Anchor lead: Treatment with radiation for many cancers is easier than ever, Elizabeth Tracey reports

When some women with breast cancer had surgery, a single dose of radiation in the OR proved as effective as a more lengthy course after the procedure, a recent study found. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says improvements to radiation therapy are key.

Nelson: The ability to very selectively target where the radiation goes is beginning to impact on how the dose is given. Now that the aiming can be much more precise that safety margin is substantial now, and it’s enabled the radiation oncologist to begin thinking about can you deliver radiation at a fraction that’s more effective in treating the cancer perhaps, and actually may be even more convenient, and I think that’s what you see here for breast cancer.  :27

Nelson says use of radiation therapy for many cancers is transitioning to much shorter courses of treatment, and these are not only more convenient for patients but also result in outcomes that are at least as good, and sometimes better than more lengthy treatment. At Johns Hopkins, I’m Elizabeth Tracey.


Anchor lead: Can a mailed in screening test for colon cancer work? Elizabeth Tracey reports

Sending people colon cancer screening kits where they can simply send in a fecal sample they collect themselves at home is cost effective and acceptable, a new study finds. The test relies on the presence of either blood in the stool or cancer DNA, and may also increase the number of people who are willing to be screened. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, comments.

Nelson: I think what we’ve learned is if you have this kind of a test in a serial manner you get it year after year after year, if you have three or more consecutive tests for blood or for cancer DNA, you’re probably in pretty good shape. I think there’s going to be more work on exactly which test to use when and the most cost effective and effective way, but the bottom line at this point is we’re talking about two approaches that have a great deal of effectiveness.   :27

Nelson says if the screening test identifies a problem, colonoscopy to further evaluate and possibly treat is indicated. He notes that colon cancer rates among those younger than 50 have been increasing, and urges people to ask their primary care physician about screening. At Johns Hopkins, I’m Elizabeth Tracey.


Anchor lead: Among those with cancer, Covid infection affects those with leukemia most, Elizabeth Tracey reports

If you have leukemia, you may be at high risk for severe Covid-19 disease, a recent study found. Yet William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says delaying your treatment is really not an option.

Nelson: The problem with leukemias is that they are very often highly aggressive diseases that have to be met with significant treatment quickly. There’s very little in the way to get around that. As agents that can treat the viral infection improve and the outcomes with leukemia and in the setting of this infection will likely improve as well. But this business of delaying some of these approaches, there is a significant worry that this will have longer term consequences.  :26

Nelson says that with regard to Covid-19 transmission, no studies have shown that people in hospitals and many other healthcare facilities are at greater risk of contracting the infection, and in point of fact, may be at reduced risk because of intensive infection control practices, so he urges people not to put off cancer treatment for this reason. At Johns Hopkins, I’m Elizabeth Tracey.


Anchor lead: A new targeted agent in certain cancers proves very beneficial, Elizabeth Tracey reports

People with a mutation in their cancers abbreviated RET may benefit from an agent called selpercatinib, two studies in the New England Journal of Medicine report. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the findings.

Nelson: They reported on two different studies. One of them for a rare-ish kind of cancer, it’s called a medullary thyroid cancer it very often arises as part of an inherited syndrome, where people get more than one cancer of the endocrine kind of organs, in that one the responses were stunning. The other trial that was reported there are defects in these RET genes, acquired defects, in many different cancers although its not a very common one, one group of them were so-called non-small cell lung cancers, and in that case the drug was also incredibly effective for those people.   :32

Nelson says the number of drugs that target specific mutations is increasing, and that’s good news for people with cancers of all types and argues for genetic analysis of tumors.  At Johns Hopkins, I’m Elizabeth Tracey.


Anchor lead: The Academy of Medicine updates its view of the nursing profession, Elizabeth Tracey reports

The National Academy of Medicine has updated its report on the state of nursing as a profession. Patricia Davidson, dean of the Johns Hopkins School of Nursing, says the original report is the most downloaded report ever by the academy, and notes that this version once again advocates for a more educated nursing workforce.

Davidson: Because we know that nurses with baccalaureate education in working in institutions there is less mortality and better patient outcomes. In essence we’ve seen the other side of the equation in the Covid-19 pandemic. Where in residential age care facilities where there’s only one registered nurse on duty for eight hours a day that we have had the ravages of Covid-19. And that has been a phenomenon across the world.   :28

Davidson says more education enables nurses to implement things like infectious disease transmission prevention strategies in their workplace, and that helps patients as well as clinicians stay safe. At Johns Hopkins, I’m Elizabeth Tracey. 

In this final podcast of the three-part series, we bring back our guest from the Center for the Practice of Collaborative Leadership, Carolyn Cumpsty-Fowler, PhD, MPH. First, Carolyn explains what a focus group is and why inquiry teams might use one. Next, Carolyn shares the number one priority when facilitating a focus group. Finally, Carolyn points out what we should be aware of when working with focus group data.


Anchor lead: Should you choose a hospital with a hospital at home program? Elizabeth Tracey reports

Hospital at home, where hospital level care is delivered to people in their own home, is burgeoning nationally. Bruce Leff, a gerontologist at Johns Hopkins and hospital at home expert, says the data are compelling.

Leff: In terms of patient and caregiver experience lots of data from studies we’ve done, randomized controlled trials done around the world, probably one of the best studies models out there consistently better patient and caregiver experience at home compared with hospital. Covid has changed a lot in healthcare delivery, so hospital A has it and hospital B doesn’t, and you have something that hospital A has hospital at home, and could probably put you in hospital at home for, and you have a favorable attitude towards getting that care at home, you should go to hospital A that has it.  :32

Leff predicts that as people become more aware of this option, more will choose hospital at home in lieu of admission to a bricks and mortar hospital. At Johns Hopkins, I’m Elizabeth Tracey.