Clinical Briefs
Discrimination's Impact On Recovery
By Marilyn Perkins | Illustrations by Bratislav Milenkovic
Traumatic brain injuries (TBIs) can lead to lifelong disability and require long-term medical care. While drugs and surgery can treat TBI, new research suggests that experiencing discrimination may hinder recovery.
We know that discrimination causes psychological distress, which can lead to downstream health problems. People with TBI are especially at risk for discrimination, as those from minoritized communities are more likely to sustain a TBI. What’s more, TBIs can cause disabilities that are subject to discrimination.
Rehabilitation researcher Umesh Venkatesan, PhD, and colleagues surveyed how often people with moderate and severe TBI felt discriminated against for any reason, related or unrelated to their injury.
The study’s results showed that TBI patients who experienced discrimination measured higher on scales of anxiety and depression, showed more behavioral problems like poor self-regulation and even reported worse quality of life.
“It makes it particularly important that we study these social factors and experiences in our patients,” says Dr. Venkatesan. “Because social issues like discrimination may have been negatively influencing their whole lives, there’s no reason to believe these factors are going to stop influencing their health after the brain injury. If anything, the injury might make tough situations worse.”
Do Steroids Affect Cancer Immunotherapy?
By Edyta Zielinska | Illustrations by Bratislav Milenkovic
Steroids are commonly given during cancer care, either to treat the disease or manage symptoms like pain or nausea. However, steroids can suppress the immune system and interfere with immunotherapy, which is why most clinical trials for immunotherapy exclude patients treated with steroids. Outside of the controlled setting of a clinical trial, though, many patients are treated with both immunotherapy and steroids, but studies specifically looking at the interaction of these two drugs have yielded mixed results.
Researchers Nikita Nikita, MD, and cancer epidemiologist Grace Lu-Yao, PhD, and colleagues at the Sidney Kimmel Comprehensive Cancer Center sought to address this question with the largest population-based real-world study to date. Through a database search, they identified 1,671 melanoma patients treated with immunotherapy, 907 of whom also received steroids within 12 months prior to their immunotherapy. “It is important to monitor cancer patients who took steroids prior to receiving immunotherapy because of the possible drug interaction,” says Dr. Nikita.
The researchers found that patients who had steroids within a month prior to immunotherapy had a 126% higher risk of death than those without steroid exposure in the year before immunotherapy. “Further studies are warranted to understand the mechanism, but this research suggests a longer time interval between these two therapies may improve survival,” says Dr. Lu-Yao.