PodcastDX

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This week we discuss stem cells. Having great therapeutic and biotechnological potential, stem cells are extending the frontier in medicine. Not only replace dysfunctional or damaged cells, the so-called regenerative medicine, stem cells may also offer us new perspectives regarding the nature of aging and cancer. This review will cover some basics of stem cells, their current development, and possible applications in medicine. Meanwhile, important remaining challenges of stem cell research are discussed as well.

​Stem cells are unique, unspecialized cells that can divide to create more stem cells (self-renewal) and can transform (differentiate) into various specialized cells, acting as the body's repair system to generate new cells for growth, repair, and maintenance, with different types existing in embryos (pluripotent) and adults (multipotent) and being studied for treating diseases like paralysis, diabetes, and heart disease.

Types of Stem Cells

• Embryonic Stem Cells: Pluripotent (can become almost any cell type) and come from early embryos.

• Adult Stem Cells (Tissue-Specific): Multipotent (limited to certain cell types within their tissue) and found in adult organs like bone marrow, skin, and the brain.

• Induced Pluripotent Stem Cells (iPSCs): Adult cells reprogrammed in the lab to act like embryonic stem cells, offering a path to personalized medicine.

​Sources of Stem Cells

• Embryos (for research),

• Umbilical cord blood,

• Bone marrow,

• Other adult tissues (like fat or skin).

​Medical Significance (Stem Cell Therapy)

• Regenerative Medicine: Uses stem cells to repair or replace damaged tissues and organs.

• Treatments: Already used to treat blood cancers (like leukemia) through bone marrow transplants.

• Research Focus: Investigated for treating conditions such as spinal cord injuries, Parkinson's, Alzheimer's, heart disease, and diabetes.

​There is some stem cell controversy, primarily centering on the ethics of using human embryos, particularly embryonic stem cells, which hold vast potential for medicine but require destroying the embryo, raising moral debates about the embryo's status as human life, with opponents seeing it as the destruction of life and proponents viewing it as a moral imperative to cure disease, though adult stem cell research and induced pluripotent stem cells (iPSCs) offer less controversial avenues. We don't discuss this aspect of the therapeutic use but if you are interested you can find out more with a simple internet search.

​Stem cell therapy in the US is not banned but restricted. Only FDA-approved products (such as cord blood transplants and CAR-T cell therapies for blood conditions) are fully legal. Other uses are allowed only in limited cases under the 361 HCT/P pathway.

Functional fitness is a simple, effective way to keep your body moving and reduce restlessness. It focuses on exercises that help you perform everyday activities more easily and safely—like getting up off the floor, carrying groceries, or reaching for items on a shelf.

By training your muscles to work the way you actually use them in daily life, functional fitness reduces injury risk and improves overall quality of life. It helps you move through your day with more confidence, strength, and ease.

Fitness expert Brad Schoenfeld describes functional fitness as existing "on a continuum." In other words, almost any exercise can be functional if it improves your ability to move well in real life. While general strength training is beneficial, exercises that mimic everyday movements tend to offer the greatest payoff.

Functional fitness also improves balance, endurance, and flexibility—benefits that matter at every age.

Below are 13 functional exercises suitable for adults of all ages. Choose five or six and perform them three to four times per week. All can be done safely at home with minimal equipment.

Squats mimic sitting and standing from a chair, making them one of the most important functional movements. Move slowly and with control. To modify, reduce depth or use a chair for support.

This exercise strengthens the muscles used to push yourself up from the floor or a surface. It's a gentler alternative to pushups and works the same muscle groups.

Planks build core strength, balance, and mobility—skills needed for getting up and down from the floor. Focus on maintaining good form rather than duration.

Wall squats provide added support and reduce strain on the lower back while still strengthening the legs.

This movement improves balance and stability and mimics stepping down from stairs or high surfaces.

Rows strengthen the back and arms, helping with tasks like lifting objects from shelves or pulling items toward you.

Lunges replicate the motion of standing up from the ground and improve leg strength and joint mobility.

Step-ups strengthen the muscles used for climbing stairs and stepping onto raised surfaces.

Single-leg exercises improve balance and core stability, which helps prevent falls.

Side planks target the oblique muscles and support overall core strength.

This yoga pose builds strength, flexibility, and balance while supporting your body weight.

Deadlifts train the hip hinge and strengthen multiple leg muscles, preparing you for lifting objects safely.

This combined movement challenges balance while strengthening both the lower and upper body.

Functional fitness prepares your body for real-life movement. It emphasizes performance over appearance, uses minimal equipment, and carries a lower risk of injury than high-intensity training styles.

Because it focuses on practical strength and movement quality—not muscle size—it's accessible, effective, and appropriate for people of all ages and fitness levels. If you have existing injuries or medical conditions, consult a healthcare provider before starting.

By the end of the first week of the new year, nearly 77% of New Year's resolutions have already failed (Norcross, 1988). That's discouraging—but it doesn't mean you should stop trying.

It means most of us are setting resolutions in ways that don't work.

You aren't weak or lazy. More often, the problem is a misaligned system—one that relies too heavily on willpower and short-lived motivation. Motivation naturally fades over time, even when our intentions are good.

Think about how often you enthusiastically agree to plans weeks in advance, only to feel tired or unmotivated when the day arrives. Or how many times you've started a project—cleaning a room, taking a course, planning a trip—only to watch your early excitement slowly disappear. We're excellent at strong intentions; follow-through is harder.

The good news? Not all resolutions fail. That same research found that 19% of resolutions are still maintained two years later (Norcross, 1988). We just don't spend enough time learning from what does work.

Resolutions that try to overhaul everything at once are overwhelming and fragile.

Examples:

• "New year, new me—I'll reinvent my career, relationships, and lifestyle."

• "I'll work out every single day this year."

• "I'll triple my income or eliminate all my debt."

Why this fails: One setback can feel like total failure, making it easy to quit entirely.

Goals rooted in self-criticism, embarrassment, or self-loathing undermine motivation.

Examples:

• "I need to get my life together."

• "I have to lose weight so I don't look bad."

• "This year I'll stop being lazy."

Why this fails: Shame erodes self-belief and increases anxiety, making lasting change harder—not easier.

Unclear goals are difficult to act on.

Examples:

• "I want to be healthier."

• "I'll work on myself."

• "I need better boundaries."

Why this fails: Without clear actions or markers of success, procrastination takes over and goals fade.

Choose one small, consistent practice that reflects what truly matters to you.

Examples:

• "Every Sunday evening, I'll spend an hour writing, painting, or making music."

• "Once a week, I'll take a phone-free walk to reflect."

Connect your resolution to generativity—contributing beyond yourself (Erikson, 1950).

Examples:

• "I'll volunteer or mentor through an organization like SCORE or Rotary."

Create simple, recurring rituals with others.

Example:

• "I'll schedule a weekly call, walk, or shared meal and treat it as a real commitment."

Traditional New Year's resolutions don't fail because people lack discipline. They fail because they're poorly designed—too big, too vague, or rooted in shame.

When resolutions focus on "fixing what's wrong," they often lead to self-criticism once early motivation fades. In contrast, resolutions grounded in meaning, purpose, and connection are more sustainable.

If you're among the 77% whose resolution didn't stick, don't fall into the shame trap. A broken resolution isn't failure—it's feedback. Reset your expectations, adjust your strategy, and start again with something manageable.

Move away from punishment and toward practices that bring joy, meaning, and connection. That shift alone can make the difference between another abandoned resolution and one that truly lasts.

May your year be filled with meaning, purpose, and connections that sustain you.

(CREDITS: PSYCHOLOGY TODAY)

The lymphatic system, or lymphoid system, is one of the components of the circulatory system, and it serves a critical role in both immune function and surplus extracellular fluid drainage. Components of the lymphatic system include lymph, lymphatic vessels and plexuses, lymph nodes, lymphatic cells, and a variety of lymphoid organs. The pattern and form of lymphatic channels are more variable and complex but generally parallel those of the peripheral vascular system. The lymphatic system partly functions to convey lymphatic fluid, or lymph, through a network of lymphatic channels, filter lymphatic fluid through lymph nodes and return lymphatic fluid to the bloodstream, where it is eventually eliminated. Nearly all body organs, regions, and systems have lymphatic channels to collect the various byproducts that require elimination . Liver and intestinal lymphatics produce about 80% of the volume of lymph in the body.

Notable territories of the body that do not appear to contain lymphatics include the bone marrow, epidermis, as well as other tissues where blood vessels are absent. The central nervous system was long considered to be absent of lymphatic vessels until they were recently identified in the cranial meninges. Moreover, a vessel appearing to have lymphatic features was also discovered in the eye. The lymphatic system is critical in a clinical context, particularly given that it is a major route for cancer metastasis and that the inflammation of lymphatic vessels and lymph nodes is an indicator of pathology.

Structure

The lymphatic system includes numerous structural components, including lymphatic capillaries, afferent lymphatic vessels, lymph nodes, efferent lymphatic vessels, and various lymphoid organs.

Lymphatic capillaries are tiny, thin-walled vessels that originate blindly within the extracellular space of various tissues. Lymphatic capillaries tend to be larger in diameter than blood capillaries and are interspersed among them to enhance their ability to collect interstitial fluid efficiently. They are critical in the drainage of extracellular fluid and allow this fluid to enter the closed capillaries but not exit due to their unique morphology. Lymphatic capillaries at their blind ends are composed of a thin endothelium without a basement membrane. The endothelial cells at the closed end of the capillary overlap but shift to open the capillary end when interstitial fluid pressure is greater than intra-capillary pressure. This process permits lymphocytes, interstitial fluid, bacteria, cellular debris, plasma proteins, and other cells to enter the lymphatic capillaries. Special lymphatic capillaries called lacteals exist in the small intestine to contribute to the absorption of dietary fats. Lymphatics in the liver contribute to a specialized role in transporting hepatic proteins into the bloodstream. The lymphatic capillaries of the body form large networks of channels called lymphatic plexuses and converge to form larger lymphatic vessels.

Lymphatic vessels convey lymph, or lymphatic fluid, through their channels. Afferent (toward) lymphatic vessels convey unfiltered lymphatic fluid from the body tissues to the lymph nodes, and efferent (away) lymphatic vessels convey filtered lymphatic fluid from lymph nodes to subsequent lymph nodes or into the venous system. The various efferent lymphatic vessels in the body eventually converge to form two major lymphatic channels: the right lymphatic duct and the thoracic duct.

The right lymphatic duct drains most of the right upper quadrant of the body, including the right upper trunk, right upper extremity, and right head and neck. The right lymphatic trunk is a visible channel in the right cervical region just anterior to the anterior scalene muscle. Its origin and termination are variable in morphology, typically forming as the convergence of the right bronchomediastinal, jugular, and subclavian trunks, extending 1 to 2 centimeters in length before returning its contents to the systemic circulation at the junction of the right internal jugular, subclavian, and/or brachiocephalic veins.

The thoracic duct, also known as the left lymphatic duct or van Hoorne's canal, is the largest of the body's lymphatic channels. It drains most of the body except for the territory of the right superior thorax, head, neck, and upper extremity served by the right lymphatic duct. The thoracic duct is a thin-walled tubular vessel measuring 2 to 6 mm in diameter. The length of the duct ranges from 36 to 45 cm. The thoracic duct is highly variable in form but typically arises in the abdomen at the superior aspect of the cisterna chyli, around the level of the twelfth thoracic vertebra (T12). The cisterna chyli, from which it extends, is an expanded lymphatic sac that forms at the convergence of the intestinal and lumbar lymphatic trunks extending along the L1-L2 vertebral levels. The cisterna chyli is present in approximately 40-60% of the population, and in its absence, the intestinal and lumbar lymphatic trunks communicate directly with the thoracic duct at the T12 level.

As a result, the thoracic duct receives lymphatic fluid from the lumbar lymphatic trunks and chyle, composed of lymphatic fluid and emulsified fats, from the intestinal lymphatic trunk. Initially, the thoracic duct is located just to the right of the midline and posterior to the aorta. It exits the abdomen and enters the thorax via the aortic hiatus formed by the right and left crura of the diaphragm, side by side with the aorta. The thoracic duct then ascends in the thoracic cavity just anterior and to the right of the vertebral column between the aorta and azygos vein. At about the level of the fifth thoracic vertebra (T5), the thoracic duct typically crosses to the left of the vertebral column and posterior to the esophagus. From here, it ascends vertically and usually empties its contents into the junction of the left subclavian and left internal jugular veins in the cervical region.

To ensure that lymph does not flow backward, collecting lymphatic vessels and larger lymphatic vessels have one-way valves. These valves are not present in the lymphatic capillaries. These lymphatic valves permit the continued advancement of lymph through the lymphatic vessels aided by a pressure gradient created by vascular smooth muscle, skeletal muscle contraction, and respiratory movements. However, it is important to note that lymphatic vessels also communicate with the venous system through various anastomoses.

Lymph nodes are small bean-shaped tissues situated along lymphatic vessels. Lymph nodes receive lymphatic fluid from afferent lymphatic vessels and convey lymph away through efferent lymphatic vessels. Lymph nodes serve as a filter and function to monitor lymphatic fluid/blood composition, drain excess tissue fluid and leaked plasma proteins, engulf pathogens, augment an immune response, and eradicate infection.

Several organs in the body are considered to be lymphoid or lymphatic organs, given their role in the production of lymphocytes. These include the bone marrow, spleen, thymus, tonsils, lymph nodes, and other tissues. Lymphoid organs can be categorized as primary or secondary lymphoid organs. Primary lymphoid organs are those that produce lymphocytes, such as the bone marrow and thymus. Bone marrow is the primary site for the production of lymphocytes. The thymus is a glandular organ located anterior to the pericardium. It serves to mature and develop T cells, or thymus cell lymphocytes, in response to an inflammatory process or pathology. As individuals age, both their bone marrow and thymus reduce and accumulate fat. Secondary lymphoid organs serve as territories in which immune cells function and include the spleen, tonsils, lymph nodes, and various mucous membranes, such as in the intestines. The spleen is a purplish, fist-sized organ in the left upper abdominal quadrant that contributes to immune function by serving as a blood filter, storing lymphocytes within its white pulp, and being a site for an adaptive immune response to antigens. The lingual tonsils, palatine tonsils, and pharyngeal tonsils, or adenoids, work to prevent pathogens from entering the body. Mucous membranes in the gastrointestinal, respiratory, and genitourinary systems also function to prevent pathogens from entering the body.

Lymph

Lymphatic fluid, or lymph, is similar to blood plasma and tends to be watery, transparent, and yellowish in appearance. Extracellular fluid leaks out of the blood capillary walls because of pressure exerted by the heart or osmotic pressure at the cellular level. As the interstitial fluid accumulates, it is picked up by the tiny lymphatic capillaries along with other substances to form lymph. This fluid then passes through the lymphatic vessels and lymph nodes and finally enters the venous circulation. As the lymph passes through the lymph nodes, both monocytes and lymphocytes enter it.

Lymph is composed primarily of interstitial fluid with variable amounts of lymphocytes, bacteria, cellular debris, plasma proteins, and other cells. In the GI tract, lymphatic fluid is called chyle and has a milk-like appearance that is chiefly due to the presence of cholesterol, glycerol, fatty acids, and other fat products. The vessels that transport the lymphatic fluid from the GI tract are known as lacteals.

Embryology

The development of the lymphatic system is known from both human and animal, especially mouse studies. The lymphatic vessels form after the development of blood vessels, around six weeks post-fertilization. The endothelial cells that serve as precursors to the lymphatics arise from the embryonic cardinal veins. The process by which lymphatic vessels form is similar to that of the blood vessels and produces lymphatic-venous and intra-lymphatic anastomoses, but diverse origins exist for components of lymphatic vessel formation in different regions.

Six primary lymph sacs develop and are apparent about eight weeks post-fertilization. These include, from caudal to cranial, one cisterna chyli, one retroperitoneal lymph sac, two iliac lymph sacs, and two jugular lymph sacs. The jugular lymph sacs are the first to develop, initially appearing next to the jugular part of the cardinal vein. Lymphatic vessels then form adjacent to the blood vessels and connect the various lymph sacs. The lymphatic vessels primarily arise from the lymph sacs through the process of self-proliferation and polarized sprouting.

Stem/progenitor cells play a huge role in forming lymphatic tissues and vessels by contributing to sustained growth and postnatally differentiating into lymphatic endothelial cells. Lymphatic channels from the developing gut connect with the retroperitoneal lymph sac and the cisterna chyli, situated just posteriorly. The lymphatic channels of the lower extremities and inferior trunk communicate with the iliac lymph sacs. Finally, lymphatic channels in the head, neck and upper extremities drain to the jugular lymph sacs. Additionally, a right and left thoracic duct form and connect the cisterna chyli with the jugular lymph sacs and form anastomoses that eventually produce the typical adult form. The lymph sacs then produce groups of lymph nodes in the fetal period. Migrating mesenchyme enters the lymph sacs and produces lymphatic networks, connective tissue, and other layers of the lymph nodes.

The lymphatic system's primary function is to balance the volume of interstitial fluid and convey it and excess protein molecules into the venous circulation. The lymphatic system is also important in immune surveillance, defending the body against foreign particles and microorganisms. It does so by conveying antigens and leukocytes to lymph nodes, where antigen-primed and targeted lymphocytes and other immune cells are conveyed into the lymphatic vessels and blood vessels. In addition, the system has a role in the absorption of fat-soluble vitamins and fatty substances in the gut via the gastrointestinal tract's lacteals within the villi and the transport of this material into the venous circulation.

Newly recognized lymphatic vessels are visible in the meninges relating to cerebrospinal fluid (CSF) outflow from the central nervous system. Finally, lymphatics may play a role in the clearance of ocular fluid via the lymphatic-like Schlemm canals.

Leaks of lymphatic fluid occur when the lymphatic vessels are damaged. In the abdomen, lymphatic vessel damage may occur during surgery, especially during retroperitoneal procedures such as repairing an abdominal aortic aneurysm. These leaks tend to be mild, and the vessels in the peritoneum and mesentery eventually absorb the lymphatic fluid or chyle. However, when the thoracic duct is injured in the chest, the chyle leak can be extensive. In most cases, conservative care with a no-fat diet (medium chain triglycerides) or total parenteral nutrition is unsuccessful. In most cases, if the injury to the thoracic duct was surgical, a surgical procedure is required to tie off the duct. If the thoracic duct is injured in the cervical region, then inserting a drainage tube and adopting a low-fat diet will help seal the leak. However, thoracic duct injury in the chest cavity usually requires drainage and surgery. It is rare for the thoracic segment of the thoracic duct to seal on its own.

In terms of accumulation of chyle in the thorax (i.e., chylothorax), if a patient has an injury to the thoracic duct in the thorax below the T5 vertebral level, then fluid will collect in only the right pleural cavity. If the injury is to the thoracic duct in the thorax above the T5 vertebral level, then fluid will appear in both pleural cavities.

The lymphatic system is prone to disorders like the venous and arterial circulatory systems. Developmental or functional defects of the lymphatic system cause lymphedema. When this occurs, the lymphatic system is unable to sufficiently drain lymphatic fluid resulting in its accumulation and swelling of the territory. Lymphedema, this swelling due to the accumulation of lymph, is classified as primary or secondary.

Primary lymphedema is an inherited disorder where the lymphatic system development has been disrupted, causing absent or malformed lymphatic tissues. This condition often presents soon after birth, but some conditions may present later in life (e.g., at puberty or later adulthood). There are no effective treatments for primary lymphedema. Past surgical treatments were found to be mutilating and are no longer implemented. The present-day treatment revolves around compression stockings, pumps, and constrictive garments.

Secondary lymphedema is an acquired disorder involving lymphatic system dysfunction that may result from many causes, including cancer, infection, trauma, or surgery. The treatment of secondary lymphedema depends on the cause. Oncological and other surgeries may result in secondary lymphedema due to the removal or biopsy of lymph nodes or lymphatic vessels. Non-surgical lymphedema may result from malignancies, obstruction within the lymphatic system, infection, or deep vein thrombosis. In most cases of obstructive secondary lymphedema, the drainage will resume if the inciting cause is removed, although some individuals may need to wear compressive stockings permanently. Also, physical therapy may help alleviate lymphedema when the extremities are involved. There is no absolute cure for lymphedema, but diagnosis and careful management can help to minimize complications.

Lymphomas are cancers that arise from the cells of the lymphatic system. There are numerous types of lymphoma, but they are grouped into Hodgkin lymphoma and non-Hodgkin lymphoma. Lymphomas usually arise from the malignant transformation of specific lymphocytes in the lymphatic vessels or lymph nodes in the gastrointestinal tract, neck, axilla, or groin. Symptoms of lymphoma may include night sweats, fever, fatigue, itching, and weight loss.

Cancers originating outside of the lymphatic system often spread via the lymphatic vessels and may involve regional lymph nodes serving the impacted organs or tissues.

Lymphadenitis occurs when the lymph nodes become inflamed or enlarged. The cause is usually an adjacent bacterial infection but may also involve viruses or fungi. The lymph nodes usually enlarge and become tender.

Lymphatic filariasis, or elephantiasis, is a very common mosquito-borne disorder caused by a parasite found in tropical and subtropical areas of the world, including Africa, Asia, the Pacific, the Caribbean, and South America. This condition involves parasitic microscopic nematodes (roundworms) that infect the lymphatic system and rapidly multiply and disrupt lymphatic function. Many infected individuals may have no outward symptoms, although the kidneys and lymphatic tissues may be damaged and dysfunctional. Symptomatic individuals may present with disfigurement caused by significant lymphedema and elephantiasis (thickening of the skin, particularly the extremities). The parasite may also cause hydrocele, an enlargement of the scrotum due to the accumulation of fluid, which may result from obstruction of the lymph nodes or vessels in the groin. Individuals presenting with symptoms have poorly draining lymphatics, often involving the extremities, resulting in huge extremities and marked disability. Lymphatic filariasis is the most common cause of disfigurement in the world, and it is the second most common cause of long-term disability. (credits: NIH)

This week we are talking about Pancreatic cancer. This is a type of cancer that begins as a growth of cells in the pancreas. The pancreas lies behind the lower part of the stomach. It makes enzymes that help digest food and hormones that help manage blood sugar.

The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma. This type begins in the cells that line the ducts that carry digestive enzymes out of the pancreas.

Pancreatic cancer rarely is found at its early stages when the chance of curing it is greatest. This is because it often doesn't cause symptoms until after it has spread to other organs.

Your health care team considers the extent of your pancreatic cancer when creating your treatment plan. Treatment options may include surgery, chemotherapy, radiation therapy or a mix of these.

Pancreatic cancer often doesn't cause symptoms until the disease is advanced. When they happen, signs and symptoms of pancreatic cancer may include:

• Belly pain that spreads to the sides or back.
• Loss of appetite.
• Weight loss.
• Yellowing of the skin and the whites of the eyes, called jaundice.
• Light-colored or floating stools.
• Dark-colored urine.
• Itching.
• New diagnosis of diabetes or diabetes that's getting harder to control.
• Pain and swelling in an arm or leg, which might be caused by a blood clot.
• Tiredness or weakness.

It's not clear what causes pancreatic cancer. Doctors have found some factors that might raise the risk of this type of cancer. These include smoking and having a family history of pancreatic cancer.

The pancreas is about 6 inches (15 centimeters) long and looks something like a pear lying on its side. It releases hormones, including insulin. These hormones help the body process the sugar in the foods you eat. The pancreas also makes digestive juices to help the body digest food and take in nutrients.

Pancreatic cancer happens when cells in the pancreas develop changes in their DNA. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the instructions tell the cells to grow and multiply at a set rate. The cells die at a set time. In cancer cells, the changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes there to be too many cells.

The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body.

Most pancreatic cancer begins in the cells that line the ducts of the pancreas. This type of cancer is called pancreatic ductal adenocarcinoma or pancreatic exocrine cancer. Less often, cancer can form in the hormone-producing cells or the neuroendocrine cells of the pancreas. These types of cancer are called pancreatic neuroendocrine tumors or pancreatic endocrine cancer.

Factors that might raise the risk of pancreatic cancer include:

• Smoking.
• Type 2 diabetes.
• Chronic inflammation of the pancreas, called pancreatitis.
• Family history of DNA changes that can increase cancer risk. These include changes in the BRCA2 gene, Lynch syndrome and familial atypical multiple mole melanoma (FAMMM) syndrome.
• Family history of pancreatic cancer.
• Obesity.
• Older age. Most people with pancreatic cancer are over 65.
• Drinking a lot of alcohol.

As pancreatic cancer progresses, it can cause complications such as:

• Weight loss. People with pancreatic cancer might lose weight as the cancer uses more of the body's energy. Nausea and vomiting caused by cancer treatments or a cancer pressing on the stomach might make it hard to eat. Sometimes the body has trouble getting nutrients from food because the pancreas isn't making enough digestive juices.

• Jaundice. Pancreatic cancer that blocks the liver's bile duct can cause jaundice. Signs include yellowing of the skin and the whites of the eyes. Jaundice can cause dark-colored urine and pale-colored stools. Jaundice often occurs without belly pain.

  If the bile duct is blocked, a plastic or metal tube called a stent can be put inside it. The stent helps hold the bile duct open. This is done using a procedure called endoscopic retrograde cholangiopancreatography, also called ERCP.

  During ERCP, a health care professional puts a long tube with a tiny camera, called an endoscope, down the throat. The tube goes through the stomach and into the upper part of the small intestine. The health professional puts a dye into the pancreatic ducts and bile ducts through a small tube that fits through the endoscope. The dye helps the ducts show up on imaging tests. The health professional uses those images to place a stent at the right spot in the duct to help hold it open.

• Pain. A growing tumor may press on nerves in your abdomen, causing pain that can become severe. Pain medications can help you feel more comfortable. Treatments, such as radiation and chemotherapy, might help slow tumor growth and provide some pain relief.

  When medicines aren't helping, a health care professional might suggest a celiac plexus block. This procedure uses a needle to put alcohol into the nerves that control pain in the belly. The alcohol stops the nerves from sending pain signals to the brain.

• Bowel blockage. Pancreatic cancer can grow into or press on the first part of the small intestine, called the duodenum. This can block the flow of digested food from the stomach into the intestines.

  A health care professional might suggest putting a tube called a stent in the small intestine to hold it open. Sometimes, it might help to have surgery to place a feeding tube. Or surgery can attach the stomach to a lower part of the intestines where the cancer isn't causing a blockage.

Screening uses tests to look for signs of pancreatic cancer in people who don't have symptoms. It might be an option if you have a very high risk of pancreatic cancer. Your risk might be high if you have a strong family history of pancreatic cancer or if you have an inherited DNA change that increases the risk of cancer.

Pancreatic cancer screening might involve imaging tests, such as MRI and ultrasound. These tests are generally repeated every year.

The goal of screening is to find pancreatic cancer when it's small and most likely to be cured. Research is ongoing, so it's not yet clear whether screening can lower the risk of dying of pancreatic cancer. There are risks to screening. This includes the chance of finding something that requires surgery but later turns out to not be cancer.

Talk about the benefits and risks of pancreatic cancer screening with your health care team. Together you can decide whether screening is right for you.

If you have a family history of pancreatic cancer, discuss it with a health care professional. The health professional can review your family history and help you understand whether genetic testing might be right for you.

Genetic testing can find DNA changes that run in families and increase the risk of cancer. If you're interested in genetic testing, you might be referred to a genetic counselor or other health care professional trained in genetics.

You might reduce your risk of pancreatic cancer if you:

• Stop smoking. If you smoke, talk to a member of your health care team about ways to help you stop. These might include support groups, medicines and nicotine replacement therapy.
• Maintain a healthy weight. If you are at a healthy weight, work to maintain it. If you need to lose weight, aim for a slow, steady weight loss of 1 to 2 pounds (0.5 to 1 kilogram) a week. To help you lose weight, exercise most days of the week. Slowly increase the amount of exercise you get. Choose a diet rich in vegetables, fruit and whole grains with smaller portions. (CREDITS: MAYO CLINIC)

This week we discuss diabetes mellitus, a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up the muscles and tissues. It's also the brain's main source of fuel.

The main cause of diabetes varies by type. But no matter what type of diabetes you have, it can lead to excess sugar in the blood. Too much sugar in the blood can lead to serious health problems.

​Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes and gestational diabetes. Prediabetes happens when blood sugar levels are higher than normal. But the blood sugar levels aren't high enough to be called diabetes. And prediabetes can lead to diabetes unless steps are taken to prevent it. Gestational diabetes happens during pregnancy. But it may go away after the baby is born.

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Mast cell activation syndrome (MCAS) is when you have unexplained episodes of severe symptoms like swelling, diarrhea, vomiting, flushing and itching. Unlike allergies that happen with a specific exposure, MCAS episodes happen without a clear trigger.

In some cases, mast cell activation can cause anaphylaxis, a severe allergic condition that can be life-threatening. It can cause you to have trouble breathing and drop your blood pressure to dangerously low levels. Call 911 (or your local emergency service number) or go to the nearest emergency room if you're experiencing severe anaphylaxis.

Mast cells are a type of immune cell responsible for immune reactions. For instance, conditions like allergic rhinitis and asthma, allergic reactions (like anaphylaxis to drugs or food) and mastocytosis all activate mast cells. This causes them to release proteins that give you symptoms that are bothersome at best, and dangerous at worst.

Other common conditions can also cause unexplained symptoms. It's important to discuss your concerns with your provider. They'll make sure you get a complete workup with a specialist, like an allergist. An allergist is a type of doctor who can diagnose and manage many types of allergic conditions.

But mast cell activation syndrome is rare. Healthcare providers diagnose mast cell activation syndrome if:

• You have repeated symptoms of possible anaphylaxis without a clear trigger
• You have more than one body system affected at the same time
• Tests show signs of mast cell activation
• Mast cell medications provide relief from your symptoms

(CREDITS: Cleveland Clinic)

Lung cancer is the third most common cancer in the U.S. It's caused by harmful cells in your lungs growing unchecked. Treatments include surgery, chemotherapy, immunotherapy, radiation and targeted drugs. Screening is recommended if you're at high risk. Advances in treatments have caused a significant decline in lung cancer deaths in recent years.

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Lung cancer is a disease caused by uncontrolled cell division in your lungs. Your cells divide and make more copies of themselves as a part of their normal function. But sometimes, they get changes (mutations) that cause them to keep making more of themselves when they shouldn't. Damaged cells dividing uncontrollably create masses, or tumors, of tissue that eventually keep your organs from working properly.

Lung cancer is the name for cancers that start in your lungs — usually in the airways (bronchi or bronchioles) or small air sacs (alveoli). Cancers that start in other places and move to your lungs are usually named for where they start (your healthcare provider may refer to this as cancer that's metastatic to your lungs).

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There are many cancers that affect the lungs, but we usually use the term "lung cancer" for two main kinds: non-small cell lung cancer and small cell lung cancer. Other types of cancer can start in or around your lungs, including lymphomas (cancer in your lymph nodes), sarcomas (cancer in your bones or soft tissue) and pleural mesothelioma (cancer in the lining of your lungs). These are treated differently and usually aren't referred to as lung cancer. (CREDITS: Cleveland Clinic)

Did you know that about half of all eye injuries happen right at home?

Home activities that can injure your eyes include:

• Cleaning. Chemicals like bleach in household cleaning products cause 125,000 eye injuries each year.
• Home Improvement. Screws, nails and hand tools can launch into the air—and into your eyes.
• Power tools can also send wood chips or other substances flying into the air.
• Yard Work. Lawn mowers, trimmers and even shovels can throw dirt and debris into the air. Branches, twigs and thorns can also be dangerous.

Unfortunately, only about three out of 10 people wear protective eyewear during home projects that could hurt their eyes. The good news? Simply wearing protective eyewear can reduce your risk for eye injury by 90 percent!

The American Academy of Ophthalmology urges every household to have at least one pair of ANSI-approved protective eyewear. ("ANSI-approved" means the protective eyewear is made to meet safety standards of the American National Standards Institute.)

• In the house
  • Using dangerous chemicals such as oven cleaner and bleach (accidents involving common household products cause 125,000 eye injuries each year). Read the labels of chemicals and cleaners carefully, and don't mix products.
  • Cooking foods can that can splatter hot grease or oil. Use grease shields on frying pans to protect yourself from splattering.
  • Opening champagne bottles during a celebration. Wrap a towel or cloth around the top of the bottle while unscrewing it to "catch" the cork. Never point a champagne bottle towards another person or yourself when opening it.
  • Drilling or hammering screws or nails into walls or hard surfaces like brick or cement. The screws or nails can fly into the air, or fragments can come off the surface.
  • Using hot objects such as curling irons around your face. Contact with your eyes can cause serious injury.
  • Loose rugs and railings or other hazards that could cause falls or slips. Secure rugs with a non-slip pad underneath. Check to make sure railings are secure and not loose.
  • Put padding on sharp corners and edges if you have children or the elderly in your house.
• In the yard
  • Mowing the lawn. Check the lawn or the outdoor area first for sticks, rocks or other items that can fly out from under the mower.
  • Using a power trimmer or edger.
  • Clipping hedges and bushes.
  • Playing sports.
• In the garage or workshop
  • Using power or hand tools. Keep your tools in good condition; damaged tools should be repaired or replaced.
  • Working with solvents or other chemicals. Make sure that all spray nozzles are directed away from you.
  • Doing anything that can cause fragments or dust particles to fly around in the air.
  • Tying down equipment or loads with bungee cords. Bungee cords are a serious danger to eyes when they snap back.

For all of these activities, remember that people nearby also face serious risk. Bystanders should wear eye protection too or leave the area where the chore is being done. This is particularly important for children who watch their parents do chores in and around the home. (CREDITS: American Academy of Ophthalmology)

This week we discuss changing the outcome of your health with nutrition & exercise. Our guest today is Dr. James Thompson, the author of Fearless Wellness and a passionate advocate for transformational change. He completed medical training 35 years ago and has dedicated my career to empowering others to live healthier, more fulfilling lives.

​He experienced a life-changing event in 2012 and participated in a 21-day Daniel Fast with my church community. Though the three-week diet, equivalent to a whole food plant-based diet, was intended to emphasize prayer, the impact of the food intrigued him. By the end of the second week, he had more energy, fewer joint aches, more mental clarity, better sleep, and lower blood pressure. He surmised the benefits were mainly from consuming real food and omitting processed food.

He decided to take a year-long certification course in integrative holistic nutrition which was the start of his transformation to a whole food plant-based lifestyle.

His training course, combined with a decade of studying nutrition science, love of animals, and concerns about climate change, has led me to the current space where he resides, a vegan.

​Here is the basic outline & links to his Blog and his new book : "FEARLESS Wellness: Transform Your Life, One Step at a Time"

F – Food: Embrace plant-based eating E – Exercise: Stay active regularly A – Avoid toxins: Eliminate harmful habits (e.g., tobacco) R – Restorative sleep: Prioritize quality rest L – Lessen stress: Manage and reduce daily pressures E – Engage your mind: Stimulate mental growth S – Social energy: Cultivate empathy and connections S – Spiritual connectivity: Foster a sense of purpose and belonging

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