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Gold Mining Is Poisoning the Planet With Mercury

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Jeovane de Jesus Aguiar was knee-deep in mud in the 100-yard gash he had cut into the Amazon rainforest, filtering brown water out of a pan, when he found the small, shiny flake he was looking for: a mixture of gold and mercury.

Mr. Aguiar had drizzled liquid mercury into the ground in his makeshift gold mine on the eastern edge of the small South American nation of Suriname, just as he had every few days.

The toxic element mixes with gold dust and forms an amalgam he can pluck out of the sludge. Then he sets the mixture aflame, burning off the mercury into the air, where winds spread it across the forest and across borders, poisoning the plants, animals and people it finds.

Left behind is the gold. That part usually ends up in Europe, the United States and the Persian Gulf, most often as expensive jewelry.

Twenty minutes along the river, the Wayana Indigenous community is getting sick. The Wayana eat fish from the river every day and, in recent years, many have been suffering from joint pain, muscle weakness and swelling. They also say birth defects are rising.

Tests show that the Wayana have double to triple the medically acceptable levels of mercury in their blood. “We’re not allowed to eat certain fish anymore,” said Linia Opoya in June, showing her hands, which ache after meals. “But there’s nothing else. That’s what we’ve always eaten.”

Driven by global scientific consensus that mercury causes brain damage, severe illnesses and birth defects, most of the world’s countries signed a groundbreaking international treaty in 2013 committing themselves to eradicating its use globally.

Yet 10 years later, mercury remains a scourge.

It has seriously harmed thousands of children in Indonesia. It has contaminated rivers throughout the Amazon, creating a humanitarian crisis for Brazil’s largest isolated tribe. And worldwide, doctors still warn against eating too much of certain fish because the toxic metal floats into the ocean and is absorbed into the food chain.

Suriname, a forested nation of 620,000 people on the northern edge of South America, is a case study in how mercury has become so intractable in large part because of society’s insatiable appetite for gold.

For decades, mercury has poisoned much of Suriname’s population. Nearly one in five births result in complications such as death, low birth weight or disabilities, according to one study, twice the rate of the United States. Yet mercury has also fueled the nation’s economy; gold accounts for 85 percent of Suriname’s exports, most of it mined with mercury.

“I could work without mercury,” said Mr. Aguiar, 51, overlooking his open pit. “But it wouldn’t be profitable.”

Suriname has banned mercury, yet the substance is easily smuggled in and widely used.

The Surinamese government did not respond to multiple requests for comment.

While Western countries, including the United States, have largely phased out mercury, more than 10 million people in 70 countries — mostly poorer nations across Asia, Africa and Latin America — still use the toxic element to extract gold from the ground, according to the United Nations.

These small-scale miners produce a fifth of the world’s gold — and nearly two-fifths of the world’s mercury pollution, according to the United Nations and the U.S. Environmental Protection Agency. Mining is the leading source of mercury emissions, ahead of coal-fired power plants.

“This is the brutal face of poverty,” said Achim Steiner, chief of the U.N. Development Program. For many miners, “the fact that mercury might harm me in 10 years’ time is too far from the reality of survival,” he added.

Large-scale gold miners use centrifuge machines or arsenic, which does not seep into the environment. Small miners choose mercury because it is cheap, easy to use and still available.

“Mercury, for better or worse, is a very simple technology, used for the better part of 2,000 years,” said Luis Fernandez, a Wake Forest University professor who has studied small-scale gold mining. “You can learn how to be a miner in 15 minutes, and you get pretty good results.”

While many countries have banned mercury in mining, enforcement is lax, Mr. Fernandez said. Gold mining “is an economic pressure valve for poorer countries,” he said. And that has only been compounded by the 12-percent rise in gold prices over the past year, to nearly $2,000 an ounce.

In 2013, the international community signed a broad treaty to take mercury off the market. It was called the Minamata Convention, named for a Japanese city where decades of industrial mercury pollution caused neurological diseases in more than 2,200 residents and even poisoned the city’s cats, causing them to jump into the sea.

Under the convention — which 145 nations, including Suriname, have now ratified — countries pledged to ban new mercury mines, close existing ones and, with some exceptions, halt the import and export of mercury.

The United States and European Union have since banned virtually all mercury exports, leaving the United Arab Emirates, Tajikistan, Russia, Mexico and Nigeria as some of the largest exporters. Researchers believe that China, which adopted the treaty, remains the world’s largest user of mercury.

The Minamata Convention, however, did not target small-scale gold mining. “Evidence has shown time and again that if you ban something that people need and there is no alternative, you simply drive them into illegality,” Mr. Steiner said.

Where Mr. Aguiar lives along the Maroni River, which forms the boundary between Suriname and French Guiana, everyone is either a miner or works for one. About 15 percent of Suriname’s work force, or 18,000 people, is connected to the gold mining industry, one of the highest percentages in the world, according to studies by the University of Amsterdam.

At the mines, workers shoot pressurized water to wash away generations of sediment, cutting into the landscape and exposing the layer they hope contains gold. Then they throw mercury into the water so it will bind naturally with any gold below.

The mercury is not hard to come by — and experts believe that much of it arrives from China.

A few hours before Mr. Aguiar was tossing mercury into his mine, where he employs seven people, he docked his canoe at one of the dozens of Chinese merchants on the banks of the Maroni. The shops sell the same goods: Coca-Cola, instant noodles, condoms and mercury. Mr. Aguiar bought a kilogram in an unmarked prescription drug bottle for $250. If he is lucky, it will be enough to mine a half-kilogram of gold, which he can sell for roughly $25,000.

Elsewhere in Suriname, vendors posted listings on Facebook and cabdrivers offered mercury connections. People across the country said mercury sellers were overwhelmingly Chinese, and interactions with several Chinese sellers revealed that they had little concern that they were doing anything illegal; mercury was a product like any other.

The Organization of American States said this year that mercury in Suriname was probably “imported from China on container ships bringing in other goods, such as mining equipment.”

In South America, researchers believe, only Bolivia imports mercury legally.

“So the question is: Where does it come from?” President Chandrikapersad Santokhi of Suriname told reporters in May. “We know it’s smuggled.”

Dr. Wilco Zijlmans, a pediatrician in Suriname who has studied the health effects of mercury, said its impact was clear. In a 2020 study of 1,200 Surinamese women that he helped conduct, 97 percent had unsafe levels of mercury in their bodies.

In addition to the elevated rate of birth complications, Dr. Zijlmans also found that children in Suriname were far more likely today than a generation ago to have delayed brain development, decreased motor skills and worse language and social abilities.

The effects are also showing up across the border. The Wayana Indigenous community has about 1,000 members spread across Suriname and French Guiana, which is French territory. Those in French Guiana have French citizenship, and French doctors have tracked the spread of mercury in some of their villages, which are surrounded by more than two dozen gold mines.

“Eventually, this will become like Minamata, too,” said Ms. Opoya, the Wayana member, who lives in one of the villages on French territory.

Upriver, when Mr. Aguiar wants to cash in, he takes his haul to the Chinese merchants who sell him the mercury. Those merchants then head to the hundreds of small gold-buying shops dotted across Paramaribo, Suriname’s capital.

At one shop, the owner, Arnaldo Ribeiro, said he buys just about all the gold that comes through his doors but has little idea where it comes from or whether it has been mined with mercury.

He then resells it to Kaloti Minthouse, a joint venture between the Surinamese government and a gold importer based in the United Arab Emirates.

“We don’t have to prove provenance,” Mr. Ribeiro said of the gold he sells.

Kaloti Minthouse then legally exports the gold around the world.

That means gold like Mr. Aguiar’s, cleaned of its mercury residue, is shipped off to become bank bullion, a necklace or perhaps a wedding ring, all its documents in order.

Rickie Lambert, conspiracy theories – and why footballers are vulnerable

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Just after clocking off time at the edge of Liverpool’s business district on Wednesday afternoon, a small but striking man with a tattoo stretching across his neck joined a crowd of 200 or so protestors outside the city’s most significant civic building.

Chris Sky is an optimistic-sounding name. His aviator glasses, gleaming white teeth and peroxide hair gave him the appearance of a Las Vegas timeshare salesman; instead, he was flogging a story to other famous men like Rickie Lambert, the former Liverpool and England forward, who had advertised this rally in advance without mentioning its special guest.

On the opposite side of the road was another group, making a stand against fascism. For a good half-hour, two men holding megaphones used the busy thoroughfare as a barrier between ideologies as cars went past and bemused commuters tried to get home.

While the anti-fascists screamed about Nazis and the real problems Liverpool’s residents should campaign against, the “freedom” movement stood behind yellow placards that advised readers to “question everything” and to “lose the denial”. There was also another warning: “15-minute neighbourhoods will be your prison.”


The 15-minute city protest in Liverpool (Simon Hughes)

That, ultimately, was what Lambert was here for: to raise awareness of the supposed threat of Liverpool becoming a “15-minute city”, where the local government stands accused of planning to essentially segregate districts in the name of climate change.

Sky emerged as an online agitator at the start of the Covid-19 pandemic by railing against restrictions at a series of “freedom rallies”. To his followers, he is a precious purveyor of truth in a world of sinister forces trying to exercise control; to many more, he is a dangerous conspiracy theorist.

There was, however, no denying he was the star attraction on Wednesday. After another “freedom” spokesman with the megaphone denied the event’s links to the far right — “This has nothing to do with racism,” he claimed — Sky and his followers ambled towards the space in front of the crown court. Then, after the rally’s organiser described those mainly middle-class-looking older women and students handing out socialist newsletters on the other side of the street as “satanic” communists trying to “steal our souls”, Sky was invited to talk.

“Hello Liverpool,” he shouted into the mic, only for his voice to disappear in a violent gust blowing in from the Irish Sea.

Sky announced that he was on a tour to change the world courtesy of speeches like this one, which included unsubstantiated claims about the return of Covid-19, the weaponising of climate change by governments in an attempt to control freedoms, and a hidden LGBT agenda that the audience needed to be aware of because according to the Bible, “pride” was one of the seven deadly sins.

Lambert, who did not speak despite his role in promoting the event, stood by, taking it all in. Most people did, but for one Liverpudlian in a vest, who piped up from the back of the crowd: “Why the f*** are we listening to some American talk about our city?”

It was at that point that someone informed him that Sky, whose surname is really Saccoccia, was in fact from Canada.


In his book, Red Pill Blue Pill, David Newert describes a conspiracy theory as “a hypothetical explanation of historical or ongoing new events comprised of secret plots, usually of a nefarious nature, whose existence may or may not be factual”.

In recent years, Newert adds that it has also become a “kind of dismissive epithet”. The majority of people, he explains, do not have the time for conspiracist beliefs and, therefore, it is easier to banish those who do as “cartoonish scam peddlers”.

A psychologist based in Merseyside, speaking on the condition of anonymity because of his working contracts, makes comparisons between conspiracy theorists and his experiences in the drug services when survivors discover salvation, prompting them to want to impart their knowledge to others by working in recovery.

“When conspiracy theorists discover something, they never keep it to themselves,” he concludes. “They have to pass it on to someone else. Now they know their place in the world, they see themselves as crusaders.”

Conspiracy theories can take root in every sector of society and yet there are compelling reasons why sportspeople — including footballers — could be particularly susceptible.

Lambert has used his social media platforms to perpetrate a variety of outlandish theories, including calling for doctors and nurses who vaccinated children against Covid-19 to be arrested, sharing posts that erroneously claim vaccine shots contain ‘cancer virus’, and saying that anyone who is “in on the globalist plan, the new world order, needs to be brought down”.

Yet he is by no means the only high-profile example. Matt Le Tissier, one of his predecessors in a Southampton and England shirt, has used social media to augment arguments among conspiracy theorists that include the denial of the war in Ukraine and actors being used to fake what is happening in front of Western cameras.

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Le Tissier has sparked controversy with his views (Robin Jones/Getty Images)

Le Tissier claims he has been pushed to the fringes by mainstream media companies because of his views. Support has come from Lambert but also from other ex-footballers, such as David Cotterill, the former Swansea City and Wales midfielder, who has used his Instagram account to make wild accusations over the existence of a network of celebrity paedophiles, climate change, Covid restrictions and that a Texas school shooting was a ‘false flag’ event.

Another former Liverpool player, Dejan Lovren, appeared to endorse the conspiracy theory that the Covid-19 pandemic was devised as a ploy to force vaccinations on the world’s population. In 2020, he responded to a social media post thanking health workers by Bill Gates, the billionaire who helped fund vaccine research, by saying: “Game over Bill. People are not blind.” He has repeatedly promoted links to talks by David Icke, the former Coventry goalkeeper, who has long held a belief that the British Royal Family are a group of shape-shifting lizards.

On a similar theme, the former Spain goalkeeper Iker Casillas revealed in 2018 that he did not believe the Moon landings were real.

The key word in any cognitive reaction to conspiracy theories, according to the psychologist, is ‘threat’. They explain the brain like this: the threat part of the brain is the most potent, telling the drive system to do something about it. But the drive system is also the part of the brain that deals with reward, which makes people feel like they are eliminating a threat. This, therefore, makes people feel like they are achieving something. When that happens, it releases chemicals like serotonin and dopamine, making them feel better.

“It gives people a purpose,” he says. “The problem is, it becomes cyclical. The threat system says, ‘You’ve done something about it this time — what about next time? You feel good now but there’s another threat around the corner.’ This means the brain jumps back into drive.

“This isn’t a million miles away from the life of a Premier League football player, who has to push themselves to avoid being dropped or heckled by 60,000 spectators who revel in telling you that you’re crap at your job. In a sporting life, that’s the threat. You’ve done well in one game, but there’s always another to follow.”

Sportspeople are susceptible to this world because of how carefully they need to manage their bodies in order to perform.

“Clean eating became a fad 10 years ago or so,” the psychologist says when asked to explain what can happen when sportspeople embrace alternative thinking. “That quickly becomes, ‘Don’t trust the professionals — take charge of what you put into your body.’ This then becomes, ‘Don’t trust the professionals — they are in the pockets of ‘big pharma’’. You throw in a pandemic in the middle of all this, along with various high-profile political scandals, and suddenly it manifests into not trusting anyone, claims about who controls the planet, and extreme views such as antisemitism.”

These are big jumps, but look at the leap Le Tissier has made in a relatively short space of time, from small city champion and legendary Southampton No 7 to a war-denier in Ukraine, who in July, without providing evidence, suggested on Twitter a “communist takeover is slyly being implemented”.

The psychologist suggests retired footballers can find life difficult without the routine of training and matches. This can lead to them seeking a lost dressing room culture that can be found initially in a chat room or a forum.

“Given golf courses were closed during the pandemic and there was nothing else to do, there was a sanctuary of sorts on the internet, where people seeking explanations for questions that had no answers seemed to find them. Such groups offer the illusion of certainty and safeness.”

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Golf courses closed during the Covid-19 pandemic (Glyn Kirk/AFP via Getty Images)

The problem, as Newert points out, is that real conspiracies do exist and have done through most of civilised history.

In Liverpool, particularly, you only need to remind people of the 1980s, when “managed decline” was suspected as a strategy of the United Kingdom’s Conservative government, before official papers were released under the 30-year rule in 2011 revealing that Chancellor Geoffrey Howe had, at the very least, proposed the policy to then Prime Minister, Margaret Thatcher.

Many people who lived in the city through this period would agree that there is enough evidence to believe the policy was, in fact, carried out. The decade finished with Hillsborough, the worst football disaster in British history, when the authorities aligned to blame fans. It would take more than a quarter of a century for a cover-up to be exposed in a courtroom and only in the past few years have some police forces started paying out damages to victims.

In some parts of Liverpool, it is still believed that the heroin epidemic of the same era was another strategy, aimed at doping the city up as the rot set in — preventing people in the haze from standing their ground.

Only a few hundred at most turned up outside Liverpool’s town hall on Wednesday, but the psychologist believes the city is fertile ground for conspiracists because of its history and a wariness towards authority.

Though it has not manifested into demonstrations, the current Conservative government’s decision to send in commissioners to run an area that hasn’t had a Tory councillor since 1997 has heightened suspicion amongst those with long memories.

This month, Icke hosted a talk in Liverpool’s Greenbank Conference Centre and he wouldn’t have organised that if he didn’t think at least some people from the surrounding area would turn up.

Super conspiracies, the psychologist thinks, are intoxicating because they have no answers, which helps maintain an interest over a long period of time.

“The awakening always feels just around the corner; that Scooby Doo moment, where the villain’s sack is removed from his head,” he says. “First, there was 5G to consider. Then there were lockdowns and masks. Now there are 15-minute cities. It’s a never-ending threat and that’s why it’s so difficult to escape from.”


Lambert, whose football career ended in 2017 following 241 goals in 701 games for nine clubs across all levels of professional football in England, perhaps stands as testament to that.

On September 11, the 41-year-old used his Twitter page to start promoting the rally with a poster that could easily have been an advert for a ghost tour, where the town hall faded into the background of a ghoulish blue light.

“People of Liverpool, start researching 15 minute city’s (sic),” Lambert wrote, “because they are coming our way very shortly if we allow it.”

Then, in capital letters, he added: “WE DO NOT CONSENT!!”

A video from a garden followed three days later, was aimed at “you Scousers”.

According to Lambert, Liverpool’s council was planning on “dividing” the city into 13 zones in an attempt to create greener and safer spaces for “us, the people”.

“It is not, it is not,” Lambert insisted. “It is a controlled tactic being implemented across this country as we speak. These are initial movements for 15-minute cities, all under the guise of climate change.”

Liverpool would be under the surveillance of cameras and, eventually, permanent barriers, according to Lambert. “This is unacceptable,” he said. “Us, the people, will not stand for this control tactic.”

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Lambert making his way to the 15-minute city protest in Liverpool (Simon Hughes)

While Lambert did not provide evidence for these claims, the city council is adamant that such plans have never been discussed at any committee meeting and it does not form a part of its planning or policy.

The 15-minute city, an urban design concept which could be perceived as a fairly mundane strategy that has been moderately successful in other parts of the world for more than a decade, aims to provide everything that a resident supposedly needs within a 15-minute walk or bike ride.

Since the start of 2023, however, it has been targeted by conspiracy theorists, who believe it to be a part of a malign international plot to control people’s movement in the name of climate change. According to the protestors standing beside Sky, new cameras in bus lanes were evidence that this process had started in Liverpool.

Not every person’s life can be viewed through their social media output, but Lambert’s might be revealing in terms of what it does not include over the first three years.

His Instagram page has been active since 2017 and until 2020, nearly all of his posts related to his family and football. If he was interested in politics, medicine, or social freedoms, he did not show it.

The nature of those posts began to change six months into the Covid-19 pandemic, specifically when Rishi Sunak told musicians they should retrain and find new jobs.

Lambert, like a lot of people, pushed back at this radical suggestion by the then Chancellor of the Exchequer, who has since become the British prime minister.

By March 2021, he was posting about lockdowns, writing: “No new variant or blaming the unvaccinated!! NO MORE!!!”

Lambert only joined Twitter in June 2023, attracting 10,000 followers since. His bio suggests he is “fighting for my children’s future”, as an ex-footballer-turned-coach, though he does not mention he is employed by Wigan Athletic. It includes the hashtag #greatawakening.

In his first video post, he described himself as a “critical thinker” before having a stab at explaining what he thought this phenomenon was.

“No one has ever told us what the great awakening is,” Lambert admitted.

A month later, he released another, more succinct video, where he “withdrew his consent to be governed by any corrupt, compromised, belligerent parliament of government”.

“I will not comply,” he added.

I had asked Lambert for an interview in July, to speak about his views, challenge them, and to see where they were rooted. Initially, he agreed, but the night before we were due to meet, he cancelled without any initial indication he wanted to reschedule. After being pressed on another date and promising to come back with a suggestion, he did not.

It became apparent on his Instagram page that two days before our original interview, he had attended a gathering with at least four other people, including Andrew Bridgen, the Member of Parliament who, earlier this year, was expelled from the Conservative Party for comparing Covid-19 vaccines to the Holocaust. He had also been found to have breached lobbying rules.

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Bridgen has been an outspoken critic of lockdown policy (Leon Neal/Getty Images)

At the start of September, Hope Not Hate, the largest anti-fascist organisation in the United Kingdom, distributed a picture of Bridgen in Copenhagen with Tommy Robinson, arguably the most notorious far-right activist in the United Kingdom.

The organisers of the rally Lambert promoted and attended in Liverpool were the British Lions, a group which was spawned out of the Covid conspiracy “freedom” movement.

Despite using ancient law and sovereign language, Hope Not Hate says the organisation is not explicitly far-right, but says that some of its members have been seen at other far-right events.

A leaflet handed out by the British Lions on Wednesday outlined, rather chaotically, all of the things they are challenging the government on. Some were rooted in reality, such as the attempt to criminalise rights to protest; others were unsubstantiated claims apparently designed to offer the impression of a super conspiracy.

So many of the origin stories for these groups and beliefs can be traced back to the pandemic, which Joe Mulhall, from Hope Not Hate, describes as an “unprecedented opportunity for engagement with the conspiracy world”.

Mulhall says conspiracists will ignore any differences when they meet believers of their secretive world. “The nuances seem tiny when they feel like they are conquering an external force. The enormity of the perceived threat means they will put aside political distinctions that traditionally might be a problem.”


Nine summers ago, I watched Lambert cry tears of joy as he completed his dream move. He was at Melwood, Liverpool’s old training ground, having just signed for the club.

When I spoke to him briefly in July, he described it as the best moment of his life. I remember being delighted for him, as so many Liverpool supporters were. His story until this point had been one of crushing rejection and extraordinary revival, heaving himself from the floor of his release from the club he loved as a teenager to working his way back a couple of decades later. “I can’t believe this has happened,” he told me.

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Lambert fulfilled a boyhood dream by playing for Liverpool (Michael Regan/Getty Images)

On much colder reflection, his path might offer clues as to why he thinks the way he does now. Lambert was born in Kirkby, an overspill town seven miles inland from Liverpool’s city centre, living in a maisonette opposite the old Kirkby Stadium, which for junior teams in the area was the equivalent of Wembley. With a notoriously hard shot, he was spotted by Liverpool scouts aged 10 and he spent five years in the junior ranks, rejecting opportunities to join Everton and Manchester United.

It was not a shock to him when he was told by Steve Heighway, Liverpool’s academy director, that he was being released because of his lack of pace. Over the next few years, he had to adapt his game and this led to him playing in a variety of positions. He joined Blackpool as a right-back, but by the last year of his apprenticeship, he was a central midfielder. Two of those years had been under Nigel Worthington, but when Steve McMahon, the former Liverpool midfielder, took over, his fortunes changed. McMahon had been his father’s hero, but within six months of his appointment as manager, Lambert was allowed to leave the club — unable to even get a game for the reserves. McMahon had seen ability but did not think Lambert’s body would allow him to regularly play for 90 minutes.

On trial at Macclesfield Town, he was not being paid and this led to him getting a job at a beetroot factory. Aged 19, he was contemplating a career in the semi-professional ranks because he did not have a car and could not even afford the cost of the travel expenses to make it to training. Yet six months later, he was sold to Stockport County for what remains a club record fee of £300,000.

Lambert believes he was entitled to earn 10 per cent of that fee, but when he tried to buy a house, he learned that the money had disappeared into an agent’s account. By the age of 19, it would be understandable if he had trust issues given he might feel let down by the club he loved, his father’s hero, and the person supposedly representing him in this cruel, unforgiving sport.

At Stockport, Lambert found it hard to adapt to a deep-lying midfield role. The team was struggling and the fans turned on the players. As the most expensive signing, he bore the brunt and this led to him dropping a division to join League Two Rochdale, where he rediscovered a sense of purpose while playing as a centre-forward. He maintained his scoring habit after moving to Bristol Rovers and when Southampton were relegated into League One, new owners, with new money, enticed him to the south coast. There, the manager Alan Pardew asked him to lift his top up. Looking at his belly, he told him he was a “disgrace”.

Despite scoring the goals that helped Southampton accelerate back up the leagues and making friends with Le Tissier along the way, Lambert says the club wanted to sell him every summer.

He was desperate to prove them wrong and when he finally made it into the Premier League, aged 30, he had played almost 400 games across each of the divisions in the English football league. Yet in the opening game of that season, at champions Manchester City, he was left on the bench. The decision by manager Nigel Adkins suggested he didn’t truly believe in him.

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Lambert always felt the need to prove himself (Glyn Kirk/AFP via Getty Images)

Listening to Lambert, you begin to realise how lonely football can be. He could only ever really trust himself: his talent and resilience. Regularly, those making decisions about the direction of his career did not. Even after proving himself in the Premier League, he felt as though international recognition with England only came out of respect for his record rather than his ability.

On his debut against Scotland, he was in “dreamland” after scoring the winner. He made it into England’s squad for the 2014 World Cup squad but felt like a “mascot” after just three minutes of playing time. The lack of action meant he felt he needed less of a summer holiday as he began his Liverpool career. Despite being given five weeks off, he returned to Melwood after a fortnight, vowing to become the fittest he had ever been.

It proved to be a mistake because he needed the break. Aged 32, Lambert had never played a full season extending into a summer tournament before. Back on Merseyside, he felt heavy — like he didn’t have any energy. On the club’s pre-season tour of the United States, he struggled with the routine of training, playing and travelling.

Liverpool’s manager, Brendan Rodgers, had told Lambert that he was bringing in Alexis Sanchez to replace the outgoing Luis Suarez. Sanchez, however, never arrived. In the 2014-15 season, Liverpool missed Suarez terribly. In Sanchez’s place, Rodgers bought Mario Balotelli despite vowing not to, and Balotelli’s signing was a failure.

Lambert was under more pressure to deliver. His first Liverpool goal at Crystal Palace coincided with what turned into a bad team performance and a defeat. After just five months at the club, Rodgers wanted to move him on, but Lambert rejected the opportunity to join Palace before he almost went to Aston Villa. He never fulfilled that boyhood dream of scoring for Liverpool at Anfield.

Out of the starting XI, his fitness got worse. He was less likely to affect a game if his chance did come. Spells at West Bromwich Albion and Cardiff City followed, but within six weeks, Lambert was told by Neil Warnock that he wanted him off the wage bill. One of the offers came from Scunthorpe United, but he couldn’t face lowering himself to a level of football which he had tried so hard to get away from.

Listening to him on the Straight From The Off podcast in 2021, it seemed as though he was still searching for answers as to why his career unravelled the way it did. Certainly, had he listened to any supposed “expert” at crucial points in his career, then he may have not even made it to Blackpool.

Across the Liverpool fanbase, he has become a figure of fun, but not because his time at the club ended in the way it did. In another podcast this year, he spoke enthusiastically about scientists conducting an experiment where they spent time speaking positively to a glass of water, which allegedly responded by dazzling them with the clarity of their crystals.

When a friend saw that clip, he messaged me straight away, asking: “What next, Rickie Lambert taking mortgage advice from a can of Fanta?”

(Top photo: Getty Images; design: Eamonn Dalton)

Will Deion Sanders be a target in next NFL coach search? League execs say ‘definitely’

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Deion Sanders is shaping up to be a prime target for NFL teams in need of a head coach.

Sanders hasn’t just captivated the college football world with his early success as Colorado’s boss. He’s also quickly piqued the interest of NFL decision-makers who are curious whether his unique coaching style can translate to the professional level.

The Athletic polled 10 high-ranking team decision-makers to gauge the league’s opinion on Sanders, and seven of them predicted Sanders would receive interview requests for the offseason head-coaching hiring cycle. The other three didn’t rule it out but believed it was too early to make a prediction.

“I’d definitely want to bring him in to hear what he has to say,” an executive said. “He’s a smart guy and a good coach who has had a lot of early success. You’d want to pick his brain to see if it could translate. He knows how to motivate his players. He’s crushed the transfer portal, and maybe that would carry over into team building through free agency.”

The Pro Football Hall of Famer became a first-time head coach in 2020 for Jackson State and led the program to a 27-6 record over three seasons, but he really made waves when he flipped top-rated recruit Travis Hunter from Florida State, legitimizing Sanders’ standing as a premier draw despite a relative lack of program resources.

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Colorado then hired Sanders in December, and he went into recruiting overdrive in the transfer portal. He brought over his son, quarterback Shedeur Sanders, Hunter and numerous other highly regarded recruits to the Buffaloes.

They’re off to a 3-0 start and ranked No. 19 in the country — already an impressive feat considering Colorado was 1-11 last season while getting outscored, 534-185. It had been their sixth consecutive season without reaching four victories.

“He clearly has a plan to develop young men,” an executive said. “It’s worked to this point. He has no issue putting people in position to do what they do best, doesn’t seem to micromanage and knows his strengths.”

Sanders has an obvious ability to relate to his players, and there’s a belief that his success in the transfer portal would carry over into NFL free agency. He has also proved he can generate a spotlight his players appreciate, and Sanders has done an interesting job of manifesting motivation through different types of adversity, self-created or otherwise.

Several of the executives characterized Sanders as a CEO-type of head coach who can oversee the operation from a grander scale, which is an important characteristic for a head coach. He has also hired highly regarded assistants, offensive coordinator Sean Lewis and defensive coordinator Charles Kelly, and Sanders delegates responsibilities to his assistants to draw upon their expertise.

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And though there have been some prolific college coaches who have failed spectacularly at the NFL level, the executives believed Sanders shouldn’t be lumped in with that group. That’s because Sanders has played in the NFL at the highest level and should understand how to get the most out of players because he’ll understand what they need to be at their best. Generally speaking, past college-to-NFL failures happened because those coaches believed they could work with professionals identically as they did with student-athletes, and that’s been a disastrous recipe.

The desire for NFL teams to interview Sanders would be to assess his plan to run a locker room, develop players, build a staff, work with the front office with roster construction and sustain that success year over year.

“I love the energy he creates, and his players respond to it,” a general manager said. “I would think you have to at least sit down and talk with him. He’s a leader, smart, a great marketer and has the (credibility) as a player and now adding to it as a coach.”

But there are two important questions. First and most importantly, would Sanders even want to jump to the NFL? With the new name, image and likeness rules and transfer portal, Sanders essentially has untapped resources to build out his roster rather than having to deal with the salary cap and a draft system designed to maintain parity. A few of the executives believed Sanders wouldn’t want to leave the college game, though that wouldn’t stop them from trying to bring him in for an interview.

And if Sanders maintains this success, it’s only a matter of time before higher-profile programs with even bigger budgets come calling. The Alabama job might be the most coveted in the nation when Nick Saban retires, and there’s a belief in league circles that time isn’t far away.

There is no shortage of big-time programs with deep pockets that would surely be enticed by Sanders’ success and marketability if their current coach stumbles.

“I think he gets (NFL head-coaching interview) offers this year,” an evaluator said. “But I believe he is better in college where he can tilt the scales and dominate the talent pool with his ability to recruit. I think he would be successful in NFL, too, but could really create a long-term powerhouse in college.”

A general manager agreed.

“I just think Deion can dominate for an extended time in college,” the GM said. He’ll have to deal with parity in the NFL. He might not have the same impact (in the NFL that) he has in college because he will be limited in how many guys he can bring in and attract because of the cap and draft.”

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The second key question relates to the rest of the season. Though Colorado has knocked off national runner-up TCU, Nebraska and Colorado State, the schedule will get far more difficult over the next two months.

It visits No. 10 Oregon on Saturday, hosts No. 5 USC a week later and has four more currently ranked opponents over its final five games. How will Colorado respond if it loses a couple in a row or gets blown out on national television?

“They beat the teams that they should beat,” a general manager said. “I’m interested in seeing how he adjusts his offense when the elements in Colorado change.”

There are plenty of variables at play in the coming months, but the NFL has been captivated by Sanders’ showing at Colorado. There’s enough reason to believe his system would translate to the professional level, just like there’s cause for concern over Sanders’ relative shortage of head-coaching experience.

But if there’s any belief whatsoever that Sanders can coach — and obviously that’s the case — organizations owe it to themselves to invite him for an interview.

After all, the most important factor is often the most apparent.

“He has been successful at everything he’s done,” a general manager said, “on and off the field.”

(Illustration: John Bradford / The Athletic; photo: Maddie Mayer / Getty Images)


“The Football 100,” the definitive ranking of the NFL’s best 100 players of all time, goes on sale this fall. Preorder it here.

Zelensky Tells U.N. Security Council It’s Useless While Russia Has a Veto

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President Volodymyr Zelensky of Ukraine, denouncing Russia’s “unprovoked aggression,” told the United Nations Security Council on Wednesday that if it did not break the grip of Russian veto power, it would be powerless to resolve conflicts around the world, adding his voice to the rising calls to overhaul how the body works.

“Ukrainian soldiers are doing with their blood what the U.N. Security Council should do by its voting,” Mr. Zelensky said on Wednesday, arguing that “veto power in the hands of the aggressor is what has pushed the U.N. into deadlock.”

Mr. Zelensky’s appearance before the Council helped make it the highest-level direct confrontation over the invasion of Ukraine, with Foreign Minister Sergey V. Lavrov of Russia and his American counterpart, Secretary of State Antony J. Blinken, taking the seats normally occupied by their ambassadors and stating their countries’ cases.

Mr. Lavrov and Mr. Zelensky did not cross paths — the Russian did not enter the hall until after the Ukrainian had spoken and left — in a bit of choreography that reflected a session in which the two talked past each other.

The Russian foreign minister read a long and detailed speech, citing decades-old events and familiar grievances, speaking so fast that the United Nations’ simultaneous translator stumbled and struggled to keep up — all without engaging with the accusations leveled against his country. “We hear slogans — invasion, annexation, aggression” Mr. Lavrov said, as if those were mere words, not facts.

In relatively brief remarks, Mr. Zelensky did not dwell at length on the bloody realities of the war, knowing that his allies would do so, but instead took aim at the structure of the Security Council, the U.N. arm empowered to take the toughest actions, including imposing sanctions and deploying military personnel.

Five nations — the United States, Russia, China, France and Britain — are permanent members and have veto power, meaning that no action that any of them objects to stands a chance. The other 10 seats rotate among more than 170 other member countries, as chosen by their peers, which do not wield vetoes.

Mr. Zelensky advocated changing U.N. rules to allow the General Assembly, which is made up of all member countries, to override a Security Council veto by a two-thirds vote. But that change would, itself, be subject to a veto, making it a nonstarter for the foreseeable future.

Notably, neither Mr. Blinken nor Deputy Prime Minister Oliver Dowden of Britain, whose countries would be averse to seeing their own powers watered down, addressed Mr. Zelensky’s proposal in their speeches. But many other countries have raised the issue of recasting the Security Council this week, calling for broader and more equitable representation for them, and at least limitations on veto power, if not its abolition.

“I think that Zelensky believes that by talking about U.N. reform, he is turning Ukraine’s battle into a global cause,” Richard Gowan, the U.N. director for the International Crisis Group, said in an interview. “He is certainly right that a lot of U.N. members believe that the Council is out of date and needs reform, and the veto is especially unpopular. But Council reform is also a diplomatic hornet’s nest, and the procedural and political obstacles to reorganizing the Council or changing veto rules are prohibitively high.”

Mr. Zelensky argued that the United Nations was wrong to allow the privileges of the Soviet Union, after it collapsed, to be inherited in the 1990s by Russia, “which, for some reason, is still here among the permanent members of the Security Council.” He called Russian diplomats “liars whose job is to whitewash the aggression and genocide.”

As he spoke, the Russian ambassador, Vasily A. Nebenzya, looked down at his phone and tapped at its screen.

Even as the Security Council prepared to meet, Russian forces struck the largest oil refinery in central Ukraine. And an explosion shook a cargo ship in the Black Sea near the border of Romania and Ukraine; it was not clear what caused the blast.

Russia found little resembling support at the Security Council, denounced not only by Council members but also by Secretary General António Guterres and leaders of many other nations who were given permission to attend and address the session. They reiterated that Russia’s invasion and the atrocities that have followed are violations of the U.N. charter and other international laws.

“It’s hard to imagine a country demonstrating more contempt for the United Nations,” Mr. Blinken said.

He spoke of his emotional visit to the town of Yahidne, Ukraine, and meeting some of the hundreds of civilians who had been held in a crowded, unsanitary basement there by Russian troops for 28 days early in the war. Some people died there, he said, including a 6-week-old baby.

“In this war, there is an aggressor and a victim,” he said.

Mr. Lavrov repeated the false claim that Ukraine is controlled by “neo-Nazis” and recited the Kremlin’s case that the conflict is the fault of the United States, for meddling in Ukrainian politics over the last two decades, and of Ukraine, for abusing and discriminating against Russian speakers.

The ousters in 2004 and 2014 of pro-Russian governments in Kyiv were purely the work of the West, he argued. This is a consistent theme for President Vladimir V. Putin’s Russia: that smaller nations that align with the West or oppose Russia must be taking orders from Washington and its allies. Mr. Lavrov even said that the United States should “command” Mr. Zelensky to negotiate.

Mr. Zelensky pushed once again for his plan for peace with Russia, but that, too, is a nonstarter, at least for now, requiring Russia to withdraw all of its troops and paramilitary forces. Similarly, Russia says its annexation of Ukrainian territory is nonnegotiable.

At the start of the meeting, Mr. Nebenzya, the Russian ambassador, engaged in a lengthy procedural argument with Edi Rama, the prime minister of Albania, who was conducting the meeting because his country holds the Council’s rotating presidency. Mr. Nebenzya objected to Mr. Zelensky’s being allowed to speak before the Council members.

“There is a solution, if you agree,” Mr. Rama replied. “You stop the war, and President Zelensky will not take the floor.”

Neil MacFarquhar contributed reporting.

Florida State has taken off fast. Can Mike Norvell’s team avoid the long way down?

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TALLAHASSEE, Fla. – Five sleeps before one of the more seismic jolts in recent Florida State football history, Mike Norvell paces inside the Dunlap Training Facility as players loosen up for practice. He stops occasionally, cupping his hands to his mouth to shout something. It’s an accident if anyone hears him. The school’s ubiquitous “War Chant” aggressively churns over the loudspeakers; the man who runs this program has made it nearly impossible to listen to him, while choosing to scream into the din anyway.

This happens every day, mostly because once the head coach does a thing, he often obligates himself to do that thing in perpetuity. Norvell decided the chant would start practices, so best anyone remembers, the chant has started every practice since he arrived in late 2019. Same way he daily yells “Good morning!” loud enough to be heard two floors up in the Moore Athletic Center. Same way a “Hi, everybody!” precedes media sessions like a starter’s gun popping.

A coach compelling everyone into his time loop. Florida State football, a flat circle. “Every day, he’s the same person,” says junior tight end Markeston Douglas. “He’s never changed.”

Some things, of course, shift. Sometimes a hurricane closes in on the area during preparation for a massive season opener. Sometimes a work crew props open an emergency exit door and an alarm annoyingly whoops throughout the entire practice. Sometimes the Seminoles have been a punchline, losing more games in a month than in whole seasons. Sometimes they’re five days away from beating LSU to launch College Football Playoff expectations, like they are in this particular moment. Sometimes they fly into a storm in Boston and barely come out the other side, prompting everyone to ask who they are again.

Norvell has been around for all that, shouting into the noise, sprinting from one field to another, telling everyone to hurry up. He chose to be the same. Now everything’s different.

Places to be. One way there.

“You need to prove,” Florida State’s coach says, “you can get through it.”


This is Mike Norvell’s eighth year running his own college football program.

He’s asked if it feels more like 80.

“Well,” Norvell says, “a couple of those middle years were really, really interesting.”

He laughs a little, because he knows they were interesting in the way piloting a space shuttle through a magnetic storm is interesting. It’s the same this week as the fervor over that opening-night win against LSU has run up against a disquieting struggle at Boston College last weekend, after which the head coach flatly conceded his team didn’t play to its standard. A trip to Clemson awaits on Saturday. The identity of Norvell’s 2023 Seminoles, suddenly in the balance again.

Going a long way up, really fast, creates a long way down, too.

Norvell became a passing-game coordinator at Tulsa in 2009, his second season as a full-time assistant coach. He was an offensive coordinator at Pittsburgh two years after that. He was 34 when Memphis made him the youngest head coach in the Football Bowl Subdivision at the time. Norvell had the Tigers in the Top 25 in Year 2 and the Cotton Bowl in Year 4. It happened that Florida State had jettisoned Willie Taggart after just 21 games and needed yet another new head coach, so Norvell bounced to Tallahassee the day after Memphis’ New Year’s Six bowl invitation landed. Into the exosphere. Full speed ahead.

Then the engines dropped clean off. Florida State lost 10 of its first 13 games under Norvell, including the ignominious 0-4 run to start 2021 that included the program’s first loss to an FCS team. By the end of that season, the Seminoles coach infamously had a Twitter Space devoted to his two-year tenure. It was titled “Fire Mike Norvell.”

Around every corner, someone with a razor-edged opinion of him. “It’s really easy to question what you’re doing, how you’re doing it,” Norvell says of those dimmer days. Meanwhile, he didn’t do that. Florida State would change, and the coach wouldn’t. Because the coach wouldn’t. It was going to work like that or not at all.

“I mean, I was very passionate about what we were doing,” Norvell says now. “I was very convicted. I got to watch the players. I saw the practice. I saw the belief; I saw they didn’t stop, they didn’t question, they didn’t pull back. So I was very passionate about where we were going. And I had the utmost confidence of what it would be.

“Obviously, there’s plenty of outside noise. And there’s the internal drive of wanting to be successful. When I came to Florida State, my expectations were to win every game from the very beginning. And that didn’t happen. We had to go through some challenging moments. But I never lost belief in what it would be, and then it just came down to the work.”

The most effective part of the work has been consistent talent evaluations. Florida State under Norvell has been as good as anyone – or better – at one of college athletics’ increasingly critical chores: plucking high-end contributors out of the transfer portal.

Thirteen offensive and defensive players who started against LSU, for example, began their college careers elsewhere. Quarterback Jordan Travis, an early Heisman Trophy front-runner, decamped from Louisville for Tallahassee a year before Norvell arrived. Jared Verse, meanwhile, was not happenstance. He was a sack-happy defensive end for Albany, an FCS school, when he decided to transfer. Soon after, a former high school coach checked in with a question.

Why did the Florida State coach just call me?

“That was before I even heard from Florida State,” Verse says now. Norvell had begun a background check before he even made contact with the player who would record 17 tackles-for-loss, including nine sacks, and earn first-team All-American honors from The Athletic in 2022. Norvell was struck by Verse’s “relentless motor;” the Seminoles coach still recalls a clip of Verse chasing a Syracuse running back, maybe 50 or 60 yards down the field, during a blowout loss. Even more intriguing was Verse using downtime on his official visit to launch his phone’s Google Docs app to finish an eight-page paper for a class at Albany.

Some dogged enthusiasm helped sell Verse, yes. But Florida State’s relatively dire predicament did, too. “All I know is hard work,” Verse says. “That’s just how I am. When someone puts in that much work and you know what kind of people they’re bringing in, you know it’s going to be a good program. You know no matter what their record was – this is somewhere I want to be.”

Still, though transfers remain a boon – receiver Keon Coleman was the breakout star of the LSU win, months after leaving Michigan State – Norvell pushes back on the notion of winning primarily due to instant, ready-made talent infusions.

He points to Patrick Payton, the redshirt sophomore defensive end typically opposite Verse, the future first-round NFL Draft pick. Payton was a four-star prospect from Miami, sure, but he also was ranked 155th in the country, a 205-pound, all-gas-no-brakes player likely too lean and too raw to contribute immediately. “Speed, speed, speed, every time,” Payton says.

Florida State’s coaching staff called or texted every day anyway. He redshirted his first season – a personal disappointment for the player – as he learned how to use his hands, among other things, to contend with college-level offensive linemen. By the end of 2022, Payton was Florida State’s first ACC Defensive Rookie of the Year in a decade. “When I had those dark days, (Norvell) still was pushing, pushing, pushing,” Payton says. “After the season, I looked back, and I saw they were real for that.”

Florida State’s 2023 recruiting haul was its highest ranked since Norvell’s arrival – 16th nationally, according to 247 Sports’ ratings – and contributed to the depth of talent raising the competitive level internally during the preseason. “You got top guys on both sides of the ball you can learn from,” linebacker Kalen DeLoach says. But the roster is not an entirely instant-mix product. It’s a lot of solid projection and attentive follow-through.

“It’s still about who,” Norvell says. “The talent is one thing. But who’s behind the talent?”

There is that, yes.

It is not because things went smoothly that a crowd gathered in a Twitter Space to rage about Norvell in December 2022. The transition was an emery-board rub to people outside the building … and many people inside it. The on-field results reflected the latter. “When he first got here, everybody was against him; a lot of people were selfish,” offensive lineman Maurice Smith says. “He had to get through that and weed out the cancers in the group.”

Even when it was a subtle revolt, it was insidious enough. Players who were disinclined to give the best practice looks if they weren’t seeing the field enough, and so forth, eroding the foundation. “In the moment, you didn’t notice that,” running back Lawrance Toafili says. “Until you see the change. I saw the change once everybody started to see how it works. How the work works.”

That word greets Florida State each day, to the left of the ramp to the practice fields: WORK. It’s the only catchphrase splashed on the only way into the area. The one sign with directions for the way through.

“A lot of coaches, one day they’ll be hyped, the next day it’ll be less,” Verse says. “Even with him, I’m sure that happens … but you can never tell. Because he doesn’t do fake energy.”

Or as Smith puts it: “Now nobody complains. Everybody just follows what he says. We were against him, and, obviously, he proved us wrong.”


Florida State coach Mike Norvell, 41, is 21-16 in his fourth season with the No. 4 Seminoles. (Joe Petro / Icon Sportswire via Getty Images)

On Aug. 2, Florida State had a moment.

As conference realignment roiled, a Board of Trustees meeting convened and the school’s president declared the shake-ups in the Big Ten and SEC had plunged Seminoles athletics into an “existential crisis,” saying Florida State would have to leave the ACC “unless there were a radical change to the revenue distribution,” which prompted one trustee to propose the school build and execute a strategy to leave the ACC within a year. This didn’t materialize – or at least Florida State didn’t give the ACC the requisite notice by an Aug. 15 deadline – but the school wound up as one of a trio unapologetically opposed to the league’s eventual annexation of Stanford, Cal and SMU.

Sound and fury. War chant, indeed.

Curiously, the discussion did not involve the man most responsible for making Florida State’s best case. But then Mike Norvell is accustomed to existing in the middle of all the noise.

“Control the controllables,” he says. “That’s what I’m here trying to do every day. That’s been my focus. I get to do this with some great people. Got a wonderful administration, from the president, board of trustees, athletic director, just all that represents Florida State. I let them handle that. If I’m ever needed in a conversation, I’m always available. But I’ve got a job to do.”

Not too long after he said that, his team scored 31 straight second-half points to beat then-No. 5 LSU. More than 10 million people, at the peak, bore witness on television. The Seminoles vaulted into the top 5 of the national rankings for the first time in seven years. Then came a trip to Boston College two weeks later, with yet another hurricane churning nearby along the Atlantic coast. Florida State nearly blew a three-touchdown lead before escaping with a 31-29 win against a mediocre and masochistic outfit; Boston College committed an absurd 18 penalties, including a disastrous face mask on a third-down stop with a minute left to play. The Seminoles ran out the clock. They could not avoid the juxtaposition of their two games against power conference teams, something that the head coach seemed altogether too aware of.

“That game didn’t need to be what it was,” Norvell said during his weekly news conference Monday. “But maybe it was just the thing we needed to show the importance of every snap, every rep, every opportunity. I think our guys, they got the message. And now we have to go do something about it.”

On Saturday, a vulnerable but capable Clemson team awaits, at home in Death Valley and parked just outside the national polls. Beat the Tigers, and the imaginations start running wild again. Florida State can claim to be everything it insists it is. Fall short, and the Seminoles are far from dismissable … but they also spend the next two months clambering to recapture what they found against LSU, only to let it slip too quickly.

Mike Norvell’s team has gone up fast. Now it has to avoid the long way down. We’ll see if Florida State can hear its coach through the noise.

(Illustration: John Bradford / The Athletic; photos: Maddie Meyer, Joe Robbins / Getty Images)

The Reach of Wildfire Smoke Is Going Global and Undoing Progress on Clean Air

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On the heels of an exceptionally fiery and smoky summer, two new reports released Wednesday confirmed what many Americans have been already seeing and breathing.

Smoke from increasingly frequent and increasingly large fires has started to undo decades of hard-won gains in air quality, and the problem is expected to only get worse, not just in the United States but also around the world.

More than two billion people were exposed to at least a day of fire-related air pollution each year between 2010 and 2019, a report from researchers in Australia found. And in the United States, wildfires have undone about 25 percent of past progress in cleaning up air pollution in states from coast to coast.

“People have known that it’s becoming a bigger issue in the Western states,” said Marissa Childs, a fellow at Harvard University’s Center for the Environment and a co-author of the study that focused on the United States. “But I was really shocked when we were running some of these estimates and seeing that states all the way to the East Coast were being influenced.”

While her paper doesn’t include data from 2023, Dr. Childs said the wildfires in Canada and subsequent smoke over large swaths of the northern United States this year had shown “more than ever” that everyone is going to be affected by the growing problem of wildfires, no matter where they live.

Climate change is one of the driving forces behind worsening fires worldwide. As the atmosphere warms, many forests and other natural ecosystems are becoming drier and more prone to catching on fire. “It’s just so clear that, sometime in the last five to 10 years, something’s changed,” said Marshall Burke, a professor of environmental policy at Stanford University and a co-author of the report that focused on the United States. “You don’t have to cook the books.”

Together, the two studies show how wildfires are a growing health threat. Wildfire smoke can contain a variety of pollutants, including fine particulate matter, or PM 2.5, a type of air pollution made up of very small particles that can invade the lungs and bloodstream.

Thanks to the Clean Air Act, air pollution in the United States has generally improved since the 1970s. But levels of PM 2.5, which are routinely tracked by the Environmental Protection Agency and had been declining, took a marked turn back up around 2016.

Since 2016, wildfire smoke has had a statistically significant effect on PM 2.5 trends in 35 out of 48 continental states, according to Dr. Burke and Dr. Childs’s study. (The data set did not include Alaska or Hawaii.) The effect was most notable on the West Coast, where air quality has worsened drastically in recent years. But even in some New England states, smoke caused pollution levels to plateau after many years of decline.

Although the air is now cleaner in the United States than in many other parts of the world, air pollution remains a problem for public health. “It’s pretty clear that wildfire smoke is affecting a lot more people on a lot more days than it used to,” said Christopher Tessum, a professor of environmental engineering at the University of Illinois Urbana-Champaign who researches air pollution but wasn’t involved in either study.

Globally, pollution from fires is taking a bigger toll on residents of poorer countries.

The study that was led by scientists from Monash University in Australia found that each year between 2010 and 2019, every person worldwide had an average of almost 10 days of wildfire smoke exposure. The concentration of polluted air was significantly higher in poorer countries, the researchers found.

Smoke exposure between 2010 and 2019 was also higher than during the decade prior, and it underscores the prevalence and health risks of wildfires.

“We need to put a lot more resources to low-income countries to fight the fire smoke,” said Yuming Guo, an environmental expert at Monash who co-wrote the study.

The study incorporated data from both wildfires and those planned or controlled by people, such as prescribed burns. The researchers used a number of sources to collect data on pollution, and examined ground-level ozone levels in addition to levels of PM 2.5 While ozone high in the atmosphere protects us from harmful radiation, ozone close to the ground can cause breathing problems and can aggravate respiratory illnesses like asthma, bronchitis and emphysema.

Countries with hot and dry conditions that make them vulnerable to wildfires were particularly choked by PM 2.5, including those in central Africa, Southeast Asia and South America.

“Different countries experience different fire smoke,” Dr. Guo said. “So different countries should deploy different resources.”

Determining what approaches to use is going to be a complicated effort anywhere.

“It can’t be done the way that we’ve dealt with, say, industrial pollution or cars,” said Colleen Reid, a professor of geography at the University of Colorado, Boulder, who studies the health impacts of wildfires, but was not involved in either of the papers released Wednesday. “There’s not like a scrubber or a catalytic converter, some sort of technological thing you can put on a wildfire.”

“While we work on policy solutions to try and deal with wildfires, we also can protect people’s health by investing in better air quality in indoor spaces,” Dr. Reid added, noting that it was important to make sure people knew how to protect themselves outside on smoky days by wearing masks or respirators. She also emphasized the importance of tackling climate change.

“In addition to all the policies to address wildfire smoke, obviously we need significant change to decrease our greenhouse gas emissions,” she said, “so we can try to deal with the climate side of the equation that’s increasing wildfire risk.”

Disney Plans to Spend $60 Billion on Parks and Cruises

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Disney’s theme parks will generate an estimated $10 billion in profit this year, up from $2.2 billion a decade ago. Not bad for a 68-year-old business, especially considering the devastation wrought by the pandemic just a couple of years ago.

But how much boom is left?

Last month, when Robert A. Iger, Disney’s chief executive officer, singled out the parks division as “a key growth engine” on an earnings-related conference call, Wall Street furrowed its brow. Disneyland in Anaheim, Calif., has long been viewed as maxed out, with little room to expand. Walt Disney World near Orlando, Fla., has become a question mark, given that Mr. Iger has said the company’s legal battle with Florida’s governor, Ron DeSantis, could imperil $17 billion in planned expansion at the resort over the next decade. Disney’s overseas parks — aside from Tokyo Disney Resort, which it receives royalties from but does not own — have sometimes struggled to turn a profit.

On Tuesday, Disney offered a clearer picture of the opportunity it sees, which can only be described as colossal: The company disclosed in a security filing that it planned to spend roughly $60 billion over the next decade to expand its domestic and international parks and to continue building Disney Cruise Line. That amount is double what Disney spent on parks and the cruise line over the past decade, which was itself a period of greatly increased investment.

In the past decade, Disney has opened the Shanghai Disney Resort, more than doubled its cruise line capacity and added rides based on intellectual properties like “Star Wars,” “Guardians of the Galaxy,” “Tron,” Spider-Man, “Avatar” and “Toy Story” to its domestic parks. Disney has also poured money into its Paris and Hong Kong parks, with themed expansions tied to “Frozen” and other Disney films scheduled to open soon. Three more ocean liners are on the way, bringing the Disney fleet to eight ships, and Disney is nearing completion of a new port on a Bahamian island. (Disney already has one private island port.)

If that is what $30 billion can buy, imagine what $60 billion might bring.

“There are far fewer limits to our parks business than people think,” Mr. Iger said in an email.

“The growth trajectory is very compelling if we do nothing beyond what we have already committed,” he continued, referring to attractions and ships that have been announced but are not yet operational. “By dramatically increasing our investment — building big, being ambitious, maintaining quality and high standards and using our most popular I.P. — it will be turbocharged.”

Disney shares fell 3 percent on Tuesday on the news, to about $82. Analysts said some investors had been worried about the company’s ability to generate free cash flow at a time when its television business — traditionally a major generator of cash — has been undercut by streaming services.

Disney already has a sizable amount of debt, largely because of the pandemic. The company suspended its semiannual shareholder dividend in 2020 to preserve cash, but is expected to restart dividend payments later this year.

“We’re incredibly mindful of the financial underpinning of the company, the need to continue to grow in terms of bottom line, the need to invest wisely so that we’re increasing the returns on invested capital, and the need to maintain a balance sheet, for a variety of reasons,” Mr. Iger said on Tuesday afternoon in a blog post.

Disney is expanding the investment after a stretch of trouble in almost all its divisions. Cable television, including ESPN, has become a shadow of its former self, the result of cord cutting, advertising weakness and rising sports programming costs. Disney had a disappointing summer at the box office, with movies like “Indiana Jones and the Dial of Destiny” and “Haunted Mansion” selling sharply fewer tickets than anticipated. The company’s Disney+ streaming service continues to lose money; Mr. Iger has said it will be profitable by fall 2024, but some investors are skeptical.

In contrast, Disney’s parks and cruise business has been a bright spot, in many ways propping up the whole company. In the most recent quarter, Disney Parks, Experiences and Products generated $2.4 billion in operating income, an 11 percent increase from a year earlier. Disney Media and Entertainment Distribution had $1.1 billion in operating profit, an 18 percent decline.

Spending per guest at Disney parks has increased 42 percent since 2019, in part because of higher prices for tickets, food, merchandise and hotel rooms.

Still, increased investment in theme parks brings increased risk. It is a business that will always be sensitive to factors beyond Disney’s control: swings in the economy, gas prices, hurricanes, earthquakes, tension between the United States and China. Disney has greatly increased security, deploying undercover guards and installing metal detectors, but these teeming resorts — Disney parks attracted an estimated 121 million visitors last year — could become ghost towns if a violent event took place.

Josh D’Amaro, chairman of Disney Parks, Experiences and Products, said people who focused on such risks overlooked the resilience of theme park fans. He noted that customers had come flooding back when Disney parks reopened during the pandemic.

“Every time there has been a moment of crisis or concern, we have managed to bounce back faster than anyone expected,” he said.

Mr. D’Amaro declined to specify how the company planned to spend the $60 billion. But he gave hints, noting that Disney movies like “Coco,” “Zootopia,” “Encanto” and others had not yet been incorporated into the company’s parks in meaningful ways.

“Imagine bringing Wakanda to life,” he said, referring to the fictional “Black Panther” kingdom. “In terms of bringing the latest Disney-Marvel-Pixar intellectual property to the parks, we haven’t come close to scratching the surface. And we have learned that incorporating Disney I.P. increases the return on investment significantly.”

Disney owns 1,000 undeveloped acres across its existing theme park resorts, Mr. D’Amaro noted. (For comparison, he said, that’s the size of seven Disneylands.) One of the biggest areas of opportunity, he said, involves the original Disneyland, which opened in 1955. If the company can persuade the City of Anaheim to change a plan, adopted in the 1990s, that limits where hotels, parking lots and attractions can be built, Disney intends to redevelop land adjacent to Disneyland, greatly expanding capacity. Disney also plans to turn a parking area south of the park into a themed shopping, dining and hotel district.

Disney released a 17,000-page environmental impact study for the project last week. The Anaheim City Council is expected to vote on the changes in mid- to late 2024.

How much Disney invests in Florida may depend on the courts, where the company is battling Mr. DeSantis and his allies for control over Disney World’s growth plan. Angered over Disney’s criticism of a Florida education law, Mr. DeSantis in April ended the company’s long-held ability to self-govern its 25,000-acre resort as if it were a county. Disney maintains that prior contracts preserve its ability to control development, however.

“We want to keep growing and investing and have ambitious plans in Florida,” Mr. D’Amaro said. “For the benefit of our guests, our cast members and the economy of central Florida, we hope the conditions will be there for us to do so.” He declined to comment further.

At the moment, Disney does not plan to build parks in new countries or cities. (In the past, the company looked at building a park in India, for instance, and expanding beyond Hong Kong and Shanghai in China.) Rather, the company will focus on developing new ports for its ships.

Starting in 2025, a new cruise ship — the biggest in Disney’s fleet so far, with space for more than 6,000 guests — will be based in Singapore. Disney’s ships have grown increasingly themed, with characters and artwork from franchises like “Frozen,” “Star Wars” and Marvel’s Avengers incorporated into restaurants and entertainment zones.

“It’s like bringing a theme park to a new part of the world,” Mr. D’Amaro said of Disney Cruise Line, which has recently been booked to 98 percent of capacity.

Load management has frustrated NBA, fans and TV partners, but will new rules help?

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For the past several years it has not been clear if the NBA fully understood the damage that the league and players were creating as a result of the load management that was becoming more and more fashionable.

Teams and players were “following the science.” Anyone who complained too loudly on behalf of the fans was dismissed as a curmudgeonly dinosaur who didn’t understand the advancements in research and data that have come along in the last decade-plus.

It appears as if, finally, a reckoning has arrived.

When commissioner Adam Silver stood behind a podium last week to discuss the league’s new fight against load management, it was a recognition of the precarious position the league finds itself in with fans and television partners about a product that has, too often in recent seasons, left the two most important outside stakeholders feeling slighted during the regular season when a star or multiple stars sat out.

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NBA board of governors approves new star rest policy

“There’s a sense from all the different constituent groups in the league that this is ultimately about the fans and we’ve taken this too far,” Silver said. “This is an acknowledgment that it’s gotten away from us a bit, and that, particularly I think when you see young, healthy players who are resting and it becomes maybe even more a notion of stature around the league as opposed to absolute needed rest, or it’s part of being an NBA player that you rest on certain days.

“That’s what we’re trying to move away from.”

It was quite the populist stance for Silver to take. Fans have belabored the practice of resting healthy players for years, gnashing their teeth when they purchase tickets for a game only to find out shortly before tipoff that a high-profile player was sitting out to rest. Though the conversations have not often been public, one would assume executives for ESPN and TNT weren’t happy either when those players sat out games in which they paid billions to broadcast.

Silver has said in the past that load management was an issue for the league, But in February, at the All-Star game in Salt Lake City, he defended the practice and said there was “medical data” to support teams giving their most important players a day off here and there.

“This year we’re going to likely break the all-time record for ticket sales,” Silver said at All-Star Weekend. “We’re likely going to have the all-time record for season-ticket renewals. So our fans aren’t necessarily suggesting that they’re that upset with the product that we’re presenting.”

Seven months later, he is singing a bit of a different tune.

“Everyone is acknowledging this is an issue,” Silver said after the league’s board of governors approved a new star rest policy that is aimed at curtailing the resting of healthy stars for nationally televised games, “and it’s an issue for the fans.”

Everyone is acknowledging this is an issue right now because the landscape appears to be rapidly changing around the league. For more than a year, team executives have been putting together long-term salary cap strategies that operate under the assumption that the cap will continue to rise dramatically, especially after the NBA agrees on a new television contract. The NBA’s current $24 billion deal with ESPN and Warner Bros. Discovery (the parent company of TNT), is set to expire at the end of the 2024-25 season.

When the current contract was agreed upon in 2014, the sheer size of it came as a shock to many. Conversations in league circles over the last couple of seasons have included estimates that the new deal could triple in size as live sports become more and more important to networks that are trying to keep viewers’ attention in the modern content consumption business.

That doesn’t feel quite so certain anymore after a recent standoff between Charter Communications and Disney that led to more than 15 million cable subscribers losing access to ABC, Disney, ESPN and many more channels earlier this month. The issue was resolved, but it was the first real sign that the seemingly boundless leverage ESPN could exert over its distributors was being challenged for the first time. Add to that the crumbling of regional sports networks and the shift of viewing habits to streaming and there is volatility under the league’s feet when it comes to how to get their games in front of more eyeballs.

So now that the NBA is taking multiple steps to address one of the most scrutinized aspects of its game, it is doing so out of necessity more than epiphany. The board of governors adopted this new rest policy that states that teams must ensure star players are available for national television and In-Season Tournament games and must maintain a balance between the number of one-game absences for a star player in road and home games, with a preference for such absences to occur at home.

The NBA also put into its new collective bargaining agreement a clause that requires players to play at least 65 games to qualify for MVP and All-NBA honors. This is to incentivize players who can trigger escalators in contracts by winning those awards to appear in as many games as possible.

The advent of the In-Season Tournament is yet another sign that the league knows its regular season needs a jolt. If the NBA is going to command enormous money from TV partners that are no longer as bulletproof as they once were, it can no longer get away with some of the resting practices the league was employing.

“There’s an acknowledgment across the league that we need to return to that principle, that this is an 82-game league. … There’s a statement of a principle that if you’re a healthy player in this league, the expectation is that you’re going to play,” Silver said.

That just has not been the case in recent years. Last season Boston’s Jayson Tatum played 74 games. He was the only player on the All-NBA first or second team who played at least 70. The 15 players who made up the three All-NBA teams played in 1,002 of a possible 1,230 games. In 2021-22, those 15 players appeared in 1,010 total games. In addition, there were scores of games missed by other All-Star players who were not All-NBA.

Many of those games were missed for legitimate injury reasons, but the steps the league has taken this offseason suggest that it believes the optics of healthy players sitting out is a serious issue. Silver said the league understands that some players need to rest so that they are healthy for the playoffs, which is the NBA’s most important product. Older players, including LeBron James and Stephen Curry, might need games off so that they can preserve their bodies for the deep playoff runs they hope to make. But the league doesn’t want Anthony Davis sitting on the same night as James with the Lakers or Klay Thompson and Draymond Green sitting right next to Curry in street clothes, which is something the Warriors have done.

Sports science has exploded throughout the league in recent years, with teams hiring more people in the field to examine how players are eating, training, sleeping and, yes, resting. The motivation is noble. More than any other league, the NBA has grown in popularity across the globe on the strength of the allure of its star players. James, Curry, Giannis Antetokounmpo, Luka Dončić and so many more faces are the primary attractions. They are bigger brands than the teams for which they play.

In the interest of preserving the moneymakers and extending their careers, teams have expanded their medical and athletic training staffs to find new and innovative ways of keeping their players on the court.

The 82-game season is an incredible grind on players, which can chew up their bodies before the most important time of year for the league: the playoffs. Home-road back-to-back games, stretches of three games in four nights or four in seven are taxing, not to mention arriving at a hotel at 3 a.m. to play a game later that night. Add to it the absurd workload that so many of the league’s players experienced in the relentless AAU circuit as kids, and it’s challenging for teams to keep them on the court and on television.

Interestingly, Silver said last week that “frankly, the science is inconclusive” as to whether load management keeps players healthy over the long haul.

“The correlation isn’t there,” he said.

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Let’s talk load management: Is it a problem? How do we know it works?

But there is no doubt that many teams think otherwise, or there would be no reason to institute policies like the one adopted last week to try to discourage teams from either resting a star in nationally televised games or resting multiple stars in any game. Silver said the NBA is not trying to infringe on teams’ game-to-game strategies, saying there would be a gradual application of the new rules to allow teams time to adjust. He also made it clear that the league can no longer sit idle, too.

Shortening the season is not an option. That would cost too much money. So it’s time to lace up.

“We’re trying to deal with some of the most egregious examples,” Silver said. “We’re letting down the fans, we’re letting down our partners by doing that.”

Some players, including Curry, have said that the load management trend has been something instituted and dictated by teams, not the players. Silver said last week that there is a belief in some circles that a certain segment of players see it as a symbol of status that they are worthy of being rested on a given night. Either way, the league and the players have a lot to lose if they do not find a way to reduce the frustration of fans and television partners on this front.

Years ago, the late Minnesota Timberwolves president and coach Flip Saunders would often speak about the league missing the bigger picture as load management became fashionable. In the never-ending pursuit of a competitive edge, Saunders believed that the league was risking alienating fans and television partners and forgetting that, first and foremost, NBA basketball is in the entertainment business.

“No doubt we are a business and part of the issue, in some cases those (television) partners are a proxy for fans. … In terms of the scale of the audience we’re reaching when we’re a network game, don’t rest your players on that night and don’t rest multiple star players on any night,” Silver said.

As the league negotiates a new television rights deal with traditional networks and also considers options from tech giants like Apple and Amazon, it appears that the bigger picture is finally coming into clearer focus. If the league wants to continue to maximize revenue, the product it is selling has to feature its headline acts as often as possible.

(Photo of Paul George and Kawhi Leonard: Adam Pantozzi / NBAE via Getty Images)

King Charles III to be treated for prostate condition, know the signs and symptoms of the cancer found in men

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Prostate cancer is the most common cancer found in men. 

King Charles III is one public figure who has been open about his prostate procedure.

Buckingham Palace announced that the king would receive hospital treatment for an enlarged prostate, a condition also very common in men. 

KING CHARLES II TO UNDERGO ‘CORRECTIVE PROCEDURE’ NEXT WEEK FOR AN ENLARGED PROSTATE

The king’s condition is benign, and a “corrective procedure” is being conducted due to the enlargement, the palace said.

The only type of cancer more common than prostate cancer is skin cancer, according to the American Cancer Society. 

King Charles III will undergo hospital treatment for his enlarged prostate. (Chris Jackson/Getty Images)

This common cancer is treatable when caught early, with a near 100%, five-year survival rate for cancers that have not spread beyond the prostate or have only spread to nearby areas, per the American Cancer Society (ACS). 

Symptoms of prostate cancer are usually minimal or not experienced at all. 

One in eight men will be diagnosed with prostate cancer in their lifetime, according to the source.  

9 PROSTATE CANCER MYTHS, DEBUNKED

The survival rate plummets to 32% among stage IV cancer cases, when the disease spreads to distant parts of the body.

King Charles III on a walkabout outside Buckingham Palace, London

King Charles III on a walkabout outside Buckingham Palace, London, to meet wellwishers on Friday, May 5, 2023, ahead of the coronation. (James Manning/PA Images via Getty Images)

Below is all you need to know about prostate cancer.

  1. What is prostate cancer?
  2. What are the types of prostate cancer?
  3. What are the signs and symptoms?
  4. What are some prostate cancer risk factors?
  5. What should you do if you think you have prostate cancer?
  6. What should I know about PSA screening?
  7. Is prostate cancer curable?

1. What is prostate cancer?

Any type of cancer starts when cells grow out of control in certain parts of the body. Nearly every part of the body can be affected by cancerous cells, and they can then spread to other areas. 

man at doctor

Prostate cancer impacts one out of eight men in their lifetimes, according to the American Cancer Society. (iStock)

Prostate cancer is a type of cancer found in men that begins in the prostate gland and can then grow beyond that in more severe cases. 

2. What are the types of prostate cancer?

Most commonly, prostate cancer is adenocarcinomas, meaning it develops in the gland cells, according to ACS.

MOST MEN DIAGNOSED WITH PROSTATE CANCER DON’T NEED TO RUSH TO SURGERY, RADIATION TREATMENTS: STUDY 

There are other types of prostate cancer, according to the source, but these are rare. 

Other types are small cell carcinoma, neuroendocrine tumors, transitional cell carcinomas and sarcomas.

Man at doctor's office

Although symptoms are not always experienced by those with prostate cancer, two common symptoms are pain in the bones and weight loss. (iStock)

In general, prostate cancer grows very slowly. 

Many people who have it die from other causes without ever knowing that they had the cancer, according to the ACS.

3. What are the signs and symptoms?

“The most common symptom is no symptom at all,” Dr. Christopher Anderson, a urologist with New York-Presbyterian/Columbia University Irving Medical Center, told Fox News in 2017.

Some men may experience symptoms like pain in their bones and weight loss when the cancer has already spread, Anderson said.

THE DO’S AND DON’TS OF THE PROSTATE CANCER DIET

Dr. Philip Kantoff, a medical oncologist and chair of the department of medicine at Memorial Sloan Kettering Cancer Center, reiterated that the disease does not typically cause symptoms. Symptoms could instead be due to an enlarged or inflamed prostate, neither of which are cancerous.

Dr. Ketan Badani, vice chairman of urology at Mount Sinai Health System, said that “some patients may have vague urinary complaints,” like having to urinate more frequently, and that there are no symptoms until the disease is advanced. The majority of men who have urinary issues do not have prostate cancer, he noted.

Doctor with patient

If symptoms are experienced, it may not be due to prostate cancer, but rather another underlying problem, like an enlarged prostate. (iStock)

Advanced cases of prostate cancer may present with symptoms “with benign prostate conditions, including weak or interrupted urine flow; difficulty starting or stopping urine flow; the need to urinate frequently, especially at night; blood in the urine; or pain or burning with urination,” per the ACS.

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Additional symptoms include pain in the hips, ribs and chest, as well as numbness or weakness in the legs or feet.

4. What are some prostate cancer risk factors?

Men ages 60 to 74 are considered more at risk, according to the SEER program. 

Family history, “especially a first-degree relative like a father or brother” who has been diagnosed, is another concern, Badani added.

African, Afro-Caribbean, South Asian and Hispanic men are more at risk for “more aggressive” forms of prostate cancer, he said.

Prostate cancer definition

If you are experiencing symptoms, it is important to have a conversation with your doctor. ( istock)

For men of African descent, there is an increased risk of both prostate cancer diagnosis and dying from prostate cancer, Anderson said.

5. What should you do if you think you have prostate cancer?

“A discussion with your physician is warranted before symptoms occur,” Kantoff advised, adding that men should decide with their doctors if a prostate-specific antigen (PSA) test, which looks at the level of PSA in blood, is right for them.

Badani recommended that men receive both annual digital rectal exams and PSA tests. Multiple PSA tests over time are a better indicator of potential concerns as opposed to a single test result, he explained.

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If you are concerned you might have prostate cancer, speak to an internal medicine doctor or a urologist, Anderson recommended. He stressed that all patients with blood in their urine should see a urologist.

6. What should I know about PSA screening?

PSA screening has been a controversial topic in the past. In 2012, the U.S. Preventative Services Task Force recommended against PSA screening when it said “there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.”

PSA screening involves a simple blood test for elevated levels of a protein that may signal cancer but can also be caused by an enlarged or inflamed prostate. It can find cancer that does not need to be treated, as it is too small and slow-growing to become deadly. Radiation or surgery to remove the prostate may result in impotence and incontinence.

In 2018, the task force said in its final recommendation that men ages 55 to 69 should discuss potential benefits and negatives of a PSA screening with their physician before undergoing the test. 

psa test prostate cancer

PSA testing is a way to diagnose prostate cancer. (iStock)

While a PSA screening has the potential to reduce the risk of death, negatives listed by the task force include “false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction.”

They do not recommend PSA screening in men ages 70 and above.

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“Proper use of PSA is what I recommend from an early detection standpoint,” Kantoff said.

Symptoms should not be the motivating factor for screening, he said, saying it should instead be a decision in one’s 40s about whether PSA testing should be done. He recommended that those with a family history or people of African American descent think about early detection.

An analysis of previous clinical trials published in 2017 said screening lessened the risk of dying from prostate cancer by 25 to 32% compared to men who did not get screened, a summary for patients explains online. 

7. Is prostate cancer curable?

Prostate cancer is curable, but many men choose not to treat it because of the typically slow progression and the fact that it usually stays in the prostate, according to Cleveland Clinic.  

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More severe cases of cancer are usually treated through radiation or surgery. 

The Associated Press contributed reporting, as did Andy Sahadeo and Zoe Szathmary. 

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All about ovarian cancer and how to reduce your risk

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Ovarian cancer is a type of cancer that impacts the female reproductive system. 

The risk of developing ovarian cancer in a woman’s lifetime is 1 in 87, according to the American Cancer Society (ACS). 

It’s most commonly seen in older women, particularly over age 63. 

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Ovarian Cancer Awareness Month is recognized every September. During the month and all year round, it’s important to spread awareness about ovarian cancer and donate to organizations that conduct vital research regarding the disease. 

Below is more information about ovarian cancer. 

  1. What is ovarian cancer?
  2. How is ovarian cancer usually detected?
  3. What are early warning signs of ovarian cancer?
  4. What should I do if I think I have symptoms?
  5. What should I know about risk reduction of ovarian cancer?
  6. What should I know about risk factors for ovarian cancer?
  7. Is ovarian cancer curable?
  8. What age is ovarian cancer most common?

September is recognized as Ovarian Cancer Awareness Month. (iStock)

1. What is ovarian cancer?

Ovarian cancer is a cancer diagnosis specific to women. The type of cancer is found when abnormal cells form in the ovaries or fallopian tubes.

The female reproductive system has two ovaries, one on each side of the uterus. The ovaries produce eggs and also release estrogen and progesterone.

SOME BREAST CANCER PATIENTS COULD BE AT RISK OF ANOTHER TYPE OF CANCER, STUDY REVEALS

When the cells, specifically in the ovaries, start to grow in an uncontrolled way, this is when ovarian cancer is usually detected. 

2. How is ovarian cancer usually detected?

There is no screening test for ovarian cancer.

The ACS says efforts to develop a comprehensive screening test have not yielded “much success so far.” 

The organization, however, provides two options in lieu of a comprehensive screening test: a transvaginal ultrasound (TVUS) and a CA-125 blood test.

Doctor holding a model of female reproductive organs

Ovarian cancer impacts a woman’s reproductive organs. (iStock)

A TVUS “uses sound waves to look at the uterus, fallopian tubes and ovaries by putting an ultrasound wand into the vagina.” Though the test can detect tumors in the ovaries, it is unable to detect whether the tumor is benign or not.

The CA-125 blood test measures the amount of the CA-125 protein in the blood. While researchers have found elevated levels of the protein in women with ovarian cancer, the ACS advises that high levels of the protein have also been found in women with “common conditions such as endometriosis and pelvic inflammatory disease” while further noting that not all women with ovarian cancer test for high levels of CA-125.

3. What are early warning signs of ovarian cancer?

There are not any specific signs of early stage ovarian cancer, Dr. Michael Worley, a surgical gynecological oncologist with Brigham and Women’s Hospital in Boston, previously told Fox News Digital.

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Ovarian cancer symptoms are often vague, Worley said. 

One symptom is losing or gaining weight.

Other symptoms may include abdominal bloating; bowel changes like diarrhea or constipation; bladder changes such as an increase in frequency or urgency; abdominal discomfort and pressure; and a sense of feeling full, Dr. Jamie Bakkum-Gamez, a gynecologic oncologist with the Mayo Clinic in Rochester, Minnesota, previously told Fox News.

4. What should I do if I think I have symptoms?

Often, symptoms associated with ovarian cancer can be difficult for women to spot as a lot of the symptoms are similar to those of a period or menopause. 

If symptoms persist, a woman should see a medical provider for a pelvic ultrasound, Bakkum-Gamez said, adding that women diagnosed should see a gynecologic oncologist.

Going to an OB-GYN “is a good place to start,” Worley said, explaining that an ultrasound or a CT scan may sometimes be ordered.

Woman with cramps

Signs of ovarian cancer are very similar to those that come with a period or menopause. (iStock)

5. What should I know about risk reduction of ovarian cancer?

For middle-aged women with the BRCA-1 gene, it is recommended they get their fallopian tubes tied and ovaries removed, per the CDC.

It is also recommended for women with the BRCA-2 gene, with different age guidelines.

CANCER TRENDS REVEALED, INCLUDING MOST COMMON TYPES OF THE DISEASE AND BIGGEST RISK FACTORS

Other aspects that may reduce a woman’s risk of ovarian cancer include giving birth, having a tubal ligation, having a hysterectomy, breast-feeding and using birth control pills, Bakkum-Gamez said.

Oral birth control is “by far the easiest way” to reduce risk, Worley said. 

The method, he explained, also “works relatively well for people with BRCA mutations,” noting there’s conflicting data about it increasing the risk of breast cancer and that these women should speak to their doctors.

Those who take oral birth control for five or more years have about a 50% lower risk of developing the cancer, according to the ACS. That being said, the pills come with other risks and side effects. Therefore, it is important to talk with your doctor about the risks before making your decision. 

Birth control pills

Taking oral birth control is one way to reduce your risk for ovarian cancer. (iStock)

Risk reduction from a hysterectomy “is a little more controversial,” Worley said, explaining that old data said the procedure didn’t reduce risk, while new data says it’s helpful. Just removing the uterus reduces ovarian risk, he said.

Furthermore, living a healthy lifestyle can help reduce your risk. This includes regular exercise, a healthy diet and avoiding smoking.

6. What should I know about risk factors for ovarian cancer?

One of the biggest risk factors for ovarian cancer is age, since it is typically found in older women.

Family history, not having children and an endometriosis diagnosis are among the risk factors for ovarian cancer, according to the CDC. 

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Others include having the BRCA-1 or BRCA-2 gene, which are linked to ovarian and breast cancer.

Additionally, Caucasians are more likely to be diagnosed with ovarian cancer. 

Early onset of menses and late menopause are also risk factors, according to Worley.

Women with a family history of ovarian, fallopian tube cancer and breast cancer “should really be thinking about seeing a genetic counselor,” Bakkum-Gamez said. “It may lead to potential prevention.”

Cancer in uterus

One of the biggest risk factors associated with ovarian cancer is age. (iStock)

7. Is ovarian cancer curable?

The earlier ovarian cancer is diagnosed in a woman, the more treatable the disease is. Typically, ovarian cancer is treated through surgery to remove the tumor and/or chemotherapy.

The life expectancy for someone with ovarian cancer is based on averages and also differs depending on the type of cancer that is present. 

The ACS outlines relative survival rates for ovarian cancer based on women diagnosed between 2012 and 2018. The five-year survival rates are broken down between the type of ovarian cancer, invasive epithelial, stromal or germ cell tumor, and also are sorted based on the stage of cancer, localized, regional and distant. 

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For someone with localized ovarian cancer, the cancer has not spread outside the ovaries. In regional ovarian cancer, it has spread outside but near the ovaries. Lastly, in distant ovarian cancer, it has spread to more distant parts of the body, such as the liver or the lungs.

The ACS says the five-year survival rate of all three stages combined in invasive epithelial ovarian cancer is 50%. This means that women with this type of ovarian cancer are 50% as likely as women who don’t have the cancer to live for at least five years after they are diagnosed.

A woman getting an ultrasound

Early detection is vital in treating ovarian cancer. (iStock)

The survival rate for ovarian stromal tumors of all three stages combined is 89%, according to the source, and the survival rate for germ cell tumors of the ovary, all stages combined, is 92%. 

Lastly, the five-year survival rate for fallopian tube cancer of all three stages combined is 55%.

8. What age is ovarian cancer most common?

One of the main factors that increases the risk of developing ovarian cancer is age. 

For women under the age of 40, their risk of ovarian cancer is rare. Half of all ovarian cancers are found in women 63 and older, according to the ACS.

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Most commonly, ovarian cancer develops after a woman reaches menopause.

Andy Sahadeo and Zoe Szathmary contributed reporting.