Head And Neck Cancer & Degenerative Cervical Myelopathy

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 353: Head And Neck Cancer & Degenerative Cervical Myelopathy Today we’re going to talk about Head And Neck Cancer & Degenerative Cervical Myelopathy But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [e-mail] If you haven’t yet I have a few things you should do.

• Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
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• Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #353

Now if you missed last week’s episode, we talked about PT In The ER & Back Pain And Mortality. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Well, let’s see, what’s up this week? I think we’re picking up a little. We had 155 chiro visits last week and being a Monday when I’m sitting down and thinking about all this, we have 47 today which includes 3 new patients and 4 re-exams so we’re looking pretty good. At the moment Monday morning, we have 134 set up for the whole week. Some will fall off and some will hop onto the schedule.

That’s just the deal but Wednesday folks will re-book on Friday and Tuesday folks will re-book on Thursday or Friday so I’m betting we wind up back around the 150-155 mark if not more. We shall see. The story is that I’m still not where I was prior to COVID which is super frustrating. Back then I was around 180-200 per week. Which if I’m being honest, is too much for me. I’m too old for that. I’m actually pretty happy with 155-165. But, have you considered your future? I know two folks with two different stories I’ll share.

One worked his whole life until he was diagnosed with cancer when he was in his 60s. He didn’t have an exit plan. He ended up passing away and his practice at that point was worthless and there was nothing to sell. Nothing. I don’t want that for you. The other died in his office working at about 75 or 80 years old. Now, this guy, I don’t believe in bad shape financially. I think he loved his job. But I also don’t want you forced into working into your 70s or 80s because you have failed to plan and you don’t have an exit plan.

So, start at the end and work backward. What do you want your retirement to look like? What age would you like to retire? I’d recommend getting a wealth planner to help you plan it out, set goals, and keep you on track to reaching those goals. How much do you have to make and how much do you need to be investing monthly? What other talents and skills do you have that can hurry up your plans? I promise you have knowledge that nobody else has. Write books, become a speaker, release online courses, podcasts, etc. Become the expert and monetize it. Real estate is a good investment. Lots of things that can be done that give you better returns than just doing the stock market alone.

These things can get you there quicker. One thing I’ll share is to make sure your clinic is sellable when you’re ready to sell one day. If you name the clinic ‘My Last Name Chiropractic’…..trust me if your last name is Williams, someone named Pavlochek doesn’t love the name ‘Williams Chiropractic’. If you’ve made the whole thing about you (and sometimes it’s really hard to not be about you), then when someone else comes in, trust fades. A lot of what we do in my clinic is ME centered but I advertise and promote our medical team a lot, acupuncture, massage, exercise/rehab and all that because I can’t have it being all about me. And when we find an associate that wants to make Amarillo and my clinic their home, you better believe we’re promoting the crap out of that associate. Before they even start. You won’t see my face on much if anything.

These are things that make your clinic more sellable. That’s why mine is called Creek Stone Integrated Medical….because I don’t want to be the focus. As a result, we are in talks with a private equity investment group to sell 60% of our clinic which will pay me a salary plus my commission plus the buyout. Then, I can get an associate, and then once they’re busy and profitable, get another associate.

That system sets up redundancy. If one leaves, the remaining associate can step up and train the next that we hire without me needing to be in the mix. Plus, we’ll be adding a PT soon so, with a nurse prac, a PT, an acupuncturist, 2 massage therapists, and 2 associate DCs….that is a system that begins to remove me from full time, hands-on treatment which frees me up to be more creative with marketing and community touches.

Then I also have Airbnbs and voice-over to fill in any gaps that might pop up. I also do fine art that you can check out at riverhorseart.com but I don’t see that ever paying all my bills. Though I wish it would. That’s what I truly love. And I play gigs singing and playing and writing songs but again, that’s not paying any big bills. That’s more stuff that feeds my soul. Not my family So, you see…..I’ve been laying the groundwork to be able to, hopefully by the age of 55, to step away nice and slowly and responsibly while maintaining my lifestyle and maybe starting to even enjoy life a little more. So, that’s my exit plan. What’s your exit plan? I’d love to hear all about it.

Shoot me an email. You may have some tips I can share with our listeners.

Item #1

Our first one this week is called, “The Frequency of Symptoms in Patients With a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review” by Jiang et al and published in Global Spine Journal in May of 2024 and it’s hot enough to bring the smoke! Remember, the citations can be found at chiropracticforward.com under this episode.

Jiang Z, Davies B, Zipser C, Margetis K, Martin A, Matsoukas S, Zipser-Mohammadzada F, Kheram N, Boraschi A, Zakin E, Obadaseraye OR, Fehlings MG, Wilson J, Yurac R, Cook CE, Milligan J, Tabrah J, Widdop S, Wood L, Roberts EA, Rujeedawa T, Tetreault L; AO Spine RECODE-DCM Diagnostic Criteria Incubator. The Frequency of Symptoms in Patients With a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review. Global Spine J. 2024 May;14(4):1395-1421. doi: 10.1177/21925682231210468. Epub 2023 Nov 2. PMID: 37917661; PMCID: PMC11289544.

Why They Did It

Delayed diagnosis of degenerative cervical myelopathy (DCM) is associated with reduced quality of life and greater disability. Developing diagnostic criteria for degenerative cervical myelopathy has been identified as a top research priority. They aimed to address the following questions: What is the diagnostic accuracy and frequency of clinical symptoms in patients with degenerative cervical myelopathy?

How They Did It

A scoping review was conducted using a database of all primary degenerative cervical myelopathy studies published between 2005 and 2020. Studies were included if they

1. assessed the diagnostic accuracy of a symptom using an appropriate control group or
2. reported the frequency of a symptom in a cohort of degenerative cervical myelopathy patients.

What They Found

This review identified three studies that discussed the diagnostic accuracy of various symptoms and included a control group. An additional 58 reported on the frequency of symptoms in a cohort of patients with degenerative cervical myelopathy. The most frequent and sensitive symptoms in degenerative cervical myelopathy include unspecified paresthesias (86%), hand numbness (82%) and hand paresthesias (79%). Neck and/or shoulder pain was present in 51% of patients with degenerative cervical myelopathy, whereas a minority had back (19%) or lower extremity pain (10%). Bladder dysfunction was uncommon (38%) although more frequent than bowel (23%) and sexual impairment (4%). Gait impairment is also commonly seen in patients with degenerative cervical myelopathy (72%).

Wrap It Up

Patients with degenerative cervical myelopathy present with many different symptoms, most commonly sensorimotor impairment of the upper extremities, pain, bladder dysfunction and gait disturbance. If patients present with a combination of these symptoms, further neuroimaging is indicated to confirm the diagnosis of degenerative cervical myelopathy.

Item #2 And the last one which continues my full assault on legalizing cannabis for recreational use, we have this one called, “Cannabis Use and Head and Neck Cancer” by Gallagher et al and published in JAMA Otolaryngol Head Neck Surgery on August 8, 2024 psssstttt…..it’s smokin’! Gallagher TJ, Chung RS, Lin ME, Kim I, Kokot NC. Cannabis Use and Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. Published online August 08, 2024. doi:10.1001/jamaoto.2024.2419

Why They Did It

Cannabis is the most commonly used illicit substance worldwide. Whether cannabis use is associated with head and neck cancer (HNC) is unclear. Objective To assess the clinical association between cannabis use and head and neck cancer

How They Did It

This large multicenter cohort study used clinical records from a database that included 20 years of data (through April 2024) from 64 health care organizations. A database was searched for medical records for US adults with and without cannabis-related disorder who had recorded outpatient hospital clinic visits and no prior history of head and neck cancer. Propensity score matching was performed for demographic characteristics, alcohol-related disorders, and tobacco use. Subsequently, relative risks (RRs) were calculated to explore risk of head and neck cancer, including head and neck cancer subsites. This analysis was repeated among those younger than 60 years and 60 years or older. Cannabis-related disorder Main Outcomes and Measures: Diagnosis of head and neck cancer and any head and neck cancer subsite

What They Found

• The cannabis-related disorder cohort included 116,076 individuals
• The non–cannabis-related disorder cohort included 3,985,286 individuals
• The rate of new head and neck cancer diagnosis in all sites was higher in the cannabis-related disorder cohort.
• After matching, patients with cannabis-related disorder had a higher risk of any head and neck cancer than those without head and neck cancer.
• A site-specific analysis yielded that those with cannabis-related disorder had a higher risk of oral, oropharyngeal, and laryngeal cancer.
• Results were consistent when stratifying by older and younger age group.

Wrap It Up

This cohort study highlights an association between cannabis-related disorder and the development of head and neck cancer in adult patients. Given the limitations of the database, future research should examine the mechanism of this association and analyze dose response with strong controls to further support evidence of cannabis use as a risk factor for head and neck cancers.

So….for actual legitimate medical use only? Absolutely. For recreational use? Absolutely not. Yes, it’s probably less harmful than alcohol and maybe the same or less harmful than ciggies. But we tried to outlaw alcohol and it didn’t work very well. There are a lot of groups RIGHT NOW trying to get rid of ciggies. Right now.

WHY ADD MORE BAD CRAP WHEN WE TRY TO GET RID OF THE BAD CRAP WE ALREADY HAVE? Hey, I see you’re drowning, here’s a 50 lbs weight just because you like weights and weights make you feel really good. Maybe it’ll help you get out of the water OK. Probably not. 2 wrongs don’t make a right. So stop it damnit.

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

Store

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Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.

Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

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