Tag Archive for: digital health

January 2024 Digital Health Roundup

Science fiction comes to life in the name of treating cancer. Scientists from MIT have created inhalable sensors combined with a urine test to detect early-stage lung cancer. Research from an ultrafast laser technology could help improve cancer treatments. Nano drones have been created to make a more targeted and precise cancer treatment.

MIT Scientists Create Inhalable Sensors to Detect Early Lung Cancer

This technique of inhaling nanoparticle sensors followed by a urine test may offer the potential for faster and early detection of lung cancer reports Interesting Engineering. This technology will be helpful to lower income countries that have little access to CT scanners. Lung cancer is caused by pollution and smoking, this makes cancer numbers higher in lower income countries. Access to this technology can have a big impact on lung cancer detection and earlier treatment, increasing better outcomes for patients. These nanosensors are given via inhaler or nebulizer. The sensors identify cancer related proteins in the lungs and use a barcoded DNA that detaches when it contacts the cancerous proteins. Eventually the barcoded DNA accumulates in the urine where it can be detected with a paper test strip. The results of this technology are available within 20 minutes. In mice trials, the test detected early-stage lung cancer. It is now moving into human trials. Click here for the full story.

Ultrafast Laser Technology Could Offer Improved Cancer Treatment

For the first time, we showed that, under certain conditions, a laser beam tightly focused in ambient air can accelerate electrons reaching energies in the MeV (megaelectronvolt) range, the same order of magnitude as some irradiators used in radiation therapy for cancer reports Phys Org. The end of a focused point of a laser can generate plasma which can be generated to high energy like radiation. FLASH radiotherapy uses a similar method to treat cancerous tumors resistant to radiation therapy. It gives high doses of radiation in a short time to protect surrounding healthy tissues. With this discovery, more research can be done to make better radiation treatments for cancer. This new knowledge highlights the need for safer handling of the laser beams for those who operate them; radiation is more of a hazard than previously known. Click here for the full story.

“Nanodrones” Enable Targeted Cancer Treatment

A groundbreaking study led by Professor Sebyung Kang and Professor Sung Ho Park in the Department of Biological Sciences that UNIST has unveiled a remarkable breakthrough in cancer treatment. The research team has successfully developed unprecedented “NK-cell engaging nano drones” capable of selectively targeting and eliminating cancer cells, offering a potential solution for intractable types of cancers reports Technology Networks. NK (natural killer) cells are the body’s immune response against cancer. The NK cell-engaging nano drones display ligands or molecules that bind to human NK cells. This technology offers development of treatments for intractable cancers, using the NK cell delivery nano drones. Click here for the full story.

December 2023 Digital Health Roundup

Scientists are being inspired by nature to create technology that helps fight cancer. A butterfly’s ability to see UV light has inspired the creation of new imaging to detect cancer cells. A programmable bacterium is being studied to destroy at least four different types of cancer. Artificial intelligence is making a big impact on the fight against cancer from designing drugs to analyzing large amounts of data to choose the best treatment option. 

New Technology Inspired by Butterflies can Detect Cancer

Butterflies possess a unique ability to recognize a broad range of colors, including those in the light spectrums ultraviolet UV range. The health care field uses UV light techniques extensively such as that used for dermatologic imaging reports Labroots . The challenge in using UV light is that it has quick absorption and attenuation. Scientists based the new UV sensor on the visual ability of the Papilio xuthus butterfly. This sensor uses two ways to detect UV light, a nanocrystal and a photodiode. This UV fluorescence imaging can tell the difference between cancer cells and normal cells with a very high accuracy. Thus far, this technology has been tested on breast cancer cells. Click here for the full story. 

Programmable Bacteria Could Cure Cancer with Single $1 Dose

Texas A&M University (College Station, TX, USA) and the University of Missouri (Colombia, MO, USA) are leading this groundbreaking research and have secured a USD 20 million grant from the Advanced Research Projects Agency for Health. Of this funding, USD 12 million is allocated to Texas A&M University for the development of synthetic programmable bacteria designed to enhance the immune system’s ability to target and destroy cancer cells (SPIKES) reports Hospimedica . Scientists are creating a pico-liter-cvolume liquid handling system to analyze individual cells quickly to find the best candidates for this therapy. Brucella Melitenis, a bacteria that can work against four types of cancer is being used. This bacterium can stimulate T-cell anti-tumor immunity. It needs to be programmed to target only the tumor and then self-destruct after the treatment by the patient taking antibiotics. The use of this technology and treatment can make cancer treatment much less expensive and more available for cancer patients. Click here for the full story. 

Is AI the Cancer Fighting Tool We’ve Been Waiting For?

New imaging technology has recently begun to give scientists precise data on the location of proteins inside and around tumors and how they interact with one another. And advances in artificial intelligence are giving them the ability to interpret the reams of data that these new imagers are generating reports Newsweek . AI is also being used to design cancer drugs; the first drug is now in clinical trials. Cancer’s ability to mutate makes it very difficult to treat, real time data at the molecular level is needed to see what the patient’s particular cancer is doing. This technology allows for that data to be collected and analyzed quickly. Artificial intelligence is cataloging and analyzing large amounts of data to assist doctors in choosing effective cancer treatments. This information has led to new developments in how to combat cancer with more effective treatments. Scientists are adapting mobile unit AI labs to be placed at hospitals to better assist doctors in providing personalized therapies for individual patients. In these AI labs, robots do the lab work and collect the data. Click here for the full story. 

September 2023 Digital Health Roundup

Technology is helping doctors save cancer patients during treatment and with brand new treatments. Remote patient monitoring is detecting neutropenic fevers early in patients undergoing cancer treatments. Scientists have developed a micro device to implant inside tumors to help treat brain gliomas. With the use of CRISPR, researchers have developed a way to reprogram cancer cells into healthy muscle cells.

How Remote Patient Monitoring Can Save Cancer Patients’ Lives

Neutropenic fever is a common complication for cancer patients undergoing chemotherapy. In fact, one out of every 29 chemotherapy-treated patients is hospitalized, with a startling mortality rate of 7 to 9.5% reports Healthcare IT News. Remote patient monitoring devices include wearable temperature sensors, heartrate monitors, and respiratory rate monitors. Neutropenic fever is a common side effect of chemotherapy, but it can be serious or even fatal. This remote patient monitoring can detect fevers without symptoms or that occur during sleep. It is a simple patch that is Bluetooth enabled and transmits the data constantly. The neutropenic event caught early enough can prevent a hospital admission. Early detection of neutropenic events will improve patient outcomes and decrease the cost of admission by prevention. This success of the remote patient monitoring depends on the training of the monitoring staff. The staff must be able to recognize early warning signs of neutropenic events and respond quickly. Click here for the full story.

Microdevices Implanted into Tumors Offer New Way to Treat Brain Cancer

The shape and size of a grain of rice, the new device can conduct dozens of experiments at once to study the effects of new treatments on some of the hardest-to-treat brain cancers reports Medical Design & Development. Researchers from Brigham and Women’s Hospital designed this micro device to treat gliomas which are brain and spinal cord tumors. It monitors the effects of drugs on the tumors while surgically implanted during the treatment and it is removed before the surgery is over. This device helps to monitor the use of combination therapies and its effects on the tumor. It is implanted for two to three hours while tiny doses of drugs are given, up to 20 different drugs. The data and surrounding tissue are analyzed to learn if the drugs are effective on the tumor’s microenvironment. During the studies, there have been no adverse effects on the patient from the device. Click here for the full story.

CRISPR Used to ‘Reprogram’ Cancer Cells into Healthy Muscle in the Lab

The study published August 28 in the journal PNAS, Researchers found that disabling a particular protein complex in cells of rhabdomyosarcoma (RMS)- a rare cancer in skeletal muscle tissue that mainly effects children under age 10- in the laboratory causes the tumor cells to turn into healthy muscle reports Live Science. Differentiation therapy is the act of changing cancer cells into healthy cells and has been used for blood and bone cancers. This therapy uses CRISPR technology to alter proteins to stop cancer multiplication and can eventually be used as a treatment option. In RMS, a genetic mutation makes a protein that causes the skeletal muscles to turn into cancerous tissue. CRISPR was used to disable certain genes to stop this mutation process, and then turned the cancerous cells into healthy cells. Click here for the full story.

August 2023 Digital Health Roundup

This month advances in technology aid doctors and scientists in the fight against cancer. Microbubbles armed with oxygen and a cancer drug are having positive results in mice trials. Scientists have developed robotic tentacles to assist doctors with lung cancer treatment. A new ultrasound scanner has been developed to screen for breast cancer.

Delivering Oxygen to Tumors May Be Key in Overcoming Radiation Resistance

A team led by researchers at Thomas Jefferson University and Drexel University has devised a strategy that combines ultrasound with microbubbles to deliver oxygen and cancer drugs to tumors. The results of a study published in the journal Pharmaceutics indicate that the method -tested in mice- primed tumors to be more vulnerable to radiation therapy, resulting in slowed tumor growth and increase survival reports Cancer Health. Radiation therapy causes hypoxia, which is a condition cancer cells grow in. Some tumors are resistant to radiotherapy because of this hypoxia. Scientists made microbubbles full of oxygen and the drug Ionidamine, that stops cancer cell metabolism. When injected into the body, it is targeted to release what it carries by use of ultrasound waves. In the trials, this method has been used for breast cancer treatment with the hope of using it on head and neck cancers. Click here to read more.

These Tiny Robotic Tentacles Could Travel into the Lungs to Treat Cancer

Scientists made robotic tentacles on the end of a bronchoscope to reach deeper into the lungs during lung cancer treatment. During the journey, magnets adapt the robot’s shape to the body’s anatomy. As it moves, both its form and position are fed back to a clinician. After reaching its destination, an embedded laser fiber can deliver localized treatment reports The Next Web. Magnets make the tentacles softer and easier to control the shape, so it conforms to the anatomy of the lungs. Early stages of lung cancer are typically treated by surgical intervention to take cancerous lung tissue. These robotic tentacles are less invasive and cause less pain and recovery time. This method makes for more precise removal of cancerous tissue, leaving behind more healthy tissue. Scientists have started testing this method on cadavers and will soon be moving to human trials. Click here to read more.

Study: Wearable Ultrasound Scanner Could Detect Breast Cancer Earlier

Researchers at the Massachusetts Institute of Technology said Friday they have developed a wearable ultrasound tracker that could detect breast cancer as at its early stages, giving it the potential to save lives reports UPI News. The new scanner is flexible and attaches to a bra. It captures images like ultrasound probes do in normal medical imaging. The scanner is portable and can easily be used from home. The openings in the patch have magnets that make it attach to a bra. The ultrasound scanner was made small so it could easily be used anywhere. This method is more comfortable than a mammogram, making more patients more willing to have the screening done. Click here to read more.

July 2023 Digital Health Roundup

In July science and technology are merging to further the fight against cancer. Scientists are using 3D printing to make immunotherapy treatments more effective for cancer patients. Using 3D models of ovarian cancer cells, researchers are learning which therapies work on cancer cells based on their location and accessibility in the tumor. With the assistance of artificial intelligence, radiologists are providing more precise radiation treatment to cancer patients.

3D Bioprinting Technology to be Used for Removing Cancer Cells

A three-dimensional (3D) bioprinting technology capable of eliminating cancer cells using the function of immune cells has been developed for the first time in the world reports Medical Design Development. Scientists are using this technology to help with immunotherapy to treat cancer. The 3D printed hydrogels completely surround natural killer (NK) cells to protect them, allowing the NK cells to get to the tumor cells. Small holes form in the hydrogel and the NK cells are released. When they are released, it functions to cause an immune response to the tumor. This technology is hoped to have a significant impact on the effectiveness of immunotherapy treatment for cancer patients. Click to read the full story.

NIH Develops Novel Tumor Identification Technology

The approach known as the segmentation by exogenous perfusion (SEEP) system reveals the genetic activity of single cells within a tumor with fluorescent dyes that spread into the tumors. According to the release, measuring how much dye gets into individual tumor cells provides information on the cell’s location and its access to the outside environment. Computational methods are then used to link the information to cells, gene activity, allowing researchers to connect the cells identities with their location reports Pharm Tech. Scientists developed this method using 3D models of ovarian cancer cells to learn why genes are turned on in relation to their location and environment. This information can help determine what therapies will work on the cancer cells. Scientists can also learn where the cells are in the tumor and how accessible they would be for drug delivery. Click to read full story.

AI Cuts Treatment Time for Cancer Radiotherapy

A new type of artificial intelligence technology that cuts the time cancer patients must wait before starting radiotherapy is to be offered at cost price to all NHS trusts in England reports BBC. This AI helps direct where to send the radiation to kill the cancer and saves healthy cells. Doctors can spend hours going through imaging to contour bones and organs for the radiation. Precision is important to save healthy tissue. This AI program is 2 1/2 times quicker and is called Inner Eye. Inner Eye is considered a medical imaging device. Radiologists still check contours created by the program and it has been found to be 90% accurate. This precision can be life changing for patients, limiting life altering side effects of radiation. This AI also frees up more of the radiologist’s valuable time. Click here for full story.

May 2023 Digital Health Round Up

Every month there is new technology developed that helps doctors treat cancer. Scientists have developed a sophisticated oxygen-eating battery that successfully helped treat cancer in trials. A hollow seed armed with immunotherapy has been successful in treating pancreatic cancer in mice trials. A new powerful microscope at a university is helping scientists to see cancer react with radiation at a cellular level. 

An Oxygen-Eating Battery Implant Cures 90 Percent of Cancer in Mice 

They have developed an implantable battery system that can identify low-oxygen environments in the human body that support tumor activity the battery system includes a self-charging saltwater battery and an anticancer drug called tirapazamine (TPZ) reports Interesting Engineering. This implant attacks cancer cells in the environment in which they grow, an environment lacking in oxygen. This battery implant regulates the low oxygen tumor conditions.

The drug TPZ only targets cells in this environment so no healthy cells are harmed. Researchers found that the volume of cancerous tumor decreased using this method. Another important finding was that there were no side effects such as weight loss or hair loss that typically occurs with chemotherapy. The battery implant creates a hypoxic environment making the TPZ work better. If this works as well in human trials, cancer patients won’t have the common painful side effects of chemotherapy. Click here for more information. 

Hollow “Seed” Shrinks cancerous Tumors From the Inside 

Pancreatic cancer is relatively rare, but it’s also notoriously difficult to detect and treat. As a result, more than 80% of patients diagnosed with the most common form of pancreatic cancer -pancreatic ductal adenocarcinoma (PDAC)- die within the first year after diagnosis, and fewer than 10% live for five or more years after reports Freethink. Doctors use monoclonal antibodies (mABS), which bind to cancer cells to either kill the cells or help the immune system fight the cancer.

These antibodies are given IV and circulate throughout the body. The mABS do not go straight to the pancreas, they are in the bloodstream, and this is what causes side effects. A nanofluidic drug-eluting seed or NDES is a device made of stainless steel that releases the monoclonal antibodies at the cancer site over 2 weeks period. Releasing it directly at the pancreas reduces side effects and allows for a smaller dose. Researchers have found promising results in mice trials. Click here for more information. 

New SEISMIC Facility Could Improve Our Understanding of Infectious Diseases, Aging, and Cancers 

The University of Surrey’s SEISMIC facility will offer scientists access to technology that enables them to pick up single cells or even parts of cells and measure the spatial position of biomarkers like proteins, metabolites and lipids reports News Medical & Life Sciences. This Research Center has an ion beam center, environmental flow laboratory, and a proton beam. 

These advanced microscopes allow scientists to follow biomarkers throughout the cell. This information will help them see how cancer affects cells. This technology allows scientists to see how cells communicate under certain conditions. They can observe the interaction between cancer cells and radiation. The University is allowing researchers and academics that are funded for cancer research to use this advanced technology. Click here for more information.

April 2023 Digital Health Roundup

This month scientists are expanding existing technology to help with the fight against cancer. Nanopore sequencing technology on tRNA has been improved to help make a cost-effective test for cancer diagnosis. A technology company is building upon the CRISPR technology to choose more precise cancer treatments for patients. A new AI can predict a patient developing lung cancer within 1-6 years and is now in clinical trials.

Proof-of-Concept Nanopore Sequencing Technology Detects Transfer RNA Biomarkers for Cancer Diagnosis, Prognosis

Measuring transfer RNA biomarkers and blood samples may offer a simple, cost effective, precise alternative to invasive cancer diagnostic and prognostic methods, according to a study published on Thursday in Nature Biotechnology, reports Lab Pulse. Cells are always modifying transfer RNA molecules to become more stable and function better. If tRNA modifies incorrectly, it makes proteins that are faulty which develop into cancer. Specific tRNA modifications exist only in very specific cancers, this serves as a cancer biomarker. The tRNA molecules can also vary based on the state of the cancer. Getting tRNA from a patient’s blood sample can help diagnose cancer as well as determine the patient’s prognosis. Nanopore sequencing can isolate tRNA in one step, making this process more cost effective and timely. This technology monitors changes to an electrical current as the tRNA passes through a protein nanopore, this signal then gives researchers the specific tRNA sequence. Click to read the full story.

Start Up Function Oncology Aims to Make CRISPR Part of Next Revolution in Cancer

CRISPR technology is used to understand gene function. It is used to edit the disease-causing mutation of a gene to make more precise therapy choices for the patient. This genetic mutation is not found in most cancer patients, so until now this technology has helped a limited number of patients. Instead of making predictions about cancer targets, the function oncology technology takes measurements, Sampath said. Do it enough times, and a personalized picture starts to form showing which genes a cancer depends on, reports MedCity News. Using CRISPR, the company technology can inhibit a gene function and then see how it affects the tumor. Based on those results the patient can be prescribed a medication that can inhibit that gene. Scientists can match the patient tumor sample to the appropriate cancer drug. Once the biopsy of a patient tumor is taken, it is sent out to process. The processing time is about two weeks. After these two weeks, the patient and physician can have more precise treatment choices. Click to read the full story .

Promising New AI Can Detect Early Signs of Lung Cancer that Doctors Can’t See

Researchers in Boston are on the verge of what they say is a major advancement in lung cancer screening: Artificial intelligence that can detect early signs of the disease years before doctors would find it on a CT scan, reports NBC News. The AI is named Sybil and was developed at MIT in Cambridge. This artificial intelligence is currently in clinical trials. It can accurately predict cancer development in one to six years for the patient. It is the only AI to predict future cancer risk and can catch what the naked eye misses. Lung cancer is the third most common cause of cancer, and the treatment is much better for the patient when the cancer is caught early. Doctors use a CT scan to detect the cancer and Sybil looks for abnormal growth as well as other patterns that scientists are still learning about. This new AI helps radiologists with more precise readings. Researchers are working on getting more data that is racially diverse to help more people. Click to read the full story.

What Are Potential Telemedicine Risks for Myeloproliferative Neoplasm Patients?

What Are Potential Telemedicine Risks for Myeloproliferative Neoplasm Patients? from Patient Empowerment Network on Vimeo.

What risks should myeloproliferative neoplasm (MPN) patients be aware of with telemedicine? Experts Dr. AnaMaria Lopez from Sidney Kimmel Cancer Center, Dr. Krisstina Gowin from University of Arizona Cancer Center, and patient Lisa Hatfield share their perspectives and advice. Watch as they discuss potential risks in MPN patient care, how to advocate for the continuation of telemedicine, and advice for patients to work toward optimal wellness.

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Transcript:

Lisa Hatfield: 

Are there any risks or drawbacks that you see to telehealth or telemedicine for digital health?

Dr. AnaMaria Lopez: 

The most important thing is to remember that the technology is a tool, and if the person feels that there’s a limitation, so, for example, if the patient is seen and they say their heart is racing or skipping beats or something, now, there are ways, there are electronic stethoscope, so you can really do a full exam except for palpation through telemedicine. But not everybody has that even in a clinic, but certainly in our own home, we don’t have that technology. So if a patient is expressing a concern for which the clinician really feels that needs a closer evaluation, then that’s the right next step, so we’re not…the technology is a tool to help us care for people, and if it’s not all available right there, then we need to see the patient in person. So I think that’s the risk is just sometimes people may feel limited like, “Oh, well, I’m not really sure It’s okay, I’m not really sure I need to see you, or you need to go here or go there for the care.”

And the other, which is a really big threat, is that part of the reason we did 70 years work in a couple months is because it was reimbursed, and we’re reaching the end of the pandemic, the federal…and with that, the payers may go backwards. We all know that if that happens, we will go backwards in telemedicine. [chuckle] There will just be decreased, decreased use. And it may lead to people then going back to traveling for four hours, waiting, only to be told, “Oh, you know what? There’s not this. This clinical trial doesn’t work for you.” So we don’t want to lose ground. And part of not losing ground is that we really need to continue to have advocacy around reimbursement.

Lisa Hatfield: 

Thank you, Dr. Lopez. And I feel compelled, just to follow up with one more question regarding that, because I’m very passionate about this. With some of these rules and guidelines coming to an end, I know in my particular state that I will no longer be able to access my specialist. I see a myeloma specialist. We do not have any here locally. I can access a specialist via telemedicine. I will not have that opportunity. So as all of us know, there are disparities and there are financial disparities in cancer patients. There are racial disparities in cancer patients, there are socioeconomic disparities. Telemedicine has been a tremendous…has had a tremendous impact on the care and the outcomes and the quality of life of so many patients. So as a patient and as an advocate, do you have any recommendations? Do I go to my doctor and say, “Okay, how can I move forward and still talk to my specialist, who’s out of state? Do I go to my state legislature? Do I talk to my insurance company? How can we get this to continue?” Because this has had such a significant impact on the quality of life and on the outcomes for patients, who otherwise, would not have been able to access that care.

Dr. AnaMaria Lopez: 

Yeah, I mean, I think all of the above. Partnering with other advocates, the American Telemedicine Association has a map that kind of says where are all the shifting sands regarding the different rules and legislative changes. But I think it’s led us to a place, where we are all advocates and where physicians, nurses, patients, pharmacists, everybody in the same way that we do team-based care, that we do team-based advocacy and it’s all for our patients.

Lisa Hatfield: 

Great. Thank you for that. Dr. Gowin, any last words that you may have about accessing specialists or telemedicine options?

Dr. Krisstina Gowin: 

Well, I think we covered the basics, but I just want to end with just how empowering the access to digital health interventions really is. And so I don’t think there is a one-size-fits-all approach to every patient. So what I would encourage patients to do is just to really think, “How do I compliment my care? What am I missing? How do I achieve my best wellness? And how do I get those resources in my home to make them more convenient for me?” And to start doing some research and self-advocacy to really get those resources because they are out there and in almost…in every domain, there is now a digital version that is accessible to you now.


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How Is Telemedicine Influencing Personalized Medicine for MPN Patients?

How Is Telemedicine Influencing Personalized Medicine for MPN Patients? from Patient Empowerment Network on Vimeo.

How can myeloproliferative neoplasm (MPN) personalized medicine be influenced by telemedicine? Expert Dr. Krisstina Gowin from University of Arizona Cancer Center explains how telemedicine helps create a more personalized and precision-based approach for optimal MPN patient wellness.

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Transcript:

Lisa Hatfield: 

Dr. Gowin, can you provide or share some examples of how telemedicine is influencing personalized medicine and MPN care, and how can MPN patients best advocate for themselves to get the latest in MPN care?

Dr. Krisstina Gowin: 

Well, I think it’s going back to some of the conversations we’ve already had, is that now with telemedicine, you can really access academic centers no matter where you are. And so rural areas now can go to academic centers, very accessible without travel, and so what that lends to is more access to precision-based clinical trials, and very often now we’re doing next-generation sequencing panels for patients with MPN. We’re looking at what are the genetic features of the disease and we may be accruing trials based on those genetic features. And so that kind of conversation really only happens at academic centers, and so I think it’s really allowing those that live far away, a few hours away, to really have those personalized and precision-based conversations. And then tying in again the aspect of integrative medicine. And then what is integrative medicine all about is personalizing your treatment plan, asking what are your goals, what is your lifestyle, what is your culture, and how do we really get you on a plan that makes sense for you, that is local for you and sustainable for you to really achieve your optimum wellness?

And so if I were counseling patients listening to this, I would say, start with the in-state academic centers and say, “What are the telemedicine services there? Is there an integrative medicine department there”? And then get a quarterback within that department and say, “Okay, this is the plan,” and then that quarterback can say, “Well, now let’s look local. What do you have? What are your resources there? Let me do some homework with you and hook you up with really evidence-based high quality providers to achieve your personalized needs in your local community.” And I think that’s how we’re really going to get all of our patients in a precision and personalized approach no matter where they live, and that’s again, the beauty of telemedicine and digital health. 


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How Will Advanced Technologies Enhance Myeloproliferative Neoplasm Care?

How Will Advanced Technologies Enhance Myeloproliferative Neoplasm Care? from Patient Empowerment Network on Vimeo.

How will myeloproliferative neoplasm (MPN) care be enhanced by advanced technologies? Experts Dr. Krisstina Gowin from University of Arizona Cancer Center and Dr. Ana Maria Lopez from Sidney Kimmel Cancer Center share information about how technology can help manage symptom burden, risk factors, and the patient experience for enhanced MPN care.

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How Is Telemedicine Influencing Personalized Medicine for MPN Patients

Transcript:

Lisa Hatfield: 

So, Dr. Gowin, do you have anything to add on, how MPN care or just cancer care, in general, could change with different technologies? We didn’t touch a lot on things like artificial intelligence and that type of thing, and we can speak to that or any other type of technology that you’re familiar with.

Dr. Krisstina Gowin: 

Well, I think the artificial intelligence aspect is really going to change the paradigm again on how we’re designing, studies. And I think one of the biggest challenges that we have in myeloma and as well as myeloproliferative neoplasms, is to think about how do we optimally sequence our therapies to achieve best survival, right? And I think this is a wonderful problem to have. We have now not only one JAK inhibitor on the market, but several and more in the pipeline and several other therapeutic targets. And so now the question is which therapy and when do we employ it? So things like artificial intelligence will help us to answer that question with machine learning decision tree analysis, all of that is going to be answered through those kind of platforms. And so I think that is going to be a shift we will see in the next five years is many different machine-based learning algorithms to better understand those problems we cannot have tackled traditionally otherwise.

Sensors though is another one, right? And so a big thing in MPNs is not only addressing the blood counts and reducing risk of thrombosis, and to address symptom burden, but it’s really addressing lifestyle because it’s things like cardiovascular disease, stroke that really we’re worried about as some of the sequelae of having the disease and what we’re trying to prevent with therapeutics. And so even going back to the NCCN guidelines, it’s addressing cardiovascular risk factors as part of our core treatment goals. And so how do we really do that? And it’s really through lifestyle medicine and that’s where the sensors come in. And so now we have, these Fitbits and smartphones that connect to our Apple watches and we have Garmins and all these wonderful devices that are prompting us to move more, prompting us to be cognizant of our heart rate and stress response prompting us to meditate. And so I can envision those evolving over time and connecting to the EMR and being very seamlessly interwoven into our clinical trials. And we’re already doing that. In fact, we’re talking about doing one very soon in MPN patients. And so I think the sensors are gonna be another big way that we’re going to be integrating, into our clinical trials and symptom management tools.

Lisa Hatfield: 

That’s fascinating. Thank you for that. And Dr. Lopez, do you have anything to add about other technologies and how they may affect cancer care in the future?

Dr. Ana Maria Lopez: 

Sure. When Dr. Gowin mentioned the sensors, it just reminded me, we’re building this new building, patient care building and oncology will be there. And I did a tour recently, and we’re used to go to the doctor, you stop in, they get your blood pressure, they get your weight, et cetera. Here, you’ll walk in directly to your exam room and you check in at a kiosk, so you just kinda check in [chuckle] with a little robot kiosk, and then it’ll tell you where you’re going. You’ll go to Room 3, let’s say, and Room 3 will say, “Welcome, Lisa.” [chuckle] And so you know that you’re in the right place. And you’ll walk in, there’s your gown, you’ll sit in the exam chair, and the exam chair automatically is gonna take your vital signs. So it just seems, really these built-in aspects to the technology. And one of the things, again, what I just love about this work is that it’s a very interdisciplinary, multidisciplinary. And one of the projects that we were working on, which it ties into this, when I was in Arizona with the telemedicine program is we worked with the College of Architecture and with this concept of smart buildings.

Dr. Ana Maria Lopez: 

So it’s kind of like that. Why should you do these different sensors that detect, but that it could also detect. You might walk into the room and you might be really nervous as you might be really cold, and it would detect that and it would warm the room for you. Or you might be coming in and be having hot flashes and it would just cool the room for you. So the technology has so much potential to really improve the patient experience.

Lisa Hatfield: 

And that’s amazing to me. I think that would be incredible to walk into a building to have that experience, as long as it doesn’t take away the compassion and care I get from my providers. I am so fortunate to have extraordinary providers, so I don’t think it will ever take over that aspect of it, I think that is a fear people have, especially with artificial intelligence and that type of thing, I think it can only go so far. Can’t provide the humanness that’s required for patient care, so yeah.

Dr. Ana Maria Lopez: 

Yeah. These are tools. 


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Will Advancing Technologies Allow MPN Clinical Trials in Patient Homes?

Will Advancing Technologies Allow MPN Clinical Trials in Patient Homes? from Patient Empowerment Network on Vimeo.

Will myeloproliferative neoplasm (MPN) clinical trials at patient homes be enabled by advancing technologies? Experts Dr. Krisstina Gowin from University of Arizona Cancer Center and Dr. Ana Maria Lopez from Sidney Kimmel Cancer Center share their perspectives on clinical trials models that work well with remote models and an update about the hospital at home concept.

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How Can Myeloproliferative Neoplasm Patients Use Integrative Health

How Can Myeloproliferative Neoplasm Patients Use Integrative Health?

What Telehealth Tools Impact Myeloproliferative Neoplasm Care

What Are Potential Telemedicine Risks for Myeloproliferative Neoplasm Patients

Transcript:

Lisa Hatfield: 

Do you think that technology has progressed enough that clinical trials might allow a patient to be at home, maybe in a more remote area and monitored remotely? Whereas in the past, that same clinical trial required them to be at the facility? Do you think that we’ve progressed to that point in some clinical trials?

Dr. Krisstina Gowin: 

You bet. Yeah. I think COVID out of necessity has forced us to do that. And I have in my own clinical trials, even with pharmacologic clinical trials conducted telemedicine visits that were approved by the sponsor. So the paradigm is shifting, and particularly when it is oral therapeutics, I think that’s really accessible when they’re IV subcutaneous, I think that has different challenges. Obviously you can’t do that as remote, but when their oral therapeutics are non-pharmacologic intervention, such as our integrative interventions, I think it really lands well to a more remote experience.

Lisa Hatfield: 

Okay. And then would that require communication between the local oncologist and maybe someone like yourself, the investigator on that clinical trial to know what is going on with that particular patient? I assume that that communication would be ongoing?

Dr. Krisstina Gowin: 

Absolutely. Always.

Lisa Hatfield: 

Okay. Yeah. All right, great. Well, thank you for that information. So, Dr. Lopez, kind of a similar question for you. What are some examples of how technology is influencing cancer care right now?

Dr. Ana Maria Lopez: 

Yeah, let me just add on the clinical trial question.

Lisa Hatfield: 

Oh, Yes.

Dr. Ana Maria Lopez: 

That there’s also the opportunity. Again, there were so many things that we thought, “Oh no, we just can’t be done.” But because of the necessity, necessity is the mother of invention, we do remote consent, so that was a big deal in the past. We can also do a televisit ahead of the appointment, and screen for the cancer clinical trials, people travel large distances for studies and instead of traveling four or five hours, and then to be told, “Oh, actually you don’t meet the criteria.” To be able to do all of that at a distance, to get the records, to get the images, to review all that needs to be reviewed. And then to say yes, and not only yes, but we can also do your consent at a distance in some situations.

And then when you come, there’s actually the more substantive, perhaps even the treatment. There’s also a large movement around hospital at home and that these patients that are eligible for that would be able…with digital support, be able to get hospital level care in some cases at home. So some of that may involve infusion, some of that…again, but that visual connectivity and in the past you really had to kind of conceptualize it, and it was kind of space aging to talk about it. But we now, we’ve all done FaceTime, so I think we all really can understand what it entails, so tremendous shifts and, we want to try to keep that momentum going for our patients. So, I do think that, there’s so many ways that technology has impacted cancer care, even when we talk about the electronic record and patients accessing the electronic record and patients having the opportunity to go into a portal and to see their labs, to see their reports…

To be able to track their changes. All of that is really, really powerful. You know, patients with…the most common I think is patients with diabetes who track their blood sugar sometimes to the minute and they can say, “Oh, I ate that and now I see the impact.” So the opportunity for monitoring, the opportunity for also bringing in experts. So let’s say there’s a patient with a rare disease and the expert is elsewhere, there might be the opportunity to bring people together. We do tumor boards. That’s just part of what we do in cancer care. And also as many…there are health systems now so that it’s not one hospital, it’s multiple hospitals together where we can bring all of those folks together, bring in local expertise, regional expertise, national expertise, all for the patient’s benefit.

So there are so many ways that technology even something as simple as the note. Now this is something we experimented with and it’s still in experimentation phase, but there were these Google classes where you could interact with the patient and as I’m talking, the Google glass would record kind of the conversation and would come up with some sort of a structure for the note. So for what that encounter had been like. So there are lots of ways of how do you capture natural language in real time to really help the workflow, the documentation process. So I think there’s aspects to help the patient, to help the families, to help the clinical teams and to help everybody work together. 

Lisa Hatfield: 

Great. Thank you. And you talked about the patient portal, and I’m one of those patients at fault of seeing a lab result before my doctor saw it and calling him or sending a message via MyChart saying, “Hey, this is going up. What’s wrong with this?” So I’m sure you don’t have to mention any names. I’m sure you’ve seen the challenges of, digital health too, are having that patient portable or portal accessible to patients. So anyway, just wanted to throw that out there that I’m sure that brings challenges to you. Also few little challenges here and there.

But at the same time, that’s so good, right? It’s so good that patients are engaged. It’s so good that you’re engaged. And I think as long as we’re communicating that yes, you may see this before me, so you may have questions and then, we just get together and answer the questions. 


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Is Technology Accelerating Progress in Myeloproliferative Neoplasm Care?

Is Technology Accelerating Progress in Myeloproliferative Neoplasm Care? from Patient Empowerment Network on Vimeo.

Is myeloproliferative neoplasm (MPN) care being advanced by technology progress? Expert Dr. Krisstina Gowin from University of Arizona Cancer Center discusses how MPN care has benefited from technology advances and explains two MPN technology tools and how they assist in MPN patient care.

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Transcript:

Lisa Hatfield: 

So, Dr. Gowin, a couple of questions for you. Is technology playing a role in accelerating progress in MPN care?

Dr. Krisstina Gowin: 

Oh, absolutely. And I think some of the ways that it really accelerates progress is pulling us together. So what we need to recognize is that myeloproliferative neoplasms truly is a rare disease, and we just celebrated Rare Disease Day. But there’s a lot of challenge in treating patients and progressing the field forward in rare diseases because you can’t do the big clinical trials. It’s hard to come together because everything’s siloed, and there’s just a couple patients here, a couple patients there in each practice. But with digital health and clinical trials that are offered on a digital platform, it pulls the nation together and even the world together. And we’ve seen that. I’ve done an international survey-based analysis and I had 858 MPN patients from 52 countries participate in that survey. And so that just shows how it pulls the world together. And for the web app that we just discussed, we had 93 patients say they were interested within three weeks, and within actually a week, we identified them all and then took three weeks to actually accrue them to the trial. So it really speaks to A, how MPN patients are digitally engaged and excited about these kinds of platforms. And then B, how effective it really can be to pull the groups together.

So yes, I think it’s…and that’s really how we’re going to get progress is through these kind of interventions with a rare disease. And I hope it’s okay if we jump back to something you said, Dr. Lopez, which is, I think telemedicine is so so important to bring everyone together. And in particular, I see that on the transplant ward. And so in myelofibrosis, that’s the only curative therapy. And so many myelofibrosis patients actually go through allogeneic stem cell transplantation. And my goodness, that is a socially isolating experience. Patients are in the hospital, not uncommonly for at least 30 days and then have to be near their transplant center for three months, which often is away from home. So to pull in their support system, both through the acuity of the transplant themselves and then the couple of months after is so crucial to a successful transplantation. And I think through FaceTime and also the MPN support groups, which is very robust, the patient advocacy and the way the MPN network sticks together on a digital platform, I think is really unique and offers unique support.

Lisa Hatfield: 

Thank you. And then what role does technology play in the disease symptom management, and in particular, in clinical trials too. What role does technology play with clinical trials?

Dr. Krisstina Gowin: 

Well, I think it helps us through different, clinical trial accrual patterns, we can see who’s eligible where, so it helps us identify patients. It helps us to, understand the different kind of precision-based medicine approaches so we can start to pool the data, say for, particular mutations… ASXL1 mutations. And so it helps us in the precision medicine aspect of clinical trials and now we’re looking at symptom management and how do we really integrate that. So large survivorship platforms like Carevive, if you’ve ever heard of Carevive, is now integrating our validated symptom assessment form into the Carevive platform. So now we can really collect that data and use that to mine it for potential kind of retrospective analysis. So it’s helpful for clinical trials as well as for our clinicians and clinics to really identify changes in symptom burden.

And just as Dr. Lopez was mentioning, that we can track these over time and it can flag and say, “Oh, your symptoms are changing, they’re increasing over time,” and maybe we need to be thinking about that. And so Carevive is really kind of an electronic medical record driven it’s really a healthcare driven platform, but now there’s patient ones too. And I just learned about this two weeks ago, I was at an MPN conference in Phoenix and learned about MPN Genie. And so MPN Genie apparently, is tracking…patients are putting their symptoms in and that’s shooting that information to the electronic medical record to their doctors. And so I think that’s fantastic, ’cause, we now get that information real time and we can change our clinical management, maybe bring that patient in sooner, maybe do a bone marrow earlier. We never would’ve identified that if it weren’t for those kind of digital engagements, so I think it’s a really exciting time. And I think we’re going to see more and more of these new platforms and ways for, different EMRs and smartphones to be communicating back and forth between patients and providers. 


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How Can MPN Patients and Care Partners Stay Aware of Telemedicine Options?

How Can MPN Patients and Care Partners Stay Aware of Telemedicine Options? from Patient Empowerment Network on Vimeo.

Telemedicine is often an option for myeloproliferative neoplasm (MPN) care, but how can patients and care partners stay aware of options? Expert Dr. AnaMaria Lopez from Sidney Kimmel Cancer Center shares her experience introducing healthcare providers to caring for patients via telemedicine and some of the benefits telemedicine provides versus an in-person visit.

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Transcript:

Lisa Hatfield: 

And some patients might be a little more reluctant to use telehealth or telemedicine. How can patients and their care partners feel more confident in voicing their concerns or communicating with their healthcare teams regarding any telemedicine options that are out there?

Dr. AnaMaria Lopez: 

So you mentioned that I had been the founding medical director of the Arizona Telemedicine Program, and it was such a wonderful experience because skepticism, and I really respected that. It was brand new, and we had our system in the library. And the library, it was down in the basement, so it was very metaphorical. I would meet the new clinician at the entrance of the library. We would walk down the stairs together and often, the conversation was, “Okay, I’m doing this for you. I’m doing it one time. We’ll see how it goes.” And I was always so reassuring that if for some reason, because ultimately the clinician needs to feel comfortable, “Yes, this works, or no, it doesn’t. And if you have any doubt and you feel that you need to see the patient in person, you just need to say that,” ‘I need to see the patient in person.’” And inevitably as we’re walking up the stairs, “Oh, I know you called me because I was on call. Just call me anytime. Don’t call the on-call person. This was great. I loved it.”

So inevitably, people really like it, and it’s good. You see the patient in their own environment, you can interact. You often get insights that you may not have gotten otherwise just because of where you are and how comfortable they feel in their own space. So I think, for me it’s the proof is in the pudding. Give people the opportunity, have the right supports and technology in place, and often it’s a very positive experience. 


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What Telehealth Tools Impact Myeloproliferative Neoplasm Care?

What Telehealth Tools Impact Myeloproliferative Neoplasm Care? from Patient Empowerment Network on Vimeo.

How are myeloproliferative neoplasm (MPN) patients impacted by telehealth tools? Experts Dr. AnaMaria Lopez from Sidney Kimmel Cancer Center and patient Lisa Hatfield discuss specific situations and telehealth tools that benefit patients for improved MPN care. 

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Transcript:

Lisa Hatfield: 

Dr. Lopez, can you also speak more broadly to innovative telehealth tools that are making an impact on symptom management and overall cancer care?

Dr. AnaMaria Lopez: 

Sure. So one of the things that we know, is that, for example, people have appointments every three weeks, or they have appointments once a month with the oncologist, and a lot can happen in that time. So setting up systems that are assisted by technology, so that patients can report their symptoms in real time can be very helpful. And some of this may require…it may not be a common way where the person may be familiar going to a computer or going to their phone to kind of say, “This is how I’m feeling.” So that may require some engagement education, but often regardless of age, regardless of background, people find that really easy and find that so helpful to be able to say, “Oh, was it two weeks ago that I had that?” As opposed to just saying, “Hey, I just had this,” and then it can happen anytime day or night that the patient can report. And that way there’s…it’s just so helpful to have an intervention in real time.

The other part that’s good is that often some of these systems can kind of track. So we can look at it together and say, “You know what? Your fatigue tends to be a couple of weeks after therapy, so how can we either prepare for that?” Or just to have the reassurance that, “Yes you have that depth, but it gets better and you get through it.” So being able to look retrospectively and identify that can be helpful and I think also just the ease for people to be able to connect with multiple specialists, sometimes to have multidisciplinary visits where not only does the patient meet with everyone, but the patient can see that we are all meeting and interacting together. So all of those are incredible tools, one of my favorites though, one of my favorites is patients who are in the hospital and patients who are in the hospital a long time, on some occasions. So and even if a person’s not there a long time, it can feel like a long time, so to use the technology, not just to connect the patient, the healthcare team, but to use the technology to connect the patient with his or her family. And I think especially…I mean, a lot of people have smartphones, but it’s using your minutes, sometimes the Internet may not be so strong. So to use the technology that would be used for the clinical piece to have that available in the inpatient setting so that patients can feel connected.  

Lisa Hatfield: 

Yeah, that’s a really great thought that you brought up, too. I know when the pandemic was in full swing, but patients were starting to go back into the office to see their provider. For me, I was not allowed to take my husband in with me, so I went in alone. I was far enough along in my journey. I didn’t necessarily need a care partner with me, but some patients do, maybe a newly diagnosed patient. So that is a really great point. Say, a patient has to come in by himself or herself, is that a technology they can use? Are you willing to let them use their phone to maybe FaceTime during that call or we had to use the actual physical landline because my phone did not connect, the signal wasn’t strong enough. But do you allow that during your appointments to have patients contact somebody?

Dr. AnaMaria Lopez: 

Absolutely.

Lisa Hatfield: 

Okay. That’s great. Yeah.

Dr. AnaMaria Lopez: 

And also there’s pandemic, but there’s also…people live everywhere. So you could say their son could be in California and I’m in Philadelphia and this way it’s okay, we’ll just beam them in. 


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How Can Myeloproliferative Neoplasm Patients Use Integrative Health?

How Can Myeloproliferative Neoplasm Patients Use Integrative Health? from Patient Empowerment Network on Vimeo.

How can myeloproliferative neoplasm (MPN) patients benefit from integrative health? Experts Dr. Krisstina Gowin, Dr. AnaMaria Lopez, and patient Lisa Hatfield discuss common symptoms of MPN patients, integrative health techniques, and benefits of including integrative medicine.

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What Telehealth Tools Impact Myeloproliferative Neoplasm Care

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Transcript:

Lisa Hatfield: 

So I have multiple myeloma, and, of course, that comes with side effects from the different therapies and symptoms of their own. We have a great integrative health center at our cancer center here locally where I live, and I’ve used it for acupuncture for some of my symptom management. I’ve also watched you on different platforms, through webinars and patient support groups where you describe different integrative health techniques and that type of thing. So I’m wondering…two questions. The first part is, what symptoms do MPN patients face the most? And then how can they use integrative health to do that, particularly as it relates to telemedicine? Are there telemedicine options for integrative health? I suppose things like acupuncture, maybe not, but other types of, of integrative health, and can they get a consult for integrative health? Can they even go as far as getting a consult? So if you can answer those questions, the symptoms they face, how to use integrative health, and if they can get a consult for integrative health, that would be great. We’d appreciate that.

Dr. Krisstina Gowin: 

Yeah. Well, Lisa, I want to take a moment just to validate your journey that you’re going through and to congratulate you for your self-advocacy to go look for those integrative therapies to support yourself. And for MPN patients, I will say that it’s a really unique group, and so all cancer patients experience symptoms. But in myeloproliferative neoplasms, it’s really kind of this heterogeneous what we call a symptom burden. And so most patients will experience fatigue about 80 percent of MPN patients. But then beyond that, there’s really a whole slew of different sequelae that can be associated with the disease, which you may or may not think about when you’re thinking about MPNs, such as psychosocial issues, sleep issues, sexual issues.

And then we have kind of the classical issues that happen with MPNs, such as dizziness, but we talked about the fatigue, bone pain, itching, abdominal discomfort from an enlarged spleen and early satiety, or feeling full quickly. It’s really a huge symptom complex, if you will. And we now have validated measurement tools to better understand those. It’s the MPN symptom assessment form, which has really, I think, revolutionized how we look at MPN. It’s no longer just treating the blood counts. We’re treating the patient as a whole, and even within our NCCN guidelines, kind of how we as oncologists go through the algorithms of how to change therapy and how we look at patients. We now have symptoms in there. So even if blood counts are controlled, we may change therapies or even do a bone marrow based on symptoms alone. So symptoms are a huge thing in MPN. So getting to your second question for integrative health.

So I think that MPN…the patients in the community are really early adopters for digital engagement, which is fantastic. Everyone’s very engaged, and I’ve had the opportunity to work on meditation apps, yoga apps, a wellness-based app here from the University of Arizona, and patients just really accrue fast. Everyone’s so excited. And most of these, though, were very small kind of pilot trials, looking at feasibility, can’t we really do these things? But most of them as well are showing some impacts on depression, anxiety, sleep, and total symptom burden. So I do think that these modalities through digital platforms certainly can make a difference on the symptoms. And we’ve seen that with meditation. We’ve seen it with yoga, and we’ve seen it with a seven domain wellness app. And is it the digital engagement? I don’t think so.

I think it’s likely the integrative therapies that they’re receiving through that platform, right? We know meditation works, we know yoga works, perhaps not so well in MPNs. We need to build that evidence base, but other solid cancers, we know those interventions really work. But it’s wonderful to get that kind of early data, say it not only works, but it also works when you’re doing it at home, when you’re doing it on a digital platform. And so I would encourage all patients listening to this to, yes, look at what’s around you, what are the resources, what are the clinical trials? Looking at these different digital modalities for integrative medicine, but also to go get an integrative consultation.

And as Dr. Lopez already had mentioned, she does all of her integrative medicine via telemedicine now, which is fantastic. And so you, it’s really, it’s that, you know, your fingertips. You now have access to wonderful oncologists like Dr. Lopez to guide you in this journey. And the journey is not only allopathic Western medicine, but it’s treating you as a person, you as a whole symptom complex. And that’s really what integrative medicine aims to support you through. 

Lisa Hatfield: 

And you mentioned that Dr. Lopez also does her integrative health via telemedicine. So I’m going to ask, Dr. Lopez, can you speak to that a little bit more? How do you do that with patients? Do they just contact you and set up an appointment for an integrative health consult or appointment? And do you conduct some of that yourself, or do you send them to particular resources in the community?

Dr. AnaMaria Lopez: 

Sure. So, yes, patients can make an integrative oncology appointment directly. I really like to do the consults through tele simply because I can…as I was mentioning, it’s like a virtual house call to really get a sense of the patient. Often a partner, significant other, caregiver might be present as well, and as we know there’s the survivor and there’s the co-survivor. So including both can be very helpful to some people, and I think the initial intake…again, as Dr. Gowin was saying, it depends so much on what the person wants to do. So the first opportunity for coming together is simply, “Where are you? What are your goals? What’s important to you? And of the panoply of options, which might be the easiest or the one that you are most interested in?”

And so depending on what it is, we might work together, we might also bring in others if the person is really interested in making lifestyle changes, let’s say related to nutrition. The person might work closely with a nutritionist for some period of time and then come back, and we’d come together and reassess. You mentioned the acupuncture, and you can’t do acupuncture at a distance, but you can certainly teach people about the points and consider acupressure for certain points. So there are so many ways to engage and interact, but yes, I think like a lot of medicine, it’s a team-based approach.


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