Natasha Noel, MD, is a pediatric cardiologist who’s been treating children with heart issues for more than a decade.

But in the past few years, Dr. Noel has seen a spike in high cholesterol with several kids she cares for. 

“It’s the diet with respect to fast foods, and the climate, especially in Illinois. Our long winter months mean less physical activity for the kids,” explains Dr. Noel. “There is a greater awareness of this condition, and young adults experiencing sudden cardiac death. It all goes hand in hand.”

With those factors in mind, OSF HealthCare Children’s Hospital of Illinois has opened its first pediatric lipid clinic at its location in Rockford at 444 Roxbury Road. The program is led by Dr. Noel, who is board certified in clinical lipidology.

The clinic specializes in caring for children with cholesterol concerns, focusing on lifestyle changes, nutrition counseling with dietitians, genetic testing and lipid testing as needed. The clinic offers in-person and telehealth visits.

The bottom line, says Dr. Noel, adults aren’t the only ones who experience high cholesterol.

“Children can have high cholesterol as adults, and it could lead to early cardiac disease over time,” says Dr. Noel. “But once found and diagnosed, there is management available. So, I say don't delay (seeking treatment).”

Cholesterol and triglycerides are fats, or lipids, in the blood. Dr. Noel says the body needs lipids and cholesterol, but at high levels it could cause damage, especially heart disease as the years go on.

A simple blood test can determine the child’s cholesterol results. It's recommended that children are screened or have their lipid levels checked between the ages of nine to 11, and then again at 17 to 21. However, Dr. Noel adds that if there are specific risk factors, then screening may occur more often or earlier, sometimes as early as age two. 

Genetic testing is important when it comes to diagnosing a familial lipid disorder.

“Screening is needed to identify that something is wrong and abnormal, because most of these kids are asymptomatic. Genetic testing comes in handy if we suspect something inherited like familial hypercholesterolemia,” says Dr. Noel. “It also helps us guide management as needed.”

Risk Factors 

Risk factors include genetics, diet and physical activity. Obesity, diabetes and lack of sleep can also increase cholesterol levels. If cholesterol problems are untreated, it can lead to plaque in the coronary arteries, which leads to cardiac disease and atherosclerosis (the buildup of fats, cholesterol and other substances in and on the artery walls).

Depending on the cause and severity, the treatment plan includes lifestyle and dietary changes, more physical activity and then medication.

Dr. Noel stresses that abnormal test results don’t always mean a child is ill or requires medication. That’s why she encourages daily physical activity at least three to five days a week. Walking, biking and swimming are some of the activities that can lower a child’s risk of cardiovascular disease.

Diet is another important factor. Parents can help their children by encouraging food low in total fat, limiting saturated fats, avoiding full-fat dairy and eating enough fiber. Vegetables, fruits and whole grains are all great options to increase daily fiber intake.

A primary care provider can perform the initial screening and if there is a concern, a referral will be made to a pediatric cardiologist. “I think most of them are comfortable with us taking over that care, especially if medication is needed,” says Dr. Noel.

For more information on cardiology or other child-related issues, visit the OSF Children’s Hospital of Illinois website. 

 

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Breast cancer is one of the most common cancers in the United States, says Heather Thompson. And she would know. Thompson is a breast health navigator at OSF HealthCare, helping patients navigate appointments, insurance and more. And Thompson is, herself, a breast cancer survivor.

But what many in the cancer space might not realize, Thompson says, is that breast cancer can affect men. It’s rare, with 1% of men statistically getting it, Thompson says. But it’s worth knowing how to spot, prevent and treat it.

“There can be severe cases. A lot of times, men don’t notice things or worry about things like women might,” Thompson says. “The cancer is there longer and has a chance to metastasize [spread] and get into their lymph nodes. A lot of times, men will get gynecomastia. That can cause swelling in the breast tissue and a mass.” Those gynecomastia masses can limit a man’s ability to feel a cancerous lump, delaying care.

Breast cancer basics

Genetics (i.e. a family history of cancer), alcohol use and smoking all put you at a higher risk for breast cancer.

So do men need to do monthly self-checks and get mammograms like women are told to? Not always, Thompson says. You should talk with your primary care provider about a plan, especially if you have a family history of breast cancer. That plan could involve genetic testing or blood work to check estrogen levels (since estrogen feeds cancer cells). But day to day, Thompson says to just keep an eye on your breasts. Look for inverted nipples, lumps, redness or achiness.

“Men really do not require regular screening or imaging for breast tissue. That is not in the American Cancer Society guidelines or any other guidelines,” Thompson says. “However, men should monitor their bodies for anything irregular. Then, get it addressed right away. Don’t wait. You might be in that 1%.” Thompson adds that if any type of cancer spreads, it can be fatal.

Treatment for male breast cancer typically involves a mastectomy, or the removal of breast tissue, Thompson says. This could be after cancer is found. Or it could be preventive if you’re at high risk, like the case of actress Angelina Jolie.

“There’s not much tissue that a man has,” Thompson points out, allaying fears that your chest will look significantly different. She says you won’t have a nipple, and your chest will be flat. But that’s about it. “We will still test those lymph nodes during surgery to make sure the cancer hasn’t spread.

“After that, there’s special testing called oncotype,” she adds. This looks at the likelihood of cancer returning. “If it’s a high score, those people sometimes have to have chemotherapy or radiation.”

Changing minds

Thompson knows men can be apprehensive about seeing a doctor in general. But when breast cancer enters the conversation? She’s heard things like “I’m not a woman. I don’t need to worry about that.”

At OSF Moeller Cancer Center in Alton, Illinois, where Thompson works, she sees one to two men per month come in for imaging. Most, she says, are cases of gynecomastia that can be managed by the person’s primary care provider. But some do hear the words “It’s cancer.”

“I tell them they’re not alone,” Thompson says. “Other men have gone through this. We have a roadmap to treat it.”

Learn more

Read more about cancer care, specifically breast cancer care, on the OSF HealthCare website. Cancer care at OSF includes the OSF Cancer Institute in Peoria, Illinois.

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Related stories

Read other breast cancer stories on the OSF Newsroom
Read breast cancer stories on the OSF blog

A potentially life-saving pilot program is launching in Bloomington, Illinois to detect a little-known but surprisingly common genetic condition that can dramatically raise cholesterol levels—and the risk of heart attacks and strokes—even in children.

It’s called familial hypercholesterolemia, or FH. It’s estimated that 1 in 200 Americans has the genetic disorder where the body can’t effectively clear LDL or ‘bad’ cholesterol from the blood.

Darrel Gumm, MD, vice president of OSF HealthCare Cardiovascular Institute says the pilot will identify people who, due to their genetics, might not know they are at risk.

“It’s estimated about 1.3 million people in the United States have it [FH] and 90% of those patients don’t know they have it, Dr. Gumm stresses. “So, it’s a tremendous opportunity for us to step in and find those patients, identify those patients and provide therapies that may prevent terrible things from happening down the road.” 

OSF HealthCare and OSF Innovation are using artificial intelligence (AI) to conduct a pilot program for detecting and treating FH. To identify high-risk patients for this pilot, the Digital Innovation Development team used a two-step approach. First, an algorithm flagged patients over the past 18 months who had concerning cholesterol levels. Then, they applied an AI tool to scanned physician notes to detect clues—such as yellowing of the eyes or hardening of the Achilles tendon—signs a doctor may have observed but not flagged as FH-related.

People inherit FH from one or both parents, and it puts them at risk for cardiovascular events far earlier in life than normal, sometimes even in childhood.

Two Types of FH

According to Dr. Gumm, there are two kinds of FH:

• Heterozygous FH, inherited from one parent, which can lead to early heart attacks or strokes—before age 65 in women and 55 in men.
• Homozygous FH, a rarer and more severe form inherited from both parents, which can lead to strokes and heart disease in teenagers or even young children.

While most people begin cholesterol screenings around age 40, those with FH can silently develop sky-high levels from a young age.

"They can be a very healthy person, think they’re doing great, be a marathon runner and really they could have astronomically high cholesterol that’s not of their fault,” explains Ryan Loudermilk, a strategic program manager in Performance Improvement at OSF Innovation.

The new screening program was launched in Bloomington, starting with support from a strong primary care network involving 9 providers including Richard Ginetti, MD, who is a champion for the effort. It started with 200 patients found to potentially have FH. If testing confirms the diagnosis, individuals will be offered treatment, typically statins, which can reduce cardiovascular risk by up to 80%.

Dr. Gumm says every time someone is identified with FH, outreach will occur to encourage screening for parents, siblings, and children.

“One of the things I love to tell my patients is the best way to treat a heart attack is not have one. Same thing with a stroke. So, even if they’ve had a heart attack and survived it, now we’re going to be aggressive at not letting the second one occur. But here’s a chance to never let it occur in the first place. It’s primary prevention … really fantastic.” 

Education in a Short-Attention-Span World

Understanding FH—and the importance of early detection—isn’t easy in a world flooded with information. That’s why the pilot program teamed with OSF Innovation’s Medical Visualization team, to create for people identified at possible risk, mobile-friendly education designed to meet people where they are.

Loudermilk emphasizes it’s not just a brochure. The visuals use a unique, semi-animated shimmer effect that adds emotional weight without overwhelming the viewer.

“It’s something that can be easily read on their cell phone; they don’t have to log onto a computer. It’s something that’s eye-catching, something that’s straight to the point – what your risks are, why it’s important for you to get tested and checked … thinking about family members, so it speaks to that. It speaks to the ease of this. That’s the other big piece of this.” 

A Simple Test with a Big Impact

The testing process is easy. It’s just a cheek swab with no needles or blood draw. It takes a couple minutes.

The pilot is tracking how many people go on to be screened after the initial outreach with a goal of at least 30%. The initiative will follow not just how many patients test positive, but how many then go on to get family members tested, the true measure of ripple effect success. Additionally, the pilot includes having the Medical Visualization team provide insights about which content drove the most engagement.

The FH pilot is part of a broader effort at OSF HealthCare to advance care through personalized medicine that is specific to a person’s genetic make-up. Loudermilk sees a time in the future where genetic testing will be even easier.

“Where I could see this going – a patient doesn’t even have to come in. These kits could actually be mailed to them, to their house and they could do the check swab themself and get it mailed in. So, those who don’t want to deal with making an appointment and seeing their provider in person, they could do a virtual visit and have the kit sent to them. That’s the future of all of this.” 

If you receive primary care in Bloomington, talk to your provider if you think you would like to be screened for familial hypercholesterolemia.

Dr. Darrel Gumm

Ryan Loudermilk

B-roll-Familial Hypercholesterolemia (FH)

Terri Odell has never had any serious health problems. She can’t even remember ever calling in sick to work. The Rockford, Illinois native attributes her good fortune to leading an active lifestyle that started when she was a young child and continued into adulthood – working out, running marathons and now owning a personal training business.

So, when she found a lump in her breast in December 2023, the 63-year-old Odell was stunned.

“That's the hardest thing for me but also the biggest benefit for me,” she says. “I know that my body's very strong, and it's extremely healthy, except for that little bit of cancer that’s moving through it. But it does make me feel a lot more secure that everything's going to be okay. And that's a big part of getting better is to believe in it and to keep yourself going.”

Family history 

Cancer is no stranger to Odell’s family. Her mother passed away from ovarian cancer when Odell was three years old. Odell, who had seven siblings, lost two sisters to lung cancer, and she has an aunt and cousin who’ve battled ductal carcinoma. The fear of cancer was always in the back of Odell’s mind.

Her lump turned out to be triple negative breast cancer, which is a cancer of the breast that does not have hormone receptors, such as estrogen and progesterone, that are found in most breast cancers. Triple negative breast cancer is usually diagnosed in women younger than 45.

“We see it in about 15% of breast cancer patients,” says Peggy Rogers, a nurse practitioner in genetics and medical oncology for OSF HealthCare. Rogers did not treat Odell but has cared for many patients with a similar diagnosis. “These patients are treated with chemotherapy and immunotherapy, and we offer genetic testing to these women who are diagnosed with these cancers because they tend to be aggressive.”

Odell carries the BRCA1 gene, which increases the risk for ovarian cancer. It turns out that Odell had a tumor in her fallopian tube, so she had oophorectomy, which is surgery to remove one or both ovaries. “BRCA” stands for “BReast CAncer gene.” BRCA1 and BRCA2 are two different genes that have been found to impact a person’s chances of developing breast cancer. Odell had a lumpectomy to remove the cancerous tumor in her breast.

Rogers says women will often consider having a mastectomy on the affected breast or bilateral mastectomy to remove both breasts and reduce the elevated risk of a potential second breast cancer. “If they don't have breast cancer, but they’re diagnosed with the BRCA1 gene, we put them on heightened surveillance with a mammogram, alternating with a breast MRI every six months,” she says. 

Now, Odell is spreading the important message of genetic testing. And no better time than the present. October is Breast Cancer Awareness Month.

“You know, people are asking me about breast cancer, but I try to tell them it's not about that. It's really about the BRCA gene,” Odell says. “That's the serious part of the whole disease. And that's the part that I want to get people to understand.” 

Genetic testing 

Genetic testing helps determine the chances of developing a disease in the future. Rogers says the purpose of genetic testing in the case of breast cancer is to detect a BRCA1 or BRCA2 mutation or other breast cancer genes in your DNA, which indicates a higher risk for developing cancer.

“Any woman who has a family history of three women affected with breast cancer, one under the age of 50, on the same side of the family, would be appropriate for a genetic referral,” says Rogers. “Or breast cancer and ovarian cancer is a red flag and is a good reason for a woman to come in for a risk evaluation.” In addition, any woman with triple negative breast cancer, male breast cancer or Ashkenazi Jewish ancestry should be tested. And family history of ovarian cancer, pancreatic cancer or metastatic prostate cancer would also be appropriate for risk evaluation. 

Genetic testing can be done using blood or saliva samples. Results are usually available within three to four weeks.

Rogers says if a person tests positive for a pathogenic variant in BRCA, she should inform all her first-degree relatives, including children, because there's a 50/50 chance they could inherit the gene, but it’s also important to share the information with other family members on the affected side of the family.

Training for the biggest race of her life 

As for Odell, she remains optimistic that better days are ahead. She’s still training her clients and continuing to push herself with her own rigorous workouts.

“I'm making [cancer] my marathon,” she says of fighting cancer. “It's the same kind of thinking – eating right, getting sleep and doing the best for your body.”

And she’s involved with cancer-related events and activities, spreading the word about prevention and genetic testing. In fact, most of her surviving siblings have now been tested. Odell says there will be no more surprises in her family when it comes to cancer. 

“It's hard to hear that diagnosis,” she says. “There was a lot of sadness. I went to a few dark places, but you have to come out of it and believe there's something bigger out there. There's a bigger plan. I believe that.” 

For more information on genetic testing, visit OSF HealthCare.

Terri Odell interview clips 

Peggy Rogers interview clips 

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Bronny James was gearing up last summer for his freshman year of basketball at the University of Southern California, when he received the scare of his life.

In July 2023, James, the son of NBA great LeBron James, suffered cardiac arrest and collapsed during a team workout. The younger James was hospitalized for three days and underwent a procedure to treat a congenital heart defect. James’ family and medical team praised the USC medical staff for their quick and effective response, which helped in preventing any brain or organ damage from a lack of oxygen.

James eventually returned to basketball activities. He saw his first action for USC in December and has played anywhere between 14 and 30 minutes a game without any issues.

February is American Heart Month – a time to bring to light conditions such as the one James experienced that may help other people going through similar circumstances.

Natasha Noel, MD, a pediatric cardiologist with OSF HealthCare Cardiovascular Institute, says congenital heart defects, such as the one James had treated, are structural heart issues that typically develop during pregnancy and go undetected. She adds that 1% (40,000) of all babies are born with a heart defect every year in the U.S.

“We do see that if there is a family history of congenital heart disease, either parent or sibling, the next child could be more at risk for congenital heart defects,” Dr. Noel says. “And then other conditions, for example, smoking during pregnancy, maternal diabetes or use of other medications during pregnancy can lead to congenital heart defects.”

While James has recovered from his heart scare, there have been other athletes who weren’t so fortunate. In 1990, Hank Gathers, a college player for Loyola Marymount University, collapsed on the court and died from of sudden cardiac arrest. Three years later, the same happened to Reggie Lewis of the Boston Celtics, who died during a game when his heart went into cardiac arrest.

James isn’t even the first player to have experienced cardiac arrest at USC. Teammate Vince Iwuchukwu collapsed during a team practice in 2022 and survived.

“During periods of intense activity, the body has a physiological response,” Dr. Noel explains. “This can include dehydration, a surge of adrenaline, electrolyte imbalance, and this may not be well tolerated in athletes, who have some underlying electrical or structural abnormality.”

Treatment depends on the patient and the heart defect. According to the American Heart Association, many young adults who have a minor cardiac defect, and have had a good result after surgery, can participate in most activities. Some participants could have restrictions including those with pacemakers or implantable cardioverter defibrillators (ICDs) or those who are taking anticoagulants to decrease blood clotting. Dr. Noel says to always check with your physician before taking on any physical activity or sports participation.

“The athlete should go through a pre-participation physical, this would include medical history, physical exam, and the American Heart Association says it’s important to look at personal and family history,” she says. “If there is something suspicious in any of these things, the pediatrician can refer to a pediatric cardiologist or they could start the work themselves, which would include ordering an EKG or echocardiogram for an example.” Genetic testing might be necessary, especially if there is a family history.

Dr. Noel says that thanks to advances, medical experts have a better understanding of congenital heart defects. Not every athlete needs to give up participation – even if they have experienced a previous issue. She also stresses the importance of learning CPR and working with schools and coaches to always have an automated external defibrillator (AED) available.

“I want to encourage kids to continue going out and having fun – sports is healthy and it's exercise,” she emphasizes. “It doesn't mean that it's the end of the world if you are diagnosed with something that needs to be treated from a cardiac standpoint.”

For more information about pediatric cardiology issues, visit OSF HealthCare. 

 

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