Prairie Doc Perspective Week of March 29th, 2026
Anatomical Variations: Breaking Down the Basic Details of Tumors and Cancer
By Ethan L. Snow, PhD, MA


Cells are the basic building blocks of all living organisms. In a healthy body, cells follow an orderly life cycle: they develop from a systematic process called mitosis, perform important physiological functions to maintain body homeostasis (i.e., a stable internal environment), and die via apoptosis when they become dysfunctional, old, or no longer needed. This cycle is tightly regulated by DNA – the body’s genetic code that controls when and how each cell functions.


With about 30 trillion cells in each human body, some cells naturally develop mutations in their genetic code that disrupt their life cycle. Mutations can be caused by genetic issues, environmental exposures (e.g., tobacco smoke, radiation), infections, lifestyle, and other etiologies. Cells with mutated genetic codes are usually detected and removed by the body’s immune system, or they stop working and die on their own. However, sometimes these altered cells survive and gain a competitive growth advantage, causing them to replicate more rapidly than normal. Over time, this uncontrolled growth can create a mass of cells known as a tumor.


Tumors can develop anywhere cells are present (i.e., essentially anywhere in the body), and they are classified as benign or malignant. Benign tumors are non-cancerous, and they typically grow slowly and exhibit clear boundaries. Contrariwise, malignant tumors are invasive to nearby tissues – a hallmark of cancer – and are characteristically more aggressive. A biopsy is often necessary to confirm whether a tumor is benign or malignant. Notably, not all tumors are cancer (e.g., a benign tumor is not cancer), and not all cancers produce tumors (e.g., leukemia is a cancer of the blood).


A serious feature of malignant cancers is their ability to spread to other locations in the body – a process known as metastasis. Metastasis occurs when malignant cells break away from the original tumor, travel through the bloodstream or lymphatic system (or other pathway), and seed new tumors in other areas of the body. This makes cancer more difficult to treat and can provoke additional sequelae.


Clinical jargon associated with tumors and cancer can be daunting, but breaking down the terminology can be helpful. For example, the root words “hem-” means blood, “angio-” means vessel, and “-oma” means tumor, so a “hemangioma” is quite literally a “blood vessel tumor”. Additional terminology can be descriptive; for example, a “giant intramuscular lipoma” describes a fatty (“lyp-”) tumor (“-oma”) that is located within (“intra-”) a muscle (“-muscular”) and is at least five centimeters in any one dimension (the criteria for “giant” classification).


While loss of control is the foundational concept for tumor and cancer development, routine screening, avoiding carcinogens, and other controllable actions are important for preventing cancer, detecting it in early stages, and performing early interventional treatment. A lump, bump, or lesion might be just that, or it might be something serious. Tumors and cancer are complex, and they command respect and proper attention. It’s important to consult a physician about such concerns so they can execute a proper workup and assemble a multi-disciplinary healthcare team as warranted.


Ethan L. Snow, PhD, MA is a clinical anatomist who currently serves as an Associate Professor at South Dakota State University in Brookings, South Dakota. Dr. Snow leads the Snow Lab Research Team – a collaborative and interdisciplinary team of undergraduate students, professional students, faculty, and clinicians who analyze rare and unique clinical cases involving anatomical variations. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm, on SDPB YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective for the Week of March 22nd, 2026
“What the heart wants (is exercise)”
By Kelly Evans Hullinger, MD FACP
Cardiovascular disease remains the most common cause of death in the US as well as a very common cause of chronic illness and disability. Heart attacks, heart failure, and strokes result in about 2500 deaths per day in the US, according to the American Heart Association®. While huge strides continue to be made in treatment of these events, including medications and procedural abilities, as always, prevention is the best medicine.
Many risk factors exist for cardiovascular disease; some, such as genetics or family history, are out of one’s control. However, there are many things we can do to reduce our risk, including quitting smoking and controlling high blood pressure, high cholesterol, or diabetes. One behavior that applies to us all is to get enough exercise.
The American Heart Association® recommends getting at least 150 minutes of moderate intensity exercise or 75 minutes of vigorous exercise per week, preferably spread over several days in the week. Moderate exercise might include brisk walking, gardening, or leisurely biking. Vigorous exercise might include walking on an incline, jogging or running, or heavy yard work. Additionally, they recommend resistance or strength training be included twice per week.
Starting from sedentary? No problem, but don’t expect to go from zero to 150 minutes in the first week. Listen to your body; you can even start with walking or chair exercise for ten minutes per day. You will find that with consistency you will be able to build on that week to week. Most importantly, find a physical activity that you enjoy enough to keep doing. For many people, exercising with a family member or friend really helps.
We know that regular exercise can cut the risk of cardiovascular disease substantially; one large study showed a reduction in mortality by over 20%, with more exercise giving even greater protection. How exercise benefits the heart goes beyond its effect on obvious markers like weight; exercise improves blood flow in the vessels around the heart in a way that reduces future bad outcomes. As I tell my patients when we discuss exercise, its benefits are far greater than its effect on weight. Your heart will thank you for the exercise no matter what the scale says.
So let’s all get moving this week! Any exercise is better than none, and there is something out there for everyone. The heart wants what it wants, and that’s exercise.
Dr. Kelly Evans Hullinger practices internal medicine at Avera Medical Group in Brookings, SD. She serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on SDPB, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of March 15th, 2026
“Old Age, Only 10 Years Away”
By Dr. Becca Jordre
Every year I ask my students, “How old is old?” The answers vary, but the most honest response I’ve ever received came from a patient who said, “Old is 10 years older than my age.” We all tend to push aging just out of reach, as though it belongs to someone else.
As a physical therapist, professor and researcher in aging, I see the consequences of that distance every day. When we mentally place older adults in a separate category, we give ourselves permission to speak and act in ways that quietly do harm. We call someone an “old lady” without pause. We dismiss a symptom as “expected at your age.” We offer the well-meaning but quietly deflating compliment that someone is doing well “for their age.” Each of these small moments narrows what we believe is possible for that person.
This is ageism. Generally unintentional, ever-present in our society.
The problem is not acknowledging that aging brings real changes. It does. Health conditions, pain, and mobility challenges become more common with age, but not in some uniform pattern that warrants focus on a number. The problem is when age becomes the answer rather than the starting point. When decline is the expectation, we stop asking about goals, we stop noticing strengths and we start designing lives around an assumed limitation.
Consider a common piece of advice: move to a single-story home as you grow older. It sounds reasonable. But research tells a more nuanced story. Studies have found that those living in homes with stairs showed less decline in physical function over time compared to those without. Climbing stairs is demanding, repetitive physical work for the legs and heart. Removing that daily challenge in the name of safety may quietly accelerate the very decline we hope to prevent.
This pattern holds more broadly. Research consistently shows that vigorous exercise, not just gentle stretching or slow walks, produces the greatest health benefits as we age. Higher-intensity activity improves strength, balance, heart health and cognitive function in people well into their 80s and 90s. When we steer older adults toward only the lightest, most cautious forms of movement, we deprive them of the very stimulus their bodies need. In trying to protect, we inadvertently take away opportunity.
Language works the same way. When family members, neighbors and health care providers speak as though decline is inevitable, we coach people toward caution, avoidance and withdrawal. Expectation shapes behavior, and low expectations are their own kind of harm.
The answer is not to ignore age or pretend it doesn’t matter. It is to treat aging as a human experience, seeing a person not as a number but as an individual with unique aspirations, interests and abilities. 
None of us are exempt from aging. We are all just at different points on the same road. The assumptions we make about older adults today are the assumptions that may one day be made about us. That alone is reason enough to think more carefully about what we say, what we recommend, and what we decide is possible with each passing year.
Dr. Jordre is a professor of physical therapy in the School of Health Sciences at the University of South Dakota. She earned her Doctor of Physical Therapy degree from Duke University in 2002 and her Ph.D. in Health Sciences from the University of South Dakota in 2021. She is board certified in Geriatric Physical Therapy and is a Certified Exercise Expert for Aging Adults. Her research centers on healthy aging, with a particular focus on athletes age 50 and older. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and  streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of March 8th, 2026
Meaningful Living in Rural Communities: Pathways to Productive Aging
By: Whitney Lucas Molitor, Ph.D., OTD, OTR/L, BCG and Allison Naber, Ph.D., OTD, OTR/L
Living in rural communities offers unique opportunities to promote successful aging. Incorporating a purposeful lifestyle, developing social connections and engaging in daily physical activity is essential to achieving positive health outcomes and quality of life.
Finding purpose includes exploring the activities you already engage in and being open to new possibilities. Engaging in motivating activities provides a framework for a purposeful life. The selected activities can promote health, foster a sense of identity and give a sense of purpose in life while aligning with personal values and interests. While some daily activities are performed without much thought, identifying others may require careful exploration. 
In rural communities, consideration of the physical context is also essential. The American Occupational Therapy Association provides a framework that incorporates reflection on personal values, interests and prior life experiences. This approach, along with establishing priorities and goals, can be a valuable way to explore daily activities and create new opportunities for engagement that enhance purpose in daily life. To align life purpose with a rural context, it is essential to incorporate outdoor activities, find creative ways to connect with family and friends and explore opportunities with local groups. Activities can be modified to support evolving interests, abilities and desires. 
Establishing and maintaining strong social connections is critical to promoting healthy aging in rural communities. Older adults in rural areas may experience social isolation due to limited opportunities for interaction. This can be due to changes in overall health, technology barriers (limited internet access or limited computer or smartphone skills) or physical barriers (limited community mobility or driving restrictions). Social isolation can pose physical, psychological and behavioral health risks. Engaging in meaningful activities with others can help build relationships, find purpose or fulfillment and develop new hobbies or skills. Educational programs or groups are an excellent way to explore new leisure activities or learn strategies to improve health and well-being. Reaching out to family or friends, visiting your local senior center, attending community events, or joining a club can all provide a sense of connection, purpose and well-being.
In addition to staying socially connected, developing a regular physical activity routine is essential for older rural adults. Adults over 65 should set goals to strengthen their muscles and improve their balance by engaging in at least 150 minutes of moderate physical activity per week. Moderate physical activity increases breathing and heart rate, but you should still be able to talk while active. Beneficial activities include brisk walking, dancing, riding a stationary bike or NuStep, using weights or resistive exercise bands, gardening or participating in water aerobics. Consider setting a goal to move your body for 30 minutes each day to reduce sedentary time. Sedentary activities include watching TV, reading, sitting or lying down. Prolonged sedentary behavior increases the risk of poorer health outcomes among older adults. Intentionally participating in meaningful activities throughout the day will reduce time spent sedentary. Reduce sedentary behavior by standing during commercial breaks, walking around your home after a meal or stretching after reading the paper or playing cards. Incorporating the strategies mentioned in this article can promote well-being and enhance quality of life.


Whitney Lucas Molitor, Ph.D., OTD, OTR/L, BCG, is department chair and associate professor in the Department of Occupational Therapy at the University of South Dakota. Lucas Molitor is a licensed occupational therapist in Iowa and South Dakota. Her research interests include health promotion and productive aging. Allison Naber, Ph.D., OTD, OTR/L, is the academic fieldwork coordinator and an associate professor in The Department of Occupational Therapy at the University of South Dakota. Naber is a licensed occupational therapist in Minnesota and South Dakota. Her research interests include occupational performance and life balance, particularly as they relate to healthy aging. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of March 1st, 2026
Cultivating Trust: A Trauma-Informed Approach to the Therapeutic Alliance
By Patti Berg-Poppe, MPT, Ph.D. and Shana Cerny, OTD, OTR/L, BCP


Health care professionals enter every patient encounter with the goal of helping individuals heal, yet many don’t realize how often past adversity shapes the way a person experiences care. Trauma, whether from childhood experiences, medical procedures, accidents, interpersonal harm or environmental conditions, doesn’t remain a distant memory. It becomes embedded in the body through biobehavioral adaptations that influence posture, muscle tension, breathing patterns, nervous system sensitivity and low body safety. When we understand that trauma lives not only in stories but also in tissues and reflexes, we begin to see why a trauma-informed approach is essential for building trust.


Trauma and adverse experiences are more common than we may realize. More than two-thirds of the patients that health care providers encounter in practice are likely to have experienced trauma in some form. Trauma‑informed care should be a universal precaution, guiding providers to assume that any patient may have a history of adversity, even if it is never disclosed. This mindset shifts the focus from “What’s wrong with you?” to “What’s happened to you, and how is it affecting your health today?” For clinicians who rely on touch, such as physical and occupational therapists, physicians, nurses and primary care professionals, this awareness is especially important. Touch can be grounding and healing, but it can also activate the sympathetic nervous system, triggering a stress response before a patient has words to explain why.


Trust becomes the foundation of the therapeutic alliance, and trust is built through safety, predictability and respect. Trauma‑informed practice encourages providers to slow down, explain what they are doing and invite patients into shared decision‑making. Simple actions, such as asking permission before touching, checking in about comfort, offering choices and being transparent about what comes next, signal to the nervous system that the environment is safe. These small shifts can reduce physiological stress responses and create space for true healing.


Research on trauma‑informed health care highlights how past adversity can influence patient engagement, adherence and outcomes. When patients feel overwhelmed, misunderstood or rushed, they may appear “non‑compliant,” when in reality their nervous system is doing its best to protect them. A trauma‑informed lens helps clinicians interpret these reactions not as resistance but as communication. It encourages us to look beyond the symptom in front of us and consider the whole person, including their history, their stress load, their strengths and their goals.


Holistic care means recognizing that physical symptoms rarely exist in isolation. Pain, fatigue, dizziness and muscle tension often have emotional and neurological components. When providers acknowledge this mind‑body connection, patients feel seen rather than dismissed. They’re more likely to share concerns, ask questions and participate actively in their care. This collaboration strengthens the therapeutic alliance, which research consistently links to better health outcomes across disciplines.


Trauma‑informed practice is not a specialty; it’s a skillset. It requires curiosity, humility and a willingness to adapt. It asks clinicians to be mindful of their tone, body language and pace. It reminds us that healing happens in relationships, and that every interaction, every moment of touch, every explanation, and every pause can either reinforce safety or erode it.


When we approach patients with the assumption that their bodies carry stories we cannot see, we create conditions where trust can grow. And when trust grows, so does the capacity for healing.


Patti Berg-Poppe, MPT, Ph.D., is a physical therapist, professor, and Chair of the Department of Physical Therapy at the University of South Dakota. She has published on trauma‑informed care, including work examining how adverse childhood experiences influence patient engagement and how trauma‑aware practices can strengthen therapeutic relationships. Her writing and teaching emphasize the importance of trust, safety and respectful communication in all health care interactions. Shana Cerny, OTD, OTR/L, BCP, is an occupational therapist and associate professor in the Department of Occupational Therapy at the University of South Dakota. Her research, service and teaching interests revolve around trauma-informed care, including publication of practice guidelines for trauma-informed occupational therapy, interventions for individuals after exploitation, and the effectiveness of a trauma-informed care curriculum for multi-disciplinary care providers. She is a Trust-Based Relational Intervention® Educator and co-creator of the Child & Adult Advocacy Studies graduate certificate at the University of South Dakota. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

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