The Shift in Dementia Care from Control to Connection
PodcastDX
Today we’re continuing our Medicine in Transition theme with a topic that is deeply personal, professionally important, and long overdue. This episode is titled “The Shift of Dementia Care: From Control to Connection.” But we’re not doing this one alone. We’re joined by a special guest, Jennifer Stoner.Jennie is a retired professor from Aurora University in Aurora, Illinois, where she taught in recreation administration and therapeutic recreation, helping train future professionals to design meaningful, person‑centered programs for older adults and...
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Cancer Care in Transition
PodcastDX
In this week’s episode, “Cancer Care in Transition: Precision Medicine, Immunotherapy, and Patient Choice,” we look at how cancer treatment is changing at the exact moment when patients are trying to move from crisis mode into something like a new normal. Precision medicine now uses a person’s genes, tumor markers, and even lifestyle to match them with targeted drugs or immunotherapies instead of one‑size‑fits‑all chemo, while immuno‑oncology has created a growing group of survivors living with long‑term effects and unique follow‑up needs. At the same time, shared...
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The Dark Side of Patient Advocacy on Social Media
PodcastDX
The dark side of advocacy is that the same social media platforms that help health advocates reach millions can also expose them to relentless trolls, coordinated pile‑ons, and even threats to their safety and careers. Studies of physicians and public‑health advocates show that a large share—sometimes more than half—have been personally attacked online for speaking about vaccines, gun violence, or other health issues, facing abuse that targets not just their ideas but also their gender, race, disability, or identity. What starts as “just comments” can quickly escalate into doxxing,...
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Various Types of Dementia
PodcastDX
Various Types of Dementia This week on PodcastDX, we’re stepping into the complex world of dementia—not as a single diagnosis, but as a family of conditions that affect memory, thinking, behavior, and independence in different ways. We’ll introduce the most common types of dementia, including Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, and mixed dementia, where more than one process—often Alzheimer’s plus vascular changes—are happening in the brain at the same time. We’ll also touch on less common causes, such as dementia related to...
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Rethinking DX: A Digital DSM and the Roots of Mental Health
PodcastDX
“Rethinking DX: A Digital DSM” looks at how the Diagnostic and Statistical Manual of Mental Disorders (DSM) quietly shapes almost every part of mental health care—from who gets a diagnosis and insurance coverage to how people understand their own symptoms and identities. In this conversation, Lita and Jean Marie unpack what the DSM actually is, why the current DSM‑5‑TR matters, and how a future, fully digital “DSM‑6” could function as a living document that updates more quickly, links to decision‑support tools, and better integrates real‑world data from electronic health...
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The Next Decade in Medicine
PodcastDX
Over the next decade, medicine won’t just add new gadgets—it will change what it feels like to be a patient. In this episode of PodcastDX, we explore how AI as a clinical co‑pilot, stem cells and regenerative medicine, genomics and precision care, wearables, and hospital‑at‑home models could reshape everyday care. We talk about the promise of earlier detection and more personalized treatment, the risks around bias, privacy, and hype, and why equity and shared decision‑making must stay at the center as technology races ahead. Most of all, we ask how patients and caregivers can be...
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Patients as Partners: Shared Decision Making in Medicine
PodcastDX
This week we are discussing the rise of a new type of health care where the patients play a vital role in their medical care. Patients as partners in care are at the heart of shared decision making (SDM), a model where clinicians and patients deliberately work together to choose tests and treatments that fit both best evidence and the patient’s values and life context. What shared decision making means SDM is a collaborative process in which clinicians contribute clinical expertise while patients contribute their goals, preferences, and lived experience. Core...
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End of Life in Transition: Earlier Palliative Care, Better Conversations
PodcastDX
At a time when modern medicine is allowing people to enjoy longer, fuller lives, mortality is not always a chief concern. But when a serious illness occurs, the topic becomes unavoidable. This became especially clear during the early days of the COVID-19 pandemic when hospitals were overrun with patients, many with grim prognoses. “The pandemic gave all of us a sense that life can be short and there’s the very real possibility of dying,” says , director of the Palliative Care Program at Yale New Haven Hospital. “It opened the door for us to talk more about death and have a...
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Is Mental Health Care Changing Fast Enough
PodcastDX
This week we discuss the current status of Mental Health Care. Mental health care is changing, but most experts argue it is not changing fast enough relative to the need, especially on access, equity, and workforce. Where change is too slow Unmet need is huge. In the U.S., millions with a diagnosable condition still receive no treatment each year; a recent national report notes that many adults with mental illness remain uninsured or unable to access care. Global workforce shortages. Nearly 50% of the world’s population lives in countries with fewer...
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Rehabilitation Reimagined: Technology, Therapy and Independence
PodcastDX
The integration of Artificial Intelligence (AI) into post-injury rehabilitation is transforming recovery paradigms by enabling personalized, adaptive, and efficient rehabilitation pathways tailored to individual patient needs. This podcast reviews the current advances in AI applications that facilitate assessment, monitoring, and optimization of rehabilitation programs following injuries. Through machine learning algorithms, wearable sensors, and predictive analytics, AI enhances the precision of therapy plans, tracks patient progress in real-time, and predicts recovery trajectories. The...
info_outlineThis week we are talking about Pancreatic cancer. This is a type of cancer that begins as a growth of cells in the pancreas. The pancreas lies behind the lower part of the stomach. It makes enzymes that help digest food and hormones that help manage blood sugar.
The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma. This type begins in the cells that line the ducts that carry digestive enzymes out of the pancreas.
Pancreatic cancer rarely is found at its early stages when the chance of curing it is greatest. This is because it often doesn't cause symptoms until after it has spread to other organs.
Your health care team considers the extent of your pancreatic cancer when creating your treatment plan. Treatment options may include surgery, chemotherapy, radiation therapy or a mix of these.
Pancreatic cancer often doesn't cause symptoms until the disease is advanced. When they happen, signs and symptoms of pancreatic cancer may include:
- Belly pain that spreads to the sides or back.
- Loss of appetite.
- Weight loss.
- Yellowing of the skin and the whites of the eyes, called jaundice.
- Light-colored or floating stools.
- Dark-colored urine.
- Itching.
- New diagnosis of diabetes or diabetes that's getting harder to control.
- Pain and swelling in an arm or leg, which might be caused by a blood clot.
- Tiredness or weakness.
It's not clear what causes pancreatic cancer. Doctors have found some factors that might raise the risk of this type of cancer. These include smoking and having a family history of pancreatic cancer.
Understanding the pancreas
The pancreas is about 6 inches (15 centimeters) long and looks something like a pear lying on its side. It releases hormones, including insulin. These hormones help the body process the sugar in the foods you eat. The pancreas also makes digestive juices to help the body digest food and take in nutrients.
How pancreatic cancer forms
Pancreatic cancer happens when cells in the pancreas develop changes in their DNA. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the instructions tell the cells to grow and multiply at a set rate. The cells die at a set time. In cancer cells, the changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes there to be too many cells.
The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body.
Most pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic ductal adenocarcinoma or pancreatic exocrine cancer. Less often, cancer can form in the hormone-producing cells or the neuroendocrine cells of the pancreas. These types of cancer are called pancreatic neuroendocrine tumors or pancreatic endocrine cancer.
Risk factors
Factors that might raise the risk of pancreatic cancer include:
- Smoking.
- Type 2 diabetes.
- Chronic inflammation of the pancreas, called pancreatitis.
- Family history of DNA changes that can increase cancer risk. These include changes in the BRCA2 gene, Lynch syndrome and familial atypical multiple mole melanoma (FAMMM) syndrome.
- Family history of pancreatic cancer.
- Obesity.
- Older age. Most people with pancreatic cancer are over 65.
- Drinking a lot of alcohol.
As pancreatic cancer progresses, it can cause complications such as:
- Weight loss. People with pancreatic cancer might lose weight as the cancer uses more of the body's energy. Nausea and vomiting caused by cancer treatments or a cancer pressing on the stomach might make it hard to eat. Sometimes the body has trouble getting nutrients from food because the pancreas isn't making enough digestive juices.
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Jaundice. Pancreatic cancer that blocks the liver's bile duct can cause jaundice. Signs include yellowing of the skin and the whites of the eyes. Jaundice can cause dark-colored urine and pale-colored stools. Jaundice often occurs without belly pain.
If the bile duct is blocked, a plastic or metal tube called a stent can be put inside it. The stent helps hold the bile duct open. This is done using a procedure called endoscopic retrograde cholangiopancreatography, also called ERCP.
During ERCP, a health care professional puts a long tube with a tiny camera, called an endoscope, down the throat. The tube goes through the stomach and into the upper part of the small intestine. The health professional puts a dye into the pancreatic ducts and bile ducts through a small tube that fits through the endoscope. The dye helps the ducts show up on imaging tests. The health professional uses those images to place a stent at the right spot in the duct to help hold it open.
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Pain. A growing tumor may press on nerves in your abdomen, causing pain that can become severe. Pain medications can help you feel more comfortable. Treatments, such as radiation and chemotherapy, might help slow tumor growth and provide some pain relief.
When medicines aren't helping, a health care professional might suggest a celiac plexus block. This procedure uses a needle to put alcohol into the nerves that control pain in the belly. The alcohol stops the nerves from sending pain signals to the brain.
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Bowel blockage. Pancreatic cancer can grow into or press on the first part of the small intestine, called the duodenum. This can block the flow of digested food from the stomach into the intestines.
A health care professional might suggest putting a tube called a stent in the small intestine to hold it open. Sometimes, it might help to have surgery to place a feeding tube. Or surgery can attach the stomach to a lower part of the intestines where the cancer isn't causing a blockage.
Prevention
Screening for people with a high risk of pancreatic cancer
Screening uses tests to look for signs of pancreatic cancer in people who don't have symptoms. It might be an option if you have a very high risk of pancreatic cancer. Your risk might be high if you have a strong family history of pancreatic cancer or if you have an inherited DNA change that increases the risk of cancer.
Pancreatic cancer screening might involve imaging tests, such as MRI and ultrasound. These tests are generally repeated every year.
The goal of screening is to find pancreatic cancer when it's small and most likely to be cured. Research is ongoing, so it's not yet clear whether screening can lower the risk of dying of pancreatic cancer. There are risks to screening. This includes the chance of finding something that requires surgery but later turns out to not be cancer.
Talk about the benefits and risks of pancreatic cancer screening with your health care team. Together you can decide whether screening is right for you.
Genetic testing for cancer risk
If you have a family history of pancreatic cancer, discuss it with a health care professional. The health professional can review your family history and help you understand whether genetic testing might be right for you.
Genetic testing can find DNA changes that run in families and increase the risk of cancer. If you're interested in genetic testing, you might be referred to a genetic counselor or other health care professional trained in genetics.
Ways to lower risk
You might reduce your risk of pancreatic cancer if you:
- Stop smoking. If you smoke, talk to a member of your health care team about ways to help you stop. These might include support groups, medicines and nicotine replacement therapy.
- Maintain a healthy weight. If you are at a healthy weight, work to maintain it. If you need to lose weight, aim for a slow, steady weight loss of 1 to 2 pounds (0.5 to 1 kilogram) a week. To help you lose weight, exercise most days of the week. Slowly increase the amount of exercise you get. Choose a diet rich in vegetables, fruit and whole grains with smaller portions. (CREDITS: MAYO CLINIC)