At 6:21 p.m. on September 18, 2016, the sun was beginning to set in New York City, and Eric Gelber started his final lap around Central Park. A crowd of supporters were running with him and cheering him on, and cowbells were ringing along the race course. Every step was painful. When he finally crossed the finish line, he broke down and kissed and hugged his wife. He had just run 200 miles and raised over $320,000—bringing his lifetime fundraising total to more than $1.1 million and moving us one step closer to a cure for multiple myeloma.
But for Gelber, the journey is not over yet. Now, he’s inviting other runners from the New York City area and beyond to join him on The Journey Towards a Cure initiative by taking part in a 12-hour endurance run/relay on October 6, 2018, to support the Multiple Myeloma Research Foundation (MMRF).
In anticipation of this new chapter in a personal journey he started more than a decade ago, Gelber explains what keeps him coming back to this cause, how this year’s event will be different than his previous efforts and why it remains vital to support multiple myeloma research.
What did it feel like to finally achieve that 200-mile run?
“It was unbelievable. I was somewhat out of it when I finished, but it felt like a dream. After two failed attempts, it was an amazing feeling to fulfill that goal. I was thinking of what all the people on my support team and I had just accomplished. Together, we pushed our cumulative fundraising total to over $1.1 million.
I’m not sure what would have happened if I did not complete all 200 miles. I decided it would be my final attempt before I did it. The following year, a documentary was released at the Tribeca Film Festival to tell my story and the stories of my friends who have been affected by multiple myeloma. I hope our story inspires more people to support this effort.”
What kept you coming back year after year to push yourself to your limits and raise money for multiple myeloma research?
“Over time, this became a massive part of our lives, and I keep coming back because I want to do as much as I can to support the MMRF.
I’m not a scientist. I’m not a doctor. But I can run, and I can fundraise. That’s my way of getting us one step closer to a cure for multiple myeloma.”
This year, you are encouraging others to run a 12-hour relay race. Why did you feel it was time to change the event?
“This year, there is a different format. I wanted others to feel like they were actively helping the cause as well. An event that gets people to come out and push themselves—either solo or in a team—expands the idea of building a community. I didn’t expect it would take this format, but it was time to evolve.
There will be the race followed by a celebration with food, kids’ activities and a music festival with four live bands. It’s important to give people a reason to come together, share their stories and celebrate life in a fun atmosphere. I’m looking forward to this new chapter.”
What advice do you have for someone who wants to get involved with this year’s event?
“If you’ve never run a race before, be cautious and set achievable goals. Pace yourself so you avoid getting injured. There is an athlete in all of us, but you don’t have to run for 12 hours. You can a join a five- or 10-person relay team and run for as long as you can. As long as you’re challenging yourself, there’s a lot to be proud of.
If you are unable to run, there’s the option to walk a loop on the course. We also need volunteers to help direct traffic, register participants and manage aid stations. All of that is critical to making this event possible.”
One of my friends has been living with multiple myeloma for 20 years. Part of that is because there are more treatments available now. It’s very encouraging.
How do you feel about the progress made in the treatment of multiple myeloma over the last decade?
“I see progress in the faces of my friends who have multiple myeloma. They’re living longer. One of my friends has been living with multiple myeloma for 20 years. Part of that is because there are more treatments available now. It’s very encouraging.
There’s still a considerable amount of work to be done. We still don’t have a cure. That’s why we’re opening the event to a broader audience. I’m still learning about organizing and putting together an event as big as this. But sometimes you have to go for it and try—just like attempting to run 200 miles. You take it one step at a time.”
To learn more about the upcoming The Journey Towards a Cure event, visit The Journey Endurance Run/Relay website.
It wasn’t easy the first time. When Kimberly Jewett was 31, she found herself listening to a doctor explain what her breast cancer diagnosis meant and what her treatment options were. But at that moment, Kimberly was thinking less about herself and more about her daughter Kalli and her son Tyler, who were 6 and 4 at the time.
“I was in shock,” Kimberly recalled. “All I could think was, ‘How do I tell my children?’”
Answering that question wasn’t any easier the second time around. Four years after Kimberly survived her first battle with breast cancer, the disease came back as metastatic breast cancer that had spread to other parts of her body. Although she knew that three out of four women who are first diagnosed with an early-stage breast cancer eventually progress to metastatic breast cancer, it was still shocking news. Her outlook was significantly less hopeful: while 90 percent of women with breast cancer are alive five years after being diagnosed, only 36 percent of women with metastatic breast cancer survive that long.
Meanwhile, her children were also older. At 8 and 10, they had a better understanding of life and death, making the experience even scarier for them. They began asking difficult questions. When they asked if she was going to die, Kimberly didn’t know what to say.
Kimberly is one of the 266,000 women each year who have to come home from the doctor’s office and tell their families that they have breast cancer. These conversations are never easy. They can be even more difficult when young children are involved, which happens frequently; an estimated 30 percent of all breast cancer in women under the age of 45 is diagnosed within a few years after giving birth.
Now in remission once again, Kimberly is teaming up with her daughter Kalli to share their stories to help other families better navigate the difficult conversation and emotions that come with a breast cancer diagnosis.
Honesty, the Best Policy
The fact that conversations may be difficult doesn’t mean they should be avoided, according to Kimberly. When she was diagnosed, her initial instinct was to protect her children from the news. But she quickly realized that keeping her disease a secret would damage her relationship with them and undermine the trust she wanted in her family.
Her kids would have eventually found out anyway, Kimberly figured, which might have distorted the truth and amplified their fears. So she believed that it was better that they heard the truth from her.
“It was also hard to shield my kids from my diagnosis because I was so emotional all the time,” Kimberly said. “My husband and I decided to tell them once my diagnosis was finalized and we knew my treatment plan.”
Looking back, Kimberly believes that one of the best things she did for her children was to be open and honest with them. By sharing her feelings with her kids, she opened the door for them to share their questions and fears with her.
“They came to me with a ton of questions, like, ‘Are you going to be okay?’ and ‘Am I going to get it?’” Kimberly said.
Sometimes, she admitted to them that she didn’t have all the answers, and that was ok. She told them that she wasn’t sure what would happen and what that meant for their future. But she assured them that whatever happened, they would find the answers together.
We continue to talk about what would happen if my breast cancer came back. All we can do is remain hopeful and continue to pay it forward by inspiring others and sharing our story.
Preparing for Difficult Conversations
Kimberly felt like she had no one to turn to for advice on breaking the news to her children. No friends or family members had gone through similar situations, and she wasn’t involved with any cancer support groups at the time.
So she started searching online for information. She found a comprehensive guide on BreastCancer.org on how to talk to children of all ages and bought children’s storybooks specifically dedicated to breast cancer. These resources were helpful in having those difficult conversations with her children.
Having now had these conversations twice with her kids, other mothers are turning to Kimberly for advice. She highly recommends an app called The Magic Tree for Breast Cancer, developed by Celgene, as a starting place. The app explains the disease in a kid-friendly way so mothers don’t have to navigate the conversation alone, according to Kimberly. It incorporates videos and games that help to answer difficult questions such as, “What is cancer?”, “Did I cause this?”, and “Can you catch it?”
“I remember reading my kids a book about a booboo on a mom’s breast, but the app does this in a video that is much more engaging for them,” Kimberly said.
Kalli—now 16—agrees. “We were so young, we didn’t understand what was truly happening. An app like this would have definitely been helpful for us.”
Kimberly said that because her kids understood what she was going through, they felt like they were part of her support system. They wanted to help her and, in the process, formed a deeper bond with their mother. Kimberly’s battle with breast cancer became a shared experience in their family.
“I wanted to take care of my mom as best as I could,” Kalli said. “She was always sitting in the same chair, tired and exhausted from her treatments. I would ask if she needed anything. I remember bringing her ice cream or whatever she asked.”
Her experience as one of her mother’s caregivers and witnessing cancer’s devastating toll firsthand certainly made a lasting impact on Kalli, who is now considering a career in oncology.
Having those difficult conversations helped to put everything into perspective for the Jewett family. Kimberly found incredible joy in sharing little moments with her children—such as watching Tyler pitch a 60-mph fast ball in a baseball game and taking Kalli to her first high school dance.
While the Jewett family are enjoying their busy lives together, they know that there’s a chance that Kimberly’s breast cancer could come back one day. “We continue to talk about what would happen if my breast cancer came back,” Kimberly said. “All we can do is remain hopeful and continue to pay it forward by inspiring others and sharing our story.”
To help facilitate conversations about breast cancer such as the ones that Kimberly had with her children, Celgene has launched The Magic Tree mobile app with input from patient advocacy groups and clinical experts. The Magic Tree is an educational interactive app with videos and activities designed to help families and their children (ages 5 to 8) to have meaningful and open discussions about a breast cancer diagnosis. The app is available for download in the United States on both Apple and Android devices.
A non-Hodgkin lymphoma diagnosis can come with many uncertainties, especially for patients with subtypes that remain chronic and incurable. Patients may feel anxious about not knowing when their lymphoma may progress or how their treatment may impact their lives. As a result, more than one-third of survivors experience symptoms of post-traumatic stress disorder.
Those uncertainties can make navigating diagnosis and treatment emotionally crippling. But a doctor who acts as a partner in their lymphoma care—educating patients on therapeutic options and supporting them throughout their treatment—can make all the difference in building confidence in their patients.
With that in mind, the theme of this year’s World Lymphoma Awareness Day, recognized on September 15, was “Small Things Build Confidence.” In recognition of this campaign, Dr. Nathan Fowler, associate professor at MD Anderson Cancer Center, discusses why taking the time to ensure people with lymphoma understand their therapeutic options can go a long way in strengthening their confidence in their treatment decisions.
How does understanding of their therapeutic options help lymphoma patients build confidence in their treatment?
“When people living with lymphoma understand their treatment options, they are better prepared to navigate what’s best for them. Fortunately, patients have multiple treatment options for lymphoma, and their participation in the decision-making process is important. They should be aware of the risks and benefits of any treatment that they’re starting.
There’s also a psychological benefit of understanding the path ahead, the chances of success and having confidence in the treatment choices made. From my observations, patients who approach treatment with understanding and confidence are less stressed and are in a better place psychologically.”
How important is the doctor-patient relationship to addressing uncertainties and building confidence for lymphoma patients?
“It’s paramount that patients feel their doctor is going to be a partner in their care throughout their entire treatment journey. Today, many patients take it upon themselves to search the internet and learn all that they can about their disease. But, they should also feel comfortable coming to their doctor with questions when things just don’t make sense. They shouldn’t feel like they have to figure it out all alone.
I’ve grown quite close to many of the patients I have treated over the years; I know details about their families, their friends and their lives. In fact, the close relationship that I’ve forged with my patients is one of the rewarding parts of being an oncologist.”
What are some common questions that your patients with lymphoma ask you?
“The most common question I get asked is ‘am I going to die from this?’ Patients also have concerns about treatment side effects, insurance coverage of their treatment and how the disease will affect their work and their families.
The best way to address these concerns is to be very honest and discuss both the good and the bad. While survival rates for lymphoma are generally increasing with new treatment options, some subtypes of non-Hodgkin lymphoma have varying outcomes for patients and remain incurable.”
Why is it important for patients with lymphoma to know their subtype?
“The more we learn about the over 80 different subtypes of lymphoma, the more we learn how dramatically different they are from each other. These diseases behave differently and respond differently to various treatments, which is why patients should have a basic understanding of their subtype.
Knowing their subtype is critical to balancing the risks of therapy against the risk of the disease. This information needs to be factored into a patient’s decision for treatment.”
What are some of the concerns that patients have about their treatment options?
“Almost every patient I see in the clinic has concerns about their treatment. I spend a great deal of time talking about how each treatment works. When a patient feels like part of the decision-making process, they can be more confident when they start their cancer treatment.”
It’s paramount that patients feel their doctor is going to be a partner in their care throughout their entire treatment journey.
After a patient has been treated, how do you address their concerns about their cancer returning?
“When a patient finishes treatment, they still need to see their doctor frequently. Return visits not only allow many of our patients’ questions to be answered but also allows us to monitor their progress and determine if their disease may have returned. Regular follow-up visits help reassure patients that multiple options exist should their cancer return, which can help relieve a patient’s concerns while furthering the doctor-patient relationship.”
To learn more about advances in lymphoma treatment, read “The Many Faces of Lymphoma.”
Disclosure: Dr. Fowler has received research funding from and is on a scientific advisory board of Celgene.
The current benchmark for efficacy in clinical trials of new plaque psoriasis treatments is a 75 percent reduction in the Psoriasis Area and Severity Index (PASI), which is a measure of the area of skin affected along with the skin’s appearance. But the most bothersome symptom, according to a survey of patients with plaque psoriasis, was not skin appearance, but itching.
As thousands of dermatologists gather at the 27th European Academy of Dermatology and Venereology Congress in Paris to discuss the latest data from ongoing clinical trials in psoriasis, Dr. Colby Evans, M.D., a dermatologist in Austin, TX, and also the immediate past chair of the Board of Directors of the National Psoriasis Foundation, discusses how researchers measure the effectiveness of treatments in clinical trials and how those measurements could be more comprehensive.
How do researchers measure the effectiveness of new plaque psoriasis treatments in clinical trials?
“Efficacy of plaque psoriasis treatments has immensely improved over the last 20 years, making more ambitious endpoints realistic. While a 75 percent reduction in PASI score has been the Food and Drug Administration’s benchmark, we see a growing interest in PASI 90 or 100 in more current trials. We want to get patients as close as we can to PASI 100. That being said, achieving a PASI 50 along with an improvement to quality of life is still clinically beneficial.”
Does PASI comprehensively capture all the clinical benefits of psoriasis treatments?
“PASI measures the size, as well as the level of scale, redness and thickness of psoriasis plaques. It does not capture other debilitating symptoms associated with psoriasis, such as psoriatic arthritis, itching or social stigma.”
How impactful are those symptoms on the lives of patients with plaque psoriasis?
“Itching can be debilitating and miserable, and can interfere with daily functioning. Survey data showed that people with psoriasis reported having a higher level of sleep-related problems compared to the general population.
Psoriatic arthritis is also of high concern among patients with psoriasis. Approximately 30 percent of plaque psoriasis patients develop psoriatic arthritis. It’s painful, can distort the joints and can be permanently disabling if untreated.”
What are the potential consequences of not capturing improvements in these symptoms?
“It’s important to take full measure of the patient and their life before you decide on treatment. PASI is a reasonable place to start, but it is more complicated than just the extent and thickness of their plaques. If you’re ignoring specific symptoms, patients can get left behind, and treatment decisions may be made without factoring in critical information.”
The more safe and effective treatment options we have, the better for patients with plaque psoriasis.
Do you measure PASI to make treatment decisions for patients who are not in clinical trials?
“In the real world, outside of trials, we don’t use a strict algorithmic treatment of psoriasis. In the regular clinical setting, I am more interested in knowing if the patient can live their life socially, occupationally and recreationally, and without feeling limited by their psoriasis. If they are, I know we’re on the path to success.”
How can clinical trials evolve to more comprehensively measure meaningful improvements for patients with plaque psoriasis?
“It’s becoming fairly common to have secondary endpoints that include itching and quality of life, which is progress. We’re seeing better management of psoriasis sub-types, such as patients with severe hand and foot psoriasis or patients who have severe arthritis without a lot of skin disease. Since the condition is quite diverse, there’s no one treatment for every patient. So the more safe and effective treatment options we have, the better for patients with plaque psoriasis.
To learn more about treatment challenges that patients with psoriasis continue to face, read “Moderate Psoriasis Patient Needs Should Not Be Overlooked.”
Most patients diagnosed with lymphoma discuss the possibility of chemotherapy with a healthcare professional at some point. Chemotherapy is a standard of care for many forms of lymphoma, but most patients will experience multiple relapses.
Chemotherapy is a broad spectrum treatment that stops cell growth and division throughout the body, which can lead to side effects. Chemotherapies cannot differentiate between cancer cells and normal cells, so they also attack fast-growing but healthy cells, such as hair follicles and the cells lining the gut. That damage can lead to both short and long-term side effects, such as fatigue, nausea, a compromised immune system, fertility loss and an increased risk of infection or a second primary cancer.
While the benefits of chemotherapy often outweigh the risks, patients are eager for alternative solutions. Thankfully, research continues to look at different treatment pathways.
“We are learning a great deal about lymphoma subtypes and making progress in the discovery and development of new approaches that may improve quality of life,” Meghan Gutierrez, chief executive officer of the Lymphoma Research Foundation (LRF), said. “There is meaningful interest in exploring potential new treatments and combinations, many of which are chemotherapy-free.”
Lymphomas are caused by changes in immune cells called lymphocytes. In patients with lymphoma, the body makes many of these defective lymphoma cells that may not be detected by normal immune cells, which can properly fight infection and disease, including cancer. Restoring the immune system’s ability to fight cancer is a growing trend that has led to the development of immunomodulatory therapies, which can boost the tumor-killing cells of the immune system.
Investigators continue to explore new approaches focused on stimulating the immune system for patients with lymphoma.
The inherent ability of some types of immune cells to attack tumors relies on “tags” called antibodies on the surface of cancer cells. This killing process is known as antibody-dependent cell-mediated cytotoxicity (ADCC). In fact, several approved lymphoma therapies are antibodies that attach to cancer cells, leading the immune system to better identify and attack them. Researchers are now studying whether combining these antibody therapies with immunomodulatory therapies might further enhance cancer-killing ADCC, without the need for chemotherapy.
With further understanding of how both of these types of treatment work, separately and in combination, there is a potential to improve outcomes.
“Investigators continue to explore new approaches focused on stimulating the immune system for patients with lymphoma,” Gutierrez said. “It’s an incredibly exciting time as research is constantly evolving.”
Over the past few years, there has been important progress in treating certain blood cancers with chimeric antigen receptor (CAR) T cell therapy, leading to the approval of two of these novel treatments last year. But ensuring patients can access these innovative therapies remains a top concern for doctors, patient advocacy organizations and other stakeholders in the life sciences community.
Those challenges were the focus of a special panel sponsored by Celgene during the 2018 Biotechnology Innovation Organization (BIO) International Conference, which was held from June 4-7 in Boston. Richard Bagger, executive vice president of Celgene Corporate Affairs and Market Access, moderated the panel, which included experts with backgrounds as varied as medical research, economics and health policy.
“We are at the threshold of a very exciting time,” said panelist Nupoor Raje, Massachusetts General Hospital. “The progress that we are seeing is promising.”
This progress also comes with challenges and potential barriers for patients. The panelists agreed that those challenges should not prevent patients who could potentially benefit from CAR T cell therapies from having affordable access to them. Part of the discussion highlighted how a number of stakeholders will need to work together to shape the regulatory and reimbursement environment for optimal patient access.
Operationally, the production of approved CAR T cell therapies is as complex as each treatment is highly personalized and unique to every patient. A patient’s T cells are extracted at a treatment center, sent to a manufacturing facility where they are engineered to recognize a specific protein or antigen and attack cells, including cancer cells that have this antigen, and then sent back to be infused into the patient. The process requires an unprecedented level of collaboration between doctors, health centers and manufacturers.
One of the approved CAR T cell therapies is for pediatric patients with relapsed or refractory acute lymphoblastic leukemia. Both approved CAR T cell therapies are for adults with relapsed or refractory diffuse large B-cell lymphoma after two or more lines of therapy. Celgene CAR T cell therapies are still investigational and are not yet approved by the Food and Drug Administration.
However, a significant blockade to patient access exists—these personalized therapies don’t fit neatly into private payer or government payment models, including Medicare, meaning delays for patients and complications for providers.
The last thing we want to do is deny a patient a therapy that could potentially benefit them.
“Waiting two to four weeks for insurance approval could be too long for many of these patients,” panelist Dr. Gwen Nichols, the Chief Medical Officer of The Leukemia & Lymphoma Society, said.
And despite the financial losses that hospitals face when Medicare and insurance reimbursement does not adequately cover the costs of CAR T cell therapy, many centers continue to try to deliver timely treatments to meet patient demand, according to panelist Beth Roberts, a health policy lawyer at the firm Hogan Lovells.
As a possible solution to expedite patient access and simplify issues for providers, panelist Henry Grabowski, Ph.D., Professor Emeritus of Economics at Duke University, suggested that private and public insurers should explore innovative payment arrangements such as payment plans, flexible pricing and value-based contracts.
— The Leukemia & Lymphoma Society (@LLSusa) June 5, 2018
Patients Are Waiting
Beyond the issue of reimbursement, the health care system is still increasing capacity to provide CAR T cell therapies to more people. For instance, because of the highly specialized expertise required, only a few community cancer centers can administer CAR T cell therapies, so patients often must travel far for treatment.
Preparing today so patients can access innovative cancer treatments such as the CAR T cell therapies must be a top priority for our health care system. “We need to manage the hype and continue to let the science lead the way,” Raje said. “The last thing we want to do is deny a patient a therapy that could potentially benefit them.”
To learn why CAR T cell therapy represents an important advance for some patients, read “CAR T Cell Research Continues to Advance.”
While Blood Cancer Awareness Month provides an opportunity to raise awareness and understanding of the various forms of blood cancer, it also serves as a reminder of the progress that has been made in treating these diseases. This progress would not have been possible without the numerous individuals who are bound together to improve the lives of people diagnosed with blood cancers.
A blood cancer diagnosis significantly alters the lives of not only patients but also their caregivers, friends and family. In 2012, more than 900,000 people worldwide were diagnosed with blood cancer. In the United States, someone is diagnosed with blood cancer approximately every three minutes.
Explore a model “Day in the Life” of various individuals through the following infographics to better understand the effect blood cancer has on their daily lives.
As director of Patient and Non-Personal Promotions at Celgene in Seattle, Becky Holman works to ensure information is communicated to patients as clearly as possible. She knows that the work she does could potentially make a difference in the lives of patients with blood cancers, but hearing it from the patients themselves is something altogether different.
Recently, Holman had just such an opportunity when she and her Celgene colleagues were asked to read letters written by blood cancer patients for a video to mark Blood Cancer Awareness Month. It was a powerful reminder of the special bond that everyone who works at Celgene shares with patients.
“At Celgene, we are bound together with patients in this fight to find a potential cure for blood cancers,” Holman said. “We share a common goal. They are fighting for their lives, and we are fighting alongside them. Celgene and the blood cancer community are truly bound by blood.”
The letter that Holman read was from a man with non-Hodgkin lymphoma (NHL) named Nick, whom she’d met earlier this year in Celgene’s Seattle office. He had recently had his 100-day treatment follow-up after treatment on a clinical trial with an investigational therapy.
Nick is a firefighter who puts his own life on the line to save others, playing an essential role in his community. He had faced heat and flames—and now cancer—with bravery.
He is also memorable because of his age; while lymphoma is most commonly diagnosed among people who are aged 65 to 74, Nick is in his early 30s. He and his wife discovered they were expecting their first child after he found out that his cancer had come back following treatment with chemotherapy.
“Knowing Nick, I could already see his face while I was reading his letter,” Holman said. “He helped me understand the ripple effect of blood cancer therapies. If we can help him, he has a chance to continue to save lives in his community through his job as a firefighter. That’s an immeasurable impact.”
Every time that we meet patients or read a letter from a patient, we deepen our commitment to the people who are fighting blood cancer alongside us.
The bonds between Celgene and the blood cancer community run deep. Patients with blood cancer, like Nick, rely on the research community and companies like Celgene to continue researching new treatment options. Meanwhile, Celgene relies on patients to take part in clinical trials of those therapies to ascertain the safety and effectiveness so we can hopefully offer them to the blood cancer community.
Celgene’s promise to the blood cancer community is to always put patients first, and the company takes steps to ensure that everyone who works there never loses sight of that promise. While it’s easy to get caught up in the strategy and operations of a large company, Celgene employees embrace the opportunity to meet and engage with people like Nick whose lives have been affected by blood cancer.
“Every time that we meet patients or read a letter from a patient, we deepen our commitment to the people who are fighting blood cancer alongside us,” Holman said. “We’re reminded why we are here, why we’re doing what we’re doing. It keeps us anchored, focused, grounded. It gives us purpose and hope.”
To learn more about the special bond shared by Celgene employees and blood cancer patients, watch the “Bound by Blood” video.
Patients with plaque psoriasis who see their doctor frequently can increase their odds of finding an effective and appropriate treatment for them, especially as there are more ways to treat psoriasis than ever before. According to an analysis of the MarketScan Medicaid database, the average time between a psoriasis patient’s initial visit to the doctor’s office and a follow-up appointment is 153 days.
To raise awareness about why it’s important for patients to work with their doctors to help manage psoriasis during this year’s Psoriasis Awareness Month (August), Mark Jackson, M.D., Clinical Professor of Medicine (Dermatology) at the University of Louisville and Forefront Dermatology, explains how often patients with psoriasis should see their doctors, how psoriasis treatments have evolved and why it’s important for patients to feel empowered to help take control of their disease.
How often do you recommend your patients with psoriasis see you?
“Plaque psoriasis requires active management. It’s essential that doctors make sure that their patient’s condition is improving within four to six weeks of starting a new treatment for them. Even if their current treatment is effectively controlling their symptoms, they should still see their doctors every three to six months. Seeing their physician frequently is imperative for patients with psoriasis.
That being said, if a patient is experiencing new symptoms or treatment side effects, they should call their doctor immediately.”
Why is it important that people with psoriasis see their doctors frequently?
“Psoriasis is not just a rash; it’s an inflammatory disease. Patients with psoriasis are more likely to have other health conditions, including metabolic syndrome, diabetes, heart disease and obesity. Up to 30 percent of psoriasis patients eventually develop psoriatic arthritis as well.
During office visits, doctors check the signs and symptoms of psoriasis and its comorbidities. Dermatologists are not just skin experts; we’re physicians. We can optimize our patients’ overall health and if we can assist in controlling the inflammation from psoriasis, we might possibly be able to help reduce the risk of these other conditions as well.”
What are some symptoms that you tell your patients to look out for?
“For most patients, psoriasis symptoms can fluctuate on a seasonal basis or with life changes. Cold, dry weather and stress can both trigger a psoriasis flare, and certain medications can make some symptoms worse.
Because of the increased risk of developing psoriatic arthritis, I make sure my patients are on the lookout for any joint pain and swelling. Patients should also know and watch out for the signs and symptoms of other comorbid conditions.”
The more that people with psoriasis take charge of their overall health and treatment, the better their outcomes can be.
How can doctors encourage their patients to see them more frequently?
“Doctors should foster a partnership with their patients through regular communication. The best outcomes occur if patients and doctors are both engaged and involved in their care. The more informed a patient is, the better decisions they make and the more compliant they can be with treatment.
Some patients may get scared when they learn about the risks that come with some systemic psoriasis treatments. It’s our job as physicians to thoroughly explain to our patients the risks and benefits of all their options and address their concerns, so we can make the most appropriate choice together.”
How have psoriasis treatments evolved over the past decade?
“We’ve seen a dramatic increase in the number of available psoriasis therapies as well as the efficacy and tolerability of those treatments. Newer treatments have become much more targeted compared with many of the older systemic medications, which cast a wider net on the immune system.”
Why is it important that patients feel empowered to manage their psoriasis?
“We can’t make patients take their medicines or schedule appointments, but we need to work to make them engaged participants. We can only provide the best information and try to build their confidence with the hope of helping improve their treatment compliance.
I encourage my patients to get involved with the National Psoriasis Foundation and learn more about their disease. My patients don’t always love hearing about diet and exercise, but I try to explain to them that their therapy may be more effective if they maintain a healthy body weight. The more that people with psoriasis take charge of their overall health and treatment, the better their outcomes can be.”
To learn more about how comorbidities can affect the health and care of people with psoriasis, read “Painting a Clearer Picture of Psoriasis Comorbidities.”