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This week’s topics include light treatment and Parkinson’s, ultrasound for bone healing, knee pain treatment over the Internet, and maintaining weight loss.

Program notes:
0:30 Treating knee pain over the Internet
1:30 How did they do at 9 months?
2:10 Maintaining weight loss
3:10 Delivering over telephone
4:10 Regain significant weight
5:05 Parkinson’s treatment and Circadian rhythm
6:07 Light therapy twice per day
7:07 Light exposure and depression
8:08 Ultrasound and bone healing
9:08 Did not improve healing
10:40 End
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Anchor lead: Why aren’t more people who are candidates for genetic testing for cancer getting tested? Elizabeth Tracey reports

Genetic testing can inform a wide range of decisions relative to cancer: one’s own individual risk, the likelihood that certain treatments will succeed, how well things are going, but a new study reports that many people either don’t have testing or the counseling that goes with it. Kala Visvanathan, a cancer expert at Johns Hopkins, comments.

Visvanathan: For the people at very high risk it’s happening, probably reasonably well, but there’s a large number of patients who are not getting tested even though they want to get tested, and there’s also a large number of patients not getting genetic counseling, which is important to explain and interpret the testing. This testing is available, insurance often covers this testing. Particularly BRCA1 and 2 testing has now been available for 20 years. We really should, as a country, be thinking about how we would make sure that everyone who’s appropriate to have testing is.   :33

Visvanathan encourages everyone to ask their doctor about eligibility. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new blood test may help manage breast cancer, Elizabeth Tracey reports

Liquid biopsies, which look for cancer in a blood sample, have moved closer to fruition with a Johns Hopkins study led by Kala Visvanathan. The study looked for aberrant DNA using addition of a chemical marker known as a methyl group in women with advanced breast cancer.

Visvanathan: In some ways it measures tumor burden. The C-meth DNA panel is a panel of markers identified from breast cancer tumors. The assay is actually novel because it’s highly sensitive and specific. And it picks up very small levels of methylation in the blood, and it’s also one of the first assays to quantify the actual amount of methylation. :21

Visvanathan: The very interesting part of this is also that higher levels at four weeks after the initiation of a new treatment in breast cancer patients with metastatic disease, those levels predicted response 12 weeks later.  :14

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: The rate of human papilloma virus infection in men is quite high, Elizabeth Tracey reports

Human papilloma viruses, abbreviated HPV, cause cancer, with some viral strains more problematic than others. Now a new study looks at a national sample and finds that almost half of men were infected. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the findings.

Nelson: They looked at 1800 men aged 18 to 59, 45% were positive for human papilloma virus. If you looked at men who were otherwise eligible for vaccination, 7% of them were positive for at least one strain that would have been prevented had they been vaccinated. The vaccine that captures 9 HPV strains, 15% would have been positive for one of those so they would have been protected. In the end only 11% of the men who were eligible for vaccine had gotten vaccinated. :30

Nelson says cervical, anal and penile cancers as well as some cancers of the mouth and throat are caused by HPV, so vaccination is beneficial for all. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Does using MRI improve prostate biopsies? Elizabeth Tracey reports

Using both ultrasound and MRI images, a new study reports that improved rates of detecting more serious prostate cancer are possible. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the method.

Nelson: This approach, by aiming at abnormalities on the magnetic resonance image, using a fused image strategy, you would be better able to assess whether high grade, dangerous cancer is present. :12

Nelson says many more men will be able to access this approach.

Nelson: The technology is becoming more broadly accessible and more used across the country. The cost of getting a magnetic resonance image in addition to the ultrasound biopsy is greater. I don’t know whether avoiding a second or a third biopsy procedure does that make it more cost-effective? :17

Nelson says that being able to find the more serious cancers that require treatment against the large number of cancers that can be safely watched is the hope, and that would clearly be cost-effective as well as less onerous for patients. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Cervical cancer rates have been underestimated, Elizabeth Tracey reports

Rates of cervical cancer have for years been reported as low and falling, but now a new analysis of the data removing women who’ve had their uterus removed from the calculations raises some concerns. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, reveals the numbers.

Nelson: Cervical cancer is a little bit bigger problem than we thought. For African American women it’s 10.1 per hundred thousand age-adjusted per year, and Caucasian women 4.7deaths per hundred thousand per year. :13

Nelson says prevention is clearly the best strategy.

Nelson: A general healthy approach involving vaccination against human papilloma virus which is the cause of cervical cancer, screening, one would hope in the future as we improve the vaccines and improve vaccine uptake and compliance that we wouldn’t have to worry so much about screening and hopefully those death rates will fall precipitously.  :19

Nelson says everyone should ask their doctor about their own vaccine eligibility. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new type of surgery on the thyroid gland is now available in the US, Elizabeth Tracey reports

Surgery on the thyroid gland to evaluate masses that might be cancerous is very common, and unfortunately, leaves a scar right across the front of the neck. Now a new approach totally avoids leaving a scar.  Jon Russell, a head and neck surgeon at Johns Hopkins who utilizes this approach, says patients especially appreciate this.

Russell: Here in the United States at Johns Hopkins we have done more of these than anyone else in the United States, to our knowledge. We’ve found repeatedly it’s been safe, our operating times are approaching the operating times that we would do for a normal surgery, these patients walk out, we send them home oftentimes the same day. They come back and they see us in a week and they feel great. they’re just always ecstatic and they say I had it done, and I don’t have a scar. :24

Russell says the operation is also suited for parathyroid masses.

Russell: We’ve actually done some parathyroidectomies as well and it works perfectly for a well-localized parathyroid it’s the perfect surgery.  :08

Russell predicts that soon most such surgeries on the thyroid will utilize this new approach. At Johns Hopkins, I’m Elizabeth Tracey.

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