Welcome to the WorldCare member e-newsletter where you’ll learn more about the value of Medical Second Opinions for serious and complex medical conditions and get research insights from The WorldCare Consortium® providers.

For Your Health: Why Getting a Second Opinion Matters

When You Are Diagnosed with a Serious and Complex Medical Condition or Illness, a Medical Second Opinion (MSO) Can Literally Be a Life Saver

An MSO can identify and correct a misdiagnosis before it leads to unnecessary surgery, complications, and wasted time and healthcare spending.

A study1 by researchers at Johns Hopkins University and CRICO2 found that diagnostic errors accounted for one in three medical errors that caused serious harm, and 64% of those errors led to death or permanent disability.

The researchers identified three categories of diagnostic errors that accounted for a majority of diagnostic error claims and payouts, and the top health issues within each category, which accounted for approximately 50% of serious harms:   

• Vascular: stroke, venous and arterial thromboembolism, heart attack, and aortic aneurysm and dissection

• Infections: sepsis, pneumonia, meningitis/encephalitis, and spinal abscess

• Cancer: lung, colorectal, breast and prostate cancer, and melanoma

Obtaining a medical second opinion significantly lowers your risk of misdiagnosis. The WorldCare Medical Second Opinion Service provides valuable guidance and empathetic support when you need it most. Specialist teams with The WorldCare Consortium® will carefully review your case and provide you and your physician with an evidence-based diagnostic opinion and recommendations to support treatment plan decisions.

1 Newman-Toker, David E., Schaffer, Adam C., Yu-Moe, C. Winnie, Nassery, Najlla, Saber Tehrani, Ali S., Clemens, Gwendolyn D., Wang, Zheyu, Zhu, Yuxin, Fanai, Mehdi and Siegal, Dana. “Serious misdiagnosis-related harms in malpractice claims: The “Big Three” – vascular events, infections, and cancers” Diagnosis, vol. 6, no. 3, 2019, pp. 227-240. https://doi.org/10.1515/dx-2019-0019
2 CRICO is the insurance program that covers the medical community associated with Harvard University.

Health IQ

Get the Facts About Lung Cancer  

Lung cancer is the leading cause of cancer-related deaths, and an estimated 236,740 individuals in the U.S. will be diagnosed with the disease in 2022, according to the American Cancer Society. Awareness and early detection are essential for the best outcomes.

Did You Know?

Test your knowledge about lung cancer by answering these questions.

1. Who is most at risk for developing lung cancer? 
A. Older adults are at the highest risk, as most cases occur in individuals over the age of 65. The average age of diagnosis is 70 years, with few cases diagnosed before age 45.

2. How can you prevent lung cancer? 
A. If you smoke, quitting is one of the best ways to prevent lung cancer. Patients who are ready to quit should talk to their doctors about resources to help.

3. What are the symptoms of lung cancer? 
A. Individuals with lung cancer may experience a wide range of symptoms, or may have no symptoms at all. The most common symptoms include:
• Persistent cough
• Coughing up blood or phlegm
• Chest pain
• Shortness of breath
• Fatigue
• Unexplained weight loss

4. Is lung cancer more common in men or women? 
A. While lung cancer is more common in men, the gender gap is closing. In fact, lung cancer kills more women than any other cancer —more than breast, ovarian and cervical cancers combined.

5. Can non-smokers develop lung cancer?
A. Yes, lung cancer in never-smokers is the seventh leading cause of cancer-related death in the U.S.

6. Who should be screened for lung cancer? 
A. The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history AND currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.

7. What are the different types of screenings for lung cancer?
A. There is one approved test for lung cancer screening: the low-dose computed tomography (CT) scan, which provides a detailed image of the lungs and uses only about one-third the radiation dose of a full-dose CT scan.

8. What are the different stages of lung cancer? 
A. Stage I: When the cancer is confined to the place in the lung where it originated
Stage II/III (sic): When the cancer grows and spreads to the lymph nodes or other structures in the chest
Stage IV: When the tumor has spread to other locations in the body, such as the brain, bones or liver

9. How is lung cancer treated?
A. Depending on the stage of the lung cancer, its location in the body and the patient’s health status, the course of treatment may differ. Options may include surgery, radiation therapy, chemotherapy, targeted therapies, and/or immunotherapy.

10. What are the benefits of being treated by a multidisciplinary team?
A. Multidisciplinary input on how to best treat and care for a patient with lung cancer is essential to ensure that providers are diagnosing, treating and supporting patients as effectively as possible.

You can read more in-depth responses from consortium member Massachusetts General Hospital physicians here.

Sources: Massachusetts General Hospital and American Lung Association

Research Updates from The WorldCare Consortium® Providers

Acquiring More DNA Mutations Leads to Neuron Loss in Alzheimer’s Disease

Individuals with Alzheimer’s disease acquired more mutations in neurons compared to people without Alzheimer’s disease, and the extra changes disabled genes essential for healthy brain function, according to a recent study led by investigators from Boston Children’s Hospital.

The researchers analyzed whole-genome sequencing data from neurons in the prefrontal cortex and hippocampus brain areas of people who had and did not have Alzheimer’s disease. They found more mutations and abnormal mutation patterns caused by reactive oxygen species (ROS), free radicals that can oxidize and damage DNA, in neurons from people with Alzheimer’s.

The finding may tie in with previous knowledge on Alzheimer’s disease processes, such as the accumulation of amyloid-beta and tau proteins, which can both encourage ROS production, and the abnormal activation of immune cells in the brain, called microglia, that attack connections between neurons and cause oxidative damage to DNA.

The study was published in Nature. You might be tempted to think that antioxidants could be a potential treatment strategy. However, scientists will need to conduct more research to answer key questions on the underlying mechanisms that cause oxidation of the genome, inflammation and over-activated immune responses in the brain. 

Gene Discovery May Explain Lower Risk of Pulmonary Hypertension in Men

Pulmonary hypertension is a rare type of high blood pressure that affects arteries in the lungs and heart. It occurs four times more often in women than men. As there is no cure, and it can be fatal, many patients with pulmonary hypertension eventually need a lung transplant.

Researchers from UCLA Health hunted for the gene that plays a role in the development of pulmonary hypertension by silencing genes in mice, one by one, in the Y chromosome. (Men have one X and one Y chromosome; women have two X chromosomes). The scientists identified the gene Uty was responsible for halting an inflammatory pathway associated with pulmonary hypertension.

Next, the researchers modeled pulmonary hypertension in female rats and treated them with an experimental drug, AMG-487. It successfully prevented the development of pulmonary hypertension by blocking inflammation. The researchers now plan to study the drug in human clinical trials.

The study was published in the American Journal of Respiratory and Critical Care Medicine. 

WorldCare Impact

WorldCare Is the Benefit That Saves Lives

1 in 4 WorldCare MSOs result in a change to the original diagnosis which can dramatically change the treatment plan. And, 75% of WorldCare MSOs result in changes to the original treatment plan.