Download Summer 2013

Compliments
of Johns Hopkins
Medicine
International
SUMMER 2013
How older adults
can reach their full
hearing potential
Insight and news from
Johns Hopkins Medicine
Chronic obstructive
pulmonary disease
affects 64 million people
worldwide. Grace Anne
Dorney Koppel
wants to change that
Empowering our
immune system to
destroy cancer
On the ground floor
of groundbreaking
vascular surgery
FdJHSU1302_01_Cover.indd 1
6/27/13 12:37 PM
Contents
S u M M e r 2 013
4 listen up
Qu ic k con s u lt
Cochlear implants help
older adults reach their full
hearing potential.
Down
5 tearing
cancer’s Walls
Doctors are using our immune
system to destroy tumors.
10 Doctor to Doctor
F irst Pe rson
A retired physician chooses an
innovative treatment to repair
a bulging blood vessel.
and
11 Hormones
Health risk
s econ D o Pi n ion
Low testosterone contributes
to concerns such as high
blood pressure and diabetes.
Breathe new life
COPD sufferer Grace Anne
Dorney Koppel shares her
journey with the lung disease
and advocates for awareness
and education.
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summer 2013
Can My Pap Test Detect
More Than Cervical Cancer?
Scientists believe they have found a way to
tease new results from a cancer screening test
already performed on millions of women,
potentially saving women from missed diagnoses or surgery.
Developed at Johns Hopkins, the method
relies on DNA analysis of cervical fluid collected during Pap smears.
“We were just looking to see if cells from
an ovarian cancer or a uterine cancer could
travel down to the cervix and be collected in
a routine Pap smear,” says Luis Diaz, M.D.,
a medical oncologist at Johns Hopkins.
“We were surprised to find that 100 percent
of the uterine cancers were detected and
41 percent of ovarian cancers were detected.”
It is important—and striking—that those
results come with no false-positives, Diaz
explains. False-positives common in other
cancer tests cause unnecessary anxiety and
often require further diagnostic testing.
“The next step,” he says, “is to repeat this
in a larger number of women to see if we can
improve on the 41 percent.”
Cover photo by Steven Biver
6
on tHe coVer
Find more questions answered
by Johns Hopkins experts and
others at sharecare.com, a
website designed to simplify your
search for quality information on
topics of health and wellness.
+1-410-614-4561 | hopkinsmedicine.org/international
6/28/13 10:02 AM
healthinsights
SAVE YOUR
SIGHT THIS
SUMMER
A Simple Spice That May Battle Cancer
Turmeric, a common Indian spice, may one
day join the cancer treatment tool kit.
Researchers have found that a tiny oral
dose of curcumin, a compound found in
turmeric, cut breast cancer rates in rats by
half. In another study, conducted by Anirban
Maitra, M.D., a pathologist at Johns Hopkins,
curcumin helped deter drug-resistant cancers.
Prepared as tiny particles for better absorption,
a combination of curcumin and the chemotherapy drug doxorubicin not only shrank the
tumors but also helped avoid the toxic side
effects of doxorubicin on heart muscles.
Compared with the United States, most
cancer rates are lower in India, where people
have been eating turmeric for centuries, says
Saraswati Sukumar, Ph.D., co-director of
the Breast Cancer Program at Johns Hopkins.
Johns Hopkins researchers sought to affirm the
dietary link.
“There must be a correlation,” she says.
“Nevertheless, the amount of turmeric we add to
food is very low, a teaspoon for the whole family.”
Sukumar would like her clinical colleagues
to conduct human trials to confirm the tumorshrinking effect among people undergoing
general chemotherapy and then follow up with
a study on turmeric and cancer prevention
among the general population.
To hear Sukumar discussing her work with
turmeric, visit bit.ly/turmericspice to listen to
a podcast.
HEALTHY RECIPES FROM JOHNS HOPKINS
Find recipes that are good for your health in the Johns Hopkins Health Library. Search by
dietary considerations and food categories. Visit hopkinsmedicine.org/healthlibrary/recipes.
?
Decoding That
Itchy Feeling
”
You know that going
outside without applying sunblock raises your
risk of getting skin cancer. It’s time that you
think of your eyes in the
same light.
In rare occasions,
ultraviolet (UV) rays
can burn your cornea.
Symptoms include
pain, watery eyes and
light sensitivity.
“The bigger problem for most people,
however, is that UV
exposure can increase
your risk of cataracts or
macular degeneration
over the long term,” says
Yassine Daoud, M.D.,
an ophthalmologist at the
Johns Hopkins Wilmer
Eye Institute.
Prevention, Daoud
says, is as easy as wearing sunglasses with
broad-spectrum protection against UVA and
UVB rays.
For more information
on the Johns Hopkins
Wilmer Eye Institute, visit
hopkinsmedicine.
org/wilmer.
FOR MANY PEOPLE , IT’ S A FINE LINE
between itch and pain, and Johns Hopkins researchers are untangling the tiny nerves in the skin that
correspond to one sensation or the other.
“Before, they thought all of the small neurons
were pain neurons,” says Xinzhong Dong, Ph.D.,
a neurobiologist at Johns Hopkins. “The most common drug is antihistamine or steroids, but
that doesn’t block itch. It just lowers inflammation,” which is a broad symptom of itch.
“Now,” Dong adds, “we can see what is really pain and what is really itch.”
A potential new drug would target the neurons for itch and prevent them from firing,
rather than simply treat the inflammation. Chronic itch sufferers would benefit from a drug
that “switches off” an itch without desensitizing them to important pain signals.
For more health news, research and events from Johns Hopkins Medicine, follow
@HopkinsMedicine on Twitter.
hopkinsmedicine.org/international | +1-410-614-4561
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quickconsult
Listen Up
Implanted device can help older
adults with hearing loss
Cochlear implants give people who have hearing loss an awareness and understanding of sound. Once used almost exclusively
for children born deaf, the small, electronic devices implanted
behind the ears are now being widely used in older adults.
Frank R. Lin, M.D., Ph.D., an otolaryngologist and epidemiologist with the Johns Hopkins Listening Center, explains.
What is the trend behind the use of
cochlear implants in older adults?
All of us will develop hearing loss as we get older. As our
population ages, more people are seeking solutions. There is
also greater awareness of the technology. Just 15 years ago,
70 percent of the cochlear implants we did were in children
and 30 percent were in adults. Today, it’s the exact opposite.
FREE
ONLINE SEMINAR
COCHLEAR IMPLANTS:
WHEN HEARING AIDS
AREN’T ENOUGH
Tuesday, October 8, 11 p.m.–midnight GMT
Cochlear implants are not just for children who have
hearing impairments. Learn how cochlear implants
are helping patients of all ages who have hearing loss
that cannot be remedied by hearing aids. Join Johns
Hopkins hearing specialist Howard Francis, M.D.,
to discover how cochlear implants along with communication therapy can change your life or the life of
a loved one. The webinar will also be presented by a
Certifi ed Deaf Interpreter. To register, visit
hopkinsmedicine.org/intlseminars.
Do cochlear implants work for every
type of hearing loss?
Cochlear implants are effective for people who have a problem
with the inner ear, as opposed to the eardrum or the ear bones.
When the inner-ear problem causes severe or profound hearing loss, hearing aids are no longer beneficial. In the U.S., we
think up to 250,000 people older than 70 could benefit from a
cochlear implant, but fewer than 5 percent of these individuals
have received one.
Should I try hearing aids before
getting an implant?
Hearing aids will always be tried before a cochlear implant is
considered. An audiologist will perform hearing and speech tests
to make sure you are a candidate for a cochlear implant. It’s best
to have your hearing evaluated sooner rather than later, as hearing loss is related to other issues such as falls, cognitive decline
and dementia. We think that’s because when the brain has to use
more resources to help with hearing, it comes at the expense of
other brain processes such as thinking and memory. If testing
reveals that you are a candidate for an implant, the surgery takes
about two hours and will be performed on an outpatient basis.
Once I get the implant,
will my hearing be perfect?
Our goal at the Listening Center is to make sure that a person
receiving a cochlear implant can listen and communicate effectively in all settings, whether it’s in a quiet room or a crowded
restaurant or listening to a speaker. To achieve this goal, the
person meets with a therapist to begin hearing rehabilitation
shortly after surgery, and the person will also work closely with
an audiologist for adjustments to the implant. Similar to individuals who require a prosthetic limb, those receiving a cochlear
implant need adequate time and rehabilitative training to learn
how to use the device and to reach their full potential. ■
For more information, appointments or
consultations, call +1-410-614-4561.
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+1-410-614-4561 | hopkinsmedicine.org/international
6/27/13 12:38 PM
Tearing Down Cancer’s Walls
a promising new treatment empowers our
own bodies to make tumors disappear
tHe figHt against C anCer is a b attle
inside the body, where cancer cells put up
shields that prevent immune cells—the body’s
line of defense—from attacking tumors.
But research being led by Johns Hopkins
is targeting weapons that help immune cells
fight back, offering new hope for people who
have cancer.
“We’re researching how to activate the
immune system to recognize and destroy cancer,” says Suzanne L. Topalian, M.D., director
of the Melanoma Program at the Johns Hopkins
Kimmel Cancer Center.
Johns Hopkins researchers have been studying a new drug, called anti-PD-1, designed to
penetrate the shield created by cancer cells, so
the body’s immune cells can do their job of
destroying tumors.
In one phase of the clinical trial, the
researchers reported extremely promising
results in people who had melanoma, the
deadliest form of skin cancer, as well as people
who had advanced lung and kidney cancers.
“One of the remarkable findings is that a
single drug could make tumors shrink in three
different cancers,” Topalian says. “We found
that 31 percent of the melanoma patients,
16 percent of the lung cancer patients and
29 percent of the kidney cancer patients all
had significant regressions of their cancer.”
The study also showed many tumors that
shrank or disappeared stayed that way—even
after people stopped receiving the drug, which
is delivered by injection on an outpatient basis.
The final stage of research that’s required
for approval by the U.S. Food and Drug
Administration is now underway. Approval
for the drug could come within two years. n
Leading the Way for
neW CanCer treatments
Considered a premier center worldwide for developing immune-based
cancer therapies, Johns Hopkins led a trial that involved a dozen cancer
centers across the united states.
according to Suzanne L. Topalian, M.D., director of the melanoma
program at the kimmel Cancer Center, Johns Hopkins led the study because
it treated a large number of people and performed key scientific studies
related to the treatment.
“there’s a lot of work that brought us up to this point,” topalian says,
referring to decades of research in cancer immunology and immune-based
therapy at Johns Hopkins. “When it’s complete, this work will have taken
more than 20 years.”
Video: Your options for skin CanCer treatment
discover more about current treatment options from Johns Hopkins’ multispecialty treatment
team, including dermatologist Timothy Wang, M.D.; surgeon Julie Lange, M.D.; and medical
oncologist William Sharfman, M.D. they discuss prevention, diagnosis and treatment in the
video “skin Cancer 101 with an emphasis on melanoma.” Visit bit.ly/skincancer101.
hopkinsmedicine.org/international | +1-410-614-4561
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B r e at h e
New
Life
Photo by Steven Biver
The shortness of breath
came on as abruptly as a thunderstorm.
One minute, attorney Grace Anne
Dorney Koppel was walking down the
street, legal briefcase in hand. The next
minute, she was stopped, gasping to
catch her breath.
“It was so sudden,” she recalls of that
afternoon in July 2001.
Concerned by several of these
frightening episodes, Dorney Koppel
consulted her physician. He gave her
a complete physical but ordered no
spirometry test—which involves blowing into a tube attached to a machine
to measure lung function—nor did he
refer her to a pulmonologist for testing.
Dorney Koppel sensed there was more
to the problem. Shortness of breath may
not sound too bad, unless you have experienced it. “You don’t know if your next
breath is coming at all,” she says.
Her husband, famed broadcast
journalist Ted Koppel, also realized his
wife’s difficulties were serious. “She
couldn’t walk a hundred feet [30 meters]
down the block without stopping,” he
recalls. “I said, ‘This is crazy. We have
to do something.’ ” >
hopkinsmedicine.org/international | +1-410-614-4561
FdJHSU1302_06-9_COPD.indd 7
A common condition, chronic
obstructive pulmonary disease
affects 64 million people
worldwide, yet many don’t
even know they have it. COPD
sufferer and spokeswoman
Grace Anne Dorney Koppel
wants to change that
summer 2013
johns hopkins health | 7
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6/28/13 10:03 AM
Dorney Koppel underwent a more thorough
exam and received a grim diagnosis: She had
chronic obstructive pulmonary disease—COPD
for short, a term that describes several lung diseases, such as emphysema, chronic bronchitis
and irreversible asthma. It was an affliction she
had barely heard of.
There was more.
“They said she had three to five years left to
live,” Ted recalls. “We were told she needed to
make ‘end-of-life preparations.’ I’ll never forget
those words. That night, we lay in bed, hugged
each other and cried.”
The crying soon stopped, and the work began.
‘There Is a Lot We Can Do’
The Koppels sought treatment at Johns Hopkins
in 2002, where Robert Wise, M.D., a pulmonologist, gave Dorney Koppel a better outlook.
“She believed that there was nothing that could be
done,” Wise says. “The first thing was to emphasize that there is a lot we can do for patients with
COPD. Although we wish we could do more, it’s
not a hopeless disease.”
Especially when you have a determined patient.
“I threw myself into the rehab,” Dorney Koppel
recalls. She enrolled in a pulmonary rehabilitation
program. She also began practicing what Wise calls
The ABCs of COPD
Although traditionally thought of as a condition affecting men,
chronic obstructive pulmonary disease (COPD) now causes more
deaths in women than men. “This is really becoming a disease of
older women,” says Enid Neptune, M.D., a pulmonologist at Johns
Hopkins. Neptune points to recent research showing that women
smokers may be 25 percent more susceptible to the disease than men.
Symptoms of the disease include breathlessness and chronic coughing and wheezing. But, cautions Robert Wise, M.D., a pulmonologist at Johns Hopkins, “it’s hard to diagnose COPD from symptoms
alone. There’s a very long period where there are no symptoms.”
Though damage to lungs from COPD cannot be repaired, progress of the disease can be halted. Quitting smoking, Wise says, is the
single most important step. And although medication can help, exercise is the second most important tool in the fight against COPD, as
it strengthens the cardiovascular system, which helps improve the
ability and efficiency with which the body uses oxygen.
“Exercise is more effective than any medication we have,” Wise
says. “It improves people’s quality of life.”
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summer 2013
SEMINAR
COPD: A TALK THAT WON’T
LEAVE YOU BREATHLESS
Saturday, November 16, in Baltimore, Maryland
Learn more about chronic obstructive pulmonary
disease (COPD), a condition that is increasing among
women, at Johns Hopkins Medicine’s award-winning
annual women’s health conference, A Woman’s Journey.
Join pulmonologist Enid Neptune, M.D., as she
describes COPD risk factors, symptoms and
treatments that may someday cure this disease.
For more information about a conference
near you, call +1-410-955-8660 or visit
hopkinsmedicine.org/
awomansjourney.
“good respiratory hygiene.” She washes her hands
frequently, gets a flu shot annually and, especially
during flu season, tries to avoid large crowds.
She takes her inhaled medications precisely as prescribed and gets regular lung checkups, which are
down now to twice a year.
Soon, the woman who couldn’t make it down the
block in 2001—and who arrived at Johns Hopkins
in a wheelchair—was walking 3 to 5 kilometers
a day on her treadmill, maintaining a brisk pace,
quicker than 12.5 minutes per kilometer.
A Need for Knowledge
The World Health Organization (WHO) predicts
COPD will be the third deadliest disease globally by 2030. Yet, Dorney Koppel says, “there’s a
stigma about this disease, because everyone assumes
that people who get it were doing something they
shouldn’t have been doing.”
In Dorney Koppel’s case, smoking is probably
the primary risk factor for her COPD. (It is important to note that 25 percent of COPD patients
have never smoked a cigarette. Environment, occupation, genetics and secondhand smoke are also
significant risk factors for developing COPD.)
Dorney Koppel quit smoking in 1992, nearly a
decade before noticing the first signs of COPD (see
“The ABCs of COPD”), but the seemingly sudden
onset actually was the acute stage of a condition
that takes years to progress. The disease has no
symptoms early on, and millions suffer in silence
until it gets to a point that it cannot be ignored.
Sufferers mistakenly think they are just aging,
slowing down or getting out of shape.
COPD claimed the lives of 3 million people
(5 percent of all deaths) worldwide in 2004,
according to the WHO. The organization
+1-410-614-4561 | hopkinsmedicine.org/international
6/27/13 12:38 PM
estimates that 64 million people around the world
have the disease.
In the U.S., more than 24 million Americans are
believed to have COPD, but only half have been
diagnosed and are getting treatment. Typically,
when diagnosed, sufferers have already lost 50 percent or more of their breathing ability. “If treated,”
Dorney Koppel says, “COPD progresses more
slowly, quality of life improves and, in some cases,
survival is increased.”
People who have symptoms—especially if they
are older than 40 and are current or former smokers—should consult their physicians and ask for a
spirometry (pronounced spy-RAH’-mih-tree) test.
“Spirometry can be done easily and inexpensively,” Wise says, “and should be part of any routine
medical test.”
Full-Time Advocate
Today, from the comfort of her home in Maryland,
Dorney Koppel has made COPD awareness a fulltime pursuit. She is now a national patient advocate
for the National Heart, Lung, and Blood Institute’s
campaign to raise awareness of COPD.
“It’s my second career,” she says, one she felt
compelled to take on after Wise recommended
her. She continues to learn more about COPD and
people’s misperceptions about the disease.
The story of her initial misdiagnosis is a common experience of many people who suffer from
COPD. “The failure to diagnose the disease early
on, the failure to give hope and optimism,” Wise
says. “Sadly, that’s all too true.”
That is especially the case with women older
than 55, an increasingly large part of the COPD
population. And yet, says Enid Neptune, M.D., a
pulmonologist at Johns Hopkins who is researching this issue, women have been underrepresented
in the research. Traditionally, COPD has been
considered a “male” disease; men tend to be heavier
smokers than women and work in environments
more likely to cause lung disease.
“Until recently, the impact of the disease on
women has not been a pressing question in COPD
research,” Neptune says. “No one thought that
women were as likely as men to develop it.”
Dorney Koppel talks passionately about the
need for greater awareness and treatment of
COPD. The priorities in her life are well reflected
in the objects around her home office. A sign
that says “If Mother Says No, Ask Grandmother”
adorns the wall (the Koppels have seven grandchildren), near an appreciation award from the
hopkinsmedicine.org/international | +1-410-614-4561
FdJHSU1302_06-9_COPD.indd 9
BREATHTAKING NUMBERS
Smoking is the primary cause of COPD
$49.9
BILLION
adults have
13.1 U.S.
diagnosed COPD
Annual economic
cost of COPD
(in US$)—ER visits,
hospitalizations and
lost productivity
adults have
12.0 U.S.
undiagnosed COPD
MILLION
MILLION
AMONG THOSE
LIVING WITH
COPD
51%
53%
American Thoracic Society. Medical journals
stacked next to framed family photos.
She has shown how a determined woman can
improve her health. Now she’s showing how a
determined woman can make a difference in public
health. Dorney Koppel sits on several boards and
committees, including the COPD Foundation
board, attends medical conventions and events
such as Johns Hopkins’ annual women’s health
conference, A Woman’s Journey (she was the keynote
speaker in 2012), and travels the U.S., speaking
about the need for greater awareness and proper
diagnosis and treatment of COPD.
“She’s a force to be reckoned with,” Neptune says.
“I’m enormously proud of what Grace Anne
has done,” says Ted, who, along with his wife,
established The Dorney Koppel Family Charitable
Foundation Inc. to help establish pulmonary rehabilitation centers in areas that have none. “I can’t
think of a better way to see her talents used than in
the fight against this terrible disease.” ■
say it limits their
ability to work
say it limits their
social activities
SOURCES: U.S. Department
of Health and Human Services;
U.S. Centers for Disease
Control and Prevention;
American Lung Association
VIDEO: HER STORY, HER WORDS
Watch Grace Anne Dorney Koppel share her journey from diagnosis to
management of chronic obstructive pulmonary disease (COPD). Visit
bit.ly/jhhealthvideos to see an excerpt of her keynote address from the
2012 Johns Hopkins women’s health conference A Woman’s Journey.
summer 2013
johns hopkins health | 9
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firstperson
Doctor to Doctor
Retired physician Ron Rolett trusted Johns Hopkins
to perform a groundbreaking vascular surgery
When my doctor
found an abdominal aortic aneurysm during a
routine screening, I knew it needed attention.
The aorta is the major vessel that supplies blood to the body. When an aneurysm causes
that blood vessel to swell, it can grow large enough to rupture. That’s a life-threatening
situation, and mine had grown past the danger threshold.
A physician friend suggested I consider seeking treatment at Johns Hopkins, and I’m
extremely happy I did. Of the three options to repair my aneurysm, they said I was a
candidate for two. One was open abdominal surgery.
The other used a device called a fenestrated graft,
which was recently approved by the U.S. Food and
Drug Administration and was only available at a few
centers in the country, including Johns Hopkins.
The fenestrated graft is inserted into an artery
in the groin and passed through to the abdominal
aorta. The flexible mesh tube has two or three windows that line up with the arteries in the kidney so
my kidney can function during surgery. The recovery
time for this minimally invasive procedure was about
two weeks compared with six or eight weeks for
open surgery.
Ron Rolett with his wife, Karin
I chose the new technique because of the
recovery time. I also wanted to give my surgeon,
James Black, M.D., the chance to perform the procedure for the first time with this new
device. I had that kind of confidence in Dr. Black and his team and their experience with
endovascular repair. From my perspective—both personal and medical—the fenestrated
graft was the way to go.
Everything went smoothly, and after three days, I returned to my home in North Carolina.
I didn’t have any limitations other than not lifting anything heavier than a gallon of milk.
Within a month of my surgery, I could easily walk 2 miles. My original goal was to be able
to pick up my 18-month-old grandson, who weighs around 30 pounds. Now, six months
after my surgery, I can do that easily—and I can lift my 12-year-old grandson, too.
At my first routine follow-up, Dr. Black was pleased with my progress. The graft is
functioning beautifully and my kidney is stable. And I’m happy to be back to doing
everything in life that I want to do. ■
At home in North Carolina
CHOOSING THE
RIGHT TREATMENT
Until recently, people with
abdominal aortic aneurysms had
two treatment options: open
abdominal surgery and endovascular graft repair. The minimally
invasive endovascular procedure
is performed via blood vessels,
but it is not an option for about
25 percent of people, including
Ron Rolett, whose aneurysms are
too close to the kidneys.
Enter fenestrated grafts.
The difference between the
tried-and-true endovascular
repair and this new technique
is the fenestrations (windows).
Instead of blocking arteries with
the graft’s metal skeleton and
risking kidney failure, surgeons
take detailed measurements of
each person’s aorta and then precisely cut windows in the graft to
line up with the openings of the
arteries to allow blood to flow
during surgery.
“The great advantage,” says
James Black, M.D., a vascular
surgeon at Johns Hopkins, “is that
we can now repair an aneurysm
that involves the kidney arteries
without actually turning off the
circulation to the kidney arteries.”
Some insurance may cover a
one-time abdominal aortic aneurysm ultrasound screening for
people who meet certain criteria.
To watch a video of Ron Rolett telling his story, visit hopkinsmedicine.org/mystory.
Or visit bit.ly/AAArepair to see Johns Hopkins vascular surgeon James Black, M.D.,
answering questions about fenestrated grafts, a new technique for treating abdominal aortic
aneurysms. For more information, appointments or consultations, call +1-410-614-4561.
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+1-410-614-4561 | hopkinsmedicine.org/international
6/28/13 10:04 AM
secondopinion
Hormones and Health Risk
Low testosterone affects more than sexual dysfunction
T
hanks to frequent advertising by
drug companies, erectile dysfunction as a sexual disorder is
now common knowledge.
What’s less appreciated,
experts say, is the role that low
testosterone, a contributing factor for erectile
dysfunction, can play in other serious diseases,
including some of the biggest killers of men:
heart problems such as high blood pressure and
cholesterol, obesity-related illnesses and diabetes.
The link is a tendency to put on weight as
we age. Belly fat is killing more than our sex
lives, it turns out.
Kevin Billups, M.D., director of the Men’s
Health and Vitality Program at Johns Hopkins,
says getting older means your testosterone level
will decline. But being overweight and inactive
can make it worse.
“Diabetes, high blood pressure, high
cholesterol—those are all associated with low
testosterone,” Billups explains. “I always focus
on those big three, the ones associated with
insulin resistance and the cluster of risk factors
around that. For men seen with those chronic
medical conditions, it is important to
FREE
screen for testosterone deficiency.”
ONLINE SEMINAR
Early testing matters: Low
HORMONES AND HEALTH
testosterone and the associated
RISK: WHAT MEN AND THEIR
symptoms—erectile dysfuncPARTNERS NEED TO KNOW
tion, decreased sex drive, lack of
ABOUT LOW TESTOSTERONE
Tuesday, September 10, 11 p.m.–midnight GMT
energy and fatigue—can show
The role of low testosterone could be a factor in
up years before more serious
more than just erectile dysfunction. Johns Hopkins
health issues are evident, Billups
urologist Kevin Billups, M.D., will discuss how
says. One study estimates that
diabetes, high blood pressure and high cholesterol
may be associated with low testosterone. Learn
the prevalence of symptomhow early testing can help and what treatment
atic low testosterone is close to
options are available. To register, visit hopkins
6 percent, with nearly nine in
medicine.org/intlseminars.
10 of those symptomatic men not
treated. Many men, Billups says,
will say they have never been checked
for testosterone.
“I think it’s an underdiagnosed condition,”
Billups says. “I see a lot of men coming in with
other chronic medical conditions, and the first
thing I do is look at their waist measurement and
ask if anyone has checked their testosterone.” ■
For more information, appointments or
consultations, call +1-410-614-4561.
‘LOW T’ TREATMENTS
Concerned about low testosterone? Consider these steps from Kevin Billups, M.D., a urologist at Johns Hopkins.
Get checked. If you have
symptoms, or if you have a chronic
disease, have a testosterone panel
performed. If it’s normal, repeat in
a few years. If it’s not, discuss next
steps with your physician.
Lose weight. Diet and exercise
can help resolve erectile dysfunction, reduce risk of heart disease
and diabetes, and perhaps even
help raise your testosterone level.
hopkinsmedicine.org/international | +1-410-614-4561
FdJHSU1302_11_2ndopinion.indd 11
Apply a topical gel. After
men have been appropriately
evaluated and diagnosed, Billups
sometimes jump-starts a patient
with testosterone gel rubbed on
the skin.
Opt for gel alternatives.
Men might prefer a slow-release
patch or periodic injections.
Under-the-skin pellets last up to
four months.
summer 2013
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