Thursday, October 15, 2015

Kaplan Health & Wellness Degrees Matter!

Byline: The Emperor of all Maladies
Author: Dorette Nysewander, EdD, “DrD”

October is widely known for breast cancer awareness month, right! Have you had a friend, colleague or family member affected by this disease? Are you wearing your pink ribbon? Even the National Football League shows support of breast cancer awareness month by wearing their strength in pink! Many individuals are aware of the campaign but do we really know cancer?

As a part of our curriculums Kaplan Health & Wellness Professors present the teachings on cancer: awareness, prevention, treatment as well as share with students the successes of this disease through prevention, science, technology and medicine. What we all have discovered is many of our teachings reside in the practice and knowledge from thousands of years ago.

Inova Hospital in Fairfax, Virginia hosted a well-known author Siddhartha Mukherjee the Winner of the Pulitzer Prize for his work, The Emperor of all Maladies, a biography of cancer. This is a must read! To understand the present, where we are in the war on cancer today is to understand its history. What happened, who was effected, how researchers determined carcinogens, treatment approaches and most important what was learned!

After having the opportunity to read his book and hear Dr. Mukherjee’s presentation I was able to put into context the brilliancy of his work. In an attempt to paraphrase his writing the next few lines provides all of us the opportunity to understand breast cancer and cancer treatments from 500 B.C. to current day and for the future. He describes for us Atossa, the Persian Queen traveling through time and what she might have experienced in breast cancer care over four thousand years. Atossa:

×        In 500 B. C. self-prescribes the most primitive form of mastectomy performed by her Greek slave;

×        Two hundred years later, Hippocrates would identify her tumor as a karkinos—today carcinogens;

×        In AD 168, Galen would hypothesizes her condition—a universal cause, black bile trapped as a tumor;

×        Might have been offered procedures by Medieval surgeons coupled with frog’s blood, lead plates, goat dung, holy water, crab paste and caustic chemicals;

×        In 1778, at the John Hunter’s clinic in London, could have been assigned with a stage for her cancer with a recommended operation;

×        By the nineteenth century 1890 at the Halsted’s Baltimore clinic, would have received a radical mastectomy—the boldest and most definitive therapy thus far;

×        By the early twentieth century would have radiation oncologists try to obliterate the tumor locally using x-rays;

×        In the 1950s, would receive cancer treatments of a simple mastectomy followed by radiation;

×        By 1970s, would have surgery followed by chemotherapy to diminish the chance of a relapse; and if the tumor tested positive for an estrogen receptor, given tamoxifen to further prevent relapse;

×        In 1986; should it be discovered that her tumor was Her-2 amplified in addition to the treatments of the last 20 years she would be given Herceptin;

Ø  Though clinical trials do not always provide a direct comparison for medical advancements to date, life expectancy for Atossa could probably be between 17-30 years;

×        In the mid-1990s, would be tested for mutations of BRAC-1 or BRAC-2; her genome would be sequenced and if mutations were found this would lead to further female family members being tested; her daughters would receive treatment for the diagnosis and offered intensive screening, bi-lateral mastectomy or tamoxifen to prevent the development of invasive breast cancer;

×        By 2050, would be expected to arrive at her physician’s office with a thumb drive containing the entire sequence of her cancer’s genome identifying every mutation for each gene! Amazing…kind of star wars medicine, huh?…at which time the fight for life becomes a warfare of surgery, with targeted therapies switching up to combat identified cancer mutations.

Well okay! So, one would think that we are well on our way to being able to take care of breast cancer through prevention, treatment and the c-word, cure! It certainly is the thinking, but unfortunately we have not won the war as of yet. Here’s why?

Scientists through the genome project have sequenced 23,000 genes making it possible in research to document genetic changes relative to these normal genes. During Dr. Mukherjee’s presentation you gained a clear understanding that even though five individuals are diagnosed with the same cancer, their bodies’ respond with different mutations being expressed as hills and mountains [or levels of potency]. This leads us to better understand that cancer treatments need to become more personalized to the patient’s genome.

Today many cancer clinical trials are failing quicker with fewer patients in hopes of understanding how these mutations will react to medical therapies. In addition surgical treatments are becoming less invasive with faster healing rates. While the cancer war rages on in medicine and research, what can we all do?
Prevention and awareness! Understand your families’ genome history, stay current with the evidence-based recommendations, practice daily healthy lifestyle choices, and participate in the prevention of disease through appropriate screening and genetic tests.

They say that laughter is the best medicine! Listen the short interview by Colbert and Dr. Mukherjee. Enjoy!

To the future of health and wellness! More importantly to aspiring Kaplan students who will continue to make advancements in science and care—DrD, October 2016
Colbert Report. (2011). Emperor of all maladies: A biography of cancer. Retrieved from
Inova Hospital. (2015). Inova summit: Make it personal. Retrieved from


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