Tag Archive for: dementia

CAR T-Cell Therapy Patient Eligibility | What Patients Should Know

/in , , , , , , , /by

CAR T-Cell Therapy Patient Eligibility | What Patients Should Know from Patient Empowerment Network on Vimeo.

What should CAR T-cell therapy patients know about patient eligibility? Expert Dr. Krina Patel from The University of Texas MD Anderson Cancer Center discusses transplant eligibility factors, why the factors are examined, and proactive advice for patients.

[ACT[IVATION TIP

“…tell your doctor, “I’m interested in CAR T. I want to go talk to a CAR T center.” And that’s where they can tell you if something is possible or not.”

Download Guide | Descargar Guía

See More from [ACT]IVATED CAR T

Related Resources:

What Is the Impact of CAR T Therapy Access Barriers on Patients?

What Is the Impact of CAR T-Cell Therapy Access Barriers on Patients?

 What Are CAR T Therapy Requirements for Care Partners?

What Are CAR T-Cell Therapy Requirements for Care Partners?

 CAR T-Cell Therapy Follow-Up Monitoring | What Patients Can Expect

CAR T-Cell Therapy Follow-Up Monitoring | What Patients Can Expect

Transcript:

Lisa Hatfield:

Dr. Patel, what challenges exist in navigating the complexities of patient eligibility criteria for CAR T therapy, particularly in the context of comorbidities and prior treatments and how can these challenges be navigated more effectively?

Dr. Krina Patel:

Yeah, I think it’s, people compare it to stem cell transplant all the time, and that’s my biggest activation tip. Transplant eligibility is not the same as CAR T eligibility. CAR T eligibility is much easier. So the absolute contraindication I would say for CAR T, is probably my patients with dementia, right? Because some of the chemo that we give prior to the CAR T can worsen that. And things like ICANS, this neurotoxicity can worsen some of those symptoms and we don’t want that.

That’s where I would use a bispecific instead where we’ve seen some great responses, but everybody else, again, even if you’re on dialysis and you have kidney failure, we can change the dosing of that chemo and patients do really well with CAR T. We work with the nephrologist, to make sure we don’t cause volume overload or anything else that they’re doing dialysis on time. We’re changing things up, etcetera. Patients with cardiomyopathy, so heart failure, again, we don’t want to go in when you have active heart failure, but just because you have a history of heart failure, we can do things to make sure that you don’t get, again, volume overload or, too much pressure on your heart.

Even patients with history of strokes, in the clinical trials that wasn’t allowed, but in the real world, again, as long as you’re not needing active therapy for your stroke, meaning, blood thinners, things like that yet anymore, then we can actually still potentially get you through CAR T. We have patients who aren’t able to speak.

They have expressive aphasia from history of stroke, but we actually have charts where we can figure out what their ICE scores are for ICANS. And we can make sure we, that they’re not having neurotoxicity. So we have other means by making sure that things are going well during that CAR T therapy that I think it’s really up to them. If they’re interested in it, my activation tip here is tell your doctor, “I’m interested in CAR T. I want to go talk to a CAR T center.” And that’s where they can tell you if something is possible or not. And I will say for the most part, most of my patients can get through CAR T. Again, we’ll talk about the different products. We’ll talk about how we would do it, how we would change it potentially.

But again, I have so many patients that are over a year, two years out without any therapy now. And they’re doing fantastically. And, and again, my patients with comorbidities and my older patients, they’re the ones who benefit when we’re not on any therapy because continuous therapy ends up causing more toxicity for them. And so I think it’s really, really important to speak up to your doctor and just say, this is something I’d really be interested in. And, any one of our centers would be happy to explain what we would do differently as well as, which product is the best one for you based on that risk comorbidity and the risk-benefit ratio.

Lisa Hatfield:

That again is great information. I’m glad you addressed the kidney dysfunction issue because we have several people in our support group who worry that they won’t be eligible for CAR T therapy because they have kidney dysfunction. So they’re all seeing specialists, which is the way to go for patients, to always see a specialist. So thank you so much, Dr. Patel.

Share Your Feedback

Create your own user feedback survey

What To Avoid When Speaking With Someone Who Has Dementia

/in /by

In recent years, those who live with dementia are leading fuller, more active lives than they may have done in previous decades. Treatment is more readily available, and though there is no known cure as yet, the general public are better informed in how to approach those who have it.

But if you’ve not met someone who has dementia before, there are a few easy mistakes to make which can be embarrassing and distressing for everyone involved. Below are a few things to avoid when conversing with someone who has dementia.

Recall

One of the most difficult symptoms of dementia to navigate is the loss of full recall (https://my.clevelandclinic.org/health/articles/11826-memory-loss-signs-of-dementia–more-). Many people with dementia can become very distressed and embarrassed when asked a direct question about past events that they have difficulty remembering. Sometimes the inability to recall can be very slight or can be dramatic.

“If a person with dementia talks about a subject that shows they are having difficulty recalling, you should ask yourself whether it is truly necessary,” writes Stephen James, an author at Academized and PaperFellows. “If you do need to help them remember something, avoid asking them directly, and talk, instead, about what you remember about an event or story.”

Confusing Directions

Dementia can affect verbal cognition. Remember that if a person with dementia is having difficulty understanding an instruction, continuing to repeat that instruction is likely to confuse them further. If you need a person with dementia to perform a series of actions, such as putting on a coat and shoes and getting into a car, listing them off in one go is going to overwhelm them.

Instead, give clear direction for each task you want them to do. It is important to issue them as directions rather than questions as they may have difficulty understanding the context for each action.

Complex Language

In fact, it is a good idea to modify your language over all. Even those who have had a large vocabulary may have difficulty fully comprehending long winding sentences. Using complex words and difficult phrases is likely to cause confusion which, in turn, can lead to embarrassment and irritation.

Instead, use simple sentences with uncomplicated words. Having said that, remember that dementia doesn’t affect a person’s IQ, so it is also important not to become condescending.

Emotional Subjects

Living with dementia can be distressing enough without someone constantly reminding you of all you may not recall. If you are speaking with someone who lives with dementia it is important to avoid conversations which may make them emotional. This can include correcting aspects of their lives that they may not recall, or distressing events such as a loved one’s death which they may not remember.

It is best to avoid conversing on explosives subjects such as politics or religion,” says Jane Renbourne, a regular contributor to Custom Writing Service and BigAssignments. “Though they may be able to recall aspects of this, those who live with dementia have difficulty dealing with conflict. Even what seems like a slight disagreement may spiral out of control. “

Impatience

Most importantly of all, it is important to remain as patient as can be when interacting with a person living with dementia. Showing haste to complete their sentences, telling them things you think they should remember and disrespecting their need to communicate for themselves is as upsetting as it is with anyone else. Remember that however difficult adapting to dementia is for the observer, it can be a constant source of frustration for the person who has it.

However, if you show some understanding and patience, there is no reason that both you and your friend with dementia cannot spend some wonderful and meaningful times together.