The New Old Age Blog: A Son Lost, a Mother Found

My friend Yvonne was already at the front door when I woke, so at first I didn’t realize that my mother was missing.

It was less than a week after my son Spencer died. Since that day, a constant stream of friends had been coming and going, bringing casseroles and soup, love, support and chatter. Mom hated it.

My 94-year-old mother, who has vascular dementia, has been living in my home in upstate New York for the past few years. Like many with dementia, mom is courteous but, underneath, irascible. Pride defines her, especially pride in her Phi Beta Kappa intellect. She hates to be confronted with how she has become, as she calls it, “stupid.”

The parade of strangers confused her. She had to be polite, field solicitous questions, endure mundane comments. She could not remember what was going on or why people were there. It must have been stressful and annoying.

That night, like every night since the state troopers brought the news, I woke hourly, tumbling in panic. As if it were not too late to save my son. Mom knew something was wrong, but she could not remember what. As I overslept that morning, she must have decided enough was enough. She was going home.

In a cold sky, the sun blazed over tall pines. As I opened the door, the dogs raced out to greet Yvonne and her two housecleaners. Yvonne often brags about her cleaning duo. They were her gift to me. They were going to clean my house before the funeral reception, which was scheduled for later that week. This was a very big gift because, like my mother before me, I am a very bad housekeeper.

Mom’s door was shut. I cautioned the housecleaners to avoid her room as I showed them around. Yvonne went to the kitchen to listen to the 37 unheard messages on my answering machine; the housecleaners went out to their van to get their instruments of dirt removal.

I ducked into Mom’s room to warn her about the upcoming noise. The bed was unmade; the floor was littered with crumpled tissues; the room was empty.

Normally, I would have freaked out right then. I knew Mom was not in the house, because I had just shown the whole house to the cleaners. Although Mom doesn’t wander like some dementia patients, she does on occasion run away. But I could not muster a shred of anxiety.

“Yvonne,” I called, “did you see my mother outside?”

Yvonne popped her head into the living room, eyebrows raised.“Outside? No!” She was alarmed. “Is she missing?”

“Yeah,” I said wearily, “I’ll look.” I stepped out onto the front porch, tightening the belt of my bathrobe and turning up the collar. Maybe she had walked off into the woods. The dogs danced around my legs, wanting breakfast.

I had no space left in my body to care. Either we would find her, or we would not. Either she was alive, or she was not. My child was gone. How could I care about anything ever again?

Then I saw my car was missing. My mouth fell open and my eyeballs rolled up to the right, gazing blindly at the abandoned bird’s nest on top of the porch light: What had I done with the keys?

Mom likes to run away in the car when she is angry. She used to do it a lot when my father was still alive — every time they fought. Since Mom took off in my car almost a year ago, after we had had a fight, I’d kept the keys hidden. Except for this week; this week, I had forgotten.

I was reverting to old habits. I had left the doors unlocked and the keys in the cupholder next to the driver’s seat. Exactly like Mom used to do.

“Uh-oh,” I said aloud. Mom was still capable of driving, even though she did not know where she was going. I just really, really hoped that she didn’t hurt anybody on the road. I pulled out my cellphone, about to call the police.

“Celia!” Yvonne shouted from the kitchen. She hurried up behind me, excited. “They found your mother. There are two messages on your machine.”

At that very moment, Mom was holed up at the College Diner in New Paltz, a 20-minute drive over the mountain, through the fields, left over the Wallkill River and away down Main Street.

Yvonne called the diner. They promised to keep the car keys until someone arrived. By that time, Yvonne had to go to work. She drove my friend Elizabeth to the diner, and Elizabeth drove Mom home in my car.

Half an hour later, they walked in the front door. Mom’s cheeks were rouged by the chill air and her eyes sparkled, her white hair riffing with static electricity. “Hello, hello,” she sang out. “Here we are.” She was wearing the flannel nightgown and robe I had dressed her in the night before. It was covered by her oversized purple parka, and her bare feet were shoved into sneakers.

I started laughing as soon as I saw her. I couldn’t help it. Elizabeth and Mom started laughing too. “You had a big adventure,” I said, hugging them both. “How are you?”

“I’m just marvelous,” said my mother. Mom always feels great after doing something rakish. We settled her on the sofa with her feet on the ottoman. By the time I got her blanket tucked in around her shoulders, she had fallen asleep.

Elizabeth couldn’t stop laughing as she described the scene. “Your mother was holding court in this big booth. She was sitting there in her nightgown and her parka, talking to everybody, with this plate of toast and coffee and, like, three of the staff hovering around her.”

The waitress said Mom seemed “a little disoriented” when she got there. Mom said she was meeting a friend for breakfast, but since she was wearing a nightgown and didn’t know whom she was meeting or where she lived, the staff thought there might be a problem. They convinced Mom to let them look in the glove compartment of the car, where they found my name and number.

It was then that I realized I was laughing – something I’d thought I would never be able to do again. “Elizabeth, Elizabeth, I’m laughing,” I said.

“Ha, ha, ha,” laughed Elizabeth, holding her belly.

“Ha, ha, ha,” I laughed, rolling on the floor.

And she who gave me life, who had suffered the death of my child and the extinction of her own intellect, snoozed on: oblivious, jubilant, still herself, still mine.

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Resignations Continue in Egypt as Tanks Deploy Around Presidential Palace





CAIRO — Resignations rocked the government of President Mohamed Morsi on Thursday as tanks from the special presidential guard took up positions around his palace and the state television headquarters after a night of street fighting between his Islamist supporters and their secular opponents that left at least 6 dead and 450 wounded.




The director of state broadcasting resigned Thursday, as did Rafik Habib, a Christian who was the vice president of the Muslim Brotherhood’s Freedom and Justice Party and the party’s favorite example of its commitment to tolerance and pluralism. Their departures followed an announcement by Zaghoul el-Balshi, the new general secretary of the commission overseeing a planned constitutional referendum, that he was quitting. “I will not participate in a referendum that spilled Egyptian blood,” he said in a television interview during the clashes late Wednesday night.


With the resignations on Thursday, nine Morsi administration officials have quit in protest in recent days.


Late in a day of tension and uncertainty, Mr. Morsi gave a nationally televised speech in which he refused to back down on plans to hold a public referendum on Dec. 15 to vote on a draft constitution approved by his Islamist allies over the objections of his secular opposition and the Coptic Christian Church.


The top scholar of Al Azhar, the center of Sunni Muslim learning that is considered Egypt’s chief moral authority, urged both sides to pull back from violence and seek “rational dialogue.”


About 1 p.m. Thursday, hundreds of his supporters who had camped outside his palace to defend it — many waking up with bandaged heads from wounds sustained from volleys of rocks and the blows of makeshift clubs the previous night — abruptly began to pull out of their encampment in unison, a development that suggested that their organizers in the Muslim Brotherhood had ordered a withdrawal. It took place just moments after several Brotherhood members camped there had vowed to stay put until the referendum, set for Dec. 15.


The Egyptian military, which seized power from Hosni Mubarak in February 2011, saying it was stepping in to protect the legitimate demands of the public, stayed silent after a statement Wednesday that it would not intervene in a dispute between political factions. The presidential guard that deployed Thursday is a separate unit that reports directly to the president.


Wednesday night’s battle was the worst clash between political factions here since the days of President Gamal Abdel Nasser’s military coup six decades ago, and Egyptians across the political spectrum responded with shock and dismay.


Abdel Moneim Aboul Fotouh, a popular former leader of the Muslim Brotherhood who ran for president as a liberal Islamist and has stayed on the sidelines of the escalating conflict between Mr. Morsi and his secular opponents, slammed the president and the Brotherhood for calling on their civilian supporters to defend the palace with force rather than relying the institutions of law enforcement.


“The palace is not a private property to the Muslim Brotherhood or Dr. Morsi; it belongs to us, all Egyptians,” Mr. Aboul Fotouh said in a televised news conference. He was flanked by a Morsi adviser who had just resigned and by a well-known revolutionary poet who is the son of Sheik Yusuf al-Qaradawi, perhaps the most influential religious scholar in the Sunni Muslim world and a spiritual guru to the Muslim Brotherhood.


Wednesday night’s clashes followed two weeks of sporadic violence around the country that erupted after Mr. Morsi, a former leader of the Muslim Brotherhood movement, seized temporary powers beyond the review of any court, removing the last check on his authority until ratification of the new constitution.


Mr. Morsi has said he needed the expanded powers to block a conspiracy by corrupt businessmen, Mubarak-appointed judges and opposition leaders to thwart Egypt’s transition to a constitutional democracy. Some opponents, Mr. Morsi’s advisers say, would sacrifice democracy to stop the Islamists from winning elections.


Mr. Morsi’s secular critics have accused Mr. Morsi and the Islamists of seeking to establish a new dictatorship, in part by ramming through a rushed constitution that they say could ultimately give new power over society to Muslim scholars and Islamists groups. And each side’s actions have confirmed the other’s fears.


Mai Ayyad contributed reporting.



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Zynga moves to enter US gambling market












NEW YORK (AP) — Online games company Zynga said it has asked Nevada gambling regulators for a decision that could pave the way for it to enter the U.S. gambling market.


This follows Zynga’s October disclosure that it has signed a deal to offer online poker and casino games, played with real money, in the U.K. It plans to launch those games in the first half of 2013.












Zynga Inc. said in an email late Wednesday that it is seeking an “application for a preliminary finding of suitability” from the Nevada Gaming Control Board. This, the company says, is part of its plan to enter regulated “real-money gaming,” that is, gambling markets.


Zynga has not said what it plans to do with a gaming license. But the company, whose games are played primarily on Facebook, has faltered in recent months and is looking for additional revenue sources beyond online games such as “FarmVille 2″ and “Words With Friends.”


The San Francisco-based company says the process with Nevada regulators should take 12 to 18 months. If Zynga passes the first regulatory hurdle, it can then apply for a gaming license in the state. That, the company said, takes two to three months.


Zynga’s stock rose 17 cents, or 7.1 percent, to close Thursday at $ 2.49. The company went public about a year ago, when its stock priced at $ 10 per share.


Gaming News Headlines – Yahoo! News


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Actor Stephen Baldwin charged in NY tax case


WHITE PLAINS, N.Y. (AP) — Actor Stephen Baldwin was charged Thursday with failing to pay New York state taxes for three years, amassing a $350,000 debt.


Rockland County District Attorney Thomas Zugibe said Baldwin, of Upper Grandview, skipped his taxes in 2008, 2009 and 2010.


The youngest of the four acting Baldwin brothers pleaded not guilty at an arraignment and was freed without bail. His lawyer, Russell Yankwitt, said Baldwin should not have been charged.


"Mr. Baldwin did not commit any crimes, and he's working with the district attorney's office and the New York State Tax Department to resolve any differences," Yankwitt said.


The district attorney said Baldwin could face up to four years in prison if convicted. The actor is due back in court on Feb. 5.


Zugibe said Baldwin owes more than $350,000 in tax and penalties.


"We cannot afford to allow wealthy residents to break the law by cheating on their taxes," the district attorney said. "The defendant's repetitive failure to file returns and pay taxes over a period of several years contributes to the sweeping cutbacks and closures in local government and in our schools."


Thomas Mattox, the state tax commissioner, said, "It is rare and unfortunate for a personal income tax case to require such strong enforcement measures."


Baldwin, 46, starred in 1995's "The Usual Suspects" and appeared in 1989's "Born on the Fourth of July." He is scheduled to appear in March on NBC's "The Celebrity Apprentice."


His brothers Alec, William and Daniel are also actors.


A bankruptcy filing in 2009 said Stephen Baldwin owed $1.2 million on two mortgages, $1 million in taxes and $70,000 on credit cards.


In October, Baldwin pleaded guilty in Manhattan to unlicensed driving and was ordered to pay a $75 fine. Earlier this year, he lost a $17 million civil case in New Orleans after claiming that actor Kevin Costner and a business partner duped him in a deal related to the cleanup of the 2010 Gulf of Mexico oil spill. The actors and others had formed a company that marketed devices that separate oil from water.


Baldwin co-hosts a radio show with conservative talk figure Kevin McCullough.


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Extended Use of Breast Cancer Drug Suggested


The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.


In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.


“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.


Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs might be taken for a longer duration as well.


“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”


Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.


Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.


About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them are in premenopausal women with estrogen receptor-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.


The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.


In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing 10 years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.


About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.


There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.


Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.


“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.


Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.


Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.


“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.


Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.


“They don’t feel well on them, but it’s their safety net,” said Dr. Garber, who added that the news would be welcomed by many patients who would like to stay on the drug. “I have patients who agonize about this, people who are coming to the end of their tamoxifen.”


Emily Behrend, who is a few months from finishing her five years on tamoxifen, said she would definitely consider another five years. “If it can keep the cancer away, I’m all for it,” said Ms. Behrend, 39, a single mother in Tomball, Tex. She is taking the antidepressant Effexor to help control the night sweats and hot flashes caused by tamoxifen.


Cost is not considered a huge barrier to taking tamoxifen longer because the drug can be obtained for less than $200 a year.


The results, while answering one question, raise many new ones, including whether even more than 10 years of treatment would be better still.


Perhaps the most important question is what the results mean for postmenopausal women. Even many women who are premenopausal at the time of diagnosis will pass through menopause by the time they finish their first five years of tamoxifen, or will have been pushed into menopause by chemotherapy.


Postmenopausal patients tend to take aromatase inhibitors like anastrozole or letrozole, which are more effective than tamoxifen at preventing breast cancer recurrence, though they do not work for premenopausal women.


Mr. Peto said he thought the results of the Atlas study would “apply to endocrine therapy in general,” meaning that 10 years of an aromatase inhibitor would be better than five years. Other doctors were not so sure.


The Atlas study was paid for by various organizations including the United States Army, the British government and AstraZeneca, which makes the brand-name version of tamoxifen.


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Senate Passes Russian Trade Bill, With a Human Rights Caveat


WASHINGTON — The Senate voted on Thursday to finally eliminate cold war-era trade restrictions on Russia, but at the same time it condemned Moscow for human rights abuses, threatening to further strain an already delicate relationship with the Kremlin.


The Senate bill, which passed the House last month, now goes to President Obama, who has opposed using United States trade policy to make a statement about the Russian government’s treatment of its people.


But with such overwhelming support in Congress — the measure passed the Senate 92 to 4 and the House 365 to 43 — the White House has had little leverage to press its case.


And President Obama has shown little desire to pick a fight in which he would appear to be siding with the Russians on such an issue.


In a statement issued after the Senate vote, the White House mentioned the human rights component of the bill only in passing, instead emphasizing that the president was looking forward to signing a measure that would level the playing field for American workers.


The most immediate effect of the bill would be to formally normalize trade relations with Russia after nearly 40 years. Since the 1970s, commerce between Russia and the United States has been subject to restrictions that were intended to punish Communist nations that kept their citizens from emigrating freely.


While presidents have waived the restrictions since the cold war ended — allowing them to remain on the books as a symbolic sore point with the Russians — the issue took on new urgency this summer after Russia joined the World Trade Organization. As part of its pact with the trade group, Russia lowered tariffs for other member countries, but only those that granted it normal trade status.


By some estimates, American exports to Russia are expected to double after its trade status is revised.


But another effect of the bill — and one that has Russian officials furious with Washington — will be to require that the federal government freeze the assets of Russians implicated in human rights abuses and deny them visas.


Lawmakers on Capitol Hill were inspired to attach those provisions to the trade legislation because of the case of Sergei L. Magnitsky, a Russian lawyer who sustained serious injuries and died in a Moscow detention center in 2009 after he accused government officials of a tax fraud scheme.


During the Senate debate, it was Mr. Magnitsky’s case, and not Russia’s trade status, that occupied most of the time.


One by one, Democratic and Republican senators alike rose to denounce Russian officials for their disregard for basic freedoms.


“This culture of impunity in Russia has been growing worse and worse,” said Senator John McCain, Republican of Arizona. “There are still many people who look at the Magnitsky Act as anti-Russia. I disagree,” he added. “Ultimately passing this legislation will place the United States squarely on the side of the Russian people and the right side of Russian history, which appears to be approaching a crossroads.”


In Moscow, the denunciation was swift, and legislators promised retaliation with a proposal of their own that would freeze the bank accounts of American human rights violators.


“This initiative is intended to restrict the rights of Russian citizens, which we consider completely unjust and baseless,” said Konstantin Dolgov, the Russian foreign ministry’s human rights envoy, in comments to the Interfax news agency in Brussels. “This is an attempt to interfere in our internal affairs, in the authority of Russia’s investigative and judicial organs, which continue to investigate the Magnitsky case.”


Russian officials have said that Mr. Magnitsky is not the hero his supporters make him out to be, and they have pursued posthumous tax evasion charges against him. And lately the case has taken some more unusual turns. One witness was recently found dead in Britain.


Initially the Senate faced some pressure to pass a bill that punished human rights violators from all nations, not just those who are Russian. But the House bill applied only to Russia. And the Senate followed suit, as supporters of the bill wanted something that would pass quickly and not require a complicated back-and-forth with the House.


But Senator Ben Cardin, a Democrat from Maryland who wrote the bill that would apply internationally to all nations, said the United States position on human rights abusers was unambiguous. “This bill is our standard,” he said. “The world is on notice.”


Ellen Barry contributed reporting from Moscow.



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Typhoon Bopha Kills Hundreds in Philippines


Bullit Marquez/Associated Press


A resident hung clothing amid fallen trees and debris on Wednesday, a day after Typhoon Bopha made landfall in the village of Andap, in southern Philippines. More Photos »







MANILA — With many roads and bridges washed away, rescue teams struggled Wednesday to reach isolated villages in the southern Philippines after a powerful out-of-season typhoon tore through the region, leaving more than 270 people dead and hundreds more missing, officials said.




Typhoon Bopha packed winds of up to 100 miles per hour when it struck Tuesday, bringing torrential rains that washed away villages and left thousands homeless.


The deaths were concentrated in the province of Compostela Valley, a mountainous gold mining area, and the neighboring province of Davao Oriental, on the eastern coast of the southern Philippine island of Mindanao, Lt. Col. Lyndon Paniza, a military spokesman, said in a telephone interview late Wednesday afternoon.


A national disaster official, Benito Ramos, said at a news conference on Wednesday afternoon that 274 people had died, 339 were injured and 279 were missing. Those figures were likely to rise, he suggested, since rescue workers had not yet reached several villages in the hardest-hit areas and the casualties there were not known.


Most of the dead appeared to have drowned or been hit by falling trees or flying debris, officials said.


“There is debris in the road, so our soldiers are moving by foot,” Colonel Paniza said. “They are crossing rivers and landslides. I don’t want to speculate, but we don’t know what they will find when they reach those cut off areas.”


Three soldiers are known to have died, and eight are missing, he said. Some of the soldiers died when a landslide washed out their patrol base, and others disappeared while on search-and-rescue operations.


Local television crews broadcast grisly footage of mud-covered bodies being loaded into trucks in villages that appeared flattened by the storm. In some areas, not a single structure could be seen standing.


In areas where roads were washed out, the government sent seagoing vessels to take relief goods to remote coastal areas from the provincial capital of Davao Oriental, Mati.


“I have thus authorized the local government of Mati, its mayor and the provincial governor to use their calamity funds to hire all available large, local fishing boats for an immediate sea-lift transfer of goods to the affected areas,” Manuel Roxas, the interior secretary, said in a statement.


The eastern coast of Mindanao, which was the area hardest hit by the storm, is a remote, impoverished agricultural area. Mr. Roxas told reporters on Wednesday that during his visit to the area, he had seen tens of thousands of fallen coconut trees and many acres of destroyed banana plantations.


In New Bataan, the town hit hardest by the storm, Virgilia Babaag had been waiting nervously in her home before dawn on Tuesday as hard rain from the approaching typhoon pounded her small village.


“My neighbors started yelling, ‘The water is coming fast! Run! Run!’ ” she said Wednesday by telephone.


Ms. Babaag gathered up her three young nieces staying with her and ran through the night toward high ground. There she stayed with dozens of others as winds ripped through the town.


“When I came back, my roof was gone,” she said from her devastated home. “The houses around my place are destroyed. There are so many who have died here. The soldiers are still finding more.”


The Philippines is hit by as many as 20 powerful tropical storms each year, but this one struck remote communities south of the usual typhoon path.


“This is the first time that the people in this area have experienced a storm like this,” Colonel Paniza said. “They aren’t accustomed to big storms.”


Last December, Tropical Storm Washi — another out-of-season storm that hit south of the usual Philippine typhoon belt — killed more than 1,200 people and left hundreds of thousands homeless.


This year, officials put out strong warnings days in advance and carried out mandatory early evacuations of vulnerable communities.


President Benigno S. Aquino III, stung by criticism last year that the national government had not done enough to prepare for Tropical Storm Washi, went on television the day before the storm hit and pleaded with people to follow the instructions of local government officials.


“I am facing you now because the incoming storm is no laughing matter,” Mr. Aquino said, adding later, “We expect the cooperation of everyone so that nobody gets in harm’s way.”


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Michael Strahan makes his Broadway debut in 'Elf'


NEW YORK (AP) — Michael Strahan has tackled something few football stars have attempted — Broadway.


The gap-toothed co-host of "Live with Kelly and Michael" made three short appearances at Wednesday's matinee of "Elf" and said he has new respect for Broadway performers.


"I was surprised at how nervous you get and the adrenaline and that feedback from the audience — it really was an amazing thing," the former football player said after the show. "To see these performers who do it every day — eight or nine times a week — is really amazing. I take my hat off to them."


Fans can see a behind-the-scenes recap on Thursday's TV show.


The musical is adapted from the Will Ferrell film from 2003 about Buddy, a human raised in the North Pole who travels to New York in search of his parents.


Strahan thought making his Broadway debut would be fun and represented a new experience for a guy who holds the single season sack record. He found himself more nervous than he has been for high-stakes football games or live TV.


"It's a little nerve-wracking because so many people depend on you, you want to get your line across and you have to play to the crowd. It's a lot more intricate with everyone hitting their marks. You don't want to be the guy that messes everyone up," he said.


Strahan, 41, played both a police officer and a Salvation Army Santa in the first act and later came on as himself in a scene with the real Santa in the second act. As he waited in the wings of the Al Hirschfeld Theatre, he saw the toll the musical takes on its dancers.


"Some of these performers are breathing as if they just went into a football game and played a 12-play drive," he joked. "I was tired walking up and down from my dressing room."


Strahan rehearsed for an hour in the morning with stage managers and associate director Casey Hushion. At 1 p.m., some in the cast came in early to work with him, including Jordan Gelber, who plays Buddy, and Beth Leavel, who plays Buddy's stepmother.


The audience was quiet when Strahan first appeared as an officer with another cop after Buddy gets kicked out of Macy's. But the seven-time Pro-Bowler and Super Bowl winner flashed his trademark smile and they went wild. More applause greeted him after he played a Salvation Army Santa as he and Buddy wrestled over the kettle bells.


In the second act, he waited to ask Santa for a present. Santa asked him his name, the newly minted actor said "Michael Strahan" and he then asked for a red Schwinn bicycle with a bell shaped like Miss Piggy. The crowd cheered when Strahan identified himself and he got another wide round of applause at the curtain call, where the cast gave him flowers.


Strahan was named in September as Kelly Ripa's permanent co-host aboard the morning show "Live with Kelly and Michael." A former defensive star who spent 15 years in the NFL, he is also a host of "Fox NFL Sunday."


He follows in the footsteps of Joe Namath, a quarterback nicknamed "Broadway Joe" who made an appearance on Broadway in 1983 as a replacement in a revival of "The Caine Mutiny Court-Martial."


Strahan would not rule out a return to the stage. "I will take it off my bucket list, but if the opportunity came across again, I might just take it up and do it again," he said. "I had a great time."


___


Online:


http://www.elfmusical.com


http://dadt.com/live


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Extended Use of Breast Cancer Drug Suggested


The widely prescribed drug tamoxifen already plays a major role in reducing the risk of death from breast cancer. But a new study suggests that women should be taking the drug for twice as long as is now customary, a finding that could upend the standard that has been in place for about 15 years.


In the study, patients who continued taking tamoxifen for 10 years were less likely to have the cancer come back or to die from the disease than women who took the drug for only five years, the current standard of care.


“Certainly, the advice to stop in five years should not stand,” said Prof. Richard Peto, a medical statistician at Oxford University and senior author of the study, which was published in The Lancet on Wednesday and presented at the San Antonio Breast Cancer Symposium.


Breast cancer specialists not involved in the study said the results could have the biggest impact on premenopausal women, who account for a fifth to a quarter of new breast cancer cases. Postmenopausal women tend to take different drugs, but some experts said the results suggest that those drugs might be taken for a longer duration as well.


“We’ve been waiting for this result,” said Dr. Robert W. Carlson, a professor of medicine at Stanford University. “I think it is especially practice-changing in premenopausal women because the results do favor a 10-year regimen.”


Dr. Eric P. Winer, chief of women’s cancers at the Dana-Farber Cancer Institute in Boston, said that even women who completed their five years of tamoxifen months or years ago might consider starting on the drug again.


Tamoxifen blocks the effect of the hormone estrogen, which fuels tumor growth in estrogen receptor-positive cancers that account for about 65 percent of cases in premenopausal women. Some small studies in the 1990s suggested that there was no benefit to using tamoxifen longer than five years, so that has been the standard.


About 227,000 cases of breast cancer are diagnosed each year in the United States, and an estimated 30,000 of them are in premenopausal women with estrogen receptor-positive cancer and prime candidates for tamoxifen. But postmenopausal women also take tamoxifen if they cannot tolerate the alternative drugs, known as aromatase inhibitors.


The new study, known as Atlas, included nearly 7,000 women with ER-positive disease who had completed five years of tamoxifen. They came from about three dozen countries. Half were chosen at random to take the drug another five years, while the others were told to stop.


In the group assigned to take tamoxifen for 10 years, 21.4 percent had a recurrence of breast cancer in the ensuing 10 years, meaning the period 5 to 14 years after their diagnoses. The recurrence rate for those who took only five years of tamoxifen was 25.1 percent.


About 12.2 percent of those in the 10-year treatment group died from breast cancer, compared with 15 percent for those in the control group.


There was virtually no difference in death and recurrence between the two groups during the five years of extra tamoxifen. The difference came in later years, suggesting that tamoxifen has a carry-over effect that lasts long after women stop taking it.


Whether these differences are big enough to cause women to take the drug for twice as long remains to be seen.


“The treatment effect is real, but it’s modest,” said Dr. Paul E. Goss, director of breast cancer research at the Massachusetts General Hospital.


Tamoxifen has side effects, including endometrial cancer, blood clots and hot flashes, which cause many women to stop taking the drug. In the Atlas trial, it appears that roughly 40 percent of the patients assigned to take tamoxifen for the additional five years stopped prematurely.


Some 3.1 percent of those taking the extra five years of tamoxifen got endometrial cancer versus 1.6 percent in the control group. However, only 0.6 percent of those in the longer treatment group died from endometrial cancer or pulmonary blood clots, compared with 0.4 percent in the control group.


“Over all, the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Trevor J. Powles of the Cancer Center London, said in a commentary published by The Lancet.


Dr. Judy E. Garber, director of the Center for Cancer Genetics and Prevention at Dana-Farber, said many women have a love-hate relationship with hormone therapies.


“They don’t feel well on them, but it’s their safety net,” said Dr. Garber, who added that the news would be welcomed by many patients who would like to stay on the drug. “I have patients who agonize about this, people who are coming to the end of their tamoxifen.”


Emily Behrend, who is a few months from finishing her five years on tamoxifen, said she would definitely consider another five years. “If it can keep the cancer away, I’m all for it,” said Ms. Behrend, 39, a single mother in Tomball, Tex. She is taking the antidepressant Effexor to help control the night sweats and hot flashes caused by tamoxifen.


Cost is not considered a huge barrier to taking tamoxifen longer because the drug can be obtained for less than $200 a year.


The results, while answering one question, raise many new ones, including whether even more than 10 years of treatment would be better still.


Perhaps the most important question is what the results mean for postmenopausal women. Even many women who are premenopausal at the time of diagnosis will pass through menopause by the time they finish their first five years of tamoxifen, or will have been pushed into menopause by chemotherapy.


Postmenopausal patients tend to take aromatase inhibitors like anastrozole or letrozole, which are more effective than tamoxifen at preventing breast cancer recurrence, though they do not work for premenopausal women.


Mr. Peto said he thought the results of the Atlas study would “apply to endocrine therapy in general,” meaning that 10 years of an aromatase inhibitor would be better than five years. Other doctors were not so sure.


The Atlas study was paid for by various organizations including the United States Army, the British government and AstraZeneca, which makes the brand name version of tamoxifen.


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Ransomware Is Expanding in the United States





CULVER CITY, Calif. — Kidnappers used to make ransom notes with letters cut out of magazines. Now, notes simply pop up on your computer screen, except the hostage is your PC.







Michal Czerwonka for The New York Times

Security researchers Eric Chien, left, and Vikram Thakur at Symantec, where Mr. Chien has been tracking ransomware schemes.







Sometimes victims get a message, ostensibly from the F.B.I., accusing them of breaking the law and demanding a fine.






In the past year, hundreds of thousands of people across the world have switched on their computers to find distressing messages alerting them that they no longer have access to their PCs or any of the files on them.


The messages claim to be from the Federal Bureau of Investigation, 20 other law enforcement agencies across the globe or, most recently, Anonymous, a shadowy group of hackers. The computer users are told that the only way to get their machines back is to pay a steep fine.


And, curiously, it’s working. The scheme is making more than $5 million a year, according to computer security experts who are tracking them.


The scourge dates to 2009 in Eastern Europe. Three years later, with business booming, the perpetrators have moved west. Security experts say that there are now more than 16 gangs of sophisticated criminals extorting millions from victims across Europe.


The threat, known as ransomware, recently hit the United States. Some gangs have abandoned previously lucrative schemes, like fake antivirus scams and banking trojans, to focus on ransomware full time.


Essentially online extortion, ransomware involves infecting a user’s computer with a virus that locks it. The attackers demand money before the computer will be unlocked, but once the money is paid, they rarely unlock it.


In the vast majority of cases, victims do not regain access to their computer unless they hire a computer technician to remove the virus manually. And even then, they risk losing all files and data because the best way to remove the virus is to wipe the computer clean.


It may be hard to fathom why anyone would agree to fork over hundreds of dollars to a demanding stranger, but security researchers estimate that 2.9 percent of compromised computer owners take the bait and pay. That, they say, is an extremely conservative estimate. In some countries, the payout rate has been as high as 20 percent.


That people do fall for it is a testament to criminals’ increasingly targeted and inventive methods. Early variations of ransomware locked computers, displayed images of pornography and, in Russian, demanded a fee — often more than $400 — to have it removed. Current variants are more targeted and toy with victims’ consciences.


Researchers say criminals now use victims’ Internet addresses to customize ransom notes in their native tongue. Instead of pornographic images, criminals flash messages from local law enforcement agencies accusing them of visiting illegal pornography, gambling or piracy sites and demand they pay a fine to unlock their computer.


Victims in the United States see messages in English purporting to be from the F.B.I. or Justice Department. In the Netherlands, people get a similar message, in Dutch, from the local police. (Some Irish variations even demand money in Gaelic.) The latest variants speak to victims through recorded audio messages that tell users that if they do not pay within 48 hours, they will face criminal charges. Some even show footage from a computer’s webcam to give the illusion that law enforcement is watching.


The messages often demand that victims buy a preloaded debit card that can be purchased at a local drugstore — and enter the PIN. That way it’s impossible for victims to cancel the transaction once it becomes clear that criminals have no intention of unlocking their PC.


The hunt is on to find these gangs. Researchers at Symantec said they had identified 16 ransomware gangs. They tracked one gang that tried to infect more than 500,000 PCs over an 18-day period. But even if researchers can track their Internet addresses, catching and convicting those responsible can be difficult. It requires cooperation among global law enforcement, and such criminals are skilled at destroying evidence.


Charlie Hurel, an independent security researcher based in France, was able to hack into one group’s computers to discover just how gullible their victims could be. On one day last month, the criminals’ accounting showed that they were able to infect 18,941 computers, 93 percent of all attempts. Of those who received a ransom message that day, 15 percent paid. In most cases, Mr. Hurel said, hackers demanded 100 euros, making their haul for one day’s work more than $400,000.


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