Category: Tests, Treatments, & Surgery

Having trouble finding reliable health information? Our medical professionals can do it for you.

By Nathan Blake | 11/14/18
Project Manager, HealthWeb Navigator

Readers sometimes ask what a typical day looks like here at HealthWeb Navigator.

Mostly we spend a lot of time browsing the web. Whether it’s groundbreaking medical research, user reviews of a diabetes smartphone app, or a new website that helps you understand your health insurance plan, we try to stay on top of everything health-related the internet has to offer.

Our tireless web browsing has helped us become one of the internet’s leading resources for finding and evaluating reliable healthcare websites. We are, to date, the only place that publishes in-depth reviews of health websites written by actual health experts. Yet we’re still on the lookout for innovative and helpful ways to meet your healthcare research needs.

That’s why we’re excited to announce a new service that gathers the web’s best health information specific to your needs or interests. Yep — we’ll check every nook and cranny to give you personalized resources from the internet’s most trusted sources. No more wondering if what you’re reading is credible. We pre-screen every resource for reliability and only send you the cream of the crop.

Start by shooting us an email at info@healthwebnav.org. Fill us in on the details — what topic you want to learn about, your preferred language and medium, the level of detail you’re comfortable with, etc. — and we’ll respond with relevant, trustworthy resources that specifically meet your preferences.

Maybe you want a Spanish-language video that introduces type 1 diabetes. Or perhaps you’re looking for clinical trials for new a Parkinson’s disease drug treatment. You might even like to know the side effects of your wife’s chemotherapy, or if there’s a support group for teens with cystic fibrosis, or where to download a podcast for caregivers. Whatever the case, we’ll see what’s out there.

We can’t guarantee that we’ll find something you haven’t seen already. And nothing we send you can substitute for medical advice. But no matter what, you’ll walk away with credible and up-to-date information that has been verified by at least one medical professional.

So what are you waiting for? Send us an email and get started today!

Free Health Research Worksheet for Patients

By Nathan Blake | 7/27/18
Project Manager, HealthWeb Navigator

Our team of medical reviewers talk with countless patients about health information on the internet. But many more patients don’t mention what they read online. Either they’re afraid the doctor will ignore them, or will think they’re being “difficult” for talking about what they learned, or they just don’t have time to bring it up.

Doctors and patients need to talk openly about what patients are reading. Browsing the web before and after a doctor’s appointment is something most of us do, as it lets us participate in healthcare decisions. But a doctor’s medical training can help us avoid dangerous or irrelevant advice. And if doctors refuse to listen to what patients have read, or if patients are afraid to speak up, then everyone misses out on valuable insights.

That’s why we’re providing this free resource to help you collect your thoughts before meeting with a healthcare professional. As you research health topics on the internet, use this worksheet to write down what you want to talk about with your doctor.

Make sure you’re clear from the start of your next appointment what you want to discuss and why it’s important to you. Then, let your doctor respond, and write down their thoughts too. Together, you can come to a decision about what to do next.

And don’t forget to browse our collection of reviews to find the most reliable health websites available today!

Download file: Health Research Worksheet

HealthWeb-Navigator-Health-Research-Worksheet

 

Radiology Imaging Tests: The Basics

By Carla Dellaporta |12/8/17
Director of Education, NeedyMeds

You’re out walking your dog, enjoying the fresh air and holiday decorations, when suddenly — bam! Down you go on a patch of black ice. Standing, you realize you can’t put weight on your ankle.

The doctor says she’s not quite sure how bad the damage is. To get a better idea, she wants to schedule what she calls a “radiology imaging test.”

Say what now? Isn’t radiology like, nuclear?

Medical jargon gets thrown around left and right these days. Thankfully this one’s pretty simple. “Radiology” is the branch of medicine that relies on technology to diagnose or treat diseases. And “imaging” means the technology involved to take pictures inside your body.

So your doctor is saying she needs to get a better picture—literally—of what’s going on inside you.

There are many radiology tests out there. They differ in terms of the technologies used to produce images of your body. Some common radiology tests requested by doctors include:

X-ray: Uses a small dose of radiation.

CT scan: Combines multiple X-ray images.

Ultrasound: Uses high frequency sound waves.

MRI: Uses magnetic fields and radio waves.

From 2000-2010, imaging services and costs grew at twice the rate of other healthcare technologies. One reason why may be what’s called “defensive medicine.” This term refers to doctors prescribing or recommending unnecessary tests to protect themselves from potential malpractice lawsuits.

A recent study estimated that unnecessary medical tests cost the U.S. nearly $7 billion dollars annually. Overly cautious medicine is a common practice that, unfortunately, comes at the patient’s expense. Don’t rush to get a test without having a clear idea of what your options are and whether or not you can afford treatment.

Below, we’ll cover some questions to ask before scheduling your radiology imaging test. That way you’ll know you’re getting the best bang for your buck.

Questions to Ask Your Doctor Before Scheduling the Test

Do I need this test? You’ll want to understand why you need a scan and how the results will change your course of treatment. If the doctor can’t justify how the results of the test would change the treatment course, then you probably can do without it. No use in wasting time or money on unnecessary tests.

Are there safer alternatives? A CT scan exposes you to much more radiation than a standard X-ray. An MRI, on the other hand, doesn’t use radiation at all. Because radiation can potentially cause DNA damage, you want to limit your long-term exposure. Ask whether there are any lower-radiation but still effective options.

How much will this test cost? Imaging fees vary widely between hospitals, private facilities, geographic location, etc. Always ask for the bottom line cost before scheduling a test. Keep in mind, there’s something called a “global fee” you’ll want to be aware of. This fee charges for the test itself as well as the professional interpretation of the results. Being aware of the global fee ensures you won’t be blindsided when the bill arrives.

How long before I get the results? Radiology test results are generally read on-site by a trained radiologist. However, it’s the doctor who usually delivers those results to the patient, and a variety of factors will influence when you’ll receive them. Ease your mind by asking up front how long this process will take. Consider calling if you haven’t received your test results after five days.

Some Final Cost-Saving Tips

Confirm which location(s) your health insurer considers in-network and how much they cover. Few people know that most of the time, imaging tests cost more when performed at a hospital rather than private facility. Contact your health insurance company directly to find out which facilities they consider in-network. By staying in-network, you won’t have to pay the for the full price of care. There’s a reason you have health insurance—let your insurer help cover the costs!

Ask for a cash discount or sliding scale payment plan. Paying out-of-pocket doesn’t mean you’re doomed to pay up-front and in-full. Most healthcare centers will work with your financial situation, but first you have to ask. A payment plan is a much more reasonable choice compared to putting the total fee on a credit card. You wind up paying a lot more money in interest if you can’t pay off your credit card bill immediately.

Check the credentials of the imaging facility. You know you can trust a facility if it’s been accredited by the American College of Radiology. That means the center has undergone a rigorous evaluation process led by experts in the imaging field. Generally, accreditation can tell you if the center’s radiologists are experienced, and whether or not the center’s equipment and staff meet/exceed nationally accepted standards. Obviously you want the best care for your money.

To learn more about the field of radiology imaging, our reviewers recommend RadiologyInfo.org as a great introductory resource. This website explains the various forms of medical imaging including their indications, complications, and relevant tips for patients undergoing tests. Read our full review for more information.

How to Effectively Manage Appointments with Your Doctor

By Mark A. Kelley, MD |7/12/17

Everyone in health care is busy these days. Most doctors have full schedules and patients often can’t afford to take time off from work.

Neither patients nor doctors are satisfied with this situation. However, once you and your doctor get together, there are ways you can make the visit more valuable.

Doctor appointments fall into two different categories:

• Urgent visits: For true emergencies, you should seek immediate medical attention. For a problem that is not an emergency but worries you,  the best approach is to contact your doctor’s office. Your doctor may be able to solve the problem by phone or work you quickly into the office schedule.

• Routine planned visits: These visits are usually for a new consultation or a follow-up for a known condition. You can get more from these scheduled visits if you do some preparation.

The New Consultation

You can take a few steps to ensure a new consultation goes as smoothly as possible.

Educate yourself beforehand: Understand the reason for the consultation from your referring doctor. Have you read up on your particular problem? Have you checked the credentials and experience of the new doctor? Is this new doctor affiliated with a hospital that you like? Does the doctor accept your insurance?

Bring your medical records, drug list, and results of any lab/radiology studies: This step can make a major difference in your first visit. Medical records provide a clear picture of your health history. The doctor can read faster than you can talk, and this written information frees up time for the doctor to have a better conversation with you. The information may also reduce the need for more tests, allowing the doctor to focus on a diagnosis and treatment plan.

Prepare a list of questions in advance: Make a list that you can share with the doctor. This conversation will help you to understand the medical issues involved, as well as help the doctor understand your concerns.

Ask a close relative or friend to accompany you on the visit: This has several advantages. Your relative may remember something about your medical history that you forgot to mention. They may also be helpful in remembering specific details that the doctor mentions. Additionally, it is always comforting to have a close companion with you to provide support.

Ask the doctor to summarize their findings and recommendations for you: Then, in your own words, repeat the summary back to the doctor. This will help you remember details and ensure that you and your doctor are on the same page regarding your problem and action plan. Don’t be shy about asking questions. Doctors want their patients to be well informed.

Understand the plan and goals before the next visit: These may include any new medications, tests, procedures, or therapies. For each one, consider asking the following questions: How does this test or therapy work? Why do I need it? How long will I need it? What are its benefits? What are its risks? For a new medication, what side effects should I look for? Will it interfere with my current medication? If I have a problem, who should I contact?

Ask for a printout: Request hardcopies of any diagnosis, medications (especially new ones), or tests before you leave the office. You can also ask the doctor to send you a written summary of the visit for your records. By law, you are entitled to this information, and physicians are usually glad to provide it.

Learn more about your condition: Although you may have read about the subject beforehand, your doctor may direct you to other helpful resources. The information may come in the form of written materials or online resources. HealthWeb Navigator can direct you to the most trustworthy, independently reviewed health websites online today.

The Follow-Up

Follow-up visits are scheduled so that the doctor and patient can monitor progress together. You should expect to discuss the following issues with your doctor:

• Are you feeling better or worse?

• Are there any problems to report? If so, let the doctor know early in the visit. They can evaluate whether this issue is serious and/or related to other conditions.

• Are you taking your medicines as prescribed?

• Have you had any new tests or other doctor visits recently? The doctor may not have the results but should be able to get them quickly.

• Do you have any questions about your condition?

• Do you understand the treatment plan? Before you leave the appointment, be sure you receive written summaries and instructions.

Based on my decades of practice, this preparation makes the office visit more productive for doctor and patient alike.

Final Tip

Sometimes routine follow-up visits become “too routine.” Physicians know that patients spend a lot of time and money on medications and doctor visits. If you are doing well and everything has been under control, you may want to pose the following questions to your doctor:

• Can I cut back on any of my medicines (or even stop them)?

• Can I reduce the number of routine follow-up visits?

• Can some of these follow-ups be done by phone or email?

Physicians are modernizing their practices to suit your needs. I suspect that most are more than willing to discuss these requests.

Prostate Cancer — Does Everyone Need Treatment?

By Mark A. Kelley, MD |09/20/16

Last week, the New England Journal of Medicine published an important study about prostate cancer. The research showed that men with early stage prostate cancer can safely choose “monitoring” instead of treatment.

This might seem like a strange recommendation for such a serious disease. However, prostate cancer is an unusual malignancy. It is more common as men age but it rarely causes death.

Prostate cancer can be detected very early with the simple blood test, the prostate-specific antigen (PSA). The treatment is either surgically removing the prostate gland or treating the prostate area with external radiation. Both treatments are effective but can cause impotence and incontinence.

This is an unusual paradox in cancer treatment. A very simple blood test can detect prostate cancer in its early stages but the cancer grows slowly and is rarely fatal. Furthermore, the treatments have important side effects. Should a patient undergo treatment for a cancer that is rarely causes death?

The new study helps to answer that question. The major goal was to determine if prostate-cancer survival is better with early treatment versus to a “watch and wait” strategy. The study recruited over 1600 men between 50-70 years old with localized, early stage prostate cancer. These volunteers were randomly assigned equally to one of three groups: immediate surgery; immediate radiation; or “active monitoring” of their cancer by a medical specialist. During that monitoring, patients whose cancer became more aggressive were offered treatment. All patients, on average, were followed for ten years.

The major results of this study are:

1.  For all patients with localized prostate cancer, the 10-year survival from the disease was 99%.

2. There was no survival advantage from early treatment or the type of treatment (surgery vs. radiation).

3. Progression of prostate cancer occurred in 20% of the “active monitoring group” and in less than 10% in the treatment groups. This difference did not have any affect on survival over the ten years of the study.

4. About 60% of the “active monitoring group” eventually had surgery or radiation during the follow-up period. However, the remaining 40% had no progression of their disease.

What did we learn from this study?

The study confirms that localized prostate cancer does not behave aggressively. Over ten years, survival is excellent. Nearly half of the patents assigned to follow-up had no progression of their disease. They were spared unnecessary procedures. This lends support to follow-up as an option for patients.

What still remains in question?

More of the “active monitoring” patients had progression of their cancer compared to early treatment patients. (20 % vs. 10 %). This difference did not affect mortality in this study. However, the significance of this finding is unknown and warrants further research.

What will physicians recommend now?

Before this study was published, most experts have been offering follow-up as an option for men with localized prostate cancer. This new study gives convincing evidence that follow-up, instead of immediate treatment, can be a safe choice for newly diagnosed prostate cancer patients. In 40% of such patients, the tumor remains stable over a decade and requires no treatment. If the tumor grows during that period, and treatment is needed, the survival rate is still 99%.

A warning: in this study, specialists carefully followed men with “active monitoring”. Men who do not have this follow-up may have less favorable results.

This study may be especially helpful for patients who are hesitant about treatment. Those concerns are often about the complications of treatment or the risks of co-existing medical conditions. For such men, this study confirms that monitoring is a reasonable choice. This information will make it easier for doctor and patient to plan the next steps.

This is a great example of how medical research can help patients make informed choices.

To read more about prostate cancer, see the American Cancer Society website.

 

The Sun — America’s Leading Cause of Cancer

By Mark A. Kelley, MD |08/23/16

Skin cancer is the most common cancer in the United States. Here are some facts:

•Over 3 million Americans are treated for skin cancer every year.

One in five Americans will develop skin cancer during their lifetime.

•Skin cancer is preventable and easy to detect.

•When caught early, this cancer is usually curable.

Skin cancer is caused by sunlight damage to the skin. The only way to prevent it is to stay out of the sun, or block the sun’s rays.

People with fair skin are more vulnerable to skin cancer. Those with dark complexions have some natural protection since their skin filters out some of the sun’s rays. Nonetheless, people of color can still get skin cancer.

The sun’s ultraviolet rays can damage the DNA of skin cells. These cells may grow abnormally and eventually become cancerous. This transformation may evolve slowly over many years or may occur earlier in life, particularly if sunlight exposure has been intense.

Sunlight can also lead to another problem–premature wrinkling of the skin.  Sun worshipers believe that a tan is healthy. In reality, a suntan is a sign of the skin injury. If it continues, the damage can destroy the foundations of the skin, and make it look like leather. Tanning also triples the likelihood of developing the most dangerous form of skin cancer, melanoma.

A melanoma starts as a pigmented skin lesion. Early detection and removal can cure this malignancy. However, if untreated, melanoma can spread to other parts of the body and cause death.

The other types of skin cancer are less aggressive and spread slowly to the surrounding tissue. The most common are basal cell and squamous cell carcinoma. These cancers are rarely fatal and in early stages, are easy to remove.  If ignored, they can invade deeply and widely, making surgical removal challenging.

To prevent skin cancer, protect your skin from sunlight:

1. Limit your exposure to the sun. The sun’s rays are most intense between 10 am and 4 pm.

2. If you must go out in the sun, block the sun’s rays with “cover-up” garments and/or with sunblock.

3. Use sunblock that has sun protection factor ratings (SPF) of 15 or more.   An SPF of 15 means that it would take you 15 times longer to get sunburn with the sunblock, compared to none at all.

4. Follow the directions for applying and reapplying the sunblock product. Sunblock can lose its effectiveness after a few hours. It can also be removed by perspiration or swimming.

5. Avoid indoor tanning salons. Research has shown that those using tanning beds have an alarming increase in skin cancer including the most deadly form, melanoma. Click here for more information.

Screening for Skin Cancer

The benefits of routine skin cancer screening are controversial. However, most experts agree that anyone with a suspicious skin lesion or with a history of skin cancer should seek medical advice. Click here for details.

More information on skin cancer can be found at the National Institutes of Health and the Skin Cancer Foundation.

What is Precision Medicine?

By Mark A. Kelley, MD |08/01/16

In his State of Union address this year, President Obama announced a federally funded program called ”Precision Medicine”. This $215M project is designed to improve disease treatment and prevention by studying the variability in genes, the environment, and lifestyle for each person. A “cohort” of one million volunteers from different parts of the nation will followed over a number of years.

This project resembles the famous Framingham Heart Study, which began almost 70 years ago. That study has provided major insights into the causes of heart disease by following patients over many decades.

In this era, we have many more tools to improve our understanding of how diseases evolve over time. We can track massive amounts of information about patients and analyze their genes. We also have new electronic communication and monitoring tools. The hope is that we can find better ways of prevention, detection and cure of diseases. Already, medical research is facing some important challenges. Here are several examples.

Inherited disease is more complicated that we thought. Medical science has achieved major breakthroughs in understanding how the human genome behaves. Genes control most of the processes in our bodies and slight changes in those genes can cause problems. Some inherited genes have been known for decades – such as sickle cell disease and cystic fibrosis. However, the system is much more complex than ever imaged. Only recently have we begun to understand how inherited genes cause disease.

Genes can control our response to prescribed drugs. Some drugs, such as those for conditions like hypertension and blood clots do not work the same for everyone. Many patients may need higher (or lower doses) and for some, the drug does not work at all. Research suggests that these variances may be due to different genes that control the way the drug interacts with our bodies. How do we know which drugs are best for each person? Should we test everyone for genes that control response to prescribed drugs?

Genes can become abnormal and trigger disease. Curing cancer is at the core of the Precision Medicine project. All cancer is from the uncontrolled growth of cells. In many cancers, genes that control cell growth no longer work normally and the result is a tumor. We do not understand how or why this happens. In some cases, genetic analysis of the patient’s tumor reveals which genes are defective and therapy can be developed to block the effects of these abnormal genes. The influence of genes on human disease is the hottest area of medical research. Precision Medicine will help us understand much more about these processes.

How are diseases related to the environment, including social factors? We know much about toxins and other environmental risks but we need to learn more. The influence of social factors on health is not well understood. Poverty, education, and life style can affect health but the details are lacking. For example, is poverty a risk factor for hypertension when you exclude all other factors except poverty itself?

Fortunately, we have the tools to improve our understanding of these issues. Studying the human gene has become very sophisticated and less expensive. With this technology, we may learn how and when genetic testing is useful in a large population. Supercomputers can analyze enormous volumes of information about patients over many years. This may reveal important clues on disease patterns and risks for individual patients.

We in the United States are a very diverse population and each of us is uniquely different. With Precision Medicine, we may better understand how to provide the best care for every individual.

For more information about Precision Medicine, go to the National Institutes of Health website or the White House webpage.

If you are interested in enrolling in the project, contact the NIH Precision Medicine participation website.

Preventing vs. Detecting Disease — What is the Difference?

By Mark A. Kelley, MD |07/11/16

For decades, the public has been educated that prevention is the best way to reduce the risk of disease.

From time to time, news articles describe how some tests or procedures may not be effective in preventing medical conditions. This can be confusing because the reports may not explain the difference between preventing a disease versus detecting it.

Prevention reduces the chance of ever getting a disease. Examples include public measures like clean water; vaccines against smallpox and polio; and lifestyle habits like not smoking. All these significantly reduce the risk of disease.

Detection of disease is a different strategy. If the patient already has the disease or condition, early detection may improve outcome, For example, early detection is particularly important in treating infections. The correct antibiotic, given early, has a much better chance of eliminating the infection before it can spread. In another example, early detection of high blood pressure or high cholesterol can lead to treatment that reduces the risk of heart attacks and stroke.

Some of the recent controversies have been about the early detection of cancer. This is an evolving strategy. Most cancers start as small tumors and cause no symptoms until they grow large or spread. In theory, finding and eliminating these early tumors could result in higher cure rates.

For the most common cancers, this strategy has been effective … but with some uncertainties.

“Early Detection” Success

Cervical Cancer: The Pap smear of the cervix has detected early, curable cancer in thousands of women. Early detection has transformed cervical cancer from an incurable disease to one with a very high cure rate.

Colon cancer: This slow-growing tumor, if detected early, is also highly curable. The detection tools are testing for blood in the stool or looking for tumors inside the colon periodically with a flexible scope.

Skin Cancer: There are multiple forms of skin cancer but in nearly every circumstance, early detection improves cure. The “test” is easy: examination of the skin by a trained expert and when necessary, skin biopsies to determine diagnosis.

“Early Detection” Success – Some Controversy

Breast Cancer: Mammography and related breast imaging technologies are excellent for detecting early breast cancer and this early detection saves lives. However, experts can disagree on the age a woman should begin this testing, or how often it should be performed. These decisions may depend on the woman’s risk for breast cancer based on family history and other factors.

Lung Cancer: Until recently, there was no early detection test for this common tumor. Recent research has suggested that periodic CT scans of the lung can detect early, curable cancer in current or former smokers. However, some experts think this recommendation is preliminary until more results are known.

“Early Detection” – More Controversy

Prostate Cancer: This malignancy grows slowly and is common in elderly men. A blood test called the PSA, when abnormal, suggests prostate cancer but the diagnosis must be confirmed with biopsies. Even if the biopsies confirm the diagnosis, it is often unclear when or how to treat prostate cancer since it is usually not very aggressive. This has made policy-makers wary of recommending the PSA since, so far, the test has not improved the cure rate. However many men and their physicians still monitor PSA levels.

Prevention and detection of disease are important to discuss with your doctor. As medical science gains new insights, some new recommendations may evolve.

However, one recommendation will never change: pay attention to your health and take the steps that can keep you healthy.

For more information about cancer screening tests, visit the website Choosing Wisely.

Does Your Physician Know What You Pay for Healthcare?

By Mark A. Kelley, MD |07/05/16

All of us should understand our own health care costs. However, as we have discussed here before, the issues can be complicated: e.g. insurance premiums, deductibles, co-pays, etc.

Physicians have a different perspective. Like any professional, they focus on how they are paid. Insurance companies require doctors to submit many details with their bills. Physicians rely on sophisticated billing systems to furnish that information, because without it, they are not paid. In a nutshell, patients worry about paying the bills and doctors worry about sending out the bills.

This raises a key question. How much do doctors know about your insurance and what you must pay?

Of course, the doctor can explain his/her own bills to you. Your doctor’s office has checked your insurance and knows how they should bill your insurance company.   Surprisingly, the doctor may not know much your hospital insurance coverage, or your deductible. Most physicians and their staffs have not been trained to gather this information because it does not affect physician payment.

But things have changed. With high deductible insurance plans, patients have more risk for out-of-pocket costs. A blood test, x-ray, or medication can come with a large bill if it drops into your deductible.

The prices may astound you. A friend recently enrolled in a high deductible insurance plan. She refilled prescription, which previously cost her $40 co-pay. With her new insurance, she had to pay $250 for the same refill because it was part of her deductible. The price was so high because the insurance company passed all the drug cost on to her.

Why is this important?   It is wise to know what you are paying for — and health care is no exception. Health care bills can mount quickly and squeeze the family budget. Sometimes, families face the tough choice of either paying the rent or seeing the doctor.

Physicians are seeing more of their patients struggling with health care bills. This pressure may discourage them from seeking medical care. Tight finances are becoming a health care risk, even for families with decent incomes.

How can patients and doctors work together to control the “costs of care”?

Here are a few suggestions:

1. Know the details of your own insurance policy, especially “out-of-pocket costs”such as co-pays, coinsurance and deductibles. If you have any questions or concerns, contact your insurance company.

2. When your doctor recommends a test, procedure, or treatment, make sure you know what it involves, why you need it, how effective it will be and how soon it must happen. These are questions that any good doctor would be glad to answer.  The timing of the test or procedure may be important if you have already paid out your deductible before the end of the year. In that case, you may not have to pay anything for the service.

3. Cost may (or may not) influence your decision to get a test or procedure. For example, for an urgent life-saving procedure, cost may not even enter your mind. However, some tests or procedures may not be so convincing. In those cases, cost might influence your decision. If so, discuss the cost issue with your doctor who may suggest less expensive alternatives. The timing, location and type of service may all influence the cost: most often for planned (elective) procedures, x-rays, or some medications.

4. If health costs worry you, talk to your doctor. Don’t be afraid to bring up the issue. You are not alone. Many more patients are asking about costs these days. Physicians welcome solving these challenges with you. They can be very helpful if they understand your concerns.

Learn how physicians are addressing this problem on the website Costs of Care.

Our Immune System Fights Infection — Is Cancer Next?

By Mark A. Kelley, MD |06/20/16

Humans have been fighting disease for thousands of years. Until the 20th century, most people died young because they were exposed to deadly infections like small pox. However, smallpox survivors never experienced the disease again. The same is true for mumps, polio and measles. During these infections, our bodies create antibodies that recognize the virus as an alien invader and kill it before it can infect again. We have used this immune system to prevent infections and now we are using it against cancer.

The war against infections has been so effective that some infections are now rare. In fact, smallpox has been eradicated across the world. The reason is that we have developed vaccines that expose the body to proteins from viruses (like small pox) or bacteria (like tetanus) These proteins cause no infection but stimulate the body’s immune system to create antibodies that kill these organisms. Vaccines are among the most important discoveries in history and have saved millions of lives.

There are a few twists to this story. First, our immune system may need a “wake-up” call with a booster shot of vaccine. This revs up the immune system to create a fresh reserve of antibodies. A good example is the tetanus booster shot.

Second, viruses can change their appearance over time so that the immune system may not recognize them. For example, the influenza virus can change every year. Therefore, we need an annual flu shot to keep our immune system up-to-date.

In the past year, two different viruses, Zika and Ebola, have caused major epidemics. The Ebola virus is easily passed from human to human and has a high mortality rate. The Zika virus is transmitted by mosquito bites and rarely causes death or serious illness. The exception is unborn infants. For them, Zika can cause severe brain destruction leaving them disabled for life.

Both these viruses began in remote tropical areas of Africa and would have gone unnoticed before modern times. However, with larger cities and modern travel, diseases can rapidly infect people around the globe. Ebola, for now, has been confined to Africa, but Zika is steadily spreading across the Western Hemisphere.

These epidemics have awakened the world to the value of vaccines. There are now major efforts to create vaccines for these two dangerous viruses. However, it will take time to be certain that any new vaccine is safe and effective

The immune system is also becoming important in treating another major disease—cancer. Some cancers are linked to a viral infection. The best example is cervical cancer, which is associated with infection by the human papilloma virus. Vaccines against that virus, when given before puberty, reduces the risk of cervical cancer.

Cancer is a collection of abnormal cells that grow uncontrollably. Our immune system does not kill these cells because, on the surface, they look normal. If we could make these cells look abnormal, the immune system would destroy them quickly, just like any other invader. The effect would be dramatic. The immune system patrols the entire body and would hunt down every “strange” cancer cell.

Cancer research is now probing how to use our immune system to cure cancer. One approach is to make the cancer look like a foreign invader to our immune system. Another is to teach our immune system to use antibodies engineered to sabotage the growth of the cancer.

It may be a long time before we see results from this research … but we should be patient. It took decades to develop vaccines but the results have been spectacular. Our immune system is smart and ruthless in protecting us from infection. If we can train it to fight cancer, we will be moving closer to a cure.

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