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eugeniogalindo · 4 months

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The Role of Tumor Boards in Cancer Care

Tumor boards represent a crucial asset in cancer care. A tumor board gathers medical professionals and experts who convene to examine and explore treatment strategies for individual cancer patients. Typically, this group includes specialists from various fields, such as surgeons, radiation oncologists, pathologists, and medical oncologists.

Various healthcare professionals, such as nurse specialists and social workers, might also participate in these discussions. A tumor board aims to pool together knowledge and innovative ideas to provide the best possible care for the patient's benefit. Primarily, tumor boards focus on cases that have exhausted standard treatment options or involve rare tumor types where established treatments might not exist.

Tumor boards can be conducted in person at hospitals or cancer centers or conducted virtually through video calls or asynchronous discussions using messaging software. In virtual settings, contributors share their opinions and suggestions for patient treatment options, allowing others to comment and collaborate until final decisions are made. A patient's privacy is strictly respected. Only individuals necessary for their care are involved in the discussion.

Before a tumor board meeting, those managing the case gather details for the patient’s case summary. This summary includes a timeline of their cancer history, starting from the diagnosis date, treatment information, imaging results, surgeries, and non-cancer-related medications to be mindful of potential interactions. Sometimes, this data is organized in a Gantt chart for clarity.

The summary also covers molecular profiling findings, which are crucial for identifying genetic changes or other alterations that might respond to specific treatments. Molecular profiling can be conducted on tumor tissue or through a blood test (liquid biopsy). If molecular profiling hasn’t been completed before the meeting and there's available frozen tumor tissue, it can still be tested, although results might take time.

Once the case summary is ready, the lead scientist or doctor researches treatment options. These can range from FDA-approved therapies for the patient’s cancer type to treatments for other cancers targeting specific alterations, investigational therapies, surgery, radiation, or chemotherapy. Options might include single-agent treatments or combinations, like two drugs targeting different alterations. A brief report detailing these options and their rationale is circulated among the participants before the tumor board meeting.

During the tumor board, the lead scientist presents the case summary and options, initiating discussions to reach a consensus on the best course of action. After the tumor board, the lead scientist drafts a detailed report outlining the options, which may be shared with the patient and their physician for consideration and discussion.

A tumor board not only helps craft the best treatment plans aligned with the patient’s treatment history and preferences but also aids in implementing these plans. For those seeking a second opinion, the board can suggest specialists and assist in scheduling appointments. In terms of treatments and clinical trials, it helps determine eligibility, facilitates trial enrollment, and explores access to therapies that might not be covered by insurance.

In certain hospitals, a tumor board evaluates all cancer cases at the outset of treatment planning. In contrast, in other hospitals, the tumor board concentrates on cases where a doctor seeks explicit input from the other members of a patient's medical team. Patients seeking to arrange a tumor board review of their case should consult with their healthcare provider to inquire if they offer tumor board assessments suitable for their situation.

#Eugenio Galindo

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eugeniogalindo · 5 months

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The Lifesaving Power of Bone Marrow Transplants

Bone marrow transplant is a life-changing intervention, offering a second chance to those facing life-threatening blood-related illnesses. The human body's resilience and the marvels of medical science converge in this transformative procedure.

A bone marrow transplant involves replacing damaged or diseased bone marrow with healthy stem cells. This intricate process is a lifeline for individuals grappling with leukemia, lymphoma, or other blood disorders where the bone marrow malfunctions, hindering its ability to produce healthy blood cells.

The procedure is a complex orchestration of medical expertise, resilience, and hope. First, the patient receives intensive chemotherapy or radiation to obliterate the diseased marrow. Then, the healthy stem cells are introduced into the body, where they navigate to the bones and initiate the production of new, healthy cells. It's a meticulous dance, balancing the destruction of diseased cells while nurturing the growth of new ones.

What makes bone marrow transplants remarkable is their potential to be life-saving. Survival rates vary depending on several factors, including the type of disease, the patient's overall health, and the donor match. For instance, the survival rate after a bone marrow transplant for acute myelogenous leukemia (a type of cancer) surpasses 50 percent at five years post-transplant, according to research published in JAMA Oncology.

Conditional upon surviving the critical initial period following the transplant, the chances of a long-term recovery substantially increase. The body's vulnerability marks this period as it navigates through the effects of the intense treatment and adapts to integrating new cells.

One of the most critical elements of a successful transplant is finding a compatible donor, a match whose bone marrow closely aligns with the patient's tissue type. This search for a compatible donor is often akin to searching for a needle in a haystack. However, organizations like Be The Match actively work to increase the pool of potential donors, enhancing the likelihood of finding suitable matches.

The impact of a bone marrow transplant extends far beyond mere survival. It promises a renewed life free from illness, a chance to cherish everyday moments, and envision a future brimming with possibilities. The Mayo Clinic underscores this transformative power, emphasizing how bone marrow transplants can cure diseases or prolong life while improving the quality of life for many individuals.

Moreover, ongoing advancements in transplant science continually refine this procedure, enhancing its efficacy and reducing associated risks. Research efforts aimed at understanding the immune system's intricacies and refining transplantation techniques open new doors of hope for patients worldwide. These advancements broaden the horizons, offering new avenues to explore for those in need.

Yet, while the potential of bone marrow transplants is immense, challenges persist. The process is physically and emotionally taxing, demanding unwavering perseverance from patients and their support systems. Complications, such as graft-versus-host disease (a condition where the donor cells attack the recipient's body), underscore the need for continued research and improvement in post-transplant care.

People's resilience shines through in the stories of individuals who have undergone this transformative procedure. They stand as testaments to the strength of the human will, showcasing the resilience needed to navigate the challenges and embrace the gift of life a bone marrow transplant offers.

#Eugenio Galindo

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eugeniogalindo · 5 months

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Different Factors Influencing Breast Cancer Treatment

Roughly 240,000 American women and 2,100 men are diagnosed with breast cancer every year. Breast cancer is the second leading cause of cancer death for American women and trails only skin cancer as the most common cancer for women in the United States.

On the global scale, there are more than 2 million new breast cancer diagnoses made each year and 685,000 fatalities. Individuals have several options when it comes to treating breast cancer, though several factors influence the optimal approach to treatment.

Different types of breast cancer are treated using other methods. The majority of breast cancer diagnoses involve carcinomas. Carcinomas in the breast are usually called adenocarcinomas, namely ductal and lobular carcinomas. A carcinoma is a tumor that forms in epithelial cells, which are found throughout the body’s tissues and organs. Depending on the size and location of the tumor, doctors may suggest surgery, chemotherapy, hormonal therapy, and other options.

Inflammatory breast cancer (IBC) is far rarer by comparison, accounting for between 1 percent and 5 percent of all breast cancer cases, according to the American Cancer Society. Medical professionals strongly recommend chemotherapy as a means of stunting the growth of aggressive IBC tumors. Because of the aggressive nature of the disease, IBC also requires surgery and several additional forms of treatment, including targeted drug therapy and more chemotherapy.

Other types of breast cancer include triple-negative breast cancer, Paget disease of the breast, and angiosarcoma. Phyllodes tumors contrast with carcinomas in that they are typically benign tumors, though they can form malignant tumors among the breast’s connective tissue.

Treatment options also depend on whether the cancer is localized or has spread. With this in mind, it is beneficial to identify breast cancer at the earliest stages. Women between the ages of 40 and 44 should receive annual breast screening or more frequent screening if they have a family history of breast cancer. By age 55, women should consider mammograms twice per year. Men typically do not require regular mammograms unless they live with a genetic mutation associated with male breast cancer. Moreover, there are many methods for performing self-examinations at home.

In addition to regular screening, individuals should be wary of common symptoms that may signal breast cancer. Any new lump or growth on or under the skin of the breast should prompt an immediate visit to the doctor’s office. Breast cancer can manifest as swelling or hardening in a specific area of the breast. Some individuals may also encounter red, dry skin, particularly around or on the nipples. While various conditions can lead to breast pain, if the discomfort persists for more than a few hours or days, seeking medical attention is crucial.

If breast cancer is diagnosed by medical professionals, there are various treatment options that can be explored. Surgery involves physically accessing and removing cancer from the body, while chemotherapy consists of the administration of a strong drug that shrinks and sometimes kills cancer cells. Chemotherapy drugs are offered in pill form and as intravenous medication.

Radiation therapy draws on the power of high-energy rays to target and kill cancer cells, ideally with as little damage to the surrounding tissues and organs as possible. These primary treatments are often combined and may be used in tandem with hormonal therapy, which denies cancer cells the hormones they need to grow, and biological therapy, which involves doctors activating the body's immune system to combat invasive cancer cells and facilitate the healing process from other cancer treatments.

#Eugenio Galindo

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eugeniogalindo · 6 months

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Perspectives in Patient-Centered Care

Patient-centered care is a revolution in healthcare and is gaining much traction among patients and healthcare providers. An important development in health care, the patient-centered healthcare delivery approach is predictive, preventive, personalized, and participative.

The transformative patient-centered approach is based on four pillars that form the cornerstone of clinical medicine: predictive, preventive, personalized, and participative. It redefines the dynamics between patients and healthcare providers and transforms the level of care provided. It marks a shift from the traditional passive patient paradigm to one in which patients actively participate in their healthcare journey.

Patient-centered care redefines the dynamic between patients and healthcare providers, elevating the quality of care. The approach shifts from the traditional passive patient paradigm to one in which patients actively participate in health decisions. It's no longer about a "one-size-fits-all" approach to health care but rather an intricate, collaborative process where the patient takes the lead in the management and design of their treatment.

Health care can often seem bureaucratic and devoid of human touch, but patient-centered care emphasizes empathy in the patient-physician interaction. At its core, patient-centered care acknowledges the values, convictions, and preferences of each patient. The uniqueness of patient-centered care is also manifest as it reduces the often bureaucratic nature of traditional health care delivery that lacks the intimate human touch. Patient-centered care emphasizes empathy in the patient-physician interaction.

Patient-centered care requires a shift in the culture of healthcare institutions. It's not just about respecting autonomy; it's about actively promoting it. The personalized care approach to care creates an environment where patients feel heard and empowered to co-create their healthcare narrative.

Patients are not passive passengers; they are navigators of their healthcare journey. They set the course with realistic goals, assume ownership of their health, and have the tools and knowledge to sail through the process. By actively engaging patients, healthcare providers ensure that the treatment plan is uniquely tailored, yielding superior health outcomes. This environment builds trust and patient satisfaction.

The bedrock of patient-centered care is communication that goes beyond the ordinary exchange of information. It involves active listening, empathetic responses, and shared decision-making. Patients should be active participants in the decision-making process, working from a position of knowledge. Patient-centered health care focuses on the patient's values, beliefs, and needs. It promotes good communication, patient involvement, emotional support, and timely access to care.

The emotional and psychological health of patients is as vital as their physical health. In patient-centered care, healthcare providers also serve as empathetic counselors. They understand that illness includes navigating emotional issues. This empathy builds trust, reinforcing the therapeutic relationship and elevating patients' overall well-being.

For people with multiple long-term conditions (multi-morbidity), care can be complex, which often makes delivery and management costly and challenging. Healthcare providers often do not tailor care to meet the needs of multi-morbidity. Patient-centered care has the potential to improve outcomes for such patients.

By understanding the medical details of each patient, patient-centered care ensures that patients receive support for each health condition. Patient-centered treatment and management also lead to more job satisfaction for healthcare providers. In addition, the approach helps build an ongoing partnership between healthcare providers and patients through regular interaction, resulting in a more individualized and caring treatment.

#Eugenio Galindo

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eugeniogalindo · 7 months

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Staging of Leukemia

Unlike most solid tumors, leukemia is not classified by stage based on tumor size or spread. Different staging systems exist for each leukemia subtype. Overall, leukemia staging consists of multiple criteria including the type, count, and degree of maturation of specific blood cells, as well as the presence of enlarged lymph nodes.

Acute lymphoblastic leukemia (ALL) staging is based on the type and maturity of affected blood cells. The two main types of ALL are B-cell and T-cell ALL. Each type is staged according to the maturity of the blood cells. For example, B-cell ALL is classified as early pre-B, pre-B, common, or mature B-cell. T-cell ALL is classified as pre-T or mature T-cell.

There are two staging systems for acute myeloid leukemia (AML). The French-American-British (FAB) system consists of eight stages based on blood cell type and maturity. Stages M0 to M5 refer to cancers that develop from immature white blood cells like myeloblasts and promyelocytes. Stage M6 refers to acute erythroid leukemia, where malignancy originates from immature red blood cells, whereas stage M7 develops from megakaryoblasts, or platelet-forming cells. Alternatively, the World Health Organization (WHO) stages AML based on prognostic factors such as genetic abnormalities, comorbidities, and cellular differentiation.

Doctors can stage chronic lymphocytic leukemia (CLL) using the Rai or the Binet system. The Rai system is used in the United States. Comprising five stages, it assesses the severity of CLL based on three criteria: lymphocyte count, enlargement of lymph nodes, liver, or spleen, and development of blood disorders like anemia or thrombocytopenia. Rai stage 0, or low-risk CLL, is characterized by high lymphocyte count only, whereas stage 1 also includes enlarged lymph nodes. The liver or spleen may become enlarged in stage 2. Anemia and thrombocytopenia may develop in stages 3 and 4, or high-risk CLL.

In Europe, the Binet staging system focuses on enlargement of lymphoid tissue. Stage A describes CLL cases where some lymph nodes are swollen, stage B includes swollen lymphoid tissues in more than three areas, and stage C - like high-risk CLL in the Rai system - features anemia or thrombocytopenia.

The staging system for chronic myeloid leukemia (CML) is composed of phases that describe the number of immature white blood cells, also known as blasts, found in the bone marrow and bloodstream. Chronic CML is the earliest stage, where blasts account for less than 10 percent of total blood cells and patients present mild symptoms. In accelerated CML, blast growth progresses rapidly and results in more severe symptoms, such as weight loss. The most aggressive stage of CML is the blast phase, where blasts account for at least 20 percent of all blood cells and patients exhibit symptoms as severe as those with AML.

Doctors conduct various tests to accurately stage leukemia. They use diagnostic methods such as blood tests, bone marrow biopsy, and imaging modalities. A complete blood count, or CBC, determines the number of different cells in the bloodstream, and plays an important role in evaluating the severity of leukemia. Similarly, a bone marrow biopsy, taken from the patient’s hip bone, allows doctors to detect and identify the type of leukemia cells present in the bone marrow. Imaging modalities like x-rays and positron emission tomography (PET) scans can locate leukemia metastases in other parts of the body.

#Eugenio Galindo

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