Category Archives: Integrative Medicine

Advances in genetic technology have rapidly changed healthcare delivery in low- and middle-income countries. NGS utilization has decreased the time to diagnosis, increased the diagnostic rate, and provided valuable insight into the genotypephenotype correlation of IEI in a timely and cost-effective way28,29. IEI is not uncommon in India; however, their diagnosis is either missed or delayed due to a lack of awareness and a paucity of diagnostic facilities. There is an urgent need to increase testing capacity for early recognition, diagnosis, and management of IEI in our country30,31,32.

We have been diagnosing patients with IEI at our centre for the past 25years. However, services for molecular diagnosis for IEI both in government and commercial sectors have not been available in India until 2016. For molecular diagnosis of IEI, we established academic collaboration with Service Hmatologie, Immunologie et de Cytogntique, Hpital de Bictre, Le Kremlin Bictre, at France in the year 2007. Later, we established collaboration with institutes at Japan (National Defense Medical College, Saitama) and Hong Kong (Department of Paediatric and Adolescent Medicine, University of Hong Kong) in the years 2008 and 2010, respectively. This has facilitated molecular diagnosis for many of our patients with IEI. Our centre was designated as Centre for Advanced Research in diagnosis and treatment for primary immunodeficiency diseases by the Indian Council of Medical Research, Government of India, in 2015. Until 2016, tests available for diagnosis of IEI at our centre include immunoglobulin estimation, NBT, and flow cytometry for several surface and intracellular proteins10. With the increase in patients diagnosed with IEI in the last few years, we felt the need to establish molecular analysis at our centre4. We initiated Sanger sequencing for BTK, CYBB, and WAS genes in our centre in 2016 (Fig.1).

Commercial laboratories in India came up with facilities (targeted exome) for molecular diagnosis of IEI in 2016. Costs incurred for sequencing in commercial laboratories were exorbitant (USD 400500) in 2016 that later reduced in the subsequent years (USD 200 currently). The introduction of targeted NGS for IEI in 2018 at our centre has enabled us to offer this diagnostic modality to many of our patients who could not afford the costs of commercial testing. We have also been able to diagnose more IEIs each year and at a much faster pace than in previous years. The cost of targeted genetic sequencing at our setup is USD 83 per sample. This is much less than the costs incurred at commercial laboratories in India33. In addition, infants less than one year are covered under the JSSK (Janani Sishu Suraksha Karyakram) scheme of the Government of India. They are entitled to avail of NGS free of cost. Our Institute also provides free diagnostic services to patients from low-income groups who cannot afford the NGS charges, and charges are minimal for those who can afford this facility.

We have worked upon and improvised the standard protocol of NGS to suit our setup. We made some ingenious modifications to the recommended protocol to reduce the cost per sample and accommodate more patient samples in each run. Towards this end, we have successfully used half the recommended volume of reagents (however, concentration remained the same) at each successive step by starting with an initial DNA volume of 2.5L instead of 5L. So, a larger number of patient samples could be accommodated in each run. We have effectively run 42 patient samples with a 24-reaction reagent kit for 24 samples.

NGS sample preparation is a tedious and labour-intensive process requiring focus and concentration at each successive step34,35. After chip-loading and sequencing, we did not get results for two runs. On both these occasions, instead of repeating from the start, we started after the library quantification step as we were sure about the quality of the library preparation. So, restarting with the template preparation step instead of beginning from the start in the case of a failed run could be a helpful strategy if we are sure about the quality of library preparation.

We describe preliminary results of targeted NGS in 121 patients with different forms of IEIs diagnosed and managed at our centre. Our variant pick-up rate of 63.6% is much higher than previous studies- 25% by Yska et al. in 2019 and 29% by Vorsteveld et al. in 202128,36. The pick-up rate of variants in other studies were 16%7 (Gallo et al., Italy, 2016), 14% (Kojima et al., Japan, 2016)37, 2.1% (Sun et al., China in a cohort of infants)38, 28.6% (Cifaldi et al., Italy, 2020)18 and 42.4% (Arunachalam et al., India, 2020)33.

There are several reasons for a higher diagnostic yield in our study. Careful patient selection with a high pre-test probability based on clinical manifestations and preliminary immunological investigations was done. Patients with a high likelihood of having a pathogenic variant in one of 44 genes included in the gene panel are sorted out in consultation with clinicians trained in immunology and have broad experience in caring and managing patients with IEI. Currently more than 400 genes are implicated in various IEI. However, we selected 44 genes based on the most common diseases we encounter at our centre and also since we aimed to provide genetic diagnosis to maximum number of patients at an affordable cost. A large panel although more desirable would be costlier to design and in addition fewer samples would be accommodated in each run. Samples of patients who are very likely to have genetic variants in the genes included in the panel were included based on clinical history and initial immunological investigations. Patients with IEI not clearly delineated upon initial immunological investigations are referred for a clinical exome or whole-exome analysis. This analysis is outsourced to commercial laboratories providing these services at an affordable cost.

NGS has facilitated the early diagnosis of patients with IEI in situations where flow cytometry was either not conclusive or did not match the clinical presentation. For instance, patient 56 was clinically suspected of having an autosomal recessive hyper-IgM was found to have biallelic variants in the ATM gene. Hence, relying solely on typical manifestations of the IEI may not be ideal, and a rapid genetic diagnosis is indispensable39.

There have also been instances when the initial analysis on the Ion Reporter did not reveal a pathogenic variant. In patient 8 with clinically suspected XLA, no pathogenic variant was detected at initial analysis. There was a strong clinical suspicion of XLA in this case; we manually visualized the data on Integrative Genomics Viewer (IGV). We found a large deletion of exon-10, 11 and 12 in the BTK gene (Fig.2)40. Similarly, in another patient with suspected CGD (Pt.27), a large deletion was found in the CYBA gene, which was missed by the ion reporter software but was detected on manual reanalysis and visualization on the IGV. Patient 42 had an indel in IL2RG gene. In patient 42, analysis by the Ion reporter software revealed two IL2RG variants in close proximity, which was confusing. However, upon visualization of the BAM file on IGV, we realized that it was an indel (insertion of 3 nucleotides and deletion of 8 nucleotides) which was misinterpreted as two variants by the ion Reporter software.

Large deletion of Exon- 10 to 12 in BTK gene on Integrative Genome Viewer.

Hence, manual data visualization on IGV and manual analysis of annotated vcf files instead of relying on variants detected by initial analysis by software is crucial. We have been able to detect these variants in these cases using this strategy.

Detection of genetic variants in genes with known pseudogene is another problem that we encountered in our patient cohort. We faced this difficulty in patients with autosomal recessive CGD due to NCF1 gene defect. The targeted NGS panel systematically missed the most common pathogenic variant in NCF1, i.e., deletion of two nucleotides at the start of Exon-2. NCF1 gene has two flanking pseudogenes (NCF1)41. We assume that the amplicon designed for exon-2 of the NCF1 gene was unable to bind to its target, and thus, there was no amplification of this region, resulting in no reads for exon-2 in these patients. We performed a gene scan in 3 patients who had no reads in Exon-2 of the NCF1 gene to check for this variant and confirmed NCF1 GT deletion in all 3 of these patients (Fig.3A,B).

(A) IGV snapshot showing no reads from Exon-2 of NCF1 gene in 2 patients with AR-CGD (B) Gene Scan for Exon 2 NCF1 gene from control and an AR-CGD patient with no reads from exon 2 of NCF1 gene.

We have also been able to offer prenatal services to many patients. Patient 40 was clinically suspected of having SCID but had expired before a genetic defect could be established. His mother was pregnant at this time, and the period of gestation was 13weeks. We were able to identify a splice-site variant in the IL2RG gene in this family with X-linked SCID, and the mother was offered prenatal diagnosis by chorionic villous sampling. Molecular confirmation of diagnosis helped the family to get timely antenatal testing and appropriate genetic counselling. For some patients, especially SCID, rapid diagnosis through targeted NGS has saved lives, or genetic counselling has prevented an affected child in the subsequent pregnancy.

Pt 76 was the mother of a deceased child suspected to have X-linked Hyper-IgM, but a genetic diagnosis could not be established during the childs life. Targeted NGS revealed a synonymous variant in exon 1 of the CD40LG gene proximal to donor splice-site. In-silico prediction for this variant was found to be damaging by Mutation Taster2. Synonymous variants involving canonical splice-sites can also be pathogenic and should not be filtered out.

Genetic findings were beneficial in providing genetic counselling to affected families, carrier screening, and prenatal diagnosis. Moreover, genetic information is required for devising appropriate transplantation related strategies. Genetic findings were also crucial in deciding the treatment modalities in a few cases. Cases harbouring defects leading to antibody deficiencies were placed on regular replacement intravenous immunoglobulin therapy.

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Utility of targeted next generation sequencing for inborn errors of immunity at a tertiary care centre in North India | Scientific Reports -...

A world-renowned author and expert in the field of integrative medicine, Andrew T. Weil, MD, founder and director of the Andrew Weil Center for Integrative Medicine at the University of Arizona College of Medicine Tucson, was recognized recently with the top award given by the Integrative Healthcare Symposium.

Im honored to receive the symposiums 2022 Leadership Award, Dr. Weil said. Integrative health care is the way of the future, and the University of Arizona Health Sciences is leading that way. Our Center for Integrative Medicine sets the standard for training physicians, nurses, and allied health professionals to provide this kind of care in order to improve health outcomes and lower health care costs.

The annual award was presented to Dr. Weil, who also gave the symposiums keynote address on The Evolution of Integrative Medicine, earlier this year in New York City.

Presenting the award to Dr. Weil was Aly Cohen, MD, a 2014 graduate of the centers Fellowship in Integrative Medicine, founder of Integrative Rheumatology Associates and The Smart Human LLC, and co-author of the book, Non-Toxic: Guide to Living Healthy in a Chemical World. Dr. Cohen is the guest on the latest Body of Wonder podcast with Dr. Weil and center executive director Victoria Maizes, MD.

In lauding Dr. Weil, Dr. Cohen told the tale of how his car broke down in Tucson in the 1970s while he was traveling across country, he fell in love with the desert and stayed. Well, lucky for us. Combining the number of patients reached through fellowship graduates, health coaches, residents in training, medical students and researchers, some 8 million patients are guided by your teachings and are quite grateful your car broke down in Tucson many moons ago, she said.

Commenting on his 15 books, Dr. Cohen said, In an era of plentiful, often radical guidebooks and scary health news flashes, he has provided an oasis for balance and common sense for readers. Dr. Weil, your long and brave history of challenging the status quo of Western medicine and your ongoing mission to educate others through print, social media, television and lectures is a testament to the beautiful and rich journey youve taken.

After graduating high school in Philadelphia in 1959, Dr. Weil won an American Association for the United Nations scholarship that allowed him to travel abroad for a year where he lived with families in India, Thailand and Greece. Upon his return, he did his undergraduate studies in biology and ethnobotany at Harvard University and earned his medical degree from Harvard in 1968.

He interned at Mount Zion Hospital in San Francisco, then took a post with the National Institute of Mental Health before writing his first book, The Natural Mind. As a fellow of the Institute of Current World Affairs from 1971-75, Dr. Weil traveled widely in the Americas and Africa, studying medicinal plants and alternative treatment methods for disease. From 1971-84, he also was on the research staff of the Harvard Botanical Museum and conducted investigations of medicinal and psychoactive plants.

Dr. Weil founded the Program in Integrative Medicine in 1994 at the UArizona College of Medicine Tucson. Fourteen years later, the program by then a division in the colleges Department of Medicine was designated a center of excellence by the Arizona Board of Regents. In 2019, the center was renamed as the Andrew Weil Center for Integrative Medicine. The center broke ground on its new $23 million, donor-funded building March 16.

A UArizona clinical professor of medicine and public health and the Lovell-Jones Endowed Chair in Integrative Medicine, Dr. Weil also is editorial director of DrWeil.com, a leading online resource for healthy living based on a philosophy of integrative medicine, and a founder and partner of True Food Kitchen restaurants, whose recipes are the basis for his New York Times best-selling book, True Food.

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Dr. Andrew Weil Receives Integrative Healthcare Leader Award - University of Arizona

While the name might seem ominous and call to mind the contents of a sorcerers cauldron, nightshades are among the most common fruits and vegetables, and you likely already have some in your kitchen. So, what are nightshades, and are they good for you?

There are 2,500 species of flowering plants known as nightshades within the Solanaceae plant family.

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Some of the most commonly consumed nightshades include:

Edible nightshades are some of the most nutritious foods around and have been consumed as part of healthy diets for centuries, says Sharon Palmer, MSFS, RDN.

Hundreds of studies have found benefits from eating these foods. In particular, tomatoes have garnished a great deal of research documenting benefits, such as antioxidant, anti-inflammatory benefits and reduced risks of diseases such as prostate cancer and heart disease, says Palmer. They have also been linked to skin and bone protection.

Meanwhile capsaicin in chile peppers may promote hair growth and reduce your cardiovascular and cancer risk. And potatoes are loaded with mood-regulating carbohydrates and muscle-building protein.

Members of the Solanaceae plant family contain alkaloids, including solanine, a natural insecticide. Solanines in belladonna, the so-called deadly nightshade, can cause delirium, hallucinations, and even death. However, the nightshades we commonly consume contain nowhere near high enough levels to cause similar harm.

There is not enough scientific support documenting that people need to avoid nightshades due to alkaloid content, says Palmer.

That being said, potato sprouts and areas of the potato that have turned green from sun exposure contain higher concentration of solanine and, therefore, should be avoided. Symptoms of solanine poisoning include abdominal pain, vomiting, diarrhea, fever or hypothermia, headaches, and a slow pulse or breathing.

Search the internet for the word nightshades, and youre bound to stumble on plenty of articles warning about inflammation and arthritis pain. But no research has turned up evidence that nightshades affect the joints.

There is a lot of urban legend and misinformation about nightshades being perpetuated over the internet and social media, says Palmer. Some people believe that they should avoid nightshades to reduce inflammation for arthritis benefits. However, studies have found that many nightshade vegetables reduce inflammation levels in the body.

Its worth noting that the Arthritis Foundation put nightshade vegetables, namely bell peppers, on its list of Best Vegetables for Arthritis. Red and yellow bell peppers contain the carotenoid beta-cryptoxanthin, which could reduce your risk of developing inflammatory disorders like rheumatoid arthritis. Additionally, tomatoes and peppers are excellent sources of bone- and cartilage-preserving vitamin C, with a single bell pepper containing more than 150% of the Food and Nutrition Boards daily recommended amount. Eggplants, meanwhile, are rich in anti-inflammatory anthocyanins as well as the essential trace element manganese, which is important to bone formation.

The scientific evidence [regarding nightshades and inflammation] isnt very strong at this time, says triple board-certified rheumatologist Micah Yu, MD, who also practices integrative medicine. Maybe in 10, 20 years, well have more evidence.

Yu notes that theres no test to determine whether someone might have a sensitivity to nightshades. If you suspect nightshades are an issue for you, he suggests keeping a food diary and seeing whether certain foods correspond with your inflammatory symptoms or other adverse reactions. You can try avoiding a food to see if symptoms improve, then reintroducing the food to see if symptoms return. If they return, its reasonable to continue avoiding the food, and consult with a registered dietitian.

At least two studies have suggested potatoes could aggravate inflammatory bowel disease. Both were performed using mice, not humans.

In one study from 2002, researchers isolated solanine and the glycoalkaloid chaconine, present in potatoes, to test intestinal permeability and function. They concluded that levels of solanine and chaconine typically found in potatoes can adversely affect a mammals intestine and exacerbate IBD.

In a 2010 study, mice were fed deep-fried potato skins. Researchers found that deep-frying the potato skins increased glycoalkaloid content and that glycoalkaloid consumption significantly aggravated intestinal inflammation in mice representing two models mimicking human IBD (interleukin 10 gene deficiency and dextran sodium sulfate-induced colitis).

But the data are limited, says Vanita Rahman, MD, clinic director of Barnard Medical Center. We know animal studies dont always translate into meaningful results in humans, so its really hard to draw any conclusions about human health, as far as inflammatory bowel disease.

Before eliminating nightshades altogether, Rahman recommends talking to a health care provider and exploring whether anything else could be contributing to IBD symptoms. Keep in mind that certain nightshadespotatoes and eggplantsare rich in fiber, which has been linked to a reduced risk of developing IBD and greater quality of life in patients with ulcerative colitis.

The bottom line is [nightshades] really are nutritious vegetables that contain a lot of important nutrients for us, says Rahman. They have a lot of health benefits. So, most people should consume them in ways that they find enjoyable.

There are plenty of opportunities to reap the health benefits of these delightful fruits and vegetables. Check out these roundups of favorite recipes from Forks Over Knives to get you started.

From baba ghanoush flatbreads to vegan eggplant parm to ratatouille, these recipes showcase eggplants melt-in-your-mouth deliciousness.

Its easy to see why potatoes are so universally beloved. Transform humble taters into impressive entrees, savory side dishes, delectable vegan cheese sauce, wholesome homemade bread, and more.

Brighten your kitchen and delight your taste buds with these colorful and creative bell pepper recipes.

Harness the ripe, juicy goodness of fresh tomatoes for full-flavored soups, bruschetta, grain bowls, marinara, and more.

For more guidance in healthy cooking, check out Forks Meal Planner, FOKs easy weekly meal-planning tool to keep you on a plant-based path. To learn more about a whole-food, plant-based diet, visit our Plant-Based Primer.

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Should You Avoid Nightshades? A Look at the Research - Forks Over Knives

In this interview, Dr. Nasha Winters, coauthor of Mistletoe and the Emerging Future of Integrative Oncology, reviews some of the benefits of this ancient herb in the modern world of oncology. Winters is herself a cancer survivor, so this topic is close to her heart.

Im coming on 30 years out of a death sentence, a terminal cancer diagnosis, she says, and still to this day get met with so much resistance to what Ive learned for myself, and for thousands, if not tens of thousands, of other patients directly, as well as way more than that, indirectly, through the training of their physicians

My crazy controversy is that I focus more on the human organism and the health of that terrain versus the condition, the disease or the label that overlays that person.

Mistletoe, a semi-parasitic plant that grows in the branches of trees all over the world, has been used as a herbal medicine for thousands of years for conditions such as epilepsy, spleen disorders, pain and rheumatic conditions.

Just over 100 years ago, in 1917, Rudolf Steiner, a philosopher with incredibly keen observation skills, noticed the mistletoe looks a lot like a tumor, and proposed it might have anticancer properties. Many vitalistic medical practices, such as Ayurveda, Chinese medicine, naturopathy and homeopathy, for example, use the doctrine of signatures, which is what Steiner was suggesting.

For instance, you look at a walnut and it kind of looks like a brain and we think, I wonder if thats any good for the brain? And sure enough, we find some significance in how it impacts the brain. Or things like lungwort. When you look at it, it looks like a lung and weve learned that this herbal medicine is very helpful for lung conditions, Winters says.

A Swiss doctor named Ita Wegman applied Steiners observation of mistletoe to see how it would impact a patient with cancer, and the plant has since enjoyed over 100 years of consistent application in oncology, both standalone and as adjuvant support.

Interestingly enough Steiner understood that you needed to harvest different components of the plant berries that bloom in the winter, which is very abnormal, and the leaves that grow in the summer and grow inward.

It has a very interesting behavior compared to other plants, and that was an observation of how cancer works as well. It goes against the rhythm. It grows out of sync with the organism. That is very much what he recognized.

And as such, he harvested the plant and aspects of the plant at different times, blended it, and then took a particular extract from it. He also noted that it needed to be injected, because you need to remember, 100 years ago we didnt know about lectins, we didnt know about viscotoxins, yet somehow, he understood that you needed to inject it to get the anticancer benefit.

You could take the full tincture. You could take it in other ways, and it has a lot of other medicinal impacts, but then it doesnt have the anticancer impacts, the reason being, weve learned or at least we suspect, because were still learning is that those lectins and things get broken down in our GI tract and they dont get into the bloodstream; they dont access the immune system in the way they need to

According to Winters, mistletoe is likely to be useful as an adjunct therapy for all cancers, and she, along with several other doctors, has been training physicians on how to use mistletoe for several years now.

One of our physicians has been using mistletoe for 45 years in his practice, and what weve seen clinically, and what the research suggests, is that this therapy, it has always been about using it with others. It plays very well with others.

It was never really developed to be a standalone therapy, though believe me, weve seen impact with that as well. And it has virtually no contraindications with any of our standard of care therapies. So, we can literally inject this into a patient the morning before they go into a surgery, or they can start on this therapy the very day theyre going to start a round of chemotherapy or radiation.

It bypasses first phase detox pathways of the liver, so it doesnt interact, intervene, speed up or slow down detox processes that could otherwise cause some adverse events, or change the desired effect of a certain medication, herbal intervention or dietary intervention.

In fact, mistletoe has been shown to enhance other interventions. Even the most toxic treatments seemingly work better and with fewer adverse effects when combined with mistletoe.

This should be utilized, in my personal opinion, with every patient going through a standard of care approach to just enhance their experience with treatment, she says.

There are a lot of things that we kind of have to be careful with but mistletoe, in my experience, and that of my colleagues, is that this is probably the least harmful and least contraindicated substance and therapy Ive ever had the privilege of working with. Its pretty extraordinary and rare to find something that is this applicable to the masses

As I said, it has over 100 years of continuous use, and has over 250 very good randomized studies It just completed a Phase 1 clinical trial at Johns Hopkins in the United States as an IV application for solid tumors, and is getting ready to be moved into a Phase 2 clinical trial.

It is the most studied integrative oncology therapy in the world, and it is utilized in upwards of 60% to 80% of all cancer patients in Europe. In parts of South and Central America, all over Southeast Asia and India, in different parts of Europe, this is just part of their medical system Its just in the United States where we have a little bit of resistance to embracing it into our conventional medical system

As a naturopathic physician whos been practicing integrative oncology for some time and who has teachers, mentors, colleagues from all over the world, some of the most powerful anticancer therapies Ive seen that are beneficial even to the standard of care model of treatment things like artesunate, curcumin, quercetin, green tea extract, all of those in intravenous forms have been taken out of our ability to use here in the United States.

Do my colleagues still find workarounds to get access to these very important medicines? Absolutely they do, but they have to tread very carefully and very lightly. But again, you go north of the border or south of the border and you have no problem accessing these therapies. Or go to Europe and this is what Ive been doing for the last two years.

These treatments that weve had great success with have been plucked out of our ability to access easily, readily, legally, so were now having to send our patients abroad for them to actually get good cancer care.

Thats whats really devastating to me. So, another part of my purpose and mission is to build an in-house residential research institute and integrative cancer hospital right here on our soil so we dont lose access and patients dont lose access [to helpful remedies].

Winters is currently building that research institute in Arizona, which will be funded entirely by private donations and research grants. Thousands of patients are anxiously waiting for the doors to open. When asked if she isnt worried our pro-pharma agencies might shut them down, she replies:

We will be doing all of our due diligence to let people know that these are not FDA approved therapies, that people are coming into a research environment. Theyre either paying cash or theyre getting grants based on their financial ability to help them cover this care.

Were doing it in a pretty open-minded medical state; Arizona has one of the broadest scopes of practice in the country. And were also very close to our southern border with Mexico, so that if we do come up against someone shutting down one of our therapies for a bit, we are able to take our patients across the border to a little sister clinic to keep the continuity of care.

We dont anticipate that happening because people are coming as a buyer beware. Theyre coming being well-informed about who we are and what were about. And frankly, we get thousands of inquiries a month from all over the world looking for this approach. The patients will drive this home.

Its a mighty David versus Goliath story, especially now, but I also think the time is now because we have these acts, like the Right to Try Act, and because we do have more and more patients facing this diagnosis with grim outcomes.

And, a study that came out in the last year that looked at 17 years worth of conventional cancer treatments found that, overall, of the 96 different drugs they looked at, the average survival rate was 2.4 months. That is the reality and this is whats driving the clinical oncologists from around the world to sign up and take my course

So, there is this massive kind of underground movement thats starting to sprout and come above ground. Thats happening. And frankly, mistletoe is one of the vehicles for that to happen Instead of trying to fix the model, were just creating a new one.

Another potential back door is to convince insurance companies that this is in their best interest. Mistletoe is a natural remedy and therefore cannot be patented, so theres no incentive for the drug companies to pursue it. But insurance companies may support its use once they realize how much money they can save on hospitalizations, drug coverage and everything else.

Your immune system and metabolic function are both integral parts of addressing cancer, and mistletoe works on both. Its important to recognize, however, that its not a magic bullet. If youre eating a standard American diet and are metabolically dysfunctional, mistletoe is not going to be as effective as for someone who is also eating a healthy whole food diet and supporting their health in other ways.

That said, mistletoe is an immunomodulator. Immune therapies are all the rage right now, with a majority of research dollars being funneled into them. Yet the effectiveness rate for these therapies is less than 20%. In other words, theyre hardly a cure.

A lot of folks have heard of Jimmy Carters melanoma story that had metastasized to his brain. He took this immune drug, Keytruda. Thats a checkpoint inhibitor. The most common drugs youll hear about are things like Opdivo, Keytruda, PD-1, PDL1 inhibitors, those are checkpoint inhibitors, or CTLA-4 inhibitors, also a type of checkpoint inhibitor.

These are drugs that kind of pull the breaks off your immune system to go hog wild in treating the cancer. Now that seems like a great idea unless you have underlying metabolic dysfunction, right? Hello! And then, if you have an underlying autoimmune condition, you are also someone whos likely going to have a not so positive response to these medications.

What I love about mistletoe is it comes in and it modulates that teeter-totter. It doesnt take the breaks off and make it go hog wild, and it doesnt suppress. Its kind of adaptogenic in some ways. So, it behaves a little bit like a smart drug, in that it can sort of match itself to the individual.

It is not a protocol, its a patient-driven process in that we look at the persons gender, we look at the tumor type, the tumor stage, the general condition of the patient, and then we consider the most appropriate host tree. The most common are the pine, the fir, and the apple tree hosts. Mistletoe [from these trees] tends to have the highest lectin content that have the highest anti-cancer content.

Then we look at the dosing frequency, and if were going to do it subcutaneous, intravenous, intratumoral, intraperitoneal, et cetera, depending on where you live in the world and how were going to pair it with other therapies, if at all. So, it is based totally on the individual and the individuals response.

We want the patient to have a little local reaction if theyre injecting it. We want it to get a little redness, irritation and itchiness and maybe tenderness. We want it to raise the bodys temperature a little bit The point is, we want to create this cytokine release at a very low-grade level. Whereas when we bring on an immune drug like Keytruda, it creates a cytokine release at an explosive level that can sometimes be fatal for patients.

Similar to drugs, mistletoe also has a systemic effect. It doesnt target a specific receptor site. Instead, its a systemic terrain-centric approach. In its mechanisms of action, its engaging with B-cells, T-cells, natural killer (NK) cells.

It will basically calm those that are acting overzealous, to prevent an excessive immune reaction, and activate those that are dormant or underperforming. Mistletoe also reduces inflammation, lowering your levels of C-reactive protein, interleukin-6, homocysteine, liver enzymes and more.

It also lowers vascular endothelial growth factor (VEGF), which can be important for certain cancers, and it lowers blood sugar and insulin. Winters also suspects mistletoe may be upregulating both the endorphin and the endocannabinoid system, so youre getting stress modulation as well.

So, its hitting all of what we call The Terrain 10, from my previous book, The Metabolic Approach to Cancer. I find that mistletoe tends to hit every one of those including epigenetic expression clean up of DNA.

We use it for people whove gone through radiation. Well use it as a DNA stabilizer. Well use it if people have taken a course of Cipro [and other fluoroquinolones] to help clean up the metabolic mayhem, the DNA damage that they cause. We know that it has some impact on insulin and IGF-1.

In our book, we have hundreds of references to all of the different mechanisms of action. My colleague, Dr. Paul Faust, [has written] a beautiful chapter on its direct impact on the immune system and all the nuances of that.

That chapter alone will illuminate for so many people why this therapeutic support and this therapeutic intervention is so helpful for the cancer patient, for prevention of cancer, for cleanup after cancer treatment

And the synergy, when you pair mistletoe with hyperthermia, like so many of my colleagues in Europe have been doing for the past 50 years, talk about the biggest bang for your buck. We see some pretty extraordinary outcomes.

Ive had patients go to Europe with Stage 4 [cancer], metastatic disease everywhere, getting IV mistletoe along with local, regional and whole body high-heat hyperthermia that have put their cancer into complete remission in many cases, but at the very least, turning it back into a manageable disease process, and even more interesting, increasing the responsivity to other therapies again.

The good news is the number of doctors trained in this therapy is growing, and the treatment itself is only between $200 and $300 a month, so its highly affordable while also being highly effective. I think it would be beyond irrational not to integrate this into any cancer therapy youre considering.

Again, for cancer, oral supplementation is ineffective, as the lectins responsible for the anticancer effects are broken down in your GI tract and therefore cant enter your bloodstream.

The Physicians Association for Anthroposophic Medicine (PAAM) sponsors Winters mistletoe trainings. While most are held in person, theres now also a course available online for licensed physicians. There are plans to take a group of physicians to Europe for immersive in-hospital training in the fall of 2023. Heres a list of resources where you can find more information:

AnthrosophicMedicine.org offers articles, research, books, webinars and more. To locate a clinician trained in the proper administration of mistletoe, see PAAMs health provider directory.

Clinicians interested in training, visit the education section of PAAMs website. The next annual training conference will be held in Loveland, Colorado, April 29 through May 6, 2023.

Metabolic Terrain Institute of Health (MTIH) is the not-for-profit association cofounded by Winters that is building a research hospital in Arizona. MTIH also offers a master course for practitioners, and grants to help patients access these therapies. Certified practitioners can be found on terrain.network.

These practitioners include medical doctors and oncologists who have been taught Winters methodology of testing, assessing and treating cancer (which includes but is not limited to mistletoe therapy). MTIH certified practitioners are also listed on DrNasha.com.

Mistletoe-therapy.org is a European website that offers helpful information for patients and scientific papers directed at clinicians.

A load of resources are found on the books website: http://www.themistletoebook.com. Proceeds from this book go to fund clinical research and contribute to physician training.

Last but certainly not least, youll want to pick up a copy of Mistletoe and the Emerging Future of Integrative Oncology. Its an excellent book.

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Mistletoe and the Emerging Future of Integrative Oncology - Verve Times

D. Srinivasa Reddy took charge as the new director of the Indian Institute of Chemical Technology (IICT) in Hyderabad on Friday. He took charge from NGRI director V.M. Tiwari officiating as the director additional in-charge since December 2021.

Prior to this, Dr. Reddy was the director of CSIR-Indian Institute of Integrative Medicine (CSIR-IIIM), Jammu, since 2020, and director (additional charge) CSIR-Central Drug Research Institute (CSIR-CDRI), Lucknow, since February 2022.

As full time director of CSIR-IICT, Dr. Reddy will also hold the additional charge of the post of director of CSIR-IIIM, Jammu and director, CSIR-CDRI, Lucknow.

He completed his graduation and post-graduation from Osmania University before completing his PhD in synthetic organic chemistry from the University of Hyderabad under the supervision of Professor Goverdhan Mehta in 2000. He did his post-doctoral work at the laboratories of Sergey A. Kozmin of the University of Chicago and Jeffrey Aub of the University of Kansas during 2001-03.

Dr. Reddy is the recipient of J.C. Bose Fellowship, Shanti Swarup Bhatnagar Prize in Chemical Sciences, Fellow of the Indian Academy of Sciences, India (FASc) and Fellow of the National Academy of Sciences, India (FNASc), said an official release.

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If youve changed your supplement routine since the pandemic, youre not alone. According to a 2020 survey conducted by the Council for Responsible Nutrition (CRN), more than 43 percent of dietary supplement users have switched things up. Among those who updated their regimens, 91 percent reported increasing their supplement intake, either by adding new supplements, taking the same supplements more regularly, or upping their dose(s). Overall immune support and health and wellness benefits are cited as the top reasons.

But while supplements are often seen as a method to ensure you meet your daily nutritional needs, they can create problems if youre not careful. Like drugs, dietary supplements can affect the way your body functions, which can cause adverse effects in some people, according to an article published in the May 2022 issue of U.S. Pharmacist.

So, how do you know if youre overdoing it with the supplements? Read on to find out.

[In general], a supplement is something youre not getting enough of through food, says Rohit Moghe, PharmD, CDCES, a pharmacist with Trinity Health Mid-Atlantic in Philadelphia, and member of the American College of Lifestyle Medicine (ACLM).

To fill in these nutrient gaps, many people turn to gummies, capsules, powders, tinctures, and even saline solutions delivered via needle (known as IV therapy).

In the Dietary Supplement Health and Education Act of 1994, Congress defined supplements as products (other than tobacco) that are intended to supplement the diet, contains one or more dietary ingredients (including vitamins, minerals, herbs, botanicals, amino acids, or other substances) or their constituents, is intended to be taken by mouth as a pill, capsule, tablet, or liquid, and is labeled as a dietary supplement.

While many people are able to meet their nutrient needs through their diet, others may benefit from supplements. Particularly those who face a greater risk of nutrient deficiencies, including those with higher requirements (like children, adolescents, and pregnant and lactating women), those who struggle to absorb nutrients (like older adults, obese individuals, and people with chronic conditions), and those who follow a restrictive diet (like vegans and vegetarians), according to an article published in January 2018 article in Nutrients.

For example, a vitamin B12 supplement may be a good idea for older adults and people who follow a vegan or vegetarian diet. Vitamin B12 helps keep your blood and nerve cells healthy, and plays an important role in making DNA, per theNational Institutes of Health (NIH). Its found naturally in animal foods, which means vegans and vegetarians may not get enough through diet alone. Older adults may also be deficient in vitamin B12, because many dont have enough hydrochloric acid in their stomach to absorb it, according to the NIH. Therefore, both groups might benefit from a vitamin B12 supplement.

A common concern about supplements is that the industry, in general, is under-regulated. Unlike medications, supplements dont have to be approved by the U.S. Food and Drug Administration (FDA) before theyre sold or marketed.

New legislation, proposed by Senate Majority Whip Dick Durbin, a Democrat from Illinois, and Sen. Mike Braun, a Republican from Indiana, aims to improve the safety of dietary supplements by requiring manufacturers to list their products with the FDA under the Dietary Supplement Listing Act of 2022 a bipartisan initiative. The new legislation, which refers to the Dietary Supplement Health and Education Act of 1994, points out that in 1994 there were about 4,000 dietary supplements marketed in the United States, but the industry has boomed and now 50,000 to 80,000 products are available.

In the meantime, consumers cant be sure the supplements theyre taking are safe or effective.

Even if a supplement is considered generally safe, it may not be safe for you. Most vitamins and minerals have a risk of harm with dosages, and the risk is based on the individual nutrient and patient, says Ravi Tripathi, MD, medical director of critical care services for the Ross Heart Hospital at The Ohio State University Wexner Medical Center in Columbus. When it comes to supplements and risks, there is no one size that fits all, he says.

For example, people with an inherited condition called hemochromatosis have to be careful with iron supplements, as hemochromatosis causes toxic levels of iron to build up in their bodies, notes theNIH. And while most people dont get enough potassium even when diet and supplements are combined, according to theNIH, people with chronic kidney disease can develop abnormally high levels of potassium in their blood. This condition, known as hyperkalemia, can cause serious heart problems if left untreated, according to theNational Kidney Foundation.

Supplements can pose risks even in otherwise healthy people. According to theNIH, youre more likely to have side effects from dietary supplements if you take them at high doses or use many different supplements.

The symptoms from taking more supplementation that your body needs vary depending on the nutrient and the amount taken, and may only show up in blood tests. However, there are some physical signs to watch for. According to the May 2022U.S. Pharmacist article, general symptoms to look out for may include:

Why its good for you: Vitamin D (also known as the sunshine vitamin) helps your body absorb calcium, making it a key nutrient for bone health. Your body also needs vitamin D to carry messages between your brain and your body and fight off bacteria and viruses, according to the NIH.

Why you might be overdoing it: On the one hand, 40 percent of Americans are deficient in vitamin D, per blood tests (when serum levels are less than 50 nmol/L), according tofindings published in June 2018 in Cureus. The reason? Most of us arent getting enough sunlight exposure, notes the NIH. Taking a vitamin D supplement may help and the CRN survey shows this supplement is becoming more popular but its important to watch your dosage to ensure you dont get more than 100 micrograms (mcg) a day. According to the NIH, overdosing is almost always caused by taking supplements, as opposed to sunlight exposure or eating vitamin Drich foods.

Risks: Very high levels of vitamin D can cause nausea, vomiting, muscle weakness, pain, loss of appetite, dehydration, and kidney stones, per the NIH.

Why its good for you: Iron is a mineral your body needs to make hemoglobin, a protein in red blood cells that carries oxygen throughout your body, according to theNIH. It also helps your body make hormones.

Why you might be overdoing it: Iron supplements are often recommended for younger women to help offset iron lost during menstruation. But according to theCleveland Clinic, many women continue to take supplements containing iron after menopause, when menstruation stops and iron needs decrease.

Risks: Getting too much iron can cause gastrointestinal (GI) symptoms like constipation, nausea, vomiting, abdominal pain, and diarrhea, per the NIH. Overdosing on iron can also lead to inflammation of the stomach lining and ulcers. Although rare, extremely high doses of iron (in the hundreds or thousands of milligrams) can even cause organ failure, coma, convulsions, and death, according to the NIH.

Why its good for you: According to theNIH, vitamin A is important for vision, immune health, reproduction, growth, and development.

Why you might be overdoing it: Its pretty easy for most people to score plenty of vitamin A. If you eat cereal for breakfast and carrots or sweet potatoes at lunch, and then pop a supplement for eye health, youve probably gone over the recommended amount, says the Cleveland Clinic.

Risks: High levels of vitamin A can cause severe headaches, blurred vision, nausea, dizziness, muscle aches, and coordination issues, notes the NIH.

Why its good for you: Vitamin C, also known as ascorbic acid, acts as an antioxidant, helping to protect your body from free radical damage. According to theNIH, your body also needs vitamin C to make collagen, a protein thats important for wound healing.

Why you might be overdoing it: The CRN survey found that vitamin C supplements have seen a big boost since the pandemic. However, most people can get enough vitamin C through food. In fact, 1 cup of strawberries, chopped red pepper, or broccoli will provide the daily amount needed, per Mayo Clinic.

Risks: Taking too much vitamin C can cause diarrhea, nausea, and stomach cramps, according to Mayo Clinic. Vitamin C supplements may also interact with cancer treatments like chemotherapy and radiation therapy, per the NIH. In addition, a past study found that men who took vitamin C supplements had a higher risk for developing kidney stones.

Why its good for you: Calcium is a mineral that builds and maintains strong bones. It also plays a role in nerve function, circulation, and hormone release, according to theNIH.

Why you might be overdoing it: You may be tempted to load up on calcium supplements to protect your bones, but according to theCleveland Clinic, its surprisingly easy to overdo it. Especially if youre already getting calcium from your food.

Risks: Excess calcium has been linked to constipation, kidney stones, kidney failure, heart problems, and cognitive issues, according to the Cleveland Clinic.

Experts often recommend speaking with your doctor before trying a supplement. Unfortunately, many physicians and nurse practitioners arent as knowledgeable in this area. I find many [healthcare professionals] are grossly unprepared to answer their patients questions, and they wind up telling them that supplements are a waste of money, when maybe theres a product that may actually work for your intended use, Dr. Moghe says.

If youre interested in adding a supplement to your diet, Moghe suggests talking with a physician trained in integrative medicine or nutritional medicine, a pharmacist, naturopath, or registered dietitian. You can check the directories of the National Board of Physician Nutrition Specialists and the American Board of Physician Specialties to find a healthcare professional who works for your needs.

Simple blood tests can reveal if youre deficient in specific nutrients, but the routine blood work at your annual physical doesnt typically include these tests, although some nutritional deficiencies can produce changes on these labs, according toRush University. Youll have to request these blood tests when you visit your doctor. A physician trained in integrative medicine and/or nutritional medicine, a pharmacist, naturopath, or registered dietitian may be able to offer suggestions and a tailored approach to getting the right levels of nutrients for you, and explore whether it makes sense to test for specific vitamin deficiencies given your unique lifestyle, diet, and health.

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Can You Take Too Many Supplements? - Everyday Health

Health experts warn that diabetes has become a silent epidemic in the U.S.and a silent killer. For the last two years, deaths from diabetes have hit record levels. It doesn't have to be this way. For many people, diabetes is preventable. Diabetes can lead to serious health complications like heart disease and stroke, so it's important to take steps to avoid developing the disease if possible. That includes avoiding the #1 root of diabetes. Read on to find out moreand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Diabetes is the body's inability to process sugar (glucose). Normally, when a non-diabetic person consumes sugar, their pancreas releases an enzyme called insulin to help cells convert and use sugar for energy. In a diabetic person, the pancreas either doesn't make insulin, or the body becomes resistant to insulin. Blood sugar can builds up in blood vessels, causing damage. This can lead to an increased risk of heart disease, stroke, blindness, even amputation.

Type 1 diabetes, once known as "juvenile diabetes," can develop at any age. But type 2 diabetes is the kind that has become epidemic in the United Statesup to 95% of people with diabetes have this typeand it's directly connected to diet and lifestyle choices. Experts predict one in 10 people will have diabetes by the year 2045.

There are many risk factors for type 2 diabetes, but one of the biggest is a poor diet high in processed foods and added sugar. They're closely relatedmany processed foods quickly break down into sugar. When the body is swamped with sugar, it can become resistant to insulin. The body isn't able to process glucose for energy, and serious health consequences can follow.

Eating this kind of diet increases your risk of being overweight or obese, a major contributor to diabetes. "You are more likely to develop type 2 diabetes if you are not physically active and are overweight or obese," says the National Institutes of Health. "Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease."

It's especially important to limit or avoid sugar-sweetened beverages, such as sodas, juices and sports drinks. The average American consumes the equivalent of 17 teaspoons of sugar a day, mainly through sugar-sweetened beverages, desserts and sweet snacks.

"A lot of the foods we eat are diabetogenic. What that means is they increase your risk for insulin resistance and diabetes," says Aaron Hartman, MD, a board-certified functional medicine and integrative medicine doctor in Richmond, Virginia, and assistant clinical professor of family medicine at Virginia Commonwealth University. "Sugars are one diabetogenic food. Processed carbohydrates are another. The first rule of thumb if you want to prevent diabetes is to eat real food." A diet rich in fruits and vegetables, whole grains, lean protein (especially fatty fish, like salmon) and good fats (like avocados, nuts and olive oil) may reduce your risk of diabetes and other chronic illnesses like heart disease and cancer.6254a4d1642c605c54bf1cab17d50f1e

To reduce your diabetes risk or manage your diabetes, increasing your physical activity is important. Exercise builds muscle and makes them more sensitive to insulin, so the body utilizes it better. "For people who have diabetesor almost any other disease, for that matterthe benefits of exercise can't be overstated," says Harvard Medical School. "Exercise lowers blood glucose levels and boosts your body's sensitivity to insulin, countering insulin resistance." Studies have found that all types of exercise help, but a combination of aerobic exercise and resistance training is particularly effective in reducing insulin resistance. Experts recommend aiming for 150 minutes of moderate-intensity exercise each week, including two sessions of resistance exercise.And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Michael Martin

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The #1 Source of Diabetes, According to Science Eat This Not That - Eat This, Not That

CHICAGO Eduardo Bruera, M.D., chair of Palliative Care Medicine at The University of Texas MD Anderson Cancer Center, has received the American Society of Clinical Oncology (ASCO) Walther Cancer Foundation Supportive Oncology Award. Bruera was formally recognized today at the 2022 ASCO Annual Meeting during the Mentorship and Career Development Roundtable.

The Walther Cancer Foundation Supportive Oncology Award is one of the highest honors presented by ASCO and Conquer Cancer, the ASCO Foundation. Endowed by the Walther Cancer Foundation, a private foundation that supports and promotes interdisciplinary and inter-institutional bench and clinical cancer research, the award and lecture were established to recognize a distinguished lecturer and leader who has made multiple, significant and enduring contributions to palliative and supportive care in oncology through the prevention, assessment and management of cancer- and treatment-related suffering.

I am honored to receive the award and to have ASCO recognize the importance of clinical and research programs aimed at alleviating the physical and psychosocial suffering associated with cancer, said Bruera, who holds the F.T. McGraw Chair in the Treatment of Cancer. We are committed to continuing our efforts to build upon these structures and processes for the benefit of our patients.

As an internationally renowned leader in the field, Bruera has made innumerable contributions to palliative and supportive care with significant impacts on the quality of life for patients with cancer and their families.

He established the Department of Palliative, Rehabilitation and Integrative Medicine at MDAnderson in 1999. Under his leadership, the department has become the largest clinical and academic palliative care program in the world, with an interdisciplinary outpatient Supportive Care Center and both inpatient and outpatient Palliative Care programs. These serve as a model for other institutions, nationally and internationally. The programs structures, processes and outcomes are shared with faculty and leaders of cancer centers across the country and have been reported in peer-reviewed journals and scientific meetings, including the ASCO Annual Meeting and ASCO Palliative Care Symposium.

Dr. Bruera is recognized as an outstanding clinician scientist, a dedicated leader and a passionate educator, said Peter WT Pisters, M.D., president of MD Anderson. Through his leadership, unwavering commitment and pioneering work, his profound contributions have increased the visibility and integration of palliative care into oncology care on a local, national and international level. We are proud that he is receiving this prestigious recognition by ASCO.

Throughout the course of Brueras distinguished career, he has pioneered practice-changing discoveries that have transformed the delivery of modern palliative care and helped to alleviate suffering for patients affected by cancer.

He developed methodologies and conducted research studies instrumental in establishing routine clinical practices in supportive and palliative care including patient-reported outcomes measurement, methylphenidate for opioid sedation and fatigue, opioid rotation and methadone for refractory pain. In addition, he established strategies for corticosteroids for fatigue and symptom control, assessment and management of delirium, opioids and oxygen for dyspnea, and the screening and management of chemical coping and opioid use disorders in cancer patients.

Bruera led numerous research studies aimed at improving the quality of life for cancer patients. He developed and validated the Edmonton Symptom Assessment Scale (ESAS) decades before patient-reported outcome measurements became fully accepted. The ESAS is designed to assist in the assessment of nine symptoms common in cancer patients and provides a clinical profile of symptom severity over time. The tool has been translated into 60 languages and is currently the most commonly used tool for symptom assessment of palliative care and cancer patients worldwide. Bruera made ESAS available free of charge for anyone to use.

Bruera has authored more than 1,075 papers in top peer-reviewed journals, such as The Lancet, Lancet Oncology, JAMA, JAMA Oncology, JAMA Internal Medicine, Journal of Clinical Oncology and Cancer, as well as co-authored Dying in America. Bruera is a frequently invited speaker at national and international scientific conferences, and he has delivered over 900 invited lectures to major cancer centers and supportive and palliative care congresses.

Dr. Bruera has been a longstanding preeminent leader in palliative and supportive care, said Christopher Flowers, M.D., division head ad interim of Cancer Medicine. His dedication and service in this field has had a tremendous impact on patients at MD Anderson and around the world, and he continues to advance research and initiatives to improve their lives.

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About MD Anderson

The University of Texas MD Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. The institutions sole mission is to end cancer for patients and their families around the world. MD Anderson is one of only 52 comprehensive cancer centers designated by the National Cancer Institute (NCI). MD Anderson is No. 1 for cancer in U.S. News & World Reports Best Hospitals rankings and has been named one of the nations top two hospitals for cancer since the rankings began in 1990. MD Anderson receives a cancer center support grant from the NCI of the National Institutes of Health (P30 CA016672).

2022 The University of Texas MD Anderson Cancer Center

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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ASCO honors Eduardo Bruera, MD, with Walther Cancer Foundation Supportive Oncology Award - EurekAlert

By Andrew L. Salner, MD, FACR, FASTRO

Medical Director, Hartford HealthCare Cancer Institute at Hartford Hospital

The number of cancer survivors living in the United States continues to increase each year as a result of updated early-detection practices and treatment advances, as well as aging of the population. In 2019, an estimated 17 million Americans were cancer survivors. According to researchers at the American Cancer Society, that number is expected to increase to some 22 million by the year 2030.

The most common diagnoses for female survivors are:

The most common diagnoses amongst male survivors are:

These numbers do not include the large number of patients who have experienced non-melanoma skin cancer (basal cell and squamous cell cancer) or non-invasive bladder cancer.

Of the 17 million survivors, over two-thirds were diagnosed and treated more than five years ago, and 18 percent have been surviving their disease for over 20 years. More than two-thirds of the survivors are age 65 or over, while 10 percent are younger than 50. Approximately 52 percent of survivors are female.

Cancer is a common disease some 43 percent of us will receive the diagnosis during our lifetime. As early detection and treatment continue to improve, the number of survivors will grow each year. The overall five year survival rate from a cancer diagnosis has increased from 49 percent in 1975, to 63 percent in 1995, to close to 70 percent today. While we celebrate these milestones, we realize we still have much more work to do in developing new prevention strategies, screening techniques and therapies. In addition, we also understand that cancer survivorship has associated with it a complex set of issues that require attention on many fronts.

Enduring a cancer diagnosis and therapy not only affects patients physically, it can also impact them emotionally, socially and spiritually. From the physical perspective, treatment can commonly disrupt a patients quality of life due to short and long term side effects including fatigue, pain, sleep disturbance and functionality. Emotional and psychological wellbeing may be impacted by fear of recurrence, anxiety, depression, concentration and memory issues. Social wellbeing may be impaired due to impacts on relationships with others, and issues of intimacy and sexuality. Spirituality may be impacted by ones enhanced hope and resilience or the impairment thereof due to despair.

Other challenges facing survivors include a slightly increased risk of second cancers, the importance of continued surveillance for the initial cancer diagnosis, and the possible presence of financial hardship as a result of the treatment journey, even when medical insurance is present, due to lost work opportunity and other associated costs.

Cancer survivors have an opportunity to help improve their quality of life and possibly reduce the risk of recurrence by adopting healthy behaviors such as:

Hartford HealthCare providers monitor patients for late effects of treatment, and suggest strategies to help cope with a wide array of these survivorship issues. In addition, specific resources are available to help patients overcome these obstacles. For example, a survivorship APRN helps patients by presenting a survivorship care plan designed to present a personalized list of potential issues for patients who so desire. Psychologists and social workers provide counseling to help patients deal with the emotional impact of the experience.

Other resources available include dietary counseling, smoking cessation and integrative medicine strategies such as massage therapy, yoga, acupuncture and Reiki, all designed to help deal with some of the physical and emotional effects of therapy. Your oncology team can help make the referrals for these services as needed.

Articles in our monthly newsletter will provide more detailed information as we dive into survivorship issues related to each type of cancer diagnosis and intervention. At the Hartford HealthCare Cancer Institute, we are committed to your long term wellness.

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Going Beyond Treatment - Hartford HealthCare's Cancer Institute Fights for Survivors - Health News Hub

Michael Glick: ADI International Dentist of the Year for 2021

Michael Glick, Executive Director of Penn Dental Medicines Center for Integrative Global Oral Health, was named the Academy of Dentistry Internationals International Dentist of the Year for 2021. The award honors career contributions to dentistry, international education, and service.

Dr. Glick has been active with the FDI World Dental Federation since 2007, serving on multiple committees. He also had a leading role in establishing FDIs Vision 2020 and most recently was the primary author of its Vision 2030, giving guidance for a global interdisciplinary and integrative role for oral health. Dr. Glick served as Editor-in-Chief of The Journal of the American Dental Association from 2005 to 2020.

Dr. Glick served as Dean of the University at Buffalo, SUNY, School of Dental Medicine (2009-2015) where he remained as professor of oral diagnostic Sciences before coming to Penn Dental Medicine in 2021 to lead Penn Dental Medicines new Center for Integrative Global Oral Health (CIGOH). The schools first policy center, CIGOH is seeking to find creative solutions to address unmet oral health needs around the world through public policy, education, and research initiatives, collaborating across disciplines and across borders.

The ADI will present the award at its 2022 annual meeting (delayed a year due to the COVID-19 pandemic), to be held in November in San Antonio, Texas. Dr. Glick was also invited to present a continuing education lecture as part of the meeting.

The ADI is an international honor society for dentists dedicated to sharing knowledge in order to serve the dental health needs and to improve the quality of life of people throughout the world.This transnational organization is devoted to the advancement of dentistry throughout the world and to the elevation of dental standards by continuing education. There are chapters and fellows in over 80 countries around the world.

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Michael Glick: ADI International Dentist of the Year for 2021 - U Penn