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Cancer diagnosis in aging patients presents unique problems

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Last week I saw a patient recently diagnosed with cancer who is also managing the challenges of early-stage dementia. Her cancer is curable with chemotherapy and radiation, so I moved to start her on a regimen which involved having an IV pump at home to deliver the drugs.

I had made sure that, given her condition, she had family or other personal support available, so someone would be able to report any side effects if they occurred. Despite these precautions, the woman got confused at one point and pulled the IV line out of her arm, leading to chemotherapy drugs spilling everywhere.

Some aging cancer patients face other health issues and might face issues of having no close family support or transportation problems. A geritric assessment is a way to help outline and deal with those issues.
Some aging cancer patients face other health issues and might face issues of having no close family support or transportation problems. A geritric assessment is a way to help outline and deal with those issues.  (Dreamstime)

On the same day I saw another elderly patient, also with a very treatable cancer, who is the main caregiver for his wife. She is also in her eighties, recovering from hip surgery and in the early stages of dementia. In addition, he has his own issues with kidney dysfunction that will affect his ability to tolerate cancer treatment. He struggles to balance his own treatment needs with supporting his wife’s chronic health conditions.

More and more I’m seeing older cancer patients having to manage the disease alongside other age-related conditions: cognitive decline, organ dysfunction and mobility issues. This poses serious obstacles for the patient, but also brings new considerations and difficult treatment decisions for oncologists like me, other care providers, and family members.

Life expectancy continues to increase in Canada and with people living longer comes the increased risk of developing diseases of aging, including cancer. While all cancer patients experience challenges with treatment and posttreatment life, older patients often find themselves in a situation of dealing with multiple medical problems at the same time.

There are promising signs in our health system as many cancer centres are starting to ask elderly patients about age-related issues or refer them to geriatricians for an assessment before starting treatment.

This extra probing can uncover crucial information. For example, we often assume that older patients will have support from family and friends to support them in their cancer experience. Often, though, relatives live too far away to see someone through a course of cancer treatment, and elderly friends have their own health challenges.

Geriatric assessments are not yet standard practice in Canadian cancer care because they require additional resources from our stretched system and may be difficult to incorporate into the cancer treatment process in a timely manner.

So older people with cancer, or their loved ones, must advocate for themselves and to establish supports as early as possible following a diagnosis. Specifically:

Ensure family and friends are aware — I have seen in my own practice that older people sometimes try to protect their family and friends by not telling them about their cancer diagnosis. In reality, this is the time when you need family and friend support more than ever. Be open and honest and look for whatever supports are available within your network. And if you do not have any feasible supports, be up front and tell your care provider as they will direct you to resources within the cancer centre or through cancer agencies.

Monitor and discuss your state of health — Keep track of any health issues you are facing and mention them to your oncologist. Have a discussion on potential effects they could have on your cancer treatment. This can naturally be challenging with cognitive decline or dementia so be sure to have a discussion with your family or caregiver to ensure they can fill in the blanks for your care providers if you are unable to do so yourself.

Discuss logistics of treatment — A recent report found that health care providers in Canada frequently do not discuss the practical aspects of cancer treatment including how a patient will get to and from appointments. This is especially important with the elderly as many no longer have their driver’s license and their children may live out of town. Be proactive and ask about what options are available. Services such as Wheels of Hope, provided by the Canadian Cancer Society, can assist with transportation to and from appointments.

Right now, there is a national engagement to modernize the Canadian Strategy for Cancer Control. Canadians with cancer and their loved ones can visit cancerstrategy.ca to share their disease experience and insights to help shape this national cancer plan.

Dr. Craig Earle is a professor of Medicine at the University of Toronto and a medical oncologist at Sunnybrook Hospital. He is also the VP, Cancer Control at the Canadian Partnership Against Cancer

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Post-vaccine surge? Michigan’s spring coronavirus case spike close to previous year’s autumn high

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(Natural News) The spike in new Wuhan coronavirus infections recorded in Michigan over the spring is similar to a spike seen during the 2020 fall season. According to a Wall Street Journal analysis, the state’s daily coronavirus case count averaged more than 7,000 for almost two weeks – before taking a slight dip to 6,891 on April 20. This echoed similar figures back in November and December 2020, which saw sharp rises in infections for those two months before plunging.

Back in autumn of last year, Michigan averaged more than 7,000 cases per day for a span of 10 days. New infections dropped slightly, then briefly spiked as the December holidays approached. It then fell to the low 1,000s for the succeeding two months – until ascending again in March.

According to University of Michigan internal medicine professor Dr. Vikas Parekh, the sudden increase in new infections could be attributed to several factors. Among the factors he cited was re-openings, which increased people’s interactions and mobility. Parekh said the loosened restrictions contributed to the spread of the highly contagious U.K. B117 variant.

“As the B117 variant spreads nationally, we will likely see other stats [with] their own surges – although I hope none are as bad as Michigan,” the professor remarked. He continued: “The milestone just tells us we are not yet in the clear, especially as we still have large portions of our population who are not vaccinated yet.”

Parekh also expressed optimism over the lower daily caseloads the Great Lakes State reported. He said he believes both cases and hospitalizations have plateaued and will likely decline soon. The professor commented: “[COVID-19] positivity has been declining now for one week, which is usually a leading indicator of case decline.”

Meanwhile, the state cited younger populations and youth sports, such as basketball, wrestling and hockey, to increase new COVID-19 infections. Because of this, Gov. Gretchen Whitmer called to suspend youth sports and indoor dining in the state. She also exhorted high schools to conduct remote class sessions for two weeks to curb the spread of the pathogen.

Michigan still experienced the spike in cases despite having one of the highest vaccination rates in the country

During the opening stages of the U.S.’s immunization drive against COVID-19, Michigan boasted of having one of the highest vaccination rates nationwide. A report by Bridge Michigan even noted the initial “frenzy for vaccines” that “far exceeded the state’s limited supply.” But things have appeared to turn around for Michigan, as it now struggles to reach the 70 percent vaccination rate needed for herd immunity.

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Scottish mom’s legs turn into a pair of “giant blisters” after first dose of AstraZeneca’s coronavirus vaccine

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(Natural News) Sarah Beuckmann of Glasgow, Scotland, felt a tingling sensation in her legs and noticed a rash flaring up around her ankles a week after getting her first dose of AstraZeneca’s coronavirus (COVID-19) vaccine on March 18.

She also had flu-like symptoms right after the vaccination.

Beuckmann called her doctor to arrange an appointment the morning she noticed the rash, but by the afternoon her skin was already breaking out into blood-filled blisters. Blisters also appeared on her legs, hands, face, arms and bottom.

“I ended up asking my husband to take me to A&E,” said Beuckmann, referring to “accident and emergency,” the equivalent of an emergency room (ER). “When I got there, my heart rate was sitting at 160bpm, which they were very concerned about. I got put on an ECG machine.”

Doctors determine AstraZeneca’s COVID-19 vaccine triggers the rash

Medics carried out tests for HIV, herpes and other skin conditions to work out what triggered the rash, but all results came back negative. Doctors finally determined that the vaccine caused her rare reaction after carrying out two biopsies.

“Once they found that it was a reaction to the vaccine, they put me on steroids and that really seems to be helping my progress,” said Beuckmann. She had been advised by her doctor not to get the second dose of AstraZeneca’s COVID-19 vaccine because of her reaction.

Beuckmann spent 16 days at Queen Elizabeth University Hospital. She was discharged to recover at home. The 34-year-old mother of one is currently wheelchair-bound due to the bandages on her legs and blisters on the soles of her feet. She may need physiotherapy to help strengthen her leg muscles.

“They are starting to heal and they’re looking a lot better than they were but as the blisters started to get worse, they all sort of merged together,” she said. “I didn’t know what was going on.”

With the blisters merging, her legs have looked like a pair of “giant blisters.” Beuckmann admitted that at one point she feared her legs might have to be amputated.

Dermatologist agrees COVID-19 vaccine causes the blisters

Dr. Emma Wedgeworth, a consultant dermatologist and spokeswoman at the British Skin Foundation, agreed that Beuckmann had likely suffered a reaction to the vaccine.

“Vaccines are designed to activate the immune system. Occasionally people will have quite dramatic activation of their immune systems which, as happened in this case, can manifest in their skin” Wedgeworth told MailOnline. “This poor lady had a very severe reaction, which thankfully is extremely rare.”

It is not clear why Beuckmann, who works in retail, was invited for a vaccine. Scotland’s vaccine rollout was focused on people over the age of 50 when she got vaccinated, although vaccines are available to those who are considered at risk from the virus, or live with someone considered vulnerable.

At least 20 million Briton have had AstraZeneca’s COVID-19 vaccine, which drug regulators say causes a rash in one percent of cases. They say rashes caused by the jab tend to go away within a week.

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Trojan labs? Chinese biotech company offers to build COVID testing labs in six states

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In 2012, BGI acquired Complete Genomics, a DNA sequencing company and equipment maker. The funds for the $117.6 million purchase were raised from Chinese venture capitals. The company has expanded its footprint globally. According to its website, BGI conducts business in more than 100 countries and areas and has 11 offices and labs in the U.S.

People are concerned about China’s access to American DNA data

Some said that with Complete Genomics providing an American base, BGI would have access to more DNA samples from Americans, helping it compile a huge database of genetic information. Some also worried about the protection of the genetic information’s privacy.

According to a 2019 report from the U.S.–China Economic and Security Review Commission (USCC), BGI “has formed numerous partnerships with U.S. healthcare providers and research organizations to provide large-scale genetic sequencing to support medical research efforts,”

There are three main reasons why many people in the biotech community and government have expressed concerns about China’s access to American DNA data.

In the “60 Minutes” interview, Evanina discussed the very likely scenario in which Chinese companies would be able to micro-target American individuals and offer customized preventative solutions based on their DNA.

Evanina asked: “Do we want to have another nation systematically eliminate our healthcare services? Are we okay with that as a nation?”

The second concern is that China may use DNA to track and attack American individuals. As the USCC report states: “China could target vulnerabilities in specific individuals brought to light by genomic data or health records. Individuals targeted in such attacks would likely be strategically identified persons, such as diplomats, politicians, high-ranking federal officials or military leadership.”

The third concern is that China may devise bioweapons to target non-Asians. Steven Mosher, president of the Population Research Institute, discussed it in his article “What Will China Do With Your DNA?” published by The Epoch Times in March 2019.

He wrote: “We know that the Asian genome is genetically distinct from the Caucasian and African in many ways. … Would it be possible to bioengineer a very virulent version of, say, smallpox, that was easily transmitted, fatal to other races, but to which the Chinese enjoyed a natural immunity? … Given our present ability to manipulate genomes, if such a bio-weapon can be imagined, it can probably – given enough time and resources – be realized.”

An article from Technocracy said: “China’s aggressive collection of American DNA should be doubly alarming because it can only spell one ultimate outcome: biowarfare. That is, genetically engineering viruses or other diseases that will be selectively harmful to U.S. populations.”

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