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ByMarilynnMarchione TheAssociatedPress CHICAGO The move to make cancer treatments gentler for children has paid a double dividend: More kids are surviving than ever before, and with- out the long-term compli- cations that doomed many of their peers a generation ago, new research shows. Radiation and chemo- therapy have saved count- less children from leuke- mia and other types of cancer, but some of these treatments can damage the heart or other organs, prob- lems that prove fatal years later. In the 1990s, a push began to try to prevent these "late effects" by giv- ing smaller, more targeted doses of radiation, avoiding certain drugs and chang- ing the way chemo is given. But doctors worried: Would gentler treatments hurt a child's survival odds? The new study, which tracked more than 34,000 childhood cancer survivors over several decades, gives a happy answer: No. Survival continued to improve, even with scaled- back treatments. And fewer kids died from second can- cers or heart or lung prob- lems 15 years after their ini- tial treatment ended. "The field needs good news" and this study gives it, said Dr. Greg Armstrong of St. Jude Children's Re- search Hospital in Mem- phis, Tennessee. He leads the Childhood Cancer Sur- vivor Study, funded by the National Cancer Institute. "We have actually re- duced treatment, reduced therapy," and yet improved survival, he said. Results were discussed Sunday at an American So- ciety of Clinical Oncology conference in Chicago. Treating childhood can- cer is "one of the miracles of modern medicine," Arm- strong said. "Fifty years ago less than 30 percent of kids would survive childhood cancer but now we know that over 80 percent will." That high success rate al- lowed doctors in the 1990s to scale back certain treat- ments for certain types of patients to try to spare them late effects. The study compared survival odds be- fore and after that change. Researchers found that the death rate 15 years af- ter treatment ended kept declining, from about 12 percent for those treated from 1970-74 to 6 percent for those treated from 1990- 94. Deaths from late effects of cancer treatment, such as heart problems, also de- clined over that period, from 3.5 percent to 2.1 per- cent. Garrett and Gatlin Stringer, brothers from Huntsville, Texas, benefited from the change, said their physician, Dr. Michael Ryt- ting at MD Anderson Can- cer Center in Houston. The boys had acute lym- phocytic leukemia, the most common childhood can- cer. When doctors first de- scribed their treatment, "we didn't really ask long-term effects, to be honest, be- cause at the time it was re- ally just kind of day to day," said their mother, Marsha Stringer. Garrett, now 20 was di- agnosed at age 7 and is now a 13-year survivor. Gatlin, now 14, was diagnosed at age 3 and is 11 years past his treatment. The boys got chemo but because scans showed the disease had not spread to their spinal cords, they were spared having to have radi- ation. Now, they are "amazing ... no side effects at all that we know of," their mother said. "They're very athletic and active and have good grades." Marilynn Marchione can be followed at http://twitter.com/ MMarchioneAP MEDICINE Cancertreatmentsgotgentler, yet kids' survival improved By Marilynn Marchione The Associated Press The first report from a big public-private project to improve genetic testing reveals it is not as rock solid as many people be- lieve, with flaws that result in some people wrongly advised to worry about a disease risk and others wrongly told they can re- lax. Researchers say the study shows the need for consumers to be careful about choosing where to have a gene test done and acting on the results, such as having or forgoing a preventive surgery. "We have very clear doc- umentation that there are differences in what pa- tients are getting" in terms of how tests on the same gene variations are in- terpreted, said the study leader, Heidi Rehm, ge- netics lab chief at Brigham and Women's Hospital in Boston. When deciding to get tested, either through a doctor's office or by send- ing in a swab to a private company, "patients need to choose labs that are shar- ing their data" with the broader research commu- nity so scientists can com- pare and learn from the results and make testing more accurate for every- one, she said. Dozens of companies now offer gene tests to gauge a person's risk of de- veloping various disorders. One of the newest tests on the market costs $250 and checks about 20 genes that can affect breast can- cer risk. But not all gene mu- tations, or variants, are equal. Some raise risk a lot, others just a little, and some not at all. Most are of unknown significance — a quandary for doctors and patients alike. And most variants are uncommon, making it even tougher to figure out which ones mat- ter and how much. To solve these myster- ies and give patients bet- ter information, the U.S. government several years ago helped form and fund ClinVar, a database for researchers around the world to pool gene find- ings, coded to keep pa- tients' identities confiden- tial. More than 300 labs contribute to it, including universities such as Har- vard and Emory and some private companies such as Ambry Genetics and GeneDX. On Wednesday, the group made its first re- port at a conference in Washington. The study also was published online by the New England Jour- nal of Medicine. So far, the project has tracked more than 172,000 variants in nearly 23,000 genes, a small portion of the millions known to ex- ist but some of the more common ones that have been identified. More than 118,000 of these variants have an ef- fect on the risk for a dis- ease — and 11 percent have been analyzed by more than one lab so re- sults can be compared. In 17 percent of those cases, labs interpreted the find- ings differently, as either raising the risk of a dis- ease, having no effect on it or having an unknown effect. At least 415 gene vari- ants now have different interpretations that could sway a medical decision, such as whether to have healthy breasts or ovaries removed to lower the risk of cancer, or to get a med- ical device such as an im- planted defibrillator to cut the risk of sudden cardiac death. "The magnitude of this problem is bigger than most people thought," said Michael Watson, executive director of the American College of Medical Genet- ics and Genomics, one of the study's authors and a partner in the data pool- ing project. And it can harm pa- tients. Rehm described a woman who had genetic testing and wrongly was told she did not have ele- vated risks for breast can- cer. She later developed the disease but could have had preventive surgery had the right gene analyses been done. An independent ex- pert, Dr. Eric Topol, direc- tor of the Scripps Transla- tional Science Institute in La Jolla, California, com- mended the study leaders and the database project for "cleaning up the mess" from labs that have not shared data in the past. "We need millions of people sequenced, shar- ing all the data," to make things better, he said. With more sharing, the mystery gene variant problem " will largely go away, but that's going to take a few years at least." Marilynn Marchione can be followed at http://twitter.com/ MMarchioneAP DNA Study reveals flaws in gene testing; results o en conflict PATSULLIVAN—ASSOCIATEDPRESS Don Stringer, le , and his wife, Marsha, laugh with their son, Gatlin, 14, center, while visiting at Houston's M.D. Anderson Cancer Center. Gatlin and his brother Garrett were both successfully treated for acute lymphocytic leukemia when they were very young. Now, they are "amazing ... no side effects at all that we know of," Marsha says. "They're very athletic and active and have good grades." By Maria Cheng The Associated Press LONDON Are you sitting down? In that case, you should probably stand up before reading this. In the first advice of its kind, British experts are recommending office work- ers stand for at least two hours a day, in a warning against the dangers of pro- longed sitting. The guidelines were de- veloped by a group of ex- perts invited by Public Health England and an ad- vocacy group and were pub- lished online Monday in the British Journal of Sports Medicine. The experts recommend people start with two hours of standing or light activity, adding they should even- tually double that to four hours. In recent years, the haz- ards of sitting too much have been compared to those of smoking, with re- search suggesting people who spend most of their days seated are more likely to be fat, have heart prob- lems, cancer and even die earlier. Not even regular exercise seems to help. "Even if you're meet- ing your physical activity guidelines, you cannot undo the risks of prolonged sit- ting," said Gavin Bradley, director of the campaign group Get Britain Stand- ing, one of the authors of the new guidance. Brad- ley, who spoke during a telephone interview while walking, said officials esti- mate the average Briton sits for more than half of their working hours. His group is expanding its campaign to other countries including the U.S. on Tuesday and is pushing for more people to have access to a desk that allows them to stand. According to the guide- lines, people who sit the most have more than twice the risk of developing Type 2 diabetes and cardiovas- cular disease, a 13 percent increased risk of cancer and a 17 percent increased risk of premature death, compared to those who sit the least. Jenny Nissler, an occu- pational physical thera- pist and spokeswoman for Britain's Chartered Soci- ety of Physiotherapists, said people who sit for long stretches could be more prone to joint stiffness and back pain. "Companies should re- consider the culture around taking regular breaks and think about whether meet- ings could be held standing up or walking," she said. Bradley, who takes all his calls standing, says curbing the amount of time people spend sitting could have huge benefits, since up to 95 percent of adults in de- veloped countries are clas- sified as inactive. "We've sat on this prob- lem for far too long," he said. MEDICAL SCIENCE Panel says you should stand for 2 hours ALEX COSSIO — ASSOCIATED PRESS If you're sitting in an office, you should probably read this standing up. In the first advice of its kind, British experts are recommending office workers stand for at least two hours a day, in a warning against the dangers of sitting. The guidelines were developed by a group of experts invited by Public Health England and an advocacy group and were published online Monday, June 1, 2015in the British Journal of Sports Medicine. Thankyou! 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