Tuesday, June 21, 2022

Top U.S. court rejects Roundup maker's appeal of decision that the weed killer causes cancer

The U.S. Supreme Court has let a $25 million verdict against Bayer, parent company of Monsanto, manufacturer of the popular weed killer Roundup, stand. 

The original jury found that Monsanto, the giant agribusiness that manufactures the pesticide, had failed to warn about cancer risks to those using the product.

The top court's decision not to intervene means not only that the decision in the suit brought by Edwin Hardeman, who was diagnosed in 2015 with non-Hodgkin's lymphoma, can remain intact but the way is cleared for thousands of similar lawsuits against Bayer. 

A story by Ann E. Marimow in an edition of The Washington Post this week notes that the "Biden administration had urged the court to deny the company's [stance], a departure from the Trump administration's position."

Hardeman's suit alleged that his use of Roundup for more than two decades caused his cancer and that Monsanto, which Bayer purchased in 2018, failed to warn about the risks associated with the active ingredient, glyphosate.

After an international research group in 2015 classified glyphosate as "probably carcinogenic to humans," the state of California demanded a warning label on Roundup, the nation's most widely used weed killer — in opposition to the Environmental Protection Agency's repeatedly concluding that "glyphosate is unlikely to cause cancer in humans."

Two years ago, according to the story, "Bayer agreed to pay more than $10 billion to settle tens of thousands of potential U.S. claims" but it admitted no wrongdoing. It also said it was moving toward alternate ingredients to "manage litigation risk in the U.S. and not because of safety concerns."

Judge Michelle Friedland
Just days before the Supreme Court ruling about the Hardeman suit, "a separate ruling from the 9th Circuit ordered the EPA to reconsider its finding in 2020 that glyphosate did not pose 'any unreasonable risk to man or the environment,'" Marimow's article reports. As a part of the unanimous decision, Judge Michelle Friedland writes that the Trump-era opinion "was not supported by substantial evidence" and didn't meet the agency's "legal obligations for reviewing environmental impact."

More information on court battles over carcinogenics 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.

Sunday, June 19, 2022

Small study shows that experimental drug makes rectal cancers vanish in 100 percent of the cases

A small rectal cancer clinical trial has had an unexpected result — remission in every patient.

According to a story by Gina Kolata in recent editions of The New York Times, the cancer vanished in each of the 18 patients, "undetectable by physical exam, endoscopy, PET scans or MRI scans." 

Dr. Luis A. Diaz Jr.
Dr. Luis A. Diaz Jr. of Memorial Sloan Kettering Cancer Center, who published a paper on the trial in the New England Journal of Medicine, is quoted as saying he knew of no other study in which a treatment completely obliterated a cancer in every patient. "I believe this is the first time this has happened in the history of cancer" he says.

That view is confirmed by Dr. Alan P. Venice, a colorectal cancer specialist at the University of California, San Francisco, was wasn't involved in the study. That kind of record, he says, is "unheard of."

The patients entered the study with the expectation that they might face chemotherapy, radiation and, most likely surgery that cold result in bowel, urinary and sexual dysfunction — and require colostomy bags. All 18 were pleasantly surprised to find that no such treatments were necessary.

Dr. Andrea Cercek
"There were lots of happy tears," Dr. Andrea Cercek, an oncologist at Memorial Sloan Kettering and a co-author of the paper, is quoted.

The immunotherapy drug the patients were given every three weeks for six months — dostarlimab, a checkpoint inhibitor produced by GlaxoSmithKline, which sponsored the clinical trial — costs about $11,000 per dose. "It unmasks cancer cells, allowing the immune system to identify and destroy them," the story says.

The study's authors indicate that although the earliest patient to complete the trial is more than two years post-treatment, many have only been involved for six months, and all patients will be monitored for at least five years.

Dr. Julie Gralow
A follow-up story by Kim Bellware and Lenny Bernstein in The Washington Post notes that the study's results marked "the first time immunotherapy alone eliminated the need for chemotherapy, radiation or surgery."

The Post story quotes Dr. Julie Gralow, chief medical officer and executive vice president of the American Society of Clinical Oncology, as commenting that "I'm excited when you see such a dramatic response. It gives me hope we can find such a dramatic [treatment] for other cancers, too." 

More information about clinical trials 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.

Monday, June 6, 2022

U.S. government cracking down on false Medicare claims by major health-care outfits

The Justice Department is continuing to investigate false Medicare claims that have apparently padded the pockets of major health-care organizations.

According to a story by Christopher Rowland in yesterday's editions of The Washington Post, the U.S. government maintains those organizations have likely been mining "patient records for outdated, irrelevant conditions to increase profits."

A major culprit, Sutter Health systems, which runs 24 hospitals in Northern California, settled a civil whistleblower lawsuit last year for $90 million that alleged it had submitted false risk codes to get higher Medicare Advantage payment. It did not, however, admit any wrongdoing or liability.

Sutter's aim, the Post story contends, "translated into millions of dollars in inflated bills to the federal Medicare Advantage insurance program." 

Dr. David Terry
Rowland's article quotes Dr. David Terry, a recently retired psychiatrist who worked with in large health organizations in Kansas that aren't part of the lawsuits, as saying that what's been done is "not ethical coding, it's how to code for more money. That pressure is there." 

A whistleblower, Kathy Ormsby, had testified that her work auditing medical case files uncovered the alleged scheme to defraud the government. Sutter supposedly paid her to scour health histories of thousands of elderly Medicare patients and then pressured physicians "to add false diagnoses it found [including cancer and stroke] to their current medical records."

According to Rowland's article, the action, aimed at making patients appear sicker than they were, was often done "without the knowledge of the patients themselves."

Ormsby, the piece continued, "discovered 90 percent of diagnoses for cancer were invalid, as were 96 percent for stroke and 66 percent for fractures."

The government suit against Sutter was filed in U.S. District Court in California as part of a broader government crackdown on abusive billing practices. Sutter is the parent company of Ormsby's former employer, the Palo Alto Medical Foundation, which has 1,600 doctors.

The government still has a similar case against Kaiser Permanente pending — and, the article says, "lawsuits also are playing out in federal arts against UnitedHealth Group, Cigna and Anthem. The government's Office of Inspector General has audited Human and found it overfilled the government."

Kaiser and United Healthcare have denied any improper conduct; the others haven't commented.

Rowland's story talks about byproducts of the abuse. "Patients' medical records, padded with false diagnoses, are inaccurate. That could unnecessarily stigmatize patients who were improperly deemed obese, or malnourished, or mentally ill. It introduces potential phantom influences on treatment decisions, critics say."

More information on abuses in the medical system 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, May 27, 2022

New supply-chain shortage is heightening anxiety for many patients in U.S. worried about cancer

A Covid lockdown in China could cause long delays in cancer imaging in the United States.

According to a story by Reed Abelson in yesterday's editions of The New York Times, a nationwide shortage of iodinated imaging agents needed for CT scans — a procedure "that relies on a special dye often injected into patients to better visualize their blood vessels, intestines and organs like the kidney and liver" — may be prompting "hospitals to ration these tests except in emergencies."

The problem was the closing of one specific Shanghai plant stemming from a lockdown aimed at quelling a coronavirus outbreak, the latest example of the U.S.'s "vulnerability to disruptions in the global supply chain."

Abelson's article goes on to say that "as many as half the nation's hospitals are affected by the shortage." 

Some 50 million exams with contrast agents are performed annually in the United States.

The Times piece says that while noting that "someone with a stroke or heart attack" also may not be able to get an angiogram because of the dye shortage, Dr. Robert Califf, U.S. Food and Drug Administration commissioner, told a Senate committee the situation is "just unbelievable."

The article additionally quotes Dr. Jamie McCarthy, chief physician executive at Memorial Hermann Health System, a large Houston hospital group, as saying, "The hits just keep on coming in this pandemic in the supply chain."

Dr. William Dahut
And Dr. William Dahut, chief scientific officer for the American Cancer Society, also was quoted to the effect that the lack of contrast dye in an exam can make it more difficult to diagnose cancer.

Some patients, the Times piece contends, "may be able to have an MRI in place of a CT scan or have the exam performed without contrast. Still, for many patients, "the shortage leaves them in limbo."

Dr. Shikha Jain, a Chicago oncologist, says the shortage and resultant delays are "definitely causing more stress for patients." 

Dr. Matthew Davenport, vice chair of the commission on quality and safety for the American College of Radiology, likened the situation to the current scarcity of baby formula.

More information about treatment problems 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, May 24, 2022

New study out of Stanford University suggests Covid brain fog and chemo brain might overlap

Researchers say Covid brain fog may mirror chemo brain — and Alzheimer's.

The major premise of a new study, according to a recent story by Ariana Eunjung Cha in The Washington Post, is that the brain inflammation in so-called long Covid is similar to that in cancer patients.

Dr. Michelle Monje
The study by Stanford University neuroscientist Dr. Michelle Monje, the article states, "is part of a crucial and growing body of research that suggests similarities in the mechanisms of post-covid cognitive changes and other long-studied brain conditions, including 'chemo brain,' Alzheimer's and other post-viral syndromes following infections with influenza, Epstein-Barr, HIV or Ebola."

Avindra Nath, intramural clinical director of the neurological disorders and stroke unit of the National Institutes of Health, declares that "there is humongous overlap" between long-Covid and those other conditions.

Monje, the Post article says, "was fascinated" to find similar brain changes among patients with chemo brain and Covid brain fog. "It was really quite striking," she's quoted as saying.

In cancer patients undergoing treatment, the article notes, a malfunction in brain cells that serve as the organ's surveillance and defense system, cells known as microglia, is "believed to be a cause of the fuzzy thinking that many describe. Scientists have also theorized that in Alzheimer's disease, these cells may be impeded, making it difficult for them to counteract the cellular war and tear of aging."

The study by Monje, a MacArthur "genius" grant recipient, involved her collaborating with Akiko Iwasaki, a Yale University immunobiologist who's become one of the leading voices on the coronavirus, and David Putrino, director of rehabilitation innovation for the Mount Sinai Health System in New York. 

The Post story also reports that "another team of researchers from Harvard and Johns Hopkins University School of Medicine have highlighted how both in Covid-19 and chronic fatigue syndrome, too many oxygen molecules pile up in a cell — possibly resulting in inflammation that leads to cognitive issues."

In addition, Cha's article points out that "an examination of brain autopsy tissue by a Columbia University professor from 10 patients who died of Covid-19 turned up a molecular change bearing the distinct signature of Alzheimer's." 

More information about chemo brain 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, May 14, 2022

Covid could be responsible for a future health-care crisis — not catching cancers early enough

The Covid pandemic has dramatically disrupted cancer screenings, putting thousands of lives in danger.

That's the conclusion of a recent story by Dylan Scott on the vox.com website.

Dr. Steve Serrao
The article quotes Dr. Steve Serrao, chief of gastroenterology and hepatology at Riverside University Health System in Loma Linda, California, as predicting that "the delayed diagnoses of various cancers and other chronic, life-threatening illnesses…will be the next crisis that overwhelms the U.S. health system."

In regard to the possible surge of advanced chronic diseases, Serrao says, "I don't think our systems are ready."

According to Scott's story, the pandemic "dealt a crushing blow to the preventive services that can catch potential health problems before they become life-threatening."

The piece cites figures from 2020, the most recent year for which complete statistics are available, that show colonoscopies dropped by nearly half from the year before, prostate biopsies fell more than 25 percent, and new diagnoses over all "declined by 13 percent to 23 percent, depending on the cancer."

Dr. Brian Englum
The story also quotes Dr. Brian Englum, a University of Maryland surgeon who co-authored a new study in "Cancer," an American Cancer Society journal, as saying that "I think we are in uncharted territory. There are no examples I know of where we have seen numbers change this dramatically."

Just how bad is the situation? Scott contends that "even a four-week delay in treatment is associated with a 6 to 13 percent higher risk of death."

He also maintains that research has shown that "people who have skipped appointments or didn't get screenings or care may be less likely to seek it in the future, and the problems could compound."

Englum says that while "we've already lost a lot of people," nobody knows "how many of these cases are out there."

More information about waves of 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.

Tuesday, April 19, 2022

AP story suggests liquid biopsies may be 'a new frontier in cancer screening for healthy people'

Liquid biopsies, or blood tests that look for cancer by checking for DNA fragments shed by tumor cells, are being billed "as a new frontier in cancer screening for healthy people."

A story in this week's San Francisco Chronicle by Associated Press medical writer Carla K. Johnson notes that these tests already are being "used in patients with cancer to tailor their treatment and check if tumors come back."

But one California-based company, Grail, is promoting the $949 test, the article says, "as a way to detect tumors in the pancreas, ovaries and other sites that have no recommended screening method."

Most insurance companies do not cover the cost, and the tests are being marketed "without endorsements from medical groups or a recommendation from U.S. health authorities," Johnson's piece says.

The Associated Press also observes that Federal Drug Administration "authorization, clearance or approval of such tests is required by law, but the agency historically has not enforced most regulatory requirements for ones – like Grail’s – that are designed, manufactured and used within a single laboratory."

The story quotes FDA spokesman Jim McKinney as reporting that the agency is working with Congress on legislation "to update the regulatory framework, which would include active oversight for such tests."

Although Grill intends to get FDA approval, it currently is marketing its test "as it submits data to the agency."

Meanwhile, Johnson's piece says, "U.S. government researchers are planning a large experiment — with 200,000 participants and possibly lasting seven years — to see if the blood tests can live up to the promise of catching more cancers earlier and saving lives."

Dr. Lori Minasian
"They sound wonderful, but we don't have enough information," the story quotes Dr. Lori Minasian of the National Cancer Institute's Division of Cancer Prevention, who is involved in planning the research. "We don't have definitive data that shows that they will reduce the risk of dying from cancer."

Whereas screening tests — mammography, PAP, colonoscopy, for example — look for one cancer at a time, claims Dr. Joshua Ofman, an executive at Grail, the new blood tests look for many cancers at once, a definite advantage.

More information on testing for 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.

Wednesday, March 30, 2022

Depression and suicide rates jump for patients diagnosed with cancer, two new studies indicate

Two new studies have found cancer patients are at a higher risk for depression and suicide.

According to a story this week by Jessica Wapner in The New York Times, the "findings make a compelling case for oncologists to have more discussions with  their patients about mental health struggles."

A caption with the story notes that one of the studies found "suicide rates among people with cancer were notably higher in the United States than in Europe, Asia or Australia." 

Dr. Corinna Seliger-Behme
The article quotes Dr. Corinnas Seliger-Behme, a neurologist at Heidelberg University in Germany, as saying, "Probably, we can prevent suicide if we talk about it, and if we really start that early."

Seliger-Behme and a colleague reviewed in their report "28 studies that included more than 22 million cancer patients across the world. Their analysis showed that the suicide rate as 85 percent higher for people than the general population."

Cancers with the worst prognoses, like stomach and pancreatic cancers, had the highest rates while the diseases with the best prognoses, including prostate, non-metastatic melanoma and testicular cancers, had the lowest.

The study's authors, according to the story, speculated that "the high cost of health care" in the U.S. might had led some patients "to forgo treatment to avoid bankrupting their families." The authors also wondered if easy access to firearms may have contributed to the higher suicide rates.

In the other new study, Alvina Lai, PhD, an associate professor at University College London, and a colleague examined health records of about 460,000 people in Britain with 26 different cancers. Five percent were diagnosed with depression, with the same number diagnosed with anxiety, after their diagnoses.

Alvina Lai, PhD

"Patients with brain tumors, prostate cancer, Hodgkin's lymphoma, testicular cancer and melanoma were most likely to hurt themselves," Wapner's piece reports.

Moreover, about 25% of the patients suffered from substance abuse — and psychiatric issues "tended to increase over time, even years after a diagnosis."

The biggest risk factor for developing a mental health condition, according to the story, was to those undergoing the triple-threat approach of surgery, radiation and chemotherapy. "The length, intensity and cumulative side effects… could explain why it triggers depression, anxiety and even personality disorders in many people," the article contends.

Chemotherapy on its own, it continues, is "also tied to high rates of psychiatric disorders, whereas 'kinase inhibitors' — targeted drugs that often have fewer side effects — had the lowest rates."

Dr. Lai wonders "whether patients are given enough opportunities to weigh the psychological risks of potential treatments," the story states. She's quoted as maintaining that "it would be useful for cancer patients who are newly diagnosed to see what the data tell us and make an informed decision."

Testicular cancer "carried a higher risk of depression than any other cancer type, affecting 98 of every 100 patients," according to her study, an unexpected result.  

Dr. Nathalie Moise, professor of medicine at Columbia University's Vegelos College of Physicians and Surgeons, suggests that while "current treatment guidelines suggest screening for depression as part of routine cancer care," these findings "may support the need to also screen for suicide and other risk factors."

More on the mental state of patients 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.