The Latest on Vitamin D and Breast Cancer

Lastest Research on Vitamin D and Breast CancerBy: Rachel Pappas, Breast Cancer Survivor and Founder of

The link between Vitamin D deficiency, breast cancer, and breast cancer recurrence is not new. But now Vitamin D has actually been shown to kill breast cancer cells.

I was so intrigued by what I read, I had to get on the phone with the clinical investigator myself, especially since I, and most of the women I know with breast cancer have a Vitamin D deficiency, and I hear it more and more.

JoEllen Welsh, PhD, a professor at GenNYsis Center for Excellence in Cancer Genomics in Albany, NY, has studied Vitamin D and breast cancer for 30 years, but for the first time, has incubated fresh human samples with Vitamin D. She took samples of early and late stage tumors, those with and without receptors for estrogen, progesterone, and HER2.

“Within days, half the cells shriveled and died in every tumor,” she said.

“Eighty percent of people have a vitamin D receptor, and if they have a tumor with this receptor it has potential to respond to Vitamin D, just as estrogen-positive breast cancer responds to tamoxifen,” says Welsh.

Vitamin D actually becomes a hormone in the body, meaning it is transmitted through the blood to any and or all tissue.

Five human samples were tested, reflecting the following types and stages of breast cancer:

  • Stage IIIC ER and PR Negative
  • Stage IIIA HER2 Negative
  • Stage I ER and HER2 Negative
  • Stage IIA ER PR and HER Positive
  • Stage IIIC Triple Negative

What next?

Currently Welsh is doing genetic engineering in mice to understand the mechanisms that trigger a response.

“For example, we need to look at what levels you need? Is there a difference in how it works on triple negative breast cancer? Does it work in the presence of tamoxifen? What if the tumor has a BRCA mutation? Answering these questions is how we can predict who is most likely to benefit from optimal Vitamin D status,” says Welsh.

Caution: If you have breast cancer, you shouldn’t take vitamin D in place of your treatment medications. Talk to your physician for more advice about taking supplements.

Founder of  1UpOnCancer.ComRachel Pappas is breast cancer survivor. She is the founder of And the author of Hopping Roller Coasters, which tells the story of her and her daughter, both diagnosed with bipolar disorder.


Exercise! It’s Important For Cancer Survivors and Thrivers

Yoga On The Lawn With Diana Ross, Breast Cancer Survivors & Family Members.

Yoga On The Lawn With Diana Ross, Breast Cancer Survivors & Family Members.

By: Brian D. Lawenda, MD, Clinical Director, 21st Century Oncology &

Almost every opportunity I get, I take the time to sit down with my active cancer patients & thrivers and ask them ‘how are you feeling?’

…The number one thing I often hear is ‘I have no energy’ or ‘I’m tired all the time.’

Although potentially serious causes first need to be evaluated and addressed by your doctors, feeling tired during and after cancer treatment (also known as “cancer related fatigue” or CRF) is often a result of the cancer or the effects of treatment on your body. CRF is one of the most common and distressful symptoms our patients face, and it can persist for months to years after treatment. Did you know that one of the most effective ways to fight and reverse CRF is with exercise? Seems counterintuitive, doesn’t it?

No one knows precisely how exercise is able to help you fight CRF. The most likely theory is that exercise reduces inflammation and free radicals in the body (by lowering levels of inflammatory proteins, called “cytokines”), both of which seem to increase the severity and risk of CRF.

Sadly, many patients and physicians feel that once you have been diagnosed with cancer there is no point in focusing on starting healthful lifestyle habits (i.e. smoking cessation, eating healthfully, weight loss if overweight, etc.)…after all, the ‘damage has already been done’, right?

NOT TRUE. Increasingly, researchers are proving that this fatalistic approach is absolutely wrong, particularly when it comes to not getting adequate physical activity.

Studies show that physical activity not only improves your overall health, but can reduce your risk of a cancer recurrence (or even dying from cancer) after treatment.

How many of your doctors have told you about the remarkable effects of exercise in fighting cancer? My guess is not many. You might want to inform them that credentialed research has found that by simply walking 3-4 total hours per week a breast cancer thriver can reduce their risk of a recurrence by up to 60%; this risk reduction is not unique to breast cancer.

An added benefit of exercise is that it will reduce your risk of developing future cancers. Unfortunately, just because you’ve had one cancer doesn’t mean you are out of the woods for developing a different one in the future. I have treated too many patients who have had more than one cancer in their lifetime.

While we are still learning exercises’ role in reducing the development, growth or recurrence of cancer, it seems that at least some of the anti-cancer effects have to do with numerous beneficial hormonal, anti-inflammatory and anti-oxidative changes that occur in the body from exercise and weight loss.

How much exercise do you need?

The majority of experts recommend that your goal be to get at least 150 minutes each week (30 minutes per day, 5 days per week) of moderate-intensity aerobic activity (i.e. brisk walking) and at least 2-3 sessions of strength training per week (i.e. weights, resistance exercises.)

New information has come out recently that is also important to know: it’s not enough to only be physically active just once a day for 30 minutes.

We now know that the amount of time we spend each day being inactive (i.e. watching TV, sitting for prolonged periods of time) also increases our risk of cancer growth, recurrence, and death. So, at the very least, get up and do something active every hour.

The health benefits of physical activity extend well-beyond cancer:

  • Reduced risk of dying early from other medical conditions
  • Improved quality of life
  • Improved sleep
  • Improved muscle strength and flexibility
  • Improved bone density
  • Improved cardiovascular health
  • Improved immune function
  • Reduced stress, anxiety and depression

Need motivation to get your activity levels up?

I’m a big fan of using a gadget called a “pedometer.” You can clip these to your

waist or wear them on your wrist, and they will count the steps or activity you do through the day. Studies show that most people think they are far more active than they actually are. Using a pedometer is enlightening, as it doesn’t lie. When a person wears a pedometer, researchers have found that activity increases by over 25%. To maintain healthful fitness levels, a goal of 10,000 steps (approximately 5 miles) per day is recommended.

It is smart to be cautious before starting an exercise regimen if you’ve had cancer as you may have new treatment-related side effects or limitations (i.e. lymphedema, neuropathy, limitations in range of motion.) That said, most experts agree that exercise is very safe during and after treatment as long as you are careful. If you have any questions or concerns about what kind of exercise is appropriate and safe for you, discuss this with your doctors. You may also want to work with a fitness professional (i.e. trainers, therapists, cancer rehabilitation programs) to help design an exercise program specifically tailored to you. Make sure that you investigate their credentials first, as it is important that they have experience working with clients who have a history of cancer.

So, what are you waiting for… just do it!

Available Exercise Resources For Breast Cancer:
Restorative Yoga For Breast Cancer Recovery: Gentle Flowing Yoga For Breast Health, Cancer Related Fatigue and Lymphedema Management

Founder of  1UpOnCancer.Com

Rachel Pappas is breast cancer survivor. She is the founder of And the author of Hopping Roller Coasters, which tells the story of her and her daughter, both diagnosed with bipolar disorder.

Breast Cancer: Guidelines For Buying Safe Supplements and Herbs

Breast Cancer How To Guide For Buying SupplementsBy: Rachel Pappas, Breast Cancer Survivor and Founder of

If your doctors are trained in conventional medicine, and you ask them about supplements and herbs, they may tell you there isn’t enough research to back that they have health benefits – and may even tell you they are unsafe. But the fact is, there is plenty of research to show that botanical, fungal, pre- and probiotic, and micronutrient-based supplements, have multiple health benefits—from boosting the immune system to fighting cancer-promoting inflammation. Some have even been proven to cause cancer cell death. They come mainly from plant-based foods, and are important, as most of us do not get enough of these nutrients from food.

As far as the safety issue, it is true: there are no guarantees that a supplement is all it is claimed to be, as they are not FDA-approved. Though the supplement and herb industry is becoming a little more regulated. And there are more measures you can take on your own to ensure you are buying a quality product.

First, know that U.S. government regulations require manufacturers to observe good manufacturing practices (GMPs), intended to help ensure there are no unsafe levels of contaminants and overall safety. And there are independent, third-party groups who test for products’ purity, strength and ingredients.

Still, your best guarantee that you are getting a safe, quality product, is to be a smart shopper.

Here are guidelines to follow when looking for supplements and herbs:

  1. Check the product label for the words “Current Good Manufacturing Practices” or “cGMPs.” This “seal” indicates that what is on the label matches what is actually in the bottle as far as ingredients and dose.
  2. Look for pharmaceutical grade. Pharmaceutical grade products have met the most stringent regulatory standards verified by an outside party. A dietician or integrative practitioner should be able to help you determine this level of quality. Or you may be able to confirm on the manufacturer’s website or call the toll-free number on the bottle.
  3. Check the label for one of these four names:, the Natural Products Association, NSF International, and the United States Pharmacopeia.   If the label has the “seal” of one of these organizations, it has passed a stringent certification process—its manufacturing facilities were inspected and the product has been tested and found to comply with specific standards for safety, quality and purity.

Avoiding interactions

Know that some supplements and herbs can interact with each other, and with prescription and over-the-counter medications.

So tell your doctor about any supplements you are taking. But bring all information you have on the supplements with you to appointments, as most medical doctors are limited in their knowledge of natural therapies. A naturopathic doctor, herbalist, some dieticians, and pharmacists will likely be able to guide you in ensuring you are not mixing natural or pharmaceutical ingredients that could have harmful interactions.

Here are more resources to help you make informed choices:

The National Institutes of Health’s Office of Dietary Supplements. For free downloadable fact sheets on individual vitamins, minerals, and other dietary supplements.

The Food and Drug Administration (FDA). For alerts, advisories, and other actions.

Consumer Reports Health’s Dietary Supplements and Natural Health Products Information. For general information on supplements and herbs, including for some specific conditions. And information on safety.

In summary, here are smart tips:

  1. Examine the label. Look for seal: Current Good Manufacturing Practices or “cGMPs” And make sure it includes the name of a third party inspector (, the Natural Products Association, NSF International, or United States Pharmacopeia.) Do your research and find out which manufacturers subject their products to third-party verification and testing. Only buy these.
  2. Always discuss any supplements you are considering with your doctor.
  3. If your doctor doesn’t know much about supplements (most conventionally trained doctors do not) consider also discussing this topic with a practitioner who is trained in their use.


Founder of  1UpOnCancer.Com

Rachel Pappas is breast cancer survivor. She is the founder of And the author of Hopping Roller Coasters, which tells the story of her and her daughter, both diagnosed with bipolar disorder.


Vitamin D And Cancer

Learn About Vitamin D and CancerBy: Rachel Pappas, Breast Cancer Survivor, Founder of and the Author of Hopping Roller Coasters.

If your Vitamin D level is at least 30 ng/ml at the time of your cancer diagnosis, you double your chance for long-term survival, according to a Canadian study, and other studies have similar findings.

But even if your blood level was lower, or you don’t know what it was when you first learned you had this illness, ensuring optimal Vitamin D moving forward will only help you;  it’s been shown to promote cancer cell death.

“If you have cancer, your Vitamin D should be at least 30 ng/ml, but I recommend no less than 60 to increase your chance for long-term survival,” said Cedric Garland, PhD, a professor at the University of  California School of Medicine, San Diego, and the first researcher to link Vitamin D and cancer. His studies date back to 1980.

Know that most of us are deficient unless we take Vitamin D supplements, so here are measures to take to ensure that your Vitamin D blood levels are where they should be …

How much Vitamin D should I take, and in what form?

Most people with cancer should take roughly 4,000 units daily for a healthy Vitamin D status, though this could vary, according to Cedric. He also emphasizes that if you get a prescription, to be sure it is NOT Vitamin D2, but Vitamin D3 (cholecalciferol).

“People should take only Vitamin D3 because we know that Vitamin D2 is a poor alternative. Experiments in animals and tissue cultures have found D2 is half to a third as effective in inhibiting cancer cell growth,” he said.

Which cancers does Vitamin D work against … and how?

Vitamin D has been shown to fight and help prevent cancer of the epithelial cells (these cells line organs), which includes over 90 percent of malignancies. The way it works, explained at the most basic level, is Vitamin D makes epithelial cells stick together.

“This is important because when these cells don’t stick together they are free agents and compete. When they compete, the ones reproducing the fastest take over. Cancer cells grow faster than healthy ones, so they dominate,” said Cedric. His research shows that epithelial cells have Vitamin D receptors, making them sensitive to this anti-cancer nutrient.

How often and when should I be tested?

Cedric recommends getting your Vitamin D tested every March, as your levels will likely be lower during and just after winter, since the sun is our greatest source of Vitamin D3, other than supplements. Ideally you should be checked again six months later.

Vitamin D during chemo

Some cancer researchers believe Vitamin D can work with chemo to improve the drug’s effectiveness.

“This vitamin enhances early cell death of cancer cells. And it helps prevent formation of arterioles and capillaries that feed tumors, so while we need more studies, I believe it enhances chemo,” said Cedric.

Two precautions

Know that pharmaceutical Vitamin D is often D2, so if you get a prescription ask your doctor for Vitamin D3. Or you can buy D3 over the counter and are likely to get a quality product at a health food store.

A second precaution: Do not assume if a blood test shows you have adequate Vitamin D that you do, at least not if you have been taking Vitamin D2. “The blood test just measures 25-hydroxy vitamin D, not specifically Vitamin D3, which is the good stuff,” said Cedric.

Vitamin D before cancer

Most people have cells en route to cancer, so everyone should pay attention to Vitamin D for risk reduction. The research showing its role in prevention is powerful.

“When Vitamin D blood levels are at 80 ng/ml, 80% of breast adenocarcinoma (cancer of the epithelium) can be eliminated. That figure is based on an extrapolation from several breast cancer studies,” said Cedric. It is equally effective at reducing colon cancer risk at 40-60 ng/ml and, again, we have seen that it works against other epithelial cell cancers.

Is there enough proof of Vitamin D’s cancer-fighting ability?

A majority of the studies are observational rather than randomized clinical trials. With randomized trials, one group would get Vitamin D and another would receive another agent or placebo; then the two groups would be compared.

But significantly lower cancer rates and better outcomes after diagnosis have been shown in studies many times over, simply by looking at patients’ Vitamin D levels and following them carefully.

“Scientists have measured Vitamin D at baseline and followed patients for 7-12 years. Those with at least 30 ng/ml had approximately 50-60%  the death rate,” said Cedric.

“We have enough solid evidence from observational studies, and from many of them; Vitamin D is very effective against cancer.  But always discuss Vitamin D with your physician. Aim for a consensus that includes your doctor,” said Cedric.

Links to studies on Vitamin D:

 What is the Dose Response Relationship Between Vitamin D and Cancer Risk?

Vitamin D Inhibits Genetic Behavior That Promotes Some Aggressive Breast Cancers

Prognostic Effects of Vitamin D in Early Breast Cancer

Serum 25-hydroxyvitamin D and colon cancer: eight-year prospective study

Vitamin D and Colorectal Cancer

Founder of  1UpOnCancer.ComRachel Pappas is breast cancer survivor. She is the founder of And the author of Hopping Roller Coasters, which tells the story of her and her daughter, both diagnosed with bipolar disorder.

Power Naps

Napping For Breast Cancer Recoveryby Rachel Pappas, Founder, and author of Hopping Roller Coasters.

Daytime naps aren’t just for kids. Studies show that all of us can reap benefits, like better sleep at night, boosted energy, and improved memory. Can’t we as cancer survivors use a boost in these areas—especially during or just after treatment?

Know the power of a power nap
Sleep expert Sara C. Mednick PhD says that even a 15- to 20-minute nap will help with energy, alertness and improve motor performance.

Short naps also help with memory, math, logical reasoning, reaction times, and symbol recognition. Naps improve our mood, help us feel less sleepy and can even help with weight management, reports WebMD.

For how long should I nap?
Sleep experts say that a 20-minute power nap is good for alertness and motor learning. Research shows that longer naps (30-60 minutes) are good for decision- making skills.

And if you have 60 to 90 minutes for a power snooze, this should help with creative, more complex problem-solving skills and with memory processing.

But even a six-minute nap can improve memory, according to a Journal of Sleep Research article (if you can fall asleep fast enough to make that six-minute nap worth it, you might want to set your alarm and give it a try.)

Our brain on sleep
While we’re asleep, our brains go through a 90- to 120-minute cycle, including stages of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. NREM sleep is the deepest sleep (about a 60-minute nap will get you into NREM sleep) and it helps with memorizing facts and various details, including facial recall.

Sleep researcher Andrei Medvedev, PhD, at Georgetown University reported to Prevention magazine that during sleep, the right brain is more active (typically it’s the left brain during wake hours). What is the significance of this different activity during nap time? Medvedev believes as the right side of our brains get busy during naptime, it may be organizing and consolidating information.

Naps may also protect brain circuits from overuse and help you organize newly learned information, according to Robert Stickgold, PhD and director of Harvard’s Center for Sleep and Cognition.

A NASA study done on pilots found that those who napped for up to 40 minutes had an increase in reaction times by 16%, and their alertness increased by 54% over those who did not nap.

The Annals of Emergency Medicine reported that planned naps have been shown to improve alertness and performance in emergency department physicians, nurses, and medical students. Subjects made less mistakes and were better able to learn on the job, with benefits lasting for several hours beyond the time nappers awoke.

Behavioural Brain Research reported that 60- to 90-minute naps were more effective than caffeine at improving verbal memory (word recall), and motor skills.

Additional physiological benefits
Napping for about 45 minutes during the day may help lower blood pressure after psychological stress (study from Allegheny College in Pennsylvania).

Daytime napping may reduce risk for heart disease or stroke, especially in men (Archives of Internal Medicine).

Other studies show a decrease in levels of the stress hormone, cortisol. When cortisol is elevated for extended times it is associated with conditions like high blood sugar levels that can increase risk for diabetes, and accumulating evidence shows regulating blood sugar reduces risk for cancer or recurrence and or may help manage metastatic cancer.

Napping tips

  • Be consistent. It’s best to nap at about the same time, and in the middle of the day.
  • Nap between 1 and 3 p.m. and you will most likely avoid falling into a deep sleep and waking up groggy or being unable to sleep well at night.
  • Make it short. Ideally, no more than 30 minutes to avoid waking up sleepy. But you may be able to go for up to 60 minutes and still avoid grogginess.
  • Avoid light. Napping in dark room will help you fall asleep.
  • Choose a spot that is quiet and not too warm or cold.

More information:

  1. Keep them short
    Your nap should be anywhere from 10-60 minutes. There is evidence that naps from 10-20 minutes tend to improve alertness. And naps 30-60 minutes tend to help with decision-making and memory.
  2. Eat right before your nap
    Avoid caffeine and sugar, which can make falling asleep harder. Instead, an hour or two before your nap, eat foods high in calcium and protein; they promote sleep.
  3. Sleep in a dark place
    Darkness stimulates melatonin, the sleep-inducing hormone.
  4. Remember that resting while reading or watching television is not the same as sleeping.
  5. Sleeping is our bodies’ repair and recovery period, and our physiology changes when we’re sleeping versus just resting. It’s a good idea when recovering from surgery, chemotherapy or radiation to take rest breaks.  But this only gives your muscles and cardiovascular system a break. You need to sleep to rejuvenate your mind and reset your physiology to help you recover.
  6. Don’t forget to set your alarm to wake you up when it’s time.

So now you have it, a good excuse to kick back and have a calming, yet refueling snooze. It will actually wake you up. Make you feel better, boost your energy, memory, and alertness.

Founder of  1UpOnCancer.ComRachel Pappas is breast cancer survivor. She is the founder of And the author of Hopping Roller Coasters, which tells the story of her and her daughter, both diagnosed with bipolar disorder.

What’s Your Breast Density And Why Should You Know?

Photo From Jasper Pickens County Georgia

Photo From Jasper Pickens County Georgia

By Rachel Pappas – Founder of  & Author of Hopping Roller Coasters

About 50 percent of women have dense breasts, meaning the tissue is more fibrous and glandular than fatty. What else it means is that it’s harder to catch cancer with digital mammography. The technology misses breast cancers 40 to 60 percent of the time in this population.  I learned this the hard way: when a mammogram missed my tumor a few months before my breast cancer diagnosis. And a second one missed it a few days before my biopsy that confirmed a 3-cm tumor.

This is not to scare anyone, but hopefully to empower you to learn your breast  density if you don’t know it. And to look into more sensitive diagnostic screening options if you do have dense breasts, especially since, while dense breasts are common, research shows they put us at higher risk for breast cancer.

Know that some states have adopted laws requiring imaging centers and or referring physicians to let women know what their breast density is, so they can opt for the best screening options. The newest technology, proven to increase early detection by 40 percent in women with dense breasts, is called 3D mammography.

This type of mammogram has been in the works since the early 90s and was FDA approved in 2012. Rather than look at a piece of the whole chest as with standard mammography, radiologists, using 3D imaging, view individual, 1-mm-thin slices of breast. They can look 1 mm deep, then 2 mm deep, all the way through the breast to detect disease that may be concealed by tissue. Think about a loaf of bread—I know, you’d probably rather not consider your body parts to be dough, but to put the concept in perspective, imagine being able to see all the way through the loaf rather than just the top and bottom slices.

The 3-D mammogram is virtually the same experience for the patient. The breast is still compressed, the procedure is about the same length of time. You get the same amount of radiation exposure, but your provider is able to retrieve more information.

Currently many insurance companies do not cover 3D mammography. But some imaging centers offer the technology at significantly reduced rates. My cancer center charges $40 to non-Medicare patients, and screens at no charge to Medicare patients.

So if you were not told what your breast density is, ask your doctor. Look into 3D mammography if you have dense breasts. See if your insurance covers the test, and if it’s not covered, ask if you can have a rate adjustment. It could save your life.

Founder of  1UpOnCancer.Com

Founder of 1UpOnCancer.Com

Rachel Pappas is breast cancer survivor. She is the founder of And the author of Hopping Roller Coasters, which tells the story of her and her daughter, both diagnosed with bipolar disorder.

Did Cancer Make Me Perfect?

By Rachel Pappas, Author, Health Writer and Founder of 1UpOnCancer.Com

So often I hear people say cancer raised them by the hairs on their neck, and helped them become the person they wanted to be.  Well, I had definite ideas of who I wanted to be and who I DID NOT want to be way before cancer. And I had been trying all along to better myself.

I wanted to nurture the people who matter most. I wanted to be happy and radiate that happiness. I wanted to be like Mary – Mary Poppins with her spoon fool of sugar. Or Mary Jenson (aka Cameron Diaz) in “There’s Something About Mary” (though I’d rather bypass the zipper fiasco on prom night, and the “cumlick”  do (sperm hair gel).

So I always worked to be who I wanted, but I have had serious anger management problems over the years. The wires in my head would tighten then pop, and I would explode. Then feel sick when I’d see the smile slide off my daughter’s face or feel my husband’s hurt.

Has cancer changed me? Yes. For one, sometimes I feel the pressure is on more than ever before to get it right.  To be more like the Hollywood Mary’s.

I especially feel the urgency when I read survivors’ stories about how they have changed hugely for the better since facing “c.” I wish I could say cancer was that powerful, that it made me into the person I want to be. But I am still very much a work in progress.

I can at least say that facing my mortality has opened my eyes wide. This one saying I’ve held onto over the years goes even deeper now: “Never go to bed angry at the one you love.”  It’s my mantra and I hear the echo every time I slip.

I am reminded again, to keep on working at it. And I stop and give a stroke to my daughter, my husband or a friend. Kindness does not make up for the hurt. But as disparaging words can reach deep, so can loving ones. And the more I practice, the more it becomes a part of who I am and what I give.

How else has cancer changed me? It has actually given me one less thing to be angry about. From the time I started this emotional roller coaster, I was having conversations with cancer. Telling it, “You are not going to piss me off because then you win. And I’m going to do everything I can to be the one still standing and to actually be better than I started.”

Funny to think you can turn off the anger at something as big as cancer, then snap over mud on the kitchen floor you just mopped, or anything else as miniscule. And this is what I forever tell myself. Because I want what leaves the deepest imprint on my family and friends to feel good for them, and for me, and for us.

So this is not a Disney story with a fairy tale-happily-ever-after ending. (I don’t like the word “ending” but use it for lack of a better one to make this point): Neither I or my life are perfect. But I will say as soon as I finish this article telling you a little of my cancer story, I’m going to forget about my outrageously long to-do list for a few minutes. I’m going to walk into my husband’s home office twelve feet away from mine. And I’m going to give him a robust bear hug. I’m going to thank him for loving me and tell him I love him too.  I can already see him look up at me, maybe a little surprised, then smile.

Founder of  1UpOnCancer.Com

Founder of 1UpOnCancer.Com

Rachel Pappas is breast cancer survivor. She is the founder of And the author of Hopping Roller Coasters, which tells the story of her and her daughter, both diagnosed with bipolar disorder.

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