on the back. Apple has ditched the FireWire jack it spent so many years promoting.

On the 21.5-incher, you can’t upgrade the memory yourself; what you buy is what you’ll have forever, unless you take it into the shop.

On the 27-inch model, you can install as much as 32 gigabytes yourself, through an easily opened door. (That, for the record, is about 262,144 times the memory as the original Macintosh.) Online, you can order your iMac with a 3-terabyte hard drive, 32 gigabytes of memory, a 768-gigabyte flash-memory drive and a $3,700 invoice.

Vizio isn’t a company you expect to be in the PC business; it made its mark selling high-quality, low-price TV sets. And sure enough, by far the best part of the All-in-One Touch PC is its lovely touch screen, available in 24- and 27-inch versions. .

A nontouch version is also available, but the Vizio comes with Windows 8, which is far more pleasant to use with a touch screen.

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