Article Category: Patient Resource

Finding comfort again: gentle vaginal dryness moisturizers after cancer 

If you’re facing vaginal dryness, painful sex or low libido after cancer treatment, please know this: you’re not alone and there is help. Many women treated with chemotherapy, radiation, or hormone therapy (like tamoxifen or aromatase inhibitors) experience changes that make intimacy uncomfortable and painful, and understandably lower interest in sex, too. There are many moisturizers and treatments available that can give relief. With the right support and tools, healing and pleasure are possible again.   

Why Does Cancer Treatment Cause Vaginal Dryness?  

Estrogen keeps vaginal tissues healthy, elastic, and naturally lubricated. Cancer treatments can lower estrogen levels, or block the effect of estrogen making the vaginal walls thinner, drier and more fragile. This can lead to itching, burning or discomfort with everyday activities. For many women this means they now experience pain during sex and intimacy.  

These side effects are common but can be managed.  

Gentle, Effective Vaginal Dryness Treatments

There are several safe, research-based ways to soothe vaginal dryness and restore your comfort. Most of these options are non-hormonal, some are all natural and many are available without a prescription.  

1. Vaginal Moisturizers to Restore Everyday Comfort

Vaginal moisturizers work gradually to hydrate and protect delicate tissues. They’re used regularly (a few times a week) and help maintain your body’s natural moisture over time. Hyaluronic acid is a common ingredient in these products. While “acid” may sound harsh, it is a natural substance found in the body that holds in moisture and promotes cushioning.   

Trusted options include:  

  • Revaree – a hyaluronic acid suppository designed to rehydrate vaginal tissues  
  • Replens™ – long-lasting moisture support  
  • HYALO GYN® – hyaluronic acid-based care  
  • Carlson® Key-E® – vitamin E suppositories  
  • Natural choices  –  vitamin E oil or coconut oil*  

These products are especially helpful when used at bedtime. Because suppositories are inserted into your vagina, laying down keeps the applied treatment in place and lets your body absorb the moisture right where you need it while you sleep.   

If you’re in perimenopause, have entered menopause, or recently finished treatment, it’s normal to need 3–5 applications per week to feel relief.  

*Note: Coconut oil is more frequently used as needed during intercourse than as a maintenance treatment. Be aware that a downside to this lubricant is that it can weaken latex condoms and cause them to break.  

2. Vaginal Lubricants – For More Comfortable Sex and Intimacy

If you’re struggling with painful sex, vaginal lubricants can make a big difference. They’re designed to ease friction and make intimacy smoother and more pleasurable.  

Look for:  

  • Water-based lubricants  
  • Fragrance-free, color-free formulas  
  • Products without warming agents or spermicide  
  • Natural products such as olive or coconut oil 

Avoid petroleum-based products, which can irritate sensitive tissue and damage condoms.  

3. Revaree: Targeted Relief Without Hormones

Many patients prefer Revaree because it’s gentle, non-hormonal, and easy to use. This hyaluronic acid vaginal suppository works by delivering deep hydration directly where it’s needed inside the vagina.  

It’s available online without a prescription and can be a great choice if hormonal treatments aren’t right for you. There are other brands available over the counter as well. 

 4. Other Natural Moisturizing Options:

  • Vitamin E gel capsules (cut open and applied externally or internally)  
  • Coconut oil (soothing, natural, and widely available)  

These may offer mild, natural relief—especially for those looking to avoid commercial products.  

5. Hormonal Treatments (When Appropriate)

For some women, vaginal estrogen or other prescription treatments can be safe and effective, but it’s important to talk to your oncology team first, especially if your cancer was hormone-sensitive.

Prescription options may include:  

  • Vaginal DHEA 
  • Vaginal estrogen cream, tablets, or rings  
  • Ospemifene (a non-estrogen oral option)  
  • Prescription hyaluronic acid treatments  

Your care team can guide you on what’s safe for your unique situation.  

  6. Pelvic Floor Therapy & Emotional Support

If pain during sex continues, a referral to a pelvic floor physical therapist may help ease discomfort and rebuild muscle control. At Siteman we also encourage emotional and relationship support—because your healing is physical and emotional.  

 You Deserve Comfort, Intimacy and Pleasure

As a person who has been diagnosed with cancer, your body has been through a lot. It makes sense that you might feel discouraged or unsure about what comes next—especially when it comes to intimacy, but healing is possible.  

These vaginal dryness treatments—from Revaree and vaginal moisturizers to lubricants and gentle therapies—are here to support you as you move forward.  

Treatments to Explore for Vaginal Dryness

A table shows vaginal dryness moisturizers and treatments

For Your Health: How sleep and exercise can help kids’ health and grades

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Now that kids are back in school, families are settling into their new routines after a long summer break. It can certainly be a busy time for everyone. But this transition can also be a great opportunity to help our kids — and our households — build healthy behaviors that can carry through the year, and beyond.

While many behaviors are important for our children’s health and wellness, improving their sleep and activity habits can have especially wide-ranging benefits.

“It is vital for children to get enough sleep, exercise regularly and limit screen time because these habits are strongly linked to positive outcomes for their physical, mental, cognitive and social development,” said Dr. Mary Fournier, an associate professor of pediatrics at WashU Medicine in St. Louis.

Together, these behaviors can help boost heart health, immune function and bone health, among other physical health benefits, she said. But the specific benefits can also reach many other key parts of children’s health and development.

“Each of these behaviors is beneficial, but when all three recommendations are followed, the combined effect is even greater and helps lower a child’s risk of anxiety, depression and behavior problems,“ Fournier said. “And research has shown that children with these healthy habits tend to perform better academically, think more clearly and have stronger attention, memory and executive function skills.”

A good goal for school-aged children is at least 60 minutes of physical activity every day, but this can include a combination of activities, like playing with friends, walking with the family and sports or other activities. For screen time on phones, computers and TV, it’s generally good to keep it under one to two hours a day outside of schoolwork. And while healthy sleep needs can vary, school-aged children should generally get around nine to 12 hours a night.

Fournier offered these tips to help families meet these goals:

Healthy Sleep

  • Keep screens out of the bedroom — and stop all screen time 30 to 60 minutes before bedtime.
  • Make bedtime the same each night and make it early enough to allow for sufficient sleep.
  • Create a relaxing bedtime routine. Dim the lights, put away screens and engage in soothing activities such as reading, drawing, writing, listening to quiet music or taking a warm bath or shower.

Limited Screen Time

  • Keep screens out of the bedroom, especially at night.
  • Plan non-screen activities. Play a game, read a book, draw a picture, put together a puzzle, or go outside to play.
  • Save screen time for a special treat or time, especially for younger kids.

Daily Physical Activity

  • Add physical activity to daily routines. Walk to school or the store, take the stairs instead of the elevator, involve your kids in active chores like vacuuming or raking leaves.
  • Make it fun! Find activities that your child enjoys or that your family can do together.
  • Be a good role model. Kids need to see regular exercise as a normal behavior for everyone. Plan family activities where you and your kids can exercise together — daily walks, family bike rides or impromptu dance parties.

This can feel like a lot, especially when life with kids can be busy and often unpredictable. But healthy changes don’t have to happen all at once. So, while it’s good to keep longer-term goals in mind, Fournier highlighted the benefits of realistic day-to-day changes:

“While working on all three behaviors can have an amplifying effect on a child’s overall health, even small improvements in any of them can help.”

It’s your health. Take control.

For Your Health: 15 small steps with big rewards

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Surveys show that most of us place a high priority on our health and wellness. That’s probably not surprising to hear. But as common a goal as improving health is, it can sometimes feel like a mystery how we can actually work toward it, with busy days filled with work, family and other important activities.

Luckily, small changes can have meaningful health benefits, and those benefits grow over time.

Try these 15 simple tips that focus on behaviors most of us could start today.

  1. Stock up on frozen vegetables. They’re easy, ready when you need them and as healthy as fresh options when they have no added salt or sugar.
  2. Place fruit where you can see it — on the counter, top shelf of the refrigerator or your desk. Make it as easy as possible to choose these snacks over less-healthy ones.
  3. Keep a reusable water bottle filled and close by. Plain water is the healthiest and easiest way to stay hydrated.
  4. Add a mini walk — a micro break — to your day. Park at the far end of the lot, get off the bus a stop or two early, or walk to the end of the block and back. Any extra steps we take count toward better health and provide a little “me” time.
  5. Take a short phone break. Staying connected is important — so is time away from the phone, even for just a little while. Put your phone in another room or in a drawer and give yourself the chance to explore other ways to enjoy the day.
  6. Stand up for 10 minutes. Cutting back on sitting and other sedentary activities has a lot of benefits. If you spend much of the day sitting, try to take regular standing breaks.
  7. Make that doctor’s appointment you may have been putting off. Whether it’s for a health screening, to keep track of a condition, or to get you or your kids caught up on vaccines, these types of visits can have really important benefits.
  8. Read some ingredients lists. It’s best to cut back on ultra-processed food. And one way to do that is to avoid foods with long ingredients lists that are filled with words we don’t recognize.
  9. Go to a park. Spending time in green spaces has proven benefits for physical and mental health.
  10. Say “no, thank you” to whipped cream. Many coffee drinks can come with whipped cream and other extras. It’s best to enjoy coffee without these — at least most of the time. They can add a lot of sugar, unhealthy fats and calories.
  11. Give plain yogurt a try. It can take a little getting used to, but plain yogurt is usually better for us than the higher-sugar, highly flavored yogurts. A great way to start is by mixing half plain yogurt with half flavored yogurt or adding fresh or frozen berries for natural sweetness and flavor.
  12. Pick something new from the produce aisle. Break the regular routine and try a fruit or vegetable you’ve never had before. You may just find a new favorite.
  13. Set out your workout clothes the night before. Make it as easy as possible to get dressed and out the door for your morning walk or gym class.
  14. Say “yes” to sleep. Good sleep helps with many parts of health and wellness. So, when it’s time for bed, make it a priority so you can get the seven to nine hours most adults need.
  15. Visit smokefree.gov. If you smoke and want to quit — or are just curious about quitting — this is a great place to start. There are also resources for supporting family and friends who may want to quit.

A great thing about these small changes is that they can often be relatively easy to make as well as to keep up over time. While it’s good to have bigger, longer-term health goals — like walking 30 minutes every day or cutting out sugary drinks — these types of smaller changes help build toward those and can be a powerful start.

It’s your health. Take control.

For Your Health: Should you sip or skip your favorite summer drink?

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For something so simple, there can be something surprisingly enjoyable about a cold drink on a hot day.

It can quench our thirst, cool us down and just taste great.

And during these warm months when we need to drink more than usual to stay hydrated, it’s important to choose drinks that we like, but it’s also important to choose drinks on the healthier side.

Figuring out which drinks hit that sweet spot, though, isn’t always easy. To help with that, I spoke with Yikyung Park, a nutrition researcher and professor in the Division of Public Health Sciences at WashU Medicine, for her insight on which popular summer drinks are easy to say “yes” to — and which ones we should try to limit.

Plain water. “The best choice!” she said. Zero calories and refreshing, with nothing extra. From the kitchen tap or bottle filling station, it’s basically free — and easy to find. Keep a reusable, plastic-free bottle in your pack or on your desk, so water’s always in easy reach.

Fizzy water. “As good as plain water.” It can cost more but also be a nice twist on plain water. Choose unsweetened versions.

Iced tea and iced coffee. “A good choice, but avoid drinking too much.” There can be some health benefits from drinking coffee, but caffeine can be a problem with both tea and coffee. And try to keep milk, cream and sugar to a minimum. The calories and saturated fat can add up quickly.

Coconut water. “It has electrolytes, which can be helpful when we’re sweating a lot, but choose those with no added sugar.”

Fruit juice. “Good option, but be sure to choose 100% fruit juice, not a fruit-flavored drink.” And even for 100% juice, it’s best to drink it only once in a while. While 100% juice has some vitamins and minerals, it also has about as much sugar as soda.

Lemonade. “Very refreshing — and a summer classic — but watch out for sugar content.” Like juice, it can have as much or more than soda. So, it’s best to have it only sometimes.

Sugary soda, energy drinks and sports drinks. “These types of sugary beverages are not a good option. They’ve been linked to an increased risk of weight gain, diabetes and other chronic diseases. Many sodas and energy and sports drinks also contain a high amount of caffeine, which can be problematic for many people, especially children.” Combined with the warm temperatures of summer, the caffeine can also lead to dehydration. Sugary drinks are popular, but they’re best to avoid, particularly for kids.

Diet soda. “Since there’s no sugar in diet soda, it seems a better option than sugary drinks, but that’s not the case.” It’s best to limit them as well. Diet sodas contain caffeine and artificial sweeteners, which have been linked to poor health outcomes in some studies.

Blended coffee drinks. “These are an unhealthy combination of sugar and caffeine, plus they can be very high in calories!” Iced coffee or cold brew with just a splash of milk is a healthier alternative.

Bubble tea. “A fun drink for summer, but best to limit. It contains a high amount of caffeine and calories.”

Beer, hard seltzers and other alcohol. “Alcoholic beverages can lead to dehydration — and they have other well-known, serious health effects.” Alcohol increases the risk of cancer as well as injury, suicide, liver disease, mental illness and even infectious disease. As much as beer and other drinks can be a traditional part of summer celebrations, the healthiest approach is not to drink. Try nonalcoholic beer for a better option that tastes like the real thing.

Enjoying our favorite drinks with family and friends — or in a quiet moment alone — can be a special part of summer. Day-to-day, though, try to choose healthier drinks overall. It’s the best way to stay hydrated and can give a real boost to our long-term health.

“Except for plain water, it’s best to drink all other beverages in moderation or less,” Park concluded. “Most we shouldn’t drink every day.”

It’s your health. Take control.

For Your Health: Staying cool and sun-safe this summer

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Food sizzling on the grill is one of the classic sounds of summer — right up there with kids splashing in sprinklers and the crack of a bat at the ballpark.

That sizzling can also be a good stand-in for how we might feel outside on a sweltering day.

With a little planning, though, we can make our time in the sun feel cooler and more comfortable — and much better for our skin.

“Any amount of tan, and certainly sunburn, represents damage to the DNA of our skin cells,” said Dr. Aubriana McEvoy, a dermatologist at WashU Medicine in St. Louis. “And the more sun people get over their lives, the more of a chance there is for damaged cells to turn into skin cancer, which can affect our quality of life and, in some cases, the length of our lives.”

Too much sun can also lead to wrinkles, coarse skin and discoloration, making our skin look older than it is, she added.

Some simple steps can go a long way toward lowering the risk of skin cancer while keeping our skin looking healthier as well. And everyone can benefit, from those with fair skin to those with darker skin.

Sunscreen is a great place to start. Choose one with Sun Protection Factor (SPF) 30 or higher and be sure to use a generous amount, about an ounce for an adult at the pool — reapplying every couple hours. There are a lot of sunscreen options these days, so try out a number of them to find one you and your family like.

“My favorite sunscreen is the one you will wear,” McEvoy said.

Clothes are another way to stay sun-safe. Long-sleeved shirts, pants and wide-brimmed hats do a great job covering skin and don’t need to be reapplied like sunscreen. And there are many inexpensive, lightweight options that are specifically made to protect from the sun and that have their own rating, called Ultraviolet Protection Factor (UPF). As with sunscreens, the higher the UPF number, the greater the protection.

The combination of clothes and shade from trees or sun shelters can be particularly important for kids. Sunscreen is not recommended for children under 6 months old. And older kids can be so active that it can be hard to keep them well-covered in sunscreen, McEvoy added.

Shade and lightweight, loose-fitting clothes can also help with staying cool and feeling good on a hot day summer day. And it’s hard to overstate the importance of drinking enough water. It can be easy to get behind on our hydration, especially on a fun-filled outing with family and friends. Try to keep a bottle close by filled with plain water or low-sugar sports drink mix. Make it as easy as possible for you and your family to stay hydrated.

For many of us, summer is the best time of year, in no small part because we get to spend so much time enjoying long days and warm weather outside. And that’s an important part of life, McEvoy feels. Also important, of course, is doing so safely and healthfully.

When asked for one of her favorite tricks for staying cool and sun-safe in summer heat, she replied:

“If I’m at the playground or park with my kids, I’ll wear a sun-protective shirt and just wet it down. That keeps me way cooler and protects me from the sun.”

For Your Health: Make wellness part of spring cleaning

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There’s always the same 24 hours in a day, but somehow when we hit spring, it can seem like we get some extra time. With more daylight and warmer weather, the days can just feel like they’re expanding.

And with that shift can come a boost in our energy and motivation to tackle lingering projects on our to-do lists: Rearranging cluttered closets, cleaning out junk drawers and more. But outside of classic spring-cleaning tasks, this can also include some important — and often pretty simple — steps to improve our health.

For many of us, health screenings may be the most common items on this list. These tests can help find risk factors and diseases earlier when they’re easier to treat or prevent.

They include the types of screening tests that may first come to mind — a mammogram looking for breast cancer, a colonoscopy looking for colon cancer or a CT scan looking for lung cancer. But they also include other types of screenings for conditions that increase the risk of diseases. These include blood tests for cholesterol levels, blood sugar and certain infections. It can also include tracking blood pressure, mental health and weight.

Keeping up to date with vaccinations is also key, even when we’re well past our school days. Vaccines can help us avoid certain diseases — including some cancers — and make some diseases less severe. And on top of protecting ourselves, vaccines also help protect our loved ones and our communities.

To get started, here’s a general preventive care checklist, based on stage of life. Of course, it’s important to talk with a health-care provider for more specific recommendations based on your age, health and medical history and family history. Those at increased risk of certain conditions may get different tests or be tested — or receive follow-up care — earlier and more often.

Screenings & Vaccinations for Young Adults

  • Cancer screenings: Cervical cancer (women, begin at age 21)
  • Other health screenings: Blood sugar (begin at age 35), blood pressure, blood cholesterol, weight, depression, hepatitis B and C (usually a one-time blood test), tobacco use, family history
  • Vaccinations: Ask a health-care provider about any vaccines you may need. Some vaccines, like the flu vaccine, are good to get every year.

Screenings & Vaccinations for Midlife and Older Adults

  • Cancer screenings: Breast cancer (women, begin at age 40), cervical cancer, colon cancer (begin at 45), lung cancer (in those who smoke or used to smoke, begin at age 50), prostate cancer (men, discuss testing with a doctor, begin at age 40 for Black men or others at high risk, at age 45 for men at regular risk)
  • Other health screenings: Blood sugar, blood pressure, blood cholesterol, bone density (women, at age 65), weight, depression, hepatitis B and C (usually a one-time blood test), tobacco use, family history
  • Vaccination: Ask a health-care provider about any vaccines you may need. Some vaccines are started in midlife or later, such as the pneumococcal vaccine (at age 50) to protect against pneumonia.

This can seem like a lot when listed out. But many of these can be taken care of during a single visit with a provider, and only a small number of tests or vaccinations should be done every year.

So, as we work through our spring-cleaning lists, we should add to our peace of mind by taking some straightforward steps that can have a large benefit for our health and wellness. And that’s certainly springtime well spent.

It’s your health. Take control.

For a list of preventive care tailored by age, visit the health.gov tool, MyHealthfinder.

For Your Health: Move more, live better

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It’s likely no surprise to read that physical activity is good for us. In fact, it may be hard to go a full day without seeing something positive about exercise and physical activity on the news or social media.

What can sometimes get lost in all that, though, is how wide-ranging the benefits of physical activity can be.

Better-known benefits include helping us live longer and keeping weight in check, as well as lowering the risk of heart disease, stroke, cancer and other chronic diseases.

But physical activity can also have an impact on many other areas, including some that may sound a little abstract but might feel like they have a more direct effect on our day-to-day lives. One of these is how we feel about our lives, which is often referred to more technically as quality of life.

While the research world has specific definitions of quality of life depending on what is being studied, one way to look at it is as an overall measure of how we feel life is going, across many different parts of it. It’s something very personal, and something we define for ourselves.

“Scientifically, there’s ‘global’ quality of life, which generally encompasses an individual’s judgment of their satisfaction with life,” said Elizabeth Salerno, a behavioral scientist at WashU Medicine in St. Louis who specializes in physical activity research. “Then there’s health-related quality of life, which includes physical, mental and social aspects of well-being.”

And the evidence that physical activity can boost these quality-of-life measures is just as strong as it is that activity can lower the risk of chronic diseases, Salerno added. “Findings from multiple studies have demonstrated that people who receive physical activity interventions have better quality-of-life outcomes over time compared to those who did not get the interventions,” she said.

It’s likely that the more physical activity we get, the bigger boost we get to our quality of life. At the same time, any amount of activity may also help.

Recommended guidelines to get 150 minutes or more of physical activity each week is a great goal to work toward. But just moving more, whatever our starting point, likely has benefits too. Walking, cycling and gym classes are classic examples of physical activity. But gardening and dancing are types of activities that can also be included. And we can creatively piece these exercises and activities together throughout our busy days and weeks.

“Any bit of activity counts towards your ‘total,’ ” Salerno said. “That means that a quick five-minute walk to the store or a 60-second jog up or walk down the stairs contributes to better health. Structured, goal-oriented exercise is still important, but maintaining a physically active lifestyle as much as possible is crucial.”

Regular activity can help improve quality of life in a number of ways. Among those, it can improve mood, provide an energy boost, help with flexibility and mobility and just generally keep us healthier.

But there is still much to learn about how physical activity benefits quality of life, Salerno said. One theory is that we may build strong social connections when, say, we’re walking or taking a gym class with others — and that can impact how we see our positions in life.

“It underscores the importance of enjoying what we do when we move our bodies,” Salerno said.


“Whatever keeps us coming back for more — and fits neatly into the unique structures of our lives — is likely to pack the biggest punch when it comes to optimizing our life satisfaction.”

New cancer care clinic opens in Center for Advanced Medicine

The Cancer Care Clinic at Siteman Cancer Center has moved to a larger, more easily accessible area within the Center for Advanced Medicine (CAM) on the Washington University Medical Campus.

The clinic provides cancer treatments, manages side effects of cancer therapy, and provides other services for cancer patients, including evaluations, infusions and injections, and care related to clinical studies.

With more treatment areas than its previous location, the Cancer Care Clinic is now located on the first floor of the CAM, at 4921 Forest Park Ave., St. Louis, MO 63110 (map), next to the Barnard Health and Cancer Information Center.

“The Cancer Care Clinic is a unique space, designed to meet the needs of patients with cancer 24/7,” said Emily Buehrle, MHA, BSN, RN, OCN, the clinic’s manager. “We understand their journey and strive to provide the most compassionate care possible.”

Amenities include complimentary Wi-Fi and beverages and light snacks. A cafeteria, Starbucks, family lounge and business center are located nearby. The closest parking garages are:

  • Euclid Garage, 224 S. Euclid Ave., St. Louis, MO 63110 (map)
  • Parkview Garage, 1 Parkview Place, St. Louis, MO 63110 (map)

While the clinic serves urgent needs, it is not an urgent care clinic. In the case of an emergency, a patient should call 911, contact his or her physician and head to the nearest emergency room.

To be seen at the Cancer Care Clinic, patients at Siteman should make an appointment through their Washington University physician or other care team member.

Learn more about the new clinic location.

Q&A: Jennifer De Los Santos, MD, highlights head and neck cancer

April is Head and Neck Cancer Awareness Month, an opportunity to highlight a set of cancers that 60,000 Americans will be diagnosed with in 2025, according to the American Cancer Society. These cancers most commonly include those of the tongue; tonsils and throat behind the mouth; and gums, floor of the mouth and other parts of the mouth.

Remembering the recent passing of actor Val Kilmer due to laryngeal cancer, Jennifer De Los Santos, MD, a WashU Medicine radiation oncologist at Siteman Cancer Center at Barnes-Jewish Hospital and WashU Medicine, talks about warning signs and raising awareness.

Tell us a little about these cancers and symptoms and other information we should be aware of.

Dr. De Los Santos: Head and neck cancers, including laryngeal cancer, can present with symptoms of sore throat, hoarse voice, ear pain and a mass in the neck. These cancers, which affect the throat, voice box and mouth, are often delayed in detection, as symptoms are often attributed to an upper respiratory infection. If patients do not have insurance or a primary care provider, diagnosis can be delayed even further.

What is laryngeal cancer?

Dr. De Los Santos: Laryngeal cancer is a type of cancer that develops in the larynx, also known as the voice box. The larynx is a part of the throat located between the back of the mouth and the trachea (windpipe) at the level of the thyroid cartilage (sometimes called the Adam’s apple). It plays a crucial role in breathing and speaking because it houses the vocal cords.

What are some risk factors for this cancer?

Dr. De Los Santos: The most common ones include:

  • Tobacco use – Smoking cigarettes, cigars or pipes is the single largest risk factor for laryngeal cancer. Both smoking and chewing tobacco can increase the risk.
  • Alcohol consumption – Heavy drinking of alcohol, particularly when combined with smoking, significantly raises the risk of laryngeal cancer. Alcohol can irritate the lining of the larynx and make it more susceptible to the carcinogenic effects of tobacco.
  • Exposure to certain chemicals – Occupational exposure to industrial chemicals such as asbestos or sulfuric acid has been linked to an increased risk of laryngeal cancer.
  • Marijuana use – New data suggest that marijuana use may also be associated with the development of head and neck cancer.


WashU Medicine’s Department of Radiation Oncology is at the forefront of the fight against head and neck cancers. Could you elaborate on some of the leading-edge treatments you’re working on?

Dr. De Los Santos: Absolutely. Our department is proud to be pioneering several promising treatment options. In particular, radiation therapy, immunotherapy and targeted treatments have made huge strides in improving outcomes for our patients. Tailoring radiation therapy to each patient can help control or even eliminate cancer cells while minimizing damage to surrounding healthy tissue. Immunotherapy is also showing great promise, particularly in helping the immune system recognize and fight cancer. Targeted therapies, which focus on specific genes or proteins involved in cancer growth, are another exciting area.

That’s amazing progress. Please talk about the importance of preserving patients’ voices, especially for those undergoing procedures like laryngectomy, and how technology is playing a role.

Dr. De Los Santos: For many patients, especially those with laryngeal cancer, losing the ability to speak is a devastating consequence. One of our main goals is not only to combat the cancer but also to preserve the patient’s quality of life. With advances in artificial intelligence (AI) and other technologies, we are investigating tools that can help patients communicate more effectively after procedures like a laryngectomy. AI-driven devices are being developed to create more natural-sounding speech, and they hold tremendous potential for improving a patient’s ability to engage in day-to-day life. This technology is transformative, offering an option that may both improve communication and preserve the patient’s natural voice.

It sounds like there’s so much hope on the horizon. How can people help support the critical research and advances you’re making at WashU Medicine and Siteman Cancer Center?

Dr. De Los Santos: Some of the best ways to support our work is through advocacy and spreading awareness. This includes promoting early detection – for example, by encouraging people with ongoing symptoms to seek follow-up care if antibiotics don’t help. The second is by recognizing the real difference that breakthrough discoveries can make. Val Kilmer’s legacy of advocacy is a powerful example of how one person’s story can inspire change, and we hope that this month, and beyond, people will join us in our mission to improve outcomes for patients battling head and neck cancers. Together, we can make a significant difference.

Learn more about multidisciplinary care and research at the Head and Neck Tumor Center at Siteman.

Jennifer De Los Santos, MD Professor of Radiation Oncology

Jennifer De Los Santos, MD

WashU Medicine radiation oncologist at Siteman Cancer Center at Barnes-Jewish Hospital and WashU Medicine

For Your Health: Spilling the beans on coffee and health

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For the morning coffee drinkers out there, a recent study found there may be one more reason to enjoy that first cup of the day. In a study of over 40,000 people in a national health survey, researchers found that morning coffee drinkers had a lower risk of dying prematurely than non-coffee drinkers. And the biggest beneficiaries might be those who drank coffee only in the morning rather than throughout the day.

Of course, these findings are from a single study, so further research is needed on the timing of coffee drinking. At the same time, this new study adds to a large and growing amount of research showing that coffee drinking overall can have many health benefits.

That could sound a little surprising. For whatever reason, coffee can still feel like one of those things we enjoy but that may not be good for us.

Yet coffee has over 1,000 compounds that could aid health. Among other possible benefits, these compounds could help improve the gut microbiome, ease inflammation, help with DNA repair and help control blood sugar.

And studies have linked moderate coffee drinking with a lower risk of stroke, heart disease, diabetes, gallstones, Parkinson’s disease and some cancers. It may even help with longevity. And many of these possible benefits seem to include decaf as well as regular, caffeinated coffee.

Coffee drinkers in the U.S. average around two cups a day — within the range of up to two to four eight-ounce cups (or up to 400 milligrams of total daily caffeine) that’s likely safe for most adults, according to the federal Dietary Guidelines for Americans. Depending on the type of coffee and how it’s made, an eight-ounce cup of brewed coffee can have around 95–180 milligrams of caffeine.

For women who are pregnant or breastfeeding, general recommendations are lower — often under 200 milligrams of caffeine a day. Women who are pregnant, wanting to become pregnant or breastfeeding should talk to a health-care provider about how much coffee or caffeine is safe for them.

Keeping it simple is usually the best approach when it comes to coffee drinks. Choose black, unsweetened coffee — or with just a little sugar and splash of milk. Try to limit specialty coffee drinks that have a lot of added sugar, unhealthy fats and calories, which can offset some of the benefits we may be getting from our coffee.

Unsweetened coffee can also be a great alternative to sugary soda, fruit drinks, energy drinks and other less-healthy, high-sugar options.

For something so many of us enjoy — and that’s so integrated into daily and social routines — it’s nice to know that moderate coffee drinking can be a healthy part of most people’s days.

And that may make our next morning cup taste that much better. Enjoy.