Drugs and Theater in Early Modern England.
Oxford and New York: Oxford University Press, 2005. vii + 212 pp. index. bibl. $74. ISBN: 0-19-927083-X.
The no-nonsense title of Tanya Pollard's Drugs and Theater in Early Modern England led me at first glance to imagine a dry tome cataloguing and exploring the medicine chest of the Renaissance English stage. This book is no such thing: not only is it meticulously researched and a compelling read, but beneath its surface its argument stretches well beyond the limited promise of its title. Pollard delves deep into the period's antitheatrical debates, making sense of their angst by parsing theater's more-than-metaphorical link to poisons and narcotics, and the possibility of its affective, transformative power over its audiences.
Pollard lays the groundwork for her suggested synergy between drugs and theater with a brief reference to A Midsummer Night's Dream--to which she returns once more in her epilogue--and to Oberon's infamous, problematic love potion. The potion is the model of Pollard's pharmacopoeia: it affects the lovers both well and ill, is both poison and remedy, messes with their minds, and, insofar as we are all Puck's dreamers, messes with ours as well. Its layered ambivalence will inform Pollard's argument throughout, for it is the book's principal contention that early modern pharmacy, like early modern theater, operates on the threshold between remedy and harm. Theater, Pollard argues, is--and was understood by the early moderns as--a kind of drug for audiences and players alike: this is what makes it feared, pleasurable, and dangerous.
Pollard's focus on the effects of spectatorship through the lens of pharmacy gives her arguments an original angle on familiar material. She is careful to note that both sides of the antitheatrical debates coded "plays as drugs" (9), and that a deep uncertainty over the potentially poisonous yet potentially curative power of theater informs playwrights and their defenders as much as their detractors. Her first two chapters capture this ambivalence smartly. Jonson, she argues in discussing both Sejanus and Volpone, uses questionable drugs to frame his "indictments of theatrical dissimulation" (53), not to condemn theater but to imagine it as "a beneficial, though often bitter, medicine" (54). Reading Shakespeare in chapter 2, Pollard builds careful links between curatives, poisons, and meta-performances first in Romeo and Juliet and later in Antony and Cleopatra. She concludes that, while "dramatic spectacles ... prove devastating, even fatal, to their onstage audiences" (79), they also provide potent imaginative consolations for audiences both onstage and off.
Pollard's final three chapters shift away from these stimulating but fairly basic close readings and into exciting new territory. Her earlier readings of figures such as Webster's Vittoria and Shakespeare's Juliet and Cleopatra hint at a connection between anxieties over gender and anxieties over pharmacy that becomes explicit in chapters 3 and 4, which handle debates about cosmetics and the related theatrical convention of the poisoned kiss, respectively. This is welcome work indeed, useful backstory for such dramatic commonplaces as the polluted and polluting woman, or for set-pieces railing about face-painting. Especially valuable here is Pollard's reading of The Revenger's Tragedy in the context of two other plays employing similar poison-kiss devices, The Second Maiden's Tragedy and The Duke of Milan. This cross-reading not only offers helpful context for Vindice's ploy with Gloriana's skull, but also allows Pollard to advance her argument about the narcotic power of spectacle through a gendered lens. In these plays, she argues, women are transformed literally into spectacle via the pharmacopoeia of the dressing table, and it is men as idolatrous spectators who suffer the consequences of an addiction to their dangerous theater.
Pollard concludes with Hamlet--not surprising, given her focus on poison, remedy, and performance. But this chapter, like her others, offers a new take on an old tale: she focuses on the materiality of the ear and the tangibly poisonous functioning of language in the play--both framed, as usual, by a helpful medical context. This chapter, in fact, exemplifies what is strongest in Pollard's work: she rethinks some of our most basic assumptions about early modern English theater by using the oft-noticed but rarely theorized lens of pharmacy. The result is a book that will be valuable reading both for historians and theater scholars of the period, as well as for performance theorists interested in learning more about the material contexts of early metatheater.
University of Western Ontario
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|Article Type:||Book review|
|Date:||Mar 22, 2006|
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There's a strange side-effect of reading this book. You see, in every other chapter, Liz is describing some friend or family member of hers, being, as she is, the consumate people person. And if you, like me, are somewhat dramatically self-aware ALL THE TIME (constantly seeing your own actions as through the eye of a camera), you may (as I do) find yourself describing, er, yourself, in Liz-voice.
"Erin, who likes to re-read my novel quite a lot, is a quiet, intense girl with a great big cloud of dark hair and a tendency to psychoanalyze, or just analyze, everything around her." See, the great thing is, she's incredibly forgiving and complimentary about everyone she describes, so when you're talking about yourself in Liz-voice, you can say really nice things. And Liz frequently discusses depression and such: "Erin knows a lot about depression, and likes to wryly compare suicidal depression to hemorrhoids. The description is apt because..." Liz would totally give me credit for being right even when I wasn't, and then would go on and complete my observations for me in a way that would make even better sense.
I only just realized that I was doing this. It's sort of a fun thing to do, and I've firmly decided not to think of it as insanely narcissistic. (Quirky, self-obsessive fun, maybe...)
* * *
toqueville just described me as having an "avalanche of hair" which is so much more incredibly accurate, in terms of my hair, than "cloud", that I promptly had to blog the awesomeness. Hair avalanche! I haz one!


STUDIES ON IN VITRO EVALUATION OF ANTIBACTERIAL AND ANTIOXIDANT ACTIVITIES OF STERCULIA FOETIDA L. BARKAbstract
The objective of the present investigation was to evaluate the antibacterial and antioxidant potential of n-hexane and methanolic extracts of Sterculia foeida L. bark. The antibacterial potential of Sterculia foetida L. bark was tested against human pathogens causing diarrhoea and dysentery such as Shigella flexneri (MTCC-9543), Salmonella enterica ser typhi (MTCC-733), Bacillus subtilis (MTCC-1305), Streptococcus mitis (MTCC-2897), Klebsiella pneumoniae (MTCC-109) and Staphylococcus aureus (MTCC-1430) by using agar well diffusion method. The result of the study revealed that n-hexane extract was highly effective against Shigella flexneri, whereas Klebsiella pneumoniae showed no response and Salmonella enterica ser typhi, Bacillus subtilis, Streptococcus mitis, Staphylococcus aureus responded moderately. The methnolic extract had high inhibition against Salmonella enterica ser typhi (15.16 ± 0.20 mm) whereas Shigella flexneri showed no response and moderate effect against other test bacteria. The antioxidant activity by DPPH scavenging method resulted in significant antioxidant potential of n-hexane and methanolic extracts with IC50 value of 51.26 and 66.84 respectively. Ciprofloxacin was taken as the reference antibiotic.
Akhtari Khatoon, Ashirbad Mohapatra and Kunja Bihari Satapathy *
P.G. Department of Botany, Utkal University, Vani Vihar, Bhubaneswar, Odisha, India
02 February, 2016
11 April, 2016
05 May, 2016
01 July 2016


Fax: (011) 81 822575877
Modulation of tamoxifen sensitivity by antisense Bcl-2 and trastuzumab in breast carcinoma cells
Article first published online: 13 APR 2005
Copyright © 2005 American Cancer Society
Volume 103, Issue 10, pages 2199–2207, 15 May 2005
How to Cite
Kim, R., Tanabe, K., Emi, M., Uchida, Y. and Toge, T. (2005), Modulation of tamoxifen sensitivity by antisense Bcl-2 and trastuzumab in breast carcinoma cells. Cancer, 103: 2199–2207. doi: 10.1002/cncr.21029
- Issue published online: 28 APR 2005
- Article first published online: 13 APR 2005
- Manuscript Accepted: 18 JAN 2005
- Manuscript Revised: 10 JAN 2005
- Manuscript Received: 30 AUG 2004
- breast carcinoma
Because the overexpression of HER-2 and Bcl-2 is associated with resistance to tamoxifen (TAM), the authors examined the effect of antisense (AS) Bcl-2 on sensitivity to TAM compared with the effect of trastuzumab on sensitivity to TAM in breast carcinoma cell lines.
Drug sensitivity was assessed in vitro using a [3-4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay with the breast carcinoma cell lines ZR-75-1, MDA-MB-453, and BT-474. AS Bcl-2 18-mer phosphorothioate oligonucleotide was applied. Apoptotic cell death was assessed with the terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick-end labeling method, and gene expression was evaluated with Western blot analysis.
The expression of Bcl-2 was identified in ZR-75-1 and BT-474 cells and, to a lesser extent, in MDA-MB-453 cells. Overexpression of HER-2 was identified in BT-474 cells, and moderate expression was identified in MDA-MB-453 and ZR-75-1 cells. Combination treatment with trastuzumab or AS Bcl-2 enhanced TAM sensitivity in ZR-75-1 cells, which showed 50% inhibitory concentration (IC50) values of 0.9 μM (7.2-fold increase) and 0.5 μM (13.0-fold), respectively. Combination treatment with trastuzumab or AS Bcl-2 slightly enhanced TAM sensitivity of BT-474 cells, with IC50 values of 3.0 μM (1.3-fold) and 1.5 μM (2.6-fold), respectively. The sensitivity of MDA-MB-453 cells to TAM was not enhanced by combination with trastuzumab or AS Bcl-2. Modulation of TAM sensitivity by AS Bcl-2 was superior to modulation by trastuzumab in HER-2-expressing and Bcl-2-expressing breast carcinoma cells. Enhanced sensitivity in combination with AS Bcl-2 was associated with down-regulation of Bcl-2 and pAkt, which was correlated with the induction of Bax and caspase-3, leading to apoptosis.
AS Bcl-2 appeared to be superior to trastuzumab with respect to regulating the signal-transduction pathways involved in breast carcinoma cells. Cancer 2005. © 2005 American Cancer Society.
Tamoxifen (TAM) is a promising agent for antiestrogen therapy in the adjuvant setting in patients with estrogen receptor (ER)-positive breast carcinoma. A survival benefit of TAM as adjuvant therapy has been shown even in the presence of axillary lymph node metastasis and regardless of menopausal status.1, 2 Although TAM is used as an antiestrogen treatment, failure occasionally occurs in the metastatic setting. Recent advances in antiestrogen therapy suggest that second-line therapy in this situation may include the use of aromatase inhibitors, which reportedly was effective against metastatic breast carcinoma in patients who were treated previously with TAM.3–5 A survival benefit of anastrozole in the adjuvant setting also was reported recently.6 Nevertheless, because TAM resistance is an inevitable phenomenon in situations of prolonged survival with metastatic breast carcinoma, overcoming this resistance may provide increased survival.
The Bcl-2 oncoprotein is a critical regulator of apoptosis induced by both antitumor drugs and antiestrogens in breast carcinoma.7, 8 Apoptosis is important in the antitumor effect, and molecular mechanisms by which antitumor drugs and antiestrogens induce apoptosis have shown that mitochondrial dysfunction is involved.9, 10 The overexpression of Bcl-2 also is involved in the acquisition of resistance to antitumor drugs and antiestrogens, which involves inhibition of the signal-transduction pathways that lead to apoptosis.11, 12 The regulation of Bcl-2 expression is mediated by the promoter region of the ER-responsive element in breast carcinoma, and the prognosis for patients with Bcl-2-overexpressing tumors is better compared with the prognosis for patients with non-Bcl-2-overexpressing tumors.13 However, the induction of Bcl-2 protein expression during chemoendocrine treatment occasionally causes resistance to antitumor drugs and antiestrogens. Thus, the induction of Bcl-2 expression is important in influencing TAM sensitivity in patients with breast carcinoma.
The HER-2 oncoprotein is a member of the epidermal growth factor family, which is involved in cell proliferation, angiogenesis, and metastasis in tumor cells.14, 15 Overexpression of HER-2 is observed in 20–30% of breast carcinomas and is associated with drug resistance and a poor prognosis.16 Transfection of the HER-2 gene into breast tumor cells leads to resistance to antitumor drugs, such as paclitaxel, docetaxel, and TAM.17, 18 Overexpression of HER-2 leads to phosphorylation of Akt, which activates nuclear factor κB (NF-κB) to inhibit apoptosis19 mediated by inhibitor-of-apoptosis proteins.20 Furthermore, activation of pAkt is correlated with induction of Bcl-2 expression through cyclic AMP-responsive element-binding protein (CREB) and coupling to an antiapoptotic signaling network.21 Thus, antiapoptotic signaling pathways that involve HER-2 and Bcl-2 play a pivotal role in the gain of resistance to apoptosis in response to antitumor drugs and antiestrogens in breast carcinoma cells. In the current study, we examined the enhancement of TAM sensitivity by antisense (AS) Bcl-2 compared with trastuzumab in breast carcinoma cells to assess the therapeutic efficacy of AS strategies for overcoming resistance to endocrine therapy in receptor-positive breast carcinomas.
MATERIALS AND METHODS
Chemicals, Drugs, and Supplies
Chemicals and supplies were purchased from the following suppliers: RPMI 1640 and fetal bovine serum were from GIBCO BRL (Tokyo, Japan). AS Bcl-2 phosphorothioate oligonucleotide (AS Bcl-2 ODN) and mismatch AS Bcl-2 (MM Bcl-2) 18-mer oligonucleotide were from Biologica Company, Ltd. (Tokyo, Japan). Transfectam was from Biosera (Marlborough, France). Anti-Bcl-2, anti-HER-2, anti-pAkt, anti-Bax, anti-caspase 3, and antiactin rabbit polyclonal antibodies were from Santa Cruz Biotechnology, Inc. (Santa Cruz, CA). Peroxidase-conjugated antirabbit immunogloblin G (IgG) was from Upstate Biotechnology (Lake Placid, NY). The enhanced chemiluminescence (ECL) Western blot detection system was from Amersham Pharmacia Biotech, Ltd., (Buckinghamshire, United Kingdom). The in situ cell death detection kit was from Boehringer Mannheim (Indianapolis, IN). TAM was from Sigma Chemical Company (Tokyo, Japan). Trastuzumab kindly was supplied by Chugai Pharmaceutical Company, Ltd. (Tokyo, Japan).
The human breast carcinoma cell lines ZR-75-1, MDA-MB-453, and BT-474 were obtained from the American Type Culture Collection (Manassas, VA). Cells were cultured in RPMI 1640 supplemented with 10% heart-inactivated fetal bovine serum plus 1% penicillin/streptomycin and 1% glutamine. Cultures were maintained in a 5% CO2, humidified incubator at 37 °C, and experiments were performed with exponentially growing cells.
The [3-4,5-Dimethylthiazol-2-yl]-2,5-Diphenyltetrazolium Bromide Assay
The [3-4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay was performed according to a previously described method.22 Briefly, cells (2 × 103) were treated with antitumor drugs for 48 hours. The tetrazolium agent was then added to each well. This was followed by a 4-hour incubation. Then, the culture medium supernatant was removed and dissolved mixed with dimethyl sulfoxide. After thorough formazan solubilization, the absorbance of each well was measured with a microculture plate reader at 540 nm. Growth inhibition was expressed as the ratio of the mean absorbance of treated cells to that of control cells. Each experiment was performed in triplicate, and the growth inhibition rate was calculated as a 50% inhibitory concentration (IC50) value.
The Terminal Deoxynucleotidyl Transferase-Mediated Biotinylated UTP Nick-End Labeling Method
The terminal deoxynucleotidyl transferase (TdT)-mediated biotinylated UTP nick-end labeling (TUNEL) method for assessment of apoptotic cell death was carried out according to the manufacturer's protocol, as described previously.23 Briefly, the cells were treated with drugs and then incubated with TdT and TdT buffer (biotin-16-dUTP), the reaction was made visible with nitroblue tetrazolium, and the cells were photographed. Apoptotic cell death was evaluated by the appearance of brightly labeled nuclei and apoptotic bodies. The induction of apoptosis was represented as the mean ± standard deviation from four random microscopic fields and was compared with that in untreated cells.
Treatment with AS Bcl-2 Oligonucleotide
The AS Bcl-2 phosphorothioate ODN sequence was as follows: 5′-TCT CCC AGC GTG CGC CAT-3′.24 The sequence of the MM Bcl-2 was as follows: 5′-TCT CCC AGC ATG TGC CAT-3′. AS and control ODNs were added to the cells in the form of complexes with cationic lipopolyamine according to the manufacturer's protocol, as described previously.25 Briefly, the medium was removed, and serum-free RPMI was added to the cells. The ODN-lipopolyamine complex was prepared and added dropwise to the cells. After 12 hours of incubation, cells were washed with serum-free RPMI, and RPMI containing 10% fetal bovine serum was added to the cells. Cells were then treated with AS Bcl-2 ODN twice for 12 hours per treatment. After the second treatment with AS Bcl-2 ODN, cells were incubated with antitumor drugs for 48 hours, and cell viability was assessed with the MTT assay. Because the specificity and optimal concentration for AS Bcl-2 have been reported in previous studies,24, 26 the appropriate concentration of AS ODNs used in this study was 1.0 μM. The treatment with 1.0 μM AS Bcl-2 for at least 12 hours did not affect cell viability of breast carcinoma cells.
Western Blot Analysis
Western blot analysis was performed according to a previously described method.27 Briefly, whole-cell lysates were extracted with lysis buffer (10 mM Tris-HCl, pH 8.0; 0.15 M NaCl; 1 mM ethylenediamine tetraacetic acid; 10 mM 3-[(3-cholamidopropyl) dimethyl-ammonio]-1-propanesulfonate; 10 μg/mL aprotinin; and 0.02 mM phenylmethylsulfonyl fluoride), and the protein concentration was determined from 10 μg of each sample. Proteins were separated on 10% sodium dodecyl sulfate-polyacrylamide gels and were transferred to polyvinylidene difluoride membranes with a polyblot. Filters were blocked in 5% skim milk in phosphate buffered saline (PBS) for 1 hour. After incubation with primary antibody for 24–48 hours, filters were washed with PBS and then incubated with secondary antibody in 5% skim milk in PBS for 1 hour. After washing the membranes with PBS for 30 minutes, bands were visualized with the ECL Western blot detection system. Films were exposed for 15–30 minutes. The intensity of the bands was quantified by densitometric scanning with NIH Image software (version 1.56). For controls, the rabbit IgG serum was used.
Statistical significance was determined with Student t tests or analysis of variance (ANOVA) with the Fisher least-squares difference (LSD) test for multiple comparisons. P values < 0.05 were considered significant.
Expression of Bcl-2 and HER-2 in Breast Carcinoma Cell Lines
To assess the expression of Bcl-2 and HER-2 in breast carcinoma cell lines, Western blot analysis was carried out. Figure 1 shows that Bcl-2 protein was expressed in BT-474 and ZR-75-1 cells, whereas BCl-2 expression in MDA-MB-453 cells was observed to a lesser extent. Expression of Bcl-2 in ZR-75-1 cells was somewhat higher than in BT-474 cells. These findings are consistent in part with the expression of ER and progesterone receptor in these cells; BT-474 and ZR-75-1 cells express both ER and progesterone receptor, whereas MDA-MB-453 cells are negative for both receptors (data not shown), in agreement with the previous reports.28, 29 These observations of Bcl-2 expression also are in agreement with previous reports. HER-2 was overexpressed in BT-474 cells and was expressed to a small extent in ZR-75-1 and MDA-MB-453 cells. These results are in agreement with a previous report due to mechanisms other than gene amplification, which lead to overexpression of the HER-2/neu protooncogene in carcinoma cells.30
Modulation of Sensitivity to TAM by Trastuzumab or AS Bcl-2
To assess sensitivity to TAM in breast carcinoma cell lines, IC50 values were determined by MTT assay. Table 1 shows that the mean IC50 values were 6.5 μM in ZR-75-1 cells, 0.7 μM in MDA-MB-453 cells, and 4.0 μM in BT-474 cells. These results indicate that MDA-MB-453 cells are relatively sensitive to TAM compared with the other cell lines, even though this cell line does not express hormone receptor. Treatment with trastuzumab increased the sensitivity to TAM in HER-2-overexpressing cells. The effect of AS Bcl-2 on TAM sensitivity was then assessed. Figure 2 shows that the dose-response curve for TAM was enhanced by treatment with trastuzumab or AS Bcl-2 in ZR-75-1 and BT-474 cells. Furthermore, TAM sensitivity was enhanced significantly to the greatest extent in combination with 0.5 μM TAM and AS Bcl-2 in the treatment arm (P < 0.05; ANOVA with Fisher LSD test). In contrast, TAM sensitivity was not enhanced by either trastuzumab or AS Bcl-2 in MDA-MB-453 cells; rather, it appeared that treatment with AS Bcl-2 decreased sensitivity to TAM. The IC50 values are summarized in Table 1. Treatment with trastuzumab alone did not differ from TAM in any of the cell lines, whereas treatment with AS Bcl-2 alone showed a slight increase in the IC50 value compared with TAM. Treatment with trastuzumab enhanced the sensitivity to TAM of ZR-75-1 cells, as shown by a 7.2-fold decrease in the IC50 value, whereas treatment with trastuzumab slightly increased the sensitivity to TAM of BT-474 cells, as shown by a 1.3-fold decrease in the IC50 value. Sensitivity to TAM of MDA-MB-453 cells was not altered by treatment with trastuzumab. Treatment with AS Bcl-2 enhanced TAM sensitivity in ZR-75-1 cells by 13.0 fold and in BT-474 cells by 2.6 fold, whereas TAM sensitivity in MDA-MB-453 cells was not altered by treatment with AS Bcl-2. MM Bcl-2 ODN had no effect. These results indicate that modulation of HER-2 or Bcl-2 by trastuzumab or AS can enhance sensitivity to TAM in receptor-positive breast carcinoma cells.
|Cell line||IC50 value (μM)|
|TAM||Trastuzumab||AS Bcl-2||Trastuzumab and TAM||AS Bcl-2 and TAM||MM Bcl-2 and TAM|
|BT-474||4.0||3.9||3.6||3.0 (1.3)||1.5 (2.6)||3.8|
|ZR-75-1||6.5||6.3||5.9||0.9 (7.2)||0.5 (13.0)||6.3|
Enhancement of Apoptotic Cell Death by Trastuzumab or AS Bcl-2
To assess the induction of apoptotic cell death by TAM in combination with trastuzumab or AS Bcl-2, TUNEL assays were carried out (Fig. 3). The apoptotic indices after treatment with 1.0 μM TAM, 0.1 μM trastuzumab, and 1.0 μM AS Bcl-2 alone in ZR-75-1 cells were 1.2%, 2.6% ± 0.9%, and 3.1% ± 1.4%, respectively; whereas cotreatment with TAM and 0.1 μM trastuzumab enhanced apoptotic cell death up to 18.0% ± 1.5%. Cotreatment with TAM and 1.0 μM AS Bcl-2 enhanced apoptotic cell death to 24.0% ± 4.5%, whereas cotreatment with MM Bcl-2 did not enhance apoptotic cell death in 3.0% ± 1.6%. In BT-474 cells, induction of apoptotic cell death by TAM also was enhanced in combination with AS Bcl-2. The apoptotic indices in response to treatment with TAM, trastuzumab, AS Bcl-2, trastuzumab plus TAM, AS Bcl-2 plus TAM, and MM Bcl-2 plus TAM were 2.5%, 3.5% ± 1.5%, 5.1% ± 1.6%, 11.4% ± 1.5%, 19.2% ± 2.1%, and 2.7% ± 2.2%, respectively. These findings indicate that, although combination treatment with trastuzumab or AS Bcl-2 enhanced sensitivity to TAM in receptor-positive breast carcinoma cells, the enhancement of TAM sensitivity by AS Bcl-2 was greater than the enhancement by trastuzumab in ZR-75-1 and BT-474 cells, which are Bcl-2-expressing breast carcinoma cell lines.
Mechanisms by which Treatment with Trastuzumab or AS Bcl-2 Enhances TAM Sensitivity
To assess the mechanisms by which combination treatment with trastuzumab or AS Bcl-2 enhances sensitivity to TAM, the expression of apoptosis-related proteins was analyzed. The expression of Bcl-2 protein and pAkt after treatment with 1.0 μM AS Bcl-2 plus 1.0 μM TAM was down-regulated, and the expression of Bax and caspase-3 was increased after the treatment for apoptosis in ZR-75-1 cells, whereas cotreatment with MM Bcl-2 did not increase the expression of these proteins (Fig. 4). Although trastuzumab treatment down-regulated pAkt activity to a lesser extent compared with AS Bcl-2 treatment, which was connected with a slight induction of Bax and caspase-3 in BT-474 cells, trastuzumab did not down-regulate Bcl-2 expression. These results indicate that down-regulation of Bcl-2 by AS Bcl-2 or down-regulation of HER-2 by trastuzumab activates apoptotic signal-transduction pathways in breast carcinoma cells and that the susceptibility to apoptotic cell death in response to AS Bcl-2 may be superior to the response to trastuzumab in terms of dual inhibition of Bcl-2-mediated and Akt-mediated antiapoptotic signaling pathways.
In the current study, we showed that sensitivity to TAM was modulated by AS Bcl-2 or trastuzumab in receptor-positive breast carcinoma cells. The enhancement of TAM sensitivity by AS Bcl-2 was greater compared with enhancement by trastuzumab. This may be due to a difference in the Bcl-2-mediated antiapoptotic signaling pathway, which is correlated with the inactivation of pAkt. Down-regulation of HER-2 after treatment with trastuzumab does not necessarily decrease Bcl-2 expression, even in the presence of down-regulated pAkt. In contrast, treatment with AS Bcl-2 down-regulated Bcl-2 protein as well as pAkt, suggesting that AS Bcl-2 may exert its inhibitory action through both Bcl-2 and pAkt antiapoptotic pathways in some breast carcinoma cells. Thus, it may be more effective to use AS Bcl-2 than trastuzumab to enhance TAM sensitivity in some receptor-positive breast carcinomas.
It is believed that antiapoptotic signaling pathways involve Bcl-2 and pAkt.9, 10 Overexpression of Bcl-2 has been found in 60–80% of breast carcinomas, and overexpression of Akt also has been reported in several human malignancies.31, 32 The molecular mechanisms by which overexpression of Bcl-2 or Akt produces resistance to apoptosis may involve the following: 1) inhibition of cytochrome c release from mitochondria and inhibition of homodimerization with Bax by Bcl-2, which blocks caspase cascades33; 2) phosphorylation of Bad and inhibition of caspase-9 activation by Akt34, 35; 3) induction of Bcl-2 expression by Akt through CREB36; and 4) activation of NF-κB by Akt and activation of inhibitor-of-apoptosis proteins.37 Thus, Bcl-2 and Akt are involved in multiple antiapoptotic signaling pathways. With respect to the mechanism of TAM resistance, it has been reported that breast carcinoma cells can undergo hormone-independent growth and, in turn, growth factor-dependent growth activated by the transcription factor AP-1.38 Overexpression of HER-2 is observed in TAM-resistant cells,39 and treatment with trastuzumab overcomes this resistance.40 Moreover, TAM resistance also is induced by overexpression of Akt and Bcl-2.41 Despite the fact that overall survival is better in patients with Bcl-2-overexpressing breast carcinoma than in patients with non-Bcl-2-overexpressing breast carcinoma, increased Bcl-2 expression causes resistance not only to antitumor drugs but also to TAM in breast carcinoma cells. pAkt-positive breast carcinomas are more prone to recur with distant metastases, which is an independent prognostic factor.42 These findings indicate that modulation of HER-2 and Bcl-2 with AS and antibody to increase TAM sensitivity is a good strategy for the treatment of hormone-independent growth in patients with breast carcinoma who have failed TAM treatment. The clinical use of AS Bcl-2 may be better than trastuzumab in terms of TAM modulation in receptor-positive breast carcinoma cells.
Trastuzumab, which is a chimeric, humanized anti-HER-2 antibody, provides a promising treatment for patients with metastatic breast carcinoma. Therapeutic efficacy in terms of response rate, response duration, and median survival in combination with doxorubicin and paclitaxel has been shown compared with monotherapy using chemotherapeutic agents.43 In addition, a therapeutic benefit of combined vinorelbine and trastuzumab has been reported in patients who failed treatment with taxanes.44 Possible mechanisms by which trastuzumab enhances sensitivity to antitumor drugs are as follows45: 1) down-regulation of the HER-2 receptor, 2) prevention of HER-2/HER-3 and HER-2/HER-4 heterodimer formation, 3) induction of G1 arrest, and 4) induction of antibody-dependent cellular cytotoxicity. Treatment with trastuzumab overcomes resistance to TAM in breast carcinoma cells in vitro, and growth factor-dependent growth of carcinoma cells is modulated by restoring TAM sensitivity. In the current study, treatment with trastuzumab enhanced sensitivity to TAM in ZR-75-1 cells, whereas sensitivity to TAM in BT-474 cells was increased only slightly, even though BT-474 cells showed more receptor overexpression than ZR-75-1 cells. The difference in modulation of TAM sensitivity by trastuzumab and AS Bcl-2 in ZR-75-1 and BT-474 cells may be due to activation of downstream antiapoptotic signal-transduction pathways. Treatment with trastuzumab down-regulates HER-2 expression at a low concentration of 10 nM. Down-regulation of Bcl-2 may occur through a different pathway. Thus, a possible explanation for the differential effect of trastuzumab in the enhancement of drug sensitivity may be its effect on the Bcl-2 signaling pathway in breast carcinoma. This implies that dual modulation of antiapoptotic signals mediated by Bcl-2 and pAkt will be more effective for enhancing TAM sensitivity than the modulation of each signal alone. The potential interaction between Bcl-2 and Akt for drug sensitivity has been implicated in previous reports. The enforced overexpression of Bcl-2 prevented daunorubicin-induced apoptosis through inhibition of Akt degradation in U937 leukemic cells.46 The inhibition of Akt produced a decreased protein level of Bcl-2 in pancreatic carcinoma cells in association with the decreased function of NF-κB, which is capable of transcriptional activation of Bcl-2.47 The integrity and function of a Akt/NF-κB/Bcl-2 signaling pathway may be dependent on various factors, including the cell type and genetic background of carcinoma cells.
AS strategies for the modulation of specific proteins involved in cell proliferation and apoptosis have been developed for protein kinase Cα,48 c-Raf,49 and Bcl-2.50 The therapeutic efficacy of AS Bcl-2 (G3139, Genasense, oblimersen sodium; Genta Inc.) combined with antitumor drugs has been examined in Phase III trials for chronic lymphocytic leukemia, multiple myeloma, and malignant melanoma. Although the recent results of Phase III trial of G3139/dacarbazine versus dacarbazine alone in patients with advanced malignant melanoma did not show a significant increase in overall survival by the addition of G3139, combination treatment with G3139 and dacarbazine showed a significant increase in progression-free survival and response rates compared with dacarbazine alone.51 The clinical efficacy of G3139 for the treatment of solid tumors, including breast carcinoma, colon carcinoma, gastric carcinoma, small cell lung carcinoma, and bladder carcinoma, also is under investigation. We have shown that treatment with AS Bcl-2 enhanced drug sensitivity to mitomycin C and paclitaxel in MDA-MB-231 cells by modulating the signal-transduction pathways involving Bax, cytochrome c, and caspase-3.26 Furthermore, down-regulation of Bcl-2 by AS activated caspase-8 through both death receptor-dependent and receptor-independent pathways. Although the mechanism by which TAM exerts its cytotoxic effects occurs through competitive inhibition of estradiol binding to the ER-responsive element, treatment with TAM actually induces apoptotic cell death in breast carcinoma cells and is associated with the induction of Bax, Fas, caspase-8, cytochrome c, and caspase-3 and with the activation of caspase cascades. In addition, treatment with TAM induces G0/G1 cell-cycle arrest in association with apoptosis.52 These findings suggest that growth arrest by TAM triggers the activation of signal-transduction pathways leading to apoptosis. Assuming that signal-transduction pathways for apoptosis are activated after TAM treatment, it appears that the signaling pathways are mediated by death receptor-dependent and receptor-independent pathways and by activation of caspase cascades. Thus, because mitochondrial dysfunction by release of cytochrome c is a critical event in promoting apoptosis, it is conceivable that AS therapies for the modulation of Bcl-2-mediated antiapoptotic pathways provide a good strategy for the enhancement of TAM sensitivity in breast carcinoma cells.
In conclusion, the use of Bcl-2 AS oligonucleotide is effective for the modulation of TAM sensitivity in HER-2 and Bcl-2-overexpressing breast carcinoma cells. Treatment with AS Bcl-2 may be more effective than trastuzumab in terms of modulating antiapoptotic signaling pathways that involve Bcl-2 and Akt in hormone-independent growth in TAM-resistant breast carcinoma cells.
- 2Early Breast Cancer Trialists' Collaborative Group. Tamoxifen for early breast cancer: an overview of the randomized trials. Early Breast Cancer Trialists' Collaborative Group. Lancet. 1988; 351: 1451–1467.
- 51Randomized multinational Phase 3 trial of dacarbazine (DTIC) with or without Bcl-2 antisense (oblimersen sodium) in patients (pts) with advanced malignant melanoma (MM): analysis of long-term survival. Proc Am Soc Clin Oncol. 2004; 711: 7505., , , et al.


Today’s Book of the Day is a highly rated Romance by award-winning author, Donna Fasano. Taking Love in Stride has a 4.0 star rating and is only $2.99!
“Donna Fasano proves again that she is a solid romance author, delivering a well-paced story with appealing lead characters and a true-to-life supporting cast. You’ll want to dash for this one!” Dana T. – Amazon Reviewer
Taking Love in Stride
by Donna Fasano
Rating: 4.0 Stars
Track coach Andrea O’Connor is fuming at the audacity of Ian Powers, the very attractive father of one of her students. He offered to buy school equipment only if Andrea agreed to train him for a half-marathon.
Well, train him, she would. And not just in running. As a widower with a high-powered job, Ian needed some instruction in being a father to an active teenage daughter. Yet as this overbearing man opened up, Andrea found herself learning lessons–in loving.
Ian knew that Andrea, with her assertive attitude and her penchant for stilettos, was some woman! But her vulnerable heart was on the run, so he’d have to prove that his love, unlike his running, had limitless endurance–and once he caught this swift beauty, he’d never let her go.
Here’s what the reviewers have to say:
Donna Fasano did a superb job at creating two characters with spunk and heart! I highly recommend this book to all. I can definitely add Ms. Fasano’s name to my list of authors to keep up with when it is time to read another good book!
Well worth the small price tag. If you like boy-meets-girl comedies, I recommend this book for a few hours of fabulous fun. I’ll be looking to see what else Donna Fasano wrote. Enjoy!
I enjoy Donna Fasano’s writing and this book met the high standards that I have come to expect. I would recommend this quick read for anybody that is looking for a bright spot in their day!
I have read other books by Donna (Fasano)and enjoyed them thoroughly. I’m happy to say that this one is no exception in the enjoyment department! It’s a great read. I highly recommend it.
I loved everything about this book, the story, the excellent writing, it kept me glued to the screen. I loved it.
Get Taking Love in Stride here: Taking Love in Stride
About The Author
Donna Fasano is a three time winner of the HOLT Medallion, a CataRomance Reviewers Choice Award winner for Best Single Title, a Desert Rose Golden Quill Award finalist, and a Golden Heart finalist. Her books have sold over 3.6 million copies worldwide and have been published in nearly two dozen languages.
What others are saying about Donna’s books:
“…complex, funny, and realistic…” ~Wilmington News Journal
“Could not help myself from reading excerpts to my husband and friends. This book is well written, the characters are real, everyday folks. It is very easy to identify with them. Donna Fasano is a talented author.” ~Elizabeth M. Caldwell on Amazon
“…a fast paced riotous look at family life today. Donna Fasano is right on target!” ~Donna Zapf, SingleTitles.com
Indulge yourself today! Pick up a Donna Fasano book! For more information about Donna and her books visit her blog at www.DonnaFasano.com.
Thank you for considering today’s Book Of The Day – Donna Fasano and ENT appreciate it.


There was once a strong young man who was offered a job as a woodcutter. He set about his task with energy; the first week, he turned 18 trees into firewood. The second week, he worked just as hard, but was surprised to find he had chopped only 11 trees. The third week, despite working nonstop from morning till night, the number was six, and he went despairingly to the foreman to offer his resignation. “I am losing my strength. I can no longer cut as many trees as I once could.”
The foreman looked at the young man, who seemed to him in fine health. “Have you thought of sharpening your ax?” he asked.
“Sharpen my ax? Who has time to sharpen an ax?” the young man asked indignantly. “I have been too busy chopping wood!”
When we aren’t making the kind of progress we feel we should be making, the natural response is to redouble our efforts. Sometimes, though, the better response is not to work harder, but to work smarter. Look at your tools. Analyze your processes. Are you directing your resources in the most effective ways? Or are you pouring all your strength into chopping wood with a dull ax?
The above is from a column in the Rotary Magazine, by K.R. Ravindran – President, Rotary International.


Many studies on legal consciousness suggest that the poor and working class are fundamentally excluded or disadvantaged, having a different legal consciousness from others that is “against the law” or cynical and dismissive about the law. My study is the first to examine polyvocality and change in legal consciousness among the poor. The women in my study are disadvantaged, to be sure, and face barriers to learning and mastering the law. But the interviews conducted for this study revealed that a remarkable shift in legal consciousness could take place as a result of the interface of perceptions, experience, and interaction with legal services, courts, and other members of the community. In this chapter, I develop a theoretical framework of legal entitlement in order to provide a more nuanced understanding of the variations and changes in legal consciousness among low-income mothers as well as how these differences impact the ways in which marginalized group members come to develop and exercise legal consciousness and also to mobilize the law.
Hernández, D. (2010), "“I'm gonna call my lawyer:” shifting legal consciousness at the intersection of inequality", Sarat, A. (Ed.) Special Issue Interdisciplinary Legal Studies: The Next Generation (Studies in Law, Politics, and Society, Vol. 51), Emerald Group Publishing Limited, Bingley, pp. 95-121. https://doi.org/10.1108/S1059-4337(2010)0000051007Download as .RIS
Emerald Group Publishing Limited
Copyright © 2010, Emerald Group Publishing Limited


Goddess Damara - Guiding Children
Damara is the Celtic Goddess of fertility, health, kindness and abundance. Today she brings the message for you to take care of your children or your inner child. We all have a child within us who feels too much, wants to be happy and have fun.
Just as you take care of your children or of children in your family, similarly you need to take care of your inner child as well. Every time you are unkind and harsh on yourself, you are doing that behaviour to your inner child. Imagine how a child would feel is you behaved like that with them.
Would they be happy and motivated to change or would they shut down and become sad or angry or aloof?
Any positive change comes from love, not from scolding or criticism. Today the goddess is guiding you to be gentle and kind to yourself. Sometimes it's difficult to do that given our upbringing where we are taught to be proper and obedient. But remember how protective a mother is towards her child? You need to do the same with your inner child, nurture them with love, protect them from unkind words and actions and gently and lovingly guide them ahead in the world.
In doing so, you feel immense love coming from within. If you have ever wanted to experience and learn self love, this is your way ahead.
Grace and Light
Isis - Past Life
Navratri is a new beginning and every new beginning is preceded by an ending. Today’s message is for you to close the past chapters so that new ones can begin.
Goddess Isis is the Egyptian Goddess of fertility and feminity. The card is the past life card which says that this situation involves your past life memories. The memories don’t necessarily have to be from past life, they can be from the past in this life. You don’t have to remember particular memories if that’s not your strong suit. Having a sense of what needs to be let go of, what needs to change and what within you needs to transform is enough for these energies to help you take a step ahead.
Today sit in meditation for a while and allow your higher self to speak to you, to tell you what within you needs to change or let go. Be completely honest with yourself. Don’t censor any thought or word. All is welcome. Don’t doubt if you will hear or understand, because you are always being guided. You cannot go wrong. Have faith and trust.
Wishing you a happy Durga Puja and Hope you have a transformational Navratri!


Gently used. Expect delivery in 20 days. Codice inventario libreria
I went walking.
What did you see?
I saw a black cat
Looking at me.
These catchy stanzas frolic through the Australian author Sue Williams?s simple, funny read-aloud picture book that tracks a crazy-haired boy?s stroll through the countryside. The boy sees a black cat, then a brown horse, then a red cow, and so on, and before he knows it, he?s being trailed by the entire menagerie! The Australian illustrator Julie Vivas brings the parade to life in lovely, lively watercolors?when the pink pig looks at the boy, for example, the boy sprays off his muddy body with a hose. Big type, repetition, friendly art, clean design?and the visual guessing game created by introducing each animal only partially at first?make this beloved tale a winner at story time.
SUE WILLIAMS is the author of the acclaimed picture books I Went Walking and Let?s Go Visiting, as well as Dinnertime! She lives in Adelaide, Australia, where she is also an editor and publisher of children?s books.
JULIE VIVAS is illustrator of I Went Walking, Let's Go Visiting, the Mem Fox classics Wilfrid Gordon McDonald Partridge and Possum Magic, and several other picture book titles. She lives in Australia.
Titolo: I Went Walking
Casa editrice: Live Oak Media
Data di pubblicazione: 2004
Condizione libro: very good
Descrizione libro Live Oak Media. Hardcover. Condizione libro: VERY GOOD. Cover and pages show some wear from reading and storage. May have light creases on the cover and binding. Some pages may contain writing and or highlighting. Codice libro della libreria 2720711081
Descrizione libro Live Oak Media. Hardcover. Condizione libro: GOOD. Good clean copy with no missing pages might be an ex library copy; Possibly may have minor marginal notes and or highlighting. Codice libro della libreria 2721263540
Descrizione libro Condizione libro: Very Good. Book Condition: Very Good. Codice libro della libreria 97815911272083.0
Descrizione libro Live Oak Media, 2004. Hardcover. Condizione libro: Used: Good. Ships with Tracking Number! INTERNATIONAL WORLDWIDE Shipping available. May not contain Access Codes or Supplements. Buy with confidence, excellent customer service!. Codice libro della libreria 1591127203
Descrizione libro Live Oak Media, 2004. Hardcover. Condizione libro: Very Good. Codice libro della libreria P021591127203
Descrizione libro Live Oak Media, 2004. Hardcover. Condizione libro: New. Codice libro della libreria P111591127203


Book Review: Vibhor Tikiya’s new book is about jest to Live after sexual assault; a comment on the brazen power of our politics, on the inertia of our legal system & on the general ‘Chalta hai’ attitude of us.
December 16, 2012 shook India and the collective conscience of the country for what happened in the National Capital. The last words of the victim in the Nirbhya sexual assault case were, “I WANT TO LIVE”. Vibhor Tikiya takes off from there to build a story around a sexual assault and the aftermath. Incidentally, I got to read the novel exactly 4 years since the humongous tragedy, on December 16, 2016.
Vibhor Tikiya’s journey as a writer started with the campus story DADA. He switched over to an intense novel like ONCE UPON A DHARMAYUDH for his second. AN EYE for AN EYE MY LOVE, I want to LIVE is his third and he has taken a new genre this time. This is a love story yet the LOVE isn’t the theme. This is a revenge story but the revenge isn’t the theme. It’s more of an attack over our system, on the brazen power of our politics, on the inertia of our legal system and on the general ‘Chalta hai’ attitude of us, the people of India.
Dhruv, a vagabond from India is a scarred soul eternally mourning for his wronged mother. He’s perpetually on the run till he meets Aisha in Paris, the city of Love. Several dates later, Aisha changes his attitude towards relationships and before he could understand, he is in love. But when he comes face to face with love, his escapist nature prevails over him and stops him from uttering those three magical words. Aisha goes missing and Dhruv comes to India in search of the only woman he loved. He finds her fighting death in an Intensive Care on ventilator support. Her last words, written on a piece of paper were, “Dhruv I want to LIVE”.
Dhruv finds a reason to live as he goes through the ordeal of the court case that ends with the conviction of a serial offender called Bheem. At the end of the case, he believes natural justice has prevailed. But an encounter with a mysterious person called Aryan and a pendrive change the course of life for him. The rest of the story is a thriller with justice being delivered in what the author believes the only way it can be done in this country.
There is lust, there is wander lust, there is love and there is wine. There is philosophy and there are mothers. The story has several mothers who suffered and a could have been mother who was ravaged and killed. There are court proceedings, there is politics, there is deceit and vengeance. And Vibhor Tikiya wraps it all in 174 pages and it is the brevity that makes it a winner.
Justice can’t always be achieved by law. There is a bit of Che Guevara in it and a lot of French wine that has matured. There is a swindler who acts a guide and a retired Major with his own mission. There is a father shattered by his daughter’s tragedy and there are activists who do not know their cause. There is a corrupt system and a lawyer who knows his client is innocent in this case. There is a gay bar and an inexplicable chase. There is training and there is a target. There is an aim and then a pretty much aimless life finds a goal. In the end, there is poetic justice and some surprise.
Vibhor Tikiya keeps it simple and his simple language is his strength. Without the burden to be heavy on vocabulary, he evolves into a good story-teller in his third novel and his most passionate work yet. It does lag a bit in pace in the early stages, especially during the Paris phase. But it gathers momentum to race towards a climax with poetic justice. But we learn, the poetic justice was in fact political justice. The growing maturity of the writer shines in his characters getting more real with their weaknesses, fallibility and vulnerability. The climax was predictable and I did predict it very early. In spite of that, An Eye for an Eye is an engaging read and is worth our time.
The book is dedicated to the author’s mother and two little nieces with a fond hope of finding them grow up to live in an India that will be a lot safer for them. That is pretty much the wish every human being is making these days.
AN EYE for AN EYE MY LOVE, I want to LIVE
Author: VIBHOR TIKIYA
Published by: Srishti Publishers & Distributors in 2017
New Delhi 110019
Price: Rs. 195/-


Breast cancer survival rate is determined by multiple good and bad prognostic factors. The survival or mortality rate is usually described in terms of the percentage of surviving patients after 5 or 10 years and the recurrence rates.
Breast cancer survival rate has improved over the years by about 39% over the last 3 decades. This is because of increased awareness, early diagnosis, and better treatment modalities.
Here are Some Factors that Influence Breast Cancer Survival Rate:
The overall 5-year survival rate of breast cancer as per the 2023 statistics is 90.8%.
This means that out of 100 women diagnosed with breast cancer, 91 women are likely to live for up to 5 years and beyond regardless of their ages, tumor size, stage of breast cancer, or other factors.
Many factors influence breast cancer survival rate. Here are some of the good and bad prognostic indicators of breast cancer survival rate:
Age of the patient:
Breast cancer in women affects mostly middle-aged females. More than half of the women diagnosed with breast cancer are between 55 to 74 years of age.
Here is a table showing the incidence of breast cancer in women by age:
% of new cases by age
|35 – 44||8.3%|
|45 – 54||18.5%|
|55 – 64||25.4%|
|65 – 74||26.8%|
|75 – 84||13.9%|
The death rates in women with breast cancer increase with increasing age. Younger age is associated with a better prognosis.
However, the prognosis depends on multiple factors other than the age.
Breast Cancer Deaths (Percentage)
|20 – 34||1%|
|35 – 44||4.4%|
|45 – 54||11.6%|
|55 – 64||21.3%|
|65 – 74||24.1%|
|75 – 84||20.2%|
The median age of at death is 70 years.
Stage of Breast Cancer:
The stage of breast cancer is one of the most important factors influencing survival rate. Stage 1 cancer, also called localized tumor which has not spread to distant parts of the body or lymph nodes has the best prognosis.
The 5-year survival rate of a localized breast cancer is 99.3%. In simple words, almost all women who are diagnosed with breast cancer in the early localized stage (Stage 1) are going to survive for 5 years or more.
In contrast to women with regional or distant spread of the tumor, the survival rates decline tremendously.
The 5-year survival rate of women with regional spread of breast cancer is 86.3%, and those with distant spread is 31%.
Breast Cancer % 5-year Survival Rate
|Regional Spread of Cancer||86.3%|
|Distant Spread of Cancer||31%|
Size of the tumor:
The size of breast cancer affects the survival rates. Breast cancer that is smaller than 1 cm and has not spread has a very favorable prognosis compared to breast cancer of 5 cm or larger.
In the TNM staging of breast cancer, “T” refers to tumor size. This signifies the importance of tumor size at diagnosis [Ref].
- TX: Can not assess the primary tumor.
- T0: Primary tumor not detected.
- T1: The tumor is less than 2 cm in size.
- T2: The tumor is 2 to 5 cm in size.
- T3: The tumor is larger than 5 cm in size.
- T4: The tumor has extended to the chest wall or skin. Can be of any size.
In one study, the 15-year survival was observed to be greatly reduced when the tumor size at diagnosis was more than 2 cm, especially in women with lymph node involvement [Ref]:
|Tumor Size at Diagnosis||Node Involvement||15 years survival|
|0.1 – 1 cm||Yes||80.4%|
|1.1 – 2 cm||Yes||70.1%|
|2.1 – 5 cm||Yes||47.1%|
Spread of the tumor:
The Spread of the tumor is commonly described in medical terms as “metastasis”. Metastasis is probably the most significant factor in predicting a 5-year survival rate in women with breast cancer.
Although other factors play a significant role, generally, the 5-year survival is estimated to be around 30% in women with metastatic breast cancer.
In the TNM staging, M0 is when there is no evidence of the spread of the breast cancer while M1 is when the breast cancer has spread to any part of the body such as the liver, lungs, or brain.
The 5-year survival rate in women with regional spread of breast cancer is about 86% while that of distant spread is 29 – 30%.
However, the survival rates differ depending on the site and organ where the cancer has spread.
The table below shows the breast cancer survival rates after it spreads to distant organs:
Spread of Cancer
Breast Cancer Survival Rates
|Sternum||10-year survival after Sternectomy: 41.8%
Median survival: 9 months after recurrence [Ref]
|Eye (Orbit)||Mean survival after diagnosis is 22 months [Ref]|
|Neck||The median survival after diagnosis of neck metastasis is 21 months|
|Pancreas||1 – 50 months [Ref]|
|Stomach||24 – 36 months [Ref]|
|Brain||2 – 27 months|
|Bone||1-year survival rate: 51%
Stage 4 breast cancer spread to bones survival rate at 1, 3, and 5 years
|Liver||5-year survival: 37% [Ref]|
In one study, breast cancer spread to the liver had a very poor prognosis [Ref]
Breast cancer with liver metastasis
Median survival (months)
|Liver Metastasis||Single: 10.34 months
Multiple: 4.6 months
|Liver and Bone||3.87 months|
|Liver and lung||5.75 months|
|Liver and pleura||4.27 months|
Lymph node involvement:
Lymph node involvement is another major prognostic indicator of survival in women with breast cancer.
Because of its association with survival, nodal positivity has been added to the TNM staging of breast cancer.
The “N” in the “TNM” staging of breast cancer denotes “Node involvement”.
Nodal involvement can be:
- Nx: Nodes can not be assessed
- N0: Nodes are free of the disease
- N1, 2, or 3: Nodes are positive
- N1: 1 – 3 nodes involved
- N2: 4 – 9 nodes involved
- N3: 10 or more nodes involved
In one study, the 5-year breast cancer survival rate was determined in a cohort of 628 women with node-positive breast cancer.
The results are given in the table below:
Lymph node Involvement
5-year disease-free survival
5-year overall survival
|N1 (1 – 3)||80.1%||84.3%|
|N2 (4 – 9)||53.9%||69.4%|
|N3 (10 or more)||50.6%||62.3%|
In another study, LNR (Ratio of lymph nodes positive to total lymph nodes examined) was used to assess the 10-year breast cancer survival rate.
Patients were divided into low, intermediate, and high-risk groups. The 10-year survival in the three groups is given below:
Lymph node Ratio (LNR)
10-year disease-free survival
|Low (0.2 or Less)||80.1%|
|Intermediate (>0.2 – <0.65)||53.9%|
The 10-year disease-free survival is greatly reduced in the high-risk groups.
The type of breast cancer:
The WHO has classified breast cancer into 21 different histologic subtypes. Of these, invasive ductal breast carcinoma of no special type (NST) is the most common [Ref]
Breast cancer with favorable histologic types include [Ref]:
Breast Cancer Type
5-Year Survival Rate
10-Year Survival Rate
|Pure Mucinous Carcinoma||94%||89%|
|Invasive Cribriform Carcinomas||Excellent||–|
|Neuroendocrine Carcinoma||Up to 0.5%||Favorable|
|Medullary Carcinoma||Generally good||95%|
|Adenoid Cystic Carcinoma||90%||–|
|Secretory Breast Carcinoma||Extremely rare||Favorable|
Apocrine carcinoma has an intermediate prognosis. Breast cancer with the worst prognosis according to histologic subtypes include [Ref]:
- Pleomorphic Lobular Carcinoma
- Invasive Micropapillary Carcinoma
- Metaplastic Carcinoma
- High-Grade Small Cell Neuroendocrine Carcinoma
Histologic grade of the tumor:
Histologic grade has a lot of inter-observer variability. There are three different histologic grades of breast cancer.
Grade 1 breast cancer is well differentiated with few mitotic processes while grade 3 is the least differentiated and abundant of mitotic processes.
The higher the grade of the tumor, the poorer the prognosis [Ref]:
- Grade 1 breast cancer: Good prognosis and better survival rates
- Grade 2 breast cancer: Intermediate prognosis and survival rates
- Grade 3 breast cancer: Poor prognosis and survival rates
The response to treatment:
A patient’s response to treatment significantly relates to overall survival rates. Patients who have a good response to chemotherapy or neoadjuvant therapy have better survival compared to patients who have a progression of the disease.
Women who have disease progression in terms of an increase in tumor size, spread to local or distant organs of the body, or develop intolerance to medications do less well and have poor overall survival compared to women who tolerate the medicines and whose tumors shrink with treatment.
Estrogen and Progesterone receptor status (ER/PR positive or negative):
Estrogen and progesterone receptor status have been strongly linked with survival rates. Generally speaking, women with ER and PR-positive breast cancers have a better prognosis.
In addition, ER and PR status are usually seen with HER-2 expression. Hence women with breast cancer can have any of the combinations:
|ER+/PR+/HER-2 + (Triple positive)||+ve||+ve||+ve|
|ER-/PR-/HER-2 – (Triple negative)||-ve||-ve||-ve|
However, for practical purposes, the following four categories of breast cancer are commonly used to decide the treatment [Ref]:
|Molecular Subtype||Description||4-year survival rates|
HR + means ER and PR positive
Estrogen receptor (ER) positive breast cancer has a better prognosis compared to women with estrogen-negative breast cancer as shown in the table below [Ref]:
Age of the patient
5 Year Survival Rates in ER-Positive Breast Cancer
5 Year Survival Rates in ER-Negative
|40 – 49 years||94%||81%|
|50 – 59 years||95%||81%|
|60 – 69 years||95%||81%|
|70 – 74 years||94%||80%|
Overall, breast cancer survival at 15 years for ER-positive breast cancer was 77%, and for ER-negative breast cancer was 70%.
The breast cancer survival rates for combined ER+ and PR+ were estimated to be better than hormone-receptor-negative breast cancer [Ref]:
|ER + PR – Tumors||91.4%||79.6%||95.9%||93.9%|
|ER – PR + Tumors||81.0%||73.1%||95.3%||88.7%|
DFS: Disease-free survival
OS: Overall survival
The prognosis is best when the breast cancer is Estrogen and Progesterone receptors positive and HER-2 negative.
The overall 5-years survival rates of ER +, PR +, and HER-2 – breast cancer is estimated as 96.7% compared to 82.7% for breast cancers which are ER -, PR -, and HER-2 + [Ref]
|Subtype||5-Year Survival Rate||5-years Disease-free survival|
|ER+ PR+ HER-2-||96.7%||90%|
|ER- PR- HER-2+||82.7%||73.3%|
HER2 gene expression:
HER-2 expression means the breast cancer cells have “human epidermal growth factor receptor 2” on their surface.
Women who have an extra copy of a gene that encodes for cell surface proteins called HER-2 express these proteins on their surface.
These protein receptors promote the growth and help the spread of breast cancer cells. These proteins are detected by molecular techniques such as FISH (Fluorescence in situ hybridization) and immunohistochemistry.
Hence, women who are positive for HER-2 receptors have a poor prognosis and a shorter survival.
It is estimated that 15 – 20% of all invasive breast cancers (invasive ductal carcinoma and lobular carcinoma are HER-2 positive) [Ref].
HER-2 positivity is an indicator of poor prognosis, however, breast cancer survival rates are best estimated along with ER (estrogen receptors) and PR (progesterone receptors).
HER-2-positive breast cancers have a 5-year survival rate of more than 90% if picked up in the early stages. However, once the disease spreads to distant organs, the survival rates are greatly reduced.
Women with breast cancer who are younger, have a small tumor at diagnosis, that has not spread to the lymph nodes, locally, or to distant organs and have a better prognosis and excellent chances of surviving for 5 years or more.
In addition to these traditional prognostic factors, novel markers of survival are being increasingly used. These include Hormone Receptors (HR) and Human Epidermal Growth Factor Receptor- 2 (HER-2).
Women with breast cancer positive for Estrogen and Progesterone (Hormone positive – HR +) have a better prognosis while HER-2 positive breast cancer has a poor prognosis.
Good Prognostic Factors
Bad Prognostic Factors
|Axillary Lymph Node Status||Node-negative disease||Positive nodes (Number of nodes correlates with recurrence)|
|Tumor Size||Smaller tumor size||Larger tumor size|
|Lymphatic/Vascular Invasion||Absence of invasion||Presence of invasion|
|Patient Age||Younger age||Older age|
|Histologic Grade||Lower grade||Higher grade|
|Histologic Subtypes||Tubular, Mucinous, or Papillary subtypes||Comedo subtype for DCIS|
|Response to Neoadjuvant Therapy||Favorable response||Poor response|
|Hormone Receptor (ER/PR) Status||Positive (responsive to hormone therapy)||Negative|
|HER2 Gene Amplification/Overexpression||Improved prognosis with targeted therapies||Worse prognosis (historically) with no targeted therapies|


“A brave compassionate, and heart-wrenching memoir, of one woman’s quest to redeem the past while learning to live fully in the present.”
Kate Moses, author of Cakewalk, A Memoir and Wintering: A Novel of Sylvia Plath
"This searing and redemptive memoir is an explosive account of motherhood reconstructed."
Ayelet Waldman, author of Red Hook Road
"This book is an important contribution to the growing understanding that we are all part of history, and we all make history. A moving account of a contemporary voyage, which is also a voyage back in time, reckoning with and bearing witness to one of the great tragedies of the last century."
Susan Griffin, author of A Chorus of Stones
"If remembering lies at the heart of all memoir, the best memoir goes far deeper, asking questions about the propulsive nature of time, the consequences of forgetting, and the treacherous liberations of solitude. Hiroshima in the Morning is a memoir of the most sophisticated kind, a lyric, a quest, a universal poem."
Beth Kephart, author of A Slant of Sun, a National Book Award finalist
"Rahna Reiko Rizzuto's new book is intimate and global, lyrical and clear-eyed, a compelling personal narrative, and an important social document. Here past and present, Hiroshima and 9/11, interweave to tell a story of unendurable loss and tragedy but also of tenacity, survival, and rebirth"
Lauren Kessler, author of Stubborn Twig: Three Generations in the Life of a Japanese American Family


Cult Survivor, Author, Keynote Speaker, Christian Evangelist ~
Hating God, Loving God: How a Young Man Born Into Suffering and Driven to Despair Found Jesus Christ.
A. K. Davies uses his own personal story to remind people that no matter what their situation is, they should never give up hope. Topics include never giving up hope, believing in your self, your relationship with God, spiritual wisdom, overcoming adversity, dealing with hard times, and more. Book now.


Spring is coming, and the days are getting warmer and lighter. And yet I know we are all feeling the heaviness and weight of the conflict and upheaval rocking the world right now. We hope you are finding healthy ways to cope. If you do need help, please reach out. Our local Addiction and Mental Health Clinic can be reached at 403-361-7277, and a wide range of resources is available at Alberta Health Services’ “Help in Tough Times” page.
One of the ways many of us cope with situations beyond our control is to immerse ourselves in another world through books. Studies have shown that in times of stress, people tend to re-read books they have enjoyed before, particularly as children. Reading a captivating story where the outcome is not in doubt and where any evil is defeated by good can be relaxing and soothing.
Here are some favourite comfort reads from our staff:
- Anne of Green Gables is my top choice. I love the way that Marilla, Matthew, and Anne (and even Rachel Lynde) are transformed by the love that they find as a family. It reminds me that daily acts of caring really matter.
- Another favourite series from childhood is the Chronicles of Narnia by C.S. Lewis, featuring some marvelous characters like Reepicheep the mouse.
- I also enjoy re-visiting a series with a strong setting or cast of characters that gives you a sense of familiarity. My top choices are Louise Penny’s books set in Three Pines or Iona Whishaw’s books set in a small rural community in the BC interior.
- Books that re-imagine well-known characters are fun too. I enjoy Laurie King’s Mary Russell series featuring Sherlock Holmes and other fan fiction or something like The Jane Austen Society by Natalie Jenner.
- A patron recently recommended the audiobook Tilly and the Bookwanderers by Anna James. In this story, a young girl growing up in a bookstore encounters fictional characters like Anne of Green Gables and Alice from Wonderland in real life and is even able to follow them into their fictional worlds. This is a charming read suitable for ages 10 and older.
- Carmen enjoys listening to the Harry Potter series on audiobook to help her go to sleep at night. They’re beautifully narrated, and Libby has a wonderful sleep timer feature that allows you to set it to play for only a set time.
- Marion likes Beautiful Joe by Marshall Saunders. This book was originally published in 1894 and is based on the true story of a Canadian dog.
- Tammy’s choice is also an older book: Andy Russell’s Adventures with Wild Animals, a book that was given to her when she was a teen. Sometimes a book is special because of the way it came into your life.
- Catherine's choice is not a book, but the movie adaptation of Pride and Prejudice because of the transformation of Mr. Darcy from aloof to completely in love.
What are your go-to comfort reads? We would love to hear from you. And we hope that spring brings good news and many good books your way.


Title: The Strange and Beautiful Sorrows of Ava Lavender
Author: Leslye Walton
Publisher: Walker Books
Source: Review Copy
Publication Date: 27th March, 2014
Foolish love appears to be a Roux family birthright. And for Ava Lavender, a girl born with the wings of a bird, it is an ominous thing to inherit. In her quest to understand her peculiar disposition and a growing desire to join her peers, sixteen-year-old Ava ventures into the wider world. But it is a dangerous world for a naive girl...


The first two presidents in this journey took me nearly three months to get through. George W. Bush and his predecessor hardly took me three weeks.
But unlike George Washington and John Adams, recent presidents haven’t been off the stage long enough to induce most historian-biographers to tackle their lives.
That will change as additional time passes, more documents are de-classified and presidential legacies (and lives) continue to marinate under the bright light of day.
I read just two biographies of Bush 43, but was excited about each for different reasons: one was written by an author who ranks as one of my all-time favorite biographers…and the other was written by an author known for his indefatigable determination and uncanny ability to piece together a story.
* * *
* “Bush” (2016) by Jean Edward Smith
No biographer has impressed me more often, or more consistently, than Smith. His…
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Steps – Image by Jemima Pett Walking on the roads of life, Meandering through its mundane alleys, Transgressions aside, Myriad paths circambulate, To meet at the steps of time. I stand at the crossroads, For I know not which path to take, I sweep the panorama, Gaping at what has gone by, As flashes of… Continue reading #WritePhoto-Steps
Days of yore when less was so more, One television and few shows, A loud hue and cry and sharp rows, All sat down to have fun galore, Neighborhood bonhomie to fore, Images only white and black, But colours of life would bounce back, Television now smart ,men dumb, Profound joys of life have gone… Continue reading Ronovan Writes Décima Poetry Challenge Prompt No. 58: (BLACK) in the C rhyme line.
Photo by Trent McDonald, photographer I have written a Garland Cinquain Fiery hope extinguished you stand at precipice staring into gorges around all dark. Inside hot inferno rages to consume all what was once full of vibrant life now dead. You walk along in fear in a tormented soul ripped fully apart at its core… Continue reading #TANKA TUESDAY WEEKLY #POETRY CHALLENGE NO. 226 #EKPHRASTIC #PHOTOPROMPT
Image from http://Pixabay.com Walking through clouds( A Tanka) Alone I climb high leaden feet tremble to keave a misty silence-- diffuses azure frail cloud a haloed dawn awaits me Via Tanka Tuesday
My heart finds peace in secluded places and in little things that once remind us why we live. I did not look up as the jagged bolts of lightning tore asunder the dark sky shrouding the world with their bright incandescence. For I was lost in the cerulean tranquil abyss of my mind.
Life Mesmerising a plethora of choices jaded souls spellbound happiness shrouded in grey souls surf in a deep hushed lull.
Ariel,the tender Sprite had descended on the land of common natives to look out for goodness. Unseen and hidden in the verdant bush, it donned its pink glasses nosed with sharp whiskers. The glasses could see through all masquerades and pretentious charades and the sharp whiskers tingled on each stroke of goodness. But the Sprite… Continue reading #WRITEPHOTO-RABBIT
Life bestows all its love on you, Give it a chance. Let the love bestowed bloom, Let it spread the fragrance around. Let it give you one chance, To bestow on others, The joys you have found.
Spring blossoms and soft fragrant love, Gently seeps into hearts to steal, As it beats fast in a cartwheel, And all malice given a shove, Melody and love hand in glove, Tranquil wisps blow away the gloom, Passions roared in the narrow flume, Splashing an array of hues bright, Leaving one rapt in pale moonlight,… Continue reading Ronovan Writes Décima Poetry Challenge Prompt No. 44: (STEAL) in the B rhyme line.


“The Game” by Jack Holt
An exploration by Patty Ganzelli
The main idea of “The Game” is to present different perspectives to a single bizarre event and allow the reader to draw conclusions of their own. “The Game” is a set of four interconnected flash fiction pieces each containing a constraint of exactly 101 words. Each piece is told from the first-person point of view, and each has a different narrator, all unnamed.
The first narrator states that they had spoken to a man named Professor Runcorn about the “Pine Woods Incident,” which Runcorn describes as a meteorite crashing to earth and killing two unidentified persons in the woods. However, there are no records of any meteor even coming remotely close to the planet and therefore the police are launching an investigation.
The second narrator tells of the wind interfering with his chase, but it will be over soon as he has his prey cornered in the woods.
The third narrator is scared and hiding behind a tree in the woods, helpless as he knows his pursuer is watching him. He is wounded and trying to calm down and catch his breath when he hears a faint whistle that he knows is not coming from his pursuer.
Finally the fourth narrator is watching the others, and indeed has been watching them for a while. He has been orchestrating their chase, subtly manipulating the elements around them from a silent distance. He decides to bend the rules to his own game creatively, still keeping the facts rooted in “their science,” thereby ending the game.
The characterization of the narrators is very successful in this piece. The author managed to give each narrator their own voice through diction despite the constraint, thereby adding to the mystery of each character. Narrator #1 gives the impression of a television journalist who has just interviewed Professor Runcorn “regarding what has been coined the ‘Pine Woods Incident.’” While the majority of his section is told by Runcorn, the narrator’s identity is still clearly defined through two short sentences. Narrators #2 and #4 are similar in that they are both pursuing someone and are aware of their power, yet both still have distinct voices. Narrator #2 is angry and vengeful, calling his prey a “little bastard” and ready to “see him quickly ended.” Narrator #4 is written with a fulsome, superior tone, an “invisible, distant” god who is controlling the tiny mortals on his “orchestrated stage.” He speaks lazily of his victims, saying he may “fancy letting loose [his] more imaginative side today” and “accept the punishment later.” Narrator #3 also has a very unique voice: he is frightened and on the run. He speaks in short clipped sentences that mirror his anxiety. He is the only character that speaks of his own physical body: “I rest my trembling, bloodied hand upon my chest.” His attempt to calm himself by counting, then by breathing, and then counting again also reveals his character: he is much more frightened than even he knows. The author does a very successful job in creating differences between the characters.
“So occupied were they with each other, the real danger registered not even a frivolous wonder.”
This sentence stuck out to me the most. It is bone-chillingly ominous and beautifully written. It makes me think how anyone could be this narrator, watching us from an invisible distance and could easily blow us away and we would have no idea. Sometimes we are so preoccupied with other things and people that not even in our wildest dreams we are aware of any possible outside danger. The phrase “frivolous wonder” really stood out to me as well. The imagery is very beautiful and has an almost childlike, fantastical connotation. Without the word “frivolous,” this sentence would not nearly function as well. The author chose this word for a purpose: rather than writing something more sinister or a phrase like “not even a fleeting thought,” frivolous does give the sense of giddy playfulness. After all, the whole thing is a game.
Having a constraint for the number of words can be beneficial to a story as it causes you to choose your words more deliberately. Each sentence serves a function to both reveal character and progress the story. I tend to be wordy with my writing and this piece shows that less is more. I also think this story will help when writing about an event from different perspectives. It’s not necessary to recap the scene with every change of narrator; subtlety can work wonders. The success of this flash fiction will help a lot of other writers who are struggling with their stories. Not every micro/flash fiction needs to be only one sentence long. You can set your own constraints that will get the best results.


When was the last time you sat down and took the time to hand-write and mail a letter?
Do you remember the anticipation of receiving a letter by “snail mail?” Holding it in your hands as you wondered what you might learn from the words written inside, before carefully opening the triangle flap on the back? Or perhaps you ripped into it excitedly, as I sometimes did?
Did you first devour every word, perhaps searching for what you hoped the letter might say, flipping page by page, before reading it again and again to savor each word?
Was the stationary sometimes scented? If it wasn’t, perhaps you might have spritzed it with your favorite scent, if it was for that “special” person.
In the house where I grew up in California, our front door had a mail flap in the middle. The mailman would simply lift the flap in the door and drop all of our mail straight onto our living room floor. When a train roared down the track a block from our house, the metal flap would vibrate with the rest of the house.
Upon arriving home from school, I’d open the front door, running over the mail splayed on the floor. I’d close the door and kneel, gathering all the mail into a pile before flipping through the stack one-by-one to see if I’d received anything. Most days I was disappointed, seeing only bills or advertising, which I’d toss onto the kitchen table.
One mail-related memory still makes me smile. Our dog, Chim, a scruffy little terrier, would bark when she heard the mailman’s footsteps. She’d growl and attack the mail as it came through the mail slot, grabbing those evil envelopes and shaking her head back and forth. Snarling, she’d defend our home mightily from the paper intruders.
Those handwritten treasures didn’t always come in the mail. Sometimes they were dropped in my high school locker. Or perhaps they were written on the back of a senior picture, or inside a hand-delivered birthday card or yearbook.
I have many other memories of hand-written notes and letters—things I took for granted and never really thought about. In fact, I didn’t even take the time to assume we’d always have letters, because . . .
Why wouldn’t we always have handwritten letters?
Then came email.
I LOVED email at first–instant gratification! Though I no longer had to wait weeks between writing and response, emails, too, had an aura of anticipation. And it’s true, they’re as permanent as the sender or receiver wants them to be. I probably have more letters I’ve received by email than I do those I received by “snail” mail, simply because they’re easier to keep, and I know precisely where to find them.
But lately, I’ve felt something was lost when email came along and we quit hand-writing letters.
Years ago, my mother gave me a box of letters. She told me they were old letters between my father and her. It was sealed all around with tape, and she asked me not to open it until after she was gone.
And so, it was packed away, practically forgotten. After my dad died last year, we packed up our house and moved from Dallas to Cleveland. While unpacking boxes in our new house, I came upon the box of letters. I placed it on a shelf in my office, waiting for the “right” time to open it and start reading.
The “right” time arrived a couple of months ago when, while writing my memoir, I thought I might find some interesting details in the letters. Inside the decades-old cardboard box, I found not only letters between my mother and father, a few dating back to before I was born, but also letters from my siblings and me to my dad when he was away on his overseas Air Force assignments.
Reading these treasures, I learned much of my family’s history that I either never knew, had forgotten, or had remembered differently. I began to realize how much was lost when we transitioned from handwritten letters to email.
In my next post, I’ll share excerpts from a few of these letters. Perhaps you, too, will understand why I’ve decided to start hand-writing and mailing letters again.


Hi Friends, I’m currently reading The Reckoning by John Grisham. However, the next book is Bridge of Clay by Markus Zusak. So I thought I’d revisit an earlier book by Markus Zusak, The Book Thief.
Since The Book Thief has been made into a movie, I’m sure a lot of people know the story. When my youngest had to read this for school, she watched the movie AFTER reading the book. I watched with her and decided to read the book as well. So many movies don’t do justice to the books. Think Harry Potter series! Again and again, I’ve heard that the movies didn’t explain things well, especially if you have not read the books. Well, muggles, read the books!
Back to The Book Thief
Again, this is another story set in the WWII era and also about saving a Jew, among other things. I guess I’m partial to that setting and that type of story line. (See posts here & here.) Death, being the narrator, tells the story of Liesel Meminger. Upon discovering the power of words, she began to save books from the Nazi book burnings and pilfer them from the mayor’s wife’s library. Later, she would use words to record her life.
One thing that leaves a lasting impression for me is again the bravery of normal people during wartime. I confessed that before reading any of these novels, I’d automatically equate German people with Hitler. It’s obviously wrong. And I’ve raised the question, “how could anyone be so stupid to follow Hitler?” many a time whenever the opportunity arises. I don’t think anyone truly knows the answer. Some give the answer, “they didn’t have a choice,” or “they didn’t know what he would do,” or some such. Then, I read these novels and likely more to come that would give me a glimpse into the life at the time in Germany, and elsewhere in the Nazi occupied territories.
I learn that some German people were decent and brave like Hans Hubermann, Liesel’s foster father, who hid the Jew. Of course, there’s also that soldier mentioned in The Ragged Edge of Night who was given an impossible choice of following evil orders or saving his own family. Or, in another one, The Nightingale, a Frenchwoman managed to save scores of Jewish children.
The state of Israel gives non-Jews who saved Jewish lives, or attempted to save Jewish lives, the formal recognition of being Righteous Among the Nations. I’m sure many more courageous souls remain unrecognized in this life, but rewards would be awaiting them in the everlasting life.
This is not a fast read. You need to take the time to read and savor. I liked it a lot. Highly recommend it.Thanks for reading! Let's keep in touch. Just one click to follow me:


2018, vol.28, no.2, pp. 175-193
Henryson’s Testament of Cresseid does not fit into the generic features of the romance. Instead, it incorporates various genres, such as the moral fable and the testament. In particular, Henryson adopts the genre of the testament, which was in fashion at the time. Controversy surrounds whether The Testament of Cresseid should be considered a testament since Henryson mostly describes the life of Cresseid after her betrayal of Troilus while showing her testament in only fourteen lines of the poem. However, Henryson still names his poem The Testament of Cresseid, which shows that the poem is not about the Cresseid who is punished, but about the Cresseid who is excused and saved through her testament. Considering that it was not common for a medieval woman to leave a will, Henryson gives Cresseid an opportunity to raise her own voice. This again highlights the theme of The Testament of Cresseid as a testament.


“No good tree bears bad fruit, nor again does a bad tree bear good fruit; for each tree is known by its own fruit. Figs are not gathered from thorns, nor are grapes picked from a bramble bush. The good person out of the good treasure of the heart produces good, and the evil person out of evil treasure produces evil; for it is out of the abundance of the heart that the mouth speaks.
“Why do you call me ‘Lord, Lord,’ and do not do what I tell you? I will show you what someone is like who comes to me, hears my words, and acts on them. That one is like a man building a house, who dug deeply and laid the foundation on rock; when a flood arose, the river burst against that house but could not shake it, because it had been well built. But the one who hears and does not act is like a man who built a house on the ground without a foundation. When the river burst against it, immediately it fell, and great was the ruin of that house.” Luke 6:39-49
Having lived a good deal of my life near the ocean, I can tell you about hurricanes from first hand experience. I remember as a child watching debris, toilets, furniture and windows, floating down the streets after a storm. When the winds and waters rise, nothing is terribly safe. The house we lived in was very old, and would whistle and sing when the winds pounded, but was on a deep foundation and held together, even after nearly 200 years. Even then, we have evacuated when called to do so, since a firm foundation and being a good citizen participant go hand in hand.
Jesus is obviously annoyed with his followers who want an easy fix to hard problems and want to find blame in others. He reminds them that their job is to be faith and bear good fruit, to be good citizens and do the hard work of building a deep foundation of faith and good behavior. Today we want a pass, an easy laid back house on the sand. But there are always storms coming and water rising and we must be those who demonstrate love and faithfulness even when things get tough.
Today I ask God to help me do the hard work ahead. May we find ourselves bearing good fruit and daily loving our enemies and working for the goodness of all in the face of many storms.


In an English Boarding school Smith, a teacher, walks the corridors and teaches his lessons, whilst Martha and her companion Jenny go about their cleaning work, heckled by the senior boys of the school.
Some time later Smith carries a large pile of books around the school, encountering the school matron on the way. She helps him with the load and together they make their way around the school, Matron (alias Nurse Joan Redfern) taking the opportunity to ask him if he will be attending the annual local dance. He begins to splutter a reply but manages to fall down the stairs before he can give an eloquent response.
Soon Joan nurses a wound on the back of his head in his study, Martha rushing in to make sure he is not harmed. Seeing all is well she begins to tidy his things whilst Smith recounts to Joan his dreams, wherein he is a man hiding from someone, he dreams he is a man with two hearts. Joan takes her stethoscope and examines his chest, playfully confirming he has only one.
He presents her with a journal of his dreams; a diary filled with scribbled writing and drawings of all manner of creatures some human. Martha looks on keenly and follows Matron out, trying to prevent her from reading the book, but to no avail.
In one of the school dormitories sit three boys, Baines, Hutchinson and a younger boy named Latimer. Hutchinson reads a letter from his father, and Latimer correctly manages to pre-empt that he has been stationed in Africa, despite knowing nothing of the man himself. He admits that he has in the past managed to predict things before knowing them, but the others ignore him. Baines decides to retrieve some concealed beer in the woods, and hurries out of the window.
That night Martha and Jenny sit outside the local pub, Martha somewhat annoyed at not being allowed inside with the men, and takes refuge in the fact she will be leaving in a month’s time. Suddenly she sees a bright green light in the sky, but Jenny denies it. However, in the woods not far away Joan, who is walking alone, is suddenly bathed in a vivid green light, which proceeds to scan the surrounding area like a searchlight.
Joan hurries to the pub, were Smith joins her. Together with Martha and Jenny they see another light falling to Earth, which Smith claims is a meteorite. He leaves with Matron whilst Martha runs off to find where the light came down.
In the woods, Baines is distracted from his work by an eerie green light descending from the skies. He nervously goes to find it but finds himself in an empty field. Suddenly he is stopped in his tracks by an invisible wall, which glows to the touch. He manages to locate a gap in the surface and wanders inside, disappearing from view.
Moments later Martha and Jenny arrive but find nothing, and returns wearily to the school whilst inside the invisible structure, which appears to be a ship; Baines is interrogated by sinister bodiless voices. He asks to know what they look like and moments later a scream rings out. He arrives sometime later back at the school, an unnatural look on his face. He sniffs around the room as Latimer looks on curiously, shining his shoes.
The next day Martha cycles into the woods, arriving at an abandoned cottage in which stands the TARDIS. She steps inside to find the ship illuminated only by the central console, the walls surrounding it are dark. She remembers arriving in the ship, chased by some unnatural force. She recounts the Doctor’s words to her:
“Martha, this watch is me”
He had explained to her that the creatures were chasing him, the last Time Lord in existence. To avoid them he had to become human. He used a helmet that descended from the ceiling, the chameleon arch, to change his own biology and store what made him a Time Lord inside the watch.
She looks up at the device still suspended from the ceiling in the darkened ship and she remembers his screams of agony. His cries of pain that rang around the ship as a new life was set for him and all that he was became stored inside the watch.
Finally she moves over to the scanner, playing back the last recording he made for her before the change; a list of instructions for what to do whilst he remains human. She scans them but finds nothing regarding meteorites in the sky, and is left alone in the hollow room.
Back at the school Latimer calls on Smith to borrow a book. Whilst his teacher searches for the title the young boy sees the watch the mantle, he opens it temporarily as voices swarm around his head, and as Smith returns he places it in his pocket. He retreats back to his room and opens the watch, a bright light emitting from within and the voices returning.
Outside Baines appears to sense the disturbance, and when he returns inside he reports back to the ship that a source has been detected, and the soldiers must be activated.
In a field not far away a man named Mr Clark sees one of his scarecrows moving. Thinking it to be one of the schoolboys he reaches inside the lining to grab them, finding only a handful of straw. Bemused he looks at the figure, which grabs him as others like it spring to life across the field. On a road nearby a small girl with a balloon walks along, but is confronted by a scarecrow, who carries her away, screaming.
Back at the school Smith oversees the boys practising to fire machineguns at dummy targets. Latimer and Hutchinson arm the weapon, the former appearing to experience a vision of war, himself and his colleague fighting in the maze of barbed wire and mud. He observes his watches and claims that the “time is now”.
Breaking from his fantasy Hutchinson takes him away to be beaten, whilst Baines simply sniffs at his teacher, Smith. Matron appears from inside and Smith moves to speak to her, finding her upset by thought of her husband who was killed in war.
Together they leave the school and walk through the local town, discussing the idea of war, a premonition Smith appears to find in his dreams. Suddenly the teacher observes an accident waiting to happen, a piano being hauled to a first floor window is about to fall, a woman with her pram slowly walking into it’s path.
He grabs a cricket ball from a nearby by and throws it at some scaffolding nearby. It pushes the poles aside, upsetting a plank of wood on which lays a brick. The brick launches into the air and upturns a milk urn, which falls in front of the pram, preventing it from moving further into the space where the piano falls.
Smith appears marvelled by his own capabilities and suddenly finds the courage to invite Joan to the village dance. Soon they are walking through the fields together, discussing the character of the Doctor. Smith sees a nearby scarecrow and moves to correct it on it’s perch whilst Joan compliments him on his drawing, provoking him to mention his home in Gallifrey, a place she assumes to be in Ireland. Having finished correcting the scarecrow the two walk off, unaware that it turns to watch them go.
Back in his study Smith sits and draws Joan in his journal, eventually moving to kiss her. He begins to mutter some excuse but she kisses him again, as Martha enters unannounced and sees them. She flees back to the TARDIS to consult the Doctor’s instructions but finds nothing to explain what she should do.
“You had to go and fall in love with a human…and it wasn’t me.”
At the school, Latimer sits with the watch and listens to the voices, stooping to observe Baines, Mr Clark and the young girl with the balloon meeting on the other side of the grounds. On a road not far away Jenny is ambushed on her bicycle, surrounded by the animated scarecrows.
Soon she is inside the alien ship, Baines introducing her to his mother, a glowing green orb. He claims that she needs a body and suddenly a green gas emerges from the orb, overcoming the poor servant.
Smith and Joan prepare for the ball as Jenny returns to her quarters, where Martha awaits. She sniffs unnaturally as Martha confesses her concern about Smith, who is to leave the school in a few weeks. She begins to realise that Jenny is not herself and hurriedly leaves. However, Jenny draws an alien gun and pursues her, firing at her as she flees.
She returns to Smith’s room and tells him they have been found. She tries to find the watch but it appears to have gone. Smith believes her to be having some sort of breakdown and patronisingly explains the situation to her, only for her to slap him in an attempt to bring him round. He grabs her by the arm and pushes her outside, dismissing her from his service. He then returns inside, where Joan tells him that Martha was not lying about the watch, it has gone.
Martha runs outside, bumping into Latimer (who appears to have a subsequent vision of the same incident occurring in Martha’s own time zone). She hurries back to the ship and rummages in the Doctor’s coat, as Baines and Jenny arrive in Smith’s now-empty quarters looking for him.
Smith and Joan meanwhile arrive at the village dance, closely followed by Latimer. As they dance around the room Baines and Jenny continue to search the school, before Mr Clark produces the poster for the dance. Jenny smiles, her daughter is already there.
At the dance the girl with the balloon watches the entertainment as Martha arrives, unaware the scarecrows are watching from the surrounding fields. Inside she confronts Smith and presents the Doctor’s Sonic Screwdriver, ordering him to identify it. She tries to explain to him that he isn’t John Smith; he is the Doctor, the man from the journal.
Soon Baines, Jenny and Clark arrive, storming the venue and shooting anyone who disobeys their orders for silence. Martha orders Smith to be silent as Baines turns on him, realising that the Doctor has taken human form. Smith fails to understand and Baines threatens to shoot him if he doesn’t change back. Jenny and Clark grab Martha and Joan and point guns at their heads. Baines offers him the ultimatum:
“Your friend or your lover. Your choice.”