Brain cancer is a very serious form of cancer. Recently, Sen. John McCain revealed he has been diagnosed with a primary glioblastoma multiforme (GBM) – the most aggressive type of brain tumor. GBMs originate in the brain; it does not spread there from another part of the body. The cause is not known. This tumor has no relation to melanoma, the skin cancer for which McCain was treated in the past.



Chemotherapy is a standard treatment for cancer. It kills healthy cells along with cancer cells, inflicting damage on the body and seriously compromising the immune system. Chemotherapy also kills most rapidly dividing healthy and cancer cells, but not all the cells are fast growing. Cancer stem cells (CSCs), a small population of cancer cells that are slow growing and thus resistant to treatment, do not die. Chemotherapy makes these cells even more numerous as the ratio of highly malignant cells….



For many women facing cancer, the most devastating aspect is learning they may lose their hair due to chemotherapy.  “Most women tell me that as soon as they hear the oncologist say, ‘You’re going to lose your hair,’ that’s the last thing they remember hearing,” said Eric Johnson, co-owner, with his wife, Jeletta, of Hair Institute in Lexington. “They can deal with the sickness; they can deal with the treatments; but it’s the hair loss that gets them the most.


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The insulin pump is a safe, valuable treatment option for those who have poorly controlled blood sugar despite multiple daily insulin injections. There are a number of advantages to the insulin pump. It provides good control and prevents glucose-level spikes. They are efficient and easy to use so a patient can use less insulin than they would with a syringe or pen. Multiple injections are not necessary because the pump delivers insulin automatically. Insulin pumps are expensive and may require justification for insurance coverage.

Jet injectors use high pressure to push a fine spray of insulin through the pores of the skin. One downside is it may deliver insulin unevenly. Because they send insulin into the body through the pores, jet injectors may not always deliver an accurate dose. Another down side is it may be more painful than injections. It also puts a considerable amount of pressure on the nerves close to the surface of the skin. Jets allow patients to inject insulin without using any kind of needle. Most jets require the patient to load the insulin, sterilize the device and change reusable parts.

Inhaled insulin delivery is a rapid- acting inhaled insulin approved by the Food and Drug Administration for use before meals. The inhaler reduces sugar in the blood in about 15 to 20 minutes and clears the body in two to three hours. Users place a dose of powdered insulin into a small, whistle-sized inhaler. Inhaled insulin can be used for both Type 1 and Type 2 diabetes. Patients with Type 1 diabetes must use it in combination with long-acting insulin.

When it comes to making a decision about insulin delivery, get help from your diabetes management team, which often includes your family physician, a diabetes educator, a registered dietician, an endocrinologist and other allied health professionals.

Sources and Resources

WebMD (2016). Diabetes Care and Treatment: When Your Diabetes Treatment Isn’t Working For You.

Diabetes is a chronic disease that affects the body’s ability to use the energy we get from the food we eat. Glucose fuels the cells in the body. These cells need insulin, a hormone made in the pancreas, in order to take in the glucose and use it for energy. Insulin allows the body to use the glucose from the carbohydrates in food for energy. The pancreas plays an essential role in maintaining energy levels by regulating this vital part of the digestive system. It is also a critical controller of blood sugar levels.

When the pancreas fails to produce enough insulin, a pharmaceutical insulin product is needed. This failure results in high levels of blood glucose, which may damage the blood vessels in the eyes, heart, nervous system and kidneys and can eventually lead to complications such as neuropathy, blindness, stroke and kidney disease.

To prevent these complications, consider finding a suitable insulin delivery system. Educational commercials appear regularly on radio and television, offering people who have diabetes a number of insulin delivery systems. The options include insulin pens, syringes, pumps, jet injectors and inhalers. Patients with diabetes and their physicians should consider a number of factors, including body metabolism and what the patient’s health insurance will cover, when choosing a delivery system. Some insurance may only pay for one type of insulin delivery system.


Among the most used and most popular delivery systems are insulin syringes. They inject insulin directly into the body with a very fine needle. The wide variety of needles and syringes are more likely than other delivery system to be covered by health insurance. Syringes require training and certain competencies in their use, such as being aware of unit measurements, avoiding getting air in the syringe and then drawing the correct dose of insulin into the syringe.

Insulin pens work much like a syringe, but they are easy to carry, come pre-filled and do not require the same kind of care as insulin syringes. The pen and needles are disposable. Reusable models have a cartridge filled with insulin. Some types of insulin aren’t available in pen form and insulin pens often cost more than syringes.

An insulin pump is good for patients who need reliable delivery of insulin day and night. The pump delivers a steady stream of insulin to the body 24 hours a day. Whenever you eat, the pump measures and injects the needed boost of insulin, called a bolus. The pump is an option primarily for people with Type 1 diabetes who haven’t reached their target blood sugar level using other delivery methods.


Thomas W. Miller, Ph.D., ABPP, is a professor emeritus and senior research scientist, Center for Health, Intervention and Prevention, University of Connecticut; retired service chief from the VA Medical Center; and tenured professor in the Department of Psychiatry, College of Medicine, University of Kentucky.

more articles by Dr thomas w. miller