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April is National Autism Month

4/23/2019

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One of the most common questions asked after a diagnosis of autism, is what caused the disorder.
We know that there’s no one cause of autism. Research suggests that autism develops from a combination of genetic and nongenetic, or environmental, influences.
These influences appear to increase the risk that a child will develop autism. However, it’s important to keep in mind that increased risk is not the same as cause. For example, some gene changes associated with autism can also be found in people who don’t have the disorder. Similarly, not everyone exposed to an environmental risk factor for autism will develop the disorder. In fact, most will not.
Autism’s genetic risk factorsResearch tells us that autism tends to run in families. Changes in certain genes increase the risk that a child will develop autism. If a parent carries one or more of these gene changes, they may get passed to a child (even if the parent does not have autism). Other times, these genetic changes arise spontaneously in an early embryo or the sperm and/or egg that combine to create the embryo. Again, the majority of these gene changes do not cause autism by themselves. They simply increase risk for the disorder


Autism’s core symptoms
are:
  • social communication challenges and
  • restricted, repetitive behaviors.
In autism, these symptoms
  • begin in early childhood (though they may go unrecognized)
  • persist and
  • interfere with daily living.
Specialized healthcare providers diagnose autism using a checklist of criteria in the two categories above. They also assess symptom severity. Autism’s severity scale reflects how much support a person needs for daily function.
Many people with autism have sensory issues. These typically involve over- or under-sensitivities to sounds, lights, touch, tastes, smells, pain and other stimuli.

Autism is also associated with high rates of certain physical and mental health conditions.



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March is Kidney Cancer Awareness Month

3/5/2019

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The Kidney Cancer Association (KCA) is the world’s first and largest international charity dedicated specifically to the eradication of death and suffering from renal cancers. KCA is a charitable organization made up of patients, family members, physicians, researchers and other health professionals from around the world. KCA funds, promotes and collaborates with the National Cancer Institute (NCI), American Society for Clinical Oncology (ASCO), American Urological Association (AUA) and other institutions on research projects. We also educate families and physicians, and serve as an advocate on behalf of patients at the state and federal levels in the United States and globally. Every March, Kidney Cancer Awareness Month helps to raise awareness and educate the public about the essential role kidneys play in our overall health. While many people remain at risk for developing kidney cancer during their lifetime, most are not aware that they may be vulnerable. To raise awareness of kidney cancer and the need for a cure, KCA is launching a series of campaigns this March, starting with #OrangeMarch.  KCA is urging supporters to wear kidney cancer awareness items, including orange ribbons – the official color of KCA. You can now visit www.OrangeMarch.com (link is external) to order your free Awareness Gear.

March is also World Kidney Cancer Remembrance Month. We invite you to  of your loved ones – including those who have survived renal cancers, family and friends, and those whose memory we honor in this month-long worldwide celebration of life and remembrance.  You can also help us raise awareness of kidney cancer by joining and sharing with Kidney Cancer Answers.

Join us in the fight against kidney cancer this Kidney Cancer Awareness Month. Learn more and find resources at www.kidneycancer.org.



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April 23rd, 2018

4/23/2018

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What is Autism?

Autism Overview
Autism is one of a group of neurodevelopmental disorders known as pervasive developmental disorders (PDDs). These are characterized by problems with communication and social interaction. Patients often demonstrate restricted, repetitive, and stereotyped behavior patterns or interests.


Signs and Symptoms

According to the Autism Society, autism symptoms typically become clearly evident during early childhood, between 24 months and 6 years of age. Symptoms include a marked delay in language and cognitive development. There may be signs of obsessive and/or antisocial behavior.
Asperger syndrome, another PDD, may be referred to as “high functioning autism.” Asperger syndrome usually lacks the primary communication and cognitive problems that characterize classic autism.
Autism symptoms can range from mild to severe. Some people may be considered autistic but manage to function in society without many setbacks. For others, the condition can have a substantial impact on their lives.

Causes of Autism The exact cause of autism and other autism spectrum disorders (ASDs) is unknown. The most current science demonstrates that there is no single cause of autism. According to the National Institute of Neurological Disorders and Stroke, it’s likely that both genetics and environment play a role.



Prevalence of Autism
Autism spectrum disorders are found in individuals around the world, regardless of race, cultural, or economic background. According to the Centers for Disease Control and Prevention (CDC), autism does occur more often in boys than in girls, with a five-to-one male-to-female ratio.
The CDC estimates that one in 68 children have been identified with autism spectrum disorder. There are indications that instances of ASDs are on the rise. Some fault environmental factors. However, experts debate whether there is an actual increase in cases or just more frequent diagnoses.

Types of Autism Spectrum Disorders
Classic autism usually entails substantial problems in all of the areas affected by ASDs. Someone with Asperger syndrome has issues with behavioral and social interaction. The symptoms experienced by people with Asperger syndrome are usually less severe than those experienced by patients with classic autism.
There is still some debate as to whether Asperger syndrome is a variation of classic autism. Some argue that it should be classified as a separate disorder.
Pervasive Development Disorder–Not Otherwise Specified (PDD-NOS) is a classification for someone who exhibits signs of autism but does not fit into the categories of classic autism or Asperger.

Treatments and Outlook
There is no cure for ASDs. The most effective treatments involve early and intensive behavioral interventions. It is generally agreed that the earlier a child is enrolled in these programs, the better their outlook will be.
Since conventional medicine has not found a cure for ASDs, patients and their advocates have sought alternatives, including:

  • high dose vitamins
  • chelation therapy
  • hyperbaric oxygen
There is currently no evidence that these treatments are effective. Parents should weigh the research and financial costs before investing in any of these therapies for their children.

Article from healthline magazine
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March 29th, 2018

3/29/2018

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What is colorectal cancer?

Colorectal cancer is a cancer that starts in the rectum or colon. Both of these organs are in the lower portion of your digestive system. The colon is also known as the large intestine. The rectum is at the end of the colon. According to the American Cancer Society (ACS), an estimated one in 22 men, and one in 24 women will develop colorectal cancer during their lifetime.
Your doctor may use staging as a guideline to figure out how far along your cancer is. It’s important for your doctor to know the stage of your cancer so they can come up with the best treatment plan for you, and give you an estimate of your long-term outlook. Stage 1 of colorectal cancer is the earliest stage. The stages progress up to stage 4, which is the most advanced stage. The stages of colorectal cancer are:
  • Stage 1 cancer has penetrated the lining, or mucosa, of the colon or rectum but hasn’t spread to the organ walls.
  • Stage 2 cancer has spread to the walls of the colon or rectum but hasn’t affected the lymph nodes or nearby tissues yet.
  • Stage 3 cancer has moved to the lymph nodes but not to other parts of the body yet. Usually, one to three lymph nodes are involved at this stage.
  • Stage 4 cancer has spread to other distant organs, such as the liver or lungs.

Symptoms
What are the symptoms of colorectal cancer? Colorectal cancer may not present any symptoms, especially in the early stages. If you do experience symptoms, they may include:
  • constipation
  • diarrhea
  • changes in stool color
  • changes in stool shape, such as narrowed stool
  • blood in the stool
  • bleeding from the rectum
  • unexplained weakness
  • passing excessive gas
  • fatigue
  • unintended weight loss
  • abdominal cramps
  • abdominal pain
If you notice any of these symptoms, make an appointment with your doctor to discuss a colon cancer screening.

Causes
What causes colorectal cancer?Researchers don’t know what causes colorectal cancer yet. However, they do know that colorectal cancer develops when healthy cells become abnormal. The abnormal cells divide and multiply faster than they should and don’t die when they should. This leads to an accumulation of unhealthy cells.
Precancerous growthsAbnormal cells accumulate in the lining of the colon, forming polyps, which are small, benign growths. Removing these growths through surgery is a common prevention method. Untreated polyps can become cancerous.
Gene mutations Sometimes, colorectal cancer occurs in family members. This is due to a gene mutation that passes from parent to child. These mutations don’t guarantee that you’ll develop colorectal cancer, but they do increase your chances.

Risk factors
Who is at risk for colorectal cancer?There are some factors that may increase your risk of developing colorectal cancer:
Unavoidable factorsSome factors that increase your risk of getting colorectal cancer are unavoidable. Getting older is one of them. Your chances of developing this cancer increase after you reach the age of 50. Some other unavoidable risk factors are:
  • a prior history of colon polyps
  • a prior history of bowel diseases
  • a family history of colorectal cancer
  • having a genetic syndrome, such as familial adenomatous polyposis (FAP)
  • being of Eastern European Jewish or African-American descent
Avoidable factorsSome risk factors for colorectal cancer are:
  • being overweight or obese
  • smoking
  • a heavy use of alcohol
  • having type 2 diabetes
  • having a sedentary lifestyle
  • consuming a diet high in processed foods or red meats

Diagnosis
How is colorectal cancer diagnosed?Early diagnosis of colorectal cancer gives you the best chance of curing your colorectal cancer. Your doctor will start by getting information about your medical and family history. They’ll also perform a physical exam. The doctor may press on your abdomen or perform a rectal exam to determine the presence of lumps or polyps.

Blood testing
Your doctor may run some blood tests to get a better idea of what’s causing your symptoms. Though there is no blood test that specifically checks for colorectal cancer, liver function tests and complete blood count (CBC) tests can rule out other diseases and disorders.

Colonoscopy
A colonoscopy involves the use of a long tube with a small, attached camera. This procedure allows your doctor to see inside your colon and rectum, and to note anything unusual. During a colonoscopy, your doctor can also remove tissue from abnormal areas. These tissue samples can then be sent to a laboratory for analysis.
X-ray Your doctor may order an X-ray using a radioactive contrast solution that contains the metallic element barium. Your doctor will insert this liquid into the bowels through the use of an enema. Once in place, the barium solution coats the lining of the colon, and helps to improve the quality of the X-ray images.

CT scans provide your doctor with a detailed image of your colon. In the case of colorectal cancer, another name for a CT scan is a virtual colonoscopy.

Treatments
What are the treatment options for colorectal cancer?Treatment of colorectal cancer depends on a variety of factors. The state of your overall health and the stage of your colorectal cancer will help your doctor create a treatment plan.
SurgeryIn the earliest stages of colorectal cancer, it might be possible for your surgeon to remove cancerous polyps through surgery. During surgery, if the polyp hasn’t attached to the wall of the bowels, you’ll likely have an excellent outlook.
If your cancer has spread into your bowel walls, your surgeon may need to remove a portion of the colon or rectum, along with any neighboring lymph nodes. If at all possible, your surgeon will reattach the remaining healthy portion of the colon to the rectum. If this isn’t possible, they may perform a colostomy. This involves creating an opening in the abdominal wall for the removal of waste. A colostomy may be temporary or permanent.

Chemotherapy
Chemotherapy involves the use of drugs to kill cancer cells. In the case of colorectal cancer, chemotherapy is a common treatment after surgery to destroy any remaining cancerous cells. Chemotherapy also controls the growth of your tumor.
While chemotherapy provides some symptom relief in late-stage cancer, it often comes with side effects that need to be controlled with additional medication.
Radiation Radiation uses a powerful beam of energy, similar to that used in X-rays, to target and destroy cancerous cells before and after surgery. Radiation therapy commonly occurs alongside chemotherapy.
MedicationIn September of 2012, the U.S. Food and Drug Administration (FDA) approved the drug Stivarga (regorafenib) to treat patients with metastatic, or late-stage, colorectal cancer that doesn’t respond to other types of treatment and has spread to other parts of the body. This drug works by blocking enzymes that promote the growth of cancer cells.

Outlook
What is the long-term outlook?When it’s caught early, colorectal cancer is treatable and often curable. With early detection, most people live at least another five years after diagnosis. If the cancer doesn’t return in that time, you’re considered cured, especially if you’re in the first three stages of the disease.

by Healthline 

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Is chocolate good for our skin?

12/13/2017

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Packed full of antioxidants, chocolate is increasingly gaining a place among the circle of healthful foods. Some studies show that chocolate may protect the skin from damaging sunlight. However, not all researchers agree.


Can chocolate protect our skin from sun damage?

There is plenty of evidence to suggest that a moderate amount of chocolate - especially dark chocolate - is good for our gut health, cholesterol levels, and brain. It may even lower the risk of developing heart disease and stroke.
The health benefits of chocolate are thought to be due to the high levels of antioxidants found in one of the nation's favorite snacks.
But what about our skin health? Can chocolate prevent skin aging, sunburn, and possibly even skin cancer?

Chocolate and sunlight

Too much sunlight leaves most people with sunburn. However, excessive sunlight exposure is also a key contributor to skin cancer and skin aging.
Could chocolate, with its high antioxidant levels, protect us from the sun's damaging ultraviolet (UV) rays? Some believe that it could.

The raw cocoa bean has very high levels of flavanols, a type of antioxidant. But most of these are lost during the process that turns the bean into the chocolate that we know and love.
That being said, chocolate manufacturers are now experimenting with new processes that preserve higher levels of antioxidants.

A study by led Prof. Wilhelm Stahl - from the Institute for Biochemistry and Molecular Biology at Heinrich Heine University in Düsseldorf, Germany - and colleagues investigated whether higher antioxidant levels in chocolate could improve the skin's ability to withstand damage from UV radiation.
For the study, 24 women consumed a chocolate drink that contained either 27 milligrams of flavanols (normal chocolate) or 329 milligrams (high-antioxidant) each morning for 12 weeks.

Medical News Today
By Yella Hewings-Martin PhD


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7 Tips For a Healthy School Year  by UT Physicians

8/14/2017

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Parents can make sure their children get the new school year off to a healthy start by getting checkups for them during the summer break.
“Well visits are important because they give us a chance to evaluate a child’s general health, growth and development,” said Ali Naqvi, M.D., a pediatrician with the UT Physicians Community Health & Wellness Center – Jensen. “We also test their vision and hearing.”
Here are seven tips for a healthy head start from the medical experts at UT Physicians, the clinical practice of McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth).

1) Ease into a school sleep schedule – A few weeks before school starts, get children up in the morning and to bed at night a little earlier. Aim for 15-minute increments each day. Keep the same sleep schedule on the weekends, too. The keys to a good night’s sleep include making sure children eat properly and get plenty of exercise. Electronics in the bedroom and caffeine after lunch are big no-nos. Research shows that children who get a good night’s sleep also get better grades.

2) Choose the right backpack – According to the United States Consumer Product Safety Commission, in 2013, in excess of 5,400 backpack-related injuries were treated in emergency rooms across the U.S. Those injuries can be reduced by buying age-appropriate backpacks and making sure children do not overload them. When lifting a backpack, it is important to bend at the knees. Improper use and lifting techniques can lead to severe back, neck, and shoulder pain, and in some cases posture problems.

3) Check those vaccination records – Immunizations can reduce a child’s risk of measles, whooping cough, tetanus, diphtheria and other disease Tragically, outbreaks of preventable diseases still occur in the U.S. from time to time. Outbreaks are generally linked to areas with low inoculation rates and they put babies too young for vaccinations or children who have low immune systems at risk. There are different immunizations for different age groups. If you miss a vaccination, pediatricians have catch-up immunization schedules.

4) Screen children for vision problems – A study shows that more than a third of U.S. children ages 12 to 17 are nearsighted. The warning signs include sitting too close to the television, recurring headaches while reading and squinting while looking in the distance. The good news is that health professionals often can correct these vision problems by prescribing eyeglasses and contact lenses. Good vision is critical to academic success.

5) Do not wait until a child is sick to see a doctor – Well-child visits are a great way to build a rapport with a physician and to monitor a child’s health. Doctors can help if a child is struggling with his or her weight, has high blood pressure or even heart issues. They can also check for lice, food allergies, pinkeye and other medical issues.

6) Protect the pearly whites of student athletes – It is hard to hide a missing tooth. Mouthguards can soften a blow to the face and thereby reduce the risk of broken teeth. Dentists can customize mouthguards for children. While there, make sure children are cavity-free.

7) Watch out for the signs of hearing loss – If a child is turning the volume on a television unusually high, asking people to repeat questions or having difficulty concentrating, he or she may have a hearing problem. Hearing loss can be caused by infection, trauma or exposure to loud noise. It is important to have a child’s hearing checked on a regular basis.

By following these tips, parents can position their children for a successful school year.  

by Rob Cahill


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Psoriasis Awareness Month: Educates Public about the Disease

8/2/2017

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Psoriasis Awareness Month is a public health and awareness campaign sponsored by the National Psoriasis Foundation for educating the public, raising awareness and dispelling myths about the disease. Psoriasis is a chronic, non-contagious, genetic autoimmune disease that causes red, scaly patches on the skin. It can also crack, itch and bleed. It is actually the most common among all the autoimmune diseases in the United States and it affects approximately 7.5 million people in the US.
Up to 1/3 of those with psoriasis will develop psoriatic arthritis which is a type of arthritis that is inflammatory. It causes pain and swelling of the joints along with the tendons. Take note that people suffering only from mild psoriasis are just as likely to develop psoriatic arthritis.

Genetics and the immune system of a person play a vital role in the development of the disease. In those with psoriasis, the immune system sends abnormal signals that significantly accelerate the growth process of the skin cells. A person needs to have a combination of certain genes that cause psoriasis along with exposure to external triggers like skin injury, stress, smoking and infections. There is still no cure for psoriasis but a variety of treatment options are available. It is important to take note that treatment is individualized depending on the type of psoriasis, its severity and how the person reacts to certain treatments.


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Heart attack: Blood vessel growth may improve treatment

7/27/2017

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Scientists have discovered a cell mechanism involving the hormone leptin that plays a key role in the formation of new blood vessels. The discovery may help to develop treatments that stimulate tissue repair following a heart attack, as well as treatments that stop abnormal tissue growth, such as in cancer. A report on the discovery, by researchers at the University of Bristol in the United Kingdom, is published in the journal Scientific Reports.
The finding reveals important new clues about the cell biology of "angiogenesis," or the generation of new blood vessels, which occurs in both health and disease.
The researchers, including study leader Paolo Madeddu, a professor of experimental cardiovascular medicine at the University of Bristol, believe that their discovery could help to improve treatments for heart attack and cancer, two of the world's leading causes of death.

For example, heart attacks damage heart muscle, and a better understanding of how to generate new blood vessels could improve regenerative medicine approaches that help the heart to repair itself.
Similarly, in cancer, tumors rely on the formation of new blood vessels to grow, so understanding how this happens could help to develop treatments that block this growth.
Heart disease, the main cause of heart attacks, is the world's biggest killer. In 2015, an estimated 17.3 million people died from heart disease and the number is expected to exceed 23.6 million by 2030.
Cancer caused approximately 8.8 million deaths worldwide in 2015. The number of new cases, currently estimated at around 14 million per year, is expected to increase by 70 percent over the next 20 years.

Pericytes and new blood vessel growth

The new study investigated how a group of cells called pericytes stimulate the growth of new blood vessels. Pericytes are a type of stem cell found in the walls of blood vessels.

In their report, the researchers note that pericytes are "emerging as promising candidates" for treatments that involve new blood vessel generation.

Studies that have investigated what happens when pericytes are transplanted into tissue that has suffered from insufficient blood supply, or "ischemia," have already shown that the cells are stimulated by lack of oxygen. However, the molecular process remained unknown.

Prof. Madeddu and colleagues discovered that the hormone leptin appears to play an important role in the ability of pericytes to stimulate new blood vessel growth.
Leptin, a hormone produced by fat cells, is already known to be important for regulation of appetite and energy balance. The authors note that there is also evidence that some components of the leptin "pathway are expressed in human stem cells," but it is not clear how it works.

Oxygen starvation ramps up leptin

The team discovered that when starved of oxygen, pericytes produce 40 times more leptin and that this overproduction continues until oxygen levels return to normal.
The researchers also found that the increase in leptin makes the pericytes more resistant to induced cell death, or "apoptosis," and that it enhances their ability to migrate and stimulate blood vessel formation.
They conclude that leptin appears to play an important part in a number of actions that help to generate new blood vessels in tissue that has suffered from oxygen starvation.

"Increasing leptin in pericytes in a damaged heart might help it to heal faster," Prof. Madeddu explains, "whereas blocking the production of leptin in cancerous pericytes might starve the tumor of nutrients and force it to shrink."

He and his colleagues hope that the discovery will help to develop treatments that mean heart attack patients do not have to undergo coronary artery bypass, which usually takes a long time to recover from.
The invasive surgery involves taking blood vessels from elsewhere in the body, such as a leg, to bypass the damaged artery and restore blood flow to the heart muscle.

"This new discovery could have important implications for the treatment of heart attacks, which is when a main coronary artery gets blocked, but also cancer. These results reveal a new signaling mechanism that may have a far-reaching and significant impact on cardiovascular regenerative medicine." 
Prof. Paolo Madeddu

Medical News Today





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Treating Melanoma in the Eye

7/17/2017

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People often associate melanoma with skin cancer that develops from exposure to ultraviolet (UV) light. However, a team of specialists at Houston Methodist Hospital have pioneered a way to treat a rare and relatively unknown type of melanoma that can occur in the eye: uveal melanoma.

Led by ocular oncologist and retina specialist Amy C. Schefler, M.D., assistant professor of clinical ophthalmology at Houston Methodist, the Ocular Oncology Team at Retina Consultants of Houston combines customized plaque brachytherapy (concentrated radiation), intraoperative ultrasound and genomic testing to treat patients affected by this rare form of melanoma.

“Over the last few years, particularly in the last five years since I’ve been here, … we’ve really upped our game in terms of the success of the procedure and a lot of the aspects of what we do,” Schefler said.
What is uveal melanoma?


A close-up image of an eye affected with uveal melanoma. (Photo courtesy of Houston Methodist Hospital)Uveal melanoma tumors are yellow or brown cells that form a mass in the tissue of the vascular layers of the eye behind the retina. Tumor masses range from 2 mm to 12 mm tall and 5 mm to 18 mm wide—no larger than the size of a jelly bean.
Studies estimate approximately 1,200 to 1,800 new cases of uveal melanoma each year in the United States. While some patients may experience floaters or blurry vision, most patients don’t exhibit any symptoms. They often discover the tumor during a routine eye exam and are surprised to learn that melanoma can develop in the eye, Schefler said.
The melanocytes, or pigment-producing cells, that travel to the eye live in a completely different microenvironment than the ones in the skin, Schefler said. Because they’re not exposed to the sun, they develop and behave differently than skin melanoma.
“[Uveal melanoma] is less related, believe it or not, to the degree of pigmentation because the sun doesn’t actually make it to the back of the eye. That’s what the role of the human lens is: to stop it,” Schefler explained. “When you look at the tissues in these tumors, genetically, they don’t have the typical mutations that you see in sun-exposed skin. There are typical mutations that sun causes: they cause mostly mutations in DNA repair mechanisms, but you don’t see that [with uveal melanoma]. These are not sun related.”
The exact causes for uveal melanoma are still unknown. No diet or environmental risk factors have been definitively linked to this type of cancer, but experts have found that uveal melanoma occurs mostly in patients who are Caucasian with lighter-colored eyes.

An eye-saving treatment approach

Traditionally, uveal melanoma was treated by surgically removing the eye, a procedure called enucleation. However, thanks to advances in biotechnology and radiation technology, uveal melanoma can now be treated without permanently removing the eye or loss of vision. Plaque brachytherapy treatment uses radioactive eye plaques that are customized to each patient’s tumor.


Examples of plaques with customized shapes and seed configurations. (Photo courtesy of Melvin Astrahan, Ph.D., and Eye Physics, LLC.)The plaques, which are about the size and thickness of a quarter, are constructed out of pure gold on one side to protect the surrounding healthy tissue. On the side facing the eye are small radioactive “seeds” that emit radiation that travels through the wall of the eye to kill the tumor cells.
Because no two tumors are alike in size, shape and location, radiation oncologist Bin Teh, M.D., professor of radiation oncology at Houston Methodist, performs radiation calculations to determine the exact number and configuration of the radioactive seeds on the plaque for each patient.
“Our goal is to avoid the optic nerve and just truly plan to treat the tumor by [modifying] our dose exactly to the shape of the tumor,” Teh said.
Once the plaques are created, Schefler and her team surgically place the plaque on the outside surface of the eye, while performing a real-time ultrasound to make sure the plaque is centered. If the plaque is not accurately positioned, the part of the tumor that is not covered will regrow.
“We don’t leave the operating room until it’s perfectly centered,” Schefler said. “By doing that, we’ve had zero local recurrences … in the five years we’ve started our program here.”
The plaque is then left on the eye for a week. Once removed, the tumor cells have been eliminated, and the eye structure and vision are preserved.
In addition to plaque brachytherapy and real-time ultrasound, Schefler and her team perform genomic profiling on uveal melanoma tumors to assess a patient’s risk for metastases.
“Twenty years ago, if a patient came in, we would say, ‘Well, flip a coin, there’s a 50 percent chance you’ll live or die. We don’t know. Good luck,’” Schefler said. “But now … we do genomic profiling to figure out which patients are at higher risk of developing metastases from the disease and which aren’t.”
Using a microscope, special retinal instrumentation and a small needle, Schefler is able to extract microscopic amounts of cells from the uveal melanoma tumor to send off for genetic analysis, which classifies the melanoma into three different categories:
  • Class 1A: Low risk of the tumor spreading
  • Class 1B: Intermediate risk of the tumor spreading
  • Class 2: High risk of the tumor spreading
“With rare cancers, we’re always playing catch-up because it takes longer for us to get funding …, but we’re finally reaching a threshold of really meaningful genomic data we can use to influence patient care,” Schefler said.
Schefler and Teh admit their multi-pronged approach of combining plaque brachytherapy, intraoperative ultrasound and genomic profiling—which usually takes three weeks from initial diagnosis to surgery—is time-consuming and labor intensive. But it has been proven to be more effective, with less collateral damage to the healthy parts of the eye.
“There’s no question that patients in our center do better than at other places because of the local control rate,” Schefler said. “But we want to get to a point in the next decade where even if we have 100 percent local control, if the patients’ genomics are such that there are a couple cells elsewhere, that we have therapy for that. That’s where the next level of science will come, and we’re working on that.”

Article By Shanley Chien  TMC


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’13 Reasons Why’: Raising Awareness and Concern

6/26/2017

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In recent weeks, Netflix’s “13 Reasons Why” has captivated audiences of all ages across the country. While the show sheds light on serious mental health issues, the intense subject matter has schools and mental health professionals calling for extra caution when watching.

The show, “13 Reasons Why,” based on a bestselling book, follows Hannah, a teenager who recently committed suicide. Hannah leaves behind 13 tapes for those who contributed to her decision to take her own life.
“I can’t think of another show that talked about suicide like this,” said Shelly Simpson, LCSW, LCDCI, clinical social worker and chemical dependency counselor at Menninger’s Pathfinder Community Integration Program.
At Pathfinder, Simpson works with teens and young adults who are recovering from depression, substance abuse and other mental health disorders as they transition into living on their own and becoming independent. Simpson has discussed the show with some of her patients who have attempted suicide.
“I have some patients who think the show is stupid, and they say, ‘Oh, no one would ever do that,'” Simpson said. “And a lot of the patients I work with won’t watch it because it is too intense for them. These are patients who are maybe four to eight months outside of a suicide attempt and they are still processing.”
The graphic nature of some of the scenes in “13 Reasons Why” has raised concerns about it being too much to handle for teens or for viewers who have experienced trauma. One of the most controversial scenes is when the main character, Hannah, commits suicide on the show.
“I think that the show alluded to it enough, we didn’t need it to be shown to know that it happened,” Simpson said. “People oftentimes are afraid to start talking about suicide because they think it will give people the idea to do it. I don’t think that talking about it does that, but showing it is something that can be traumatic to people … I think it was unnecessary to show that.”
Additionally, mental health workers, educators and parents are concerned that teens may not be able to fully process what they are watching, and that portions of the show glamorize suicide and normalize drug and alcohol use.
“As a mental health professional, I know suicide is not glamorous—the devastation it leaves in people’s lives is not glamourous,” Simpson said. “That doesn’t happen when someone takes their life. There are not these 13 tapes that we leave people. Oftentimes it’s the people themselves left to do the reeling about why did that happen, what did I miss? What signs was that person trying to show me?”
For Simpson, she recommends parents, friends, siblings and loved ones pay attention to changes in behavior, mood shifts, changes in grades, or loss of interest in a sport or hobby they used to enjoy. She also reminds us all to listen.
“I love when shows like this come out, because it can be such a conversation starter and a safe way for kids to voice their opinions,” Simpson said.
Although she does think the show has opportunities to grow in the second season, Simpson is thankful that it has helped to get the important conversation of mental health awareness and suicide awareness in the open.
“I was reflecting on how many people I have heard in the last month say the word suicide which is such a ‘we don’t say that’ word,’” Simpson said. “I’ve heard teenagers I work with say it, I’ve heard friends that aren’t in the mental health industry say it, and it’s interesting. It is a word that we, as a society, are afraid to utter and [the show] has gotten people all over the place saying it.”

TMC Pulse
By Britni Riley

If you or someone you know are struggling with the thought of suicide, you can call the Crisis Intervention hotline at 832-416-1117, for Teen Talk 832-416-1199 and they are also available to text. 281-201-4430.
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