Category Archives: Cancer

Girl Wearing a Hat

Hats for Cancer Patients

I recently saw a report on the media about the availability of hats that can be used for cancer patients. I searched for information on this subject as I think this is an innovative idea that will make life easier for that woman having to deal with her cancer and hair loss. Why should losing the hair be another issue at a time like this?

There are stores, catalogs and websites that now specialize in hats, caps and turbans for people that are experiencing hair loss caused from their cancer treatment. You don’t have to spend a lot of money for specialized head coverings, as any type of hat can work for you. Spice it up and choose something fashionable that makes you feel better.

When you are selecting the hat, be aware that it should be deep and will fit down over your head. Many men’s-style of hats and 1920’s make a statement and will work well. Avoid those that you can see through and will give little protection from the sun and won’t mask your hair loss as well.

Where will you be wearing the hat? A wide-brimmed hat is fun for outdoor use and does a really great job of shading those UV rays, also blocks overhead lighting at the office but might be rather awkward in crowded spaces like elevators, trains and restaurants. This type might also be difficult to wear while driving when it hits the back of your seat.

Those adjustable baseball caps are popular and you can find a really wide variety and choose a nice, casual look. Some of them expose part of your scalp so use that sunscreen if this is the type you choose. There is a wide variety of hats available through the American Cancer Society’s TLC catalog. The turban is made of soft stretch fabrics that come in a comfortable and wide range of colors. There are public service programs for women with cancer that will teach various beauty techniques and will show you how to make quick and easy turbans out of t-shirts. Spice that turban up with a broach, but don’t venture into “Madam Zorba the Fortune-Teller” area! You can even give a little extra height to the hair underneath by adding a shoulder pad or two.

Just be sure your choice of hat fits snuggly but not restrictive where you might get a headache. You can add a layer of foam to the inside of a loose-fitting hat to tighten it. If the hat has an inner hatband, slip the padding between the hat and band or buy the foam that has an adhesive backing and attach it directly to the hat. The elasticized inner bands that adjust to the size of your head can usually be found at camping and travel stores.

You will need to wear a wig cap, sleeping cap or scarf underneath to protect your scalp from irritation unless the hat is made of extremely soft material. Retailers and many stores online often offer sleep caps and wig caps. If you choose to use a scarf, be sure to use a cotton scarf and not silk, as it will be too slippery. Just remember that bald can be beautiful, too!

Dr Fredda Branyon

Cancer Cells

IFT20 Protein & Cancer Cells

It has been discovered by an international research team that the IFT20 protein helps some cancer cells to invade by facilitating the transportation of membranes and proteins within parts of the cell. Most human cells have cilia on the surface, acting as cell antenna that receives information from outside the cell. The protein IFT20 is present in most human cells and plays an essential role in the formation and functions of these primary cilia. It acts as a cargo adaptor in healthy cells to transport proteins along microtubules within cilia but many of these cells lose cilia when they become cancerous. For the first time light is being shed from research on the function of IFT20 in non-ciliated cancer cells. That has brought to light that this discovery has potential applications for developing new cancer treatment methods that block invasive cancer cells by targeting the IFT20. The Scientific Reports published the findings online.

An international team including Associate Professor NISHITA Michiru, Professor MINAMI Yasuhiro, Professor Victor W. Hsu and Professor Gregory J. Pazour carried out the research. These professors are affiliated with Kobe University, Harvard Medical School and University of Massachusetts Medical School.

Cell invasion causes most cancer-related deaths and the spread of cancer cells to other parts of the body. Scientists are searching for mechanisms that control the invasive properties of cancer cells to counter this.

It was already known that a cell membrane protein known as Ror2 expresses highly in various cancer cells and promotes cancer cell invasion and metastasis. Various kinds of non-ciliated cancer cells were investigated by the team, and discovered that Ror2 promoted cancer cell invasiveness by inducing the expression of IFT20.

Many tumor cells are able to break through the barrier of the extracellular matrix and infiltrate their surroundings. It was demonstrated that in tumor cells IFT20 induces the Golgi complex to form microtubules by promoting interaction between the Golgi proteins GM130 and AKAP450. They state that this research has clarified a new molecular mechanism related to the formation of Golgi-derived microtubules, and its important role in invasive cancer cells.

It is still unclear about the relationship between loss of cilia and a cell’s cancerous properties. In non-ciliated cancer cells it is clear that IFT20 is responsible for the formation of invadopodia. The line of analyzing the relationship between IFT20 and the loss of cilia could help to shed light on the fundamental question of why many cancer cells lack cilia. If the specific regulatory mechanism of IFT20 in cancer cells is revealed, this could be used to develop treatment that targets IFT20 to block invasive cancer cells.

Dr Fredda Branyon

Leather Goods

Dangers Lurking in Leather

 

Leather Goods

Those enticing handbags, jackets, sofas and armchairs we view as we walk through the mall are normally made from genuine leather. Every car interior covets the new leather smell we all love. But, where is it that this leather comes from? Of course, we know most are from pigs, cows, snakes, buffalo, kangaroos and even some from fish and ostriches. Leather products are sought after and the global market for the plethora of leather applications is gargantuan. A digital publication of the Knight Science Journalism Fellowship Program at the Massachusetts Institute of Technology, estimates the leather industry to be around $200 billion annually. Footwear is the largest seller and worth about $47 billion while gloves come in next at $12.3 billion. But did we ever think about the negative impact these products might have on our health?

Leather tanning is a big industry business in Bangladesh. About 90% of the country’s leather was tanned in Hazaribagh in 2015 and 2016 to the tune of about $1.5 billion in leather and leather goods. These tanneries have dumped about 5.8 million gallons of untreated liquid waste into the Buriganga River that included scraps of hide, flesh, surfectants, chromium III and ammonium sulphate. This river was once the main source of drinking water and has become so polluted now that it is widely regarded as unsafe for human consumption.

The chromium has been associated with several negative effects for both human health and the environment as it can easily oxidize to chromium VI that is a suspected carcinogen. This causes acute and chronic damage to the aquatic environment. Chickens are fed tannery scraps as a staple and most people there eat an average of 250 grams of chicken per day and ingest 4X the amounts of chromium deemed healthy.

Human health is adversely affected by tanning toxins and dyes where studies have linked them to nasal, testicular and bladder cancers. These have all been linked by studies to the dyes or solvents used during the leather finishing process. Later lung and pancreatic cancers began to be reported in association with leather dust and tanning.

Most consumers have no way of knowing where the leather in their products come from. Some designers and retailers refuse to purchase from tanneries where human rights are violated because of the age of the workers, conditions and chemicals used for processing. The fashion industry should have a moral responsibility as well as the consumers towards the use of leather products. Even those dog chews that we buy for the pet we love like our children can be toxic. It does keep their teeth strong and some have meat or protein in them, but it is a by-product of the leather industry. Dyes and highly toxic chemicals are used to make these chewy toys and then they are often painted with titanium dioxide to make them a pale, uniform color. Testing might reveal substances like lead, arsenic, mercury and formaldehyde. These can cause digestive issues, including diarrhea and even become a choking hazard or cause dangerous blockages in the esophagus or digestive tract.

Giving up leather as part of our wardrobe is an individual choice, but do consider the environmental issues before making a decision as the process of tanning leather is incredibly toxic. Try turning to vegetable, tree-bark or other natural tanning alternatives. The finished product isn’t as stable or supple as the chemically generated methods, but much safer. Synthetically tanned leather might be another method of choice. Even fabrics as cork, wood, linen, hemp, cotton, bamboo and ultrasuede are good alternatives. The chemical Chromium VI has been labeled a known human carcinogen by the U.S. Environmental Protection Agency, the U.S. Department of Health and Human Service, the World Health Organization and IARC and has become strictly regulated.

Dr Fredda Branyon

Hospital Equipment

Immunotherapy

Hospital Equipment

Immunotherapy, sometimes called biologic therapy, has been a game changer for many types of cancer. This might actually improve your life and extend your years longer than with other treatments.

With allergies, you might have gotten allergy shots. With each shot they provided a very small amount of the allergen, which was the thing that caused your problems. These shots put your immune system on alert but don’t make you sick. Over some time your doses get bigger and that helps you build a tolerance to the allergen, or causes you to become immune. These shots are a type of immunotherapy. Vaccines for diseases like the measles, mumps and flu are all a type of immunotherapy as well.

In relating to cancer, the disease starts when one cell in your body goes rogue and the researchers are hoping that immunotherapy treatment will harness the power of your body’s natural defenses to fight cancer cells, just as it would with a germ, virus or allergy. Two approaches can be used: one is to tell your system to stage a full-out assault on cancer cells and another is to try to make your defenses stronger. Currently, the researchers are exploring new ways to help your immune system recognize and destroy cancer cells. New Hope Unlimited has been doing Immunotherapy with great success for years without using synthetic drugs.

The Adoptive T-cell immunotherapy is designed to boost your key immune cells. This is where the researchers remove T cells (the white blood cells in your immune system) from your tumor and then figure out which ones are fighting the growth the most. Then they can genetically engineer the genes in those cells to be stronger and return them to your system through an IV. Using this approach shows a lot of promise in the treatment of many types of cancer.

Cancer vaccines work like many others and fall into two groups. Preventive vaccines have a lot in common with tradition types and work with a substance called an antigen that gives your immune system a nudge. The preventive cancer vaccine is used against the human papillomavirus (HPV) that causes cervical, anal and other types of cancer. Treatment vaccines help your T cells pick out and destroy specific cancers.

Checkpoint inhibitors work with the cancer cells that hide from your defense, almost disguising themselves as normal cells. These drugs will help your immune system see the cancer as a problem and then fight it. The inhibitors are in clinical trials for many cancers and some people with metastatic melanoma and Hodgkin’s lymphoma are being treated with them.

Monoclonal antibodies are molecules that are made in a lab. They are designed to act the same way as your own antibodies, which are part of your defense against viruses and germs. The immune system can spot things that cause harm, but don’t always see cancer cells as bad. The monoclonal antibodies help to mount an offense as they attach to cancer cells. Like a beacon, they then make those cells more visible to your immune system in order to fight them better. It might also be possible for this to help stop the growth of cancer and help traditional treatments better target the cancer cells.

The researchers are working to find other ways to help your immune system fight cancer and to better understand your defense and how they protect you. How to combine immunotherapy with other treatments to make them work even better is also being investigated along with looking into what happens when you pair two types of immunotherapies. The big question is still, why does this work for one patient but not another? Much more study, and discovery will continue for the sake of those suffering from cancer.

Dr Fredda Branyon

toxic teethers

Toxic Teethers

An industrial grade chemical used in epoxy resins, known as bisphenol A (BPA), is a protective lining of some food and beverage cans. They believe this makes a product safer and easier to use, but the chemical has actually demonstrated significant side effects that damage your health. This chemical was discovered in the 1890’s and later found in the 1950’s that it could be added to polycarbonate plastics to make them stronger and more resilient.

Exposure to BPA has shown effects on the brain, behavior, increased blood pressure and fetal and infant development, but the FDA continues to tell us it is safe in low doses.

Many products such as food containers, baby toys, plastic bottles and containers are found to contain BPA where even low doses might be a challenge. When products are labeled BPA-free, that doesn’t necessarily mean the product does not release BPA or endocrine-disrupting chemicals used to strengthen plastics.

toxic teethersIt takes many years for plastics to decay or erode while leaching chemicals into our environment every day. The Environmental Health Perspective, in their 2011 study, found products claiming to have estrogenic-activity free plastics were still leaching chemicals into food products when placed under regular stresses. There are studies demonstrating endocrine-disrupting chemicals like BPA do trigger diseases in humans and animals. European Union has restricted their use in baby bottles.

The researchers immersed plastic teething toys in water for an hour to stimulate use, and then measure the amount of chemicals that had leached into the water. Parabens were the most commonly leached chemical in this part of the study. Europe, China and Canada has restricted the use of BPA and other endocrine-disrupting chemicals, but there is still an argument in the U.S. over whether these chemicals pose a danger enough to warrant restricting use and cutting industry profits.

Exposure to any chemical or toxin is dangerous to human health but even more serious in infants and children as their body is not fully developed and chemicals have a greater potential for impacting their neurological, digestive and immune systems.

BPA has been linked to many health concerns as well in pregnant women, fetuses and young children. Some of these concerns in adults include structural damage to the brain, changes in gender-specific behavior and abnormal sexual behavior, hyperactivity, increased aggressiveness and impaired learning, early puberty, stimulation of mammary gland development, disrupted reproductive cycles, ovarian dysfunction and infertility, increased fat formation and risk of obesity and diabetes, stimulation of prostate cancer cells, altered immune function, increased prostate size and decreased sperm production, increased risk of high blood pressure and heart disease, breast cancer, preterm birth and reduced efficacy of chemotherapy treatment.

Limit your exposure when shopping for baby toys, food and other home products and choose those such as unfinished wooden teething toys, organic cloth teething toys, using glass baby bottles, storing your food in glass, eat mostly fresh whole foods, breastfeed your baby exclusively if possible, use glass containers to heat food in microwaves, be aware that even BPA-free plastics are just as bad as BPA, buy products in glass, check home tap water for contaminants, teach children not to drink water from the garden hose and be careful of cash register receipts. With these tips, we might limit our children’s exposure to these bad chemicals, as well as ourselves.

Dr Fredda Branyon

Causes of High White Blood Cell Count

As I always tell our patients at New Hope Unlimited, our immune system is an amazing thing! Vital components of the blood are the white blood cells. They fight infection and are essential for our health and well being. It may indicate an infection if a person has a high white blood cell count. The immune system is working to destroy the infection and it may also be a sign that the person is experiencing physical or emotional stress. Some blood cancers may also show high white blood cell counts.

This might signal that something is destroying the cells faster than they are being made, or that the body is producing too few of the cells. These white blood cells account for about 1% of the total blood cells and are essential to normal immune function. These cells are also known as leukocytes. White blood cells have a very important function in protecting the body from attack that can be from bacteria, viruses or other foreign substances that the body sees as some kind of threat.

Bone marrow continuously produces white blood cells and keeps them ready within the blood and lymphatic systems until they are needed. A large number of white blood cells are produced by most people. Laboratory levels that are considered normal are between 4,000 and 11,000 cells per microliter of blood, but this can vary according to a person’s race.

Several different types of white blood cells are:

  • Lymphocytes that are vital for producing antibodies that help the body to defend itself against bacteria, viruses and other perceived threats.
  • Neutrophils are powerful white blood cells that destroy bacteria and fungi.
  • Basophils alert the body to infections by secreting chemicals into the bloodstream, mostly to combat allergies.
  • Eosinophils are responsible for destroying parasites and cancer cells, and they are part of an allergic response.
  • Monocytes are responsible for attacking and breaking down germs or bacteria that enter a person’s body.

The monocytes travel to other organs, as needed, such as the spleen, liver, lungs and bone marrow, where they transform into a cell called a macrophage that is responsible for many cellular functions. These include removing dead or damaged tissue, destroying cancer cells and regulating the immune response.

An increase in white blood cells (leukocytosis) typically occurs in response to the following conditions: infection, immunosuppression, medications, bone marrow or immune disorder, certain cancers as acute or chronic lymphocytic leukemia, inflammation as that experienced with rheumatoid arthritis, injury, pregnancy, smoking, allergic reactions and excessive exercising.

If levels of one particular type of white blood cells rise, this may be due to a specific trigger as monocytes, lymphocytes, neutrophils, basophils or eosinophils. Those affected by idiopathic hypereosinophilic syndrome may experience symptoms as weight loss, fevers, night sweats, fatigue, coughing, chest pain, swelling, stomach ache, skin rash, pain, weakness, confusion or coma.

Some other imbalances of white blood cells could be a sign of a weakened immune system due to HIV or Aids, leukemia, lymphoma and a number of conditions known as myeloproliferative disorders.

If the white blood cell count is too high it might be indicating there is a problem as cancer or an infection. A blood test can assess the white blood cell count and other tests might be needed to pinpoint the exact cause of the problem.

Dr Fredda Branyon

cancer

Importance of Location of Colon Cancer

Robert Preidt recently submitted an article on the importance of where your colon cancer is located. This can affect a patient’s chances for survival, according to a new report. There are so-called left-sided and right-sided colon cancers, and an oncologist who reviewed the findings explains. Dr. David Bernstein, chief of hepatology at Northwell Health in Manhasset, NY says that the left-sided cancers are located closer to the anus and located in the rectum, sigmoid colon and descending colon. These usually present with bleeding or partial obstruction and patients tend to seek medical care earlier. But then the right-sided lesions located in the first part of the colon and near the junction with the small intestine, do not typically present with obstruction but tend to present with anemia and are more likely to be associated with metastatic disease, especially to the liver.

They are quite often detected later in their progression so these right-sided colon tumors have a worse prognosis than left-sided colon cancers. There were 66 studies where a team led by Dr. Fausto Petrelli of the ASST Bergamo Ovest, in Treviglio, Italy, reviewed data from 66 studies. This involved a total of more than 1.4 million patients who were followed for a median of more than 5 years.

The colon cancer patients with left-sided tumors were nearly 20% less likely to die than those whose tumors occurred on the right side. There seemed to be more than simply later detection, as the Italian team noted. The difference in survival between the left and right-sided colon cancer held even after the researchers factored out cancer stage at diagnosis. Prior research has shown that right and left colon cancers are genetically distinct, as well.

These new findings show that primary tumor locations should be carefully considered when deciding treatment intensity. Findings were reviewed by another oncologist who said that they have implications for patients deciding on which tool – a sigmoidoscope or colonoscope – to opt for in colon cancer screening.

Dr. Jules Garbus, a colorectal surgeon at Winthrop-University Hospital in Mineola says the report reaffirms the importance of choosing the appropriate screening tool for the prevention and detection of colon cancer. The sigmoidoscopy provides a limited exam of the left side of the colon from the anus directly up to the left upper abdomen and colonoscopy is a complete exam of the entire colon which extends past where the sigmoidoscopy reaches. It crosses over to the right side of the abdomen and down to the right lower abdomen. This study suggests that the location of the cancer may be an integral part of establishing prognosis and treatment, therefore colonoscopy remains the gold standard in colon cancer screening. The study can be found in the journal JAMA Oncology.

Dr Fredda Branyon

Surgery in Operating Room

Early Removal of Ovaries

The University of Warwick has found through a study that there is a link between the removal of ovaries during hysterectomy and an increase in heart disease, cancer and premature death. This is the largest study of this kind conducted on the subject and covered a 10-year period comparing women who were treated for a benign disease that had both ovaries removed with those who had one or none removed. About 113,679 cases of women aged 35-45 from April 2004 to March 2014 were reviewed. Both ovaries were removed from 1/3 of these patients. The results of this study have been published in the BMJ.

Results were that those women who had one or no ovaries removed were less likely to develop ischemic heart disease (coronary artery disease) or cancer after hysterectomy than those that had both of the ovaries removed. They also found that fewer of the women who retained one or both ovaries compared to those having both removed, died within the duration of the study.

The researchers believe premenopausal women should be advised that this benefit comes at the cost of an increased risk of cardiovascular disease and other cancers and mortality when both ovaries are removed, even though this does protect against subsequent development of ovarian cancer.

Richard Lilford, Professor of Obstetrics and Gynecology and Chair in Public Health at the University of Warwick’s Warwick Medical School, led this particular study. He indicated that the combination of biological plausibility and the massive effect size make a compelling case that women be advised that their risk of ovarian cancer is greatly reduced by surgical removal of both ovaries. Also that the lifetime risk of developing ovarian cancer is 1 in 52 in the UK, and the removal of a metabolically active organ as the ovary may have harmful effects in the long term. Therefore, these long-term disadvantages must be offset by the benefit offered by protection from ovarian cancer.

A national database of hospital admissions that were examined revealed that 40% of women with no specific risk factors for reproductive cancer had their ovaries removed during abdominal hysterectomy in the 35-45 age group. They believe that this might be a higher amount than expected among those women who were aware of the worse health outcomes with bilateral removal. This would possibly decline as the health risks that must be traded for a reduced incidence of ovarian cancer comes into focus as revealed to the women.

There has been a slow decline in the number of hysterectomies performed from 9,000 women in 2014 compared to 13,000 in 2004-5. The data available wasn’t as detailed as the researchers would have liked, however they plan to re-examine the data at a later date to examine trends over the long term.

Dr Fredda Branyon

potatoes

Relationship of Brown Toast & Potatoes to Cancer

potatoes

According to the U.K. government scientists, you should cook your toast and potatoes to a golden color, not browned, in order to reduce the intake of a chemical that may increase the chance of having cancer.  Acrylamide is a natural byproduct of the cooking process and not deliberately added to food. Acrylamide is formed when you heat certain foods, such as starch foods like potatoes and root vegetables, as reported by professor Guy Poppy, chief scientific adviser to the U.K.’s Food Standards Agency.

These foods form acrylamide when cooked to above 120 degrees.  Other foods that have high levels of acrylamide are potato chips, cakes, cookies, cereals and some coffee.  Acrylamide exposure to cancer has been linked through studies in rats, according to the National Cancer Institute. The National Toxicology Program and the International Agency for Research on Cancer have evidence from human studies that acrylamide is a “probably human carcinogen.”

According to Diane Benford, head of risk assessment at the Food Standards Agency, the current levels of acrylamide that are found in our present diet are higher than they are comfortable with.  They are encouraging the industry to try to reduce acrylamide levels in processed foods and wish to raise the awareness among consumers of the things they could do to help reduce their exposure to acrylamide in food.

Some easy steps we can all take to reduce acrylamide at home are:

  • Go for the golden yellow color or lighter when frying, baking, toasting or roasting starchy foods.
  • Check the package for cooking instructions and follow them carefully.
  • Don’t keep raw potatoes in the fridge if you are going to roast or fry them as this can increase the overall acrylamide levels.  Cool instead in a dark, cool place at temperatures above 42 degrees.
  • Keep a varied and balanced diet that includes at least five servings of fruit and vegetables every day.

By re-evaluating the way we cook our starchy foods it just might prevent our body from being exposed to the increased risk of cancer.  We also want to be reminded that starchy foods are carbohydrates that convert to sugar….the food cancer loves most.

Dr Fredda Branyon

breath

Breath Test to Detect Stomach & Oesophageal Cancers

breath

There is a test that now measures the levels of 5 chemicals in the breath that has shown promising results for detecting cancers of the oesophagus and stomach in a large patient trial that has been presented at the European Cancer Congress 2017.  

Stomach and oesophageal cancer together, currently account for around 1.4 million new cancer diagnoses each year worldwide.  Both of these cancers are usually diagnosed late because their symptoms are ambiguous, or meaning that the five-year survival rate for these types is only 15%.  

New research of more than 300 patients has shown that the test could diagnose cancer with an overall accuracy of 85%.  An NIHR Clinical Trials Fellow from Imperial College London, Dr. Sheraz, under the supervision of Professor George Hanna, informed Congress that at present the only way to diagnose oesophageal and stomach cancers is with endoscopy, which is expensive, invasive and has some risk of complications with this method.

A non-invasive and first-line breath test could be used to reduce the number of unnecessary endoscopies.  This could also mean in the longer term that earlier diagnosis and treatment as well as better survival could be realized.

They based this trial on the results of previous research that suggested differences in the levels of specific chemicals as butyric, pentanoic and hexanoic acids, butanal and decanal between patients with stomach or oesophageal cancer and patients with upper gastrointestinal symptoms without cancer.  This research was targeted to test whether this chemical signature that seemed to typify cancer could be the basis of a diagnostic test.

The research team collected breath samples from 335 people at St Mary’s Hospital, Imperial College Healthcare NHS Trust, University College London Hospital and the Royal Marsden Hospital in London.  Around 163 had been diagnosed with stomach or oesophageal cancer and 172 showed no evidence of cancer when they had an endoscopy.

The samples were analyzed with a technique called selected ion flow-tube mass spectrometry that is able to accurately measure small amounts of different chemicals in mixtures of gases such as breath.  They then measured the levels of the 5 chemicals in each sample to see which ones matched to the chemical signature that indicated cancer. The test was 85% accurate overall with a sensitivity of 80% and a specificity of 81%.  Not only was the breath test good at recognizing those who had cancer (sensitivity), but was also good at correctly identifying those who did not have cancer.

Since the cancer cells are different than healthy ones, they produce a different mixture of chemicals.  This then suggests that we may be able detect these differences and use a breath test to indicate which patients are likely to have cancer of the oesophagus and stomach, and which do not.  Validation of these findings is needed in a larger sample of patients before the test could be used in the clinic.

Researchers will continue with a larger trial using the test with patients given an endoscopy for gastrointestinal symptoms but not yet diagnosed with cancer, over the next 3 years.  This will assess the ability of the test to pick up cases within a group that is likely to contain only a small percentage of cancers.

Breath tests for other types of cancer, such as colorectal and pancreatic is also being worked on by the team, which could be used as first-line tests in general practice surgeries.

Dr Fredda Branyon