Digestive Health and Wellness

A Mediaplanet Guide to Maintaining Your Gut Health

Digestive Health & Wellness

Dr. Megan Rossi Read what the influencer and doctor wants you to know about keeping your gut healthy

Discover the surprising benefits probiotics can have for colicky babies

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core strength is good. CORE HEALTH IS BETTER.

Everything You Need to Know About Bowel Health It’s not polite to talk about, but your bathroom habits can provide important signs about your overall health.

As adults, we don’t openly talk about our own body’s natural process of defecation. Pooping is not sexy, but it can be an indicator of your overall health — so pay attention.

The trillions of microorganisms (microbiome) that live in your gut affect other systems’ health in your body, including mental well-being and the autoimmune system.

Don’t let the fear of embarrassment prevent you from consulting your healthcare provider if you notice a bowel

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issue that doesn’t go away within two weeks.

Seek medical attention promptly when you experience pooping problems such as bleeding, pain, weight loss, or any radical changes in your bowel movement habits. If your stool is bright red or black, consult your physician right away, as this may suggest blood loss.

Early detection means early treatment for gastrointestinal (GI) disorders such as colorectal cancer and inflammatory bowel disease.

Follow through with your gastroenterologist with recommendations, including preventive screening colo-

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Eileen Babb BSN, RN, CGRN, CFER, SGNA Board of Directors noscopies. Colorectal cancer is treatable and beatable in its early stage.

Sometimes, the signals waste sends us aren’t obvious, so it is important to know what a healthy stool looks like, including the shape and size.

Consistency, size, and how long it takes for the body to pass

may vary significantly from person to person, but a person should be able to go No. 2 easily, painlessly, and with minimal strain in under 10-15 minutes.

Most people go one to three times daily or every other day. At a minimum, a person should pass their stool three times a week.

Any changes in the smell, appearance, frequency, or color of your poo can indicate a problem, but other variables may have an effect as well.

Diet and other factors such as medications may temporarily cause a rainbow of colors. Once food has passed through the GI tract, it should go back to the baseline brown.

If the unusual color change persists for two weeks or more, consult your physician.

Certain medical conditions, such as those for inflammatory bowel disease and cancer can cause abnormalities. Food intolerances and allergies can cause diarrhea or constipation and irritable bowel syndrome can be exacerbated by stress.

Lack of dietary fiber can also lead to bowel problems. Many of the health conditions that cause bowel issues can be managed with proper care.

Taking care of your digestive health is just as important as any other kind of wellness, because a well-functioning gut is essential for life. n

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Publisher Arianna DiBella Business Developer Joelle Hernandez Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Tiffany Jackson Lead Editor Mina Fanous Copy Editor Kathleen Walsh Partnerships and Distribution Manager Jordan Hernandez Director of Sales Stephanie King Director of Product Faye Godfrey Cover Photo Love Your Gut All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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MAKING IMPOSSIBLE POSSIBLE

Children’s Gut Bacteria May Set the Stage for Their Future Health For fighting infections and fending off diseases such as diabetes and asthma, diet and lifestyle may only go so far.

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esearchers are increasingly studying how a community of diverse bacteria that develop during an infant’s first few weeks of life has the potential to influence their future health.

How a child is delivered and fed can affect their gut microbiome. According to a 2018 article in Nature, babies delivered by Caesarian section (C-section) can miss out on exposure to beneficial microorganisms in the mother’s vaginal tract. Similarly, the article noted, breast milk contains potentially protective microbes from the mother’s gut.

In turn, babies born too soon may suffer from gut inflammation (clinically called necrotizing enterocolitis), which is the leading cause of death in preemies.

Why? The reasons are numerous and include the tendency to be delivered by C-section; given a strong course of antibiotics; and housed in sterile incubators made

of plastic, allowing for minimal human skin contact. Scientists are exploring ways to rebalance microbes in these babies to prevent gut inflammation.

By around toddlerhood, an individual’s gut microbiome looks like that of an adult’s. Don’t clean your home too much or freak out if your dog licks your child. Exposure to bacteria from these types of sources can promote a healthy gut.

The gut is part of the body’s first-line defense against illness.

According to Danone Nutricia Research, a person’s gut microbiome and immune system are tightly connected. Indeed, the inside lining of the gut, called the epithelium, is home to 70-80 percent of the body’s immune cells. This lining helps guard the body from intestinal invaders in early life and aids development of a healthy gut microbiome, which may offer protection from illness for years to come.

A healthy brain depends on a healthy gut. Called the gutbrain axis, the relationship between the brain and gut is a complex one, affecting metabolism, immunity, and hormonal and neurological health, noted Danone Nutricia. Therefore, having a balanced gut is critical for normal brain development.

For preventing a gamut of diseases, gut health may hold clues. According to a 2014 article in the journal Pathogens, there is a wealth of early research on the potential effects of an imbalanced gut on risk for diseases such as autoimmune conditions, including celiac disease and type 1 diabetes, along with the skin condition atopic dermatitis, asthma, and allergies. Authors point out that early exposure to antibiotics, supplementation with probiotics and prebiotics, and feeding approaches may all have an impact on gut health. n

Probiotics for Babies?

Research Indicates There Are Big Benefits There is a growing body of research indicating that probiotics help foster a healthy immune system, even for infants.

Parents are becoming more aware of the role of the gut microbiota in their children’s health. Studies show that when there are imbalances in the microbiota — a complex system of cellular organisms that include bacteria, viruses, fungi, yeast, and protozoa — we are at greater risk for diseases of the digestive tract and immunity disorders. A probiotic can help the microbiota rebound and strengthen it to support digestion and a healthy immune system.

But parents have questions. How young can children start taking probiotics? What do studies tell us? And can probiotics really make a difference?

A number of studies indicate probiotics are safe for young children, even infants. Trials in 2011 and 2014 indicated that probiotics helped reduce the infants’ crying, and the latter study found that use of probiotics “decreased the reported incidence of inconsolable crying and regurgitation in the first three months of life.”

The growing body of research pointing to the benefits of probiotics for babies is good news for parents. Maintaining a healthy gut provides crucial benefits, including increased enzymes to digest dietary sugars, more efficient breakdown of complex carbs, and a strengthened immune system response. Probiotics can also facilitate the absorption of nutrients and increase digestive enzymes, and also stimulates the production of Immunoglobulin A (IgA), the primary antibody in our digestive tracts that defends against infections.

Parents want to help their children flourish. Probiotic supplements can help give their babies a healthy start in life — even in their first few months — setting them on the path to healthy digestion and a strong immune system.

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Melinda Carter MEDIAPLANET

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How expanding Medicare coverage for medical nutrition therapy could be the difference between life and death for many patients.

For many medical conditions, following a specific prescribed diet significantly affects health and mortality, and adapting to a lifelong medically necessary diet often requires counseling from a registered dietitian or other nutrition professional.

Medical nutrition therapy (MNT) provided by a registered dietitian nutritionist can help patients better adhere to their diets and is a cost-effective component of treatment for celiac disease and other chronic conditions, yet is currently only covered by Medicare for patients with diabetes, renal disease, and post-kidney transplant.

The Medical Nutrition Therapy Act of 2020, introduced by U.S. Representatives Eliot Engel (D-NY) and Peter King (R-NY) and by U.S. Senators Susan Collins (R-ME) and Gary Peters (D-MI), aims to expand Medicare coverage to give Medicare beneficiaries access to the care they need. These bipartisan bills would provide coverage of MNT for people with celiac disease, prediabetes, obesity, high blood pressure, high cholesterol, malnutrition, eating disorders, cancer, HIV/AIDS, and unintentional weight loss. This bill would also authorize nurse practitioners, physician assistants, clinical nurse specialists, and psychologists to refer their patients for MNT. Counseling provided by a registered dietitian nutritionist (RDN) as part of a healthcare team can positively impact dietary adherence, weight, blood pressure, blood lipids, and blood sugar control. For many chronic conditions, this counseling can significantly impact mortality.

In the case of celiac disease, a lack of dietary compliance leads to a six times greater risk of non-Hodgkin’s lymphoma and a four times greater risk of small bowel cancer, making dietary counseling an integral part of care for a condition whose only treatment is strict dietary adherence.

Medicare coverage drives what private insurers will cover, making covered MNT for seniors the first step towards covered MNT for all celiac disease patients. People can show support for nutrition care for those in need by asking members of Congress to co-sponsor the Medical Nutrition Therapy Act of 2020.

Sierra Manning, Research & Advocacy Coordinator, Celiac Disease Foundation

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Dr. Megan Rossi On Spreading the Gut Health Gospel Influencer and digestive health doctor Megan Rossi was frustrated by the lack of public understanding about gut health, so she decided to do something about it.

“Over 70 different chronic diseases have now been linked with our gut microbes,” said Dr. Megan Rossi Ph.D., who leads research at King’s College London investigating nutrition-based therapies in gut health, including pre and probiotics, dietary fibers, food additives, and more. She is also known to her social media followers as The Gut Health Doctor.

Rossi noted that studies show good gut health can help people with type 2 diabetes, heart disease, mental illness, and more.

Impact Dr. Rossi said that she finds her work satisfying, but she had grown frustrated that the public didn’t know enough about gut health.

“The injustice of the gut is actually that it had so much power and potential but the information wasn’t being translated to the general public,” she said. “So I thought you know what? I can continue to complain and see patients one-on-one and really [not] have much of an impact, or I

PHOTO: THE GUT HEALTH DOCTOR

New Legislation Aims to Extend Nutrition Care to Chronic Conditions

can do something about it. So, that’s when I decided to try social media.”

The response was overwhelmingly positive. Dr. Rossi shares recipes and tips with her 245,000 Instagram and 17,500 Twitter followers at @TheGutHealthDoctor.

She also has her own health food company, Bio & Me, selling good-for-your-gut prebiotic granola bars made with 15 different plant-based ingredients.

Personal approach Dr. Rossi, whose latest book “Love Your Gut” will be available in 2021, advises people with gut health concerns to get checked out by their doctor, including screening for celiac disease or irritable bowel syndrome.

Next, develop and personalize your own gut health action plan to help improve concerns like bloating, constipation, or diarrhea.

Enjoy it A big misconception is that you have to go vegan to have good gut health.

Instead, Dr. Rossi said you just need to nourish your gut microbes with different plantbased foods. She recommends a target of 30 different types of plant-based foods per week from the different food groups including whole grains, legumes, vegetables and fruits, and herbs and spices.

Fiber is essential too. Studies show an increase of eight grams of fiber per day — such as a cup of beans, a piece of fruit, or a handful of nuts — can reduce risks for heart disease, type 2 diabetes, and colon cancer.

Most of all, eating shouldn’t be about deprivation. “We should be enjoying it, we shouldn’t just have to like boring kale,” she said. “It’s about beautiful flavors as well.” n Kristen Castillo

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A Gutsy Girl Gives Hope to Women Struggling With Digestive Issues P

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How one woman created a community for women living with a stigmatized but fairly common condition.

Four years after receiving a colitis diagnosis, Sarah Kay Hoffman endured a long and difficult IVF cycle that didn’t result in pregnancy. It was 2012 and she felt alone.

“I desperately wanted to create a community where women, even if they choose to sit in silence behind a computer screen, could feel a sense of belonging. I purchased agutsygirl.com and then continued on with a journey I could have never predicted. I was open, honest, and transparent about it all. Eventually, A Gutsy Girl became not only a community, but also a trusted resource.”

Ending the stigma Unfortunately, women are often embarrassed by their digestive problems. Hoffman says it was only through opening up that she was able to discover that IBS and IBD issues worldwide are common.

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“They are normal, but the longer we wait to normalize them, the longer it will be for full healing to occur,” said Hoffman, who believes there’s no one way to see improvement.

“As women, we expect to be treated as individuals, so if we expect to be treated as an individual, then how can any specific template ever fit your healing journey?”

Achieving ultimate healing To feel better, Hoffman said a proper diagnosis is critical.

What you eat is also important, and that doesn’t have to mean fat-free, low calorie, paleo, or vegan choices.

“I’m talking about the diet that is conducive for you and your own gut-healing journey.”

Altering your lifestyle also plays a role but can be the most difficult challenge.

“This includes sleep, how you eat, managing stress, dealing with any past or present circumstances and emotions, household cleaning supplies, feminine products, etc.”

Understanding what works In 2014, Hoffman experienced small intestinal bacterial overgrowth, resulting in fatigue, perioral dermatitis, and a bloated stomach. To fight it, she took specific herbs, supplements, and antibiotics and avoided high-FODMAP foods, such as apples. Now healed, she consumes greens and prebiotics, and does short, high-intensity interval workouts.

To keep track of gut healing and health, Hoffman maintains a journal. She follows a sensible intermittent fasting routine, and practices meal spacing. Hoffman also takes four supplements each day and refuses to diet.

“Though I don’t eat a ton of dairy and gluten, they are no longer forbidden food groups. I do intentional breathing, take long walks, and never eat when I’m under a lot of stress.”

Said Hoffman, “I believe, because I know first-hand, that when you heal your gut, you heal your life.” n Cindy Riley

The Mind-Gut Connection: How Gut Health Impacts Mental Health Our gut microbiome is not doing well — while it is certainly appreciative of the pandemic’s home-cooked meals and the homemade banana bread, it’s still working overtime.

When our mental health is suffering it doesn’t just affect our sleep or our stress levels or our ability to focus, it also affects our gut. Scientists have told us for years that our mental health and our gut health are interconnected.

The positive news is that this mind-gut connection is a two-way street — and because of this relationship we really have no excuse to neglect digestive wellness.

What we need Digestive enzymes are naturally produced by the body to help aid in the appropriate breakdown and absorption of nutrients from our food. However, there are some conditions where the body may become deficient in these enzymes, or they may not function properly. This is where supplementation may be helpful for some individuals.

The idea for FRISKA, a newly launched digestive enzyme and probiotic brand, stems from my own personal health issues including acute pancreatitis. What I discovered was that while the benefits of probiotics are widely known, the power of enzymes is often overlooked.

The nuance of digestive enzymes is that they really help your body break down the food you eat and turn your food into bio-available energy. The fact that you can take a multivitamin for 20 years and not tell if it works — I wanted to create a product that we could proudly stand behind, and consumers could feel working.

FRISKA’s digestive health collection gives you all you need in one. They’re not just probiotics or just enzymes or just botanicals, but all three in one dose. On top of that, the line is condition-specific, offering unique formulations for men and women, supplements catered specifically to carb-sensitive or dairy-sensitive folks, keto diet devotees, and supplements designed specifically for sleep, immunity, and mood. Pricing at about a dollar a dose also makes our guts pretty happy. You can learn more about the benefits of introducing FRISKA into your daily routine at getfriska.com, and it is available for purchase at your local CVS and CVS.com.

John Peine, Founder, FRISKA MEDIAPLANET

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Colorectal Cancer Doesn’t Discriminate

By Age The number of cases of colon and rectal cancer has been rising in adults under 55 years old since the 1990s, particularly among non-white people.

Since the passing of actor Chadwick Boseman at age 43, there has been increased awareness of colorectal cancer (CRC) in the young, and its disproportionate impact on Black Americans.

Boseman represents thousands of young people in the prime of their lives who will die of colorectal cancer within the United States and abroad. In turn, advocates and clinical providers are actively working on strategies to explore the delay in diagnosis and alleviate unique challenges earlyage onset colorectal cancer patients face. The number of new cases of colon and rectal cancer has been rising in adults under the age of 55 since the 1990s. Furthermore, African Americans bear a disproportionate burden, with an incidence of CRC that is more than 20 percent higher than in whites with an even larger difference in mortality.

In June 2020, more than 400 researchers, scientists, and patient or research advocates worldwide joined together virtually to develop pathways based on a 2019 published research blueprint designed to better study causation of early-age onset CRC. The types of questions and risk factors to be studied include diet in childhood; obesity at certain times in life; microbiome within the colon; antibiotic use in childhood; and gene and environment interactions. Researchers also must take into consideration how we can study interlinked factors in existing studies and data repositories, and when new approaches must be explored. This will require multilevel research on the dynamic relationship between individual factors and macroenvironmental influences, plus disparities of race in early-age onset CRC. The medical and scientific communities feel the great loss of countless parents, children, partners, employers, and families who have lost loved ones to this cancer. We must all be committed to harnessing our collective energy and talents across borders and oceans to address and confront early-age onset colorectal cancer with humanity and equity.

Andrea Dwyer, Advisor to Fight Colorectal Cancer Research and Patient Education, The Colorado School of Public Health, University of Colorado Cancer Center

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“Today” Show Anchor Craig Melvin Shares Why Colorectal Cancer Is Personal to Him Colorectal cancer hits close to home for journalist Craig Melvin, who’s committed to educating others about the disease.

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The new guideline for screening is age 45, but Melvin cautions if you have a family history, it’s wise to get screenings earlier than that.

Getting checked out Even though he was just 37 at the time, Melvin promptly underwent a colonoscopy.

The report was good, but Melvin knew he’d need to stay diligent about getting tested.

“Colorectal cancer is the third most common cancer in Black men and women, but a lot of folks don’t realize that if it’s caught early, its completely treatable.”

A delayed diagnosis Melvin said his brother was having pain in his abdomen that persisted, but his physician assumed it was stress related. He was later told to add fiber to his diet. On his third visit, tests were finally performed.

“They found he had a tumor the size of a small orange in his abdomen,” explained Melvin. “It was stage 4 cancer.”

It’s unclear if acting sooner would have changed the prognosis but getting a second opinion proved wise.

“The first doctor wanted to put him in hospice immediately. They basically threw up their hands.”

At MD Anderson Cancer Center, one of the foremost experts in the field was honest about the diagnosis and treatment options, helping his patient move forward.

hen Craig Melvin’s h a l f brother Lawrence was diagnosed with cancer at the age of 39, it was a wake-up call.

“We always thought colon cancer is a disease for the elderly, like Alzheimer’s and prostate cancer. We were also totally unaware of the family history. Part of the diagnosis required the doctor asking some questions. My brother called my dad and we came to find out that our late grandmother at some point had colon cancer.”

Ignorance isn’t bliss Melvin, who works with the nonprofit Colorectal Cancer Alliance, said a lot of men feel if they don’t know something’s wrong, then it can’t be.

“There’s also typical machismo, like with my brother. Here’s a guy who played college football, who didn’t smoke or drink, a Baptist minister who lived a clean life. To all of a sudden be struck with late-stage colon cancer — we didn’t think he was the kind of person who got colon cancer.”

Melvin realizes the topic isn’t a common or easy conversation.

“Especially in Black families. There’s also this stigma that’s associated with colorectal cancer. No one wants to talk about their colon or changes in their stool, and understandably so.”

As for his brother, “It hasn’t been an easy journey.

He’s lost a lot of weight and isn’t as strong as he was, but he’s still kicking.” n Cindy Riley

Chadwick Boseman’s Death Spotlights a Rising Trend in Colorectal Cancer The tragic loss of a superstar moved huge numbers of people and the media to ask, “What is colorectal cancer and does it really affect young people, too?”

From his breakout role as Jackie Robinson in “42” to his brilliant portrayal of T’Challa in “Black Panther,” Chadwick Boseman had amassed a passionate following across generations and races.

The sudden news of Boseman’s death, an unfortunate hand dealt by young-onset colorectal cancer, stunned the world.

Overnight, Google searches for “colon cancer” rocketed to trending status and dozens of major news outlets talked about the increasing incidence of young-onset colorectal cancer, which occurs in people younger than age 50. Not since journalist Katie Couric’s colonoscopy on live television had so many people been curious about this disease, the second-leading cause of cancer deaths in the United States among men and women combined.

“Somberly, we share that young-onset colorectal cancer is on the rise and cuts short thousands of lives every year,” said Michael Sapienza, CEO of national nonprofit Colorectal Cancer Alliance, in a statement after Boseman’s death. “Even superheroes can get colorectal cancer.”

Understanding the disease Colorectal cancer has long-affected people later in life, which is why screening traditionally began at age 50. But colorectal cancer incidence has increased in adults 20-39 years old since the mid ‘80s and in adults ages 40-54 years since the mid ‘90s.

And while mortality rates have decreased in recent decades among individuals diagnosed over age 50, mortality rates in individuals diagnosed under the age of 50 have increased by 1.3 percent per year.

These data moved the United States Preventive Services Task Force (USPSTF) to release a draft recommendation to lower the screening age from 50 to 45 for average-risk individuals. If this recommendation is formally adopted in 2021, people age 45 and older will, in most cases, be eligible for insurance reimbursement for CRC screening.

Research is underway to identify the cause behind the noted rise of young-onset colorectal cancer, including projects funded by the Colorectal Cancer Alliance. Hypotheses under investigation include diet, physical activity, smoking, and alcohol consumption, as well as the role of the microbiome and environmental exposures before and after birth.

Protecting yourself Young-onset colorectal cancer is a highly preventable disease with routine screening. When caught early, it’s also highly treatable.

Ninety percent of patients with localized tumors live five or more years after diagnosis.

“The No. 1 way to prevent colorectal cancer, if you’re above age 45, is with screening,” said Dr. Laura Porter, the Colorectal Cancer Alliance’s Medical Affairs Senior Consultant. “For men and women who are younger than the standard screening age, they must pay attention to their bodies, speak up if something is wrong, and keep pushing their doctors for answers.”

Porter’s advice is reinforced by the findings of a recent Colorectal Cancer Alliance survey of young-onset patients and survivors. According to respondents, 49 percent had no knowledge of colorectal cancer symptoms prior to their diagnosis, 62 percent said they waited more than three months to see a doctor after symptoms began, and 75 percent said they saw two or more doctors before receiving a diagnosis.

Symptoms of colorectal cancer include blood in the stool, changing bowel habits, and abdominal discomfort, among others. n Steven Bushong, Senior Manager of Strategic Communications, Colorectal Cancer Alliance

Young People Are at Risk for Colorectal Cancer, Too Young people may not realize they are also at risk of colorectal cancer, but the good news is that treatment exists.

Colorectal cancer cases are rising in young people. By one estimate, about 12 percent of all cases diagnosed in 2020, or about 18,000 people total, will be among those younger than 50.

“There is a misunderstanding that colorectal cancer is a cancer of older patients and can only be detected by an invasive procedure, a colonoscopy,” said Scott Kopetz, M.D., a professor of gastrointestinal medical oncology at The University of Texas MD Anderson Cancer Center.

“The treatments and outcome of younger patients are different and requires a better understanding of what is unique about their tumors.”

Kopetz advised anyone with bowel movement changes to consult a doctor.

And he recommended those with a family history of colorectal cancer get screened at least 10 years before the age their family member was diagnosed.

As far as treatment options go, Kopetz noted that advancements including liquid biopsies have allowed doctors to individualize patients’ post-surgical therapy. “The future of colorectal cancer treatments will undoubtedly use liquid biopsies to guide the use of new therapies to reduce the risk of recurrence after surgical resection,” he explained.

Immunotherapy, which bolsters or draws upon the defenses of a patient’s immune system to target cancerous cells, can help treat certain cancers, including lung and skin, according to the Cancer Research Institute and the American Cancer Society. But it’s also a promising horizon for colorectal cancer treatment, Kopetz explained. “We anticipate new treatments that utilize immunotherapy combination agents to engage the body’s immune system and target disease,” he said.

“These strategies will likely involve tumor vaccines designed for specific characteristics of the cancer or will use novel cellular therapies to treat patients with immune cells that are engineered to target the cancer.”

Melinda Carter

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