RENEWHOUSTON.COM • THURSDAY, NOVEMBER 17, 2022 • SECTION D

RENEW

Scientific method DeBakey High still ‘fundamental pipeline’ for health field By Evan MacDonald |

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associate professor at Baylor College of Medicine. “I’d never seen anything like that before.” Cotton is among thousands of students who have walked the halls at DeBakey since it opened in 1972 as the first high school geared toward health professions in the United States. Over the past five decades it has earned a reputation as one of the top high schools in the nation. Many of its alumni have gone on to successful careers in medicine, including at the nearby Texas Medical Center. The high school celebrated its 50th anniversary last month at a Science Symposium, which featured a gala and presentations from 50 alumni. Many of those alumni DeBakey continues on D2

ots of high school students experience a moment that shapes the rest of their lives. For Dr. Ronald Cotton, it was the day he observed his first openheart surgery. Cotton can still recall the sight of a heart beating in a patient’s chest nearly 25 years after that surgery at the Texas Medical Center. It was the first time the Houston native could see himself following in the footsteps of his uncle, who was his mentor and a general surgeon. And it was a moment he was unlikely to experience anywhere but DeBakey High School for Health Professions. “It was just this amazing, ‘a-ha’ moment,” said Cotton, a 1998 graduate who is now a transplant surgeon and an

TOP: Students George Kuo and Cherish Amby-Okolo conduct a science experiment involving thermal energy while Prapti Kaur, above, fills a graduated cylinder with liquid during an AP chemistry class at DeBakey High School. Photos by Leanora Benkato/Contributor

CLINICAL TRIALS OFFER HOPE FOR PANCREATIC CANCER. D5 Feeling a hot mess? Try mindset workouts for next-level wellness. D5

D2 THURSDAY, NOVEMBER 17, 2022

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DEBAKEY From page D1

credited their success to their time at DeBakey, where they were exposed to an array of possible careers in medicine when they were teenagers. “You show just the slightest interest in the medical field, and this high school was just built, and this curriculum was just built, to really grow it exponentially,” said Dr. Lisa Wofford, a 1999 graduate who is now the chief of anesthesiology at Ben Taub Hospital. Like Cotton, Wofford also has vivid memories of shadowing TMC doctors as a high school student. Her main rotation was at Ben Taub, where she’s now been working for 10 years. “I have very vivid memories — and this was like 30 years ago — of that rotation,” she said. “It was so important to help me determine the path I wanted go down.” DeBakey was originally called the Houston High School for Health Professions when it started as a partnership with the Houston Independent School District and Baylor College of Medicine. Its goal was to integrate healthfocused subjects into a traditional high school curriculum, to increase interest in health professions and make them more accessible. It was renamed in 1996 to honor Michael E. DeBakey, the renowned surgeon and former president of Baylor. When it opened, just 45 students attended the high school classes at Baylor. Today, about 900 students take classes at the $67 million campus that opened in 2017 on the edge of the Texas Medical Center. The building has changed, but the high school has maintained its reputation for rigorous academic standards. More than 1,000 students apply for admission each year, and they are chosen through a matrix score — which considers grades and other factors — and a lottery. They are also required to take a health science and math “readiness” assessment. Adjusting to DeBakey can be tough, even for students who were among the brightest at their middle schools. Marrthella Diaz loves spending time with her friends, but she realized early in her freshman year that she needed to prioritize studying in order to thrive at DeBakey. But Diaz, now a senior, also knew early on that she was in the right place. As a freshman, she would see upperclassmen in scrubs or personal protective equipment, and she knew she was surrounded by others who shared her interests. “I realized that a lot of people here, like me, had a passion for improving people’s lives, and making people’s lives better,” said Diaz, who plans to pursue a career in public policy and focus on health care issues. The fact that so many students share common interests and goals tends to foster a sense of community among them, current DeBakey High School Principal Jesse Herrera said. “They feed off each other,” Herrera said. “They’ll see their classmates do something and they’ll want to do it, too. They want to achieve and get everything they can out of their high school experience.” At DeBakey, typical high school classes like English, math, and history are taken

Photos by Leanora Benkato/Contributor

DeBakey High School students Jason Li and Zane Asadi participate in an experiment about thermal energy during an AP chemistry class.

alongside health science courses that focus on topics like medical terminology, patient care and dentistry. Students analyze blood and urine samples; make a patient’s bed; learn dental charting; conduct an STD test; and learn CPR, among other things. Angel Perez, another current senior, knew in middle school that he wanted to pursue a career in medicine. The feeling of putting on scrubs for the first time for one of his classes was thrilling, he said. “It really brought that dream to life,” said Perez, who wants to be a cardiovascular surgeon. “It was like, ‘Man, I’m doing this.’” The success of DeBakey’s students is also a testament to its teachers, alumni and current students said. Wofford remembers how her teachers — many of whom had worked in a clinical setting — prepared her for what she’d experience while shadowing TMC physicians. Diaz, Perez and their classmates missed out on opportunities to shadow at TMC due to ongoing COVID-19 restric-

Biology teacher Marla Maharaj helps Riley Anderson, a senior, with her two-dimensional model of the cell cycle in AP biology.

tions, but they’ve gone on trips to nearby medical research labs. They also have opportunities to network with TMC physicians and DeBakey alumni, including at the recent 50th anniversary gala. “I’ve been emailing cardiovascular surgeons, nonstop, for about two years already,” Perez said. “Recently I’ve been invited to a few lectures and online Zoom meetings with them. And I’m starting to build relationships with them.” Both Cotton and Wofford feel their experiences at DeBakey set them up for success later in life. Cotton graduated at the top of his class and was accepted into the Houston Premedical Academy, an eight-year scholarship program where students attend the University of Houston and receive a provisional acceptance to Baylor College of Medicine out of high school. Wofford found the rigorous academic standards at DeBakey honed her work ethic. She also attended UH, then went to medical school at New York University. “Honestly, college was a piece of cake compared to high school,” she said. “It was because of what I learned in high school, and the foundation that high school gave me.” While many DeBakey alumni have gone on to successful careers in medicine, Cotton believes the school’s legacy is in the fact that it opens the door to those health professions. Without DeBakey, many of its students might not have those opportunities, unless they had a family member who also worked in health care. Cotton knows the effect that being exposed to those types of careers can have on a teenager, having experienced it himself as a DeBakey student. “It is this fundamental pipeline — this fundamental opportunity for access,” Cotton said. “How many people know all the careers that exist in medicine from a high school age? Being exposed to it in a hospital setting, even if it’s a brief exposure — that can be transformative.” [email protected]

DeBakey High School seniors Samantha Johnson, Shams Al Faisal, Sonia Joshi and Prapti Kaur are among the 900 students who take classes at the $67 million campus that opened in 2017 on the edge of the Texas Medical Center.

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THURSDAY, NOVEMBER 17, 2022 D3

QUIZ

How long do leftovers last? Test your food-safety smarts Pre-holidays quiz can help spare you and loved ones from foodborne illnesses By Ann Maloney WA S H I N GT O N P O ST

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enerous buffets, treasured covered dishes, golden turkeys stuffed with dressing. Each is a staple of holiday entertaining, and each brings its own challenges when it comes to safely feeding ourselves and others. That’s why when this festive winter season rolls around we’re encouraged to pay special attention to food safety. “We would love for people to be careful with their food all year-round, not just during the holidays,” said Meghan Lassiter, family and consumer sciences agent for the North Carolina Cooperative Extension. “But there is definitely something about the holiday season that gets people thinking about being more safe and being more careful.” That is probably because we’re eating away from home more, at restaurants, parties and the houses of family and friends, or we’re playing host ourselves, she said. “We don’t want to be the one who gets people sick,” Lassiter said, adding that we can eliminate most of the risk for food-borne illness by following simple rules. Think you know just what to do to keep your family and friends safe? Let’s find out! Take the quick quiz below, and if you get stymied, we’ve got all of the facts, so you can channel your inner food safety expert as you prepare delicious meals in the weeks to come. Q: Is it safe to store perishable foods however you like as long as they are in the refrigerator and freezer? A: No. First, clean your refrigerator and freezer and make sure there is enough room for storing foods before you go shopping. Then, store fruits and vegetables separately from meats or seafood and avoid crowding, leaving space for air to circulate. If storing or thawing meats or fish in the refrigerator, place them inside another container to catch any juices and store them on a lowest shelf to avoid cross contamination. An inexpensive appliance thermometer can help ensure your refrigerator is at a safe 32 to 40 degrees and your freezer is at 0 degrees. Interior shelves maintain more consistent temperatures. If possible, reserve refrigerator shelf doors for condiments, butter, hard cheeses and freezer doors for nuts, whole grains, butter or bread/rolls. Q: We all know we should wash our hands with soap and running water, but for at least how long? A: 20 seconds. Wash your hands with soap and water for at least 20 seconds. Rinse them under running water and dry them thoroughly. Do this before touching food, containers or utensils. (In a pinch, if soap and water are not available, use a hand sanitizer with at least 60 percent alcohol, rubbing it in for at least 20 seconds.) Also, remember to wash surfaces, containers and utensils with hot soapy water or, if possible, use

Scott Suchman/For the Washington Post

Take steps to make sure Thanksgiving dinner and leftovers are safe.

the dishwasher, between each food preparation. If you want to make your own sanitizer, add 1 tablespoon bleach in a gallon of water and use that solution to clean cutting boards and countertops. Q: What’s the best way to thaw frozen foods, including a turkey? A: In the refrigerator. Never thaw food on the counter. The safest way to thaw frozen foods is in their original packaging in the refrigerator. If the item, such as a turkey, contains juices, place it inside a rimmed baking sheet or bowl to catch any released liquid. Remember, you’ll need about 24 hours for every 4 to 5 pounds, so a 16-pound, frozen turkey, for example, will need at least 4 days to thaw. (The only time you should not thaw food in its original packaging is vacuum-packed fish because of the potential of botulism. It should be moved to a clean container with a cover.) If you’re in a hurry, other safe ways to thaw food include: Place the food in a zip-top bag or airtight container and submerge it in cold tap water; changing the water every 30 minutes and allowing about 30 minutes per pound. Also, you can safely thaw food in a microwave. Food thawed in water or in the microwave, however, MUST be cooked immediately. If you have to cook your turkey from frozen, you can do that. Check out our Desperation Turkey (From Frozen). Q: What is the best indicator that food is cooked or reheated to a safe temperature? A: Take its temperature. The temperature is the ONLY way to be sure cooked food is safe to eat. Invest in a calibrated digital instant read thermometer. America’s Test Kitchen recommends Thermoworks Thermapen Mark 4 for $99 and the more reasonably priced Thermopop for $29. Both work well. For example, a turkey should be cooked to 165 degrees, with the legs cooked to 175. If the turkey is stuffed, the stuffing also

should be at 165 degrees. To test foods, measure it at its thickest spot, avoiding any bone, if present. If testing a stew or other dish with a sauce, stir it before taking its temperature. Reheat sauces, soups and gravies by bringing them to a rolling boil. Q: How long can you leave perishable food at room temperature? A: Two hours. Foods that require refrigeration can be left at room temperature for up to 2 hours, 1 hour if the room or space is 90 degrees or hotter. This includes cooked and uncooked foods. Bacteria grow most rapidly in the range of temperatures between 40 and 140 degrees - considered the “danger zone.” The amount can double in as little as 20 minutes. Some foodborne bacteria produce poisons or toxins that are not destroyed by high cooking temperatures, so if food is left out beyond the recommended times, it should not be reheated and should be discarded. Anything that looks or smells off or suspicious should be thrown out. Q: Leftovers are the best part of holiday meals. How long do I have to eat them? A: Four days. Properly stored leftovers — those that have not been at room temperature for more than 2 hours — should be eaten or frozen within 4 days. This rule doesn’t apply to all foods — some, like cranberry sauce, can be eaten for up to 5 days, while others, like gravies and sauces, will taste best if eaten in two days. If you know you have more leftovers than you can finish in a couple of days, food safety experts say go ahead and freeze it rather than wait. It will taste better and that is the safer way to handle leftovers. Don’t wait. Refrigerate leftovers as soon as you finish your meal. Chill them quickly by placing them in shallow containers and cutting larger foods, like that turkey, into smaller pieces. Wrap them tightly or put them in an airtight container to keep bacteria at bay. If a large

quantity of food is piping hot, transfer it to smaller containers and place it over ice to cool it down for 20 minutes to avoid heating up your refrigerator. When reheating, it is best to reheat only the portion you plan to consume rather than reheating the whole amount. Before serving, reheat casseroles to 165 degrees and bring sauces and gravies to a rolling boil. Refrigeration slows but does not stop bacterial growth, so there is some risk of snacking on any cold leftovers, especially for infants, the elderly, and those who are pregnant or immunocompromised. Q: Which of these foods should not be prepared in advance before cooking? Pie crust Stuffing/dressing Mac and cheese Green beans A: Stuffing/dressing. Never refrigerate uncooked stuffing. This is because it is at a high risk for bacterial growth. If not freezing or cooking, the dry and wet ingredients can be mixed separately and refrigerated, but should not be mixed together until just before cooking. If stuffing a whole bird, spoon the stuffing in loosely, about 3/4 cup of stuffing per pound. It should be moist because heat destroys bacteria more rapidly in a moist environment. The stuffed bird or casserole dish should immediately be placed in an oven set no lower than 325 degrees. When finished baking, use a food thermometer to ensure the stuffing is at least 165 degrees. If the stuffing is baked inside the whole bird, take the poultry out of the oven and let it stand 20 minutes before removing the stuffing. Refrigerate cooked poultry and stuffing within 2 hours. If freezing cooked stuffing, place in a shallow container and freeze immediately. To use it safely, do not thaw it before cooking. Cook the frozen stuffing until it reaches 165 degrees. Premade storebought stuff should also be cooked to 165 degrees. Q: How long can I

leave my homemade fruit and nut pies on the counter? A: Two days. The USDA says fruit pies made with sugar are food-safe at room temperatures for up to 2 days because the sugar and acid slow bacterial growth. After that, they can be refrigerated for up to 2 more days. If the house is warm, however, experts recommend storing all the pies in the refrigerator. Any pies or pastries containing eggs or dairy even in a topping - must be covered and refrigerated. They should stand at room temperature for only up to 2 hours. This includes pecan, pumpkin and custard pies, according to the USDA. Commercially produced pies, such as pumpkin, are typically made with preservatives to keep them shelf-stable for longer, but, if they contain egg, the USDA advises that leftovers be refrigerated as well. Use foil, plastic wrap or an overturned bowl to cover pies unless you have a pie keeper. If using a bowl, allow the pie to chill first to avoid condensation. And remember when baking that you should not eat raw dough or filling containing eggs or flour. Both are raw and can cause illness. If you are not cooking the eggs, such as for meringues, use pasteurized eggs. Q: What do I need to know before I bring food to a potluck? How long will I travel? When will my food be served? Will the host have space for my food in the refrigerator/freezer/oven or on the stove? A: All of the above. Remember the two-hour rule as you consider both travel time and the time between your arrival and when the food will be eaten. Don’t assume you’ll be able to slip your dish into the refrigerator or oven. Check with the host to find out what’s possible before offering to bring a certain dish. If you are hosting, be sure to share these details with attendees. It is easier to bring something cold or something that is room temperature than something hot. For short distances, say within 30 minutes, the best way to travel with a hot casserole is to keep it in the pan it was cooked in, double wrap it in foil, then wrap it in tea towels and place it in an insulated box or bag large enough to store it flat so that it won’t spill. For longer distances, consider making the dish the day before and then refrigerating or freezing it properly. Transport the cold food in a cooler with freezer gels or ice. Reheat it to 165 degrees once you arrive. (If foods are frozen, pack them directly from the freezer into a cooler.) A full cooler maintains its cold temperature better, so pack empty space with ice or frozen gel packs. Keep snacks or drinks in a separate cooler. Be sure to keep cooked foods separate from fresh vegetables or breads. Upon arrival, put cold foods in the refrigerator or over ice. Place hot foods in a 200-degree oven or in a chafing dish, slow cooker or warming tray capable of holding foods at 140 degrees or warmer.

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THE EXPERTS Q: I am 77 and have been diagnosed with osteoporosis. I am taking Fosamax and taking all the steps recommended for strengthening bones. But I have two questions: First, is it possible to avoid a fracture without taking medication. Second, is it necessary to avoid coffee Dr. Keith completely? I Roach am confused about both TO YOU R GO O D questions, HE A LT H having read a lot of conflicting information online. I recently finished reading a book that strongly condemned osteoporosis medication and have also read that coffee is OK, even good for bones; though, other sources say it leeches calcium from bones. I would appreciate some clarity on these issues. A: I have also read dire warnings about osteoporosis drugs, particularly the bisphosphonate class such as alendronate (Fosamax), but the truth is more complex than it first appears. The most important thing to realize is that every person has their own individual risk of developing an osteoporotictype fracture. For young, healthy people with strong bones, the risk is very small, but as we age, the risk of fracture increases. Many medical conditions, as well as diet, exercise and some medications, affect the risk of fracture. Whether we are men or women, and even what our ethnicity is, affects fracture risk. The bone mineral density measured by a DEXA scan provides much information, but an accurate fracture risk prediction needs to take a person’s whole history into account. Only people at high risk for a fracture should be taking medication like Fosamax. A standard guideline is that people should be recommended medication therapy if their 10-year risk of a hip fracture is greater than 3 percent, or their 10-year risk of any kind of major osteoporotic fracture is 20 percent or higher. If a person’s risk is less than these numbers, they may be subjecting themselves to the risk of medication unnecessarily. The FRAX score is a standardized, country-specific way of estimating risk (shef-

That almost always means surgery is recommended if the disease is thought to be potentially curable. This is because the best results come in people who have as complete of a surgical resection as possible. With ACC in particular, radiation treatment is very commonly recommended as well after surgery, but radiation treatment alone is not very effective for this tumor. Chemotherapy is not part of standard treatment at this time for people with malignant salivary gland tumors unless the disease has spread at the time of diagnosis. Your husband has extensive local disease from what you are telling me, but for the surgeon to recommend extensive surgery, it suggests the surgeon feels that, right now, the tumor is potentially curable with surgery.

Fracture risk determines need for osteoporosis meds

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Age and many medical conditions, as well as diet, exercise and some medications, affect the risk of fracture.

field.ac.uk/FRAX/tool.aspx). If a group of people has a risk of fracture of 20 percent in the next 10 years, then 80 percent of them will not have a fracture if they don’t take medication. Like treatment for high blood pressure or high cholesterol, medication treatment helps only a small proportion of those who receive it. We don’t have the ability to predict with certainty who will have a bad outcome from these conditions, so we recommend treating people at some degree of risk. Treating only higher-risk patients leads to the drug helping a higher proportion of the group, but some people who were not offered medication will develop the bad outcome we’re trying to avoid. A person who gets a hip fracture that could have been prevented with medication treatment is a tragedy. In my opinion, a person should know the risks of treatment and the risk of with-

holding treatment before making a decision. The calcium question is also controversial, but while it is true that caffeine causes the body to lose calcium, if you take in enough calcium through diet, coffee does not seem to increase your risk of a fracture. Q: My husband has a tumor in the right sinus of his face, and the biopsy results show that it is cancer of the salivary glands (adenoid cystic carcinoma). The oral surgeon says it will continue to grow and cause discomfort and wants to remove part of his jaw and teeth to do reconstructive work. All this involves several weeks in the hospital and a lot of trauma. He says radiation won’t help. My husband is distrustful and says “surgeons just want to cut.” He wants to study all the options, including chemothera-

py. The tumor has “migrated” into the upper roof of his mouth and is causing ear and jaw pain, as well as loosened teeth. A: Salivary tumors are rare, so the best treatment for them is not as well studied as it is for cancers that are more common. Ideally, a treatment plan is decided on by a combination of specialists, including radiologists, pathologists, surgeons and oncologists. (This is often done by a regular meeting of a “tumor board,” who review the data from the radiologist and pathologist and then decide on the best treatment to recommend to the patient and family). Knowing the stage of the tumor, especially whether the cancer is in the lymph nodes or has spread elsewhere, is critical when deciding the optimum treatment. Adenoid cystic carcinomas (ACC) can be aggressive and are nearly always treated with a combination of modalities.

Q: I’ve been diagnosed with spinal stenosis and sciatica. I’m taking prednisone for my pain, but taking prednisone before used to be excruciating. Why does my health provider want me to stop taking prednisone now and go see a pain management specialist? I have no pain and am able to walk, sleep and work. I am aware of long-term complications. Only occasionally do I get leg cramps. I’ve gained weight, but I’m painfree. A: It is the long-term complications that are the issue. Persistent use of steroids will often cause high blood pressure, diabetes and osteoporosis. The amount of prednisone and how long you take it are the most important factors in whether you’ll develop these problems. Steroids, like prednisone, work by reducing inflammation, and the fact that you are pain-free on prednisone strongly suggests part of the compression of the nerve is due to inflammation. A pain management specialist might be able to inject a steroid directly into the area of inflammation and nerve compression, giving you the benefit of the steroid with much less risk. Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or send mail to 628 Virginia Drive, Orlando, FL 32803.

Extra-virgin olive oil offers important health benefits

Olive Oil Council or the USDA Quality Monitoring Program. One of these certifications may help you find a good quality bulk olive oil.

JOE AND TERESA GRAEDON PE O P L E’S P HA R M ACY

Q: Recently I read, with interest, your article about the benefits of consuming olive oil. The amount of olive oil was very modest, but you did not specify the quality of olive oil. What were these people using? Did it matter where the olive oil comes from? I do hope you will be able to fill in the details. Furthermore, I am planning to give U.S.-made products for the holidays this year. I’d like to purchase bulk olive oil and fill small bottles as personal gifts for my friends. Can you recommend a bulk olive oil that would offer the benefits you described? A: In the research we discussed, the quantity of the olive oil was specified (at least 7 grams a day or half a tablespoon). However, the investigators did not address the quality or source. That is probably because their study included almost 100,000 nurses and other health professionals who filled out dietary questionnaires periodically for 28 years (Journal of the American College of Cardiology, January 2022). Those who consumed more olive oil were less likely to die during that time from cancer or cardiovascular, neu-

Angel Garcia/Bloomberg

Extra-virgin olive oil is unrefined and made from the first pressing of the olive fruit. It contains phenols that give it a distinctive flavor and have important health benefits.

rodegenerative or respiratory disease. A previous study, the PREDIMED trial, compared people following a prudent diet low in fat to those who followed a Mediterranean diet with additional nuts or extra-virgin olive oil (New England Journal of Medicine, June 21, 2018). Those

consuming extra-virgin olive oil had fewer cardiovascular events. Extra-virgin olive oil is unrefined and made from the first pressing of the olive fruit. It contains phenols that give it a distinctive flavor and have important health benefits. (Cells, Feb. 19, 2020).

ConsumerLab.com recently evaluated 10 EVOO products. Their top two picks were California Olive Ranch Everyday EVOO (available in bulk) and Lucini Italia Organic EVOO. ConsumerLab.com suggests looking for a quality seal such as the North American Olive Oil Association, the California

Q: About three months ago, I gave up dairy and no longer take Celebrex for my arthritis pain. I do drink golden milk (almond or coconut milk with a dash of black pepper, a squirt of ginger paste and half a teaspoon of powdered turmeric) morning and evening. I have found that this keeps my joints moving. A: Thanks for sharing your recipe. Golden milk is a timehonored way of taking turmeric in the Ayurvedic tradition. One reader told us that when he was growing up in India, his mother gave him golden milk to ward off colds. Other people use it for digestive disorders, and many find it helpful, as you do, against arthritis. We include a traditional dairy-based recipe for golden milk along with numerous other remedies in our book, “Recipes & Remedies From The People’s Pharmacy.” Substituting nondairy “milk” also works for this recipe, although the fat in cows’ milk aids absorption of the turmeric. “Recipes & Remedies” also provides natural approaches for lowering blood pressure and managing cholesterol, easing indigestion and treating colds and coughs. You will find it in the books section of the store at PeoplesPharmacy.com. Contact the Graedons at peoplespharmacy.com.

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’ve been working on myself for a while. I exercise, pay attention to what I eat, occasionally get enough sleep. I do other random stuff too: I journal, keep my house sort of organized (as much as possible with 3- and 4-year-olds and a less-organizationallyinclined husband). Oh, and I take good care of my skin. I’ve been doing lots of things, in various forms, for a long time. But I’m not saying this to brag. I’m saying it in my own defense — because I’m still a hot mess. One thing that’s become crystal clear to Marci me over the Sharif years is that all FE E L I N G MAT T E R S this stuff is good — it makes a difference and helps me feel better. And it’s not enough. Really feeling and living well requires addressing what goes on in our heads. Our mindsets determine how we see things, and how we respond. How quickly we bounce back from a blow. How oriented we are toward joy. There’s a lot we can’t control in this life, but we can choose our mindsets and actively, lovingly work on making them stronger, healthier, brighter. But that takes some training. Just like physical health requires ongoing physical exercise, building and maintaining a healthy mindset takes some concerted effort, too. This is why I started something called “Mindset Workouts.” It’s a new program featuring one simple exercise each week. The intention is to get into better shape — in our heads. Here’s what we’re doing this week: mental noting. Change starts with awareness; this week’s exercise is all about building that up. The practice is to pay attention to whenever you notice a level of unease creep up, in one form or another. When you notice it, make a mental note of what’s going on. Do

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this silently, in just one word, which you might repeat a few times to yourself. For example, I often find myself feeling panicked about my kids. The idea is to catch that, and since the best word to describe what I’m doing in that moment is “worrying,” I then gently say “worrying” in my head two to three times. Or, say I notice myself feeling bummed, a little down and out. I might check in and note that I’m “judging” or “comparing.” Other word I find myself using often: stressing, resisting, clinging. I tend to stick with words that end in “ing” — ones that sum up what I’m doing. Occasionally, when I can’t pinpoint that, I just name the prevailing emotion and note how it feels in my body. But this is all this process involves: just observe; just note. The point of this exercise is to bring more awareness and consciousness to what’s happening in our minds, specifically in tense moments when it’s easy to check out or react. I sometimes find doing this gives me a bit of relief in a tense moment by helping me disentangle from whatever I’m caught up in. But whether it offers a but of relief or not , at a minimum it increases selfawareness, which isn’t ever in vain. Getting more familiar with our own thoughts is a key aspect of mindset health. So, give this exercise a try this week, and consider joining my weekly “Mindset Workouts” program online. It feels good to positively and proactively work on ourselves, and it feels even better to do that in community. We do physical exercises together, why not exercise our mindsets together too? Whether you join the program or not, consider how you can chisel your mindset more and more — it’s a really important muscle.

Are you a hot mess, too? Try mindset workouts for next-level wellness

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Our mindsets determine how we see things, how we respond and how quickly we bounce back from a blow. Taking mental notes can help you exercise self-awareness and disentangle from whatever has you in rut.

Marci Izard Sharif is an author, yoga teacher, meditation facilitator and mother. For her weekly Mindset Workout, which is reinforced with a guided meditation and gentle yoga class, visit marcisharif.com.

D6 THURSDAY, NOVEMBER 17, 2022

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MEDICAL

Clinical trials offer hope for treatment of pancreatic cancer As the third-leading cause of cancer-related deaths with a low survival rate, new research at Baylor center hopes to improve detection and outcomes By Kim Kyle Morgan CO R R E S P O N D E N T

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hen Houston resident Edgar Salazar began experiencing back pain, he didn’t pay a lot of attention. When he began having trouble eating, he became more concerned. When his stomach became swollen, he couldn’t keep food down and he began losing weight, he and his wife Joanna knew it was time to seek medical attention. Tests revealed the 54-year-old father of four had a mass on his pancreas, an organ located deep in the abdomen that is essential for digestion and sugar control. “The last thing on our mind was pancreatic cancer,” Edgar said. According to the Pancreatic Cancer Action Network, there are approximately 62,000 new cases and 50,000 deaths each year in the United States. It affects men and women almost equally. November is Pancreatic Cancer Awareness Month. It is currently the third leading-cause of cancer-related deaths in the United States but is projected to be the second-leading cause within the next decade. The five-year survival rate is only eight percent. It can be difficult to diagnose, challenging to manage and highly lethal, but there’s hope for improved treatments coming from the patients themselves, in the form of clinical trials. Dr. Benjamin Musher, director of medical oncology at the Dan L Duncan Comprehensive Cancer at Baylor St. Luke’s Medical Center, said there are currently multiple “home-grown clinical trials testing novel immunotherapies in all stages of pancreatic cancer studies underway at Baylor St. Luke’s,” but only about 5 percent of patients with pancreatic cancer participate in such studies. “We know that we are not going to improve outcomes without more patients enrolling,” Musher said. Salazar felt he had nothing to lose. “Dr. Musher asked if I wanted to do a trial,” said Salazar, who underwent a Whipple surgery before joining a study in July 2022. “If I can help other people going through this, I am happy to do so.” He’s feeling better and is even putting on weight, he said. “The greatest hope right now is a small miracle to give me at least a couple more years with my wife and kids,” he said. “I’m feeling really good compared to how I felt when I first started the trial treatment.” One of the most promising components of pancreatic cancer clinical studies is immunotherapy, which relies on the patient’s own built-in defense system against cancers. It has greatly improved the prognosis of many other cancers, but doctors have yet to reach that degree of success with pancreatic cancer. The newest clinical trial at Baylor St. Luke’s recently enrolled its first patient, said Dr. E. Ramsay Camp, chief of surgical oncology at Baylor College of Medicine. It combines chemotherapy with immunotherapy, followed by surgery, and is for patients with early-stage cancer who are candidates for surgery. “What we’re trying to do is use chemotherapy to change the tumor, which should then make the tumor more responsive to immunotherapy,” Camp said. “We’re hoping to do this before the tumor is surgically removed, creating that strong immune response to where the patient gets lasting protection.” Deciding which trial is best for individual patients depends on whether the tumor is operable, if the patient has already had surgery or not, if the cancer has metastasized and what stage it’s currently in.

Michael Wyke/Contributor

Dr. Benjamin Musher, left, and Dr. Ramsay Camp consult with patient Edgar Salazar, a 54-year-old father of four who had a mass on his pancreas, at Baylor St. Luke’s McNair campus.

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Joe Cardello’s father, John Cardello, died of pancreatic cancer, and he wonders if genetics played a role.

“Because of a clinical trial, we have hope,” said Joanna Salazar. “We are thankful for the opportunity to extend his life.” One of the reasons pancreatic cancer is so deadly is it’s often already advanced by the time its caught — and that’s because symptoms can be subtle, such as vague abdominal or back pain, loss of appetite and nausea. Other symptoms are clearer, such as jaundice and unexplained weight loss. Unlike breast cancer or colon cancer, there isn’t yet a reliable screening method for pancreatic cancer. However, Camp said the Dan L Duncan Comprehensive Cancer Center and the Liver and Pancreas Center at Baylor St. Luke’s Medical Center are working together on early detection research. “Signs of diabetes might be an early detection marker, but it’s a long way off from changing current clinical practice,” Camp said. “Right now, there’s no real effective screening test for most patients.” But national guidelines have been updated to recommend genetic counseling for anyone diagnosed with pancreatic cancer, regardless of age or family history. “Anywhere from 10 to 20 percent of pancreatic cancers are thought to be inherited,” Musher

PANCREATIC CANCER • It’s the third-leading cause of cancer-related deaths in the United States, but is expected to become the second-leading cause of cancer-related deaths in the next decade. • At only 8 percent, it has the lowest five-year survival rate of any major cancer. • More patients will die from pancreatic cancer this year than breast cancer. • For more information about pancreatic cancer clinical studies at Baylor St. Luke’s Medical Center call 713-798-3743 or visit clinicaltrials.gov.

UNITED IN PURPLE 5K WALK The local chapter of the National Pancreatic Cancer Foundation,is hosting a 5K walk at 1 p.m. Nov. 19 at Rob Fleming Park in The Woodlands. Registration is $30 and all proceeds will be donated to the National Pancreatic Cancer Foundation. Register at npcf.us.

said. “Some of those people will be found to harbor a mutation that explains why that person developed pancreatic cancer.” The most common mutation is the BRCA mutation, Musher said, which predisposes carriers to breast, pancreatic, ovarian

and other cancers. PALB2 is another mutation that increases the risk for breast and pancreatic cancer. “It’s important for someone to know if they have a genetic cause of their pancreatic cancer because it means other family members are also at risk if they carry that gene,” Musher said. “Furthermore, we have targeted medication for BRCA-related pancreatic cancer, another reason why genetic testing is recommended.” Besides inherited mutations, risk factors for pancreatic cancer include smoking, obesity and heavy alcohol consumption. “But most of the time, we can’t look at a patient and tell them ‘you have pancreatic cancer because of X, Y and Z,’ ” Musher said. Gina and Joe Cardello of The Woodlands have often wondered what role genetics play in their family history of the disease. Joe’s father, John “Chubby” Cardello died of pancreatic cancer in April 2014. He was 71. John’s brother Anthony died of pancreatic cancer in 2022 at age 81. Joe’s father had vague symptoms for some time before the diagnosis — symptoms the family initially attributed to John’s work as a truck driver. “His back pain — well, he drove a truck for years, and that’s hard on the back,” Joe said. “Nausea, belching and stomach pain could have been from not eating well on the road. He didn’t realize anything was seriously wrong. We were shocked when he was diagnosed. I knew he would fight, but I knew it wouldn’t be a great outcome.” John Cardello lost his battle after three years. Joe and Gina Cardello have since become involved with the National Pancreatic Cancer Foundation, a nonprofit organization that supports patients, families, and research. “There’s enough trauma in finding out you have a disease that has a low survival rate,” Gina said. “We want them to focus on positive thoughts and have a positive spirit, instead of worrying about where the rent is going to come from.” Since 2009, the foundation has provided more than $1.4 million in assistance to more than 400 families. In 2016, the foundation contributed more than $220,000 in research funding. “The survival rate is just not good enough. We need to do better for our patients,” said Camp.