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ON THIS PAGE: You will learn about the different ways doctors use to treat people with this type of cancer. To see other pages, use the menu on the side of your screen.
This section outlines treatments that are the standard of care (the best proven treatments available) for this specific type of cancer. When making treatment plan decisions, patients are also encouraged to consider clinical trials. A clinical trial is a research study to test a new approach to treatment to evaluate whether it is safe, effective, and possibly better than the standard treatment. Clinical trials may test approaches such as a new drug, a new combination of standard treatments, or new doses of current therapies. Your doctor can help you review all treatment options. For more information, see the Clinical Trials and Latest Research sections.
Treatment overview
In cancer care, doctors specializing in different areas of cancer treatment work together to create a patient's overall treatment plan that combines different types of treatments. This is called a multidisciplinary team and includes surgeons, medical oncologists, radiation oncologists, plastic surgeons, and others as needed.
The biology and behavior of a breast cancer affects the treatment. Some tumors are small but grow fast, while others are large and grow slowly. Treatment options and recommendations depend on several factors, including:
- The stage of the tumor
- The tumor's hormone receptor status (ER, PR) and HER2 status (see Diagnosis)
- Other markers, such as Ki67, Oncotype DX™, Mammaprint™ (if appropriate)
- The patient's age, general health, and preferences
- The patient's menopausal status
- The presence of known mutations in inherited breast cancer genes, such as BRCA1 or BRCA2
Even though your health care team will specifically tailor the treatment for each patient and the breast cancer, there are some general steps for treating breast cancer.
For both DCIS and early-stage invasive breast cancer, doctors generally recommend surgery to remove the tumor. To make sure that the entire tumor is removed, the surgeon will also remove a small area of normal tissue around the tumor. Although the goal of surgery is to remove all of the visible cancer, microscopic cells can be left behind, either in the breast or elsewhere. In some situations, this means that another surgery could be needed to remove remaining cancer cells. For larger cancers, or those that are growing more quickly, doctors may recommend treatment with chemotherapy before surgery, called neoadjuvant therapy. Neoadjuvant hormonal therapy may also be recommended in specific situations.
After surgery, the next step in managing early-stage breast cancer is to lower the risk of recurrence and to get rid of any remaining cancer cells. These cancer cells are invisible, but are believed to be responsible for both local and distant recurrence of cancer. Treatment given after surgery is called adjuvant therapy. Adjuvant therapies include radiation therapy, chemotherapy, targeted therapy, and/or hormonal therapy (see below for more information on these treatments). Whether adjuvant therapy is needed depends on the chance that any cancer cells remain in the breast or the body and the chance that a specific treatment will work to treat the cancer. Although adjuvant therapy lowers the risk of recurrence, it does not completely get rid of the risk.
Along with staging, other tools can help estimate prognosis and help you and your doctor make decisions about adjuvant therapy. The website Adjuvant! Online (found at another, independent website called www.adjuvantonline.com) is a tool that your doctor can access to interpret a variety of prognostic factors. This website should only be used with the interpretation of your doctor. In addition, other tests that can predict the risk of recurrence for your specific tumor by testing your tumor tissue (such as Oncotype Dx™ and Mammaprint™; see Diagnosis) may be also used to better understand whether chemotherapy may work.
When surgery to remove the cancer is not possible, it is called inoperable. Chemotherapy, targeted therapy, radiation therapy, and/or hormonal therapy may be given to shrink the cancer.
The treatment of recurrent cancer and metastatic cancer depends on how the cancer was first treated and the characteristics of the cancer mentioned above, such as ER, PR, and HER2.
Descriptions of the most common treatment options for breast cancer are listed below. Your care plan should also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment, and after the treatment is completed. Learn more about making treatment decisions.
Surgery is the removal of the tumor and surrounding tissue during an operation. Surgery is also used to examine the nearby underarm or axillary lymph nodes. A surgical oncologist is a doctor who specializes in treating cancer with surgery. Generally, the smaller the tumor, the more surgical options a patient has. The types of surgery include the following:
- A lumpectomy is the removal of the tumor and a small, cancer-free margin of normal tissue around the tumor. Most of the breast remains. For both DCIS and invasive cancer, radiation therapy to the remaining breast tissue is generally recommended after surgery. A lumpectomy may also be called breast-conserving surgery, a partial mastectomy, quadrantectomy, or a segmental mastectomy.
- A mastectomy is the surgical removal of the entire breast. There are several types of mastectomies. Talk with your doctor about whether the skin can be preserved, called a skin-sparing mastectomy, or the skin and the nipple, called a total skin-sparing mastectomy.
Lymph node removal and analysis
Cancer cells can be found in the axillary lymph nodes in some cancers; this information is used to determine treatment and prognosis. It is important to find out whether any of the lymph nodes near the breast contain cancer.
Sentinel lymph node biopsy. The sentinel lymph node biopsy procedure allows for the removal of one to a few lymph nodes, avoiding the removal of multiple lymph nodes in an axillary lymph node dissection (see below) procedure for patients whose sentinel lymph nodes are free of cancer. The smaller lymph node procedure helps patients lower the risk of swelling of the arm called lymphedema and decreases the risk of numbness, as well as arm movement and range-of-motion problems, which are long-lasting issues that can severely affect a person's quality of life.
In a sentinel lymph node biopsy, the surgeon finds and removes about one to three sentinel lymph nodes from under the arm that receive lymph drainage from the breast. The pathologist then examines these lymph nodes for cancer cells. To find the sentinel lymph node, the surgeon injects a dye and/or a radioactive tracer into the area of the cancer and/or around the nipple. The dye or tracer travels to the lymph nodes, arriving at the sentinel node first. The surgeon can find the node when it turns color if the dye is used or gives off radiation if the tracer is used.
If the sentinel lymph node is cancer-free, research has shown that it is likely that the remaining lymph nodes will also be free of cancer and no further surgery is needed. If the sentinel lymph node shows that there is cancer, then the surgeon may perform an axillary lymph node dissection to remove more lymph nodes to look for cancer, depending on the stage of the cancer, the features of the tumor, and the amount of cancer in the sentinel lymph nodes. It is recommended that patients with signs of cancer in the axillary lymph nodes receive an axillary lymph node dissection, regardless of whether a sentinel lymph node biopsy is done. Find out more about ASCO's recommendations for sentinel lymph node biopsy.
Axillary lymph node dissection. In an axillary lymph node dissection, the surgeon removes many lymph nodes from under the arm, which are then examined by a pathologist for cancer cells. The actual number of lymph nodes removed varies from person to person. Recent research has shown that an axillary lymph node dissection may not be needed for all women with early-stage breast cancer with small amounts of cancer in the sentinel lymph nodes. Women having a lumpectomy and radiation therapy who have a smaller tumor and no more than two sentinel lymph nodes involved with cancer may avoid a full axillary lymph node dissection, which helps reduce the risk of side effects and does not decrease survival. If cancer is found in the sentinel lymph node, whether more surgery is needed to remove additional lymph nodes varies depending on the specific situation.
Most patients with invasive cancer will have either a sentinel lymph node biopsy or an axillary lymph node dissection. A sentinel lymph node biopsy alone may not be done if there is obvious evidence of cancer in the lymph nodes before any surgery. In this situation, a full axillary lymph node dissection is preferred. Normally, the lymph nodes are not evaluated when the cancer is DCIS, since the risk of spread is very low. However, the surgeon may consider a sentinel lymph node biopsy for patients diagnosed with DCIS who choose to have or need a mastectomy. If some invasive cancer is found with DCIS at the time of the mastectomy, which happens occasionally, the lymph nodes will then need to be evaluated. Once the breast tissue has been removed with a mastectomy, it is more difficult to find the sentinel lymph nodes since it is not as obvious where to inject the dye.
Reconstructive (plastic) surgery
Women who have a mastectomy may want to consider breast reconstruction, which is surgery to create a breast using either tissue taken from another part of the body or synthetic implants. Reconstruction is usually performed by a plastic surgeon. A woman may be able to have reconstruction at the same time as the mastectomy, called immediate reconstruction, or at some point in the future, called delayed reconstruction. In addition, reconstruction may be done at the same time as a lumpectomy to improve the look of the breast and to match the breasts, this is called oncoplastic surgery, and many breast surgeons can do this without the help of a plastic surgeon. Surgery on the healthy breast is also often done so both breasts have a similar appearance. Talk with your doctor for more information.
External breast forms (prostheses)
An external breast prosthesis or artificial breast form provides an option for women who plan to delay or not have reconstructive surgery. Breast prostheses can be made to provide a good fit and natural appearance for each woman.
Summary of surgical options
To summarize, surgical treatment options include the following:
- Removal of cancer in the breast: Lumpectomy or partial mastectomy almost always followed by radiation therapy or mastectomy, with or without immediate reconstruction
- Lymph node evaluation: Sentinel lymph node biopsy and/or axillary lymph node dissection
Women are encouraged to talk with their doctors about which surgical option is right for them. More aggressive surgery, such as a mastectomy, is not always better and may cause more complications. The combination of lumpectomy and radiation therapy has a slightly higher risk of the cancer coming back in the same breast or near the breast and new cancers in the breast, but the long-term survival of women who choose lumpectomy is the same as those who have a mastectomy. Learn more about cancer surgery.
Radiation therapy
Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using a probe in the operating room, it is called intra-operative radiation. When radiation is given by placing radioactive sources into the tumor, it is called brachytherapy. Although the research results are encouraging, intra-operative radiation and brachytherapy are not widely used, and treatment is reserved for a small cancer with no evidence that it has spread to the lymph nodes.
A radiation therapy regimen (schedule; see below) usually consists of a specific number of treatments given over a set period of time. Most commonly, radiation therapy is given after a lumpectomy, and following adjuvant chemotherapy if recommended. Radiation therapy is usually given daily for a set number of weeks to get rid of any remaining cancer cells near the tumor site or elsewhere in the breast. This helps lower the risk of recurrence in the breast. In fact, with modern surgery and radiation therapy, recurrence rates in the breast are now be less than 5% in the 10 years after treatment, and survival is often the same with lumpectomy or mastectomy.
Adjuvant radiation therapy is also recommended for some women after a mastectomy, depending on the age of the patient, the size of their tumor, the number of lymph nodes under the arm that contain cancer, the width of normal tissue around the tumor removed by the surgeon, the ER, PR, and HER2 status, and other factors.
Neoadjuvant radiation therapy is radiation therapy given before surgery to shrink a large tumor, which makes it easier to remove, although this approach is not common and is only used when a tumor cannot be removed by surgery.
Radiation therapy causes side effects, including fatigue, swelling of the breast, redness and/or skin discoloration/hyperpigmentation and pain/burning in the skin where the radiation was directed, sometimes with blistering or peeling. Very rarely, a small amount of the lung can be affected by the radiation, causing pneumonitis, a radiation-related swelling of the lung tissue. This risk depends on the size of the area that received radiation therapy. In the past, with older equipment and radiation therapy techniques, women who received treatment for breast cancer on the left side of the body had a small increase in the long-term risk of heart disease. Modern techniques are now able to spare most of the heart from the effects of radiation.
Many types of radiation therapy may be available to you with different schedules (see below). Talk with your doctor about the advantages and disadvantages of each option.
Radiation therapy schedule
Standard radiation therapy after a lumpectomy is external-beam radiation therapy given Monday through Friday for five to six weeks. This often includes radiation therapy to the whole breast the first four to five weeks, followed by a more focused treatment to where the tumor was located in the breast for the remaining treatments.
This focused part of the treatment, called a boost, is standard for women with invasive breast cancer to reduce the risk of a recurrence in the breast. Women with DCIS may also receive the boost. For women with a low risk of recurrence, the boost may be optional. It is important to discuss this treatment approach with your doctor.
If there is cancer in the lymph nodes under the arm, radiation therapy may also be given to the same side of the neck or underarm near the breast or chest wall. Patients who have a mastectomy may not need radiation therapy, depending on the features of the tumor. Radiation may be recommended after mastectomy for patients with tumors larger than 5 cm, for those with cancer in many lymph nodes, for those with cancer cells outside of the capsule of the lymph node, and for those whose cancer has grown into the skin or chest wall, as well as other reasons. Radiation therapy following a mastectomy can be given after reconstruction, and is usually given five days a week for five to six weeks.
There has been growing interest in the use of newer regimens that shorten the length of radiation treatment from six to seven weeks to three to four weeks. In one method called hypo-fractionated radiation therapy, a higher daily dose is given to the whole breast so that the overall length of treatment is shortened to three to four weeks. This approach can also be combined with a boost to the tumor site either during or after the whole breast radiation treatments. Even shorter schedules have been studied and are in use in some centers, including accelerated partial breast radiation for five days, and others are researching a three-week schedule.
Research studies have shown that these shorter schedules are similarly safe and control the cancer as well as longer radiation treatment schedules in patients with node-negative breast cancer. These shorter schedules are becoming more accepted in the United States for cancers that have a lower risk of recurrence, and are one way to improve the convenience and reduce the time needed to complete radiation therapy (see also partial breast irradiation below). Information about the long-term effectiveness of these very short courses of radiation is not yet available.
Partial breast irradiation
Partial breast irradiation (PBI) is radiation therapy that is given directly to the tumor area, usually after a lumpectomy, instead of the entire breast, as is usually done with standard radiation therapy. Targeting radiation directly to the tumor area more directly usually shortens the amount of time that patients need to receive radiation therapy. However, only some patients may be able to have PBI. Although early results have been promising, PBI is still being studied. It is the subject of a large, nationwide clinical trial, and the results on the safety and effectiveness compared with standard radiation therapy are not yet ready. This study will help find out which patients are the most likely to benefit from PBI.
PBI can be done with standard external-beam radiation therapy that is focused on the area where tumor was removed and not on the entire breast. PBI may also be performed using brachytherapy. Brachytherapy is the use of plastic catheters or a metal wand placed temporarily in the breast. Breast brachytherapy can involve short treatment times, ranging from one dose to one week, or it can be given as one dose in the operating room immediately after the tumor is removed. These forms of focused radiation are currently used only for patients with a smaller, less-aggressive, and node-negative tumor.
Intensity-modulated radiation therapy
Intensity-modulated radiation therapy (IMRT) is a more advanced way to give external-beam radiation therapy to the breast. The intensity of the radiation directed at the breast is varied to better target the tumor, spreading the radiation more evenly throughout the breast. The use of IMRT lessens the radiation dose and the possible damage to nearby organs, such as the heart and lung, and lower the risks of some immediate side effects, such as peeling of the skin during treatment. This can be especially important for women with medium to large breasts who have a higher risk of side effects, such as peeling and burns, compared with women with smaller breasts. IMRT may also help to lessen the long-term effects on the breast tissue that were common with older radiation techniques such as hardness, swelling, or discoloration.
Even though IMRT has fewer short-term side effects, many insurance providers may not cover IMRT. It is important to check with your health insurance company before any treatment begins to make sure it is covered.
Adjuvant radiation therapy concerns for older patients and/or those with small tumors
Recent research studies have looked at the possibility of avoiding radiation therapy for women age 70 or older or for those women with a small tumor. Overall, these studies show that radiation therapy reduces the risk of breast cancer recurrence in the same breast, compared with no radiation therapy, but does not lengthen lives. Guidelines from the National Comprehensive Cancer Network (NCCN) continue to recommend radiation therapy as the standard option after lumpectomy. However, they note that women with special situations or low-risk tumors could reasonably choose not to have radiation therapy and use only hormonal therapy (see below) after lumpectomy, if they are willing to accept a modest increase in the risk that the cancer will come back in the breast. This includes women age 70 or older or those with other medical conditions that could limit life expectancy within five years.
Learn more about radiation therapy.
Chemotherapy is the use of drugs to destroy cancer cells, which work by stopping the cancer cells' ability to grow and divide. Chemotherapy is prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication.
Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).
Chemotherapy may be given before surgery to shrink a large tumor and reduce the risk of recurrence, called neoadjuvant chemotherapy. It may also be given after surgery to reduce the risk of recurrence, called adjuvant chemotherapy. Chemotherapy is also commonly given if a patient has a metastatic breast cancer recurrence.
A chemotherapy regimen (schedule) consists of a specific treatment schedule of drugs given at repeating intervals for a set period of time. Chemotherapy may be given on many different schedules depending on what worked best in clinical trials for that specific type of regimen. It may be given once a week, once every two weeks (also called dose-dense), once every three weeks, or even once every four weeks. Common drugs for breast cancer include:
- Capecitabine (Xeloda)
- Carboplatin (Paraplatin)
- Cisplatin (Platinol)
- Cyclophosphamide (Neosar)
- Docetaxel (Docefrez, Taxotere)
- Doxorubicin (Adriamycin)
- Pegylated liposomal doxorubicin (Doxil)
- Epirubicin (Ellence)
- Fluorouracil (5-FU, Adrucil)
- Gemcitabine (Gemzar)
- Methotrexate (multiple brand names)
- Paclitaxel (Taxol)
- Protein-bound paclitaxel (Abraxane)
- Vinorelbine (Navelbine)
- Eribulin (Halaven)
- Ixabepilone (Ixempra)
A patient may receive one drug at a time or combinations of different drugs at the same time. Research has shown that combinations of certain drugs are sometimes more effective than single drugs for adjuvant treatment. The following drugs or combinations of drugs may be used as adjuvant therapy to treat breast cancer:
- AC (doxorubicin and cyclophosphamide)
- AC or EC (epirubicin and cyclophosphamide) followed by T (doxorubicin and cyclophosphamide, followed by paclitaxel or docetaxel, or the reverse)
- CAF (cyclophosphamide, doxorubicin, and 5-FU)
- CEF (cyclophosphamide, epirubicin, and 5-FU)
- CMF (cyclophosphamide, methotrexate, and 5-FU)
- TAC (docetaxel, doxorubicin, and cyclophosphamide)
- TC (docetaxel and cyclophosphamide)
Trastuzumab, lapatinib, and pertuzumab are HER2-targeted therapies that may be given with chemotherapy for HER2-positive breast cancer (see Targeted therapy, below). Bevacizumab (Avastin) is another targeted therapy that has been used in combination with chemotherapy for the treatment of metastatic breast cancer, but is no longer approved for the treatment of breast cancer.
The side effects of chemotherapy depend on the individual, the drug(s) used, and the schedule and dose used. These side effects can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects can often be prevented or managed during treatment, and they usually go away once treatment is finished. Rarely, long-term side effects may occur, such as heart damage, nerve damage, or secondary cancers.
Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor, oncology nurse, or pharmacist is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.
Hormonal therapy
Hormonal therapy, also called endocrine therapy, is an effective treatment for most tumors that test positive for either estrogen or progesterone receptors (ER-positive or PR-positive; see Diagnosis), in both early-stage and metastatic cancer. This type of tumor uses hormones to fuel its growth. Blocking the hormones can help prevent a cancer recurrence and death from breast cancer when used for early-stage disease either by itself or after adjuvant or neoadjuvant chemotherapy. Hormonal therapy is also effective as treatment for metastatic breast cancer, shrinking the cancer and improving cancer-related symptoms.
Tamoxifen is a drug that blocks estrogen from binding to breast cancer cells. It is effective for lowering the risk of recurrence in the breast that had cancer, the risk of developing cancer in the other breast, and the risk of distant recurrence. It is also approved to reduce the risk of breast cancer in women at high risk for developing breast cancer and for lowering the risk of a local recurrence for women with DCIS who have had a lumpectomy. Tamoxifen is also an effective treatment for metastatic hormone receptor-positive breast cancer.
Tamoxifen is a pill that is taken daily by mouth. It is important to discuss any other medications or supplements you take with your doctor, as there are some that can interfere with tamoxifen. The side effects of tamoxifen include hot flashes; vaginal dryness, discharge or bleeding; a small increased risk of cancer in the uterus including uterine sarcoma; cataracts; and an increase in the risk of blood clots. However, tamoxifen may improve bone health and cholesterol levels and is effective for the treatment of breast cancer in both premenopausal and postmenopausal women.
Aromatase inhibitors (AIs) decrease the amount of estrogen made by tissues other than the ovaries in postmenopausal women by blocking the aromatase enzyme, which changes weak male hormones called androgens into estrogen when the ovaries have stopped making estrogen during menopause. These drugs include anastrozole (Arimidex), letrozole (Femara), and exemestane. All of the AIs are pills taken daily by mouth. Treatment with AIs, either alone or following tamoxifen, is more effective than tamoxifen alone at reducing the risk of recurrence from early-stage breast cancer in post-menopausal women. AIs are also an effective treatment for metastatic hormone receptor positive breast cancer.
The side effects of AIs may include muscle and joint pain, hot flashes, vaginal dryness, an increased risk of osteoporosis and broken bones, and increased cholesterol levels. Research shows that all three AI drugs work equally well and have similar side effects. However, women who have severe side effects while taking one AI may have fewer side effects with another AI for unclear reasons. Women who have not gone through menopause should not take AIs, as they do not block the effects of estrogen made by the ovaries. Often, doctors will monitor blood estrogen levels in women whose periods have recently stopped, or those whose periods stop with chemotherapy to be sure that the ovaries are no longer producing estrogen.
Women who have gone through menopause and are given hormonal therapy have several options: take tamoxifen or an AI for five years, begin treatment with tamoxifen for two to three years and then switch to an AI for the rest of the five-year period, or take tamoxifen for five years then switch to an AI for what is called extended hormonal therapy. Recent research has shown that taking tamoxifen for longer than five years can further reduce the risk of recurrence following a diagnosis of early-stage breast cancer, although side effects are also increased with longer duration of therapy. Learn more about ASCO's recommendations for hormonal therapy for hormone receptor-positive breast cancer.
As noted above, premenopausal women should not take AIs, as they are not effective. Options for adjuvant hormonal therapy for premenopausal women include five or more years of tamoxifen, switching to an AI after menopause begins, or either drug combined with suppression of ovarian function. One of the oldest hormone treatments for hormone receptor-positive breast cancer is to stop the ovaries from making estrogen, called ovarian suppression. Medications called gonadotropin or luteinizing releasing hormone (GnRH or LHRH) analogues stop the ovaries from making estrogen, causing temporary menopause. Goserelin (Zoladex) and leuprolide (Lupron) are drugs given by injection under the skin that can stop the ovaries from making estrogen for one to three months. Most commonly, these are given with tamoxifen or AIs as part of adjuvant therapy for breast cancer. Less commonly, these drugs may be given alone. Surgical removal of the ovaries, which is a permanent way to stop the ovaries from working, may also be considered in certain situations. Ovarian suppression or ablation is also used for premenopausal women with metastatic breast cancer, in combination with tamoxifen or an AI. Learn more about recommendations for ovarian ablation.
Tamoxifen, ovarian suppression and AIs are also commonly used to treat metastatic breast cancer. Fulvestrant (Faslodex) is an additional hormonal therapy approved for patients with metastatic breast cancer. Fulvestrant is a selective estrogen receptor downregulator (SERD). Unlike the other oral hormonal therapies used to treat breast cancer, fulvestrant is given monthly by an injection into a muscle. Most commonly, two injections are given every two weeks for three doses, then continued monthly. Side effects from fulvestrant include menopausal symptoms, such as hot flashes and vaginal dryness. The combination of fulvestrant and an AI has been tested as treatment for metastatic breast cancer that has not yet been treated with hormonal therapy. The combination was more effective than an AI alone in one study, but similar to the AI in a second study. Additional clinical trials are testing this combination, so more data should be available in the near future.
Other hormonal therapies used to treat metastatic breast cancer after AIs, fulvestrant, tamoxifen, and targeted therapy include megestrol acetate (Megace) and high-dose estradiol, which is an estrogen replacement.
Targeted therapy
Targeted therapy is a treatment that targets the cancer's specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.
Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor, although this is considered experimental. In addition, many research studies are taking place now to find out more about specific molecular targets and new treatments directed at them. Learn more about targeted treatments.
The first approved targeted therapies for breast cancer were hormonal therapies. Then, HER2 targeted therapies were been approved to treat HER2-positive breast cancer. Most recently, a drug that targets a protein called mTOR, which contributes to cancer growth, was approved in combination with hormonal therapy for the treatment of metastatic breast cancer. Targeted therapy is also used to prevent growth of cancer that has spread to the bone and to maintain bone health. Talk with your doctor about possible side effects of specific medications and how they can be managed.
HER2 targeted therapy
- Trastuzumab is approved for both the treatment of advanced breast cancer and as an adjuvant therapy for early-stage HER2-positive breast cancer. Currently, one year of trastuzumab is recommended for the treatment of early-stage breast cancer. For metastatic cancer, trastuzumab is given in combination with different types of chemotherapy. Patients receiving trastuzumab have a small (2% to 5%) risk of heart problems. This risk is increased if a patient has other risk factors for heart disease or receives chemotherapy that also increases the risk of heart problems at the same time. These heart problems do not always go away, but they are usually treatable with medication.
- Pertuzumab is approved for the treatment of advanced breast cancer, and is being studied as a treatment for early-stage disease. Research shows that adding pertuzumab to trastuzumab and the chemotherapy drug docetaxel for advanced breast cancer not yet treated with either chemotherapy or trastuzumab increases the effectiveness of treatment and lengthens lives with few additional side effects. Based on this data, the combination of trastuzumab, pertuzumab, and either docetaxel or paclitaxel has become the standard of care for the treatment of untreated advanced breast cancer. Pertuzumab is also approved as neoadjuvant treatment for breast cancer in the United States, in combination with trastuzumab and docetaxel or paclitaxel.
- Lapatinib is commonly used for women with HER2-positive metastatic breast cancer when trastuzumab and pertuzumab in combination with docetaxel are no longer effective at controlling the cancer's growth. The combination of lapatinib and the chemotherapy capecitabine is approved to treat advanced or metastatic HER2-positive breast cancer when a patient has already received chemotherapy and trastuzumab. The combination of lapatinib and letrozole is also approved for metastatic HER2-positive and ER-positive cancer. Lapatinib is also used in combination with trastuzumab for patients whose cancers were growing on trastuzumab. Lapatinib is being studied for early-stage breast cancer in combination with trastuzumab. The recent approval of ado-trastuzumab emtansine (see below) has changed the use of lapatinib, as this drug was shown to be more effective than the combination of lapatinib and capecitabine. Lapatinib is now more commonly used following treatment with T-DM1.
- Ado-trastuzumab emtansine or T-DM1 is approved for the treatment of metastatic breast cancer for patients who have previously received trastuzumab and chemotherapy with either paclitaxel or docetaxel. T-DM1 is made up of trastuzumab linked to a type of chemotherapy. Research shows that treatment with this drug caused fewer side effects and controlled tumor growth better than the combination of lapatinib and the capecitabine. T-DM1 is given by vein every three weeks. Studies are now testing T-DM1 as a treatment for early-stage breast cancer
mTOR inhibitor therapy
Everolimus (Afinitor) is approved in combination with exemestane (see above) for the treatment of metastatic hormone receptor-positive breast cancer that has grown while receiving hormonal therapy with letrozole or anastrozole. In clinical trials, the combination controlled cancer for longer than exemestane alone, although it also resulted in more side effects including mouth sores and rarely an inflammation of the lungs called interstitial pneumonitis. Everolimus and similar drugs are being researched in combination with hormonal therapy for metastatic and early-stage breast cancer.
Osteoclast targeted therapy (drugs that block bone destruction)
- Bisphosphonates are drugs that block the cells that destroy bone, called osteoclasts. Bisphosphonates are commonly used in low doses to prevent and treat osteoporosis. Osteoporosis is the thinning of the bones. In women with breast cancer that has spread to bone, higher doses of bisphosphonates have been shown to reduce the side effects of cancer in the bone, including broken bones and pain. Pamidronate (Aredia) and zoledronic acid (Zometa) are two intravenous bisphosphonates used to treat breast cancer bone metastasis. These drugs may also be able to reduce breast cancer recurrences, particularly in bone, when given after treatment in postmenopausal women, although the research on this effect is conflicting.
- Denosumab (Xgeva) is another osteoclast-targeted therapy called a RANK ligand inhibitor. Recent studies have shown that denosumab works well to treat breast cancer bone metastases, and may be better than bisphosphonates at controlling the symptoms of bone metastases. Denosumab is also effective at treating osteoporosis and is being studied as a cancer treatment in early-stage breast cancer.
Learn more about drugs that block bone destruction.
Getting care for symptoms and side effects
Cancer and its treatment cause symptoms and side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person's symptoms and side effects. This approach is called supportive or palliative care, and it includes supporting the patient with his or her physical, emotional, and social needs.
Supportive or palliative care can help a person at any stage of illness. People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.
Palliative treatments vary widely and often include medications, nutritional support, relaxation techniques, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, and radiation therapy. Talk with your doctor about the goals of each option in your treatment plan.
Before treatment begins, talk with your health care team about the possible side effects of your specific treatment and supportive care options. During and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it is addressed as quickly as possible. Learn more about palliative care.
Metastatic breast cancer
If cancer has spread to another location in the body or come back in a distant location, it is called metastatic breast cancer. Patients with diagnosed with metastatic breast cancer are encouraged to talk with doctors who are experienced in treating this stage of cancer, because there can be different opinions about the best treatment plan. Learn more about seeking a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. This discussion may include clinical trials studying new treatments.
Your health care team may recommend a treatment plan that includes a combination of systemic therapies, such as chemotherapy, hormonal therapy, and targeted therapies. Radiation therapy and surgery may be used in certain situations for women with metastatic breast cancer. Supportive care is also important to help relieve symptoms and side effects. For instance, radiation therapy is often used to treat painful bone metastases.
For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.
For an overview of metastatic breast cancer, read a one-page fact sheet (available as a PDF) that offers information on coping the diagnosis.
Remission and the chance of recurrence
A remission is when cancer cannot be detected in the body by physical examination or imaging tests and there are no symptoms. This may also be called "no evidence of disease" or NED.
A remission can be temporary or permanent. This uncertainty leads to many survivors feeling worried or anxious that the cancer will come back. While many remissions following treatment of early-stage breast cancer are permanent, it's important to talk with your doctor about the possibility of the cancer returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if the cancer does return, and will help you make decisions about your treatment. Learn more about coping with the fear of recurrence.
If the cancer does return after treatment for early-stage disease, it is called recurrent cancer. It may come back in the same place (called a local recurrence), in the chest wall or lymph nodes under the arm or in the chest (regional recurrence), or in another place, including distant organs such as the bones, lungs, liver, and brain (distant recurrence). A local or regional recurrence is often managed with further treatment. A metastatic (distant) recurrence is generally incurable, but treatable. Some patients live years after a metastatic recurrence of breast cancer, depending on a number of factors.
Other than mammograms and MRI scans of the breast, routine scans and blood tests after a diagnosis of early-stage breast cancer are not a good way to screen for recurrent cancer, and they can expose a patient to risk from unnecessary additional testing. Generally, a recurrence is detected when a person has symptoms or an abnormal finding on physical examination. These symptoms depend on where the cancer has recurred and may include:
- A lump under the arm or along the chest wall
- Pain that is constant, worsening, and not relieved by over-the-counter medication
- Bone pain or fractures, a possible sign of bone metastases
- Headaches or seizures, a possible sign of brain metastases
- Chronic coughing or trouble breathing, possible symptoms of lung metastases
- Abdominal pain or yellow skin and eyes from a condition called jaundice, which may be associated with liver metastases
Other symptoms may be related to the location of metastasis and may include changes in vision, changes in energy levels, feeling ill, low appetite and/or weight loss, or extreme fatigue.
If a woman has a recurrence, a cycle of testing will begin to learn as much as possible about the recurrence, including whether the cancer's stage has changed. A biopsy of the recurrent tumor is recommended confirm the diagnosis and to check for ER, PR, and HER2 status, because this may have changed since the original diagnosis. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the therapies described above such as surgery, radiation therapy, chemotherapy, targeted therapy, and hormonal therapy, but they may be used in a different combination or at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer.
The treatment of recurrent breast cancer depends on the previous treatment(s), the time since the original diagnosis, the location of the recurrence, and the characteristics of the tumor, such as ER, PR, and HER2 status.
- For women with a local recurrence within the breast after initial treatment with lumpectomy and adjuvant radiation therapy, the recommended treatment is mastectomy. Usually the cancer is completely removed with this treatment.
- For women with a local or regional recurrence in the chest wall after an initial mastectomy, surgical removal of the recurrence followed by radiation therapy to the chest wall and lymph nodes is the recommended treatment, unless radiation therapy has already been given because radiation therapy cannot usually be given at full dose to the same area more than once.
- Other treatments used to reduce the chance of a future distant recurrence include radiation, chemotherapy, hormonal therapy, and targeted therapy and are used depending on the tumor and the type of treatment previously used.
Women with recurrent breast cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.
If treatment fails
Recovery from cancer is not always possible. In general, metastatic breast cancer is incurable, although it can be treated and controlled for some time. However, at some point, options for treatment become very limited and the cancer will become difficult to control.
This diagnosis is stressful, and this is difficult to discuss for many people. However, it is essential to have open and honest conversations with your doctor and health care team, as well as your family, to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.
Patients who have advanced cancer and who are expected to live less than six months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in an inpatient hospice environment. Nursing care and special equipment can make staying at home a workable and preferable alternative for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
The next section helps explain clinical trials, which are research studies. Use the menu on the side of your screen to select About Clinical Trials, or you can select another section, to continue reading this guide.


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Great Lakes
Site Information
- Hammond, IN (Lake County)
- Grand Calumet River AOC
- Status: Cleanup ongoing
- Map showing cleanup areas (PDF) (1 pg, 91K)
Scott Ireland
Great Lakes National Program Office
(312) 886-8121
Grand Calumet River
Legacy Act Cleanup
Grand Calumet River Area of Concern
Restoration and remedial efforts in the East Branch (Zone B) of the Grand Calumet River are in progress. The 1.8-mile stretch of the river from Indianapolis Boulevard to Hohman Avenue is currently undergoing projects designed to remove contaminants and restore habitat. 350,000 cubic yards of sediment are slated to be removed and a cap will be placed over the dredged sediment. Wetlands and nearshore habitats will be restored with native plants following the completion of the dredging, expected in 2016.
Zone A - West Branch including Roxana Marsh
The West Branch portion of the cleanup was completed in 2012. This zone experienced two major remedial projects occurring at separate locations in the West Branch.
- Dredging was completed in August 2011 at the Roxana Marsh stretch. Nearly 150,000 cubic yards of contaminated sediment was remediated through the removal of the top two feet of sediment and the placement of a cap over the remaining sediment.
- Dredging operations at the other end of the West Branch were completed in December 2011. About 235,000 cubic yards of polluted sediment were removed from the river between Columbia Avenue in Hammond, Indiana and Indianapolis Boulevard in East Chicago, Indiana. A cap covering 345,000 cubic yards of contaminated sediment was placed over the dredged area. The cap consists of 6 inches of organoclay covered by an additional 12 inches of sand. Restoration of the site took place in spring 2012.
The West Branch portion of the project has remediated 730,000 cubic yards of contaminated sediment. $81.1 million dollars were spent to successfully remove large quantities of PCBs (polychlorinated biphenyls), PAHs (polycyclic aromatic hydrocarbons), heavy metals and pesticides from the river.
Restoration at Roxana Marsh progresses from May 2012 to June 2013.
Zone C - Hohman Avenue to state line
Zone C is located on the West Branch of the river between Hohman Avenue to the Indiana/Illinois state line. 11,700 cubic yards of contaminated sediment are targeted for removal and a cap will be placed over an additional 70,000 cubic yards of polluted sediment. Remedial efforts are also planned that include deep pool restoration and the revival of shallow marginal wetlands. The project is expected to begin in early 2014.
Zone D
Project negotiations began for Zone D in July 2013. Two projects are likely to be implemented from Cline Avenue to the terminus of the U.S. Steel dredging project, which was completed in 2007. The first project considers Ralston Street Lagoon as a sediment disposal location. In turn, a remedial effort would likely be executed that would accompany the sediment projects upstream of the site on the West Branch of the river. Activities to consider the viability of placing the sediments in the lagoon are anticipated for completion in 2014.
Zone E
Negotiations for Zone E have also begun. The final zone is actually a collection of the remaining Grand Calumet River segments within East Chicago, Indiana. The parts of Grand Calumet River that have not been remediated will undergo a remedial investigation, feasibility study and remedial design, which are expected to be completed in 2015. The project will also address parts of the Indiana Harbor Ship Canal that the U.S. Army Corps of Engineers does not intend on dredging.
EPA is providing 65 percent of the project costs with funds designated for the Great Lakes Legacy Act. The State of Indiana is providing the remaining 35 percent of costs using Natural Resources Damage Assessment funds. EPA's Great Lakes National Program Office, the U.S. Fish and Wildlife Service, Indiana Department of Environmental Management and Indiana Department of Natural Resources are collaborating on these projects.
You will need Adobe Reader to view some of the files on this page. See EPA's PDF page to learn more.
- Legacy Act Grand Calumet River Cleanup gets Underway (PDF) (2 pp, 591K) December 2009
- Legacy Act project targets Grand Calumet River (PDF) (2 pp, 574K) October 2008
- EPA and Indiana announce $33 million cleanup of Grand Cal River - Oct. 21, 2008 news release

subset: commoncrawl


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Slow Food USA Blog
Reflections, insights and news about the food movement and "going Slow"
Slow Meat 2014: In Search of Solutions
Mar. 7, 2014
What can we do to ensure all meat in the 21st Century is Good, Clean and Fair? Those are the questions we hope to begin to answer this summer in Denver, Colorado at Slow Meat 2014.
The True Benefits of Organic Farming
Mar. 7, 2014
Recently, organic agriculture has been under attack, of sorts, by folks who claim its benefits are a bit overblown. In my humble opinion, writers such as Slate's Melinda Wenner Moyer, make a mistake by taking a very siloed look at organics and judging it based on findings in one narrow area. They miss the entire point of the organic system, which takes an ecological or holistic approach to agriculture.
Are you "Food Enough" to represent Slow Food USA in Italy?
Feb. 21, 2014
Slow Food USA is looking for a few good delegates to represent us at this year's Terra Madre and Salone del Gusto 2014. Every two years Slow Food International gathers leaders from more than 160 countries in Turin, Italy to celebrate good, clean and fair food.
Slow Food Refocuses on Africa with 10,000 Gardens and One New Vice President
Feb. 21, 2014
If you've been following Slow Food International lately, you may have noticed a theme in their events and announcements: Africa. In the last week, Slow Food has made their global priorities clear by relaunching the A Thousand Gardens in Africa project, announcing the appointment of new Vice President Edie Mukiibi from Uganda, and hosting 450 leaders at the Slow Food for Africa conference in Milan.
From Crisis to Riches: Valuing the Wealth of Local Agriculture
Nov. 12, 2013
Kirikou is a young boy, bursting with curiosity. When something bad happens in his village, the elders blame the evil witch Karaba. But Kirikou looks around, tries to understand, and in the end manages to solve the problems himself. Kirikou is a character in an animated film, but his adventures are not actually so far from reality.


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Description: 4120 DLT7000 Library 15 slot 2 Drives Option Part# 350365-002
Overview:The DLT Cartridge Tape Library is an 8U rack-mountable highly reliable high performance high capacity automated tape backup library that can provide weeks of operation without human intervention for NT Netware and SCO UNIX Server. Seagate Backup Exec Computer Associates ARCserve and Legato Networker support the DLT Cartridge Tape Library.
Part Number350365-002
Products ID13228
Tape TypeDLT
Native Capacity35GB
Interface TypeSCSI
Compressed Capacity70GB
PlatformPC, Unix
Dimensions (HxWxD)14.03 in x 17.53 in x 29.04 in
Weight97.02 lbs


text:
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The Wistful Weekender by Petunia Pickle Bottom is the perfect overnight bag for the modern mother. An exceptionally functional large weekend diaper bag, this luxurious duffle-sized bag captures not only features needed for travel, but those of a mother with children on the move.
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ecommerce enabled by fastpivot | PRIVACY POLICY


text: I am wondering what are the latest features to look for in a tablet? My wife owns an original transformer and loves it. I am looking to get one for myself. I have not been paying too close attention to the tablet market so do not know what are the latest "specs" to look for. Are we still stuck on a 1Ghz Processor or have quicker processors been integrated into these devices? What about memory, connectivity, etc? I know the tegra3 is the latest graphics chipset.


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What does あらいだす mean? I have been hearing it from my colleague and based on his explanation it means to identify. For example identify the problem. I tried to search the net and it only results to "Washout" 洗い出して{あらいだして}. Does anyone know what this mean? if it really is identify.
Take the 2-minute tour ×
Japanese Language Stack Exchange is a question and answer site for students, teachers, and linguists wanting to discuss the finer points of the Japanese language. It's 100% free, no registration required.
According to jisho.org 洗い出す means "to reveal by investigation". Hope this helps.
From EDICT via Rikaichan:


text:
Filter by:
Content type:
Stage 1&2
Stage 2&3
Stage 3&4
Stage 4&5
Challenge level:
The class were playing a maths game using interlocking cubes. Can
you help them record what happened?
What statements can you make about the car that passes the school
gates at 11am on Monday? How will you come up with statements and
test your ideas?
What can you say about the child who will be first on the playground tomorrow morning at breaktime in your school?
This article for teachers describes an activity which encourages
meaningful data collection, display and interpretation.
A random ramble for teachers through some resources that might add a little life to a statistics class.
Design and test a paper helicopter. What is the best design?
You are organising a school trip and you need to write a letter to
parents to let them know about the day. Use the cards to gather all
the information you need.
This short article gives an outline of the origins of Morse code and its inventor and how the frequency of letters is reflected in the code they were given.


text:
Dress her up in a fancy frock or keep her casual in a comfy day dress. Compare prices to save on the cutest girls' dresses from cotton to lace.
More legal stuff: Smarter.com is a comparison shopping website that compares prices and products at online stores to help consumers save money. Stores are responsible for providing us with accurate price and product information, including the proper codes for coupons, discounts and rebates. Tax and shipping costs are estimates. Please confirm all costs before making your final purchase at the online store. All merchant ratings, product reviews and video reviews are submitted by shoppers or third-party websites. We are not responsible for their content. If you have any concerns about content on our website, please contact us. For more information, please view our Privacy Policy.


text:
Welcome to the Radford University Student Affairs website. I hope you find the accompanying information helpful in identifying programs, services, activities, and facilities and navigating through the resources, policies, and materials provided.
Student Affairs serves as the primary interface between students and the university. The focal point of our work is to help prepare students to learn, lead and serve.
We extend a warm welcome to you. Please let us know if we can be of assistance.
Mark Shanley
Vice President of Student Affairs


text:
'Office Hours'
My office hours are Monday to Friday 0800 to 1730, except Public and Bank Holidays (when the office will be closed).
During these times I will usually be available to respond to questions arriving via email or telephone/text. I might be away from my desk when you call or send your message, so please allow me time to respond.
Outside office hours during the week, I will, when I can, monitor messages and respond when I am next in the office. Over weekends, I will respond as soon as I am able.


text:
This page, along with all XCP pages, is now located on wiki.XenServer.org.
Xen.org's servers are hosted with RackSpace, monitoring our
servers 24x7x365 and backed by RackSpace's Fanatical Support®.
©2013 Xen Project, A Linux Foundation Collaborative Project. All Rights Reserved.
Linux Foundation is a registered trademark of The Linux Foundation.
Xen Project is a trademark of The Linux Foundation.


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This project was suggested by tech-king. Oh, and you can't grow cactuses in here (thanks tech-king)
Oh, and if you like this project please rate/vote then! All I want is a Robot T-shirt to look spiffy in.
UPDATE: I will try and add pictures everyday in the intro to show the progress of growing.
Step 1: Items
Seeds (I chose Basil since it grows really fast)
Tiny vials (I just found these, I used 4 in this project)
top soil (or dirt)
pipette or syringe (some way of watering the plant)
This project costed be nothing cause I found/had everything.
Would look cool as a necklace!
Small glass bottles at $4.50/10 bottle: 5/8 dram, 1/2 dram, and 1 dram available: http://www.blackcatmining.com/mining-equipment/glass-vials.cfm


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Steven Levine, MD, senior attending otolaryngologist at Bridgeport Hospital, is one of four Americans invited to lecture at the 10th Congress of the Russian Rhinologic Society, June 27-29, in Moscow. Dr. Levine, who is also assistant clinical professor at Yale School of Medicine and immediate past president of the Connecticut Ear, Nose & Throat Society, will speak on "Surgery for Allergic Rhinitis" and "High-Frequency Radio Surgery for Otolaryngic Disorders."
Kanaga Sena, MD, former Chief of Neurology, received the Uthayan International Special Award from the news organization on March 31. Dr. Sena was recognized for his services and contribution as a neurologist and through the International Medical Health Organization (IMHO), which creates healthcare infrastructure in developing countries. He is a founding member and president of the IMHO.
For a FREE subscription to
Healthy & Wise or The Heart Institute Newsletter,
please call us toll free, 24/7, at 1-888-357-2396


text:
How does Seattle get priority??
Yes, via waivers or FA
Yes, only via waivers
Yes, only via FA
How does Seattle get priority??
Follow me at www.twitter.com/robi2184, always updating Dolfans with the latest Miami Dolphins news.
Zach Thomas: I played against New England twice a year every year my whole career. I learned to not like that team. I wasn't going to join them.
Lombardi just mentioned that trouble players is not something that would scare off Sparano.
Why does Seattle have priority over Miami? They're both 4-3. Whats the tie breaker?
www.twitter.com/Adam_SchefterTeams likely to consider claiming Randy Moss on waivers: Cowboys, Redskins, Rams, Bears, Dolphins, Raiders, Chiefs, Jets, Patriots.
Bet the Cowboys claim him haha!
YESSS please
This is probably more of a strategic move than anything else. Miami putting in a claim blocks both the Jets and Patriots from obtaining Moss.


text:
Psalm for the January Thaw
God shows himself not just in the orderliness of nature, but powerfully, joyously and always surprisingly in its beautiful "non-order" as well.
The Resource Finder has powerful filtering features — check out the tutorial to learn more.
God shows himself not just in the orderliness of nature, but powerfully, joyously and always surprisingly in its beautiful "non-order" as well.
The BioLogos Foundation explains to the findings of the Encyclopedia of DNA Elements (ENCODE) project and responds to the claims that its discoveries challenge the theory of evolution, especially regarding so-called "junk DNA".
In this excerpt from the book Delight in Creation: Scientists Share Their Work with the Church, astronomer Deborah Haarsma shares her excitement about recent findings about our universe from a Christian perspective.
The song is built around the image of a river flowing through a canyon it has sculpted—an image that can easily be played out as a picture of the way that the Lord has been at work preparing a path for us in the material world, complete with signposts to his former and present activity.
Many Christians believe that they face a painful choice-- either life was designed by God or it is an evolutionary product of natural selection. Charles Darwin himself believed in this dichotomy, and people ever since have felt the need to "choose sides". However, looking back at history, we find that one of Darwin's chief scientific colleagues, Asa Gray, did not share this perspective. In this three-part essay, part 1 charts the relationship of Asa Gray and Charles Darwin. Part 2 describes Darwin's struggle with the problem of natural evil and design in nature, and part 3 explores how Asa Gray was able to embrace evolution without rejecting the idea of design.
Our desire to engage in gracious dialogue with fellow believers who reject biological evolution has been receiving increased attention in both the Christian and secular press. More importantly, we are being joined in this reconciling project by our brothers and sisters in Christ who have often been defined primarily as our "opponents".
The universe that inspired the psalmist three thousand years ago grows grander as each new generation of astronomers adds yet another layer of understanding.
Last week, Tennessee legislators approved a bill on science education (the Teacher Protection Academic Freedom Act) that has stoked controversy around the country.
Predictably, "Jesus Wept" did not make it into the Jefferson Bible. John 11 was cut out entirely, falling onto the floor of his Monticello home and discarded, along with Martha's confession.
In this brief series (taken from a 2009 paper), Jennifer Wiseman uses an excerpt from the famous hymn "How Great Thou Art," to explain why the study of God's creation can lead Christ's followers into meaningful worship and overcome the obstacles which impede true praise. Creation as encountered through our senses is pondered by our minds, which flows into wonder-filled songs from the soul. She further explains how knowledge of creation will help Christians to address the moral dilemmas of science, and she encourages all to see the process of scientific inquiry as a means to discover God's truth.
Now that we have covered significant ground with respect to what various classes of pseudogenes are and how they arise, we are now able to properly evaluate antievolutionary arguments put forward in an attempt to discredit these lines of evidence for evolution.
Dr. Heather Whitney's double major in physics and performing and visual arts suggests that she lives—as well as understands—the connections between subjective and objective ways of engaging the creation. She is committed to communicating that experience with her students, too.
It is easy to be confused about what science is and what scientists do. In part, this is because scientists do so many different things in so many different ways.
We should not be ashamed of the fact that our faith integrates spirit and body; our faith calls us to regard the stuff of creation in all of its materiality as good, and thus offers the best starting point for the practice and pleasure of art.
In this series, Dennis Venema describes his personal journey that took him away from the Intelligent Design arguments toward the evolutionary creation worldview. Through careful and honest research, he discovered ID scientific reasoning to be analogy-based, in sharp contrast to evolutionary science, which was supported by concrete data. After accepting this view, God's presence ever strengthened him as he explored the compatibility between the Bible and God's creative mechanism.
Media-hungry atheist, creationist and religious fundamentalist provocateurs have dominated the science and religion narrative for the past decade. A recently published large-scale survey of college students, however, finds that the call to arms has fallen on deaf ears.
Providing the crutch for non-believers to lean on is a well-intentioned strategic error that has no benefit and likely does much harm. However, I am even more concerned about something else related to our construction of these crutches.
In this series, Oliver R. Barclay examines the idea of God as Designer. He concludes that God did indeed design creation, and that the "state of the world is evidence not only for the existence and power of God but for his kindness and care for his creation." Barclay then goes on to investigate the arguments for Intelligent Design which attempt to prove that certain examples of design necessarily imply direct intervention by a Great Designer. He points the flaws of such an argument and discusses its implications.
In this six part series, Karl Giberson discusses evolution with BioLogos founder Francis Collins as it relates to the scientific community and the church. Their conversation addresses Collins' scientific perspectives, his Christian faith, and the abundant evidence for evolution. Throughout, the two critique various unscientific approaches to evolution such as Young Earth Creationism and Intelligent Design. Overall, they both express the deep need for the Church in America to accept evolution as a valuable, true theory as well as to cultivate a richer understanding of the Bible among the people.
In this series, Ard Louis addresses concerns that Christians may have about the BioLogos view that stem from specific misconceptions. Among these are misunderstandings about the nature of science, God's action in the universe, and natural theology. In addition, there is unwarranted mistrust towards the academic world. Finally, he encourages the BioLogos team to carefully confront "the ways we in the church have all been shaped by the spirit of the age" and to patiently listen and speak about these issues.


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Pictured above is another one of my favorites, the rose colored Acropora millepora. The deep red and elongated polyps give this coral a beautiful fuzzy red appearance that isn't overly abundant in reef aquaria. Typically, blue and green corals dominate the reef scene, but red corals made a big comeback in recent years with the release of the ORA Red Planet and the rare Strawberry Shortcake Acro. The particular individual colony pictured above pales in comparison to those amazing acros, but it a good looking coral nonetheless.
Photo credit: Brandon Klaus


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Minneapolis, MN (Sports Network) - Blair Walsh booted a 38-yard field goal in overtime as the Minnesota Vikings edged the Jacksonville Jaguars, 26-23, in the season opener for both teams at Mall of America Field.
After Walsh knocked through the game-tying 55-yarder in the closing seconds of regulation, Minnesota won the toss and began the overtime period with the ball at its own 25.
Adrian Peterson, playing in his first game since suffering torn anterior cruciate and medial collateral ligaments in his left knee late last season, got the Vikes into Jacksonville territory with a 20-yard run to the 42. Christian Ponder hit Toby Gerhart for eight yards on 3rd-and-13 to get down to the Jags 20, and Walsh easily booted it through the uprights to give his team the lead.
As per the new overtime rules, Jacksonville got the ball and needed at least a field goal to keep the game going, but Blaine Gabbert threw an incomplete pass on 4th-and-2, sealing the win for the Vikings.


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On September 29, ASPCA Humane Law Enforcement Agents arrested Manhattan resident Anthony Polanco for striking and injuring his four-year-old Yorkie, Jack.
The investigation began on August 9, when Polanco brought his dog to the ASPCA Animal Hospital for treatment—Jack was unable to walk. When questioned by veterinarians, the 27-year-old admitted to striking the dog while grooming him. Upon further examination, veterinarians determined that Jack had sustained severe blunt force trauma to his spinal cord.
"Inflicting such severe injury on a helpless dog signals the potential for violence directed at other vulnerable victims," says Stacy Wolf, Vice President and Chief Legal Counsel for the Humane Law Enforcement. "We too often see that animal abusers are repeat offenders."
Jack is currently recovering at the ASPCA Animal Hospital, where he will remain until he is able to be placed up for adoption. Due to the extent of his injuries, Jack may never regain complete function of his right limbs.
"Jack sustained serious injuries—his body may never fully recover," says Wolf. "But this victim of abuse deserves a second chance at a better life and the comforts of a new forever home."
Polanco, 27, was charged with one count of aggravated animal cruelty and faces up to two years in jail if convicted.
On August 25, ASPCA Humane Law Enforcement Agents arrested Matthew Soto, co-owner and daily manager of Bark & Play, a dog-boarding and day-care facility in Brooklyn, NY. Soto has been charged with five counts of misdemeanor animal cruelty for severely neglecting several dogs boarded at the kennel.
The investigation began in late June after ASPCA Agents discovered that the facility was housing dogs in extremely unsanitary conditions. The animals were left unattended in poorly ventilated areas saturated with urine and feces. Two underweight Pit Bull mixes named Tango and Sweets were transported to the ASPCA Bergh Memorial Animal Hospital, where they were treated for severe urine burns as well as other conditions of neglect. Dr. Robert Reisman, ASPCA Medical Coordinator of Animal Abuse Cases, provided emergency veterinary treatment.
Tango and Sweets were just two of several dogs who had been boarded at the kennel by local rescue groups. "Rescue groups would pay the facility to temporarily board dogs until they found homes for them," says Stacy Wolf, the ASPCA's Vice President of Chief Legal Counsel for Humane Law Enforcement. "However, several dogs had been left there for months."
Tango, pictured here at the ASPCA, is recovering from his injuries and will soon be made available for adoption.
Soto faces up to two years in jail if convicted. Since the June seizure, Bark & Play has closed its doors to the public.
If you know of an animal whose health is being compromised by neglect or abuse, please report it. Visit our Report Cruelty FAQ to learn how to report cruelty in your neighborhood.


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- »
ВµTorrent 3.2.26904 Beta
31-10-2012, 13:02download software (Author: tidargi)
ВµTorrent 3.2.26904 Beta | 5.23 MB
ВµTorrent is one of the most popular BitTorrent clients, with plenty of features such as bandwidth prioritization, RSS auto-downloading, scheduling and Mainline DHT (which is compatible with BitComet, another well-known BitTorrent client), Protocol Encryption joint specification (used also by Azureus 220.127.116.11 and above, BitComet 1.30+) and peer exchange. ВµTorrent was written with efficiency in mind. Unlike many torrent clients, it does not hog valuable system resources - typically using less than 6 MB of memory, allowing you to use the computer as if it weren't there at all....


text:
Most people look at the Science Center as a fun and educational place to go on a Saturday afternoon...
What they might not realize is that we're also trusted partners to the school systems of the areas we serve. Our educational programs supplement traditional classroom learning with a valuable informal education and serve to build on the foundation of knowledge kids gain in school. Most importantly, they further the mission of increasing competency in S.T.E.M. (Science, Technology, Engineering and Math) competency.
Our educational programs include:
- Field Trips
- Off-Site Programs
- School Break Camps
- Summer Camps & Academy
- Science Competitions
- Homeschool Programs
- Scout Programs
- And much more
These activities enhance classroom experience and provide students with a different way of looking at science, math and technology.
13 December 2014
Posted in Curtis Kinetic Science Competition
This year's awards will be as follows:
- An individual medal to each team member and $500 to the "Best in Fair" team in each division
- An individual medal to each team member and $250 to the "Best use of Science" team in each division
- An individual medal to each team member and $250 to the "Most Innovative/Creative" team in each division
- $250 to the "Best in Fair" team's teacher/coach


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Waterworld this is not; Waterpod is the real deal! Concieved by artists Mary Mattingly and Mira Hunter, the Waterpod is a visionary, floating habitat set to launch—certainly not coincinentally—on May 1st (a.k.a., International Workers' Day, Labour Day and millions of other workers' protests around the world). A collaboration between an eclectic group of artists, curators and educators, Waterpod is an experimental, self-sustaining community or as the organizers say, "a floating, sculptural, eco-habitat designed for the rising tides."
While it may not seem like it at first, the Waterpod is actually a pretty radical idea. Why? Bear with me a moment. Though cited as the primary cause of most of the environmental challenges that we face, population growth gets surprisingly little press. Solutions are few and far between and those that make the headlines trade in unthinkable currency: draconian human rights violations, predictions of Malthusian catastrophe or worse, a kind of perilous, technological optimism. The Waterpod however, turns the debate on its head by suggesting that we have close to seventy percent more livable space than we thought: the ocean!
Beginning on May Day, 2009, Waterpod will travel down the Newtown Creek between Brooklyn and Queens, down the East River to the waters of New York Harbor, docking at several Manhattan piers on the Hudson before "continuing onward."
Designed to test the feasibility of a fully self-sustaining, floating community, Waterpod is a triple-domed island fashioned from reclaimed wood, metal and plastic and affixed to an eighty by twenty-five-foot surplus barge. Organizers say the primary power sources will be passive and active solar systems combined with a wind turbine which together will power all on-board systems including "rotating art installations and a permanent projector illuminating the Waterpod dome each night."
Waterpod organizers say it will"… showcase the critical importance of the environment and art, serving as a model for new living, d.i.y. technologies, art, and dialogue. It illustrates positive interactions between communities: private and corporate; artistic and social; aquatic and terrestrial while exploring the cultural richness of New York's five boroughs and beyond."
We are thrilled for the whole Waterpod team and are looking forward to the launch. See you there!
Via Designboom
4 Comments
April 1, 2009 at 3:02 pm
For an interview with Mary Mattingly about this project, visit Artforum.com's 500 Words: http://www.artforum.com/words/#entry22408
February 26, 2009 at 12:29 am
i hate to be a downer but this is a rip off. brooklyn artist andrea zittel has done this already. waaaaa-waaaaaah
February 19, 2009 at 8:35 am
Keep on the Good Job!!! In time of crisis, knowledge, convictions, faith are nothing without imagination. Creative imagination that could be put on practice is what we need. It's a start, a good start!!


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AMES — Things got off to a smooth start for the Southwestern Community College track program here on Saturday, as the team competed well at the Iowa State Track and Field Open.
"It was an exciting day," head coach Bill Huntington said. "We talked about this with the kids, 30 or 40 years from now when you look back at you ran track, you realize you were the first kids that ran Southwestern varsity track and field. It was good to get that first one out of the way. I think it was really exciting to see how competitive we were, because we were extremely competitive."
Sophomore Kalli McCann of Osceola had a strong race in the 3,000 meter run, finishing sixth overall with a time of 11:29.66, which puts her in the ballpark for qualifying for the national meet.
Regina Hafner finished 19th in the race with a time of 12:52.39.
"I think right off in the 3,000 open, Kalli finishing sixth overall and really only about 23 seconds off of qualifying for nationals, which I think that's doable," Huntington said. "First race out of the block and they practiced over break, but only organized practices those last four days going in. Regina ran a really solid 3,000."
Sophomore Mariah Kruse of Afton also impressed Huntington with her performance in the 400 meter dash.
Kruse finished 36th overall, and won her heat with a time of 1:03.96.
Huntington said one of the most impressive races of the day for the Spartans was the 600 yard run, where Rayvonne Brown and Joe Bierl each performed well.
Brown finished 40th in 1:16.40 and Bierl finished 53rd in 1:19.14.
"Going in, we were talking 1:24," Huntington said. "Ray ran a 1:16.40, so he just missed qualifying for the 600 yard run by about .23 of a second. Joe ran a real nice race in that. This weekend, they're both going to be in the 600 meters. I think, at least by the end of the season, that's something they both have a good shot in."
Huntington said sophomore Dave Prchal ran good races in both the 3,000 meters and the mile.
The Spartans return to action Saturday at the Dutch Athletics Classic in Pella.
Southwestern results
60 meter dash — 51. Mariah Kruse, 8.56.
400 meter dash — 36. Kruse, 1:03.96.
3,000 meter run — 6. Kalli McCann, 11:29.66; Regina Hafner, 12:52.39.
60 meter dash — 65. Marquis Flowers, 7.47; 67. Terrence Gaye, 7.52.
400 meter dash — 52. Rayvonne Brown, 52.58; 70. Gaye, 55.08; 73. Jackson Shantz, 55.53; 80. Flowers, 58.14; 81. Adam Pool, 1:00.61.
600 yard run — 40. Brown, 1:16.40; 53. Joe Bierl, 1:19.14; 70. Brandon Bergren, 1:28.89; 71. Pool, 1:30.36; 72. Nate Carr, 1:30.70; 73. Eric Robinson, 1:40.18.
800 meter run — 63. Carr, 2:33.43; 64. Robinson, 2:36.48.
Mile run — 50. Dave Prchal, 5:02.05; 53. Gage Beers, 5:05.45; 59. Brandon Bergren, 5:27.58.
3,000 meter run — 30. Prchal, 10:14.71; 31. Beers, 10:32.46; 32. Josh Cobb, 11:14.76.
60 meter hurdles — 57. Shantz, 9.58.


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First of all, this dude is a beast! He reminds me of Richardson in a lot of ways!
We could pick him up in the 2nd or 3rd round, unless he has a great combine.
Thomas is very injury prone, and continues to get concussions! Even tho he is a good RB,
I cant pass on Lacy. He has 1st round potential written all over him, and is pretty good in the passing game.
He and Reggie would be a great duo! (Opinions) ??


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SmartScript team
Views: 264
I lost money last week. After paying for material the guy just disappeared.
Dear Albert
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YMPG Publishers would like to develop or customise the learning material qualification you have lost for free.
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© 2015 Created by Alan Hammond.


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Men's tennis drops a 4-3 heartbreaker to Notre Dame at NCAA Tournament
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Friday, May 13, 2011
COLUMBUS, Ohio (May 13, 2011) -
With the score tied at three apiece and only one match remaining, Notre Dame freshman Greg Andrews outlasted ETSU senior
Charles Bottoni
(Bois Guillaume, France) in the third set to propel the No. 30
-ranked Fighting Irish to a narrow 4-3 victory over the No. 55 Bucs on Friday afternoon in the NCAA Tournament at the Stickney Tennis Center.
After the Bucs took the doubles point to take an early 1-0 lead, Notre Dame responded by winning the first two singles matches to take the 2-1 advantage. However, the Bucs won the next two matches to regain the lead at 3-2.
Then, after Notre Dame picked up a victory at the No. 3 position to even the match at 3-3, only the No. 4 position match remained. Bottoni got off to a strong start by easily taking the opening set 6-2, but Andrews responded by taking the second set 6-4, to force a third set. Andrews got out to a quick start in the third set by jumping out to a 3-0 lead, but Bottoni fought his way back to tie it at 3-3. After Andrews won the next game to go up 4-3, both players traded games to make the score 5-4 in favor of Bottoni. However, Andrews battled back and took the next three games to clinch the victory for the Irish.
ETSU jumped out quickly in doubles competition by holding early leads in two of the three matches. The duo of
Sander Gille
(Kuringen, Belgium) and
Jesus Bandres
(Caracas, Venezuela) continued their winning streak by defeating Casey Watt and Stephen Havens, 8-6, at the No. 2 position. Gille and Bandres closed out the season by winning their last 14 doubles matches.
The Bucs got out to the early 1-0 lead after the senior duo of Bottoni and
Grega Teraz
(Mojstrana, Slovenia) knocked off the No. 82-ranked doubles team in the country, Niall Fitzgerald and Spencer Talmadge, 8-6.
Notre Dame responded in singles play by earning two quick victories to take the lead. The first win came at the No. 1 position as No. 62-ranked Casey Watt defeated Teraz in straight sets, 6-2, 6-3. Then, Blas Moros knocked off ETSU freshman
Roger Ordeig
(Gurb, Spain), 6-0, 6-3.
ETSU tied the match back up after sophomore
Juan Ramirez
(Asuncion, Paraguay) won a three set thriller over Samuel Keeton, 6-4, 4-6, 6-3. Ramirez, who closed out the season tied for the team lead in wins with 21, won his last seven matches.
Then, with the match tied at two apiece, Gille picked up an exciting come from behind victory over Stephen Havens, 1-6, 6-2, 7-6, to put the Bucs back in front. Gille closed out the season with a 13-7 dual match singles record after winning his last eight matches.
The Bucs close out the 2011 campaign with a 17-7 overall record, while Notre Dame improves to 18-11.
Notre Dame advances to play the winner of the Ohio State-Ball State in the regional final tomorrow at 1 p.m.
The winner of the regional final match will advance to the NCAA final site in Stanford, Calif.
For more information on ETSU menâs tennis please go to ETSUBucs.com and click on the men's tennis link. Also, be sure to follow ETSU Athletics on
May 13, 2011 at Columbus, Ohio (Stickney Tennis Center)
#30 Notre Dame 4, #55 ETSU 3
Singles competition
1. #63 Casey Watt (ND) def. Grega Teraz (ETSU) 6-2, 6-3
2. Sander Gille (ETSU) def. Stephen Havens (ND) 1-6, 6-2, 7-6
3. #95 Daniel Stahl (ND) def. Jesus Bandres (ETSU) 7-6, 6-4
4. Greg Andrews (ND) def. Charles Bottoni (ETSU) 2-6, 6-4, 7-5
5. Juan Ramirez (ETSU) def. Samuel Keeton (ND) 6-4, 4-6, 6-3
6. Blas Moros (ND) def. Roger Ordeig (ETSU) 6-0, 6-3
Doubles competition
1. Charles Bottoni/Grega Teraz (ETSU) def. #82 Niall Fitzgerald/Spencer Talmadge (ND) 8-6
2. Jesus Bandres/Sander Gille (ETSU) def. Casey Watt/Stephen Havens (ND) 8-6
3. Tyler Davis/Greg Andrews (ND) vs. Robin Akser/Juan Ramirez (ETSU) 7-5, unfinished
Match Notes:
ETSU 17-7; National ranking #55
Notre Dame 18-11; National ranking #30
Order of finish: Doubles (2,1); Singles (1,6,5,2,3,4)
First Round of 2011 NCAA Division I Men's Tennis Championship
Copyright ©2015 East Tennessee State Athletics. All Rights Reserved.


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This is a replacement cartridge for the Hewlett Packard CB380A (823A) black laser toner cartridge which is manufactured by LD and is guaranteed to perform with your HP printer. It replaces the original HP CB380A toner cartridge. LD remanufactured replacement CB380A laser toner cartridges are specially engineered to meet the highest standards of quality and reliability you can expect from LD. Our toners have exceptional yields that meet or exceed the OEM (Original Equipment Manufacturer) page yield for the CB380A. Our remanufactured HP 823A contains up to 85% new parts including an electronic smart chip for accurate toner level readout and other internal components. While most competitors simply refill the toner cartridge, we fully disassemble the toner cartridge and rebuild it to ensure the highest quality prints. High quality LD remanufactured CB380A toner cartridges are an economical and sensible alternative to expensive OEM CB380A (HP 823A) Hewlett Packard laser toner cartridges and supplies. The use of LD remanufactured replacement laser toner cartridges and supplies does not void your printer's warranty. LD remanufactured laser cartridges are not remanufactured by HP.
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text:
This story has been updated Monday, May 20, 2013.
Police continue to investigate an accident in Wheaton Thursday morning, which resulted in the death of a pedestrian.
Mary Josephine Fish, 52, was walking on the median of Veirs Mill Road near Georgia Avenue when a van hit her, according to a Montgomery County police statement.
Investigators said a white 1998 Honda Accord and a white 2012 Nissan van were traveling southbound on Veirs Mill Road.
The driver of the Honda made an unsafe lane change from the middle lane to the left lane and struck the Nissan, which was traveling in the left lane, according to a police statement. The impact of the collision propelled the Nissan up onto the curb of the roadway, where it struck Fish, who was on the median, the statement said.
Rescue personnel took Fish, of Cordwall Drive in Beltsville, to Suburban Hospital. She died on Friday.
Police identified Felicitas Cayo Carpio, 37, of University Boulevard East, in Silver Spring, as the driver of the Honda. Eric Seeling, 26, of the N. Woods Trail in Hampstead, Maryland, was the driver of the Nissan, according to the statement.
Neither was injured in the collision.
Police spokesperson Angela Cruz said that any charges would come at the end of the investigation, which could take up to two months.
Fish's relatives could not be reached for comment.


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I currently only bottle beer, but I would like to have the flexibility of kegging beer to bring to a party from time to time. I do not want to commit to a kegerator. I will be happy to try to keep the beer on ice during the event. What is the smallest amount of gear that I can get away with to accomplish this and about how much will it cost?
Take the 2-minute tour ×
Homebrewing Stack Exchange is a question and answer site for dedicated home brewers and serious enthusiasts. It's 100% free, no registration required.
Something like this setup would be the minimum for 5 gallons of beer:
A 5 gallon keg, CO2 tank, regulator, and tap.


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For centuries, people have watched the sky for the changes of season and then celebrated with colorful festivals and rituals.
In India, many people celebrate the festival of Navroze, or "new Day," on the spring equinox. It is a day to clean and paint houses, wear new clothes, and hang jasmine flowers and roses on doors and windows.
In ancient times, women and girls in Sweden would bathe in a river in the belief that this would bring plenty of rain for the crops, while village people would dance around a decorated tree.
Now, in late June, Swedes dance around a pole covered with greenery and flowers.
The Chinese mark the end of summer with the Mid-Autumn Moon Festival, which occurs when the Moon is at its brightest.
After dark, people stroll with brightly lit lanterns, admire the full Moon, and eat moon cakes, which are pastries with a whole egg yolk in the center symbolizing the Moon.
Ancient Romans welcomed winter with the festival of Saturnalia, honoring Saturn, the god of agriculture. People decorated their houses with evergreen branches and lit lamps all night to ward off the darkness.


text:
Is Judah ben Bava, noted for continuing the tradition of ordination, the son of Bava ben Buta, the Rabbi who was spared by Herod?
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Mi Yodeya is a question and answer site for those who base their lives on Jewish law and tradition and anyone interested in learning more. It's 100% free, no registration required.
Toldos Tanaaim V'Amoroim Volume 2 Page 137 says that it is highly unlikely that Rabbi Yehuda ben Bava was the son of Bava ben Buta. Bava ben Buta lived in the times of Hordos (73/74 BCE - 4 BCE - source) and was a student of Shamai Hazakain (50 BCE–30 CE - source) while Rabbi Yehuda ben Bava was killed after Churban Beitar (135 CE - source).


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iHerb Customer Reviews
Posted by Reviewer1593716 on Jun 23, 2009
Loved this in my coffee. Just a few drops will do it.
not impressed with the vanilla taste
Posted by Reviewer1696816 on Apr 17, 2011
Vanilla is not noticeable in coffee ... don't like the alcohol and might get the Alcohol free version next time! Can't really get over the stevia aftertaste either but that may be a personal thing.
just a few drops will do ya
Posted by Reviewer1551459 on Apr 23, 2011
Very sweet and adds a wonderful flavor to most dishes
To strong
Posted by Reviewer2768292 on Sep 01, 2011
Have to use very little of it, because of strong taste. Probably good in tea.
strange taste
Posted by XusoIherb on Aug 04, 2012
Good price and quality but a strange taste. Not good for cofee in my opinion


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Friday, March 01, 2002Kingsport, Tenn. (March 1, 2002) - East Tennessee State's baseball team (4-4) split a doubleheader with the Indiana University Hoosiers (3-3) in Kingsport, Tenn. at Hunter Wright Park on Friday. The Bucs took the first game, 10-7 then the Hoosiers took game two, 12-4. In the day's first game, both team scored in the first inning but ETSU would then score eight unanswered runs in the next five innings. Indiana did score four runs in the seventh including a three-run homer by IU's Eric Blakeley, which brought home Kennard Jones and Mark Minor. That was Blakeley's third homerun of the year. ETSU's Tim Turner (Marietta, Ga.) went 3-for-5, scored three runs, hit a double and triple in the first game. Matt Traylor (Knoxville, Tenn.) stole his fifth base of the season, which currently leads the team. Kirk Keithley (Peoria, Ill.) went 4-for-5 at the plate in game one. The winning pitcher was Reid Casey (Kingsport, Tenn.)who is now 2-1 on the season and 2-0 playing at home. Donnie Sharp (Oak Ridge, Tenn.) earned his second save of the season. Jacob Carey (1-1) gets credited with the loss. The second game would turn out to be a different story. ETSU was the first to get on the board in the second inning when Ryan Hyder (Erwin, Tenn.) stole second and Keithley stole home. Then Traylor would hit an RBI single to right field to score Hyder to make the score 2-0. Then in the fifth inning, Indiana would score four runs on five hits to move ahead 5-4. ETSU would respond with one run when Traylor would score off a single to right field by Chad Boruff (Knoxville, Tenn.). The sixth inning would seal the game for the Hoosiers. Indiana's Josh Romero would score on an error. Jones scored off a single by Mark Calkins. ETSU then walked a run home. With the bases loaded, IU's Joe Kemp hits it over the wall in right center field. That inning would end with Indiana scoring seven runs on two hits with ETSU committing two errors. ETSU would not be able to respond and lose to Indiana 12-4. Jarrod Hyder (Elizabethton, Tenn.) earned his first loss of the season while Indiana's Nick Vitiellis (2-0) gets the win. Earning his first save of the season for the Hoosiers was Adam Pegg. The Bucs and Hoosiers will play their third game starting at 2:00 p.m. Saturday, March 2nd in Kingsport, Tenn. at Hunter Wright Stadium.
|Copyright ©2015 East Tennessee State Athletics. All Rights Reserved.


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Drug Policy Alliance Blog
The New York Times made history last weekend when they became the first national paper to call for marijuana legalization. What makes the news so huge is not only their position, but the passion and space they are giving to... Read More
Last Monday, Bill O'Reilly included a segment on marijuana criminalization in his Fox News show. When I tuned in to watch Stephen Gutwillig, Deputy Executive Director of the Drug Policy Alliance, speak in support of... Read More
The New York Times editorial board made history yesterday, as the first major national paper to call for an end to marijuana prohibition. And how they did it is half the story – with rare flash and panache, as well as... Read More
Last week, nine year-old Anna Conte died after a long battle with a seizure disorder. Anna and her family had been at the center of a successful fight to pass a medical marijuana law in New York. Medical... Read More
Most arguments in favor of prohibition don't pass the smell test anymore, yet some of the more entrenched positions remain. Here is some perspective on these arguments, and why they're plain wrong. 1. Prohibition... Read More
Perhaps the terrible truth of drug war violence will finally be addressed as all of America bore witness this summer to the horror of some 52,000 unaccompanied children who were fleeing devastating violence that had erupted... Read More
*Editor's note: In a new feature of the Drug Policy Alliance blog, DPA's Dr. Malik Burnett and Dr. Amanda Reiman will lend their expertise to answer your questions about marijuana every other Thursday. Dr. Malik... Read More
Last year, I had an opportunity to travel to Iceland for the Airwaves Music Festival, when I tagged along with a fantastic group of "ambassadors" from the city of San Francisco. I fell absolutely in love with my... Read More
The FIFA World Cup presents an opportunity for journalists and activists from the competing nations to bring international attention to issues in their countries. Let's highlight the progress some of this year's... Read More
The White House Office of National Drug Control Policy (ONDCP) released its 2014 National Drug Control Strategy today. The strategy has shifted some from previous years in that it more clearly focuses on reducing the harms... Read More