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Well-oiled cancer care 'machine' gives Hamilton man quality of life – Hamilton Health Sciences

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Danny Prosic has undergone more treatments than most cancer patients due to his complex medical issues. He’s currently undergoing immunotherapy and doing very well.

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Danny Prosic repaired equipment for a tool-making company until a leg circulation disorder forced him to stop working.

But that wasn’t the only serious health issue to plague the Hamilton man, who went on to develop life-threatening conditions including liver cancer, a heart blockage requiring quadruple bypass surgery, and most recently a cancerous tumor on his spine.

Spotlight on Danny Prosic, liver cancer patient

“The human body is like a machine, but it’s far more intricate,” says Prosic, 63. “And machines don’t have feelings. It’s really hard living with such serious, ongoing health issues and I’m grateful for the way I’ve been treated by the doctors, nurses and staff at Hamilton Health Sciences (HHS). Everyone has been very kind and caring. I wouldn’t be here today if it wasn’t for them.”

Prosic receives cancer care at HHS’ Juravinski Hospital and Cancer Centre (JHCC). Earlier this year he had surgery to remove the tumor on his spine, at the base of his neck. This was followed by radiation therapy to kill or damage remaining cancer cells so they can’t reproduce. He’s considered palliative, meaning his cancer is too advanced to be cured. Instead, the goal is to continue knocking back the cancer with treatment so Prosic can live as long as possible with a good quality of life. He’s currently undergoing immunotherapy, which ramps up the immune system to keep the disease at bay.

“I have lots of patients, like Danny, who are surviving years rather than months.” — Dr. Brandon Meyers, medical oncologist

The neck tumor was a secondary cancer stemming from an earlier liver cancer diagnosis. Prosic wasn’t eligible for a transplant due to his history of poor circulation to his legs and heart. Instead, he received treatments including surgery, a specialized and intensive type of radiation therapy called stereotactic body radiosurgery (SBRT), and transarterial chemoembolization (TACE) – where blood supply to liver tumors is blocked and chemotherapy is administered directly to tumors.

“Danny’s had a lot of therapies compared to most cancer patients,” says his medical oncologist, Dr. Brandon Meyers. “He responded to these treatments extremely well.”

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Life-changing cancer care

JHCC is the only hospital in the region where patients can be treated for all forms of cancer, and is a designated leader in the provincial cancer system in a number of highly specialized cancers. Its staff and doctors support more than 26,000 patients with cancer each year.

Liver cancer falls under the category of hepato-pancreato-biliary (HPB) cancers, along with pancreas, gall bladder and bile duct cancer. HPB cancers are serious and complex with high mortality rates. They typically require a range of treatments.

At JHCC, doctors and staff are organized into disease-site teams based on areas Illuminight 2022: Donate today. ShineALightOnCancer.caof cancer care, with the gastrointestinal team covering HPB cancers. Each team includes medical oncologists, radiation oncologists, surgeons, nurses, radiation therapists, pharmacists, social workers, nutritionists, and psychiatrists.

Danny Prosic, outside Juravinski Cancer Centre

Danny Prosic, liver cancer patient

“That’s the beauty of working at a large centre like JHCC,” says Meyers. “We have a wide range of expertise all under one roof, and our collaborative team approach is helping our patients live longer with a better quality of life.”

On paper, liver cancer patients have a poor prognosis.

“If they’re seeing me for palliative treatment – which focusses on managing the disease because it’s no longer considered curable — the best case scenario statistically is a 12 month survival,” says Meyers. “But over half of my patients easily do better than that, thanks our team approach. I have lots of patients, like Danny, who are surviving years rather than months.”

Spotlight on Dr. Brandon Meyers, medical oncologist 

Black and white portrait of Dr. Brandor Meyers

Meyers joined HHS in 2006 as a resident doctor, then went on to complete a fellowship before joining the hospital system full time in 2012 as a medical oncologist. He works primarily with gastrointestinal (GI) cancer patients, with a focus on liver cancer.

“GI cancers are an area of care than I’m especially interested in, and it’s also an area of need,” says Meyers, referring to cancers of the digestive tract and liver.

Among the most satisfying aspects of his work is seeing patients like Prosic beat the odds. “Danny has already survived three times longer than his life expectancy, with a good quality of life.”

“It’s really hard living with such serious, ongoing health issues and I’m grateful for the way I’ve been treated by the doctors, nurses and staff at Hamilton Health Sciences.” — Danny Prosic, patient

Looking to the future, Meyers would like to see a nurse navigator join the team, but it would require funding. A nurse navigator works with patients who might otherwise fall through the cracks, helping them navigate the system so they understand their care plan and don’t miss appointments. Navigators could even help free up hospital beds, since their support could allow patients to recover at home after certain procedures instead of in hospital.

“Our liver cancer patients would especially benefit from a nurse navigator’s support, because their cases are so complex and they see so many different physicians for their care,” says Meyers. “It can often feel overwhelming, and it’s not unusual for some patients to lose track of appointments and miss them.”

Spotlight on Melanie Carrigan, medical radiation therapist

Black and white portrait of Melanie Carrigan

Medical radiation therapist Melanie Carrigan is also keenly aware of the difference that funding can make in providing the very best care. Donations from Hamilton Health Sciences Foundation support JHCC’s radiation therapy program for children, says Carrigan, who works with children and teens but also treats adult patients. She was Prosic’s radiation therapist for four of his five SBRT treatments for liver cancer.

“Cancer care isn’t all doom and gloom. It’s about working together to help people during the most difficult experiences of their lives.” — Melanie Carrigan, medical radiation therapist

With SBRT, highly concentrated doses of radiation are safely and precisely delivered over a much shorter period of time than with usual radiation therapy. “We can finish in a week what traditionally took months, with same or better benefits,” says Carrigan.

Carrigan is part of JHCC’s research, innovation and learning committee and she works closely with the radiation and medical oncology teams in running clinical trials.

“The future is happening now with the advent of new immunotherapies, and shorter, less toxic, and more effective combined therapies,” says Carrigan. “It’s very exciting to see the progress being made toward improved outcomes.”

But as much as she loves research and technology, the best part of her job is connecting with colleagues and patients.

“What it really comes down to is the people,” says Carrigan. “Cancer care isn’t all doom and gloom. It’s about working together to help people during the most difficult experiences of their lives, and giving them the confidence to know that our expert team is here to support them every step of the way.”

2022 Illuminight: Help shine a light on hepato-pancreato-biliary (HPB) cancer

Illuminight is an annual fundraising event that aims to shine a light on the nationally-leading, life-saving cancer care and research at JHCC. This year, we’re celebrating Illuminight with a five-part series of stories and videos from Sept. 22 to Oct. 11 featuring gynecologic, blood and hepato-pancreato-biliary (HPB) cancer care as well as cancer research and health equity.

Look for:
Tuesday, Oct. 4: Partnering for equitable, high-quality cancer care
Tuesday, Oct. 11: Lung cancer research and treatment working wonders

Since 2018, Illuminight has raised more than $500,000 to support the highest priority needs of the cancer program at Juravinski Hospital and Cancer Centre. Help us shine a light on cancer and donate today.

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What’s alarming pediatricians about surge in children’s respiratory infections, the flu & COVID-19

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Oscar G. Gómez-Duarte, M.D., is chief of the division of infectious diseases, department of pediatrics in the Jacobs School of Medicine and Biomedical Sciences at UB, and director of the PediUBatric Infectious Diseases Service at John R. Oishei Children’s Hospital. (University at Buffalo photo)

Tue, Nov 29th 2022 01:10 pm

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Oscar G. Gómez-Duarte, Jacobs School’s pediatric infectious diseases division chief, discusses why physicians are so concerned – and how to keep kids healthy

Submitted by the University at Buffalo 

The request by children’s hospitals nationwide this month that the federal government declare a formal state of emergency given the surge in respiratory syncytial virus (RSV) and flu cases was no surprise to Oscar G. Gómez-Duarte, M.D.

As chief of the division of infectious diseases, department of pediatrics in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, and director of the pediatric infectious diseases service at John R. Oishei Children’s Hospital, Gómez has seen firsthand the jump in cases of both RSV and flu, and the resulting increase in hospitalizations of children.

By September, Oishei Children’s Hospital reported having seen more patients admitted to the hospital with RSV than it had seen during the entire 2019-20 respiratory season, along with higher rates of flu infections, some requiring hospitalization.

Gómez says the surge this early in the season is unusual and especially concerning since there are very low vaccination rates for COVID-19 and flu in children. Cases may rise this winter, especially among unvaccinated children in addition to the rise in RSV cases.

How would you characterize this season so far for RSV and flu in kids?

“What’s concerning to us are not only the number of infections, but the severity of these infections leading to a high number of emergency room visits and hospitalizations. The surge in cases is putting pressure on hospitals nationwide. This is a very dramatic increase over what we normally see, especially at this point in the season. This year, we have been seeing significant increases in cases and this is even before the winter season has begun. We saw RSV cases peak over the summer this year and then another peak was reported in October. This RSV infections pattern is quite different from what we normally saw pre-COVID-19 pandemic.”

How do you think COVID-19 has influenced this increase in other respiratory viruses?

“It’s very possible that this jump in respiratory viruses that we are seeing now is related to the dramatic changes in community behavior during the past two years due to the COVID-19 pandemic.

“Those behaviors significantly limited the normal exchange of viruses that people typically have through interactions with each other. That’s especially true of young children, who exchange different viruses with each other at day care, at school and public gatherings. That exposure allows children to develop a natural immunity to common respiratory viruses at a young age.

“During much of the pandemic, that exchange of viruses wasn’t happening, and there was a gap in natural protective immunity. Now that children are again attending day care and school and other gatherings, getting exposed to these viruses that they haven’t been exposed to in the past two years has resulted in a high peak of infections and an overwhelming number of ER visits and hospital admissions. We are seeing increases especially in RSV, and some of these cases are severe.”

What factors make children especially susceptible to developing RSV?

“RSV tends to affect the very young, those under 2 years of age. Infants at the highest risk are those who were born prematurely or who are immune-compromised.”

Is it mostly children with underlying conditions who are being hospitalized with RSV and/or flu?

“We are seeing hospital admissions for RSV and/or flu among previously healthy children with RSV who have no comorbidities; but we are also seeing it in children with underlying conditions, such as asthma, cardiac conditions, neurological disorders, among other chronic conditions.”

Are you seeing cases where a child gets infected with two viruses at once?

“Yes, some children are getting what we call coinfections, where they become infected with more than one virus at a time. In some instances, a child becomes initially infected with flu, begins to recover and subsequently comes down with rhinovirus (a common cold virus), RSV or any other respiratory virus. These coinfections tend to be more severe than when the child just has one infection. Different viruses can attack different receptors and use different mechanisms to damage respiratory cells, and this can worsen the disease and, in some cases, may require that the child be admitted to the intensive care unit for management.”

What kinds of treatments are available for children hospitalized with either RSV or the flu?

“While we do have specific treatments for flu and COVID-19, there is no specific treatment for RSV or other respiratory viruses. The mainstay management of respiratory infections is supportive care, such as hydration, control of fever and supplemental oxygen if needed. When the child’s breathing is very compromised, we will put the child on oxygen and, depending on the severity of the respiratory compromise, they may even require more intense measures such as mechanical ventilation.”

Can children be immunized against RSV?

“Passive immunity in the form of monoclonal antibodies is available for premature infants during RSV season. This FDA-approved monoclonal antibody named palivizumab has the ability to block RSV and decrease the severity of the RSV infections.

“There is no approved active vaccine against RSV in the U.S. for children or adults. There is evidence, however, that pregnant mothers do transmit antibodies against RSV to their babies. It was recently reported that pregnant mothers who received an experimental vaccine against RSV did pass those antibodies onto their babies and these infants were at lower risk of developing RSV infections. These developments are very good news for the future, so that maybe pregnant women who are immunized can pass this protection to their babies.”

How concerned are you that along with RSV and the flu, children may begin to get sick from COVID-19 this winter?

“COVID-19 will stay among us in the same way as RSV, influenza and any other respiratory virus. Accordingly, we expect to continue to have COVID-19 infections in children, along with RSV and the flu. Current variants of the COVID-19 virus are becoming resistant to preventive measures such as monoclonal antibodies, although vaccines remain protective.

“It is concerning that the vaccine coverage for COVID-19 and flu vaccine among children in our community is low. Nationally, only 4% of children younger than 5 and fewer than a third of children ages 5 to 11 have had any COVID vaccine series. There is strong evidence that vaccines prevent infection, prevent hospitalizations, and prevent deaths due to COVID-19.

What should parents watch for?

“The first and most important way to protect children is to make sure they get vaccinated against the diseases where vaccines are available, among them the flu and COVID-19.

“If a child acquires a respiratory infection, the child will likely experience upper respiratory symptoms, such as fever, sore throat, cough and nasal congestion.

“Parents should be vigilant for more concerning symptoms, such as shortness of breath. If a parent notices that the child’s breathing is labored and difficult, this is an emergency situation that requires immediate attention, such as taking the child to the closest emergency room or calling 911.

“Most respiratory infections in children, though, are self-limited, and are not associated with shortness of breath. In most cases, a call to the pediatrician for advice is the best measure to take.”

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The views and opinions expressed in this commentary are based on the opinions and/or research of the faculty member(s) or researcher(s) quoted, and do not represent the official positions of the University at Buffalo or Niagara Frontier Publications.

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Awareness, usage of prostate cancer genetic testing are low vs other cancers

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November 28, 2022

“The other aspect of this study that really fascinated us was how patients are getting information about cancer genetic testing,” says Sameer Thakker, MD.

In this video, Sameer Thakker, MD, discusses noteworthy findings from the Urology Practice study, “Attitudes, Perceptions, and Use of Cancer-based Genetic Testing Among Healthy U.S. Adults and Those With Prostate and Breast/Ovarian Cancer,” for which he served as a study author. Thakker is a urology resident at New York University Langone Health, New York City.

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Got cold or flu symptoms? Guelph’s COVID-19 assessment clinic expands to treat more people

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People in Guelph who have cold and flu symptoms will be able to be assessed and treated through an assessment centre set up for COVID-19.

The centre, located at 400 Southgate Drive, has been where people have gone to get tested for COVID-19 for two years. Starting Thursday, it will become the Guelph COVID Cold Flu Care Clinic.

The goal is to help people in the city get care while also “ease the pressure on the emergency department at Guelph General Hospital,” a press release said. The clinic is run by the hospital and the Guelph Family Health Team.

People will be able to make appointments at the clinic seven days a week, although weekend hours will be shorter. People are encouraged to contact their family doctor before booking an appointment at the Guelph COVID Cold Flu Care Clinic.

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“People with mild respiratory symptoms are advised to monitor their symptoms, rest, and drink plenty of fluids,” the press release said.

The release also noted “most people in the community with symptoms are not eligible for COVID-19 testing” because they must meet provincial guidelines, which prioritizes people at increased risk of severe outcomes and people who live and work in high-risk settings.

 

Cold and flu season started early this year, and it’s still going strong. Many adults are dealing with ongoing coughs and other symptoms. Calgary urgent care doctor Dr. Raj Bhardwaj spoke with CBC Calgary News at 6 host Rob Brown about why coughs can stick around and when you should seek medical attention.

Feel sick? ‘Do not go and join the party’

Marianne Walker is president and CEO of Guelph General Hospital and also the hospital lead for Waterloo Wellington’s COVID-19 response.

She says in Waterloo region, Guelph and Wellington County, hospitals are over capacity with both adult and child patients.

“I think our major issue right now is managing the issues with very sick children and so we are working with Ontario Health to look at taking a provincial approach to that,” Walker said.

To help manage capacity in the health-care system and make sure “not everyone is getting sick at the same time,” Walker says people should listen to public health experts who are recommending people get vaccinated for COVID-19 and get their flu shot, wear masks, avoid large gatherings and stay home if not feeling well.

Walker says that advice is particularly important right now as December is a time when many people might get together with family and friends.

“The big thing too is making sure that if you’re sick, do not go and join the party,” she said.

 

The Morning Edition – K-W6:48Not feeling well? Skip the holiday parties until you’re better, Guelph hospital’s CEO says

Marianne Walker, president and CEO of Guelph General Hospital and the hospital lead for Waterloo-Wellington’s COVID-19 response, talks about what local hospitals are facing right now and what people can do to avoid getting sick during a busy time of year.

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