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Brenda F. Johnson

RN at Gi Lab

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  1. Brenda F. Johnson

    Have you had your Colonoscopy? March is Colon Cancer Awareness Month

    That is very brave!
  2. Brenda F. Johnson

    Have you had your Colonoscopy? March is Colon Cancer Awareness Month

    I find that docs have different views on when to bring someone back for a follow up colonoscopy. Some of the criteria is family history, if they found any polyps, etc. If you have a screening that shows no disease at all, and no polyps, then it really can be 10 years. I hope this helps.
  3. I’ve been a GI nurse for about 25 of my 27 years of nursing and I have seen a multitude of changes take place. The proficiency of a colonoscopy has improved as scopes have become more flexible with high definition cameras that lead to an increased adenoma detection rate. Now that screening colonoscopy is paid for by insurance, more people are getting one and lives are being saved. But there still remains a societal imputation around the test that hopefully over time will disappear with education and awareness. March 24 - 28 is GI nurses week this year, so if you know a GI nurse, please celebrate with them. SGNA is the national organization for GI nurses that sets the guidelines for standards of practice and provides many services with the most important being education about gastroenterology. There are many opportunities in your community to serve as a volunteer or participant at a colon cancer awareness event. Here in Chattanooga, we have the Rump Run on March 9th. It is a run or walk event with a bouncy house and face painting for the kids, and a large colon to walk through that exhibits different types of colon polyps and cancers. Colon cancer survivors are the highlighted guests of the day as they share their stories to help spread awareness. It is a fun way to spend a Saturday morning. The reason a colon screening is so important is that very often there are no symptoms when a person has colon cancer. There may not be any visible bleeding or pain and therefore some cases of colon cancer are not detected until there is an occluding tumor or metastasis. Educate your circle of friends and family to talk to their doctor about when they should get a colonoscopy. The first time screening is at age 50 except for African Americans who should get one at 45, and of course those with a family history. Some of you may have read or heard that colon cancer is on the increase in younger people. The highest increase has been seen in the age group of 20s. Although the exact cause is not known, genetics and environmental factors are thought to play a role. These younger patients are more likely to die from the diagnosis than older patients (Priedt, 2018). Some signs and symptoms that we can tell our patients to watch for is blood in the stool, diarrhea and constipation, abdominal cramps, and the feeling that aren’t empty after a bowel movement. If one of your patients, friends or family has unexplained weight loss, fatigue, and jaundice, make sure they make an appointment to see their doctor right away. These are signs of advanced colon cancer and they need to be addressed. Most of us have known someone affected by colon cancer, and the fright that diagnosis can bring. We lift up those going through the trenches of surgery, chemo and radiation in our prayers. Also, we celebrate the survivors, those who have been in the pit and are now on the other side. Many survivors give back by telling their story and educating their community. March is the month to highlight these wonderful people and one by one, save a life. I am proud to be a GI nurse and I learn something all the time. I have come to respect the GI system and how important it is to our bodies. Research is continually realizing all that the GI system does for us and how we treat it is so important. What we eat and drink really does matter. Celebrate Colon Cancer awareness month in your unit or office this year and make it an annual event. Participate or volunteer in a local event, it is rewarding and not to mention a lot of fun! Are you a colon cancer survivor? If so, please share your story with us. Reference Preidt, R. Colon Cancer Hits Younger Adults Especially Hard, 1 Oct, 2108. Healthday Reporter. Retrieved from https://www.webmd.com/colorectal-cancer/news/20131001/colon-cancer-hits-younger-adults-especially-hard-study-finds#1
  4. Brenda F. Johnson

    Congratulations! You're a New Nurse Leader…Now What?

    Thank you for this article, I can relate to the information because I am in a new role of leadership after many years. The biggest change for me is the information that I learn, I also want to share, but cannot. Before, I didn't really have to have a filter, now I have to check myself before sharing certain things. Doing the little things for my unit and staff goes a long way for unity and satisfaction.
  5. In our country, and specifically in healthcare, we are leadership deprived. It is difficult to lure good leaders into management positions due to the increased stress that they will have to deal with. Adding to that, younger nurses don’t want it either. There are other fields of nursing that they can invest education and experience in that will yield them more money. Some nurse managers are promoted out of convenience or because they are great nurses. However, Good clinicians don’t always make effective managers because they may not have any leadership skills. Over 70% of nurse staff turnover is because of bad managers (Roussal, 2016). When a nurse leaves a position, it can cost around $75,000 to replace that person (Roussal, 2016). This includes the recruitment of the new staff person, replacement, and possibly temporary staff until the position is filled. Included in that number is the overtime paid to the present staff and the orientation of the new person. When there is a high turnover, the core staff become burned out and unhappy leading to the potential of additional turnover. Personally, I have had some fantastic nurse managers, and some not so fantastic. But my recent experience tops the not so fantastic scale by epic proportions. I kept waiting for the lies to catch up to this person, or the emotional bullying to escalate until someone finally reported the problem. For years, I had begged for help from the manager’s superior, but to no avail. Nothing happened. I felt trapped, frustrated, and angry. Was there no one who cared that the whole department was stressed and unhappy? A part of my frustration was that my co-workers would not stand up for themselves and report the manager. A culture of co-dependency and toxic circumstances had festered for so many years, that I guess they accepted it as status quo. Recently, my manager did something that was so egregious that this person is now forced to step down from their position. What I have realized from this experience is that some of my co-workers who would not have reported this incident. The manager would have gotten by with it, and gone on to commit other intentional errors. Now that there is some exposure to the bad management, my co-workers are more willing to speak up. The people who were brave enough to speak up in the first place did so with much consideration and purpose. There are incidents that are reportable, that must be reported by those with knowledge of what happened. Of course, there are incidents that aren’t harmful but still need to be reported. This allows for a review of the system and root cause analysis that improves how we do things and prevent future incidents. There are a few leadership qualities that lead to failure; lack of vision is one of them. Leaders must be able to articulate their vision so that the staff can relate and understand. This will help staff know that they are a vital part of fulfilling that vision. If a leader has no connection to the larger picture, the staff feel disconnected and unimportant. When a manager has no empathy, the staff don’t feel cared for. Part of having empathy is being able to listen and hear them when they have concerns. No motivation can kill a department’s ability to thrive. Having an environment that helps to create energy and purpose will allow the staff to enjoy their workplace. Also, when a leader has no eye on the future, the staff feel stifled and are unable to learn and grow. Good leaders create trust between themselves and the staff. If the staff has trust, then they will feel comfortable bringing to you issues that they have. They will also know that the manager has their back in difficult situations. A nurturing environment will grow empowerment amongst the staff. A good leader accepts responsibility for things that are their responsibility. They don’t deflect blame onto the staff, or elsewhere but instead are mature enough to self evaluate and use situations to improve their leadership skills. Being an advocate and liaison between the staff and upper management, other departments, and ancillary is an important part of being a good manager. Being open and approachable will go a long way in human relationships. Having a good emotional IQ helps as well. Communication is extremely vital in maintaining any relationship, and especially important with management. Being able to effectively communicate and have crucial conversations will make all the difference in how staff respond to changes. Not every good leader can be excellent in all aspects, but they can continue to try and learn. As for those bad leaders. . . I have no idea! Tell us about your good leader, or bad one. Give us the reasons they are either good or bad. Reference Roussal, L., Harris, J., Thomas, T. (2016). Management and Leadership for Nurse Administrators, 7th Edition. (Western Governors University). Retrieved from: https://wgu.vitalsource..com/#/books/undefined/
  6. Brenda F. Johnson

    Mental Illness Awareness Week October 7-13, 2018

    Thank you for working in mental health, it is a difficult area. I understand what you are saying because I see it in my own family. We can hope that with more awareness, the younger generation will get treatment earlier and be more open to it.
  7. Brenda F. Johnson

    Mental Illness Awareness Week October 7-13, 2018

    I know, it is so frustrating. But often this is the case.
  8. Brenda F. Johnson

    Mental Illness Awareness Week October 7-13, 2018

    Whether it is a family member, friend, or you, mental illness can be devastating, especially when it goes untreated. When a person with mental illness reaches out to someone they feel safe with and then receive negative feedback, they can be devastated. People who don't understand, will often say something that hurts the person reaching out. As a result, that person may not tell another person, ever. People who are suffering with a disease need help, support and treatment. Mental illness is no different than any other disease but it is one that often gets hidden until something tragic happens. Sometimes all a person needs is for someone to listen. Caring enough to actively listen can mean a lot. We know as healthcare workers how much listening can change a situation. The National Alliance on Mental Illness is an organization here to help change America's perception of mental illness. They advance their cause through education, support, and patient advocacy. Their website tells us that eating disorders are the most harmful. Eating disorders can start young, so being able to detect a child with one could save their lives. The National Institute for Mental Health reported a study from 2015 that tells us that one in five people (43.8 million) adults have a mental illness. America's young people age 13-18 have a high number of those affected as well. In fact 21.4% will deal with some form of mental illness in their life. These numbers are high, and that isn't including those who do not discuss their problems with their doctors and go undiagnosed. Whenever we have a problem, no matter what it is, having someone who understands, helps us to feel better about the situation. We share our stories because we know that the other person relates on a gut level. As a person with a mental illness, finding a support group, or someone they can talk to, can make a huge difference in their treatment. Knowing that they are not alone can be the difference between life and death. Having family members who have mental illnesses, I see how ignoring the issue can make it so much worse. These people often mask their feelings with alcohol or drugs, leading to other physical illness. Many people refuse treatment while others take medication and once they feel better, they stop taking it. This cycle can be dangerous for the patient. Talking to our loved ones can be tricky. Staying nonjudgemental and open to what they say is essential. Having real conversations helps everyone involved. Connect with Someone The helpline for the National Eating Disorders Association is 800-931-2237 Text NEDA to 741741 to get connected to a volunteer National Suicide Prevention Lifeline 800-273-TALK (8255) The more we share information and talk about mental illness, the more the stigma will dissolve. We can be part of the movement to educate ourselves and others about mental illness. As nurses, we can talk to our patients openly and honestly helping them to get the correct treatment. Involving their families will also decrease the stigma that surrounds mental illness. Allowing both the patient and the family to ask questions of us and the doctors will help one by one getting past learned prejudices about mental illness. We as nurses can also be the voice of reason among our peers. A person who is mentally ill can cause their caretaker to fear them due to not knowing how to properly approach their care. When we coach our co-workers and lead by example we will improve the patient's experience along with educating each other. Understanding the dynamics of their illness will help us in treating them. Speak to the patient about their illness as you would their other physical issues. They will appreciate the openness and honesty. I know there are a lot of nurses out there that work in the field of mental illness. Share with us your experience to help us educate each other and the patient.
  9. Brenda F. Johnson

    Investigating Cannabinoid Hyperemesis Syndrome

    The reference is at the end of the article
  10. Brenda F. Johnson

    Investigating Cannabinoid Hyperemesis Syndrome

    Wow, thanks for sharing. I know this has to have an extreme effect on the family.
  11. Brenda F. Johnson

    Investigating Cannabinoid Hyperemesis Syndrome

    Knocking on the door, I paused a second before opening it. Inside were two people, the young man who was the patient, and his mother. I introduced myself and began asking the usual questions for esophagogastroduodenoscopy/ colonoscopy patients. Did you finish your prep? Did you eat any solid food yesterday? He passed my test, so then after checking his armband, he hopped on the stretcher and off we went. As I pushed the stretcher to my department, he had a few questions of his own. How long will this take? Will I feel anything? During our conversation both to the department and back to his room, I noticed some unusual words, and some not so unusual such as hot showers, how many drugs he had done and when, and pot smoking. Some of the conversation seemed cryptic between mother and son. I didn't participate in that part of the exchange, but listened. Both exams showed normal results, and when I got report from my fellow GI nurse, she mentioned pot smoking, and in a whisper insinuated that there was more to the story than the mother knew. Once he was settled back in his room, I went to the nurses station to give report and that is when I found out about his diagnosis, "Cannabinoid Hyperemesis Syndrome". The other nurse was just as interested as I, and she told me that it was basically when too much pot was smoked that they got severe abdominal cramps and vomiting,and then took long hot showers to relieve the cramping. That's when I decided I needed more information about this. According to the article, "Cannabinoid Hyperemesis Syndrome", it is a rare situation that advances to repeated and very severe spells of vomiting. It is seen only in patients who use cannabis daily on a long term basis. The marijuana in these cases works paradoxical of what it usually does. Normally, it decreases nausea and vomiting, however in these cases, the opposite is true. Marijuana is harvested from the dried leaves, seeds, and flowers of the Cannabis sativa plant. The chemicals in the plant bind to the brain and cause the "high" felt by the users. But not only does it bind to the brain, but also to the digestive tract. Long term users feel the effects of the drug because it affects the length of time it takes to empty the stomach as well as decreasing the pressure of the lower esophageal sphincter, leading to the emesis. Certain receptors in the brain stop responding to the drug which leads to hyperemesis. Researchers are not sure why some patients get the syndrome while other do not. During these bouts of hyperemesis, patients can see blood from a tear in their esophagus called a Mallory Weiss tear. Whenever we see blood, it is scary and further investigation is needed to make sure there isn't something more serious wrong. There are three stages of CHS, the prodromal stage, the hyperemetic phase, and the recovery phase. Below it is explained further: Prodromal phase - early morning nausea and abdominal pain, most keep a normal eating habit during this phase, and use more marijuana to help the nausea. This phase can last from months to years. Hyperemetic phase - ongoing nausea, repeated vomiting, abdominal pain, symptoms of dehydration, and decreased food intake, weight loss. Vomiting is intense and the patient is overwhelmed. They take multiple hot showers during the day and it eases the nausea. Most seek medical attention during this phase. Recovery phase - the symptoms go away only if the patient stops using the drug. Normal eating is resumed and this phase can last days to months. The symptoms usually return if the patient smokes marijuana again. The symptoms of CHS are very similar to other issues, and because of it's relatively new diagnosis, it can often be misdiagnosed. The treatment for CHS is IV fluids for dehydration, antiemetic medications, pain medication, PPIs, and ironically frequent hot showers. To recover completely, the patient must stop the use of marijuana. Some of the complications that can occur with CHS are: Muscle spasm/weakness Brain swelling Seizures Kidney failure Heart rhythm abnormalities shock If you see patients with repeated admissions due to severe vomiting, consider CHS. Patients often do not admit they smoke pot to their doctor, however, it can save them possibly years of misdiagnosis and prevent further health problems. Have you had any patients with CHS? Please share your story. Reference "Cannabinoid Hyperemesis Syndrome". N.d. Saint Lukes Health System. 17 May, 2018. Web.
  12. Brenda F. Johnson

    Deadly Water: An Era Gone By

    Dark clouds moved over the farm, casting shadows on the grass. The birds sang and fluttered among the tree branches. A calm settled over the fields while the dogs ran in circles around the cattle. Sitting at the kitchen table, William could smell the rain. He erased the" A" he had just drawn on the small chalkboard and began again. Inhaling deeply, William exhaled slowly as he squinted at the board. The afternoon light dimmed as the sun hid behind the storm clouds. The candle's flame disappeared as a cool burst of wind punched through the window, knocking the curtains back. Spring was around the corner, but the day's cold temperature kept the lake frozen. William got up from the table to look outside. He was thirsty, so he grabbed the hammer and ran outside to the lake. He broke some ice off the lake and put the pieces in his pocket as he ran back into the house. He barely made it inside before the rain began. Giggling, he put the ice in a cup and poured water from the pitcher into his cup. The next morning, William was collecting eggs from the chickens when he began to feel stomach cramps. His flannel overcoat suddenly seemed too heavy, so he took it off and laid it over the fence so it wouldn't get dirty in the damp chicken coop. Bending over once again, he picked up two more eggs. Suddenly he stood up straight in his knickers and dropped the eggs. Running to the outhouse, he started crying as diarrhea ran down his leg: the suspenders and buttons were too much to undo in time. Wiping the sweat from his forehead, William went back and collected his coat and the eggs, taking them into the house. Tears began again as he saw his mother take in the scene before her. He didn't expect the look of panic he saw in her brown eyes. She took the eggs from him and led him to the tub to clean up. William never saw the blood on his pants. Once in bed, William slept. Over the next couple of days, William's diarrhea got worse. He could not keep water or food down. When he had a seizure, his mother screamed out in horror. She had never seen a person have a seizure and did not know what was happening. William's little body lie limp, his eyes blank. The next morning, William was gone. Outside, the rain started falling from the black sky in fat drops, then turned into a flurry of a storm. William in his innocence had no idea that the ice he gathered from the lake was contaminated. He just wanted a cool drink after working on his homework. It could have been E. coli or shigella bacillus, either way it was fatal for this young boy. Because they lived on a farm, far away from medical care along with the lack of knowledge that was common in this era, William, like many people, died from contaminated water. In the book, Hygiene and Sanitation A text book for Nurses by George M. Price, M.D. he tells nurses about the health concerns regarding water. Ice is used frequently for drinking and also for keeping food cold. Most ice is "taken from lakes, ponds and rivers" that can be contaminated. He says that it is ok to use this ice as a "cooling method" but not for drinks. Freezing does not kill the bacteria that lurks in the water, so use it only for ice chests and refrigerators (some use electricity) made of wood. These old books give us the gift of seeing into the past when nursing and disease prevention was just beginning to become a public concern. In the forward, Price writes these precious words: "The last decade has seen a wonderful expansion of the function of the trained nurse and a great broadening of the scope of her usefulness. No longer are her duties limited to the simple care of the sick. The nurse has become a priestess of prophylaxis. Her work in preventative medicine has become invaluable. She has become an important factor in social, in municipal, and in public health work." I enjoy reading my old medical books and writing the "era gone by" series. I learn something every time. Most importantly, I feel a connection with the nurses who once held the old, dusty books. If you like this article, you can read the rest of my series at my blog. Reference Price, George M. M.D. Hygiene and Sanitation a Text Book for Nurses. 3rd ed. Lea & Febiger, 1917.
  13. As nurses, learning how to take a blood pressure is one of the first skills we learn. We are very familiar with the numbers, knowing immediately if the numbers are too high, or too low. It never hurts to review exactly what is happening behind those numbers. Pathology of Blood Pressure The measurement of blood pressure is the velocity of blood pressing against the walls of our arteries. The greater the pressure, the harder the heart has to work. Untreated high blood pressure can cause a lot of damage to our hearts, kidneys, brain, lungs and blood vessels. The top number - (systolic) represents the heart beat, while the bottom number -(diastolic) represents the heart at rest (the refilling of the heart with blood). Symptoms of hypertension can be severe headache, nose bleeds, and shortness of breath. However, some patients may not feel any symptoms, garnering hypertension the title of silent killer. Risks of Hypertension Hypertension is one of those conditions that some patients have the power to decrease their risk factors. In the guideline, "Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults", by Paul K. Whelton, MB, MD, MSc, FAHA, they share that in 2010, hypertension was at the top of the list for causing disability and death. "In the United States, hypertension accounted for more CVD deaths than any other modifiable CVD risk factor and was second only to cigarette smoking as a preventable cause of death for any reason". Often those with hypertension may have other CVD risk factors. For example, current smokers, obesity,diabetes, hypercholesterolemia, and chronic kidney disease. Controlling cholesterol and being compliant with kidney treatment are ways to decrease a patient's risk of CVD. Smoking and obesity are some risk factors that the patient is accountable for. As in almost every other disease process, diet and exercise improve the body's ability to fight disease. What we eat is directly related to our health. There are risk factors that the patient can't necessarily change. There is a strong correlation with hypertension and genetics. We have all seen patients diagnosed early in life with hypertension and when we ask them about family, almost always they have a strong family history. As we grow older, the higher the chance for us being diagnosed with hypertension. Males have a greater percentage of hypertension than females, along with those who have obstructive sleep apnea, and high levels of stress. Another factor that is out of the control of the patient, is the ethnic group we are born into. Those at the highest risk are African-American and Hispanics. Whites and Asian patients come next. Hypertension is sometimes diagnosed with one reading at the doctor office, resulting in over diagnosing of the disease. Rather, it should be based on the average from several visits, combined with the patient keeping a log at home. New Blood Pressure Guidelines The article by the American College of Cardiology broke down Whelton's research in their article, "New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension". The approach of treatment lowers the range of blood pressure from 140/90 to 130/80. The focus is to treat earlier, modify risk factors and use a preventative approach to lowering patient's risks to debilitating disease or even death. This new set of numbers will lead to an increase of "46 percent" of the population being diagnosed with high blood pressure. This will affect men under the age of 45 the most (it will triple the men diagnosed), and double the amount of women under 45 who will be treated for hypertension. Again, the objective is early detection, early treatment. However,treatment isn't always in the form of medication. New Guidelines taken from the American College of Cardiology article Normal: Less than 120/80Elevated: Systolic between 120-129 and diastolic less than 80Stage 1: Systolic between 130-139 or diastolic between 80-89Stage 2: Systolic at least 140 or diastolic at least 90. Other recommendations - only prescribe medication for Stage 1 if the patient already has had a heart event such as heart attack/stroke. Sometimes patients will need more than one medication to control their blood pressure, and combination drugs increase compliance. The third recommendation is for doctors to recognize that socioeconomic and psychosocial stress play a role in risk factor for hypertension and should be part of the plan of care. The new guidelines were developed by a large panel of professionals. Nine health professional organizations were involved, and then written by 21 scientists and health experts all who reviewed over 900 published studies. Controversy Over New Guidelines The American College of Physicians had several reasons that they did not care for the new guidelines. First, it would put a lot of people at an earlier age on a daily medication where they state, "adverse events could outweigh the benefit". They tell us that it would increase the number of adults on hypertension medication by 4.2 million. Other concerns are the cost to patients, potential in lack of individualized care, and overburdening the doctors with managing these patients. Conclusion Sometimes change can be difficult. It remains to be seen how this new guideline effects our statistics regarding hypertension and prevention. Have you had a doctor use this new guideline? Have you heard them discuss it, if so, tell us what you have learned about how they feel about it. References Darrah, Joe. "AHA Guidelines Causing Controversy". Jan. 19, 2018. Advance healthcarenetwork. Web.Feb. 27, 2018. "New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension." Nov. 13, 2017. American College of Cardiology. Web. Feb. 27, 2018 Whelton, PK. et al. "2017 ACC/AHA/AAPA/ACPM/AGS/APhA/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults". 2017. A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Web. Feb. 27, 2018.
  14. Our Amazing Immune System When our body detects an abnormal cell or a microbe that can make us sick, then the white blood cells, or leukocytes jump into action to fight for us. When cancer cells are detected, the killer T cells attack them. There are occasions when it can be difficult for the immune system to detect cancer cells, or the cancer cells escape anticancer responses of the killer T cells. Vaccines - Preventative and Therapeutic In an article by the National Cancer Institute called "Cancer Vaccines", the difference between a preventative vaccine and therapeutic vaccine is defined as follows. "Preventive (or prophylactic) vaccines, which are intended to prevent cancer from developing in healthy people. Treatment (or therapeutic) vaccines, which are intended to treat an existing cancer by strengthening the body's natural immune response against cancer. Treatment vaccines are a form of immunotherapy." To date, most people have heard of the vaccine for HPV (Human papillomavirus) that is given to young girls to prevent cervical cancer, anal cancer, vulvar, oropharyngeal cancer. It is given to young boys for prevention of penile cancer, anal cancer, and genital warts. The other preventative vaccine for cancer is the Hepatitis B virus vaccine. This is given in the United States to babies shortly after birth. There are more than one vaccine, some act on Hepatitis B only and others on both Hepatitis B and A. These vaccines prevent the virus from infecting the body, therefore inhibiting the cancer caused by the viruses. What is Immunotherapy? The article, "Cancer Vaccines and Immunotherapy", reviewed by Caitlin E. Lentz, PharmD, research is focusing on vaccines that will generate the immune system to attack cancer cells as well as "boost the immune system's response to cancerous cells". This therapeutic approach would be treating cancer once it has been diagnosed. The two subgroups of these vaccines are autologous and allogeneic. The autologous (one's self) vaccine is one that is developed from the patient and their own cancer cells. The cancer cells are harvested and then treated to be an objective for their immune system. Once injected, the cells are identified and then destroyed along with the rest of the cancer cells present. This method is a treatment for the present cancer, or to prevent cancer from coming back after surgery and other treatments. There are some completed, but not licensed according to Lentz. The other type of autologous vaccines are made from a person's own immune cells. There is one that has been licensed called Sipuleucel-t (Provenge) for prostate cancer. The following are steps the patient takes in getting such a vaccine as taken from the latter article. Patient goes to the lab to get blood drawn. Lab isolates a certain type of immune cell from the patient's blood. Lab technicians expose the immune cells to a prostate-cancer antigen fused with an immune-cell stimulator. Treated immune cells are infused back into patient, through a vein. Treated immune cells signal other immune cells to attack prostate cancer cells. The allogeneic cancer vaccines are made from "non-self cancer" cells grown in a lab. These vaccines are less costly to make, and several are being researched, however, they haven't been found effective so none are licensed. Two other types of vaccines are still in clinical trials, the protein or peptide cancer vaccine and the DNA vaccine. The first used the protein or peptide from cells and the second uses the patient's own DNA. As the research continues, cost and effectiveness are a large part of the equation. More often, the types of cancer such as breast, lung, and pancreatic that are the best candidates come with high cost and a lot of side effects. The Latest in Research In the article, "Cancer 'Vaccine' Eliminates Tumors in Mice", by Krista Conger they boast that in their studies of mice, they were able to eradicate metastases. Clinical trials are being set up that will study patients with lymphoma. How they are doing this is by injecting "two immune stimulating agents directly into tumors." In fact, Ronald Levy, MD professor of oncology states, "When we use these two agents together, we see the elimination of tumors all over the body. This approach bypasses the need to identify tumor-specific immune targets and doesn't require wholesale activation of the immune system or customization of a patient's immune cells." Clinical trials are being done for one of the components to be used on humans, the other is already approved. The method Levy uses is one that works to revive cancer-specific T cells by injecting the two agents straight into the tumor. These T cells then seek out other identical tumor cells in the body. This kind of research gives hope to future cancer patients that has never been thought possible. Cuba's Role in Cancer Vaccines Most of us do not think of Cuba as being on the cutting edge of the medical community, nonetheless, they have been vital in developing cancer vaccines. 2016 saw a change in travel and trade between the U.S. and Cuba, also lifting restrictions on joint medical research between the two countries. Due to the embargo that prohibits commercial cargo flights, shipping items from Cuba to the United States is very difficult. Sarah Zhang tells us in the article, "Cuba's Innovative Cancer Vaccine Is Finally Coming to America," how hard it was to get a box of water from Havana to Buffalo New York. This was no ordinary box of water, it contained the test run for a vaccine for lung cancer called CIMAvax. The box traveled to Toronto where it was then escorted to the U.S. border and then on to the Roswell Park Cancer Institute. The CIMAvax vaccine is not approved by the FDA here in the U.S., but it is used in countries like Colombia, Cuba, and Peru. Because of their research and the change in political climate between the two countries, they can work together to help people all over the world have a higher quality of life living with cancer. Cuba was also the country responsible for developing the meningitis vaccine in the 1980s. What could the future look like with global collaboration in health care. Conclusion The future treatment of cancer is looking more hopeful as researchers continue to develop new methods of treatment. Immunotherapy is getting more publicity and could one day be the standard. Cancer vaccines have moved from being preventative to also being prophylactic, thanks to the help of Cuba. There is a huge amount of information regarding this subject with more coming all the time. Read the research and take notice when you see the news talking about this to see what's new. Have any of you had any experience with this type of treatment? Please share, we would love to hear your story. To find information on clinical trials for cancer vaccines you can call the NCI Contact Center at 1-800-4-Cancer (1-800-422-6237). References "Cancer Vaccines". Reviewed 18 Dec. 2015. National Cancer Institute. Web. 6 Feb. 2018. Conger, Krista. "Cancer 'Vaccine' Eliminates Tumors in Mice". 31 Jan. 2018. Stanford Medicine. Web. 6 Feb. 2018. Lentz, Caitlin E. (Reviewer). "Cancer Vaccines and Immunotherapy." 10 Jan. 2018. History of Vaccines. Web. 6 Feb. 2018. Zhang, Sarah. "Cuba's Innovative Cancer Vaccine Is Finally Coming to America." 7 Nov. 2016. TheAtlantic. Web. 6 Feb. 2018.
  15. That's a fantastic idea!