In the News
Tackling brain inflammation ameliorates Alzheimer's disease (AD), according to a study published in The Journal of Experimental Medicine.
THRIVING AFTER CANCER
New treatment options based on integrative health mean better life for cancer survivors
March 10, 2015: Cancer treatments continue to improve: there are more and more cancer survivors – an estimated 18 million in the U.S. by 2022.
But what happens after treatment? Many survivors report continued symptoms ranging from depression, fatigue, listlessness, to memory trouble and difficulty concentrating - symptoms which conventional oncology has no treatments for.
This often leaves cancer survivors feeling lost and abandoned: even though treatment has ended, the impact of cancer on their lives has not.
A group of researchers affiliated with Saybrook University are using integrative medicine to change that, and change what it means to be a cancer survivor with no costly pills, no surgical interventions – just a simple treatment technique that connects the mind, body and spirit in a way that cancer survivors desperately need.
- Dr. Lyn Freeman, a Saybrook alumna and faculty member, has received a National Institutes of Health grant to study the impact of integrative health techniques like visualizations on the impact of cancer treatments, and whose studies have been so successful that the National Cancer Institute has directed her to make her program, called Envision, available to cancer patients and survivors in Alaska and Seattle.
- Francinne Lawrence, a doctoral candidate at Saybrook, has created a new center for cancer survivors in Louisiana, called THRIVE. Based on a health and wellness coaching model and supported by an array of complementary health services, the program addresses the physical, social, emotional, and spiritual concerns of cancer survivors, their families, and caregivers.
- Dr. Lynne Shaner, a Saybrook alumna, works with Hope Connections, a community cancer center in the Washington D.C. area. Shaner has written movingly about her use of techniques like acupressure, psychodynamic counseling, and meditation to help alleviate the health problems cancer survivors bring to her.
- Dr. Jeanne Wallace, a Saybrook alumna, leads a consulting group that provides nutritional consulting to cancer patients, and has found that cancer cells are highly influenced by the foods one eats.
All of them have moving personal stories to tell: Dr. Freeman’s husband was diagnosed with cancer during her clinical studies, while Lawrence began her career as a hospital chaplain and discovered that cancer survivors had an ongoing need for a kind of ministry that simply wasn’t provided by conventional medicine.
Dr. Shaner was using a treatment called EFT (“Emotional Freedom Technique) that combines touch and talk therapy, with “Lisa,” a cancer survivor who suffered from significant chest pain. Normally EFT works exceedingly well, but Lisa’s pain was resistant. But when Dr. Shaner asked, “Does the pain have a face?” Lisa immediately named her daughter. She not only visualized the pain as carrying her daughter’s face, but also could go through a list of recent experiences with her daughter that had brought her fear, frustration, and anger. Dr. Shaner went through the treatment again, but this time, including the daughter’s name and a discussion of the emotions it brought up with each touch – and the pain was gradually eliminated.
All these researchers, health administrators, and practitioners are centered around Saybrook University’s School of Mind-Body Medicine. It is a community that is fast becoming known in medical circles for offering rigorously tested, evidence-based, solutions to intractable contemporary health problems ranging from cancer treatment symptoms to high blood pressure to depression – and all firmly grounded in an integrative approach to health-care that requires no expensive drugs or invasive surgeries.
That’s the new shape of medicine in the 21st century: more effective, more patient-centered, and even less expensive, as it’s integrated with everything we know about the mind-body (and even spirit) connection. It focuses on things patients and communities can do themselves, and sees health care practitioners as partners with patients, rather than bosses giving them instructions they have to follow.
Statin Adverse Effects Much More Common than Appreciated
Family physician Duane Graveline, MD, a former astronaut, used to prescribe statin drugs enthusiastically to lower cholesterol. Then he took them as a patient. When he published his experience with transient global amnesia in Peoples Pharmacy, he received some 30,000 emails reporting statin adverse effects. After FDA's MedWatch database became available, Graveline compiled reports. His results appear in the spring 2015 issue of the Journal of American Physicians and Surgeons.
Physicians are often dismissive of patients' reports of weakness or cognitive decline, states Graveline. They may attribute complaints to aging, or say "statins don't do that."
A recent FDA posting downplays the risk of cognitive impairment as "generally not serious" and reversible within a few weeks of stopping the drug.
FDA's deputy director for safety, Amy Egan, MD, MPH, advises patients not to stop the drugs if they experience "cloudy thinking."
Graveline notes, however, that an amnesic state so brief that the patient doesn't notice it can be very dangerous in an airline pilot or heavy equipment operator. He counted almost 9,000 MedWatch reports in the category of severe cognitive disturbance for atorvastatin and rosuvastatin alone between 2006 and 2013.
Statins block an essential metabolic pathway, Graveline explains, leading to a deficiency in coenzyme Q10 (CoQ10 or ubiquinone) and dolichols. These factors are critical to the function of mitochondria, the body's energy producers. Additionally, cholesterol itself is considered by many to be the most important biochemical in the body, as it is especially vital for cognitive function.
Accelerated aging seems to be a common feature of statin adverse effects.
The most commonly reported effect is muscle pain and weakness. There were nearly 11,000 cases in MedWatch of rhabdomyolysis, the breakdown of muscle fibers, with about 1,000 deaths from kidney failure as the breakdown products clog the kidneys.
Patients and physicians need to be better informed about potential adverse effects of statin drugs, with a careful assessment of risks and benefits, and attention to achieving the inflammation-reducing effects of statins with lower doses or alternate means, Graveline concludes.
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943. The Journal is committed to "promoting open debate and scientific integrity." Articles represent the views of the author, and do not necessarily reflect an official position of AAPS or the Journal.
Source: Association of American Physicians and Surgeons (AAPS), aapsonline.org
TAP Integrative Partners with Southwest College of Naturopathic Medicine
TAP Integrative and Southwest College of Naturopathic Medicine (SCNM) just announced their partnership to help further the exchange of evidence-informed and experiencebased knowledge between integrative practitioners. Members of tapintegrative.org will now have access to fulltext copies of published articles made available through SCNM’s extensive library.
TAPintegrative.org is a membership site designed for “on-demand” access to clinically reviewed and sciencebased clinical practice topics and research, leading clinical experts and to a community of integrative healthcareprofessionals. In keeping with their mission to promote and foster the exchange and validation of professional knowledge in integrative medicine, TAP’s partnership with SCNM offers members the ability to access published research. This partnership benefits SCNM faculty and students by granting them complimentary membership to TAP Integrative.
“The partnership with SCNM provides TAP members with an additional resource for learning and collaboration,” said Dr. Lise Alschuler, Executive Director or TAP, “We’re very excited to welcome SCNM faculty and students to TAP. We plan to continue supporting opportunities which open dialogue between communities invested in the development and progress of integrative medicine.”
In addition to SCNM research, TAP Integrative membership also includes access to peer-reviewed, expert led clinical topics and case discussions, summarized research in audio and video format, and updates on published clinical research in the area of integrative healthcare. For more information on TAP membership, please visit www.tapintegrative.org/Membership. You can also learn more about TAP by visiting Welcome to TAP Integrative.
Geneia Survey Finds 84% of Physicians Believe Quality Patient Time May Be Gone
Invites Physicians to Compete in the Joy of Medicine Challenge
BOSTON, March 5, 2015 /PRNewswire/ -- Geneia today revealed the striking findings of its Physician Misery Index, and in response to these results, invited physicians to share their ideas to restore the Joy of Medicine.
A Google Hangout featuring Heather Lavoie of Geneia, Dr. Jennifer Joe of Medstro, and Dr. Bryan Vartabedian will be held at 2:00 pm Eastern on Thursday, March 5th. To participate in the Google Hangout, visit http://www.youtube.com/watch?v=X-dYZiQjIN8.
In a nationwide survey among more than 400 physicians who practice medicine full time, Geneia found:
- Two-thirds (67%) of all surveyed doctors know a physician who is likely to stop practicing medicine in the next five years, as the result of physician burnout. This includes both younger and more experienced doctors.
- Despite their education and skill, a majority of doctors (51%) say they have considered career options outside of clinical practice. That percentage is even higher among those who have been practicing medicine for less than 10 years – 62% say they have considered other options.
- 78% of doctors say they frequently feel rushed when seeing patients.
- An overwhelming majority – 87% - say that the "business and regulation of healthcare" has changed the practice of medicine for the worse.
- Overall, the nationwide Physician Misery Index is 3.7 out of 5, indicating that scales are tipping from satisfaction to misery.
"We found that most physicians still love medicine, but increasingly are frustrated by the business of medicine. For most physicians, the ability to create meaningful relationships with their patients and truly impact health outcomes is why they entered the practice of medicine in the first place, and is critical to experiencing joy in their work. Yet 84% of respondents believe that quality patient time may be a thing of the past," said Heather Lavoie, Geneia's Chief Operating Officer. "At Geneia, we're deeply concerned about physician dissatisfaction and the implications for doctors and their patients, and that's why we created the Joy of Medicine Challenge."
Geneia and Physicians are Partnering to Restore the Joy
The Geneia Joy of Medicine Challenge is an online competition to solicit ideas from U.S. licensed physicians on how to best restore the meaning behind the practice of medicine. Judging will be done by a panel of physician judges in combination with peer-sourced, online voting. The winner in each of the three categories – the EHR of the Future, Population Health, and Joy of Medicine - will receive a $1,000 cash prize and one winner will receive in-kind Geneia consulting resources valued at $5,000 to help refine their idea. The Challenge is being managed by Medstro, a social professional networking and career development community by physicians for physicians.
"Today's physician is juggling increasing demands, and the level of stress and burnout is escalating," said Dr. Jennifer Joe, CEO of Medstro. "It's high time we involve physicians in creating solutions to restore their joy in practicing medicine."
"As one who has been talking about the intersection of medicine and technology for nearly a decade, I believe wholeheartedly in the potential for technology to improve the practice of medicine and the professional lives of physicians. But we're not there yet. That's why I'm eager to hear the ideas that physicians have for restoring the joy of medicine," said Dr. Bryan Vartabedian, a pediatrician at Baylor College of Medicine/Texas Children's Hospital, one of healthcare's influential voices on technology and medicine, and a judge for the Joy of Medicine Challenge.
Physicians interested in joining the challenge can submit their ideas until April 29th by visiting https://medstro.com/groups/joy. Finalists will be announced in May and invited to a live pitch off later this year.
Three Research Leaders Join Forces To Study Diet's Role In Inflammatory Bowel Diseases
The Crohn's & Colitis Foundation of America (CCFA) today announced that it has entered into a research partnership with the Perelman School of Medicine at the University of Pennsylvania, and Nestlé Health Science, to study the effects of diet on gut bacteria. The study is part of a major CCFA effort to develop new treatments targeting the gut microbiome—the "ecosystem" of microbes populating the intestines—linked to the development of inflammatory bowel diseases (IBD). Partnerships such as these are extremely beneficial in moving the research forward at a much faster pace.
"We are delighted to be working with such esteemed partners on this important work. Determining how diet affects the microbiome—and in turn affects the course of IBD—has major implications for efforts to improve the quality of life for patients and families affected by IBD," comments Caren A. Heller, MD, MBA, CCFA's Chief Scientific Officer. "This study has tremendous potential to inform the development of novel and alternative therapies that address the cause of IBD, as well as the symptoms."
Part of CCFA's Microbiome Initiative, the Food and Resulting Microbial Metabolites (FARMM) study aims to understand how different diets—including a vegan diet and a defined formula diet sometimes used in treating IBD—influence the bacteria and bacterial products in the intestine.
In the FARMM study, healthy volunteers will follow a defined "Western" diet, vegan diet, or formula diet for two weeks. The researchers will look at how the three diets affect the population of microbes present in the gut, as well as the individual's metabolomic profile. Cutting-edge tools and techniques will be used to identify microbial, metabolomic, and immune system "signatures" that may be involved in the development or treatment of IBD.
The findings will be an important first step toward understanding how a formula diet (exclusive enteral nutrition) works to induce remission in patients with Crohn's disease. The study will also provide new information on how antibiotics affect the gut microbiome and the metabolites produced by these organisms.
"We hope this research will advance our understanding of the complex relationship between our diet, the microrganisms that live in our gut, and the small molecules they produce that end up circulating throughout our body," comments one of the principal investigators on the study, Gary Wu, MD, the Ferdinand G. Weisbrod Professor in Gastroenterology at the Perelman School of Medicine at the University of Pennsylvania, and co-director of the Penn-Children's Hospital of Philadelphia (CHOP) Microbiome Program.
Along with other factors, diet and the gut microbiome may play an important role in the development and progression of IBD. Studies have linked a diet high in total fats and meat to an increased risk for IBD, while high fiber, fruit, and vegetable intake are associated with a decreased risk. Co-principal investigator James Lewis, MD, MSCE, professor of Gastroenterology at the Perelman School of Medicine at Penn and director of Penn's Gastroenterology and Hepatology Clinical Research Program, noted that, "We hope that these discoveries will provide a launch pad for developing novel interventions aimed at manipulating microbial targets with the goal of treating or even preventing IBD without suppressing the immune system."
Both Lewis and Wu are being compensated for their involvement in this study. Funding for the study is provided by the CCFA and Nestlé Health Science. Drs. Wu and Lewis both report receiving honoraria from the Nestlé Nutrition Institute.
MAKING PROGRESS TOGETHER
"This research partnership with top scientists and clinicians at the University of Pennsylvania, as well as the CCFA, is a high priority for Nestlé Health Science. It will not only allow for a better understanding of the role of nutrition in chronic disease, but also pave the way to develop safe and effective nutritional therapeutic approaches to improve patient's quality of life," comments Irène Corthésy, Head of R&D at Nestlé Health Science.
Crohn's disease and ulcerative colitis are painful, medically incurable illnesses that attack the digestive system. Crohn's disease may attack anywhere along the digestive track, while ulcerative colitis inflames only the large intestine (colon). Symptoms may include abdominal pain, persistent diarrhea, rectal bleeding, fever, fatigue and weight loss. Many patients require hospitalization and surgery. These illnesses can cause severe complications, including colon cancer in patients with long-term disease. Some 1.6 million American adults and children suffer
SOURCE Crohn's & Colitis Foundation of America
Tackling brain inflammation ameliorates Alzheimer's disease (AD), according to a study published in The Journal of Experimental Medicine.
AD is characterized by the toxic build-up of a brain protein called beta-amyloid, and clearance of these protein "plaques" reduces disease. Immune cells called macrophages infiltrate the brain during AD and are thought to help clear away these toxic proteins, with the help of resident brain cells called microglia. Macrophages and microglia express a surface receptor called TREM2, and although debilitating mutations in TREM2 have been associated with AD, the function of the receptor is uncertain.
To decipher TREM2's role in AD, Bruce Lamb and colleagues from the Cleveland Clinic's Lerner Research Institute deleted the receptor in mice that develop an AD-like disease. Removal of TREM2 decreased plaque formation, reduced brain inflammation, and improved the survival of neurons. This protection was associated with fewer infiltrating macrophages. Macrophages lacking TREM2 were apparently better at engulfing beta-amyloid aggregates, suggesting that they might assist in the brain clean-up effort.
Although additional studies are needed to clarify the exact mechanism of TREM2's action in AD, these results suggest that toning down the receptor's activity may help put a stop to neurodegeneration in AD patients.