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Education Posts

13 Top Breast Cancer Movies and TV Shows

by Daniel Vaillancourt

The 13 Best Breast Cancer Movies and TV Series

In honor of October being Breast Cancer Awareness Month, here are 13 notable movies and TV shows that revolve around breast cancer.

 

“Terms of Endearment” (1983)

A classic, Oscar-winning film that tells the story of a mother-daughter relationship (played by Shirley MacLaine and Debra Winger), with the daughter being diagnosed with breast cancer. 

 

 

“Stepmom” (1998)

This film tells the story of a terminally ill woman (Susan Sarandon) who has to come to terms with her ex-husband’s new partner (Julia Roberts), who will take over the role of stepmother to her children.

 

 

“My Life Without Me" (2003)
In this poignant film, a young mother (Sarah Polley) keeps her terminal breast cancer diagnosis a secret while she prepares her family for life without her, making a list of things to do before she dies.

 

 

“The L Word” (2004-2009)

In this groundbreaking TV series about a group of lesbian friends, one of the main characters, Dana Fairbanks (Erin Daniels), is diagnosed with breast cancer in the third season.

 

 

“The Family Stone” (2005) 
A family-centered holiday drama (starring Sarah Jessica Parker, Diane Keaton, Rachel McAdams, Claire Danes, and more) that subtly deals with the topic of breast cancer through the matriarch's illness, offering emotional depth within the family dynamics.

 

 

“Why I Wore Lipstick to My Mastectomy” (2006)

Based on the true story of Geralyn Lucas (Sarah Chalke), this TV movie follows a young woman diagnosed with breast cancer who decides to face her mastectomy with humor and red lipstick.

 

 

“Living Proof” (2008)

This TV movie is based on the true story of Dr. Dennis Slamon (Harry Connick Jr.), who helped develop the breast cancer drug Herceptin.

 

 

“The Big C” (2010-2013)

This TV series centers around Cathy Jamison (Laura Linney), a suburban mother who is diagnosed with terminal cancer and decides to live life to the fullest. While it covers various types of cancer, it prominently addresses breast cancer.

 

 

“Five” (2011)

An anthology of five short films directed by five different women, including Jennifer Aniston and Alicia Keys, that explore the impact of breast cancer on women’s lives.

 

 

“Decoding Annie Parker” (2013)

A film starring Helen Hunt and Samantha Morton about the true story of Annie Parker, a breast cancer survivor, and the discovery of the BRCA1 gene mutation, which increased the understanding of hereditary breast cancer.

 

 

“Chasing Life” (2014-2015)
Following a young journalist’s life after being diagnosed with cancer, this series portrays the struggles of treatment and balancing personal relationships. Although it is not exclusively about breast cancer, it portrays a broader perspective on cancer diagnosis.

 

 

“Ma Ma” (2015) 
This Spanish drama, starring Penélope Cruz, explores the life of a woman diagnosed with breast cancer and her efforts to remain hopeful and positive despite the challenges ahead.

 

 

“Miss You Already” (2015)

This film follows two lifelong best friends (Toni Collette and Drew Barrymore), one of whom is diagnosed with breast cancer and must navigate the challenges it brings to her life and relationships.

 

These films and TV shows provide different perspectives on breast cancer, highlighting the emotional, social, and physical impacts, as well as stories of hope, humor, and survival. They have been influential in raising awareness, offering support, and helping to destigmatize conversations about breast cancer. Happy viewing!

 

And to register for one of DAP Health’s free mobile health screening mammograms, taking place at various locations from now through December 19, please scroll to the bottom of this page.

My Menopause Manifesto

by Daniel Vaillancourt

My Menopause Manifesto

Or how I fit an avalanche of expert advice into a proper desert lifestyle.

Words by Tracey Engelking

 

Let’s be honest. Aging and all that goes with it happen entirely against our will. We didn’t ask for this. There was no consultation. No group text. I mean, I’m embracing as best I can, but traversing the landscape of perimenopause into menopause can feel like going on a side quest to collect as many do’s and don’ts as possible. Our caregivers do their best to explain it all, but their advice is far too plentiful and daunting for most of us. So, I offer you all the ways I’m tailoring it to fit my best life.

 

Get Your Diet Sorted

We’ve all tried to cut out refined sugar, white flour, candy, desserts, chips, pizza, fried foods, fast food, joyous food… It’s too much. I’m going with finding balance. Mostly low-carb, high-fiber, high-protein. I eat dark chocolate when at home, instead of my beloved chips and ice cream. But I always have dessert if I go out to eat. And there is very large chance a Juicy Lucy cheeseburger and extra crispy fries from Blackbook finds their way into my tummy here and there. Balance, babes.

 

Get Mad Fit and Calm Your Soul

Body in motion/mind in meditation really does feel better in the long run. Thankfully, I’ve always been a sporty gal, so I do fairly well here. If you haven’t upped your fitness game, start easy and find something that works. You like music and dance? Try Zumba or country line dancing. Like to be outside? Vigorous walking or pickleball. Water-lover? Swim laps, try water aerobics, or go big into water polo or Underwater Torpedo League! Get workout sweaty to stop getting hot flash sweaty.

 

Supplements For Days

Gurl, I did not know we could need so many remedies just to get back to the way we felt at 40, but here we are! Estradiol cream, turmeric, multivitamins, vitamin D, black cohosh, beef liver spleen, magnesium, shilajit, fish oil, rose hip oil, hyaluronic acid suppositories, hairgrowth pills, warm lemon water, etc. The list is endless. But taken alongside our prescriptions, they do work. So, cheers to us with our rattler pill cases in our refrigerators! Group high-five!

 

Limit Your Naughty Habits

Yeah, OK, so we give ourselves a C+ here. We cannot act like we don’t know experts will tell us to limit or totally avoid alcohol. But we also do love a good happy hour and two-brunch Sunday. I mean, life is happening. We can’t not have at least a few days here and there spent tipsily tripping our way around an Uber, right? As for illicit drugs, well, speaking of tripping, LOL! A little edible THC help slide you into a more mellow you. Know the source and test your product. Kits are free and readily available — either via DAP Health’s Harm Reduction department, or at the nonprofit’s harm reduction vending machine inside Hunters Nightclub on Arenas Road in Palm Springs. Put your mind at ease before you alter your state.

 

Increase Your Naughty Habits

As the owner of a high libido with a voracious sexual appetite, I was shocked to hear that vaginal atrophy can hit even the most active of us. Another “WTF?” moment brought to us by our meno journey! I am now at peace with sweet lady lube, and vaginal creams and suppositories. Also, I make sure I’m keeping track of my orgasms — quality, ease of achievement, number per week. If this isn’t something you find easy, or are a little embarrassed to ask advice on, talk to your doctor or the staff of a sex shop like Rough Trade. Even if you need to write it down and pass a note. There are tons of solutions, so no need to suffer here!

 

Love Yourself Inside and Out

This is the one, right? We can totally get rung out during this chapter. We look in the mirror and somedays we don’t see ourselves as we remember. Our body hurts or is flat-out revolting against our wants. We’re tired and hormonal…but we are here. We are in this. Unsolicited, but in it regardless. We have to find a way to love this new us. On the days when we can’t find that self-love, we have to get on the text chain with our besties, or get on a message board, and lament to the likeminded. We need to ask for and find support, because this is the ride where some days, we love it and have our hands up whooping in joy. Other days, we just want to get off and stop the spinning. Reach out, baby. We don’t totally have this, but we kinda do, right?

 

There you go. The ways I’m really getting through it. If you have your own secret sauce, I’m all ready to hear and try it! When you see me out, come share away! Let’s be in this together.

 

If you would like to become a DAP Health OB-GYN patient, please click here.

Childhood Obesity: Kids in Crisis

by Daniel Vaillancourt

Kids in Crisis: Childhood Obesity

DAP Health Director of Pediatrics Dr. Jasmin Brown says that to address the problem, we need to look beyond the number on the scale.

Words by Maggie Downs

 

Over the past 30 years, childhood obesity has more than doubled in children and quadrupled in adolescents, according to the Centers for Disease Control and Prevention. This rise has led to an increase in obesity-related health issues among youth, including cardiovascular disease, pre-diabetes, and bone and joint problems. But addressing these challenges requires a shift in how we think about childhood obesity, moving away from blame and toward a more compassionate, holistic approach.

 

“One of the big misconceptions is that it’s the child’s fault or the parents’ fault. But this is a society problem. It’s a health care problem,” says DAP Health Director of Pediatrics Dr. Jasmin Brown, who practices at the Coachella Valley Community Health Center in Coachella. “It’s important for us to stop looking at this as a personal problem and more like, ‘How can we help one another?’”

 

One of the most debated tools in measuring and diagnosing obesity is the Body Mass Index (BMI). Originally developed in the 1830s to estimate the size of the average European man, BMI is a measure of body weight relative to height. However, it was never intended to assess individual health, especially in children.

 

“The BMI doesn’t account for different ethnicities or body shapes; it doesn’t differentiate between body fat, muscle, pregnancy — there are a lot of different things that affect a person’s weight, and therefore, their BMI,” Brown explains. “So, while I look at the BMI chart, I don’t use that as the crux of my management for kids.”

 

Obesity is influenced by various factors, including diet, physical activity, mental health, and socioeconomic status. That’s why Brown sees every visit as an opportunity to guide children. She emphasizes the importance of encouraging healthy eating habits, regular physical activity, and positive self-esteem, all key to addressing childhood obesity effectively. She suggests shifting the focus away from weight altogether.

 

“I really try to take it off the scale, because the scale is not the only measurement of health,” she says. “What I care about are the healthy habits that can start now and stay with the child for the rest of their life.”

 

When there are concerns, Brown may order laboratory tests to assess cholesterol levels, kidney function, and blood sugar, starting anywhere from age 3 and beyond. “My goal is to say, ‘Your cholesterol is elevated. We’re going to work on how to improve that,’ not ‘How can you lose weight?’” she notes. “Because I do see a lot of cholesterol problems and fatty livers and pre-diabetes, even in very young children, which can cause lasting health issues.”

 

During meetings with families, Brown discusses lifestyle factors like diet, physical activity, and screen time, suggesting small, manageable changes the family can make together. To avoid stigmatization — and empower parents to create a healthy environment for their children — she ensures these conversations are framed positively and without judgment. “If you have sensitive, caring discussions with the child and their family about how to manage health — taking the number on the scale out of it — these are important conversations to have,” Brown says. “Because if you ignore it, the repercussions can be severe.”

 

She says it’s important for every parent to build a trusting relationship with their child’s doctor so they can feel confident that concerns about weight will be addressed with care and respect. This foundation allows parents to bring up sensitive topics like weight with the assurance that their doctor will support the family in a positive, non-judgmental way.

 

If you are concerned about your child, please speak to your DAP Health pediatrician. If your child is not yet a DAP Health patient, please click here to access our pediatric services.

Manny’s Pride Story

by Steven Henke

The Emotional Wellness Journey of Coming Out with Pride: A Personal Reflection

For many LGBTQ+ individuals, coming out is a profound, transformative experience that deeply impacts emotional health.

As a Latino gay man who grew up in a conservative religious household and attended an all-boys Catholic school, I understand the emotional toll of hiding one’s true self. The pressure to conform to societal and familial expectations forced me to suppress who I really was. For years, I lived in fear of rejection, constantly battling an internal struggle between the person I was and the person I pretended to be.

This dual existence took a heavy toll on my emotional well-being. I never felt comfortable in my own skin and always felt like an outsider in my own life. The stress of hiding my true identity led to feelings of isolation, anxiety, and depression. I wasn’t living—I was merely existing.

Coming out changed everything. The moment I decided to embrace who I truly was, my life began to shift in unimaginable ways. The weight of secrecy and fear was lifted, and for the first time, I felt a sense of freedom and peace. By living authentically, I was able to create my own path, find love, and build a family that supports and celebrates me for who I am.

One of the most empowering experiences after coming out was attending my first Pride parade. I vividly remember the overwhelming sense of belonging as I stood among the crowds, surrounded by people who were proudly and unapologetically themselves. It was the first time I truly felt seen and heard, and it affirmed my decision to live openly. That day, I realized I wasn’t alone—that there was a whole community ready to embrace me. It was a moment of hope, inclusion, and safety that I had longed for my entire life.

Today, at DAP Health, I’m motivated by my journey to create change and make an impact in the lives of others. I understand the importance of emotional wellness in the process of coming out, and I’m committed to fostering an environment where individuals can feel safe, supported, and empowered to be their authentic selves.

Pride is a reminder that living authentically is not just about revealing one’s sexual orientation or gender identity; it’s about reclaiming your emotional well-being. It’s about shedding the layers of fear and shame, and stepping into a life that is true to who you are. By doing so, we not only improve our own emotional health but also inspire others to do the same.

As we celebrate Pride, let’s remember that the journey to emotional wellness begins with the courage to be ourselves. For those who might still be waiting for that feeling of inclusion, safety, and hope—I encourage you to connect with us at Pride. Together, we can create a world where everyone can live openly, freely, and authentically.

Harm Reduction is Health Care

by Daniel Vaillancourt

                                                                                                                 DAP Health Community Health Harm Reduction Supervisor Neil Gussardo, flanked by                                                                                                                                                                                                                                         Harm Reduction Educator Bree Clark-Pharr and longtime volunteer  Suzanne Petersen.

                                                                                                                (Photo by Donato Di Natale)

Everything You Ever Wanted to Know About Fentanyl Harm Reduction

Words by Daniel Hirsch

 

Given it’s a hundred times more potent than morphine and 50 times more potent than heroin, the prescription opioid fentanyl and its growing use have led to a spike in overdose deaths — 5,942 Californians in just three years, according to the California Department of Public Health.

 

Through its Harm Reduction program, DAP Health is working to stop overdose deaths. I spoke with Community Health Harm Reduction Supervisor Neil Gussardo to get the no-nonsense, no-stigma lowdown on preventing fentanyl overdoses, and what harm reduction means at the organization.

 

What exactly does the term “harm reduction” mean?

Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. It’s a movement for social justice built on a respect for the rights of people who use drugs.

 

Let’s talk about harm reduction for fentanyl. What are the risks of taking fentanyl?

The big thing — really, why it’s so dangerous — is how it impacts the lungs by causing respiratory depression. When somebody starts to overdose, their body is slowing down to the point where they could stop breathing altogether.

 

How can you identify a fentanyl overdose?

See if a person is breathing. Look at their lips. If their lips are a lighter color than the rest of their skin, that’s a good indication that their breathing is super shallow. Or, if they’re drowsy and you’re unable to rouse them, that’s also a clear sign of overdose.

 

What can you do to help someone experiencing an overdose?

The first thing you do is call 911. After, I recommend people yelling at the person to keep them awake. The next piece that you would do is actually cause them a little bit of physical pain. Take your knuckles and give the person a hard sternum rub. If you can’t keep them awake, if their breathing is shallow, use Narcan if you have it.

 

What’s Narcan?

Narcan is the brand name of the drug naloxone, in nasal spray form. Opioids like fentanyl attach to receptors in the brain. The naloxone gets between the drug and the receptor, temporarily stopping the effects of the drug in the system.

 

How do you use Narcan — and can anyone administer it?

Absolutely. It’s super simple to use. You just spray it into a person’s nose. If after about two minutes there isn’t a response — the person isn’t coming out of the overdose — you should give a second dose. A person can go into withdrawal after using naloxone because the opiate is temporarily not impacting their brain. So be warned, it can kind of be an unpleasant experience for an individual, too.

 

What would you tell someone who is an occasional drug user but says they’d never use fentanyl, so they don’t need to worry about this stuff?

One can never know exactly what’s in the drugs they use. We suggest testing drugs prior to using them. So, we give out a lot of fentanyl testing strip kits. Our kits have everything in them that you would need to test your drugs. I’d also suggest you have Narcan so you can help other people.

 

This is a bit of a spicy question, but don’t some of the strategies DAP Health provides — and the philosophy of harm reduction in general — enable people to use drugs?

People who use are going to use. We’re enabling people to use drugs more safely, and to stay healthier longer. If a person’s not alive, they don’t have an opportunity for change. People who access harm reduction services are five times more likely to go into substance use disorder treatment than people who are not accessing those services.

 

DAP Health has a range of harm reduction resources, including a free vending machine that dispenses Narcan, fentanyl testing strips, and more at Hunters Nightclub on Arenas Road in Palm Springs. For more information, please click here. 

 

Is an Injectable HIV Med For You?

by Daniel Vaillancourt

Everything You Ever Wanted to Know About the Long-Acting Injectable HIV Medication Cabenuva

Words by Daniel Hirsch

 

For many, living with HIV has meant living with daily pills. However, the January 2021 FDA approval of Cabenuva radically changed antiretroviral HIV treatment.

 

Cabenuva is the first long-acting, injectable HIV medication. It is typically administered every eight weeks. However, there are instances where it must be provided every four weeks, depending on the treatment plan decided by the health care provider and the patient’s specific needs. The regimen involves two injections — one of cabotegravir and one of rilpivirine — given on the same day.

 

To understand the pros and cons of Cabenuva, I spoke with DAP Health Director of Specialty Programs Dr. Jason Halperin. As a longtime advocate for better and more accessible HIV care, Dr. Halperin considers himself a Cabenuva proponent.

 

Who is Cabenuva for?

It’s really for anyone living with HIV who is interested in injectable medication. There are a lot of patients who meet the criteria for Cabenuva. It’s much fewer who don’t. I would say to people living with HIV, “Don’t be afraid to ask your provider if you think injectables might be right for you.”

 

What makes an injectable drug preferable to an oral medication?

I’d first say that we are at such an amazing place in terms of HIV medications — they’re incredibly effective and well-tolerated. Typically, one pill per day is all that most people living with HIV require. That said, though oral medication is well-tolerated, I often hear patients complain about nausea. And you have no nausea at all from the injectable medication. Other than occasional reaction or soreness at the injection site, there are fewer side effects.

 

And you don’t have to worry about forgetting to take a daily pill, correct?

A missed pill here and there is never going to lead to resistance. The barrier to resistance for our newer medications is extremely high. But yes, you don’t need to worry about that at all with the injectable.

 

In fact, we have our first trial population where injectable outperformed oral medication. This was in a population that has struggled taking oral medication before — 50% struggling with substance use, almost 40% were unhoused. They were randomized to either start an injectable or continue with oral medication. Those who were randomized to the injectable did so much better that the study was stopped early because it was considered unethical to continue [with patients on oral medication].

 

I’ll often have a patient come in and say, “I’ve been missing medicine,” “I’ve lost a job,” “I’m struggling with methamphetamine use,” or “I’m having difficulty with housing.” Before this study, I would’ve said, “Let’s get you back on oral and get you stabilized.” I’m really going the other way now. I’m telling my patients, “If a lot is happening in your life, injectables might be the right decision for you today.”

 

Can anyone who wants it access Cabenuva? Does insurance cover it?

Our insurance system in California has been very supportive. It’s very rare that I cannot get approval from insurance companies for Cabenuva for my patients. However, we are seeing equity issues around the country. We’re seeing that higher-income patients — those more likely to be White and to self-identify as a gay man — being started on Cabenuva over other populations.

 

Besides having to get poked with a needle, are there downsides to Cabenuva?

The one frustrating thing for me with this medication is it was not approved for self-administration. It has to be administered within the clinic setting. Oral medication does allow for more flexibility.

 

Also, let’s say one of my HIV patients moves to Los Angeles. They may not be able to just see another provider there and seamlessly start back on their injectable medication at that new clinic with that new provider. It’s not impossible, but it’s difficult. Cabenuva uncovers the layers of how disjointed our insurance system is. We really just need to have a health system where people are insured at all times and can access medical care at all times.

 

If you would like to investigate HIV treatment with Cabenuva, please speak to your DAP Health clinician. If you are not yet a patient at DAP Health, and would like to become one, click this link.

Every Child Needs the HPV Vaccine

by Daniel Vaillancourt

Every Child Needs the HPV Vaccine. Adults Can Get It Too.

Words by Daniel Hirsch

 

Given that an estimated 85% of people will be infected with HPV (human papillomavirus) in their lifetime, and that symptoms generally clear up on their own — if they appear at all — it’s tempting to write off the infection as no big deal.

That would be a big mistake for two reasons. One, HPV can lead to several types of cancer — including that of the cervix, vagina, penis, anus, and throat. Two, HPV is preventable via a childhood vaccine administered to both girls and boys.

DAP Health and other experts recommend routine vaccination at as young as 9 years old. It’s a series of two shots before the age of 15, and a series of three shots if one starts at 15 or older.

I spoke with DAP Health Director of Pediatrics Dr. Jasmin Brown about HPV, its powerful vaccine, and why this is an issue every parent of young children should be aware of.

 

What is HPV?

HPV is an infection that causes warts in various parts of the body. In particular, the cervical or vaginal region, throat, penis, and anus. It can also be asymptomatic. So, you don’t have the warts but you have the virus, and you can still spread it. It’s sexually transmitted, spread through skin-to-skin contact.

One of the biggest things about HPV — and why vaccines are so important — is because once you have HPV, there’s no cure. We only have prevention.

 

What’s the link between HPV and cancer?

It’s estimated that every year in this country, more than 36,000 people are diagnosed with types of cancer caused by an HPV infection. Because we screen for cervical cancer in the United States, we have found over 196,000 cervical pre-cancers linked to HPV. While it’s important to find the pre-cancer before it becomes full-blown, treatments can limit a person’s ability to have children afterward.

 

But these infections are preventable. How long has this vaccine been around?

It became available in the United States in 2006, so a lot of the adults who accompany my pediatric patients didn’t get the vaccine as kids, and there’s hesitancy about this “new vaccination.” Over 135 million — and counting — doses of HPV vaccine have been given. This is by no means a new vaccination.

 

Has it been effective in curbing the spread of HPV and related cancers?

Absolutely. The CDC reports that for teenage girls, there’s been an 88% drop in HPV infection. Among adult women, infections with HPV types that typically cause cancers have dropped about 81%. The percentage of cervical pre-cancers caused by HPV has dropped by 40%. So, huge numbers. Important numbers.

 

Does the vaccine have any side effects?

Just like any vaccination, there can be pain or swelling at the injection site. To be honest, I really don’t see things like fevers, body aches, or pains from HPV vaccination. We do monitor for some dizziness or fainting immediately after the vaccination.

 

Who should get the HPV vaccine?

The most recent research shows younger people develop a more robust immune response which, in turn, means better protection for their future. So many — including we at DAP Health, and the American Academy of Pediatrics — recommend vaccination at 9 years old, which is the earliest you can give it. The goal is to vaccinate kids before they become sexually active.

 

What do you tell hesitant parents who say, “My child isn’t having sex. We can wait on that particular vaccine”?

This vaccine is not important for people who are having sex. It’s important for people before they even have sex. As a pediatrician, I talk to patients by themselves all the time, and it’s a reality that children are becoming sexually active at younger ages, without their parents knowing. Waiting isn’t an option for this particular vaccine.

This is one of the few vaccinations we have that can protect against cancer. Cancer is rising at alarming rates in our world. I cannot argue enough for making parents aware that, yes, their kids might seem young for this vaccine, but it’s because we’re trying to protect them from something in their future. I have a 3-and-a-half-year-old too, and so I let parents know that if I encourage you to do something for your child, it’s because I’d do the same for mine.

 

Interested parents who have questions may talk to their DAP Health pediatrician. To schedule a child for vaccination, please call your DAP Health location to make a routine appointment with a nurse. Nothing more is needed.

But What If I’m an Adult Who Wants the HPV Vaccine?

 

The Efficacy of the HPV Vaccine for Sexually Active Adults

The HPV vaccine is most effective when given before any exposure to the human papillomavirus, which is why it’s typically recommended for preteens. However, the vaccine can still provide benefits to sexually active adults, even if they may have already been exposed to HPV. Here’s what you need to know:

  1. Protection Against Multiple Strains: The vaccine protects against multiple strains of HPV, including those most likely to cause cervical cancer and genital warts. Even if you’ve been exposed to one strain, the vaccine can still protect you against others.
  2. Partial Immunity: If an adult has already been exposed to certain strains of HPV, the vaccine won’t treat an existing infection but can still offer protection against strains they haven’t encountered.
  3. Reduced Risk of Cancer: Studies have shown that the HPV vaccine can reduce the risk of developing cervical and other HPV-related cancers in adults.

 

Insurance Coverage

In the United States, many insurance plans cover the HPV vaccine for adults up to age 26, and sometimes up to age 45, following updated guidelines.

  1. Private Insurance: Most private health insurance plans cover the HPV vaccine without cost-sharing for individuals within the recommended age groups.
  2. Medi-Cal: Medi-Cal covers it up to age 45.
  3. Older Adults: For those older than the recommended age groups (up to 45), coverage might be less common and could require out-of-pocket payment.

 

Cost

If the HPV vaccine is not covered by insurance, the cost can be significant:

  1. Per Dose: The HPV vaccine typically requires three doses. Each dose can cost between $200 and $250.
  2. Total Cost: Without insurance, the total cost for the full series of three doses might range from $600 to $750.

 

If you’re considering getting the vaccine as an adult, it's a good idea to check with their insurance provider to confirm coverage and potential out-of-pocket expenses. 

July 28 is World Hepatitis Day

by Daniel Vaillancourt

The ABCDEs of Hepatitis

Words by Daniel Hirsch

 

Every year, World Hepatitis Day is marked on July 28. It’s an occasion to raise awareness about the spread and prevention of the disease. Given that the World Health Organization (WHO) reports that more than 354 million people live with either hepatitis B or C, and that roughly 4.5 million premature deaths could be prevented by 2030 through education, vaccination, testing, and treatment, it’s a very good thing to know about.

 

I spoke with DAP Health Director of Infectious Diseases Dr. Shubha Kerkar about what can be done to slow the spread of hepatitis, and why some forms of it are dubbed “the silent killer.” With three decades of experience fighting infectious disease, Dr. Kerkar is intimate with the complex factors involved in ending pandemics.

 

Why is hepatitis serious?

Untreated viral hepatitis B or C causes three things: liver failure, liver cirrhosis (permanent liver scarring), and liver cancer. Almost always, the number one reason for liver cancer or liver transplant in the U.S. — up until very recently — was hepatitis C-related cirrhosis. Untreated, hepatitis B or C can be fatal.

 

There are many types of hepatitis — A, B, C, D, E — why focus on types B and C?

Since 1982, hepatitis B has been preventable via a vaccine administered to children before they are two years of age. Still, we have 254 million people living with hepatitis B today. There are certain medicines to control it, but it can still lead to liver cancer. We need to get more people vaccinated, but people have developed tremendous distrust in vaccines over the last few years, so there are challenges.

 

Hepatitis C was a bigger pandemic until 2015 or so. We are now rapidly able to cure hepatitis C. The burden went down, but currently, 50 million people still live with hepatitis C.

 

So, of these two viruses, C is curable, and B is preventable. That’s the bottom line.

 

How does hepatitis C spread?

Primarily through contact with infected blood, which means intravenous drug users are at especially high risk.

 

However, about 50 to 60% of people who have hepatitis C may not even know it because they’ve never been tested — and there are often no symptoms initially. Over two to four decades, it then slowly scars the liver. Symptoms of liver failure occur when the liver decompensates, and a cure may not save the need for transplant. That’s why it’s known as “the silent killer.”

 

Because the test was only developed in 1992, hepatitis C has spread all over the world. So regardless of risk factors, baby boomers have a five-fold higher risk of unknowingly having hepatitis C. They need to get tested to see if they have it. Then, we can cure them.

 

The other thing about hepatitis C is that you can get reinfected after being cured, so it’s important to learn how to stay cured by managing risk factors and avoiding exposure, which led to the infection in the first place.

 

And hepatitis B?

Hepatitis B is mainly transmitted through sexual contact, but can also spread through contaminated food or water. Most importantly, pregnant-mother-to-child transmission can occur during labor.

 

What can be done to stop the spread?

I have been treating and trying to cure hepatitis C since 1996. From 1996 to 2015, there was a 35 to 45 % cure rate. However, since the newer medications — which are easy to tolerate without any side effects — the cure rate is nearly 100%. So, the easiest part of treating hepatitis C is getting people tested so they know they have it, then linking them to care.

 

Hepatitis B is preventable via vaccine, yet I do manage several patients who have hepatitis B. It is treatable but prevention is best.

 

To eliminate viral hepatitis, we need education, prevention, screening, and linkage to care. Here in the Coachella Valley, DAP Health has been doing a lot of free testing.

 

For both hepatitis B and C, elimination and cure are the goals. Eliminate hep B by vaccination. Eliminate hep C by widespread testing and linkage to care, and cure those who have it with treatment.

 

For free hepatitis C testing, please contact one of DAP Health's three sexual wellness clinics, in Palm Springs, Cathedral City, or Indio.

 

To be tested for other forms of the disease, for vaccination, or for treatment, please see your primary care physician — at DAP Health or elsewhere.

 

And to learn more about individual types of the disease, read below.

 

The ABCDEs of Hepatitis

 

Each type of hepatitis has unique transmission methods, symptoms, potential for chronic infection, and prevention strategies. Read on…

 

Hepatitis A (HAV)

 

  • Transmission: Fecal-oral route, often through contaminated food or water.
  • Symptoms: Acute illness with jaundice, fatigue, abdominal pain, and fever.
  • Chronicity: Does not become chronic.
  • Prevention: Vaccination and good hygiene.

 

Hepatitis B (HBV)

  • Transmission: Blood, sexual contact, and from mother to child during childbirth.
  • Symptoms: Acute and chronic liver disease. Can lead to cirrhosis or liver cancer.
  • Chronicity: Can become chronic.
  • Prevention: Vaccination prevents infection

 

Hepatitis C (HCV)

  • Transmission: Blood, primarily through sharing needles or blood transfusions. Tattoos
  • Symptoms: Often asymptomatic initially, it can lead to chronic liver disease.
  • Chronicity: Often becomes chronic.
  • Prevention: No vaccine but avoid sharing needles and ensure safe blood products.
  • Cure: Can be easily cured, but cure does not give immunity.

 

Hepatitis D (HDV)

  • Transmission: Blood, similar to HBV; requires HBV for replication.
  • Symptoms: Similar to HBV but more severe liver disease.
  • Chronicity: Can become chronic.
  • Prevention: HBV vaccination (since HDV requires HBV to propagate).

 

Hepatitis E (HEV)

  • Transmission: Fecal-oral route, similar to HAV, often through contaminated water.
  • Symptoms: Acute liver disease with jaundice, fever, and abdominal pain.
  • Chronicity: Rarely becomes chronic.
  • Prevention: Good sanitation and hygiene practices; vaccination

July is Disability Pride Month

by Daniel Vaillancourt

July is Disability Pride Month

With disabled Americans being the largest minority group in the U.S. — one in four adults, spanning all abilities, races, ethnicities, sexual orientations, and socioeconomic statuses — the Disability Pride movement is on the rise.

 

National Disability Pride Month, celebrated each July, is a time for acknowledging, embracing, and celebrating the contributions and achievements of people with disabilities. This monthlong observance is pivotal in promoting understanding, reducing stigma, and advocating for the rights and inclusion of people with disabilities in all aspects of society.

 

Historical Context

The roots of Disability Pride Month trace back to the passage of the Americans with Disabilities Act (ADA) on July 26, 1990. This landmark legislation, signed into law by President George H.W. Bush, prohibits discrimination against individuals with disabilities in all areas of public life, including jobs, schools, transportation, and all public and private places open to the general public. The ADA’s passage was a significant victory for the disability rights movement, laying the groundwork for greater societal inclusion and equality.

 

Raising Awareness and Reducing Stigma

One of the primary objectives of Disability Pride Month is to raise awareness about the experiences and challenges faced by people with disabilities. Despite advancements in legislation and societal attitudes, people with disabilities still encounter significant barriers, including physical accessibility issues, employment discrimination, and social stigma. Disability Pride Month provides a platform for education and dialogue, encouraging people to learn about the diverse experiences of individuals with disabilities and to challenge their own preconceptions and biases.

Reducing stigma is a critical aspect of Disability Pride Month. Society often views disability through a lens of pity or as something to be fixed. This perspective can be damaging and dehumanizing. Disability Pride Month shifts the narrative, promoting the idea that disability is a natural and beautiful part of human diversity. By celebrating disability as an integral aspect of identity, the observance helps dismantle harmful stereotypes and promotes a more inclusive and accepting society.

 

Celebrating Achievements and Contributions

Disability Pride Month is also a time to celebrate the achievements and contributions of people with disabilities. From arts and culture to science and technology, individuals with disabilities have made significant impacts across all fields. Highlighting these accomplishments not only honors those who have paved the way but also provides inspiration and role models for future generations.

 

Advocacy and Policy Change

Advocacy is a crucial component of Disability Pride Month. The observance serves as a reminder of the ongoing need for policy changes and improvements to ensure that people with disabilities have equal opportunities and access. Activists and organizations use this time to push for legislative advancements, such as increased funding for disability services, improvements in health care accessibility, and stronger enforcement of existing disability rights laws.

Moreover, Disability Pride Month encourages individuals and communities to become advocates themselves. By raising their voices, sharing their stories, and engaging in activism, people with disabilities and their allies can drive positive change and foster a more inclusive society.

 

Community and Solidarity

Finally, Disability Pride Month fosters a sense of community and solidarity among people with disabilities and their allies. It provides a space for individuals to connect, share experiences, and support one another. Events such as parades, workshops, and panel discussions offer opportunities for community-building and collective empowerment.

By embracing disability as a natural and valued part of human diversity, society can move toward a future where everyone is empowered to thrive and contribute fully.

 

The Disability Pride Flag*

Initially designed in 2019 by Ann Magill [a writer with cerebral palsy], the Disability Pride flag was created to encompass all disabilities. It was revised in 2021 with community input, and is now in the public domain. Within the flag, each color stripe has a meaning:

 

  • Red - physical disabilities
  • Gold – neurodiversity
  • White - invisible disabilities and disabilities that haven’t yet been diagnosed
  • Blue - emotional and psychiatric disabilities, including mental illness, anxiety, and depression
  • Green - sensory disabilities, including deafness, blindness, lack of smell, lack of taste, audio processing disorder, and all other sensory disabilities

 

The faded black background symbolizes mourning and rage for victims of ableist violence and abuse.

The diagonal band cuts across the walls and barriers that separate the disabled from non-disabled society, also representing light and creativity cutting through the darkness.

 

*Courtesy of Columbia University

July is National UV Safety Month

by Daniel Vaillancourt

The Vital Role of UV Protection

Summertime in the Southland means fun in the sun. But shielding your skin from harmful UV rays is paramount.

Words by Maggie Downs

 

Life in Southern California has its perks: picturesque landscapes, clear skies, and an abundance of sunshine. Unfortunately, the relentless sun also brings an invisible threat — ultraviolet (UV) radiation.

Protecting your skin from UV rays is crucial, not just for maintaining youthful looks, but for safeguarding your health. By embracing a multifaceted approach to sun safety, you can enjoy the outdoors while minimizing your risk of skin damage and cancer.

Did you know July is National UV Safety Month — a U.S. Department of Health and Human Services initiative whose goal is to raise awareness about the dangers of UV rays to the skin and eyes? This issue is especially important for all of us living in Southern California. So please, read on…

 

The Perils of UV Radiation

UV radiation, primarily from the sun, consists of UVA and UVB rays. UVA rays penetrate deeply into the skin, causing premature aging and wrinkles. UVB rays, on the other hand, are responsible for sunburn.

Both types can damage the DNA in skin cells, potentially leading to skin cancer. Our sun-drenched climate means increased exposure, making UV protection a daily necessity, says Dr. Silas Gyimah, associate chief medical officer at DAP Health.

 

Sunscreen: Your First Line of Defense

Sunscreen is a vital tool in your UV protection arsenal. Dr. Gyimah recommends using a broad-spectrum sunscreen with an SPF (sun protection factor) of at least 50, reapplied every two hours, or more often if swimming or sweating.

Broad-spectrum sunscreens shield your skin from both UVA and UVB rays, providing comprehensive protection. It’s important to apply sunscreen to all exposed skin, including often-missed areas like the ears, back of the neck, and tops of the feet.

Parenting an infant? Sunscreen should be avoided in children younger than six months, says Dr. Gyimah, but alternate methods of protection — like dressing the baby in loose clothing that covers the skin, and staying in the shade — will suffice.

 

Sun Protection for All Skin Tones

A common misconception is that people with darker skin tones don’t need sun protection, which is dangerously misleading, says Dr. Gyimah. While it’s true that higher levels of melanin in darker skin provide some natural protection against UV radiation, it is not sufficient to prevent UV damage.

“Because of that mindset, we tend to see a lot of skin cancers in Black folks more than other populations,” he says. “Everyone should be going through the basic protection mechanisms from the sun.”

Also note that there are special formulations of broad-spectrum sunscreen especially made for those with darker skin. Meaning, the product won’t leave a white residue.

 

Comprehensive UV Protection Strategies

While sunscreen is essential, it shouldn’t be your only line of defense. To fully safeguard your skin, combine several UV protection strategies. Seek shade during peak sun hours — typically between 10:00 a.m. and 4:00 p.m. — when the sun’s rays are the strongest. And use UV-blocking window film or shades in your home and car to reduce indoor UV exposure.

Wearing protective clothing — such as long-sleeved shirts, wide-brimmed hats, and UV-blocking sunglasses — can also significantly reduce your exposure. Many outdoor enthusiasts in Southern California opt for clothing specifically designed with built-in UV protection.

“Keep in mind that protection is necessary even on overcast days and indoors,” says Dr. Gyimah. “Any protection is better than none.”

 

The Role of Regular Skin Checks

In addition to preventive measures, regular skin checks are crucial. Perform monthly self-examinations to look for new or changing moles or spots, talk to your doctor about any concerns, and schedule annual skin exams with a dermatologist.

Early detection of skin changes can significantly improve the prognosis if skin cancer does develop.

Have a happy — and safe — sunny summer!