Presentation: Celebrating Minnesota’s African American Photographers and Artists

Saturday February 17, 2018

This presentation will take place at the Minneapolis Hennepin County Library, 300 Nicollet Mall.

Presenters include: Olivia Crutchfield, Bruce Palaggi, Gilbert Baldwin and Dr. Charles Crutchfield III.

The time of this event is 11 am – 1 pm.

The George Scott Trio will provide entertainment, and refreshment will be served. The Pollination Project Foundation will sponsor entertainment and refreshments.

Spotlight on Minnesota’s Black Community Project  

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Newly approved drug a trail-blazing approach to cancer treatment

The FDA just approved a new revolutionary drug for the treatment of cancer. The medication, Vitrakvi (larotrectinib), is unique in that it treats the geneticbasis of what is driving cancer and not the type of cancer once it hasdeveloped.

The mutation that causes cells to become cancerous is found in many different types of cancers. So, this new treatment is not just for one cancer but may treat many different types of cancer. This is avant-garde thinking.

Vitrakvi (larotrectinib) is manufactured by Bayer and is available in pill and liquid forms. It can treat cancers in children and adults, but it isn’t cheap. For adults, the medicine is just under $400,000 per year. In children, the cost is about $135,000 per year.

How does Vitrakvi (larotrectinib) work?

This drug works by blocking a specific mutated enzyme (tyrosine kinase) in cancer cells. When present, this defective enzyme causes cancerous growth in many different types of cancer.

Why is it revolutionary?

Vitrakvi (larotrectinib)is one of the first drugs of its kind that focuses on treating the genetic basis of cancer, not just the type of cancer. That is, it goes after the switch that turns a normal cell into a cancerous cell.

By analogy, there are many types of car manufacturers. Instead of trying to treat a single entity, like a Chevy or a Ford or Honda, this medicine focuses on treating the force that makes the cars go — the engine!

As a result, this radical approach has the potential of treating many kinds of cancers (all cars have engines) rather than a specific type of cancer (Chevy, Ford or Honda). This groundbreaking approach has a much broader potential in the war against cancer. By developing the ability to stop the engine of any car, there is the potential of stopping many different types of cars from running, which supports the analogy of fighting many kinds of cancer.

Since it is FDA-approved, will insurance cover it?

Yes and no. The drug has a broad appeal and the benefit of treating both children and adults.  Unfortunately, the price tag is astronomical.

Medicare and Medicaid are not covering the medication yet, but it is hopeful that they will.  If they do, third-party payers usually follow suit, but once again, due to cost, any and all insurances may have restrictions, limitations, and only partial coverage. Insurance coverage, of course, will improve as the price comes down.

If someone has cancer, how do they discover if this medicine will work for them?

The appeal of this medication is that it works in many different cancers both in children and adults. This fact, by itself, is remarkable and substantial.

Unfortunately, the type of genetic mutation that drives these cancers represents only a small percentage of overall cancers, probably less than five percent. So, it certainly won’t work in all cancers. But when it does work — and it has already helped many patients in the tests and trials — some patients have experienced remarkable results.

We currently don’t know which cancers will respond. Fortunately, tests will be available to see if a person’s cancer is responsive to this new treatment. A person’s cancer will be mapped for mutations. Once the mutations are discovered, any available medications that attack that mutation can be employed.

Hopefully, over time, we will build a bigger and bigger army of medicines that attack a wide variety of genetic mutations that cause a wide range of cancers located anywhere in the body. Unfortunately, these tests are new, expensive and challenging. They will very likely get better and less costly on a rapid and regular basis. Regardless, people should get tested, because we now have a revolutionary and effective treatment for select cancer patients.

The future of cancer treatment

Vitrakvi (larotrectinib) is the first medication designed specifically to attack cancers based on the gene mutations that make them malignant and not where they occur in the body or the type of tissue the cancer comes from. We will no longer treat the tissue where cancer comes from; we will address the DNA mutation that causes a cancer in the first place.

Calling a cancer by the mutation that causes it and not the tissue or organ it comes from, such as breast or prostate cancer, is a trail-blazing approach in the treatment of cancer. It now shifts our thinking and focus when it comes to treating and curing cancer. This new view is the future of cancer treatment.

We no longer need to consider or call cancer the name based on its tissue type. We will now look at cancers based on the gene mutations that drive them. These very mutations can then be detected, and drugs can be designed and selected to attack the mutations.

Attacking the genetic cause of malignancy has been the Holy Grail for cancer treatment, and we are now about to sip from the cup. The future has never been brighter for the war on cancer.

Related content:

New advances in the war on cancer: living cell therapy

What is cancer?

Good news: we are winning the war on cancer

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Katlyn H., CMA, Answers 5 Questions – Crutchfield Dermatology Skin & MediSpa

Crutchfield Dermatology spa esthatician
Katlyn H.

Favorite TV show?

The Good Life

Favorite skin care product?

Neostrata Smooth Surface Daily peel pads followed by Dr. Crutchfield’s Natural Face Cream!

If there’s one thing you wish people did for their skin, what would it be?

Stop worrying too much about what you’re cleansing with and just keep it simple. Cleanse WELL to give your skin a good base before putting anything on your skin and never skip a moisturizer!

When and why did you decide to enter the Dermatology World?

5 years ago I started my Career as a Medical Assistant and it was pure luck that I ended up here, but I cannot imagine not working with skin now!

What’s your favorite Treatment and why?

HydraFacial because it is simply great for anyone. The afterglow and fresh feeling is addicting!

What are my beauty must haves in your purse? 

Jane iredale Lip drink lip balm in color “flirt” and Aquaphor ointment for additional lip moisture!

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All About Colds

How to lessen their frequency and ease their symptoms

It’s that season again — cold season! Let’s talk about what a cold is, how to prevent them, and how to treat them.

A cold is a viral infection of your sinuses/nasal passages and
throat. Sometimes it can spread into your deep throat and cause
bronchitis.

There are over 99 different viruses that can cause a cold. Because
colds often affect the nasal passages, most of the viruses that cause
colds are “rhinoviruses”; the term “rhino” means “nose.”

There is no cure for colds, so one must let a cold “run its course.” Most colds last about four to seven days.

The difference between a cold and the flu is that colds are not as
severe, don’t produce high fevers, and don’t cause significant tiredness
or fatigue. There are measures one can take to prevent the number of
colds one gets and to treat the symptoms if a cold develops.

Common cold symptoms

  • Stuffy nose
  • Runny nose
  • Sore throat
  • Coughing
  • Sneezing
  • May have mild fever
  • May have mild fatigue-tiredness
  • Nasal pressure
  • Watery eyes

Prevention

The best way to treat a cold is to prevent it in the first place. Some things that help to prevent colds include:

  • Hand washing. This is the most important thing you can do to prevent
    colds. Wash hands for at least 30 seconds. Some people sing “Happy
    Birthday” silently, twice, as a timing device as they wash their hands.
  • Get a flu shot or mist every year.
  • Don’t touch the faucet handles or doorknobs in public restrooms. Use
    a towel to turn the water off and your elbow to open the door.
  • If a sink is not available, use hand sanitizing gels.
  • Don’t cough into your hand; cough into your elbow.
  • Don’t touch your food with your hands; use eating utensils.
  • Get plenty of rest.
  • Eat healthy, including a daily multivitamin.
  • Clean commonly encountered surfaces regularly with disinfectant
    sprays. This includes bathroom surfaces, cell phones, doorknobs,
    refrigerator handles, steering wheels, and other commonly touched door
    handles.

Treatment

There is no cure for the common cold, so reducing aggravating
symptoms is the goal. Because colds are caused by a virus, classic
antibacterial antibiotics are useless. The following are steps to reduce
symptoms:

  • Take a pain reliever such as Tylenol, Ibuprofen or aspirin. Talk to
    your doctor before giving any child with cold symptoms a fever aspirin;
    unwanted side effects can occur.
  • Use nasal decongestant sprays. These work well to ease breathing but
    should only be used for two or three days. If used too long, the user
    can develop dependence.
  • Use cough medicines. This includes throat lozenges and liquid
    syrups. These will make you feel better, but they won’t resolve a cold
    any sooner.
  • Drink lots of fluids. Sports-like drinks, fruit juices, and warm tea
    and broths work well.  Chicken soup has been proven to make cold
    sufferers feel much better. Avoid alcoholic beverages or anything that
    can cause dehydration.
  • Take Vitamin C. 1000 milligrams a day for three to five days has been reported to be helpful.
  • Calm the throat. For sore throats, gargling with warm salt water or throat lozenges works well.
  • Get plenty of rest. Don’t over-extend yourself; allow your body’s immune system to strengthen and fight back.

We all get colds. It is a part of living. Hopefully, this information
will lessen their frequency and symptoms. Remember, if you are
concerned about any illness, contact your doctor immediately.

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Tinnitus: common, constant, incurable — but very manageable

Dr. Crutchfield, my sister told me recently that she was suffering with severe ringing in her ears. Her doctor told her it was something called ‘tinnitus.” What is tinnitus?

Great question. I’ve asked one of my colleagues, Inell Rosario, MD, an
expert on the subject, to enlighten us with a discussion on tinnitus
this week.

Dr. Rosario: Tinnitus is a fairly common medical malady that afflicts
many people in mild forms, although they may not always be aware of it.
As many as 50 to 60 million people are affected by a phantom ringing,
whistling or buzzing noise that is usually only perceived by them. A
much smaller percentage (usually one to two percent) describes the
condition as debilitating and, although there is no cure, must seek
treatment to see a significant impact on their condition and to live a
normal life.

Most of the time, the cause of tinnitus is unclear. In the absence of
damage to the auditory system (such as head or neck trauma), things
like jaw-joint dysfunction (TMJ), chronic neck-muscle strain, and
excessive noise exposure have been suggested as causes. Certain
medications can also cause tinnitus, which, in this case, can either
disappear again after usage of the medication ends or can cause
irreparable damage that results in permanent tinnitus.

Other causes may be wax buildup, cardiovascular disease, or a tumor
that creates a strain on the arteries in the neck and head. These tumors
are usually benign.

Tinnitus can be managed through strategies that make it less
bothersome. No single approach works for everyone, and there is no
FDA-approved drug treatment, supplement, or herb proven to be any more
effective than a placebo.

Behavioral strategies and sound-generating devices often offer the
best treatment results; this is partially why distracting the
individual’s attention from these sounds can prevent a chronic
manifestation. Some of the most effective methods are:

Cognitive behavioral therapy (CBT) 
Uses techniques to relax and restructure the way patients think about
and respond to tinnitus. Sessions are usually short-term and occur
weekly for two to six months. CBT usually results in sounds that are
less loud and significantly less bothersome, with the overall quality of
life improved.

Tinnitus retraining therapy 
Effective based on the assumption that the tinnitus results from
abnormal neuronal activity. This therapy habituates the auditory system
to the tinnitus signals, making them less noticeable or bothersome.
Counseling and sound therapy are the main components, with a device that
generates low-level noise that matches the pitch and volume of the
tinnitus. Depending on the severity of the tinnitus, treatment may last
one to two years.

Masking 
Use of devices generating low-level white noise that can reduce the
perception of tinnitus and what’s known as residual inhibition. Tinnitus
will be less noticeable for a period of time after the masker is turned
off. A radio, television, fan, or another sound-producing machine can
also act as a masker.

Biofeedback 
A relaxation technique that helps control stress by changing bodily
responses to tinnitus. A patient’s physiological processes are mapped
into a computer, and the individual learns how to alter these processes
and reduce the body’s stress response by changing their thoughts and
feelings.

Treatment options are vast, but vary in effectiveness depending upon
the type of tinnitus. Research shows more than 50 percent of tinnitus
sufferers also have an inner-ear hearing impairment. While hearing aids
act as an effective relief method for those with tinnitus by amplifying
external sounds to make internal sounds less prevalent, they are not the
only method.
Careful diagnosis by a professional with years of experience creating solutions for tinnitus sufferers is essential.

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50 Over 50

Charles E. Crutchfield III, M.D.

Busy Healer

Skin is the body’s largest organ—and Dr. Charles E. Crutchfield III, owner of Crutchfield Dermatology, works tirelessly to keep skin of all shades healthy. And “tireless” is perhaps an understatement. The 57-year-old Eagan resident sees patients five days a week, manages a staff of 40, and serves as a clinical professor at the University of Minnesota Medical School, where he’s earned three distinguished teaching awards. Dr. Crutchfield also serves as team dermatologist for the Timberwolves, Twins, Vikings, and Wild; and publishes a dermatology “case-of-the-month” that’s delivered to over 50,000 physicians worldwide. He also writes a highly regarded column on skin care for the Minneapolis Spokesman-Recorder, and has penned over 200 scientific and educational publications, plus several books, including one for children. He’s a founding member of a nonprofit dedicated to improving the safety and ethics of cosmetic skin care for people of all ethnicities, and he sponsors a lecture series on the topic. So, it’s no surprise that Dr. Crutchfield has received virtually every prestigious professional recognition, including the Karis Humanitarian Award from the Mayo Clinic.

Success in business is sometimes measured with simple arithmetic, but many in business see true success as finding ways to sustain both themselves as well as the environments in which they exist. That’s the common bond between these 10 business leaders. Whether they’ve made a name for themselves in banking, financial planning, life planning, marketing, media or medicine, they all apply their effort and know-how to invest in their neighbors and communities. They’re living proof that these unique combinations of skills and values don’t depreciate past age 50.

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New advances in the war on cancer: living cell therapy

On April 6, 2016, we discussed several new successful treatments against cancer in the Minnesota Spokesman-Recorder
article “Good news: We are winning the war on cancer.” This is an
update on one of those treatments we referred to then as combination
cell, or chimeric cell, therapy.

Researchers and reporters alike are now calling it “living cell
therapy.” It works well and has been approved to treat certain resistant
childhood leukemias and adult lymphoma. Unfortunately, results against
solid tumors are not yet favorable. Success rates as an FDA-approved
treatment is greater than 70 percent, which is remarkable considering
that, in the recent past, these cancers, failing traditional therapies,
were incurable.

There are particular types of immune cells called T-cells that are
the real powerhouses when it comes to fighting disease and cancer.
Doctors can perform a pretty slick trick where they extract a T-cell
from a patient’s body and mix it with a specific virus. That is why it
has been called combination cell, or chimeric cell, therapy.

This virus infects the T-cell and directs it to produce unique sticky
proteins on its surface that recognize novel proteins on the cancer
cells. They fit together like hand and glove. These living therapy
T-cells float freely in the blood and recognize blood-born malignancies.
They bind to the malignant cells in the blood and obliterate them.

This type of living cell therapy works best for specific blood-borne
malignancies, especially those of the liquid form, such as leukemia and
lymphoma. Here’s how it works:

Leukapheresis

Special immune T-cells are isolated from a patient’s blood using a
particular filter. These cells are then frozen and sent to a unique
laboratory that transforms them into living treatment cells.

Cell programming

In the lab, the T-cells are mixed with a specific virus that causes
the T-cells to make unique proteins on their surface that can later
recognize and stick to leukemia or lymphoma cancers cells.

Multiplication

These newly programmed T-cells are grown and multiplied over a
million-fold in the laboratory, so they are in large enough numbers to
fight cancer when they are needed later.

Quality review

The new group of programmed and multiplied cancer-fighting T-cells
are specially checked and screened to make sure that they have only the
desired cells with unique cancer-fighting properties.

Lymphocyte reduction

The number of lymphocytes in the patient is reduced so that when a
large number of the newly programmed lymphocytes (originally from the
cancer patient, but now grown to much larger numbers) can be more easily
given back to and accepted by the patient and can function at optimal
levels.

Living cell drug infusion

The newly programmed cancer-fighting T-cells are slowly injected back
into the cancer patient. This is done over several minutes.

Cancer cell death via cytokine storm

The cancer-fighting T-cells can sense what size job they need to do
and can increase their numbers even more inside the body, if needed.
They can then launch an all-out attack on the cancer cells, killing
them.

During this attack, the cancer-fighting cells release many substances
called cytokines that enable the most effective attack. This release is
called a cytokine storm. It usually occurs one to two weeks after the
T-cells are injected back into the cancer patient.

The cytokine storm can make the patient feel like they have the flu.
Oddly, that is considered a good sign, except in a few cases where the
storm can be so severe it can harm or even kill the patient. Doctors are
getting better and better at treating and handling the storm, so most
patients do well.

A costly process

The process of transforming normal immune T-cells into
cancer-fighting cells is called CAR-T production, for “Cancer Antigen
Receptor T-cells.” It is an extremely expensive process: Currently, the
cost to produce CAR-T cells for injection is just short of $500,000 per
treatment. Prices may come down as the techniques to develop CAR-T cells
improve.

Additionally, researchers are devising ways to make the CAR-T cells
recognize multiple targets on cancers cells rather than the single
target employed now. The ability to identify various targets on a cancer
cell will make the CAR-T cells more efficient and will increase the
number of successful treatments. There are over 50 CAR-T studies
underway.

In conclusion

Although the war on cancer is not over, I’m delighted to report that
right now we have some of the best tools ever available in the fight. In
fact, former president Jimmie Carter used some of these tools to have a
complete remission of malignant melanoma that metastasized to his
brain.

If you or a loved one is diagnosed with cancer, it’s not the same
prognosis that it was even a few short years ago. Talk to your physician
about a combination of therapies including traditional surgery,
radiation, and chemotherapy along with the new strategies including
CAR-T living drug cancer treatments and many other new cancer therapies.

The war on cancer has never looked better than it does today.

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