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If you are having medical imaging studies done you may soon hear of a new technique to assess those images called ‘radiomics.’ Elliot Fishman, a medical imaging expert at Johns Hopkins, explains.

Fishman: What radiomics is is a way of having the computer look at the images. It’s a complex pattern, we run lots of computer algorithms, to try to figure out can we pick up cancer or any abnormality earlier. We’ve been spending the last five years at Hopkins looking at early detection of pancreatic cancer. We’re creating fingerprints of the patient’s tumors. The fingerprint of the normal pancreas and the fingerprint of the cancer look different. When we did this we were able to pick up cancer with a 99% accuracy.  :33

Fishman says radiomics has the potential to transform assessment and diagnosis of many cancers to allow much more precise and individually tailored treatment. He notes that at some point it may also be useful for screening. At Johns Hopkins, I’m Elizabeth Tracey.

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Cancer is an area where artificial intelligence or machine learning is making great strides. Elliot Fishman, a medical imaging expert at Johns Hopkins, says the computer’s role goes from interpreting the image obtained in scanning to applying information from many previous similar scans.

Elliot Fishman: We’re trying to use the computer to accentuate normal from abnormal, to show you precisely what is going on, and then taking the body as literally a three D map from looking at the vessels, the organs, and all the individual structures, we can then take those images and look at them with augmented reality. One of the biggest things you’re going to see in medicine over the next two years is augmented reality. If we can get the precise best definition of what the patient’s tumor is and how it will need to be operated on.  :30

Fishman notes that no additional scans or studies are needed from the patient to apply this technology, and that the information is often used during surgery to achieve the best outcome. At Johns Hopkins, I’m Elizabeth Tracey.

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Low vision is common, especially as we age. Judith Goldstein, a low vision expert at Johns Hopkins, says that in addition to seeking comprehensive care for the condition, loved ones really need to be involved also.

Goldstein: This is where we bring the family and the caregivers back into the fold. It’s very important that they are educated. You know when you have vision loss it’s not physically evident oftentimes. You’re not using a walker or a wheelchair or a cane. People don’t know that you have an eye problem. People don’t understand why their mom can see a piece of lint on the carpet but can’t recognize their face. And so it’s a lot about teaching the family about how to help them. Maybe you should walk on this side. Maybe you should give them verbal clues. Let me teach you how to use the technology so you can help your husband or your wife or your family member.  :32

Goldstein says most people with low vision can use a range of technologies and techniques to learn to live best with the condition, and the support and perspective of loved ones is key. At Johns Hopkins, I’m Elizabeth Tracey.

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Some one in six people over the age of 45 have a condition called low vision, where they have trouble reading, driving, or telling colors apart. And that number rises to one in four in those over the age of 75. Judith Goldstein, a low vision expert at Johns Hopkins, says fear often accompanies the vision loss.

Goldstein: People who are losing vision are quite scared. They don’t know who to turn to and they feel very alone. People are worried about am I going to go blind? They want to know why their vision is fluctuating, why are they having good days and bad days with their vision. They feel like their vision continues to decline even though their eye doctor tells them everything is stable. As part of this examination we develop a rehab plan. We might have people come back for additional visits to kind of try on the adaptations. What works in the clinic doesn’t always work in the real world. And so it’s very important that we make sure that it works for the patient.  :32

Goldstein says a patient, systematic approach to managing low vision is best. At Johns Hopkins, I’m Elizabeth Tracey.

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Low vision, which affects one in four adults over 75, is often associated with damage to the macula, the part of the eye where our vision usually works best. Judith Goldstein, a low vision expert at Johns Hopkins, says there are well defined ways to help.

Judith Goldstein: What happens if that macula isn’t working so well? Glasses are probably not the answer, so we have to use specialty lenses, and lighting, magnification systems and telescopic systems, all with the aim of enhancing that image, not on the macula but maybe next to the macula where there’s a little bit healthier retina. What if the enhancement isn’t good enough? Then we have to rely on our other senses. We call this sensory substitution, the ability to use our other senses to help us accomplish our everyday activities.  :29

Goldstein says management of low vision requires a team approach, since there are multiple strategies in learning to live with the condition. Initial assessment of low vision should involve comprehensive testing and assessment so best techniques can be employed. At Johns Hopkins, I’m Elizabeth Tracey.

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HPV causes cancer, and we have an effective vaccine against it. Now the World Health Organization is advocating for a single dose of the vaccine in places where completing the two dose regimen is challenging. Johns Hopkins Kimmel Cancer Center director William Nelson applauds the strategy.

Nelson: A single HPV dose might be effective for girls aged 9 to 20. The usual regimen is to have a dose of the vaccine, wait six months and then get another one. That requires a lot of health system effectiveness and coordination, which in the underresourced parts of the world is a little bit harder to achieve. So the notion that you can protect girls by giving them one vaccine is a very attractive one and could really help in that part of the world. What they do recommend still is that older girls if they’re going to get vaccinated have the two doses, boys still get the two doses.  :33

Nelson notes that the vaccine protects against cancers of the cervix, the mouth and throat, and several other rarer types. At Johns Hopkins, I’m Elizabeth Tracey.

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Breakthrough infections, which occur in those who have been vaccinated against Covid-19, are more troubling for people with cancer than those without, a new study confirms. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, reviews the data.

Nelson: The severity was also concerning. If you looked among the people who got an infection who had been vaccinated, with cancer, 31 to 32% of them ended up in the hospital and 3.9% of them died as a result of this infection. Probably still need to be careful, even if you’re vaccinated, and you have a cancer. We had a pretty good understanding about hematologic malignancies. I think it’s a little surprising that that fraction of folks with pancreatic cancer, liver cancer, lung cancer, colorectal cancer, were vulnerable to get a breakthrough infection even if they’d been vaccinated.  :32

Nelson urges people with cancer to obtain all vaccinations and boosters they are eligible for, and to make thoughtful choices when it comes to socializing, traveling, and wearing a mask. At Johns Hopkins, I’m Elizabeth Tracey.