Sunday, January 13, 2019

Dubious ties to cancer industry undercut docs

Sloan Kettering pulls rug out from under its execs after apparent conflicts of interest

Memorial Sloan Kettering Cancer Center, under siege for potential conflicts of interest, has severely tightened the reins on its top executives.

No longer will they be able to serve on corporate boards of drug and health care companies, according to a story by Katie Thomas and Charles Ornstein in The New York Times this week.

The sanctions were imposed following a series of stories by The Times and ProPublica, a nonprofit journalism organization, that exposed questionable exec ties to the industry. 

In some cases, the article indicates, the companies "had paid them hundreds of thousands of dollars a year."

Officials at the facility, one of the world's most prominent, apparently also were informed by officials of their parent hospital that "a series of reforms designed to limit the ways in which its top executives and leading researchers could profit from work developed at Memorial Sloan Kettering, a nonprofit with a broad social mission that admits about 23,500 cancer patients each year," were being made permanent.

The conflicts at the center, the story continues, "have had a rippling effect on other leading cancer institutions across the country."

Dana-Farber Center Institute in Boston and Fred Hutchinson Cancer Center in Seattle, for example, are said to be reconsidering their policies on financial ties.

Dr. Craig B. Thompson
After muck-raking reports were published last fall that included information that Dr. Craig B. Thompson, Sloan Kettering's chief exec, was paid about $300,000 for his services in 2017, Thompson resigned from the board of Merck.

Earlier, The Times and ProPublica had alleged that Dr. José Baselga, Sloan Kettering's chief medical officer, "had failed to disclose millions of dollars in payments from drug and health companies in dozens of articles in medical journals."

Baselga resigned within days of the stories going public — and "stepped down from the boards of the drugmaker Bristol-Myers Squibb and Varian Medical Systems, a radiation equipment manufacturer."

Sloan Kettering employees who represent the hospital on corporate boards now will be barred from "accepting personal compensation, like equity stakes or stock options, from the companies."

The Times story quotes Dr. Walid Gellad, director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, as calling the policy changes a "watershed moment."

More information about research facilities can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Saturday, January 5, 2019

Link possible between obesity and cancer

Fat cells can fuel the growth and spread of skin cancer, new Sloan Kettering study finds

Is being fat a potential cause for a surge in cancer?


At least if you believe a story by Matthew Tontonoz a while back on the Memorial Sloan Kettering Cancer Center website.

It says, in short, that cancer cells eat fat to grow and spread.

It cites discoveries at the Sloan Kettering Institute that "melanoma cells in zebrafish use fat from nearby fat cells to fuel their growth and spread," and indicates that a new study finds fat cells, or adipocytes, are filled with fats called lipids that can fuel cancer's aggressiveness.

In humans as well as fish.

Dr. Richard White
The story, sent me by my high school classmate Philip Greenhut, focuses on the words of Richard White, a doctor-scientist in SKI's Cancer Biology and Genetics Program:

"This is the seed-and-soil hypothesis. Tumor cells like to go to places where there is fertile soil. Based on the results of our study, we think that adipose tissue can be very fertile soil for melanoma."

The story notes that "knowing that adipose tissue enables some cancer cells to grow and spread suggests that cutting off their fat supply could be a way to fight the disease."

The findings, it contends, "also add to the growing understanding of the link between obesity and cancer."

White and his colleagues "stumbled onto the connection," Tontonoz's article claims, after using "zebrafish as a model system for studying skin cancer" because those "small freshwater fish get melanomas that are very similar to human melanomas" and because it's easy to see where the fish's cancer cells go as tumors progress since the creatures are transparent.

Ultimately, of course, the researchers examined the connection in human beings by looking at tumor samples from people with melanoma who were treated at Memorial Sloan Kettering.

Details of the findings were published in the journal "Cancer Discovery."

Details about other research can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Tuesday, December 25, 2018

FDA approves 31 new therapies in one year

New screenings and treatments are helping to boost the number of cancer survivors in the U.S.

By 2026, some 20.3 million cancer survivors will be living in the United States — up from 15.5 million a decade earlier.

That, according to a recent article in Parade magazine by Sheryl Kraft, is because innovations in screening and treatment are helping patients beat the odds.

"In just one year," the piece reports, "31 new therapies to treat more than 16 types of cancers were approved by the U.S. Food and Drug Administration."

Dr. Otis Brawley, chief medical and scientific officer for the American Cancer Society, believes that screening can save lives. "Some estimates say that we can decrease the number of colorectal deaths by 12,000 to 20,000 if screening guidelines were followed."
Dr. Jame Abraham
And Dr. Jame Abraham, director of Cleveland Clinic's Breast Oncology Program, notes that hormone therapy might be all that's necessary to treat 70 percent of women with the most common form of breast cancer. 

"That means a large number of patients can safely avoid chemotherapy," the Parade story quotes her as saying. "We can individualize treatment and make sure we are prescribing the right treatment for the right purpose."

It was tough previously to identify which women with early-stage breast cancer were at risk for recurrence, so many had received unnecessary chemo, radiation and hormonal therapy. But a groundbreaking study known as the TAILORx trial found that many women could be saved from "unnecessary side effects like fatigue, hair loss, nausea, vomiting and anemia," the quote continues.

Another new treatment, immunotherapy, which "works by reprogramming a patient's own immune cells to find and attack those cancer cells through the body," also is being held out as innovative — and the American Society of Clinical Oncology's "advance of the year."

Immunotherapy now is being heralded as "extremely promising for treating triple-negative breast cancer, one of the most difficult-to-treat breast cancers," after having already been shown to have "significant results in young patients with a form of leukemia and adults with multiple myeloma (a type of blood cancer) and lymphoma (a type of cancer involving cells of the immune system)."

Yet another new testing method, CancerSEEK — according to the Parade piece, "a simple blood test, which in its research phase was performed on people already diagnosed with cancer," can identify markers for for tumors containing mutated DNA in the bloodstream. 

These markers are associated with eight common cancer types: breast, lung, colorectal, ovarian, liver, stomach, pancreatic and esophageal.

Lastly, the story cites a less invasive and faster lung-cancer technique called microcoil localization, "which can pinpoint and remove small bits of affected tissue using a needle inserted through the chest wall to remove the cancer at its earliest stage."

Minimally invasive surgery — instead of the currently popular "lobectomy, which removes a portion of the lung by opening up the chest, followed by radiation and chemotherapy."

More details on new techniques and treatments can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Tuesday, December 11, 2018

American Cancer Society vs. U.S. advisory group

Agency and task force disagree on when people should start screening for colon cancer 

Whether U.S. adults should start colon cancer screening at age 45 or 50 is still in doubt.

The most recent guidelines from the American Cancer Society advocate the former, but an influential government advisory group, the U.S. Preventive Services Task Force, still believes the latter age is perfectly okay.

According to an Associated Press story by Mike Stobbe a while back, the cancer society admits its recommendation of the earlier age "could cause confusion for doctors and patients." 

Both groups, however, apparently recommend six other kinds of screening exams, "from inexpensive take-home stool tests performed every year to colonoscopies done every 10."
Dr. Rich Wender
The best test, the cancer society's Dr. Rich Wender is quoted as saying, "is the test that gets done. All of these tests are good tests, and the choice should be offered to patients."

Most colon cancer occurs, according to the story, "in adults 55 and older, and the good news is rates of cases and deaths have been falling for decades."

Colon cancer, combined with rectal cancer, is the second leading cause of cancer deaths in the United States — the top cause being lung cancer.

Some 140,000 Americans were expected to be diagnosed with colon cancer this year, "and about 50,000 will die from it," Stobbe's piece reports.

Only "about two-thirds of people 50 and older have been following screening guidelines," the article notes, quoting Dr. Marcus Plescia of the Association of State and Territorial Health Officials as saying that "it's hard enough to get people to do it at all."

But Dr. Andrew Wolf, lead author of the American Cancer Society study, reportedly said his agency had considered and rejected that reasoning.

More information about conflicting research and findings can be found in "Rollercoaster: How a man can survive his partner's breast cancer,"  a VitalityPress book that I, Woody Weingarten, aimed at caregivers

Sunday, December 2, 2018

Can laparoscopic surgery spread cancer cells?

New data shows less invasive operation causes more deaths for women with cervical cancer

In news that may appear counter-intuitive, two studies have shown a higher death rate for a less invasive version of a cancer operation in women.

According to a recent Associate Press story by Carla K. Johnson, the new evidence challenges standard practice "and the 'less is more' approach to treating cervical cancer."

The article notes that the unexpected findings already "are prompting changes at some hospitals that perform radical hysterectomies for early-stage disease."
Dr. Pedro Ramirez
Dr. Pedro Ramirez of the University of Texas MD Anderson Cancer Center in Houston, who led the more rigorous study, says that after the results became known "we immediately as a department changed our practice and changed completely to the open approach."

Findings from his study, which was conducted at more than 30 sites in a dozen countries and were published in the New England Journal of Medicine, showed "women who had the less invasive surgery were four times more likely to see their cancer return compared to women who had traditional surgery."

Dr. Jason Wright of New York-Presbyterian Hospital, a co-author of the other study, says "we're rethinking how we approach patients. There's a lot of surprise around these findings."

And Dr. Amanda Fader of Johns Hopkins Kimmel Cancer Center, explaining that the Baltimore hospital "has stopped doing less invasive hysterectomies for cervical cancer until there is more data," is quoted as saying the new research "is 'a great blow' to the [newer] technique and the findings are 'alarming.'"

Surgeons, she adds, ""should proceed cautiously."

In both studies, Johnson's story says, "researchers compared two methods for radical hysterectomy, an operation to remove the uterus, cervix and part of the vagina. The surgery cost around $9,000 to $12,000 with the minimally invasive version at the higher end."

Traditional surgery involves a cut in the lower abdomen; in the newer method, laparoscopic surgery, from which patients recover more rapidly, small incisions are made for a camera and instruments.

Some experts believe the reason for the higher death rate is because "there may be something about the tools or technique that spreads the cancer cells from the tumor to the abdominal cavity," AP's article reports.

More information on research into cancer for both men and women can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Friday, November 23, 2018

Should users worry about disease link to phones?

After tests with rats, 2 U.S. agencies clash over whether cellphone use can cause cancer

Two federal agencies are at odds about cellphone radiation.

According to a recent Associated Press story by Lauren Neergaard and Seth Borenstein, "one says it causes cancer in rats. The other says there's no reason for people to worry."
Dr. Jeffrey Shuren
The article says the Food and Drug Administration, which oversees cellphone safety, has challenged an earlier ruling by the National Toxicology Program that linked the devices to heart and brain cancer, saying the findings didn't apply to humans.

Dr. Jeffrey Shuren, its chief of radiological health, represented the FDA position.

Dr. Otis Brawley
His statement was supported by Dr. Otis Brawley, chief medical officer of the American Cancer Society.

"The incidence of brain tumors in human beings has been flat for the last 40 years. That is the most important scientific fact," Brawley was quoted as saying.

AP's story notes that "in a $30 million study, scientists put rats and mice into special chambers and bombarded them with radio frequency waves, like those emitted by older 2G and 3G phones, for nine hours a day for up to two years, most of their natural lives."

The levels the rodents experience, the piece continues, "were far higher than people are typically exposed to."

In February, the toxicology program concluded there was "some evidence of a link," after finding "a small increase in an unusual type of heart tumor in male rats, but not in mice or female rats."

The agency's recent update changed its terminology to "clear evidence" of heart tumor increase — and it added "some evidence" of brain cancer.

More information on cancer research can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Saturday, November 17, 2018

Memorial Sloan Kettering forced to shift focus

Are conflict of interest chances sullying the reputation of a prestigious cancer center?

The famed Memorial Sloan Kettering Cancer Center apparently is in turmoil, at least as far as raising money is concerned.

And possibly as far as its reputation is concerned.

According to a recent story by Katie Thomas and Charles Ornstein in The New York Times, the facility — which the piece refers to as "one of the nation's most prestigious cancer centers" — "has abruptly changed the focus of an annual fund-raising campaign amid a widening crisis that has already led to the resignation of its chief medical officer and a sweeping re-examination of its policies."

A brochure on the center's website indicated that the campaign, "initially titled 'Harnessing Big Data,' was to have focused on the cancer center's research into the use of artificial intelligence in cancer  treatment."

The shift in focus followed an earlier Times article, written in conjunction with ProPublica, a nonprofit journalism organization — just as the latest story was. That piece dealt with an exclusive deal the center made with an AI start-up "to use digital images of 25 million tissue slides analyzed over decades."

But the company, Paige.AI, "was founded by three hospital insiders and also involved investors who were Memorial Sloan Kettering board members."

According to the Times story by Thomas and Ornstein, pathologists at the hospital, whose main campus is in New York City, "complained that their work was being commercialized for private gain and that patients were not being informed that images of their tissue slides were being shared with an outside company." 

Although the hospital and its officials claimed they didn't do anything wrong, they did acknowledge "that they could have communicated better," the Times piece contended.

Kenneh Manotti
After the first article, Kenneth Manotti, the center's senior vice president and chief development officer, sent an email "to board members of the Society of MSK, the hospital's fund-raising effort, and an affiliated committee [that said the effort] would be postponed 'under the current circumstances, as we navigate through the issues at hand.'"
The society normally raised between $800,000 and $1 million annually for the hospital.

In September, Dr. José Baselga, the hospital's chief medical officer, quit under fire after the Times and ProPublica "revealed that he had failed to disclose his extensive industry ties in dozens of medical journal articles in recent years."

The hospital, the latest article says, "has announced a task force to study its conflict-of-interest policies."

In an email from Dr. Craig B. Thompson, the hospital's chief executive, and Dr. Lisa DeAngelis, acting physician-in-chief, low staff morale was acknowledged. 

Other stories about fund-raising efforts can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Wednesday, November 7, 2018

Split cancer ruling befuddles the public

Top California court says three companies don't need to put warning labels on cereals 

The California Supreme Court has let three breakfast-cereal giants off the hook.

Last week's ruling that denied a review of an appellate decision means the corporations needn't put warning labels on boxes of their whole-grain cereals to the effect that an ingredient — acrylamide — might cause cancer.

The ruling came despite the chemical having been identified by federal and state agencies as a potential cause of the disease.

It left the public unsure what's real — or dangerous.
Bob Egelko

According to a story by Bob Egelko in yesterday's San Francisco Chronicle, General Mills' Cheerios, Post's Grape-Nut Flakes and Kellogg's All Bran will not have to carry the red flags under the state's Proposition 65, a 1986 ballot measure requiring "businesses to notify the public when their products contain ingredients that have been shown to cause cancer or birth defects." 

At the same time as it left that ruling intact, the court's decision removed it as a legal precedent — which was a relief to attorney Joseph Mann, who'd argued on behalf of the Center for Environmental Health, the Center for Food Safety and other groups that the courts should limit the scope of the ruling.

The Chronicle story goes on to report that Mann, who earlier had said "the opinion is just dead wrong," maintains that making a cookie product with whole grains "doesn't mean [manufacturers] can jack it up with sugar and call it a health food, and say states can't regulate that."

The ruling, not incidentally, didn't mandate that warning labels should be required "for other food products that contain both healthy ingredients and possible carcinogens," Egelko writes.

Researchers way back in 2002 had detected the presence of acrylamide "as a byproduct of baking, roasting or frying carbohydrate-rich foods such as potato chips and French fries, both of which now carry Prop. 65 warning labels," the story says.

In response to the suit seeking the same labels for the cereals, "the Second District Court of Appeal in Los Angeles [in a 3-0 ruling in July] agreed with federal health officials who said that such warnings would cause more harm than good," the Chronicle story continues.


Because, the story quotes the court, "requiring warnings on all foods containing acrylamide at levels that pose any risk of cancer 'would cause many otherwise healthful foods [such as peanut butter, rye and whole wheat bread, sunflower seeds and prune juice] to appear to consumers to be unhealthful.'"

More information on ingredients that may cause the disease can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.