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Fall 2013

New Clinic for Prostate Cancer Patients Receiving Hormone Therapy

While androgen deprivation therapy (ADT) is an extremely effective treatment for prostate cancer, it causes various side effects related to decreased testosterone levels, including fatigue, hot flashes, decreased libido and decreased erectile function. It is also associated with weight gain, loss of muscle mass and an increased risk of diabetes.

While androgen deprivation therapy (ADT) is an extremely effective treatment for prostate cancer, it causes various side effects related to decreased testosterone levels, including fatigue, hot flashes, decreased libido and decreased erectile function. It is also associated with weight gain, loss of muscle mass and an increased risk of diabetes.

The new UCSF STAND (Supportive Therapy in Androgen Deprivation) Clinic is one of the first of its kind that provides comprehensive care to prostate cancer patients who have started hormone therapy.

During an integrated clinic visit, a multidisciplinary team meets with each patient at the UCSF Helen Diller Family Comprehensive Cancer Center. The team includes exercise specialists, a physician and nurse practitioner with expertise in prostate cancer, a physician with expertise in symptom management, and nutrition specialists. A comprehensive and individualized action plan is designed for each patient. Hormone therapy injections are also administered during clinic visits. Patients also have the opportunity to participate in research studies with the goal of developing new hormone therapies for prostate cancer.

To refer a patient or for more information, call patient navigator Geronima Cortese at (415) 885-7795; or the main clinic at (415) 353-7171.

UCSF West Coast Center for National Pediatric Pancreatitis Study

Pancreatitis in children is uncommon. However, recent studies have shown that in the past decade, pediatric pancreatitis cases have increased and children now contract the disease almost as often as adults (approximately 1 in 10,000). The increase may be a result of more accurate diagnoses and testing for rare diseases. While most children with pancreatitis have a single acute episode that resolves without complications, a subset develop recurrent episodes of acute pancreatitis or chronic pancreatitis. The epidemiology, etiologies, pathogenesis, natural history and outcome of these disorders in children are not well-understood. Pediatric literature is limited to retrospective reviews and small cohorts.

To better understand pediatric pancreatitis and improve treatment, UCSF is one of the 14 centers nationwide participating in INSPPIRE (International Study Group of Pediatric Pancreatitis: In search for a cuRE). To date, nearly 200 children and adolescents (< 19 y/o) have been recruited into the registry. Study participants are still needed. Children and adolescents, who have had more than one episode of pancreatitis or have had an unresolved case of pancreatitis, are eligible to participate. To refer a patient to the study, please contact co-investigator, Elizabeth Yen, MD, at (415) 502-2045.

UCSF Opens Pediatric Exercise Medicine Clinic

Exercise is a vital component to every child's life. However, children with chronic medical conditions often have significant exercise limitations due to decreased cardiorespiratory reserves. These children tend to be sedentary, either because of their inability to exercise or on advice from others. Though research shows that appropriate physical activity for children with chronic conditions results in increased fitness, fewer exercise-related symptoms, decreased incidence of long-term complications and improved prognosis and quality of life. In addition, exercise testing is the single best predictor of survival in children with various chronic diseases.

The new Pediatric Exercise Medicine Program at UCSF Benioff Children's Hospital uses exercise as a tool to diagnose disease and improve the health and quality of life of children with chronic conditions and those who are overweight. The program assesses patients' ability to engage in exercise safely and collaborates with referring providers to integrate exercise medicine into patients' treatment plans.

Exercise testing is used as an important diagnostic tool. While many children arrive at the clinic with a known diagnosis, an exercise test can establish a diagnosis when the cause of symptoms is unclear, or when symptoms are only present during physical exertion. In addition, specialized exercise testing is offered to young athletes to evaluate for conditions specific to athleticism and to assess their aerobic performance.

To make a referral for a clinical exercise evaluation or exercise treatment plan, or to refer a patient directly for exercise testing, please call the UCSF Benioff Children's Hospital Access Center at (877) 822-4453 [(877) UC-CHILD].

Managing Concussions in Young Athletes

Each year, approximately 300,000 sports-related concussions occur, many affecting young athletes. An unknown number of these athletes experience post-concussive syndrome. However, because there is no specific test to diagnose a concussion; the condition cannot be seen on a standard MRI or X-ray; and due to its variable nature, many cases are untreated or mismanaged, which can result in disabling and permanent cognitive and neurobehavioral problems. Moreover, suffering a second head injury while recovering from an initial concussion can have fatal consequences. Second impact syndrome was responsible for approximately 30 to 40 deaths over the past decade. Yet, with early recognition of symptoms, a prompt evaluation and comprehensive care, approximately 85 percent of concussion patients experience a full recovery within a month or two.

The new California Assembly Bill 25 (signed into law October, 2011) mandates awareness, education and protocol for concussion-related injuries in California school athletes:

  • Athletes and guardians must sign a concussion information form yearly
  • Any athlete suspected of having concussion must be removed from game or practice at the time of injury
  • The athlete can return only after cleared by a health care professional trained in evaluation and management of concussion

The Bay Area Concussion and Brain Injury Program at UCSF specializes in evaluating, diagnosing and managing head injuries in young athletes. The program provides comprehensive diagnostic testing, including computerized ImPACT testing, 3T MRI imaging, vestibular therapy and various tests for spatial and visual awareness and memory. The team includes nationally-recognized experts in sports medicine, physical medicine and rehabilitation, neuropsychology, neuroradiology, neurology and neurosurgery. The program works closely with schools to guide re-entry. To refer a patient, call (415) 353-1915 or visit www.ucsfbenioffchildrens.org/concussion.