Media Coverage

Prostate cancer is back in the headlines after word that U.S. Defense Secretary Lloyd Austin was hospitalized with complications from prostate cancer surgery. Song Jiang, MD, PhD, urologic oncology expert at Northwestern Medicine Central DuPage Hospital, joined ABC 7 Chicago to provide insight on Secretary Lloyd Austin’s recent hospitalization. Jiang stated that the complication Secretary Austin may have experienced was a known possibility, though less than 5% of cases experience any complications. Statistics show that black men, like Secretary Austin, are 70 percent more likely than white men to develop the disease. Jiang stated, “For black men and men with a significant family history of prostate cancer, they indeed are at an elevated risk. As a sort of specialty, we recommend earlier screening for these men as early as their mid-40s to allow them to detect cancer earlier on.”

If putting down the booze entirely hasn’t proven sustainable for you, health experts suggest taking a softer approach. “Damp January” may be easier to pull off, and yields many health benefits from cutting back on alcohol. The CDC and National Cancer Institute have also tied alcohol use to an elevated risk of several types of cancer, including mouth and throat, larynx, esophagus, colon, liver and breast. For many people, the idea of cutting back is less intimidating than cutting something out altogether. “The key thing with alcohol is moderation,” said Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Lake Forest Hospital and clinical assistant professor of general internal medicine at Northwestern University Feinberg School of Medicine, in an interview. “If you want to have a drink it’s OK, but don’t have too many drinks.” Heavy drinkers should talk to their doctor about best ways to cut back, said Berki. But for most people, even just small changes can make long lasting impacts. “Don’t overthink it,” said Kopin. “If you’re drinking in moderation, if you’re drinking in a way that’s appropriate for you, it’s fine. There’s no health reason not to do that, unless you have an underlying medical condition that says you shouldn’t be drinking at all.”

As hospitalizations and deaths from Covid-19 rise, fueled by a fast-moving new variant that now accounts for a majority of U.S. cases, Paxlovid can help protect patients from some of the worst outcomes of the illness. Paxlovid consists of two medications, which, when taken together, stop the virus from replicating in your body. A recent study from the National Institutes of Health found that taking Paxlovid slashed the risk of death by 73 percent in people at high risk for severe disease. Some experts think the treatment might also reduce the risk of long Covid, although there is not yet definitive evidence for that, said Marc Sala, MD, co-director of the Northwestern Medicine Comprehensive Covid-19 Center in Chicago. But by reducing Covid symptoms in the first place, the medication may lower the chances that those symptoms linger. If you take Paxlovid, you need to take it within five days of developing symptoms and finish the full five-day course.

Getting COVID-19 today is much less scary and more common than it was three years ago. By now, many people have had it not just once, but two, three, or even more times. As cases continue to rise and more variants arrive on the scene, infectious-disease experts are warning that repeat infections could have cumulative, lasting effects. “There is some early evidence starting to show that if you had COVID-19, there can be all sorts of problems after getting infected” and reinfected, says Robert Murphy, MD, professor of medicine and executive director of the Havey Institute for Global Health at Northwestern’s Feinberg School of Medicine. “We are just at the beginning of learning about them.” Regardless of a person’s health status, each COVID-19 infection can raise the risk of developing blood clots, which can travel to the brain or lungs. That’s why Smith believes anyone who is eligible for antiviral drugs such as Paxlovid should take them, since controlling the virus as quickly as possible can reduce any potential long-term or lingering effects an infection can have on the body.

The U.S. Food and Drug Administration said on Thursday its preliminary review did not find evidence that weight-loss drugs such as Novo Nordisk’s Wegovy were tied to suicidal thoughts and the agency will continue to study the issue. Still, the FDA, which has listed suicidal thoughts as a potential safety signal for such drugs, said it could not definitively rule out that a small risk may exist due to the limited data available. The idea of warnings regarding suicide ideation for weight loss treatments comes from older studies of drugs that worked differently than GLP-1s, said Robert Kushner, MD, professor at Northwestern University Feinberg School of Medicine. “It’s kind of a legacy effect that is now applied to all medications for obesity,” Kushner said. The FDA said its months-long evaluation of clinical trials, and its public dashboard called the FDA Adverse Event Reporting System (FAERS) did not show a clear relationship between the drugs and suicidal thoughts or actions. Kushner added that it was prudent to continue monitoring people on GLP-1 medicines and that data from long-term use of the drugs could help alleviate any concerns. Healthcare providers like doctors should monitor their patients for new or worsening depression, suicidal thoughts, or any unusual changes in mood or behavior, consistent with the prescribing information for the drugs, the FDA said.

For decades, primary physicians and cardiologists have focused on two numbers: LDL or low-density lipoproteins, known as “bad cholesterol,” and HDL or high-density lipoproteins, a.k.a. “good cholesterol.” The two numbers are considered key determinants of a patient’s cardiovascular disease risk. But a growing number of physicians and researchers are saying that it’s time to move beyond this timeworn emphasis on “good” or “bad” cholesterol. Decades’ worth of evidence show that measuring the number of apoB particles in the blood predicts cardiovascular risk far more accurately than the standard good-cholesterol/bad-cholesterol lipid panel, but cholesterol guidelines barely acknowledge its existence. Current guidelines only offer it as an option for certain high-risk patients. Proponents of apoB say it offers more specificity than non-HDL cholesterol — and helps doctors identify individuals who might otherwise slip through the cracks with “normal” cholesterol numbers. “It’s not that non-HDL or LDL-C are bad lipid markers – it’s that apoB is better,” says John Wilkins, MD, a professor at Northwestern University’s Feinberg School of Medicine. “It’s easy enough to add to a standard lipid panel.” ApoB testing may be especially important in people younger than 40, Wilkins adds. He co-authored a 2016 study showing that younger people with high apoB levels but normal LDL were at greater risk for coronary artery calcification, a relatively advanced stage of heart disease. “There’s a very clear correlation between apoB levels and disease later in life,” he says.

Chicago’s COVID-19 risk level has risen from “low” to “medium” for the first time since last January. Over the last week, 34 people per day have been admitted to Chicago hospitals because of complications with COVID-19, CDPH data shows. Hospitalizations have slowly risen since July, when admissions hit a pandemic low of three per day. COVID-related hospital admissions rose 11% in the last week, according to the CDPH. At Northwestern Memorial Hospital’s intensive care unit, medical director Susan Russell, MD has seen an uptick in COVID-19 patients. “It’s certainly not the surge levels we’ve seen in the past few years, but there is a definite increase,” Russell said. “I’m disappointed, but not surprised.” The hospital isn’t seeing the prolonged severe illness that many caretakers handled early in the pandemic, she said. But while hospitalized patients are generally having shorter ICU stays, many people — especially immunocompromised people — are still facing severe complications. “We are still seeing some very bad infections and people ending up on a ventilator,” Russell said. “It’s not the same volume as it was before, but we are seeing it.”

There is a major medication change in the new year many may not know about. A widely used drug for those with asthma is off the shelves and a local pharmacist says patients need to act fast to stay healthy. The switch to a generic will lower the cost, but Northwestern Medicine pharmacist and assistant professor of orthopaedic surgery at Northwestern University Feinberg School of Medicine Sterling Elliott says there’s more to the story than economics. “It really has a huge percentage of the marketplace,” Elliott said. “The best things steroids do is help with inflammation, and asthma is inflammation in the respiratory tract.” Users will have to re-apply for coverage of essentially the same drug they’ve been taking all along. “It’s the same formulation. It’s certainly the same active steroid,” Elliot said. “It will be sent to the insurance carrier under a different identity and that identity needs to be approved and moved through the insurance process when they go to their local pharmacy to get the prescription.” Any delays could be dangerous – especially during respiratory virus season. “The trickle-down impact is you run the risk of asthma being more poorly controlled and you have some of those urgent asthma flare ups,” Elliot said. “It has the potential to send anyone to the ER if the flare up is that bad that it can’t be controlled at home.”

Sumanas Jordan, MD, PhD, knows transgender and nonbinary patients have unique needs. About half of her patients come in for gender-affirming surgeries, and their tests and treatments often lead to deep conversations about gender identity. Jordan is an assistant professor of plastic surgery at Northwestern University Feinberg School of Medicine. Now, conversations about gender at Northwestern Medicine are expanding to include patients’ medical records. As of December 18, Northwestern Medicine patients can record their legal sex as “X’ in electronic medical records. “X” is an alternate gender marker for those who do not identify as male or female. On legal records, it’s commonly used by transgender, nonbinary and intersex people. “Over the last year, since we knew this law was going to be put into place, we’ve been working really hard to make sure our system was ready for that,” Jordan said. “It doesn’t seem like a huge task … but that little letter actually affects a number of downstream events.” Further, “Patients with X will have many different needs, but one need they’re all going to have is to have been treated with dignity and respect across the board,” said Lauren Beach, director of the ADVOCATE program at Northwestern Medicine and assistant professor of medical social sciences and epidemiology at Northwestern University Feinberg School of Medicine, who uses the pronouns they/them. The program works to improve public health research by incorporating the needs and concerns of LGBTQ+ patients. Seeing an X on a patient’s legal medical record will prompt doctors to ask for a patient’s name and pronouns, and to ask about their anatomy separately from their gender identity, Beach said.

The market for dietary supplements – vitamins, minerals, botanicals, herbs and other products promoted as ways to help you feel better, look better, perform better, sleep better and stay healthy – is booming, and that boom isn’t done. The industry grew from about 4,000 products in 1994 to 80,000 in 2016. Experts worry about adverse effects from mega doses and point out the lack of evidence of benefit for many supplements. More government oversight is sorely needed, some say. Most people view supplements, at worst, as benign preventive products, said Jeffrey A. Linder, MD, MPH, chief of general internal medicine at Northwestern University’s Feinberg School of Medicine in Chicago. But they aren’t always harmless. With too much emphasis and reliance on supplements, Linder said, “I’m more worried that people are getting distracted from things that will actually help them be healthy, like exercise, eating a healthy diet, and maintaining a healthy weight.” While there’s no one-stop reference on which supplements are worth taking, various organizations as well as researchers attempt to summarize the evidence and issue conclusions. Recently, the U.S. Preventive Services Task Force issued recommendations on the evidence for supplements in preventing cardiovascular disease (diseases of the heart and blood vessels) and cancer. Linder co-wrote an editorial to go with those recommendations. In summary, he said, the task force concluded that “there is insufficient evidence about pretty much all supplements” for preventing cardiovascular disease and cancer, and specifically recommended against vitamin E and beta carotene for preventing those diseases.