The People's Pharmacy Radio Program Everything from home remedies to the latest breakthrough drugs are discussed on The People's Pharmacy. Pharmacologist Joe Graedon and medical anthropologist Terry Graedon talk to leading experts to discuss issues relating to drugs, herbs, home remedies, vitamins and related health topics.
The People's Pharmacy Radio Program

The People's Pharmacy Radio Program

From North Carolina Public Radio

Everything from home remedies to the latest breakthrough drugs are discussed on The People's Pharmacy. Pharmacologist Joe Graedon and medical anthropologist Terry Graedon talk to leading experts to discuss issues relating to drugs, herbs, home remedies, vitamins and related health topics.

Most Recent Episodes

Show 1236: The Inside Story on Vaccines Against COVID-19

SARS-CoV-2, the coronavirus responsible for COVID-19, has infected many millions of people both in the United States and around the world. The death toll is horrifying, with more than a quarter of a million people in the US alone. With infections soaring as we head into winter, the news that a couple of vaccines against COVID-19 appear to be effective is especially welcome. What Do We Know About Vaccines Against COVID-19? Pharmaceutical firms around the world are working hard to develop vaccines against COVID-19. In the US, those that are farthest along are based on a new technology using messenger RNA (mRNA). Both Pfizer and Moderna are using this approach, and both have recently announced effectiveness rates approaching 95 percent. So far, what the world has seen are press releases. However, when the companies apply for approval or emergency use authorization, the FDA will examine the data carefully. How Do the Companies Test the Vaccines? To determine a vaccine's effectiveness, some volunteers in the trial must get the immunization while others get a placebo. Neither the participants nor the researchers can know who has received vaccine and who got placebo. That is the only way to be able to tell if the vaccine actually works. For the vaccines currently under development, the companies made a special effort to recruit a diverse group of volunteers. They wanted participants of various ages, genders and ethnic background so they could make sure the shot will be safe and effective for everyone. Moreover, they wanted to make sure to test it in tens of thousands of people. That way, they could be reasonably sure to detect common side effects. Even some uncommon reactions will show up if you give a shot to 20,000 individuals. Distributing Vaccines Against COVID-19: Once data on these vaccines have been closely examined by the FDA and its advisory committee, the Centers for Disease Control and Prevention will also take a look. If they are given the green light, the firms face the hardest part: producing and distributing the shots. Both of these new vaccines need to be transported and stored at cold temperatures. However, the Pfizer vaccine has some extreme requirements that are likely to pose logistical challenges. Who Should Be First to Get Their Immunizations? Public policy suggests that people at highest risk should be the first to get their shots. That would definitely include health care workers and first responders. It might also include essential workers and people with health conditions that put them at risk. It may take some time before everyone can be protected. In the meantime, we will all have to stay vigilant with distance, facial coverings, hand hygiene and avoiding gathering with others indoors. Our guest, Dr. Paul Offit, is one of the country's leading experts on vaccines. He serves on the advisory committee for Vaccines and Related Biological Products at the FDA. He shares his knowledge, his concerns about vaccine-related misinformation and his vision of how we can bring this pandemic to a close. This Week's Guest: Paul A. Offit, MD is the Director of the Vaccine Education Center at the Children's Hospital of Philadelphia as well as the Maurice R. Hilleman Professor of Vaccinology and a Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. Dr. Offit is the author of several books, including his most recent, Overkill: When Modern Medicine Goes Too Far. His website is http://paul-offit.com/ Listen to the Podcast: The podcast of this program will be available Monday, November 23, 2020, after broadcast on November 21. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1235: Safer Sex in the Time of COVID

In the midst of a pandemic, many people feel isolated. When you are not even supposed to shake hands, much less hug or kiss, how can those who live alone meet their needs for sexual intimacy? Is it possible to date without running a high risk for COVID-19–or a sexually transmitted infection? How can people have safer sex, even in these risky times? Talking About STIs: Our guest, Dr. Ina Park, talks frankly about sexually transmitted infections (STIs) and how to reduce the risk. She describes ways people can have safer sex. In fact, the first health professionals to use public health tools such as contact tracing were striving to control conditions like syphilis and gonorrhea. Now contact tracers are on the front lines against the spread of COVID-19. It is a critical tactic in trying to figure out who may have been exposed to an infection. Many people are very reluctant to talk about STIs due to the stigma we associate with them. However, nearly every sexually active person will catch one strain or another of human papillomavirus (HPV) at some point in their lifetimes. As a result, we should drop the stigma and deal with these infections based on knowledge and compassion. Testing at Home: Although people have cut back dramatically on their visits to doctors and clinics, they can still check on their sexual health. Those who continue to be sexually active with more than one partner may need access to testing for safer sex. We discuss how to use home tests for sexual infections. Dr. Park offers this link from the Kaiser Family Foundation to learn more about online access to testing and contraception: https://www.kff.org/womens-health-policy/issue-brief/a-look-at-online-platforms-for-contraceptive-and-sti-services-during-the-covid-19-pandemic Negotiating Safer Sex: When you want to socialize safely during the pandemic, you need to negotiate. That is a lot like negotiating safer sexual practices. Embarrassing as it may be, you need to ask if your partner has been tested and what the results were, as well as whether they are interacting with others or just you. Masks and condoms are certainly vastly different. However, the practice of negotiating may be more similar than you realized. The Talk About Safer Sex: Dr. Park suggests that when parents try to fit everything they want to impart into a single big talk about birds and bees, they are putting themselves under a lot of excess pressure. Instead, she recommends having dozens of little talks instead of one big one. Then, perhaps your children will grow up comfortable discussing the risks and rewards of sexual activities in a matter-of-fact way. This Week's Guest: Ina Park, MD, MS, is an Associate Professor in the Department of Family and Community Medicine at the University of California San Francisco School of Medicine, and the Medical Director of the California Prevention Training Center. Her website is at: https://www.inapark.net Dr. Park is the author of Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs, (available on 2-2-2021). The photograph of Dr. Park is by Stefan Cohen. Listen to the Podcast: The podcast of this program will be available Monday, November 21, 2020, after broadcast on November 14. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3 You can find more informatioin on the special sale on CocoaVia that we mentioned during the show at this post.

Show 1234: How Microbes Evolve to Become Enemies or Allies

The SARS-CoV-2 coronavirus behind COVID-19 is changing. This should not be a surprise, since microbes evolve by nature. What implications might this have for the infection in future months? We speak with an evolutionary biologist to see how his perspective can illuminate the pandemic. How Do Microbes Evolve? SARS-CoV-2 is a coronavirus that evolved initially in bats. How can microbes that have adapted to one species leap into a different species–say, from a bat to a pangolin or a human being? What sorts of changes will it make along the way? We consider other examples of microbes that have moved to new host species. What does this suggest about COVID-19? In addition, we'll look at the interaction with our immune systems as microbes evolve. Are Microbes the Hidden Cause of Some Chronic Diseases? A number of chronic conditions that are difficult to treat may be traced in part to infection with certain microbes. Some doctors don't believe patients suffer chronic Lyme disease. In this case, they recognize the pathogen, Borrelia burgdorferi, but no one has proven it causes the persistent health problem. On the other hand, many clinicians doubt that there are microbes behind chronic fatigue syndrome. Unfortunately, researchers have not yet identified them conclusively. Moreover, although scientists have demonstrated links between heart disease and oral microbes, few cardiologists test their patients for these germs. Initially, we consider some important questions. How would microbes evolve from agents that cause acute illness to those that cause chronic disease? What role do our immune systems play in these developments? Furthermore, what does this mean for people recovering from COVID-19? We worry that when microbes evolve, some individuals may end up suffering long-haul coronavirus symptoms. Finally, how can evolutionary biology help us understand such issues more fruitfully? This Week's Guest: Paul Ewald, PhD, is an evolutionary biologist, specializing in the evolutionary ecology of parasitism, evolutionary medicine, agonistic behavior, and pollination biology. He is Professor of Biology at the University of Louisville, in Louisville, Kentucky. His books include Plague Time: The New Germ Theory of Disease and Evolution of Infectious Disease. Listen to the Podcast: The podcast of this program will be available Monday, November 9, 2020, after broadcast on November 7. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1233: How Does Your Immune System Overcome Viruses?

One of the striking things about the COVID-19 pandemic is how differently people respond. Some people contract the virus but never really have symptoms, while others land in the hospital struggling for breath. More than a million people around the world have died from the infection, with about a quarter of those in the US. We can understand this immense variability better if we consider how does the immune system overcome viruses. How Does the Immune System Respond to Viruses? Before the immune system can overcome viruses, it has to recognize that pathogens are invading. Human immune systems have two different branches: the innate immune system that kicks in very quickly to respond to anything it perceives as a threat, and the adaptive immune system that responds very precisely to microbes it has met before. How do our bodies know that a pathogen is invading? What Is a Virus? Viruses are essentially genetic material–either DNA or RNA–that must invade a host cell and commandeer its genetic material in order to replicate. Some viruses have envelopes surrounding them, while others are "naked." All viruses can trigger signals called pathogen-associated molecular patterns (PAMPS). These in turn activate the pathogen recognition receptors that put out the alarm to the immune system. The first responders of the immune system are the cells that make up the innate immune system. Neutrophils, macrophages, monocytes and natural killer cells pick up the signals from the pathogen recognition receptors and react quickly, usually within hours. Part of their reaction is to ramp up inflammation. As a result, an infected cut gets red, swollen and painful. Certain molecules, including cytokines, draw immune cells to the site where they are needed. In the process, they create inflammation. How Does a Fever Help Your Immune System Overcome Viruses? Such inflammatory chemicals are also responsible for the fever you may experience with a systemic infection. Although many people are quick to try to bring a fever down, that might not be smart. Often a fever can help the body fight off an infection. What Happens in a Cytokine Storm? Cytokines are an important part of the innate immune response. But when the immune system overreacts, the result can be high fever, respiratory distress and lung damage. Runaway cytokines can also damage blood vessels, a common problem in COVID-19 (The Lancet Respiratory Medicine, April 27, 2020). This is called a cytokine storm. Our guest is a virologist and immunologist whose special interest is the innate immune system and how it can overcome viruses. Learn about the most promising future approaches against SARS-CoV-2, including ways to make vaccines more effective (Current Opinion in Immunology, Oct. 7, 2020). This Week's Guest: Michael Gale, Jr., PhD, is a professor of Immunology at the University of Washington School of Medicine. Dr. Gale is a formally trained immunologist and virologist whose research is focused on understanding the molecular mechanisms of innate immune response and immune programming against infection by RNA viruses, including emerging SARS-CoV-2, emerging flaviviruses, HIV, and influenza viruses. Listen to the Podcast: The podcast of this program will be available Monday, November 2, 2020, after broadcast on October 31. You can stream the show from this site and download the podcast for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

How Can You Take Control of Your Digestive Health?

The conventional view of the digestive system was that it took care of digestion and wasn't involved very much with the rest of the body's systems. Now, though, science has shown that the gut and the millions of microbes that live in it have a profound impact on other aspects of our body, from immune response to brain health and psychological well-being. How can we put that knowledge into action? To find out, we spoke with Dr. Marvin Singh. He is an integrative gastroenterologist at the forefront of delivering personalized medicine to his patients with a focus on digestive health. This is a special podcast from The People's Pharmacy, just for podcast subscribers, and it features information about one of our underwriters, Verisana. Dr. Singh shares his unique perspective as an integrative gastroenterologist who is also board certified in internal medicine. He describes how our gut health influences other aspects of our health. How Has COVID-19 Affected Our Digestive Health? The SARS-CoV-2 virus that causes COVID-19 affects the digestive tract as well as the respiratory tract. That is why some people experience diarrhea and loss of appetite among their symptoms of the disease. While we are staying out of restaurants to avoid catching ÇOVID-19, most of us have been doing more cooking at home. What are the nutritional implications? What should we be paying most attention to as we plan and shop for home-cooked meals? How Does the Gut Microbiome Shape Our Digestive Health? What is the gut microbiome? How could it modify the behavior of seemingly unrelated parts of our body. When we talk about the microbiome, we are not just describing a single species, but an entire collection. The ecological balance of bacteria, viruses and fungi that live in our intestinal tract both reflects and influences nutrition, metabolism, inflammation and hormones. How do we know whether our microbiome is healthy or out of balance? Dr. Singh describes conditions that can disrupt the microbiome as well as the consequences of dysbiosis. To improve our microbiome, it would be helpful to be able to learn more about it. You probably don't want to be spending any unnecessary time at the doctor's office during the pandemic. That's where the home health tests offered through the Verisana Health Plan can be so helpful. What Is the Verisana Health Plan? At Verisana.com, you can order home health tests for hormones, gut health and the microbiome. But which ones do you need? The advantage of the Verisana Health Club is that it provides you with the tests you need to keep track of your microbiome, hormones, and markers of inflammation and metabolism. They are offered in a rational sequence throughout the year so you don't have to stop and ponder which test you need next. With regular testing, you can detect and correct health imbalances before they lead to illness. As a special introductory offer to People's Pharmacy podcast listeners, Verisana Health Club is offering a 50% discount off the first month. To claim your discount, go to www.verisana.com/health-club/ and enter the code PEOPLE50 when you check out. Taking Control of Your Own Health: The philosophy of home testing is that patients control their own health. Monitoring our health status conscientiously with home tests is one aspect of taking control. Dr. Singh describes how we can use that information in the context of precision medicine, addressing exactly what we need when we need it. Learn what we should be doing to keep our digestive tracts healthy during the pandemic and henceforth. The Guest for This Episode: Marvin Singh, MD, is founder and CEO of Precisione Clinic. He is also director of Integrative Gastroenterology at the University of California, Irvine and a board member of the American Board of Integrative Medicine. Dr. Singh is board certified in internal medicine and gastroenterology and is also a diplomate of the American Board of Integrative Medicine.

Show 1232: What Should People Do to Protect Their Hearts?

Far too many Americans have died of COVID-19 during 2020, but heart disease is still the number one killer. Moreover, people with heart disease are more vulnerable to complications from the coronavirus. What should they do to protect their hearts? How People Can Protect Their Hearts: There are a few things that everyone can and should do to protect their hearts: eat right, exercise regularly, don't smoke and don't stress (as if you could avoid that this year). To take your heart-healthy game up a notch, though, you need to know whether you are at risk. How can you tell? Going Beyond Cholesterol Levels: Doctors usually want to know about your blood fats, like cholesterol and triglycerides, when they are considering your risk for heart disease. While this information is useful, it is far from the whole story. Our first guest, Dr. Blaha, describes calcium CT scans of the coronary arteries. When are these images useful? What other risk factors might be relevant? Have You Heard of Lp(a)? Doctors don't always consider a little-known but important risk factor called Lp(a). (It's called ell-pee-little a.) Perhaps they give it short shrift because they don't have a good treatment for it. After all, the level of Lp(a) in your body apparently is determined mostly by your genes. Diet, exercise and other lifestyle factors don't seem to affect it noticeably. Unfortunately, cardiologists do not have targeted therapies for Lp(a). The drugs they prescribe most often, statins, may raise this risk factor slightly instead of lowering it. However, statins have other benefits for people at high risk of heart disease, so cardiologists frequently prescribe a statin for a patient with a high level of Lp(a). That should help protect their hearts. What Should You Know About Blood Lipids? Blood lipids other than Lp(a), like LDL cholesterol, are considered important risk factors for heart disease. If your LDL cholesterol (LDL-C) is high, chances are you will be advised to follow a low-fat diet to get it down. However, a review of studies does not support the efficacy of a low-fat diet. Our guest Dr. DuBroff is a specialist in blood lipids. He analyzed a number of studies of statins and discovered that the link between statin use and lower heart-disease mortality is weak. Learn what risk factors really matter for people who are trying to protect their hearts. This Week's Guests: Michael J. Blaha, MD, MPH, is Professor of Cardiology and Epidemiology at Johns Hopkins School of Medicine. He is the Director of Clinical Research for the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease. Clinically, Dr.Blaha practices as a preventive cardiologist and in the interpretation of cardiac CT. Dr. Blaha has received multiple grant awards from the National Institutes of Health, FDA, American Heart Association, Amgen Foundation, and the Aetna Foundation. The photo is of Dr. Blaha. Robert DuBroff, MD, is a clinical professor of medicine in the division of cardiology at the University of New Mexico's School of Medicine in Albuquerque. He is the co-author, with Dr. Michel de Lorgeril, of "Fat or fiction: The diet-heart hypothesis," published May 29, 2019, in BMJ Evidence-Based Medicine. Listen to the Podcast: The podcast of this program will be available Monday, October 26, 2020, after broadcast on October 24. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1231: How Can Women Reduce Their Risk for Dementia?

Two out three people with Alzheimer disease are women. Why are they at higher risk for this devastating condition than men? Even more important, how can they reduce their risk for dementia? Many of the usual explanations for this imbalance don't stand up well to scrutiny. Too many of them have been accepted without much evidence, such as the idea that women's preponderance among people with dementia is a simple reflection of their greater longevity. While women do tend live a bit longer than men, the difference is not enough to explain the imbalance. Moreover, Alzheimer disease develops over decades, so scientists should be looking much earlier in life for the factors increasing the risk for dementia. Myths About Dementia in Women: Another myth that many women accept is that genes are destiny. In other words, if your mother or grandmother had Alzheimer disease, then you are doomed to suffer from it yourself. That is simply not true, according to Dr. Lisa Mosconi. However, women who have a genetic predisposition may have to work harder to reduce their risk for dementia. How Can You Reduce Your Risk for Dementia? Medicines: There are a number of factors to consider. Do you regularly use an anticholinergic medication? Such medicines can contribute to your risk for dementia, especially when taken over a long period of time. Keep in mind that women's brains react differently to certain medicines than men's brains. One good example is the sleeping pill zolpidem (Ambien). Several years ago, the FDA established that a lower dose of this popular medicine is more appropriate for most women. It works as well and is less likely to cause side effects such as next-day hangover or sleep-driving. Menopause: Another factor to consider is menopause. When the body's production of estrogen drops precipitously, many women experience effects such as hot flashes and night sweats. Starting estradiol therapy at the start of menopause may help cushion the brain from some long-term effects of going without it. It may also help protect a woman from the sleep deprivation so common during menopause. What Kind of Exercise and Diet Can Help Reduce Your Risk for Dementia? Moderate-Intensity Exercise: Regular exercise is recognized as a pillar of health. But what kind of exercise is best for women? Research indicates that frequent bouts of low to moderate intensity exercise–such as walking or dancing–can be very helpful for women. Mediterranean Way of Eating: When it comes to diet, think Mediterranean to reduce your risk for dementia. We don't mean pasta and gelato, though. A protective Mediterranean-style eating pattern includes plenty of vegetables and fruit, lots of legumes and nuts and very little meat and processed food (including desserts). Instead of meat, think about fish, eggs or even peanuts. All of these are good sources of choline, which is critical for maintaining brain health. This Week's Guest: Lisa Mosconi, PhD, is the director of the Women's Brain Initiative and associate director of the Alzheimer's Prevention Clinic at Weill Cornell Medical College, where she serves as an associate professor of neuroscience in neurology and radiology. In addition, she is an adjunct faculty member at the NYU Department of Psychiatry. She is the author of Brain Food and The New York Times bestseller, The XX Brain. Listen to the Podcast: The podcast of this program will be available Monday, October 19, 2020, after broadcast on October 17. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1230: What Happens When COVID Symptoms Don't Go Away

Experts estimate that 30 million people worldwide have had COVID-19. More than a million have died, and approximately 20 million have recovered. However, while health professionals usually think of this as an acute illness, recovery may be far slower than anticipated. The CDC has found that 35% of adults who tested positive for SARS-CoV-2 still had symptoms more than two weeks later (JAMA, Oct. 5, 2020). What happens when COVID symptoms don't go away? When COVID Symptoms Don't Go Away: Health professionals may know, generally, what to expect from a disease. On the other hand, having undergone it yourself gives you a different perspective, whether you are a health professional or not. We speak with a doctor who had COVID-19 and recovered. We also talk with a social epidemiologist. This previously healthy young person will tell us what it feels like when COVID symptoms don't go away even though it has been months since the initial infection. Which COVID Symptoms Don't Go Away? According to the CDC report, fatigue and trouble breathing easily are the most common symptoms that linger long after a positive test for SARS-CoV-2 has cleared. Other potential problems include heart inflammation and impaired lung function. Losing the sense of smell graphically demonstrates that this virus can affect the nervous system. The infection may trigger seizures as well. Patients struggling to recover often report "brain fog" or mood swings. Testimony from a Long-Hauler: Our guest Margot Gage Witvliet, PhD, describes her experience as a long-hauler. She was an extremely healthy young woman who caught the infection in March. After six months, she is nowhere near the state of health she enjoyed before. Despite lingering symptoms like fatigue and sore throat, she has started an online support group for women of color suffering as COVID symptoms don't go away. Discussion with a Doctor Who Recovered: We also speak with physician Michael Saag. In addition to treating patients with COVID-19, Dr. Saag had the infection himself. Find out what it is like for a health care professional to experience the very condition he is treating in other people. Our interview with Dr. Saag was conducted prior to President Trump's diagnosis and treatment. This Week's Guests: Margot Gage Witvliet, PhD, is an Assistant Professor and social epidemiologist in the Department of Sociology, Social Work and Criminal Justice, at Lamar University. http://www.margotwitvliet.com @drgagewitvliet (Twitter, Instagram) You may wish to read her compelling essay in NC Health News. Michael Saag, MD, is the Associate Dean for Global Health in the School of Medicine at the University of Alabama, Birmingham. He is Director of the UAB Center for AIDS Research and a Professor of Medicine in the Division of Infectious Diseases. Listen to the Podcast: The podcast of this program will be available Monday, October 12, 2020, after broadcast on October 10. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1229: The End of Food Allergies

Very likely you have heard of children who are allergic to peanuts. Sometimes the tiniest whiff of peanut dust can trigger a frightening reaction. Food allergies have been increasing dramatically among American children. In fact, one in 13 is vulnerable to a serious or life-threatening consequence if they accidentally consume the wrong food. The rate of such serious allergies doubles approximately every decade. Avoiding Food Allergens: The standard advice for families in which someone has food allergies is to keep those foods out of the house and away from the allergic individual. Parents may need to worry about cross-contamination, and events like school picnics or birthday parties can be scary. Pediatricians used to warn parents whose young child might have an inherited tendency to allergy that they should not let the baby have any exposure to possible allergens. That is now beginning to change, with studies demonstrating that early exposure to peanut protein, for example, may be protective. Still, once a youngster has had an allergic reaction, vigilance is key. The allergic individual or the parent must keep epinephrine (EpiPen) on hand at all times in case of anaphylaxis. Is There Another Way to Deal with Food Allergies? Research on oral immunotherapy is encouraging. This approach is not yet standard in most pediatricians' offices, so you may have to hunt for a clinical trial. However, as our guests explain, a person could be exposed to a controlled tiny amount of the food allergen to desensitize the immune reaction. Subsequently, the doctor gradually increases the quantities under safe, controlled circumstances. The goal of this treatment is that the immune system adapts. Sloan Barnett's two children went through this protocol under the guidance of pediatrician Kari Nadeau. They tell us how it is done, and how the outcome could save lives. We stress, however, that this is NOT a project that you can or should try at home. Medical supervision is crucial. This Week's Guests: Kari Nadeau, MD, PhD, is the director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford University and is one of the world's leading experts on food allergy. Dr. Nadeau holds the Naddisy Foundation professorship in medicine and pediatrics at Stanford University and as well as both an MD and PhD from Harvard Medical School. She is a member of Stanford's Children's Health Research Institute and the Stanford Institute of Immunity, Transplantation and Infection. She is the author, with Sloan Barnett, of The End of Food Allergy: The First Program To Prevent and Reverse a 21st Century Epidemic. Sloan Barnett is a lawyer, journalist, and the New York Times bestselling author of Green Goes with Everything: Simple Steps to a Healthier Life and a Cleaner Planet. Barnett chairs the California Pacific Medical Center Foundation Board and is a member of the Leadership Council of the Harvard School of Public Health. Her children have had their allergies reversed through Dr. Nadeau's program. She is the author, with Dr. Kari Nadeau, of The End of Food Allergy: The First Program To Prevent and Reverse a 21st Century Epidemic. The photo is by Bellamy Brewster. Listen to the Podcast: The podcast of this program will be available Monday, October 5, 2020, after broadcast on October 3. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

Show 1228: Why Clinical Trials Matter for COVID-19 and Cancer

Until December of 2019, doctors had no experience with pandemic that has now killed hundreds of thousands of people around the world. As the infection raced from country to country, they tried a lot of different treatments that seemed promising. But in many places, the onslaught of serious cases was so extreme that scientists couldn't find the time and resources to test those therapies in clinical trials. Should We Try First or Do Clinical Trials First? Our guest, Dr. Vinay Prasad, is an expert on medical evidence. He regrets the lost opportunities to learn what really works for COVID-19. Similar waves of enthusiasm are common in his own field of cancer treatment. Sometimes, though, a therapy that seems like a really good idea doesn't turn out to work as well in practice. Moreover, there's also the question of side effects. How do we know which approaches will have unacceptable side effects unless we actually do controlled studies? Overcoming the Confusion of Study Statistics: It takes practice to be able to read reports on clinical trials and understand exactly what they are saying. Some basic statistics are also useful. Far too often, journalists or even study authors who want to impress their readers present their findings in terms of relative risk instead of absolute risk. What is the difference and why does it matter? How did this distinction trip up FDA Commissioner Stephen Hahn? TV Drug Ads: If you've ever watched television commercials for cancer drugs, you've probably encountered that type of statistical razzle-dazzle. Quite aside from the question of why companies run TV ads for drugs that will benefit very few people, if you are among that select few, you really need to understand the benefit. Also, you'll want to pay close attention to the list of side effects. Some of them are nearly as serious as the disease the drug is supposed to treat. How can patients who've just received a frightening diagnosis, whether cancer or COVID, get reliable information about their condition and its potential treatments? Screening for Cancer: For decades, we've heard that early detection constitutes our best chance at defeating cancer. As a result, we may be encouraged to participate in screening procedures designed to pick up the first signals of prostate or colon cancer. How good are these tests, and how do we know they are good? Are there any harms that might result from finding a cancer that doesn't need to be treatment? We'll consider how to balance significant statistical evidence from clinical trials against unambiguous clinical benefit. Dr. Prasad advocates using real-world data in addition to clinical trials to evaluate the benefits and risks of tests and treatments. This Week's Guest: Vinay Prasad, MD, MPH, is a practicing hematologist-oncologist and Associate Professor of Medicine at the University of California San Francisco. He studies cancer drugs, health policy, and clinical trials and better decision making. Dr. Prasad is author of these academic articles, and the books Ending Medical Reversal (2015), and Malignant: How Bad Policy and Bad Evidence Harm People with Cancer (2020). He hosts the oncology podcast Plenary Session, and runs a YouTube Channel VinayPrasadMDMPH. He tweets @VPrasadMDMPH. Audiobook version of the book Malignant – link to listen with a 30-day free trial of Audible: https://www.audible.com/pd/B08864KFHW/?source_code=AUDFPWS0223189MWT-BK-ACX0-195112&ref=acx_bty_BK_ACX0_195112_rh_us Listen to the Podcast: The podcast of this program will be available Monday, September 28, 2020, after broadcast on September 26. The show can be streamed online from this site and podcasts can be downloaded for free. CDs may be purchased at any time after broadcast for $9.99. Buy the CD Download the free mp3

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