CEDARS-SINAI NEWS | LIFE | HEALTH
How to take care of a loved one— and yourself P. 4
THE RIGHT GAINS A patient’s passion for running helped her shed 50 pounds—and inspired others to make healthier choices, including her doctor P. 6
SPRING 2022
A Tarzana oncologist practices art and science through coffee roasting P. 12
Getting back to your doctor’s office P. 16
EDITOR IN CHIEF
Laura Grunberger SENIOR EDITOR
Sarah Spivack LaRosa ASSOCIATE EDITORS
Cassie Tomlin Nicole Levine
PROJECT MANAGER
Karen Link DESIGN
DISTINC_ CONTRIBUTORS
Victoria Pelham Rosanna Turner
EXECUTIVE VICE PRESIDENT, CEDARS-SINAI MEDICAL NETWORK
John E. Jenrette, MD
VICE PRESIDENT, STRATEGIC INTEGRATION, CEDARS-SINAI MEDICAL NETWORK
Mary Clare Linge
EXECUTIVE DIRECTOR, BRAND STRATEGY AND CREATIVE SERVICES
Jennifer Fagen
cedars-sinai.org/csmagazine Cedars-Sinai is published three times a year. TO UNSUBSCRIBE please go to giving.cedars-sinai.org/unsubscribe Provide the code that appears above your name, your full name as listed on the mailing, your mailing address, email, title of piece received and request type (unsubscribe from all Cedars-Sinai mailings or only Cedars-Sinai). MAIL
Senior Editor 8700 Beverly Blvd., Suite 2416 Los Angeles, CA 90048 EMAIL groupeditorial@cshs.org ©2022 by Cedars-Sinai. All rights reserved. Reproduction or use in whole or in part without written permission is prohibited. This publication is for informational purposes only and should not be relied upon as medical advice. It has not been designed to replace a physician’s medical assessment and medical judgment. Always consult first with your physician regarding anything related to your personal health. Cedars-Sinai does not discriminate against any person on the basis of race, color, national origin, disability, age or sex in admission, treatment or participation in its programs, services and activities, or in employment. For further information about this policy, contact the public civil rights coordinator at 310-423-7972.
CEDARS-SINAI NEWS | LIFE | HEALTH
SPRING 2022
HERE & NOW
12 THE PERFECT BLEND
An oncologist practices art and science through coffee roasting
2 NEWS FEED
Stories from the Cedars-Sinai landscape
4 PREPARE & PREVENT
TAKING CARE
How to manage caregiver stress before you hit a breaking point
6 LIFE & HEALTH
THE RIGHT GAINS
A patient’s passion for running helped her shed 50 pounds—and inspired others to make healthier choices, including her doctor
14 AT-AGLANCE
Removing taboos around testicle health, getting back to your doctor’s office, community engagement and more
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NEWS FEED
STORIES FROM THE CEDARS-SINAI LANDSCAPE
DOWNTOWN L.A.
Cedars-Sinai teamed up with Angel City Football Club, a women’s soccer team, to be a sponsor at the American Cancer Society’s Making Strides Against Breast Cancer walk.
MID-CITY INGLEWOOD
Lung cancer survivor Di’Ann Smith (right) and her oncologist, Dr. Karen Reckamp, were honored at an L.A. Rams game at SoFi Stadium for Lung Cancer Awareness Month last November. Cedars-Sinai is the official health partner of the L.A. Rams and SoFi Stadium.
Second graders at 6th Avenue Elementary School got moving during a Cedars-Sinai Healthy Habits lesson. In partnership with Los Angeles Unified School District, Healthy Habits educators lead kids in fun, interactive classroom activities that teach the importance of physical activity and a healthy diet.
WEST HOLLYWOOD
Moxi robots help Cedars-Sinai nurses carry supplies, medicine and linens—and can even travel to the gift shop to pick up items for patients.
MARINA DEL REY
The new Cedars-Sinai Marina del Rey Hospital, which will be completed in 2026, will include additional private patient and procedure rooms, state-of-the-art operating rooms and labs, procedure suites to handle complex cases, an emergency department with expanded capabilities, and beautiful outdoor space for patients and visitors (artist’s rendering below).
MANHATTAN BEACH
Employees at Torrance Memorial Medical Center, a Cedars-Sinai affiliate, coping with job-related emotional stress took surf-therapy sessions provided by the Jimmy Miller Memorial Foundation. 2
CEDARS-SINAI — SPRING 2022
WEST HOLLYWOOD
As of December 2021, Cedars-Sinai had administered COVID-19 vaccines to more than 100,000 patients. Make an appointment at Cedars-Sinai’s free drive-through vaccination clinic by visiting myturn.ca.gov.
MOUNT EVEREST
David Johnson, a Cedars-Sinai imaging transporter, recently trekked to Mount Everest Base Camp.
PASADENA
When Lily Huang was 6 years old and being treated at Huntington Hospital for an injury, a brightly colored donated blanket lifted her spirits. Lily, now 12, recently paid it forward by knitting a colorful blanket to comfort another pediatric patient. Huntington Hospital, now a Cedars-Sinai affiliate, has hospitalbased pediatricians available 24 hours a day to provide kids the care they need, when they need it.
MELROSE HILL
SILVER LAKE
Lauren Bratman was trying to become pregnant— then she was diagnosed with breast cancer. Her team at Cedars-Sinai Cancer and Dr. Erica Wang, a reproductive endocrinologist at the Cedars-Sinai Fertility and Reproductive Medicine Center, helped her protect her fertility. She and her husband, Anthony, welcomed baby Gio in November 2019.
After a leukemia diagnosis and a bone-marrow transplant, Cathy Griffin is grateful to be back to walking with her dog, Marcel. “The miracles just kept coming,” she says. “I know how blessed I am that I got this donor, this perfect match.” FOLLOW US @CEDARSSINAI cedars-sinai.org/csmagazine
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PREPARE & PREVENT
TAKING CARE OF A LOVED ONE —AND YOURSELF
by Victoria Pelham illustration by Caitlin Cordtz
LOOK OUT FOR BURNOUT Being there for a loved one in need can be rewarding. But when the demands of caregiving start to outweigh its positive aspects, the caregiver is at risk of burnout—and likely needs support.
MISSING MOTIVATION “Lack of sleep and appetite, losing weight, an unclean house, irritability, not being as vocal about the care of the patient—these are tipoffs that something is going on.” AL TSANG, MD, Internist, Cedars-Sinai Internal Medicine—Tarzana
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CEDARS-SINAI — SPRING 2022
CRIES FOR HELP “Caregivers of patients who have dementia-related behaviors such as agitation, aggression or disinhibition are at high risk of burnout and should seek support from their healthcare providers.” ALLISON M. MAYS, MD, Geriatrician, Cedars-Sinai Geriatrics Program
“You’re doing something really challenging— but also really meaningful.” — Allison M. Mays, MD
Caregivers often, understandably, put their loved ones first, but ignoring your own physical and mental health needs is risky. Cedars-Sinai providers explain why and how to manage caregiver stress before you hit a breaking point.
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hen primary care physician Al Tsang, MD, treats a chronically ill or senior patient who is being cared for by a loved one, he keeps an eye out for certain signs. Has the patient been falling, or not eating well, for example? In these cases, the patient’s health remains the first priority— but their caregiver’s health is also front of mind. In 2020, more than one in five adults—some 53 million people—were unpaid family caregivers, according to the American Association of Retired Persons (AARP). Charged with taking care of relatives in recovery from health crises or with conditions such as Alzheimer’s disease or cancer, they work long hours, sometimes on top of full-time jobs. It’s a commitment that can be all-encompassing and draining, and usually doesn’t have a clear end in sight. Often, asking the caregiver direct questions will open the floodgates— they may break down crying, admitting that they are struggling to keep up with the strain. The associated stress can take a toll on family members’ minds and bodies, leading to high rates of depression, poor sleep, increased risk for chronic diseases and vulnerability to infections, according to caregiver advocates. Nearly one-quarter of caregivers in 2020 reported that their own health had worsened as a result of their role. “Often, it’s hard to reach out to the person caring for the patient, because they think, ‘Why should I complain? My loved one is sick,’” says Tsang, an internist at Cedars-Sinai’s Tarzana medical offices. But over time, unchecked stress can give way to burnout, ultimately harming both patient and caregiver— unless someone recognizes the problem and takes steps to remedy it.
EDUCATION IS VITAL
Many people become caregivers with little or no preparation, so they’re afraid of making a mistake and accidentally hurting the patient. “There’s this idea that someone should just automatically know what to do, but there really is a skill set for caring for someone who has complex medical needs or problems with memory and thinking,” Mays says. A patient’s care plan typically includes juggling various doctor’s appointments and medications, at-home health screenings and assistance with daily living activities. In fact, 26% of family caregivers report difficulties coordinating care. Learning more about a loved one’s specific condition and related tasks can enable caregivers to better understand the patient—and help manage expectations. Chronic illness and aging are unpredictable processes, and patients can take a turn for the worse, regardless of the quality of care. “Sometimes, we get thrown a curveball,” Tsang says. TAKE BREAKS WHEN YOU CAN
While feelings of guilt and responsibility frequently overshadow caregivers, they deserve relief, Tsang says. That’s especially true when caretaking wears on for several years. “There is a desperate need for more support for people in this position,” Mays says. Regularly enlisting the help of other family members can give caregivers precious time to themselves, as can using professional adult daycare centers for short stays. YOU MATTER, TOO
RELEASE EMOTIONS
Caregivers navigate the emotions of a loved one’s illness alongside their own complicated feelings. There is also often the issue of “role strain,” says Allison M. Mays, MD, a geriatrician in the Cedars-Sinai Geriatrics Program. Someone looking after a spouse or aging parent can experience tension as their relationship dynamic changes. At a time when it is easy to become socially isolated, caregivers need an emotional outlet more than ever. Support groups, such as those offered by Alzheimer’s Los Angeles, can help caregivers connect with others sharing similar experiences. Providers also encourage caregivers to seek a therapist or other mental health professional who can guide them through common symptoms of stress, including anxiety, depression, exhaustion, helplessness, irritability and frustration.
Nearly three-quarters of caregivers report not visiting the doctor as often as they should, with more than half skipping appointments, according to the Family Caregiver Alliance. Providers caution caregivers not to neglect their own health and urge them to keep in touch with their doctors. At home, self-care is key: eating a nourishing diet, exercising and aiming for seven to eight hours of sleep. Using tools such as journaling or mindfulness can also help caregivers de-stress. And caregivers shouldn’t be shy about giving themselves credit. “You’re doing something really challenging—but also really meaningful, important and special for your loved one,” Mays says.
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LIFE & HEALTH
THE
RIGHT
GAINS
Caren Esmaeilzadeh is more interested in all that she gained— happier mood, more confidence and more energy—than the 50 pounds she lost. Her passion for running inspired others in her life to make healthier choices, including her doctor.
by Nicole Levine photos by Diana Feil
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CEDARS-SINAI — SPRING 2022
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W
hen Caren Esmaeilzadeh talks about dropping 50 pounds, she rarely mentions what she lost in ounces, dress sizes or inches. Instead, she emphasizes what she has gained: focus, mental clarity, more energy, better relationships, self-respect and improved health. “I had accepted my body and all the changes brought about by my three pregnancies,” Esmaeilzadeh says. “It’s not about wanting to look good in a dress. It’s self-care—and that doesn’t just mean makeup and manicures. It’s doing better for myself so that who I am on the outside matches who I am on the inside.” Three years ago, Esmaeilzadeh, 44, returned from a vacation with her husband at an all-inclusive resort. The hardworking mom of three rarely took much time to focus on herself, giving most of her energy to her family, so she appreciated the break. After days spent soaking in the sunshine, luxuriating in the surf and enjoying lush buffets and free-flowing beverages, she expected to feel great. “When the plane landed, I felt so yucky,” she says. “I had so much inflammation, and I just felt tired.” A less relaxing trip to her longtime primary care physician, Violette Gray, MD, confirmed her worst fears: high blood pressure, prediabetes and the heaviest weight of her life. Gray encouraged her to change, giving her helpful advice and six months to improve her numbers. Otherwise, medications would be the most prudent route for protecting Esmaeilzadeh from stroke, diabetes and other risks. 8
CEDARS-SINAI — SPRING 2022
Those two trips started a journey of many small steps for Esmaeilzadeh. Bit by bit, she changed her life and inspired others—even her doctor—to do the same. WALKING THE WALK
According to the Centers for Disease Control and Prevention, more than 42% of American adults are obese. It’s a complex health issue influenced by many factors, including income and access to healthcare. Esmaeilzadeh’s weight gain became an issue when she started having children 17 years ago, and her weight increase was a topic of discussion during her regular checkups with Gray. Esmaeilzadeh had tried many diets and weight-loss plans. With glowing skin, glossy chestnut hair, a playful and fashion-forward sense of style, she embraced her body at any size. She still tried to lose weight, but often found herself turning to food for comfort and stress-relief. “I would read books, join groups and try so hard to do what other people did, but it never worked for me,” she says. “I thought it was too difficult to even wrap my head around it.” To help guide her, Gray suggested foods that Esmaeilzadeh could eliminate. She recommended intermittent fasting, which meant eating only during certain hours of the day. “I was overwhelmed and felt like I was going to be drinking water and breathing air, and that would be it,”
Esmaeilzadeh says. “But I didn’t want to have to take the medication.” She tried limiting her eating to the hours between 10 a.m. and 6 p.m. However, during those hours, she found herself turning to food for comfort or mindlessly eating. She lost about 10 pounds but didn’t think it would be enough to make a difference. The six-month deadline approached, and she delayed her appointment. Then, the COVID-19 pandemic hit. The claustrophobic conditions of quarantine, with kids learning from home and parents working from home, frequently sent Esmaeilzadeh outside for some mindclearing fresh air. A walk around the block became a push to walk 30 minutes at a time. “I was just doing this to decrease my anxiety and be a better mom,” she says. “The more I walked, the less anxious I felt. I also found I didn’t want to eat as much.” Soon, she headed to Santa Monica to walk on the beach. She started alternating walking and running. Intervals of running stretched into a mile, then 2 miles. Soon she was running 8 miles regularly. A DAILY PRIORITY
Just as her running picked up, Esmaeilzadeh lost a dear friend to COVID-19. They’d talked about running together but never had the chance. “I was so deeply devastated,” she says. “The only time I felt like I could go on without my friend was when I was running. Even though I lost my friend, our friendship was essential to my progress.”
MEASURABLE GOALS Letting go of the idea of a perfect weight and focusing on healthier habits can be an effective path to weight loss, Gray says. “You don’t have to get down to a ‘Hollywood’ weight to reap the rewards of exercise and cleaner eating,” she says. Start with one minute. Esmaeilzadeh is training for a marathon, but she started with a walk around the block. Walking in place for just one minute is also a reasonable starting goal. Add one serving at a time. Rather than adjusting all your eating habits at once, begin with one thing, like adding a serving of vegetables every day. Shoot for 10%. Losing 10% of your body weight is often adequate to decrease blood pressure, improve blood sugar levels and increase overall health. Focus on feelings. Happier mood, less anxiety, more energy and increased confidence motivated Esmaeilzadeh to reach for her running shoes in a way the scale never did. Have fun. Exercise isn’t punishment, Gray says. Bring a friend, window shop while you walk, listen to your favorite music. If it’s fun, you’ll keep doing it.
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Running became a necessary outlet for her at least five times a week. At first, her new routine was a tough adjustment for her family. Her two teenagers would call her constantly during her workouts. Resisting the impulse to give in to them, she addressed their issues on the phone or told them it could wait until she returned home. “For the first time, I made myself a priority,” she says. “The more I ran, the more stamina I had. I started to miss it on days I couldn’t go.” AN INSPIRATION TO OTHERS
Several months into her running regimen, Esmaeilzadeh returned to Gray for a follow-up appointment. “When she walked into the exam room,” Esmaeilzadeh says, “I could see the shock on her face and in her eyes, and she literally started to tear up. It wasn’t until then that I realized what a big change I’d made.” She had lost about 30 pounds. Her blood pressure was in the healthy range and signs of prediabetes had vanished from her blood work. Esmaeilzadeh’s running habit and weight loss impressed Gray—and so did her obvious happiness. “I spend a lot of time talking to my patients about diet and exercise, but obviously, I struggle with my own health and habits just like everyone else,” Gray says. “I’ve never been an athlete.” Newly inspired, Gray made a 7 a.m. appointment with herself to walk with her German shepherd, Lady, four
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CEDARS-SINAI — SPRING 2022
“
I had accepted my body and all the changes brought about by my three pregnancies. It wasn’t about wanting to look good in a dress. It’s self-care—and that doesn’t just mean makeup and manicures. It’s doing better for myself so that who I am on the outside matches who I am on the inside.
”
— Caren Esmaeilzadeh
times per week. She’s gradually increased the intensity of their daily activity, and now they jog more than 3 miles together. “Caren really inspired me to do this,” she says. “She started out like me, and now she’s training for a marathon.” Esmaeilzadeh’s most memorable race so far was with her children. Her husband, Kasha, stayed with their youngest daughter, Kylie, 10, while she headed down to the beach with Sophie, 17, and Evan, 15. They started out jogging together on the sand, and Evan was the fastest at first. But a mile or so in, the teenagers were unable to keep up with their mom. “I know I gained a few points in their eyes,” she says. Kasha started running with her, too. The family recently took another vacation together. This time they went to Hawaii. Instead of luaus, their plans revolved around outdoor adventuring. They hiked Diamond Head, a trail circling a 300,000-year-old crater with breathtaking views of the Pacific Ocean. “I can’t believe that when I get ready for vacation the first thing I pack is my running shoes,” she says. “This is my life now. The motivation is showing my children that we need to really love who we are. The motivation is to be a better mom, better wife and better friend. I like that. I like that very much.”
VIOLETTE GRAY, MD Doctors influence their patients—and patients do the same for their doctors, says Violette Gray, MD. “They inspire us, and they’re such a big part of our lives,” she says. Gray graduated from the Keck School of Medicine of USC, where she also completed her internship and residency, and then went on to a primary care fellowship at Cedars-Sinai. She’s been a primary care physician for more than 16 years. She has some patients who have been seeing her since the beginning of her career—Esmaeilzadeh among them. “I chose primary care because I wanted to connect with people and make a difference in their lives in a meaningful way,” Gray says. “It’s really exceeded my expectations.” She is one of the leaders of Cedars-Sinai’s primary care transformation effort, working with other physicians to improve patient experiences and outcomes.
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HERE & NOW
THE PERFECT BLEND A Tarzana oncologist practices art and science through coffee roasting.
by Cassie Tomlin photos by Bill Pollard 12
CEDARS-SINAI — SPRING 2022
R
yan Ponec, MD, is not a coffee snob. “After training in medicine, I learned to take any coffee I can get,” says the newest physician at Cedars-Sinai Cancer in Tarzana. Even so, Ponec does make a ritual of his morning pour-over—starting one step before most of us. During medical school, he taught himself to roast coffee, first in a cast-iron skillet that scorched many beans beyond recognition before graduating to more sophisticated machinery. Today, in his Sherman Oaks kitchen outfitted with a human-height stack of cookbooks and an unmentionable number of coffee-making tools, he roasts small batches of raw, green beans in a machine that looks like a little microwave. For about 10 minutes, the beans fill the house with a baked-cookie smell, announcing they’re nearly done with the “first crack,” when they expand and split open. Soon after, Ponec lets them cool and rest for a few days before they’re ready to grind and decant into an hourglass-shaped coffee maker. The home roast is an inexpensive luxury that appeals to Ponec’s defining scientific curiosity. “There are so many different compounds in coffee beans—the roasting changes the chemical structure and brings out the sweetness and aromas,” he says. “You can experiment with temperature and speed. When you get it right, you can taste blueberries or other notes.” There’s an art to the science—and that’s the approach Ponec takes to medicine, too. All patients need precise, thoughtful and attentive care, whether they’re dealing with a manageable condition such as anemia or confronting complex metastatic cancer. Ponec’s first step, after a solid diagnosis, is to work with a patient and their family to decide the best treatment. “No matter a person’s diagnosis, we talk through options and what to expect,” he says. “It doesn’t matter how straightforward the treatment can seem for us, for the patient and their family, it’s always a new, huge, life-altering thing.” Most importantly, Ponec says, he encourages patients to keep in close touch about their questions or concerns, an openness that extends to the entire care team at Cedars-Sinai Cancer in Tarzana. Ponec frequently collaborates with his colleagues—nurses, surgeons and specialists who work in the same building—to share perspectives about different approaches, or news about clinical trials that could benefit some patients. “It’s really important for us to build close relationships—everyone in the office ends up knowing the patient,” he says. “When a case is very complicated and needs multiple insights, everyone works together to consider the best treatment for the individual.”
Treatments are getting better and more targeted. Embracing new and emerging therapies has been a foundation of Ponec’s work since his early training in molecular and cellular biology, analyzing the tiny, unseen mechanisms that drive disease. He pays close attention to advances in medications that can better attack certain cancers, such as lung cancer and melanoma. “Because cancer research is so strong, the standard of care is constantly changing,” he says. “Many cancers are still difficult to treat, but we can prescribe so many treatments that target cancer at the most specific level, even for people in more advanced stages.” The intensity of managing cancer care can weigh on physicians, who need to stay engaged and dedicated to every patient. To recharge, Ponec and his husband, Daniel, an attorney, cook dinner most nights of the week—Mediterranean, Thai and Indian meals are favorites. They save more involved dinners, which can become “projects,” for weekends, when Ponec also bakes bread and cookies to share (the couple made their wedding cake: a chocolate chip layer cake with passion fruit curd and coffee icing). They also stay active with weekend hikes around the Valley and beyond with their rescue dog, Melvin. Ponec also has fun trying new beans, learning to tease out their best qualities to make authentic, personalized, well-considered roasts.
DR. PONEC’S TIPS FOR GREAT COFFEE AT HOME It doesn’t take too much ambition to be your own barista. Whether you’re roasting your own coffee like Ponec does or just want to get the best from store-bought beans, follow these tips. RECENT ROAST Flavors in coffee can degrade quickly, so use beans that were roasted recently—buy beans at a local coffee shop. RIGHT RATIO Experiment with the proportion of beans to water to get the right strength. Ponec uses about 1:17 beans to water by weight for black coffee. If you add milk or cream, consider a stronger brew. RISE AND GRIND Wait to grind your coffee until immediately before you brew—crushing the beans releases their flavors, but oxygen depletes them.
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COMMUNITY ENGAGEMENT
Real-Life Health Solutions
Wellbeing isn’t only dictated by genes or habits. A growing body of data directly links a person’s health to their life challenges—such as struggles related to housing, food, finances, transportation, substance use and mental illness. Researchers refer to these types of challenges as “social determinants of health.” A 2015 study concluded that only 20% of health outcomes are attributable to medical care, while 80% are driven by social influences. Cedars-Sinai is addressing these real-life risk factors through the new Community Connect Program, which aims to screen all patients for social determinants of health. Care teams can then refer patients experiencing health-related social needs to community support services. Particularly vulnerable patients are paired with community health workers who provide one-onone assistance. Cedars-Sinai has also launched CS Community Resource, a database accessible to patients and the public that locates free or reducedcost support services.
89,513
BY THE NUMBERS
patients screened for social determinants of health
5,000+ social service organizations throughout Greater L.A. listed on CS Community Resource
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580+
social service organizations to which the Community Connect team can refer patients in need
social factors considered in screenings
1:1
ratio of community health workers to vulnerable patients who need individualized assistance 14
CEDARS-SINAI — SPRING 2022
AT-A-GLANCE
Testicular Health: Overcoming the Taboo Some men might not know their risk of testicular cancer or even feel comfortable talking about the health of their testicles. “Testicle health, and male sex organs in general, can seem like a taboo topic for some,” says Ariel Moradzadeh, MD, urologist at Cedars-Sinai. “Removing this taboo is key to raising men’s awareness of testicular cancer.” Testicular cancer is the most common type of cancer for men between the ages of 15 and 35. Here are the main things to know.
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EN SHOULD DO A TESTICULAR SELF-EXAM M EVERY MONTH
I t’s best to do a testicular self-exam during a shower or warm bath, when the scrotum is more relaxed. Cup one testicle at a time with both hands, then roll the testicle between the thumbs and fingers, feeling for any lumps, changes in size or irregularities. “It’s not hard to detect an abnormality,” Moradzadeh says. “The testicle should feel smooth between the fingers, like a hard-boiled egg without the shell.”
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YOUNGER MEN ARE MORE LIKELY TO DIE OF TESTICULAR CANCER
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REMOVING A TESTICLE DOES NOT GUARANTEE A CANCER-FREE FUTURE
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MEN WHO ARE YOUNG, HEALTHY AND “FEEL FINE” ARE STILL AT RISK
The average age of a testicular cancer diagnosis is 33. Younger men also tend to develop more aggressive subtypes of testicular cancer, which may contribute to a higher mortality rate. “Younger men are in their prime age for fertility,” Moradzadeh says. “Sperm-producing cells in younger men are constantly having cell turnover, which may be the reason why testicular cancer tends to occur in younger men.”
For men who are diagnosed with testicular cancer and have a testicle removed, it’s important to continue follow-up care to ensure early detection of any new cancers. “Men can get testicular cancer in the other, unaffected testicle later on, so having one testicle removed doesn’t mean they’re out of the woods,” Moradzadeh says.
Younger men often think they’re healthy if they feel fine and can go to the gym and participate in other regular activities. This attitude can be a deterrent to seeking care. “If you do a self-exam and feel an abnormality, or are concerned about your risk of testicular cancer, don’t live in a state of denial,” Moradzadeh says. “Definitely seek medical advice from a healthcare provider.”
Research Roundup THE MYSTERIES OF COVID-19 IMMUNITY Most everyone should feel confident that their COVID-19 shots keep them safe from serious infection. But person to person, immunity is still a bit of a mystery: Who produces the strongest post-vaccine antibodies? Who stays protected the longest—and what can this reveal about a person’s overall current and future health? Cedars-Sinai investigators are leading an ambitious five-year study that seeks to better define how and why people may respond differently to COVID-19 vaccines. Ultimately, they hope to understand how factors such as age, gender and preexisting conditions influence immune response. Results could inform public health efforts to curb the spread of the virus that causes COVID-19 and improve long-term health across the population. COVID-19 AND IBD When vaccines first became available for COVID-19, 70% of people with inflammatory bowel disease (IBD) expressed concerns about side effects. Crohn’s disease, ulcerative colitis and other forms of IBD are chronic conditions that occur when the intestinal immune system becomes overreactive, causing chronic diarrhea and other digestive symptoms. Because immune system malfunction is one possible cause of IBD, patients also worried that vaccines might not produce a sufficient immune response to protect them against the virus that causes COVID-19. But recent Cedars-Sinai research should ease their minds—and digestive systems. A study revealed that IBD patients were at no risk of increased side effects from the PfizerBioNTech or Moderna COVID-19 vaccines. Additionally more than 90% of IBD patients produced antibodies in response to those two vaccines. HEART ASSIST FOR OLDER PATIENTS Patients unable to undergo heart transplantation sometimes receive mechanical left ventricular assist devices (LVADs) to get the blood flowing properly—and otherwise healthy patients over age 75 should be provided the option more often. Fear of complications such as stroke, bleeding and infection has made some physicians wary of suggesting LVADs for elderly patients. But it’s time to reevaluate who might benefit from the devices, and for many patients with advanced heart failure, newer-generation LVADs are transformational, according to Cedars-Sinai research. These LVADs are smaller than older models—half the size of a fist, rather than the previous dinner-plate dimensions—and use new technology to reduce blood clots and infection. Patients older than 75 even experienced fewer LVAD-related complications than their younger counterparts.
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AT-A-GLANCE
Getting Back Into Care
Healthcare visits plummeted as the COVID-19 pandemic added layers of disruption and fear to many aspects of normal life. More than 40% of American adults have avoided or delayed medical care during the pandemic, according to a Centers for Disease Control and Prevention survey. If you’ve stayed away from the doctor’s office, getting back on top of your health might seem daunting, but it doesn’t have to be, says primary care provider Michelle Shukhman, DO. DON’T WAIT ANY LONGER Postponing care raises the possibility of missed cancer diagnoses, mistaken self-diagnoses and preventable illnesses. START WITH YOUR PRIMARY CARE PROVIDER A primary care provider can give you a physical exam and evaluation, refer you to specialists, address unusual symptoms and provide important immunizations and screenings. “There’s even more urgency for people who have chronic illnesses and are taking medications to make sure the medications we’re prescribing are still safe for them to take,” Shukhman says. TAKE CARE OF SCREENINGS RIGHT AWAY A survey from the Prevent Cancer Foundation found that 35% of American adults missed scheduled cancer screenings during the pandemic. My CS-Link and most health portals offer a timetable of recommended health exams as well as automatic reminders for patients. CONSIDER VIDEO VISITS If you need a health assessment on demand, CedarsSinai offers existing patients a Video Visit Now service. Patients can access virtual visits with a healthcare provider in lieu of in-person urgent care. “Online options like video visits might make it easier to get questions answered quickly,” Shukhman says.
Cedars-Sinai offers video visits with individual providers as well as the Video Visit Now service for urgent virtual health assessments. Ask your doctor about your options, or visit www.cedars-sinai.org/virtual-care.
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THERE’S NO REASON TO FEAR If you’ve avoided the doctor, an evaluation might cause you some anxiety. Remember that your doctor is here to help. “It’s just so important to come in, face what’s going on and get back on track,” Shukhman says.
VISIT OUR DOCTORS CASSRA ARBABI, MD VASCULAR SURGERY
MIA MILLER, MD EAR, NOSE AND THROAT
MICHELLE CHEN, MD HEAD AND NECK SURGERY
LISA MOORE, MD ENDOCRINOLOGY
EDWARD CHO, MD EAR, NOSE AND THROAT
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MICHAEL GALABI, PHARMD, MD INTERNAL MEDICINE
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99 N. La Cienega Blvd., Suite 307 Beverly Hills, CA 90211 310-423-7040
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8767 Wilshire Blvd., 3rd Floor 99 N. La Cienega Blvd., Beverly Hills, CA 90211 Suite M-102 310-385-6064 Beverly Hills, CA 90211 310-385-2992 ALLISON MAYS, MD p.4 GERIATRICS RYAN PONEC, MD p.12 8501 Wilshire Blvd., Suite 100 ONCOLOGY Beverly Hills, CA 90211 18133 Ventura Blvd., Suite 300 310-385-3511 Tarzana, CA 91356 818-981-3818
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