How many lymph nodes need to be removed when cancer is found? Elizabeth Tracey reports
When someone has the skin cancer melanoma, a lymph node nearby, called a sentinel node, is frequently assessed to see if the cancer has spread. If cancer is found there also removal of all the lymph nodes in the area is frequently done. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, applauds a new study showing that most of the time, that may not be necessary.
Nelson: 823 folks randomized to the sentinel node biopsy alone. Eighty percent of them were free of progression or recurrence. The reason this is so important is if you go and complete the lymph node dissection the rate of lymphedema, that’s the obstruction to lymph flow, for instance out of the arm or the leg, which leads to a fat arm or leg, prone to infection. It’s really not a condition that anybody wants to have, was 34% if you had the completed lymph node dissection versus only 6% with the sentinel node biopsy. :32
At Johns Hopkins, I’m Elizabeth Tracey.
Can singing improve voice quality in people with Parkinson’s disease? Elizabeth Tracey reports
People with Parkinson’s disease often lose voice volume, making it difficult to communicate with others. Alex Pantelyat, director of the Center for Music and Medicine at Johns Hopkins, says one recent study at the center has demonstrated the benefits of singing to help.
Pantelyat: What we tried to do for the Parkinsonic study was to see if group singing once a week could actually improve, objectively, the voice volume, in other words loudness, in people who were singing. Under the direction of a professional choir director half of the people started to sing right away, while others did the support group, and after 12 weeks of this we crossed people over. We found that there were objective voice loudness improvements when we looked at people reading a standard paragraph, and when we had people describe a standard picture. There were actually some sustained benefits including in voice volume. :33
And people enjoyed singing, too. At Johns Hopkins, I’m Elizabeth Tracey.
Can music help people with neurological conditions move better? Elizabeth Tracey reports
People with Parkinson’s disease often have difficulty walking. Now a new study undertaken in the Center for Music and Medicine at Johns Hopkins aims to use music to help improve walking ability. Alex Pantelyat, a neurologist and study director, says it looks like music really helps.
Pantelyat: The results are not yet published but I’m happy to tell you that they’re very promising when it comes to enabling people with Parkinson disease to walk more rhythmically and to walk more. One of the key things we need to encourage all of our patients, whether it’s Alzheimer disease, Parkinson disease or other illnesses, to do is to move more and particularly get at least a moderate level of aerobic exercise. The goal is to enable people to walk more rhythmically and to walk more. And we were double people’s amount of moderate intensity walking from baseline to the end of the one month pilot study. :33
Pantelyat looks forward to using music to help improve walking in other movement disorders as well. At Johns Hopkins, I’m Elizabeth Tracey.
How can we assess the best music therapy for someone with Alzheimer disease? Elizabeth Tracey reports
Music helps people with Alzheimer disease with some of the manifestations of the condition such as memory difficulties or anxiety. Now a Johns Hopkins Center for Music and Medicine study led by Alex Pantelyat aims to identify exact characteristics of music individually selected by patients that helps.
Pantelyat: We take the very top song that they identify and scramble it beyond recognition. And we’re playing a snippet of the actual song, that’s recognizable, then we’re playing the same exact recording for the same exact duration scrambled beyond recognition. Third task we are playing another song that the patients have not identified. We’re using Spotify to identify a well matched song that nevertheless doesn’t have that emotional connection for the patient. We are seeing what the differences are in network activation. :30
Pantelyat says knowing which parts of the brain are activated in response to music will enable clinicians to develop the best individualized intervention for each person. At Johns Hopkins, I’m Elizabeth Tracey.
Can a prescription for music therapy help memory deficits in Alzheimer’s disease? Elizabeth Tracey reports
Most people have memories associated with music, and such associations may be helpful in delaying worsening or even improving memory function in people with Alzheimer’s disease. That’s the hope of Alex Pantelyat, a neurologist and director of the Johns Hopkins Center for Music and Medicine.
Pantelyat: We are exposing people to eight weeks of twice a week music therapy delivered to their home via Zoom, by a professional music therapist with at least ten years of dementia care experience, and we are of course doing memory testing, other cognitive testing at baseline, before the study begins, and are getting an MRI scan, where we are evaluating the extent of network damage that they have at the time, using both structural MRI and functional MRI, when they’re at rest and when they’re doing a task. :29
Pantelyat says a music intervention is individually tailored so people are exposed to music they find personally meaningful. He says at the very least, people report enjoying the sessions. At Johns Hopkins, I’m Elizabeth Tracey.
What kinds of music help people with conditions like Parkinson’s best? Elizabeth Tracey reports
Individually prescribed music may become part of your treatment if you have a disorder like Parkinson’s disease or a host of other conditions. The therapy is underway at the Johns Hopkins Center for Music and Medicine, directed by neurologist Alex Pantelyat.
Pantelyat: From a cultural standpoint, if somebody is raised in a Western country, some types of classical music, some types of soft rock, may be seen as relaxing, whereas somebody who’s coming from the Indian subcontinent might prefer music that they heard in their childhood. One size does not fit all. Cortisol, the stress hormone, can be reduced in meaningful ways by listening to certain types of preferred relaxing music. Activating this parasympathetic, rest and digest, part of the autonomic nervous system is definitely one way that music can help relieve stress. :33
Pantelyat says soothing the nervous system with music helps both physical and psychological aspects of health. At Johns Hopkins, I’m Elizabeth Tracey.