Colon cancer spotted by blood test

Colon Cancer and Polyps: What You Need to Know

Cancer Cells

I drank loads of liquids and made it through. I also wore a ‘sea band’ to prevent upset stomach. I’m a relatively small person of 130 lbs. The worse part for me was the polop removal , 3 in my case which were pre-cancerous. This test is something I have to have again in 2 years. Yippie. But its worth it. June 11, 2013 at 06:50 | Report abuse | myreply Does this also help anyone with a family history of colon cancer? Early detection and prevention are the best, including a diet with lots of fiber, fresh foods, and low consumption of flesh food/meat. Daily exercise is a must too! June 9, 2013 at 09:37 | Report abuse | Reply karen Both my mom and her brother had colon cancer, and survived. They both had stage 1. Read my comment.

view publisher site http://thechart.blogs.cnn.com/2013/06/07/blood-test-may-detect-colon-cancer/

Over the past 10 years, more than 600,000 people have succumbed to this highly preventable and treatable cancer, and over 1.5 million have been diagnosed. Colon cancer, sometimes referred to as colorectal cancer, usually starts as slow-growing precancerous polyps, a term used to describe bumps on the surface of the colon. Virtually all colon cancers begin with these growths. When found early, colon cancer is approximately 90% treatable. Colon cancer risk factors The lifetime risk for developing colon cancer is 1-in-18 and over 90% of these cases occur after the age 50. Increasing age, a family history of colon polyps, colon cancer or other early cancers can double or triple your risk for developing this disease. If any of these risk factors run in your family, you need to start the discussion about screening at age 40 or even earlier depending on when your family members were diagnosed. Persons with ulcerative colitis , Crohns disease or a personal history of cancer are also at increased risk for colon cancer and need to tailor regular, more frequent colonoscopies. Studies also indicate that diet and smoking may increase the risk of developing colon polyps and colon cancer. While family history and other risk factors matter, not having risk factors does not eliminate your need for screenings. What polyps tell us As we age, about 1-in-4 of us develop polyps in our colon and about 10% of these polyps eventually turn from a benign growth into colon cancer. For the most part, these polyps take about 10 years to transform into colon cancer. Polyps and early colon cancers often have no symptoms and can be detected only by screening exams. How can colon cancer best be prevented? There are several effective ways to reduce your colon cancer risk, but none more important than getting timely screenings and removing polyps before they become malignant. Refraining from smoking, maintaining healthy weight and regular exercise, managing normal body levels of nutrients, especially vitamin D also appear to lower risk factors.

via this link http://www.foxnews.com/health/2011/09/20/colon-cancer-and-polyps-what-need-to-know/

Tapeworm Drug Inhibits Colon Cancer Metastasis

The results are reported in the Journal of the National Cancer Institute. Plans are already underway with Professor Peter M. Schlag (Charite Comprehensive Cancer Center) to conduct a clinical trial. Colon cancer is one of the most common tumor diseases in Western countries. In Germany alone, there are approximated 73 000 new cases of the disease every year. Despite surgery, chemotherapy and radiation therapy, only about half of the affected patients are cured. The reason is that around 20 percent of the colon cancer patients already have metastases at diagnosis and in about one third of the patients, metastasis occurs despite successful initial treatment. Of these patients with metastatic colon cancer, the five-year survival rate is only about 10 percent. By contrast, for nonmetastatic colon cancer patients the survival rate is 90 percent. Scientists have known for several years that the gene S100A4/metastasin can initiate colon cancer metastasis. Five years ago Professor Stein, working together with Professor Schlag and Professor Walter Birchmeier (MDC), showed how this gene is regulated. They found that the beta-catenin gene, when mutant, activates this S100A4/metastasin gene, thus triggering colon cancer metastasis. Beta-catenin normally regulates cellular adhesion. The scientists looked for compounds that block the expression of the metastasin gene.

continue http://www.sciencedaily.com/releases/2011/06/110617164128.htm

Tapeworm drug inhibits colon cancer metastasis

Colon cancer is one of the most common tumor diseases in Western countries. In Germany alone, there are approximated 73 000 new cases of the disease every year. Despite surgery, chemotherapy and radiation therapy, only about half of the affected patients are cured. The reason is that around 20 percent of the colon cancer patients already have metastases at diagnosis and in about one third of the patients, metastasis occurs despite successful initial treatment. Of these patients with metastatic colon cancer, the five-year survival rate is only about 10 percent. By contrast, for nonmetastatic colon cancer patients the survival rate is 90 percent. Scientists have known for several years that the gene S100A4/metastasin can initiate colon cancer metastasis. Five years ago Professor Stein, working together with Professor Schlag and Professor Walter Birchmeier (MDC), showed how this gene is regulated. They found that the beta-catenin gene, when mutant, activates this S100A4/metastasin gene, thus triggering colon cancer metastasis. Beta-catenin normally regulates cellular adhesion. The scientists looked for compounds that block the expression of the metastasin gene. They screened 1280 compounds and found what they were looking for: niclosamide, a drug until now approved for use to treat intestinal parasite infections from tapeworms. Surprisingly, the researchers discovered that niclosamide inhibits the beta catenin-driven expression of the S100A4/metastasin gene, both in the cell culture and in mice. The animals had fewer metastases. Next, the researchers want to conduct clinical trials to find out whether the compound is also effective in patients with metastasizing colon cancer. ### *Novel Effect of Antihelminthic Niclosamide on S100A4-Mediated Metastatic Progression in Colon Cancer Ulrike Sack, Wolfgang Walther, Dominic Scuiero, Mike Selby, Dennis Kobelt, Margit Lemm, Iduna Fichtner, Peter M.

have a peek at these guys http://www.eurekalert.org/pub_releases/2011-06/haog-tdi061711.php

Soy Protein may Reduce Colon Cancer Metastasis

Heavy Coffee Consumption Linked to Early Death

That led the scientists to do this study in which they experimented with oral doses of the peptide. “After all, soy is a food, and we wanted the animals to consume it as a food. Because this lunasin would be digested, we needed to figure out how much should be fed to achieve the desired concentration in the bloodstream,” de Mejia said. Using mice that had been injected with human colon cancer cells, the scientists began by feeding the animals 8 mg/kg of lunasin daily, which reduced the number of new tumors in the liver by 55 percent. They increased the dose five times, at last achieving a 94 percent reduction in tumors at 20 mg/kg of lunasin. “We were very impressed by the reduction, but the results were short of statistical significance from the control group. More animals are needed to strengthen the power of the analysis. It’s a small study but very promising,” de Mejia said. The scientists plan to repeat the study again using 30 mg/kg of lunasin as soon as they can obtain funding. “One tumor is still too many. We’d like to see no tumors,” she said. The scientists said that consuming the equivalent of 20 to 30 mg/kg of lunasin in soy foods would be daunting in terms of number of servings per day. “But it would certainly be possible if food companies began to offer lunasin-enriched soy milk or yogurt,” she said, noting that lunasin-enriched flour is already on the market. De Mejia said that chronic daily exposure to lunasin could make an even bigger difference in terms of cancer development and metastasis. “These animals were acutely exposed to the peptide for only 28 days, and we still achieved these results.” There is evidence that lunasin accumulates in the body tissues, most notably the livers, of animals that have experienced chronic exposure to this bioactive component of soy. “Consuming soy protein regularly in the diet could be important not only for nutrition but also for cancer prevention,” she said.

that guy http://www.medindia.net/news/soy-protein-may-reduce-colon-cancer-metastasis-121721-1.htm

Ottawa researcher says virus-based treatment blows up leukemia cells ‘like popcorn’ (video)

Within a day of an injection, the membranes of the cancer cells are compromised. The cell membranes deteriorate and the cells blow up “like popcorn,” says hematologist Dr. David Conrad, the senior co-author of the study. Three doses cured 60 per cent of the mice, and 80 per cent of the experimental population had long-term survival. This is a “paradigm shift” in the understanding of using virus-based therapies to treat acute leukemia, the researchers said in Blood Cancer Journal, which is associated with the prestigious science journal Nature. The news generated a lot of buzz at a recent international cancer conference in Quebec City, says Conrad, who’s part of a research team with members from the Ottawa Hospital Research Institute, the Ottawa Hospital and the University of Ottawa. “When the immune system sees these cells, it gets rid of the debris. It forms an immune response. If new cancer cells grow, the immune system recognizes them and kills them,” says Conrad. “There’s a lot of interest because it’s not just potent, it’s safe.” For about a decade, Ottawa Hospital Research Institute scientists including Dr. John Bell, who was the other senior researcher in this study, have been investigating viruses as cancer therapeutics. But there’s an added wrinkle to using viruses to attack leukemia. Blood is a liquid, not a solid, as with most cancer tumours.

basics http://www.canada.com/health/Ottawa+researcher+says+virus+based+treatment+blows+leukemia+cells+like+popcorn+video/8787648/story.html

Clearwater, FL Gum Disease Treatment is Now Performed Using Laser Gum Surgery at Northwood Dental

Even worse, research indicates that untreated gum disease can cause or aggravate illness elsewhere in the body. Unfortunately, many people resist gum disease treatment because until now, traditional options of treatment involved a scalpel. Scalpel surgery may cause greater discomfort, because it entails cutting into the gum line to dig away the bacteria that causes periodontal disease. Northwood Dental is one of only a handful of dental professionals to offer the minimally-invasive LANAP gum disease treatment. LANAP is the only FDA-cleared laser gum surgery to restore health to teeth and gums with remarkable precision and minimal pain. Northwood Dental uses the PerioLase MVP-7, a unique, FDA-cleared dental laser that has revolutionized gum disease treatment, because it removes bacteria from gum pockets without compromising nearby healthy tissue. While the scalpel can destroy some of the healthy gum tissue, the laser identifies and kills only bacteria and diseased tissue. The undamaged healthy tissue can begin to reattach to the tooth root surfaces. Backed by scientific and microscopic tissue studies, laser gum surgery can even reverse bone loss by generating new bone growth around existing teeth. Bone regeneration is a new discovery unique to this gum disease treatment. Healthy teeth and gums are essential to good health. Northwood Dental hopes more patients will take the opportunity to learn about laser gum surgery by calling or visit their website. About Northwood Dental Northwood Dental is a general practice offering personalized dental care for patients in Clearwater, FL since 2003. Drs. Jill Hagan and David Wagner both bring advanced dental technology to the practice. Dr.

full report http://www.chron.com/business/press-releases/article/Clearwater-FL-Gum-Disease-Treatment-is-Now-4732850.php

New Treatment may Help Prevent 80 Percent Neural Defects in Newborns

What is an even better is that this new procedure was able to treat certain NTDs that are not currently responsive to Folic Acid. Nicholas Greene, Professor of Developmental Neurobiology at the ICH, said, We are still in the early stages of this research, but we hope that these promising results in mice can eventually be replicated with human NTDs. If it is found to be effective, this nucleotide treatment could boost the effects of folic acid and offer expectant mothers an even more reliable safeguard against relatively common defects like spina bifida. ICH is the research partner of Great Ormond Street Hospital for Children NHS Foundation Trust. The team hopes that the same treatment can help prevent a number of NTDs in humans too. Globally spina bifida and anencephaly are among the few NTDs that still effect 1 in 1000 pregnancies with some countries showing higher percentage than others. Folic Acid recommended for pregnant women in the early stages of their pregnancy helps prevent 20-80 percent of these birth defects in children, at a time when their central nervous system is developing inside the womb. Folic acid works by helping the embryos neural tube to close normally, which is an essential step of development. However, a number of NTDs are still unresponsive to Folic Acid and the new treatment might help bridge this gap. Experts believe that one reason why folic acid might not be affective is when a genetic blockage stops folic acid from reaching the embryo. The new treatment plans to add nucleotides, which are needed to make DNA as cells divide in the growing embryo. These nucleotides can bypass the blockage in the way folic acid is handled, and ensure the growth of crucial cells in the embryo. The team also believes that because NTDs may be due to a number of different causes, the treatment route also has to be different with varying combinations. In a previous study the vitamin inositol was found to have a protective effect and researchers are also testing its viability in reducing NTDs.

try these out http://www.growingyourbaby.com/2013/08/14/new-treatment-may-help-prevent-80-percent-neural-defects-in-newborns/

Colon Cancer: Causes, Symptoms and Treatments

colon cancer, colon polyps

These factors include genetics, diet and health. Individuals with a family history of colon cancer, especially if more than one relative has had the disease, are at increased risk. Also, two genetic syndromes, known as familial adenomatous polyposis and Lynch syndrome, have been associated with colon cancer. A diet rich in fat and red meat may increase disease risk. In addition, heavy alcohol use as well as smoking may contribute to a colon cancer diagnosis. Health factors such as obesity, diabetes and lack of exercise are associated with increased risk. Moreover, inflammatory disease such as other types of cancer or conditions such as ulcerative colitis can increase the likelihood of developing colon cancer. These risk factors, however, do not guarantee a diagnosis of colon cancer. As with many cancers, colon cancer develops from the complex interplay of many factors, and no two individuals are the same. Symptoms Symptoms that may indicate the presence of cancer cells in the colon or rectum include blood in bowel movements, weight loss, stomach pains, and constipation or diarrhea. Often, individuals will not experience any symptoms of colon cancer until it has become advanced. For this reason, the U.S.

go here http://www.livescience.com/34716-colon-cancer-symptoms-colonoscopy.html

Oral Bacteria Linked to Colon Cancer: Scientists Learn How to Prevent Fusobacterium Nucleatum From Attaching to Cells

Oral Bacteria

The microbes have been linked with colon cancer before. But it was not known whether they were directly involved in tumor growth until this latest research published in the journal Cell Host & Microbe . Experts hope the findings could lead to new treatments, as well as earlier diagnosis and prevention. The first study by Harvard researchers showed high levels of fusobacteriain adenomas, benign bowel growths that can turn cancerous over time. More from GlobalPost: Toss your toothbrush after a sore throat? Maybe not In the second study , Case Western scientists found a molecule called FadAon the surface offusobacteriathat enabled them to attach to and invade colon cancer cells in the human body. “I think we all need to be concerned, because almost everyone has Fusobacterium to some extent,” Yiping Han, a periodontics professor at Case Western, told the Cleveland Plain Dealer . “We need to do more work” Colon cancer is the second-leading cause of cancer-related death in the United States, according to the Centers for Disease Control and Prevention . In 2009, the most recent data available, 136,717 people in the United States were diagnosed with the disease. http://www.globalpost.com/dispatch/news/health/130814/mouth-bacteria-may-cause-colon-cancer-study Art Basel gathers works from around the world for its annual shows. Photo Jaume Plensa’s “Tel Aviv Man” at Art Basel, the worlds premier trade fair for leading galleries and collectors focused on modern and contemporary art. – [/] Photo The front of the Art Basel building. This years show attracted 303 of the worlds top galleries from 36 countries, showing the works of more than 2,500 artists.

continue http://www.globalpost.com/dispatch/news/health/130814/mouth-bacteria-may-cause-colon-cancer-study

Mouth bacteria may cause colon cancer, studies say

Dentist working on mouth teeth 2013 08 14

(Photo : Flickr) New research findings show a surprising link between oral bacteria and colon cancer, according to a study from Case Western Reserve University School of Dental Medicine. “We found this cancer is linked to an infection from [the bacterium],” said Yiping Han, professor of periodontics at the dental school and the study’s lead investigator in a news release . “As Han completed the work on FadA and VE-cadherin, researchers from Harvard University and the University of British Columbia discovered the presence of Fn was higher in malignant tumors compared to the surrounding tissue,” Case Western Reserve University said in a news release. Han said she immediately suspected Fn interacted with cells in the colon similarly to those in blood vessels and shifted her lab’s work to focus on colorectal cancer. “This was one of those serendipitous scientific moments in making this discovery,” Han said. The University offered the following explanation about the findings: Because her lab was able to track Fn’s ability to attach to the VE-cadherin receptor on blood vessels, Han said it didn’t take long before her team found how FadA attached to the E-cadherin receptor on cells in the colon. Subsequently, FadA’s attachment to E-cadherin set in motion a protein called -catenin, which, among its many functions, produces two important actions in the cancer process: an inflammatory response that alters the immune system, and another that spurs cancer cell growth. Han’s lab designed a novel synthetic peptide that prevents FadA from attaching to E-cadherin and inciting actions that lead to cancer development. Findings show FadA gene levels were 10 to 100 times “higher than normal in precancerous and malignant colon polyps.” “FadA can be used as a diagnostic marker for early detection of colon cancer. It can also be used to determine if treatment works effectively at reducing Fn load in the colon and the mouth,” Han said.

internet http://www.hngn.com/articles/10097/20130814/oral-bacteria-linked-colon-cancer-scientists-learn-prevent-fusobacterium-nucleatum.htm

Food and lifestyle: non-chemo treatments for colon cancer

Chris Wark was just 26 years old when he was diagnosed with one of the later stages of colon cancer, stage 3. He was told that he was insane by the oncologist when he refused chemo. His decision instead was to embark on a raw vegan diet. Chemotherapy for colon cancer for Chris wasn’t conceivable. The idea of poisoning himself was not in the cards for him. He, like many others, sought alternative treatments for disease. Is colon cancer curable? To answer the question of whether or not colon cancer can be cured, I invite you to ask Dave the Raw Food Trucker and Chris Wark. I’m sure the conversation will enter into the realm of eating cleanly. I’m also sure that the raw food diet will be discussed. Wark started to eat special salads and began juicing his way to good health. He also started a lymph cleansing program that involved the use of a mini trampoline or rebounder.

view it now http://www.naturalnews.com/041423_colon_cancer_alternative_treatments_healthy_food.html

Differences in Staging and Treatment Likely to Be Behind UK’s Low Bowel Cancer Survival

This study examined both types of bowel cancer. The researchers examined how far the patients’ cancer had spread at the time of diagnosis – from very early (localised, stage A) to very late (spread to other parts of the body, stage D). They also examined the proportion of patients at each stage of disease who survived for one year and three years after diagnosis, after correction for the impact of other causes of death. Two-thirds (67%) of colon cancer patients in the UK survived for at least one year, compared with 80% in Sweden. Three-quarters (75%) of rectal cancer patients in the UK survived for one year or more, compared with 84% in Sweden. Low overall survival in a particular country can arise either because the patients there tend to be diagnosed at a later stage of disease than in other countries, or because survival at each stage of disease is lower than in other countries. The proportion of colon cancer patients diagnosed at the earliest stage (stage A) was lowest in the UK — only 8% compared with 11-17% elsewhere. But UK patients were also less likely to be diagnosed at the most advanced stage (20% at stage D, compared with 24-31% elsewhere). For both colon and rectal cancer, survival among UK patients diagnosed at the earliest stage of disease (stage A) was similar to that in the other five countries (96%, compared to 92-98% elsewhere), but survival in the UK was consistently lower for those diagnosed at a more advanced stage (5-11% lower than elsewhere). The researchers used population-based data for all patients diagnosed in a given country or region, not just the small proportion of patients included in clinical trials. The international differences in survival may arise from differences in the availability or use of diagnostic tests, and in the use of surgery, chemotherapy or radiotherapy at each stage of diagnosis. Countries do not all collect information on stage at diagnosis in the same way, however, and this can cause artefacts in international survival comparisons. Camille Maringe, lead author based at the Cancer Research UK Cancer Survival Group at the London School of Hygiene & Tropical Medicine, said: “Accurate investigation of how far the cancer has spread (the stage) when it is diagnosed is essential for clinicians to be able to offer their patients the most appropriate treatment. This will increase survival.

linked here http://www.sciencedaily.com/releases/2013/04/130416214738.htm

Erbitux Tops Roche‚Äôs Avastin for Colon Cancer Survival

Colonoscopy: The Key to Colon Cancer Survival

colonoscopy

The study only included the roughly 60 percent of colon cancer patients whose tumors have the non-mutated KRAS gene that makes Erbitux more likely to be effective. Outcomes could have been influenced by differing access to therapies once initial treatment was over, Mayos Grothey said. Though he wasnt involved with the trial itself, Grothey will serve as chairman this weekend for a combined advisory board on the study for Erbitux partners Merck, Bristol-Myers Squibb Co. (BMY) and Eli Lilly & Co. (LLY) These results are intriguing, but an unexplained positive finding from a secondary endpoint will not influence U.S. practice patterns, Scott Kopetz, an associate professor of gastrointestinal medical oncology at the University of Texas MD Anderson Cancer Center, said in an e-mail. Switching Treatment About half the patients in each arm of the study switched to the opposite medicine — from Erbitux to Avastin, or vice versa — as a second treatment once their cancer had worsened, said Volker Heinemann, a professor of medical oncology at the Ludwig Maximilian University of Munich and lead author of the study. Full data on the treatment patients got once their cancer had worsened will be presented at the World Congress on Gastrointestinal Cancer in July, Heinemann said. The results show that doctors who treat patients with the unmutated KRAS gene should choose Erbitux over Avastin, Heinemann said. For the moment we have to remain at that conclusion, he said. We are going to wait for support from the larger study. For the moment that is a reasonable conclusion. Roche looks forward to seeing full details of the study presented at the conference later today, spokesman Daniel Grotzky said in an e-mail before the results were released. Avastin is the Basel, Switzerland-based companys third-biggest drug, with about $6 billion in sales last year.

continued http://www.bloomberg.com/news/2013-06-01/erbitux-tops-roche-s-avastin-for-colon-cancer-survival.html

By Brett Spiegel, Everyday Health Staff Writer WEDNESDAY, June, 19, 2013 If you’ve been putting off getting a colonoscopy cause you’re scared, lazy, suspicious of them, or just don’t think you need one, you may want to reconsider, and fast. Screening colonoscopies do in fact increase your chances of colon cancer survival, according to new research published today in JAMA Surgery. Researchers from Massachusetts General Hospital and Harvard Medical School in Boston reviewed 1,071 patients who underwent colon cancer surgery between 2004 and 2011. Of these patients, 217 had been diagnosed through screening colonoscopy. They found that patients who were not screened through colonoscopy had higher risk for more invasive tumors, nodal and metastatic disease, cancer recurrence, and death than those who were diagnosed through screening. Additionally, they also experienced shorter intervals of disease-free and survival episodes. “Patients with colon cancer identified on screening colonoscopy not only have lower-stage disease on presentation but also have better outcomes independent of their staging,” wrote the study authors. Considering the tremendous effect early diagnosis through screening has for the prognosis of patients, this further emphasizes the important role compliance to screening colonoscopy guidelines can play in prolonging longevity, improving quality of life, and reducing health care costs through early detection of colon cancer,” the study authors concluded. The U.S. Centers for Disease Control and Prevention reports that colon cancer is the second leading cause of death in the country with about 140,000 men and women diagnosed annually and more than 50,000 deaths. However, since their inception in 2000, colonscopies have been responsible for consistent decreases in rates of colon cancer death in the U.S., according to The National Cancer Institute Surveillance Epidemiology and End Results Database , with rates dropping by roughly 35 percent from 2002 to 2010.

click this link now http://www.everydayhealth.com/colon-cancer/colonoscopy-the-key-to-colon-cancer-survival-2989.aspx

Colon Cancer Survival Has Family Link

The findings suggest that as yet unidentified genetic influences are associated with both an increased risk for developing colorectal cancer and an improved prognosis for surviving the disease, Jennifer A. Chan, MD, PhD, who led the study, tells WebMD. The study appears in tomorrow’s Journal of the American Medical Association. “This is reassuring for patients with a family history, but it could also be important for treatment,” says Chan, who is an instructor of medicine at Harvard Medical School. “If we are able to identify the factors associated with family risk and improved prognosis, this could help guide treatment decisions in the future.” Greater Risk, Better Survival As many as one in five colorectal cancer patients have a close family link to the disease, and having a first-degree relative such as a parent, sibling, or child with the cancer is associated with a twofold increase in risk. While it is clear that family history is an important risk factor for developing colorectal cancer, its influence on recurrence and survival are not well understood. In their effort to change this, Chan and colleagues from Harvard Medical School and the Dana-Farber Cancer Institute followed 1,087 patients with stage III colon cancer who were treated with surgery followed by chemotherapy. A total of 195 patients (18%) reported a history of colorectal cancer in one or more first-degree relatives. During an average of 5 1/2 years of follow up, 29% patients with a family history of the disease and 38% of patients with no family history either died of their disease or experienced disease recurrence. Patients with a family history were 26% less likely to have their disease recur than patients with no afflicted close family members. Screening Wasn’t a Factor Aggressive colorectal cancer screening is recommended for people with a family history of the disease. The American Cancer Society recommends earlier and more frequent screening for anyone with a first-degree relative who has had the disease, especially if that relative was diagnosed before age 60. Early screening saves lives, but it did not appear to be a factor in the improved survival among patients in this study, because all the patients had the same stage of advanced disease. The patients also had similar treatments, suggesting that genetic influences were the key to better survival.

great post to read http://www.webmd.com/colorectal-cancer/news/20080603/colon-cancer-survival-has-family-link