Cases of whooping cough (pertussis) increase in Kentucky

By Sarah Ladd
Kentucky Lantern

Kentucky is seeing an uptick in cases of pertussis, more commonly called whooping cough, a highly contagious respiratory illness.

The state Cabinet for Health and Family Services said in a Friday newsletter: “Recent cases have occurred primarily in Central Kentucky but cases are being seen throughout the commonwealth.”

Whooping cough can be a life-threatening illness and is most dangerous for babies, according to the the Centers for Disease Control and Prevention. It can, however, affect people of any age.

Whooping cough is highly contagious, according to the CDC. Vaccines are available to children as young as 2 months old and can help prevent it.

Early symptom onset to recovery can take around 12 weeks, according to the state Department for Public Health, which says symptoms of whooping cough include:

• Runny or stuffy nose
• Uncontrollable coughing
• Vomiting from coughing
• Fever below 100.4 Fahrenheit
• Apnea (life-threatening pauses in breathing) and cyanosis (turning blue or purple) in infants and young children

Opinion: Misinformation, inaction and politics seem to be limiting Kentucky schools' response to recent increase in Covid-19 cases

By Kevin Kavanagh

As Kentucky’s fall school year commences it has achieved another first in the nation, first to have two school district closings associated with Covid-19. Politics, inaction and disinformation seem to have paralyzed our Covid response and placed children and teachers in harm’s way.

The myth that children do not have to worry about Covid and other respiratory diseases is firmly rooted in our society, planted there by many of our leaders who have based their guidance on misinformation.

Kevin Kavanagh, M.D.

There have been multiple studies which have found that children readily spread the disease, placing susceptible family members and teachers at grave risk of becoming infected and developing "long Covid." Sweden is often used as the poster child for Covid minimizers, but during the first week in December 2020 (the last available data) 70% of public environment (non-health-care related) Covid-19 outbreaks in Sweden were in preschools, primary and grammar schools.

Primary school teachers were 67% more likely to develop Covid-19 than the average occupation, higher than nurses and doctors. Secondary-school teachers were at a 48% higher risk.

Children are also at risk for long-term disabling effects. 12 to 16% of children had "long Covid" three to six months after infection. Covid-19 in children also almost doubles the risk of developing Type I diabetes, and there is also the risk of widespread organ system damage from Multisystem Inflammatory Syndrome (MIS-C). Post-Covid immune dysfunction is probably responsible for the large waves of RSV infections our children are experiencing. Covid minimizers need to internalize that Sweden, a country with little masking, also experienced large RSV spikes, thus, public-health interventions are not to blame.

No one truly knows the extent of the virus’s long-term effects and lately there has been little good news in this regard.

Source control is effective in preventing infections and involves both masking and high-quality ventilation.

Two-way masking is highly effective but also highly politicized. Masking can reduce indoor aerosols (i.e., viral particles) in schools by 69%. A healthy wearer of a mask is not fully protected, since they can still be exposed to viral particles through their eyes, but a mask on an asymptomatic carrier will interact with almost all of the exhaled viral particles. Well-fitted N95 or KN95 masks are much more effective than cloth masks.

Improving ventilation is less controversial than masking. Inadequate ventilation not only spreads disease but also affects students’ school performance. CO2 levels can be used as a screening tool for adequate ventilation. Outdoors, CO2 levels are below 500 ppm. Indoors, they should be below 870 ppm (preferably below 700 ppm). At higher CO2 levels there is an increased risk of contracting airborne diseases. Above 1000 ppm, decreased mental performance occurs which can affect a child’s learning in school, along with the performance of teachers.

Portable CO2 monitors can be purchased online and help parents identify safe indoor settings for their children.

Unfortunately, too many of our schools have unhealthy buildings with outdated HVAC systems. This will adversely impact our children’s learning, along with placing them at risk for acquiring respiratory diseases (RSV, flu and even colds). I felt the spending of Covid funds on outdoor sports and running tracks, as opposed to improvements in indoor air quality and Covid mitigation strategies, exemplified Kentucky’s embrace of disinformation and inability to safeguard the lives and well-being of our children.

Let’s make Kentucky the national leader in providing a safe educational environment for our children. The first and easiest steps will be to upgrade school ventilation and to respect parents who are masking their children.

Kevin Kavanagh of Somerset is a retired physician and chairman of Health Watch USA, a group concerned with infection control. This was first published in the Louisville Courier Journal.

Young heavy drinkers much more likely to carry a handgun

Kentucky Health News

A young person in rural America who drinks heavily is 43% more likely to carrying a handgun in the following year, according to a study conducted in seven states over 15 years and published in The Journal of Rural Health.

“Our study establishes a clear link between these two behaviors in rural areas, and there are evidence-based prevention programs to address both,” said lead author Alice Ellyson, an acting assistant professor of pediatrics at the University of Washington.

The study defined "heavy drinking" as consumption of five or more alcoholic drinks in a row at least once in the two weeks before the question was asked of 2,002 youth, aged 12 to 26, from 12 rural communities in Colorado, Illinois, Kansas, Maine, Oregon, Utah, and Washington. Survey responses were collected annually from 2004 to 2019 starting with children who were in fifth or sixth grade, as part of the university's national Community Youth Development Study (CYDS).

Ellyson told Kentucky Healh News that no Southern states were included in the study because the Southern communities that participated in the survey consortium that helped develop the CYDS "chose not to continue as part of the community-randomized trial portion where we obtained our data for this study."

The association between heavy drinking and gun-carrying also was evident (38% greater) among young adults ages 19 to 26, perhaps not surprising, due to minimum legal ages for drinking. The study did not break out differences between male and female respondents or address their likelihood of firing the handgun.

"Recent evidence suggests that rural adolescents may start carrying a handgun earlier and carry with a higher frequency and duration than their urban counterparts," the university says. "Handgun-carrying is associated with bullying, physical violence, and other risk factors for violence.

"Understanding youth behaviors associated with carrying a firearm has significant safety implications. In 2020, suicide and homicide were among the leading causes of death among U.S. individuals ages 12-26 years. About 91% of homicides and 52% of suicides among this age group involved a firearm."

For adolescents, Ellyson says, the message is simple: Don’t drink alcohol or carry a handgun. But she said young adults, will need a more nuanced message: “Both alcohol use and handgun-carrying become legal in young adulthood. We want to use a harm-reduction approach for young adults who engage in both behaviors (drinking and handgun carrying) so they are done in a safe way,” she said.

Communities That Care is a program for preventing these behaviors and their consequences in rural areas. It has no communities in Southern states, "but they would be very willing for that to change," Ellyson told Kentucky Health News.

The university says, "An earlier study by Ellyson and colleagues found six distinct patterns of when and how often individuals in a rural area carry a handgun. In these communities, young people carry handguns at more than twice the rate of their counterparts in urban settings. Because alcohol use is also more common among rural youth, prevention programs focusing on them are important."

Kentucky Opioid Symposium will be held Oct. 9-10 in Lexington

Kentucky Health News

The Kentucky Opioid Abatement Advisory Commission will host what it calls its inaugural opioid symposium Oct. 9 and 10 in Lexington. 

The two-day conference will feature presentations and workshops by experts in their respective fields "to foster increased awareness of the impact of the opioid epidemic and to bolster a collaborative approach to combatting this scourge," says a news release from the commission.

"Special rate" tickets are available for $99 until Monday, Sept. 11 for the symposium and the welcome  reception, according to the event website. After that date, the cost of the combined ticket increases to $135, with sales ending Oct. 1.

Purchased separately, a ticket to the Oct. 8 welcome reception at Marriott Griffin Gate Resort is $50 and the cost for a ticket to the symposium is $100, with sales ending Oct. 1. 

The symposium will be held at the Central Bank Center, 430 W. Vine St. To register for earlybird tickets visit kentuckyopioidsymposium.com.

The site says, "You can purchase tickets for individual events, or purchase a package for all events."

The agenda addresses s a number of opioid-related topics from the perspectives of prevention and treatment and recovery and reform. U.S. Rep. Hal Rogers will be a speaker, and the keynote speaker will be Sam Quinones, author of Dreamland and The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth.  Click here to see the full agenda and here for a list of the presenters. 

The symposium's presenting sponsor is the Kentucky Association of Health Plans, the trade association representing commercial insurers and Medicaid managed care organizations. 

"KAHP is honored to help the Opioid Advisory Commission with convening this important gathering," Tom Stephens, president and CEO of  KAHP, said in a news release. "Managed care organizations continue to show their commitment to fighting the opioid scourge through awareness campaigns, incentivizing alternative therapies, providing Medically Assisted Treatment (MAT), encouraging strong peer supports, and focusing on areas like expungement assistance and recovery housing.”

The Kentucky Opioid Abatement Commission was created by the General Assembly to distribute the state's  portion of the more than $842 million in opioid-settlement money. The funds come from opioid manufacturers and distributors, half of which goes to the state and the other half goes to cities and counties.  The commission is housed in Attorney General Daniel Cameron's office. 

Research finds 'long Covid' could be linked to changes in cells in people with severe Covid-19; underscores importance of vaccine

Small study finds an inflammatory cytokine 
called Interleukin 6 (IL-6) could play a role
 in "long Covid." (Wikipedia illustration)

By Melissa Patrick

Kentucky Health News

A small study has found that severe cases of Covid-19 can lead to lasting changes in the human immune system, the first line of defense against germs entering the body. 

The finding could explain why Covid-19 can damage so many different organs and why some people with "long Covid" have high levels of inflammation. 

The study, published in the peer-reviewed journal Cell, examined immune cells and molecules in blood samples from 38 people recovering from severe Covid-19, others who had recovered from other severe illnesses, and 19 healthy people.

The researchers also used a new technique to collect rare blood-forming stem cells that circulate in the blood, eliminating the need to extract such cells from bone marrow. A news release describes those rare stem cells as the parents of immune-system cells. 

What they found in examining those rare stem cells was that there were changes in them that led to an increased production of immune cells, called monocytes, and that these changes were passed on to "daughter cells" and ultimately resulted in the increased production of molecules called "inflammatory cytokines," compared to healthy people or those with non-Covid-19 illnesses. 

The Cleveland Clinic defines cytokines as "signaling proteins that help control inflammation in your body" and says, "too many cytokines can lead to excess inflammation and conditions like autoimmune diseases." 

The release says "The researchers observed these changes as much as a year after the participants came down with Covid-19."

While the small sample size did not allow the researchers to make a direct association between the cellular and molecular changes in those rare stem cells and health outcomes, the release said the researchers suspect that an an inflammatory cytokine called IL-6 might play a role in the changes in the rare stem cells.

The researchers tested their hypothesis both in mice with Covid-19-like disease and in people with Covid-19 and found that blocking IL-6 early in the disease process with antibodies reduced altered gene expression in stem cells and the production of monocytes and inflammatory cytokines during recovery, compared to the subjects that didn't receive the antibody. This also resulted in less organ damage in mice. 

The release notes that these findings suggests that the changes in the innate immune system caused by Covid-19 may last long after the illness is over. The findings could also lead to new therapeutic approaches to treat long Covid. Also, they underscore the importance of vaccination. 

"The results also underscore the importance of staying up to date with recommended Covid-19 vaccines, which are proven to protect against serious illness, hospitalization and death," says the release.

The study was led by Steven Z. Josefowicz  of Weill Cornell Medicine in New York City and funded by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

Kentucky has nation's highest rate of a type of cancer that can be prevented with a vaccine recommended for 11- and 12-year-olds

Photo by Inside Creative House via iStock/Getty Images Plus

By Erin Poteet
University of Kentucky

Kentucky has the nation's highest rate of cancers caused by the human papillomavirus — a dire statistic considering HPV can be largely preventable through vaccination.

The HPV vaccine can prevent over 90% of sexually transmitted cancers caused by the human papillomavirus, including cervical, anal, penile, vaginal, vulvar and head/neck cancers.

Today, you can take an extra step toward protecting your children against HPV-related cancers with the HPV vaccine. The Centers for Disease Control and Prevention now recommends that all 11-12 year-old children (girls and boys) get just two doses, with the second being given 6-12 months after the first.

While the vaccine is most effective when given to children, it can still provide protection against HPV for teens and adults. So if you have not yet been vaccinated for HPV, it may not be too late. The FDA now approves the use of the HPV vaccine in men and women up to age 45.

People aged 26 to 45 should discuss the benefits of the vaccine with their doctor. Getting vaccinated in this age range can still have benefits, since people can acquire different strains of HPV over time. If you’re unvaccinated, you can still acquire the higher-risk strains later in life.

In addition to the HPV vaccine, it’s important for women to get regular screenings for prevention and early diagnosis of cervical cancer. Also known as a pap smear, this test looks for cancerous cells on the cervix, and can even find precancerous changes that have not yet developed into cancer. Screenings usually begin at age 21 or three years after first sexual intercourse. Talk to your doctor about a timeline for regular screenings.

One reason the vaccine (and for females, cervical screenings) is so important is because HPV-related cancers often don't cause obvious symptoms until more advanced stages.

For cervical cancer, some of the most common symptoms reported include abnormal bleeding or bleeding after sexual intercourse, and an abnormal discharge. As the cancer advances further, it can cause urinary blockage, back pain, leg swelling, or neuropathic pain, such as a "pins and needles" sensation in the skin.

Erin Poteet, Pharm.D., is director of retail and community pharmacy services for UK HealthCare.

Ky. Covid hospitalizations more than double, and exceed U.S. rate, but hospitals say they have been small and 'manageable'

CNN photo

By Melissa Patrick
Kentucky Health News

Kentucky has seen an uptick in Covid-19 cases, and local outbreaks, along with other illnesses, have shut down several school districts. This has also been reflected in hospital admissions, which is considered one of the most reliable indicators for tracking the virus since the end of the public-health emergency on May 11.

In the first two full calendar weeks of August, the latest period for which figures are available, Kentucky saw a 110% increase in daily Covid hospital admissions, with an average of 28 patients per day, according to the Covid-19 tracker of The New York Times, which uses Centers for Disease Control and Prevention.

During that two-week period, Kentucky had 20 hospital admissions per 100,000 people, which was 25% higher than than the national rate of 15 per 100,000.

More recently, several of the larger hospitals in Kentucky said the uptick has continued, while noting that the increases have been small. 

Data provided by UK HealthCare show that through mid-June, the hospital system was taking care of at least 15 to 20 Covid-19 patients each week. That dropped to between eight and nine in mid-July, then started to slowly increase until it reached 19 to 29 Covid patients the week of Aug. 21. The next week, it was 26 to 27.

These numbers reflect the number of people with an active Covid-19 infection at UK HealthCare and also those who came in with an active infection, but were still in the hospital when they were no longer infectious, UK HealthCare spokeswoman Allison Perry said.

Dr. Nicholas Van Sickels, an infectious disease physician and the interim director for UK HealthCare Infection Prevention and Control, said in an email that this small uptick in Covid cases is "largely driven by the newer EG.5 variant of Covid."

He added, "With schools starting back, seeing an increase in Covid-19 and other respiratory viruses isn’t unusual. As we move into the colder season and people begin spending more time indoors, we would also anticipate seeing additional increases in the prevalence of these viruses." 

Van Sickels offered suggestions for how to thwart the virus. 

"You can help prevent the spread of these viruses by practicing good handwashing hygiene; staying up to date on the latest available vaccines for Covid-19, flu and RSV; and wearing a mask if you are experiencing any symptoms of respiratory illness when you are around others," he said. "This is especially important for people who are at a higher risk for developing severe complications from viruses including Covid-19, flu, RSV and more.”

RSV is respiratory syncytial virus, which is a common virus that usually causes mild, cold-like symptoms, but can be serious, especially for infants and older adults. 

Baptist Health said its nine hospitals started seeing an uptick in Covid-19 cases in early August. 

"For most of the summer, Baptist Health hospitals were seeing averaging four to five Covid hospitalizations a week in total at our nine hospitals. An uptick started the first week of August and began dropping off this week," Kit Fullenlove Barry, director of public relations at Baptist Health, said in an email. 

Calling them "rough numbers," Fullenlove Barry said the Baptist system had 15 to 20 Covid-19 inpatients the first week of August; 20 to 25 the week of Aug. 6; 30 to 35 the week of Aug. 13; and 60 to 65 the week of Aug. 20. Interviewed with two more days left in the week of Aug. 27, she said the system had between 50-55 inpatients with Covid-19. On Aug. 31, the nukber was 52, with only one or two of them in intensive care and none on ventilators, she said.

"We are adhering to all CDC policies and procedures using established, evidence-based practices and appropriate infection control measures (as we did during the course of the pandemic) in managing confirmed and exposed patients," Fullenlove Barry said. "The uptick is manageable." 

CHI Saint Joseph Health did not provide case numbers but said it had seen a small uptick in Covid cases at its hospitals in Lexington, Bardstown, Berea, London and Mount Sterling. Dr. Dan Goulson, the group's chief medical officer, said in an email, "We will continue to monitor cases within the communities we serve and will make adjustments if warranted. We recommend individuals who are eligible to stay up to date on vaccinations, and to adjust habits based on their comfort level. If you are feeling sick, get tested and treated as needed."

Overdose Awareness Day was opportunity to raise awareness and reduce stigma of drug use; now it's National Recovery Month

By Melissa Patrick
Kentucky Health News

Each year, the last day of August is observed as International Overdose Awareness Day, to raise awareness of overdoses, acknowledge the grief felt by families and friends who have lost someone to a drug overdose, and to reduce the stigma of drug-related deaths. 

Heather Spurlock-Venters, who is a peer-support specialist at Addiction Recovery Care, shared her story of loss in an ARC news release. 

Spurlock-Venters, who is in addiction recovery, said she was sharing the story of her brother-in-law Sean Riley's overdose death to help others battling addiction. The release notes that Riley died a year ago and that Spurlock-Venters was early in her own recovery when she learned of  his overdose death. 

“When you’re in active addiction, you think you’re bulletproof and that nothing like that can happen to you. It never crossed my mind that one day one of us wasn’t going to be here,” she said in the release. “He passed away that day not only because he used, but used alone. He didn’t have anyone there to help him or try to bring him back. That’s what we do as people in recovery. We reach back for the ones still suffering because we know what it is like to suffer. I don’t want anyone else to ever go through that – not if I can help it. . . . We don't have to be a statistic." 

The release adds that with the influx of fentanyl and other synthetic opioids, there has never been a more dangerous time to be using illicit substances. It also provides a one-page list of resources to educate people on overdose risk factors, prevention, signs and symptoms of an overdose and how to respond to an overdose. 

According to the Kentucky Office of Drug Control Policy’s 2022 Overdose Fatality Report, there were 2,135 overdose deaths in Kentucky last year. This was 5% fewer than in 2021. Fentanyl was identified in 1,548 of the deaths, or 72.5%. Nationwide, 109,680 people died as a result of drug overdoses in 2022.

In recognition of Intrenational Overdose Awareness Day, the Kentucky Injury Prevention and Research Center highlighted resources for preventing workplace drug overdoses and supporting recovery from substance-use disorder.  

KIPRC reports that Kentucky had its highest number of workplace overdose fatalities in 2021, with 18, which was triple that of 2019. The number dropped to seven in 2022. 

“We are glad to see that fatal overdoses decreased both in Kentucky residents in the general community and at work,” Rebecca Honaker, program director for KIPRC's Kentucky Occupational Safety and Health Surveillance, said in a news release. "Despite the decrease, workplace overdose deaths remain a significant concern."

To help small businesses address this issue, KIPRC issued a "Hazard Alert" in August about the issue of workplace overdose deaths that included recommendations and resources for employers to help them create a recovery-ready workplace.

And to recognize Drug Overdose Awareness Day, the center released the Kentucky Small Business Toolkit for Hiring Employees in Recovery, which provides additional ways to become a recovery-friendly workplace, including addressing stigma, recruitment, how to use tax credits, bonding programs, community resources, and how to promote a business a recovery-friendly.

Looking forward, September is National Recovery Month.

“Substance use is a dangerous and deadly disease, but treatment is available and recovery is possible,” Matt Brown, president of ARC Healthcare, said in the ARC release. “We remain committed to doing everything we can to reduce overdoses in Kentucky and educate people on the many pathways to recovery.”

People who are struggling with drug abuse or who are concerned about a family member's substance use can search for treatment providers at www.findhelpnowky.org. And for those seeking recovery housing, visit findrecoveryhousingnowky.org. KIPRC also offers a Drug Overdose Prevention Tackle Box, A Guide for Communities.

Cameron declines to give more details of plan for work rules in Medicaid; Beshear says Cameron 'heck-bent' on cutting benefits

At a happier time: In 2019, Gov. Andy Beshear appointed Daniel
Cameron attorney general to succeed him after they each won
offices with different starting dates. (AP photo by Bruce Schreiner)

Kentucky Health News

Gov. Andy Beshear said Thursday that Attorney General Daniel Cameron, his opponent in the Nov. 7 election, appears "heck-bent" on changing the Medicaid program in ways that would lead to some people losing their benefits.

Cameron said at a Kentucky Farm Bureau forum July 26 that "one of the first things I would do as governor" is seek federal approval for a requirement that able-bodied adults on Medicaid work to maintain their coverage. His campaign said later that adults would have to work, be enrolled at least part-time in college or be involved in job training or community service, and quoted him as saying, “We will protect the truly vulnerable but we will not allow able-bodied people to take advantage of taxpayer generosity.”

Cameron said in a KET debate during his May primary campaign that the work requirement could be met by 20 hours a week of "volunteer" work, as was proposed by Beshear's predecessor, Republican Matt Bevin.

Asked Wednesday whether his plan would be substantially similar to Bevin's, or how it would be different, Cameron said, "Well obviously, as I move into the governor's office, I'll obviously consult with my team about the specifics."

The next day, at his weekly press conference, Beshear shot back: "When asked about it, he didn't know how he was going to do it. I guess he's just heck-bent on ensuring that 100,000 Kentuckians can't go to a doctor when they're sick."

The Bevin administration estimated that its plan would reduce the state's Medicaid rolls by 95,000 over five years, largely because some Medicaid beneficiaries would be unwilling or unable to comply with its rules, including paperwork to certify their eligibility. The administration reduced that estimate to about 79,000, but academic health experts said in a lawsuit challenging the plan that a more likely range was 175,000 to 297,500.

The Courier Journal's Joe Sonka asked Cameron how many able-bodied Medicaid recipients in Kentucky are not working.

Cameron replied in an email, "It's not a specific number that matters, but rather the general principle that able-bodied people should work. "Why should a middle-class taxpayer subsidize an able-bodied person because they have become so dependent on the government? Let’s get that person the skills they need and get them back on the job."

Beshear's campaign has been running a television commercial about the issue. Sonka took a close look at the issue and did a fact-check.

Three U.S. appeals court judges hear arguments on new law restricting health care for transgender minors in Kentucky

By Sarah Ladd
Kentucky Lantern

A three-judge federal panel on Friday heard opposing arguments over Kentucky’s ban on gender-affirming medical care for transgender minors, after first hearing arguments in a similar case in Tennessee.

Stephanie Schuster presented arguments for the American Civil Liberties Union of Kentucky and the National Center for Lesbian Rights, which are suing on behalf of seven anonymous transgender minors and their parents seeking to restore access to hormone treatments and puberty blockers for transgender minors in Kentucky.

Attorney General Daniel Cameron’s office is fighting to keep the ban imposed by Senate Bill 150, which the Republican-controlled legislature enacted earlier this year over Democratic Gov. Andy Beshear’s veto.

Schuster argued that SB 150 is inherently discriminatory on the basis of sex because a patient’s biological sex – what was assigned at birth – would need to be known for treatment to be legal or illegal.

Solicitor General Matthew Kuhn argued for Cameron that the law deals with “regulating the practice of medicine” and is not sex-based discrimination. He said the state “has chosen a particular condition and has chosen particular treatments for that condition and restricted that. That is not a a sex-discrimination issue.”

Judges Jeffrey Sutton, Amul Thapar and Helene White heard
arguments at the Cincinnati court. (L.A. Blade photo illustration)

The arguments before a three-judge panel of the 6th Circuit U.S. Court of Appeals in Cincinnati came after the same panel rejected on a 2-1 vote an August request from the ACLU of Kentucky to let transgender minors get certain medical care, such as puberty blockers.

SB 150 also bans gender-related surgeries like phalloplasty, vaginoplasty or hysterectomies and vasectomies on minors. But neither the ACLU nor Kentucky LGBTQ+ organizations are challenging the ban on such surgeries.

Schuster argued, “The evidence in this record shows that withholding treatment – even up until the age of 18 – and allowing puberty to occur consistent with the sex identified at birth is extraordinarily harmful to these children.

“And what this regulates is not just procedures that they can’t get until the age of 18. It’s many aspects of these children’s lives while they’re in school and able to get treatment that is medically indicated and medically necessary for them to live and develop into functioning and happy adults.”

Friday’s arguments — streamed to the press and public with audio only — were heard by Chief Judge Jeffrey Sutton and judges Amul Thapar and Helene White.

One of the judges said “I feel like there’s compassion (in) both directions.”

He continued: “It’s not crazy to say that there’s a compassion component to the other side of this, that maybe this is the kind of thing some people might regret if they do it at age 14, 15.”

Kuhn argued that the law is indeed “a compassion measure.”

“The plaintiffs think that Senate Bill 150 is going to cause harm to children,” Kuhn said in rebuttal. “And the Kentucky General Assembly thinks it’s going to prohibit harm for children.”

September is Prostate Cancer Awareness Month; American Cancer Society provides info on prevention, risk and treatment

By Melissa Patrick

Kentucky Health News

When prostate cancer is detected early, the odds of survival are high. That is the message being spread far and wide in September, which is Prostate Cancer Awareness Month. 

Prostate cancer is the second leading cause of cancer death among men in the United Statesm and Black men are two times more likely to die from it than white men. Black men having the highest death rate for prostate cancer of any racial or ethnic group.

According to the American Cancer Society, more than 288,000 men will be diagnosed with the disease this year, with close to 35,000 deaths. 

The good news is that more than 3.5 million men diagnosed with the disease in the U.S. are still alive today, the ACS reports.

The incidence rate for prostate cancer in Kentucky is 108 cases per 100,000 people, with 28 counties having the highest rates of  between 112.6 and 153.3 cases per 100,000 people. The statewide rate is  below the national rate of 109.9 cases per 100,000 people. 

The death rate for prostate cancer in Kentucky is 18.1 per 100,000, with 24 counties having the highest rates of between 22.5 and 44.9 deaths per 100,000 people. This is about the same as the national rate of 18.8 deaths per 100,000 people. 

For Prostate Cancer Awareness Month, Dr. Lorelei Mucci, director of strategic research partnerships at the ACS, provided information in an ACS news release about the signs and symptoms of prostate cancer,  risk factors, screenings and more.

Prevention: Mucci stressed the importance of Prostate Cancer Awareness Month as a way to promote prevention, early detection and treatment to improve survivorship. In addition, she said it's important to set aside time to reflect on those who have been impacted by prostate cancer and those who have lost their lives to it. Further, she said increased awareness of the disease can prompt officials to invest in more prevention and treatment opportunities. 

Warning signs of prostate cancer: "For some men, prostate cancer may lead to urinary problems, such as having difficulty starting urination or urinating frequently, or pain during ejaculation. This is because of the location of the prostate close to the bladder and urethra. These symptoms and signs also occur with non-cancer conditions, so it is important to follow up with a physician to find out what might be causing these symptoms.

"If a cancer has already grown beyond the prostate, there may be pain in the hips, back, or other areas that does not go away. For most people, however, there are no signs or symptoms indicating prostate cancer and the cancer is diagnosed with a biopsy following an abnormal blood test," she writes. 

Who is at risk: Anyone with a prostate is at risk of prostate cancer. 

However,  she writes that ACS research shows that Black men and those of African ancestry are 70% more likely to be diagnosed with prostate cancer. And, the risk of prostate cancer gets higher with age. In addition, people with a family history of prostate cancer (such as in their brother or father) as well as a family history of breast cancer in a sister or mother, are at higher risk of prostate cancer. 

That said, Mucci notes that "maintaining a healthy body weight, not smoking, and being physically active can help to offset this higher risk." 

Treatment and advancements: "There are effective treatments for prostate cancer," she writes. "When the cancer is still confined to the prostate (localized), surgery (radical prostatectomy) and certain forms of radiation are useful to treat and cure prostate cancer. For men who have a low risk of their prostate cancer metastasizing, active surveillance - in which a patient is closely monitored for signs of cancer progression - can also be an important treatment to consider. When the cancer is more aggressive, there are additional therapies that are used, including therapies that target hormonal pathways, chemotherapy, immunotherapy, and radiopharmaceutical therapies. "

"In fact, this is an exciting time in prostate cancer with substantial progress in the discovery and approval of new therapies over the past 5-10 years, as well as several other therapies being developed," she writes. 

Screening test: The main screening test for prostate cancer involves taking a blood sample and testing it for the level of a marker called prostate-specific antigen (PSA). Higher levels of PSA in the blood can indicate prostate cancer, but also may be higher in benign conditions such as an enlarged prostate, so it is important to follow up with a doctor to discuss the results and the next steps. 

She adds that while there is good evidence showing that regular PSA screening can reduce prostate cancer mortality, there is some controversy with screening for prostate cancer since the test can pick up slower-growing cancers that will never lead to harm. She said researchers are working on more effective screening approaches. 

When should you get screened? The ACS recommends that men at average risk for prostate cancer discuss the benefits and limitations of screening with their healthcare provider at age 50.

Men at high risk (which includes Black men in general and any man with a first-degree relative who had prostate cancer before age 65) should have the conversation at age 45. 

Black men with a family history of breast, ovarian, or prostate cancer, and men with more than one first-degree relative who had prostate cancer at an early age should discuss screening at age 40.

"Detecting prostate cancer early can lead to more effective treatment and improved outcomes," she writes. 

In response to the question, "What is the ACS doing to combat prostate cancer?" Mucci said they have established the "Improving Mortality Toward Prostate Cancer Together" (IMPACT) initiative, which she leads. 

She writes, "This cross-institution initiative will address urgent unmet needs with the goals of significantly improving outcomes for all men including survivorship and survival; reducing disparities; improving diversity in prostate cancer clinical trials; accelerating engagement and awareness and accelerating the implementation of known prevention strategies into at-risk communities." 

Dr. Michael Kuduk, a Winchester pediatrician, is the new president of the Kentucky Medical Association

Michael Kudluk, M.D.

Dr. Michael Kuduk, a Winchester pediatrician, is the new president of the Kentucky Medical Association. He was sworn in as the 173rd president at the organization's annual meeting, held Aug. 25-27 in Louisville. 

Kuduk, a native of New Jersey, is is an assistant professor of pediatrics at the Kentucky Children’s Hospital. He graduated from the Johns Hopkins University and graduated from the University of Medicine and Dentistry of New Jersey (now Rutgers Medical School) in Newark. He completed his residency at Baylor College of Medicine in Houston. 

He previously served as board chair and vice-president of the KMA, as well as chair of its political action committee. He is a 2018 graduate of the Kentucky Physicians Leadership Institute.

In his inaugural address, Kuduk discussed his goals for the year, including a focus on prior authorization reform, which was indicated as one of the leading causes of physician burnout in a KMA membership survey in 2022. The KMA House of Delegates also passed a resolution calling for prior authorization reform, a KMA news release said.  

“I will continue to advocate for prior authorization reform, an issue that we can all agree not only impacts our daily lives, but the lives of our patients. Many of our physicians came to Frankfort to advocate on the issue, and we plan to put an even greater focus on it this year," Kuduk said in the release. "We know that telling a story can be the most effective form of advocacy, and we all have many patient stories to tell showing how prior authorizations negatively impact the health of our patients.”