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If you're having digestive issues, your stomach may not be the problem.
Additional Info
- Segment Number 2
- Audio File clean_food_network/1629cf1b.mp3
- Featured Speaker Nan Lu, OMD
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Guest Bio
Nan Lu, OMD, Grand Master of Wu Ming Qigong, is the country’s foremost spiritual leader, practitioner and teacher of traditional Chinese medicine. He is the best-selling author of three TCM books published by HarperCollins. Master Lu is also a master herbalist and has competed and medaled in international martial arts and Taiji competitions.
In 1995, Dr. Lu founded Traditional Chinese Medicine (TCM) World Foundation. Based in New York City, it is the country’s leading educational organization for TCM. He holds a doctorate from Hubei College (University) of TCM, Hubei, China, and is a clinical associate professor at the State University of New York (SUNY), School of Social Welfare, where he also serves as an executive board member of the Center for Culturally Competent Education and Training.
He has been featured in Newsweek (special issue on alternative medicine) and also in the PBS documentary, Harmony and Spirit: Chinese Americans in New York.
Making your own personal care products doesn't take a lot of effort; it's a lot easier than most people imagine.
Additional Info
- Segment Number 1
- Audio File clean_food_network/1629cf1a.mp3
- Featured Speaker Kathrin Brunner
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Guest Bio
Kathrin Brunner is a Toronto-based nutritionist and yoga teacher.
She has a passion for holistic living and is a super-avid DIYer who has created several lines of natural body care products and is a nutrition expert and recipe developer for Clean Eating Magazine and Tuja Wellness.
Kathrin teaches at The Institute of Holistic Nutrition and has a private practice that offers nutrition counselling, a variety of workshops, corporate talks and yoga classes.
Additional Info
- Segment Number 2
- Audio File city_hope/1628ch2b.mp3
- Doctors Salgia, Ravi
- Featured Speaker Ravi Salgia, MD
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Guest Bio
Ravi Salgia, MD is professor and chair in the Department of Medical Oncology and Therapeutics Research and also serves as the associate director for clinical sciences in the Cancer Center. He is bestowed with the title of Arthur & Rosalie Kaplan Endowed Chair in Medical Oncology.
Prior to joining City of Hope, Dr. Salgia served as tenured professor of medicine, pathology and dermatology; director of the Thoracic Oncology Program and the Aerodigestive Tract Program Translational Research Lab in the section of hematology/oncology; vice chair for translational research in the department of medicine; and associate director for translational science at the University of Chicago Comprehensive Cancer Center in Chicago.
Learn more about Ravi Salgia, M.D., Ph.D. -
Transcription
Melanie Cole (Host): After years of modest gains in the field of lung cancer--the leading cause of cancer-related deaths throughout the world--doctor and researchers say significant advances in treatment and screening practices point to very good news. My guest today is Dr. Ravi Salgia. He's a professor and Chair in the Department of Medical Oncology and Therapeutics Research at City of Hope. Welcome to the show, Dr. Salgia. So, tell us a little bit about what's going on. What treatment advances do you expect for lung cancer patients in 2016?
Dr. Ravi Salgia (Guest): So, we've come a long way for lung cancer. We know that, initially, when we started treating lung cancer patients, especially metastatic disease, that we only had one or two options. Those were really in the context of palliative care and chemotherapy, such as platinum-based chemotherapies, as well as if we needed to for symptom relief, radiation therapy. But, over the past decade, especially over the past few years, we really have made incredible strides in terms of understanding lung cancer, in terms of the genetics of lung cancer, the proteomics of lung cancer, and then, based on that coming up with various therapeutics. So, we're very excited about what are called “precision medicines” for lung cancer, especially, for example, tyrosine kinase inhibitors, as well as immunotherapies.
Melanie: So, let's start with immunotherapies. How is that working to advance the lung cancer treatment?
Dr. Salgia: You know, when I was at Harvard a while ago, we had done some immunotherapies for lung cancer and we didn't have striking results. Over the past few years, what's happened is that immunotherapy has had huge breakthroughs, initially coming, for example, from melanoma, but really being applied to lung cancer as well as bladder cancer. Especially for lung cancer, what we wanted to do is to really engineer various therapeutics so that our own T cells, for example, can be revved up. So, as an example, there are these checkpoint inhibitors known as PD-1 or PD-L1, that have been brought to clinical fruition and they have been already approved by the FDA for us to utilize in our clinics. There are lots of other immunotherapies in terms of immunotoxins, as well as CAR T cells, so a lot of research is going on. Unlike before, where we only saw a handful of patients responding to immunotherapy, we're seeing a large number of patients respond to immunotherapy and really sustained responses to immunotherapy. So, we're quite excited by that for our patients.
Melanie: So what is adoptive T cell therapy and how does that work to treat cancer?
Dr. Salgia: So, T cell therapy is really looking at our own immune cells. So, our own immune cells, what they do, is they fight off any kind of foreign cells or our own cells that potentially have gone awry. So, adoptive T cell therapies really involve engineering these T cells and giving it back where one can really look at how you can engineer the immune system to really fight better.
Melanie: So, what do you do with the T cells? Do you remove them from the patient and sort of teach them to fight the tumor? Or, did they have blinders on? What goes on with them?
Dr. Salgia: Exactly. So, you really-I like that word, "teach them." So, you really take the T cells, engineer them so that they become much more in the attack mode, or the fight mode, so then they can recognize the cancer cells and then ultimately kill off the cancer cells.
Melanie: And when those T cells are put back in, do they recruit other cells to help them fight? How does that work?
Dr. Salgia: Yes. So, there is what's called a tumor milieu in stroma that surrounds the tumor cells. So, you need a lot of fighter cells, and so T cells are one component of it, but there are lots of other cells in the immune cells that have to group together and come together to be able to recognize the cancer cell, then be able to attack the cancer cell, and then to kill the cancer cell. And, ultimately, actually remove the debris from the cancer cells that have died.
Melanie: So, will this improve the patient experience or the patient outcome? Are there side effects to these types of therapies?
Dr. Salgia: Every therapy we give, unfortunately, has side effects, so we have to watch out for them and it's really important that we can't truly predict the side effects that the patients will get until, if the patients develop that, we have to be able to manage that. Most side effects that we see with these types of therapies, especially immune therapies, and even non-immune therapies, can be handled. They can be handled in terms of having expertise in being able to recognize it, but then to be able to provide that supportive care.
Melanie: And, do you think that early detection, thanks to screenings and new screening techniques will help with this if it's caught earlier?
Dr. Salgia: Lung cancer, as you know, occurs in four different stages. So, Stage 1 is the earliest stage of lung cancer that can happen. Basically, what that means it's a small tumor that's within the lung, no lymph node, no metastasis, especially metastasis, for example, to the other parts of the lung or the lymph nodes or to the bone or to the liver or brain or adrenal gland, as an example. But, we know that early stage disease, especially Stage 1 lung cancer, if detected, as well as Stage 2 lung cancer--that involves lymph node involvement--if detected, can really be cured and a sustained cure. So, early detection, early screening are important tools. We are recommending screening for patients of the right criteria and that has been approved by the CMS as well.
Melanie: Do you think at some point lung cancer may become a chronic disease? Where do you see it going in the future?
Dr. Salgia: Ultimately, we want to cure cancer. We want to prevent lung cancer, but we'll also take a chronic disease. For example, metastatic breast cancer, metastatic prostate cancer has already arrived at this chronicity level and patients can live for a long time with even metastatic disease. However, lung cancer, there are only sub-sets of those patients who have metastatic disease that can live a long time, potentially as "chronic disease"; that is, to be able to control the disease with the various therapeutics and monitoring, but, ultimately, our goal is for lung cancer to become a chronic disease. One of the things that we have to really lookout for, though, lung cancer is a sub-set of a sub-set of a sub-set, now. We think of lung cancer as two major categories: small-cell lung cancer and non-small-cell lung cancer. We treat them differently. And then, in non-small-cell lung cancer, it can be adenocarcinoma, squamous cell carcinoma, as well as large-cell carcinoma. Then, in adenocarcinoma, as an example, you can have an EGFR mutation, or an [7:38] translocation or an RS-1 translocation, or a [7:42] translocation. So, we have to take all of those into account for us to be able to guide us to say which sub-sets of lung cancer will become chronic disease? Ultimately, we want everything to be potentially manageable for a long period of time but we have to be able to figure out which therapeutics for what disease.
Melanie: So, in just the last few minutes, give your best advice to patients that have recently been diagnosed with lung cancer, which is a very scary diagnosis at the outset. Give them some hope on what you're doing in research and why they should come to City of Hope for their care, or a second opinion.
Dr. Salgia: Oh, absolutely. You want to really not be afraid if one has a diagnosis of lung cancer because there is so many therapies available. What you have to do is find the experts. You have to be able to define what the stage of the disease is, you have to incorporate your primary care physician, as well as your local oncologist, as an example, but also have that expert opinion from those people who've been doing lung cancer for a long time. For me, for example, a lung cancer medical oncologist for the past 25 years, and this is what I do for a living. So, we know the nuances that have to go into our therapy decision-making. What we really want to be able to do find out are there potential clinical trials? What clinical trials mean is that, are there therapies that are better than what are the current existing therapies? Can you be monitored even more closely? Can you think about the future and try to come up with that what you call "chronic disease" or even a cure for lung cancer? So, why City of Hope? City of Hope is a really important player in the context, of course, having those experts available who only do certain sets of diseases. Let's say, for example, I'm a lung cancer physician. Then, we also have breast cancer physicians, we have prostate cancer. So, really, this is a specialty within a specialty and then, at the same time, there are a lot of clinical trials that have come to fruition here at City of Hope where one could think about for lung cancer patients, is it appropriate? Will this make a difference? Will the survival be better? Will the quality of life be better? And so, I think this is why it's important to not be afraid, even if you have a diagnosis of lung cancer, but to seek out the experts.
Melanie: Great information and such a fascinating topic. We applaud all the great work that you're doing, Dr. Salgia, at City of Hope. Thanks so much for being with us today. You're listening to City of Hope Radio and for more information, you can go to cityofhope.org. That's cityofhope.org. This is Melanie Cole. Thanks so much for listening.
- Hosts Melanie Cole, MS
Additional Info
- Segment Number 1
- Audio File city_hope/1628ch2a.mp3
- Doctors Vora, Nayana L
- Featured Speaker Nayana L Vora, MD
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Guest Bio
Few medical professionals are as well-versed and experienced in all facets of Radiation Oncology as Nayana L. Vora, M.D., For more than three decades, Dr. Vora has been a fixture at City of Hope, where she serves as a Clinical Professor, and Director of the Department of Radiation Oncology. Dr. Vora is a nationally recognized authority on brachytherapy, which uses radioactive “seeds” to target tumors. In addition to her work on breast cancer, she helped develop the City of Hope Prostate Seed Program for localized prostate cancer.
Dr. Vora has authored over 50 publications in peer-reviewed journals and delivered dozens of abstracts and presentations. She serves on numerous committees at City of Hope, as well as national committees.
Learn more about Nayana L. Vora, M.D - Hosts Melanie Cole, MS
Food allergies? Discover these delicious (yet simple) gluten-free and dairy-free recipe ideas.
Additional Info
- Segment Number 5
- Audio File clean_food_network/1627cf1e.mp3
- Featured Speaker Gabrielle Myers, Chef
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Guest Bio
Gabrielle Myers is a writer, teacher and chef living in the Sacramento Valley of California.
For over a decade, she worked as a cook and chef for San Francisco Bay area restaurants and catering companies. During the growing season of 2006, she apprenticed under Laura Trent, farmer and owner of Tip Top Produce, an organic farm that specialized in supplying Bay Area farmers’ markets and fine-dining restaurants with heirloom vegetables.
Gabrielle, an Associate Professor of English at San Joaquin Delta College, went to graduate school in her early thirties to earn an M.A. in English from the University of California at Davis and an M.F.A. in Creative Writing from Saint Mary’s College of California.
Her poems and essays have been published in professional journals and literary magazines. She coauthored a nutrition book, The New Prostate Cancer Nutrition Book. Access links to her poems, essays, and recipe blog through her website: www.gabriellemyers.com.
She has had two articles published recently, one in Natural Solutions and in Eating Naturally so far this year, and an a recipe published on Shape.com and a review in Edible East Bay Review.
Food allergies can be dangerous; even deadly.
Additional Info
- Segment Number 4
- Audio File clean_food_network/1627cf1d.mp3
- Featured Speaker Heather Christo, Chef
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Guest Bio
Heather Christo is a formally trained chef, caterer, and the voice behind the popular food blog HeatherChristo.com, as well as a permanent contributor to ThePioneerWoman.com.
Her recipes and food photography have been featured in many national magazines and television shows, and she is the author of Heather Christo’s Generous Table.
She lives in Seattle with her husband and two young daughters.
Change is a process. If you attempt to ditch all your bad habits at once, you might become so overwhelmed that you just give up.
Additional Info
- Segment Number 3
- Audio File clean_food_network/1627cf1c.mp3
- Featured Speaker Jane Wilkens Michael
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Guest Bio
Beauty, health and fitness expert, Jane Wilkens Michael, is host of the Jane Wilkens Michael Show on iHeartRadio Talk and the author of Long Live You! Your Step-by-Step Plan to Look and Feel Better Than Before.
Starting with the International Herald Tribune based in Paris, and then creating the monthly "Beauty Talk" column for Town & Country Magazine, Jane has continued to contribute her columns and articles to an extensive list of publications, newspapers and websites the world over. She has also written Breakfast, Lunch and Dinner of Champions, for which she interviewed athletes in ten major sports and discussed their nutritional needs and ideal diets.
Michelle Dudash returns to Clean Food Network to share her top five light and natural low-calorie summer drinks.
Additional Info
- Segment Number 2
- Audio File clean_food_network/1627cf1b.mp3
- Featured Speaker Michelle Dudash, Chef & Clean Eating Expert
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Guest Bio
Michelle Dudash is the creator of CleanEatingCookingSchool.com and a writer whose “Dish with Dudash” column is published in the Arizona Republic. It reaches over 1.5 million readers per week.
She is also a featured monthly guest on KPNX-TV’s Arizona Midday show, and a regular contributor to the Food Network’s Healthy Eats blog, one of the most heavily read columns on the television network’s site.
Learn how you can shrink your waistline and your carbon footprint.
Additional Info
- Segment Number 1
- Audio File clean_food_network/1627cf1a.mp3
- Featured Speaker Kate Geagan, RD
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Guest Bio
One of America’s most recognized nutritionists, Kate Geagan is an award-winning dietitian who has helped millions fall in love with food that powers a vibrant, high energy life.
She is an internationally known author, speaker, consultant and nutrition communications expert, as well as a spokesperson for several global brands in the organic and natural space.
Additional Info
- Segment Number 2
- Audio File allina_health/1627ah5b.mp3
- Doctors Peters, Jamie
- Featured Speaker Jamie Peters, MD- Orthopedics/ Sports Medicine
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Guest Bio
Jamie Peters, MD, is a board-certified physician specializing in family medicine and sports medicine. His professional interests include non-surgical orthopedic care, fracture management, joint injections, chronic and acute injuries, management of musculoskeletal chronic conditions, preventive care for runners, runner issues and sport conditions.
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Transcription
Melanie Cole (Host): As the seasons start to change, you get ready to get back into your favorite sport, whether it's skiing, softball, soccer, basketball. This year, you want to make sure not to get an injury or a pulled muscle or even worse. My guest today is Dr. Jamie Peters. He's a sports medicine physician with Sports & Orthopaedics Specialists, part of Allina Health. Welcome to the show, Dr. Peters. So, what are some of the most common types of sports injuries you see when people haven't prepared and they've just jumped in?
Dr. Jamie Peters (Guest): Well, probably most common is typical strains of muscles. So, when muscles are too tight, they haven’t been used much and they tend to be more prone to tearing. So, the actual fibers of the muscle tear and then it manifests itself for the patient or for the athlete in soreness lasts for usually 2 to 5 days or so. Sometimes if it’s a larger tear, it can last a whole lot longer.
Melanie: We're coming to fall sports soon and kids are starting to train already now for some of the fall sports; and then, there's winter sports. Do you see an increase in either one of those seasons?
Dr. Peters: Yes. Well, you know, I guess I would take that question back to say, ideally. for any of our athletes or pretty much anybody, year round training would be ideal. So, year round, being active; year round using your muscles in any of the seasons. So, I guess, commonly, when we're looking at some of the school sports like cross country, running and football, soccer--all those fall season sports--if someone hasn’t been staying active then, as I've said before, then they do tend to have a more likelihood of these sprains. Staying active and, actually, even specifically working on the core muscles are really great strategies for prevention. The core would be the abdominal core and also, just as importantly, would be the hip core, the group muscles. There are specific exercises that help maintain those muscle strengths and they’re very protective against other types of injuries that occur in these sports.
Melanie: So, when you mention being active year round, sports specific has been an issue lately and we’re seeing more chronic injuries in kids that are staying with one sport all year round. What do you think about cross training? What advice do you have for coaches and parents of kids who play a sport all year round?
Dr. Peters: That's a great topic. If we can encourage our kids to do a couple of things: one is to, as you say, cross train, meaning that you don’t just do one sport year round because then you’re just using the same muscles and the muscles that aren’t involved in that sport are not being used. So, if someone is a runner, adding in some biking, adding in some of the other kinds of sports, like soccer, where you're using different muscles, can be very, very protective over time.
Melanie: So, cross training is a great idea. Now, what about somebody who gets a pulled muscle? Whether they’re in shape or not, sometimes the aches and pains happen, Dr. Peters. So, what do you recommend as the first line of defense if someone feels an ache in their knee or feels their ankle strained or quad strained. What do you tell them to do?
Dr. Peters: Well, first of all, I think it’s important to note some of the red flags or the warnings for which you would want to get help sooner. That would be if a joint is actually swelling. So, knee swelling, that would be something you'd want to see a sports medicine specialist or a very qualified provider to get that assessed. Persistent redness in areas also would be a red flag warning sign that you probably shouldn’t wait on that. But, if it’s a more typical sprain, that you’d feel a pull, you don’t want to continue full out and continue to play because what happens is, that particular muscle that’s been strained ends up being a little weaker and you can actually extend that injury and make what might be a more mild injury that could last 2 or 3 days into a much longer duration type injury. So, be somewhat aware of the typical ways that we recommend treating it, if you were treating this and not going to a provider initially if it looks like a milder injury would be some icing on that area. Ice tends to work really well. We’d usually recommend a 15-minute duration using a soft ice pack or a back of frozen peas. You can do that 2 to 3 times a day. It can be very effective. And then, starting up again, sort of testing that, get it moving, sometimes just walking is more effective as a healing technique than just sitting around. So, you want to get these muscles moving again so that the circulation is there and the muscle can help mend itself but not pushing it really hard when it’s not ready.
Melanie: What about NSAIDS and ibuprofen, Advil and things like that. Are you allowed to take that if you’re sore? Do you wait it through? What do you do?
Dr. Peters: Well, that’s a really good question. I think there’s a really changing way of thinking in the sports medicine community about using non-steroidal anti-inflammatories like ibuprofen or Aleve initially with injury. They can affect the bleeding times, so we don’t want to have more blood in the tissue because that takes longer for the tissue to heal. So, probably trying to stay away initially with ibuprofen because basically they’re good for pain but sometimes the body needs a little inflammation to heal. So, that also could be a reason not to use ibuprofen initially. For certain types of injuries where we see more of a tendonitis or bursitis or things like that, ibuprofen or that kind of drug can be helpful but, in general, be a bit more conservative on the use of those medications. Tylenol works reasonably well for pain but, a lot of times, as I mentioned, icing can also be helpful for pain and doesn’t have the negative downsides of some of these other drugs.
Melanie: What if you have an imbalance or little limiting factor, some muscle that isn't as strong, do you recommend bracing for tennis or for girls in soccer with their knees. We know ACL in girls is a huge issue right now. Do you recommend bracing, Dr. Peters?
Dr. Peters: Well, it's sort of a yes and no answer. So, what I'll say is, since you brought up ACL and the higher likelihood of women athletes having ACL injury, which is major ligament in the knee type injury that we see with Adrian Peterson, for instance, with the Minnesota Vikings and others have sustained that. But, it's more frequently injured in female athletes and really bracing won’t prevent that injury. What can prevent that injury is proper training, again, going back to the core, women athletes who are able to maintain that core strength, especially hip core, have been shown by a number of studies to be less likely to injure the ACL. Now, if we're talking about a sleeve, there's been some tweaking of the knee and sometimes having a compression sleeve is helpful but a brace itself, unless it’s a very specialized brace and someone has a deficiency in ligament and it’s been prescribed by a sports medicine specialist, a brace in itself it’s not really protective, the kind that you would get at Walgreens or Target or other similar places.
Melanie: So then, what do you advise people about warming up and stretching and flexibility. People never know whether to stretch a cold muscle, wait until they’re warm and then stretch it. Give us your best advice for really preparing for a sport.
Dr. Peters: Another great topic. These are really changing ways of thinking in sports medicine and what we're advising. So, definitely warming up the body and warming up the muscles before you do full out exertion is always a good idea. We're less enthusiastic about cold stretching. It used to be when I played soccer, for years the first thing we do is get to the field and start stretching but stretching cold muscles could actually be detrimental and studies have shown that even performance can suffer if you stretch cold muscles and then go out and try to play full out. So, warming up the body first. Kicking the ball around in soccer or other type of warming up is the best way to go for those muscles and then doing some stretching of muscle groups pretty thoroughly is a good idea for a lot of these sports. And then, doing after event gentle stretching. You don’t want to stretch to pain. You don’t want to crank on your muscles as that’s not good for you but gentle stretching so you feel a slight discomfort is a great way to go. Holding stretches for 30 second duration each group. And then, also being very symmetric. So, even though you may have some soreness on one side and that’s the side you want to stretch, always stretch the other side, too. The body loves symmetry and doesn’t like asymmetry very much.
Melanie: So, in just the last few minutes, wrap it up for us Dr. Peters. It's such great information and so important. Wrap it up for your best advice about preventing sports injuries as the season starts ramping up.
Dr. Peters: My best advice is really going over some of the things that we've talked about. Cross training, actually taking a break from time to time. For some of these high level athletes constantly are pushing, taking a month or two off after a season is a great idea. The core strength is so important and there are things on the internet or even specialists in physical therapy and other specialists who can really assist in a great core strengthening home program for prevention. And then, listen to your body and also being observant of those red flag concerning signs that would really direct you more towards getting earlier advice from a qualified sports medicine specialist. Those would encapsulate the most important points of injury prevention as we get into the fall sports.
Melanie: Thank you so much for being with us today. You're listening to The WELLcast with Allina Health. For more information, you can go to allinahealth.org. That's allinahealth.org. This is Melanie Cole. Thanks so much for listening.
- Hosts Melanie Cole, MS
