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BY KATHY LATOUR | JANUARY 25, 2013
My email box had its usual number of press releases relating to health and well being this morning. I get them from all kinds of sources and generally scan to see if they relate to cancer before sending them off to the trash bin. This morning the CDC put out a media advisory about the latest state related smoking statistics. And then a few emails later it put out another one with a correction. That got me interested. They don't usually make mistakes, so I opened it.
The first one said: Each year, approximately 443,000 people die from smoking or exposure to secondhand smoke, and another 8.6 million suffer from a serious smoking-related illness. Moreover, costs associated with smoking-related illness amount to nearly $96 million in medical expenses, $97 million in lost productivity, and 5.1 million years of potential life lost in the United States annually.
The corrected one said: Each year, approximately 443,000 people die from smoking or exposure to secondhand smoke, and another 8.6 million suffer from a serious smoking-related illness. Moreover, costs associated with smoking-related illness amount to nearly $96 BILLION in medical expenses, $97 BILLION in lost productivity, and 5.1 million years of potential life lost in the United States annually.
That's right, BILLIONS.
What is the matter with us. Cigarette smoking is the leading cause of preventable death in the United States, accounting for approximately 1 of every 5 deaths in the United States each year.
And you can be darned sure that lots of those billions are from uninsured Americans, meaning the cost is coming back to you and me in our insurance costs.
When do we stop this. When do we just put our foot down and demand that this end. We don't allow people to shoot us, but they can stand next to us and blow second hand smoke in our face -- or in the faces of children in their care.
Some states have made it really uncomfortable -- and costly to smoke. Check out how your state is doing at the CDC website.
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BY ELIZABETH WHITTINGTON | JANUARY 7, 2013
Today, the Annual Report to the Nation on the Status of Cancer was released, again showing cancer deaths continue to decrease overall. That's the good news.
The not-so-good news is some hard-to-treat cancers aren't. Melanoma (men only), liver, pancreatic and uterine cancers have increased in the past decade.
The number of oral cancers associated with human papillomavirus (HPV) is also rising. HPV is most notably known to cause cervical cancer, but lately it has been the cause of the high rate of oral cancers, specifically oropharyngeal cancers. ["Facing the Facts: HPV-Associated Head and Neck Cancers Get a Second Look" June 14, 2012]
In 2011, an analysis from the National Cancer Institute predicted HPV-related oral cancers could significantly increase over the next decade, overtaking HPV-related cervical cancer. ["Men May Be at Greater Risk Than Women for Developing HPV-Related Cancers" June 8, 2011].
The Annual Report to the Nation on the Status of Cancer is co-authored by researchers from the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute and the North American Association of Central Cancer Registries. The full report will be available online and published in the Journal of the National Cancer Institute.
The report also features a special section on HPV, including HPV-associated cancers vaccination factoids. The NCI reports:
...in 2010, fewer than half (48.7 percent) of girls ages 13 through 17 had received at least one dose of the HPV vaccine, and only 32 percent had received all three recommended doses. Vaccination series completion rates were generally lower among certain sub-populations, including girls living in the South, those living below the poverty level, and among Hispanics. The national three-dose coverage estimate among girls ages 13 through 17 in 2010 falls well short of the U.S. Government's Healthy People 2020 target of 80 percent for three-dose coverage among girls ages 13 through 15...
The HPV vaccine is also approved for young boys. The CDC predicts that about 7,000 HPV-associated cancers in the U.S. may be prevented by vaccine each year in men, including oropharyngeal cancers.
Cancer prevention methods that appear so easy on paper (reduce tobacco, decrease obesity, vaccinate against cancer-associated viruses), unfortunately doesn't play out as quickly in real life. Here's hoping that we figure it out pretty soon.
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BY ELIZABETH WHITTINGTON | OCTOBER 29, 2012
Along the East Coast many are preparing for Hurricane Sandy to hit, and like many other natural disasters, cancer goes on - it just makes treating it a lot tougher for patients and their caregivers.
Breast cancer survivor (and CURE publisher) Sue McClure would always joke with us that she'd get her radiation treatments Monday through Friday ... because cancer doesn't grow on the weekends. Unfortunately for many, unplanned interruptions in cancer treatment can bring about stress and anxiety.
Several organizations and bloggers have put together preparation tips for patients:
Cancer.Net, the patient-facing website for the American Society of Clinical Oncology offers these tips:
> Develop your plan with your oncologist. Talk to him or her about what you need to do to manage your cancer during emergencies.
> Talk with your family about different disasters that could occur and how the person with cancer could be affected. Write down a few solutions for coping with each scenario.Choose a place where everyone will meet during a disaster.
> Identify a friend or a relative for everyone to communicate with in case you and your loved ones are separated or cannot get to the meeting place. This person can also be a back-up for any important information you may need, such as phone numbers for your doctor or pharmacy.
> Don't forget to brainstorm specific needs, such as evacuation transportation assistance or help coordinating medical appointments during and after a disaster.
You can read more at "Emergency Planning for People with Cancer."
Survivor Jody Schoger, Women with Cancer blogger, explained how having your medical information on a flash drive or protected online could be helpful if you need to evacuate during a disaster in "Disaster Drill."
Following the devastation of the Japanese earthquake in 2011 led Jody to write the post, but having weathered at least one hurricane, she writes, "compile your medical history, current medications and other pertinent medical information into a document and transfer it to the drive. Zip that puppy into your wallet and leave it there. You can also store the document in Dropbox or another web-based program like Backupify just in case."
Another tip is to collect your medical team's contact information. CURE touched on this topic several years ago when Hurricane Katrina scattered many patients and survivors throughout the country for weeks and months. Working with their oncologists, many were able to get treatment locally. New Orleans-based oncologist Oliver Sartor gave his cell phone number to many of his patients before the storm hit. When it appeared that many residents weren't going to be able to return home immediately, he told them to find a medical oncologist where they were and have the physician call him to coordinate treatment.
Many hospitals have a plan in place for natural disasters and evacuations. This tip sheet from Texas Oncology includes some other handy advice, such as "Know Your Coverage." Keep your insurance card handy and know what's available to you.
To talk with other patients and survivors about problematic issues and helpful advice, the #bcsm (Breast Cancer Social Media) Twitter chat tonight focuses on emergency preparedness during cancer treatment. Patients of all cancers (and medical professionals too) are welcome to join the conversation.
And it's not just patients that are affected. I heard this morning that the ASTRO (American Society for Radiation Oncology) annual meeting has been suspended in Boston until tomorrow.
To all those facing Hurricane Sandy, stay safe. And if you have additional tips for patients and caregivers, feel free to comment.
Update: You can read the full #bcsm Twitter transcript here.
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BY LINDSAY RAY | OCTOBER 29, 2012
The Food and Drug Administration has approved the second drug in two months for treating chronic myeloid leukemia (CML). On Oct. 26, Synribo (omacetaxine mepesuccinate) was approved to treat adult patients whose CML has progressed after treatment with at least two tyrosine kinase inhibitors (TKIs), such as Gleevec (imatinib), Sprycel (dasatinib) and Tasigna (nilotinib). The previous drug approval came in September for the tyrosine kinase inhibitor Bosulif (bosutinib).
When disease progresses after treatment with multiple TKIs, it can be more difficult to treat and options become more limited. There are some mutations that don't respond well to TKIs. Synribo works by blocking certain proteins that promote cancer cell growth and provides another option after TKI treatment.
Synribo's effectiveness was established in trials with a cohort of patients whose disease had progressed despite treatment with TKIs, and all patients received Synribo. In the group of 76 chronic phase CML patients, effectiveness was determined by a reduction in the number of cells that have the Philadelphia chromosome genetic mutation, which most CML cells have. After an average of 3.5 months of treatment, 14 of the 76 patients had a response that lasted for a median of 12.5 months. For those patients in the accelerated phase, effectiveness was measured through a normalization of white blood counts or absence of leukemia. Five out of the 35 patients had a response in an average of 2.3 months, and the response lasted for a median of 4.7 months.
Synribo is injected under the skin twice a day for 14 days over the course of a 28-day cycle. Once the white blood cell count normalizes, Synribo is then given twice a day for seven consecutive days for a 28-day cycle, and the patient continues with Synribo as long as he or she has a clinical benefit. Common side effects include low platelet, red and white blood cell counts; diarrhea; nausea and fatigue.
For more information, please visit synribo.com or call 800-896-5855.
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BY LINDSAY RAY | SEPTEMBER 27, 2012
After the approval of Zaltrap (ziv-aflibercept) for colorectal cancer in August, there's more good news for metastatic colorectal cancer patients. This morning, the Food and Drug Administration announced that it had approved Stivarga (regorafenib) for patients with metastatic colorectal cancer (mCRC) who have progressed after trying other therapies. The FDA had granted the drug a priority review in late June, which guarantees a drug will be reviewed within six months.
Stivarga works as a multi-kinase inhibitor, which means it targets several different pathways that can promote tumor growth, including the vascular endothelial growth factor receptor (VEGF), which signals tumor blood vessel growth, and c-KIT, an oncogene that also helps cancer growth. Patients take the drug orally, once-a-day in four week cycles (three weeks on, one week off before starting the therapy again).
The approval is based on the phase 3 CORRECT trial, which randomly assigned 760 mCRC patients who had prior treatment to either receive Stivarga or placebo. All patients in the trial received best supportive care. Stivarga was shown to extend median overall survival to 6.4 months compared with the 5 months for those in the placebo arm. The drug also delayed tumor growth by two months compared with the 1.7 months for those on placebo.
Common side effects include fatigue, hand-foot syndrome and diarrhea. The drug also carries a warning that severe and fatal liver toxicity can sometimes occur.
Stivarga has already been made available to some patients through an extended access program. Regorafenib is also being considered for FDA approval for patients with gastrointestinal stromal tumors (GIST).
Be sure to check out CURE's feature on colorectal cancer in our Winter issue.
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BY KATHY LATOUR | SEPTEMBER 21, 2012
I am so tired of attack ads – you know the personal assaults on the man instead of talking about issues. So, it was particularly nice to hear about the Republicans and the Democrats doing something together where there were no attacks on the other camp.
The effort I am talking about is the Pink Ribbon Red Ribbon Initiative, which is directed by Doyin Oluwole, MD, a Fellow of the Royal College of Pediatrics and a Fellow of the West African College of Physicians. She is barely 5 feet tall and speaks softly, but as the executive director of the Pink Ribbon Red Ribbon Initiative, she is filled with a passion for the women of Africa that is bipartisan and a great example of what a private/public partnership can do when everyone is committed to getting something done instead of playing politics.
In a nutshell, the Pink Ribbon Red Ribbon Initiative is using the infrastructure and resources created by George W. Bush through the President's Emergency Plan for Aids Relief (PEPFAR) during his administration to now screen women for cervical cancer and educate them about breast cancer.
And here's the amazing part. To screen for cervical cancer they are using very simple tools that allow healthcare workers to identify precancerous lesions and remove them with cryosurgery in the woman's home or in the small clinics scattered through Sub-Saharan Africa. To detect the lesions the cervix is swabbed with vinegar, which makes precancerous spots turn white. They can then be immediately frozen off with a metal probe cooled by a tank of carbon dioxide.
The procedure is one of a wide array of inexpensive but effective medical advances being tested in developing countries. With a Pap smear, a doctor takes a scraping from the cervix, which is then sent to a laboratory to be scanned by a pathologist. Many poor countries lack high-quality labs, and the results can take weeks to arrive.
For women with more advanced cervical lesions in the Pink Ribbon/Red Ribbon Initiative, they are referred to doctors who can often treat the disease before it becomes lethal. And, with the combined efforts of pharmaceutical partners, the next generation is being vaccinated against cervical cancer so that more might avoid dying of this disease. In addition, the same network is being used to educate women about breast cancer and early detection.
Cervical cancer, which is no longer a major threat in the U.S., is still the most common women's cancer in Sub-Saharan African, and the third most common ailment in females,with 530,000 new cases and 275,000 deaths each year. Dr. Oluwole explains that women with HIV are particularly susceptible to cervical cancer because they are immune suppressed. Despite this, few women are screened for cervical cancer in Africa. As the first Initiative of the George W. Bush Institute in Dallas, the program is truly a public/private partnership with support from the Obama administration, UNAIDS, the Joint United Nations Programme on HIV/AIDS; Susan G. Komen for the Cure; and the Caris Foundation, which provides pathology training and support tumor profiling and other innovative technologies. Merck and GlaxoSmithKline, the pharma giants donated vaccine to prevent HPV, and Bristol-Myers Squibb Foundation paid for cervical and breast cancer training in community-based treatment support programs.
QIAGen contributes test kits, training and support services to the program, and IBM offers what the press release calls a "scalable and replicable" in-country plan for communication. Becton Dickinson provides deeply discounted prices for their diagnostic tests in addition to education and training for laboratory staff and healthcare workers on how to screen for cervical cancer. The US company is also working with Pink Ribbon/ Red Ribbon to develop guidelines and policies for effective cancer screening in developing countries.
On the day we talked, Dr. Oluwole was particularly excited because it was the one year anniversary of the beginning of the program in Zambia, the first of what will be five countries, and the statistics were in.
From December 2011 to July 2012, 13,053 women were screened and 2,986 were found to be HIV positive; 2,491 were positive for a precancerous condition and 1,188 had cryotherapy on a precancerous condition. Another 1,303 of the total screened were referred for advanced diagnostics and treatment.
On July 4, 2012, which Dr. Oluwole finds appropriate, the second country in the first phase began screening the women in Botswana, to be followed soon by Kenya and Rawanda. It's heartening to see what can happen when people get together for a good cause. It's just sad we can't get past politics in this country for a good cause.
Even if they had to go to Africa, it's wonderful to see people playing well together to save women's lives.
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BY JON GARINN | SEPTEMBER 6, 2012
You may have heard that an international team of more than 440 scientists has published 30 studies detailing discoveries from a five-year investigation into the human genome. By all accounts, the results are mind-boggling.
The project, called the Encyclopedia of DNA Elements, or ENCODE, tries to make sense of the unknown part of the human genome. It seems that about 80 percent of DNA that was once thought to be "junk" is actually responsible for regulating all of the genes.
Gina Kolata from The New York Times did a great job of explaining the project and its implications on human health, so I won't try to reinvent the wheel here. But it suffices to say that scientists will soon have what they need to fight diseases much more effectively than ever before.
I asked our editor-in-chief, Debu Tripathy, MD, for his take on the news and its possible impact on cancer. He said this is "just the beginning of the story--we now have a better atlas of the genetic defects in cancer, but it will take time to understand how to target these genetic defects."
He added that it will take some time to sort out and start to validate which of these mutations are real drivers and then to develop drugs to target them. We're planning a feature on next-generation gene sequencing, so stay tuned to CURE to help you understand the genetic basis for cancer and new avenues for therapy.
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BY LINDSAY RAY | SEPTEMBER 5, 2012
Yesterday, the Food and Drug Administration (FDA) approved a new drug, Bosulif (bosutinib), to treat patients with Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML). Bosulif is approved for patients in the chronic, accelerated or blast phase of the disease that has progressed with other therapies, including imatinib, which is a standard first-line treatment, or could not tolerate the side effects of other therapies.
Patients with a genetic mutation, the Philadelphia chromosome, produce an enzyme called tyrosine kinase that promotes the growth and proliferation of abnormal white blood cells. These abnormal cells can then build up in the bone marrow and crowd out the normal, healthy cells that are necessary for fighting off infection.
Bosulif is a tyrosine kinase inhibitor, which means it blocks the tyrosine kinase enzyme from signaling the production of these abnormal cells.
The approval was based on a single phase 1/2 study of 546 adult CML patients who had progressed after prior therapy or could not tolerate the side effects of that therapy. All patients received Bosulif. After 24 weeks, 34 percent of patients who had previously been treated with imatinib experienced a major cytogenetic response (35 percent or less of cells in the bone marrow are Ph+). For those patients who had a major cytogenetic response at any time, 52.8 percent of them had maintained a response for at least 18 months. For patients in the accelerated phase who had been treated with imatinib, 33 percent had blood counts in the normal range after 48 weeks and 55 percent had normal blood counts with no evidence of leukemia. For those in the blast phase of CML, results were slightly less dramatic: 15 percent had their blood counts in the normal range and 27 percent had normal blood counts with no evidence of the disease.
Common side effects include diarrhea, nausea and vomiting, low platelets and red blood cells, and fatigue.
For more information, visit bosulif.com.
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BY KATHY LATOUR | SEPTEMBER 4, 2012
The Medicare Rights Center, a national, nonprofit consumer service organization, sent out their e-newsletter this week with some troubling news about the Romney-Ryan plan for Medicare. The Center from what I can see gets its funding from a variety of sources and does not appear to be partisan. If it is, please let me know because that's not what this is about. It's about Medicare.
What the newsletter said was this: The Romney-Ryan plan will increase Medicare costs now and in the future. The Center based the comments on a report by the Center for American Progress (CAP), which also professes to be bipartisan. And it gives the web page so you can read the whole report for yourself. But here are the high points.
1. The RR budget proposal increases Medicare premiums and drug costs for current seniors and increases Medicare costs during retirement for those who qualify for Medicare after 2011.
2. Specifically the plan converts the traditional Medicare program into a voucher system, repeals the Affordable Care Act(ACA),and turns Medicaid into a block grant.
3. CAP says these changes would significantly increase health care costs for both current and future Medicare recipients.
4. Younger people would face the most cuts under the RR plan with increases of almost $60,000 for people who turn 65 in 2023. Each year the voucher would grow at a rate of .5 percent over the rate of gross domestic product (GDP).
5. Because health care costs will increase much faster than the voucher, seniors will be forced to spend more of their own money.
Go in and read the whole report "Increased Costs During Retirement Under the Romney-Ryan Medicare Plan." I know many of you support this ticket, so explain the other side that can't be seen.
I really want to understand this, as do many of our readers, and we all know that Medicare has been a hot potato in this election. So explain what is not clear here.
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BY LINDSAY RAY | AUGUST 31, 2012
On Aug. 29, the FDA approved Afinitor Disperz (everolimus tablets for oral suspension), making it the first pediatric dosage approved for a pediatric tumor.
While Afinitor has previously been available for patients 3 years or older, this new dosage form is to treat patients one year and older with tuberous sclerosis complex (TSC) who have a rare brain tumor, subependymal giant cell astrocytoma (SEGA), that can't be treated surgically. TSC is a genetic disorder that causes noncancerous tumors to form in various organs, and even though the tumors are noncancerous, they can still cause complications. SEGA tumors are generally slow-growing and form in 1 out of 10 individuals with TSC. SEGA is also more likely to affect children and young adults under 21.
This dosage form is available in smaller amounts than the adult dosage and can dissolve in a small amount of water, making it easier to swallow.
Side effects include mouth ulcers and respiratory tract infections.
For more information on the approval visit the FDA site.
For more information on TSC and SEGA, visit tsalliance.org.
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