Sunday, March 10, 2019

Stop sugary drinks and lessen your risks 46%

Yale study finds daily diet soda might lower risk of colon cancer recurrence — and death

Drinking diet soda every day can be particularly beneficial for those who've beaten colon cancer.

A new study by Yale University researchers, according to a story by Nyssa Kruse of The Hartford Courant a while ago, found that patients who drank it "were less likely to see a recurrence and less likely to die than those who didn't drink diet soda."

The study analyzed 1,018 patients, determining that "those who drank one or more 12-ounce artificially sweetened drink a day saw a 46 percent improvement in risk."
Dr. Charles S. Fuchs
Kruse's story quotes Dr. Charles S. Fuchs, director of the Yale Cancer Center, as calling the findings "exciting" — after noting that "artificially sweetened drinks have a checkered reputation in the public because of purported health risks that have never really been documented." 

The researchers attributed half the benefit of diet drinks "to patients substituting diet sodas for drinks full of sugar," the Times story indicated.

In a separate cancer study, unrelated to soda, Yale researchers found cancer patients who used complementary treatments (such as yoga, acupuncture and homeopathy) alongside traditional treatments such as chemotherapy "were more likely to die than those only using traditional treatments" — because they'd be likely to refuse a component of traditional treatment.

Details on other 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, March 2, 2019

Did patients get risky cancer pain drugs?

Documents given to N.Y. Times describe federal failure to block restricted opioid prescriptions

When risky cancer pain drugs were prescribed for patients of other diseases who couldn't tolerate them, the federal government did little or nothing to stop the practice.

That, at least, is the conclusion of  a recent story by Emily Baumgaertner in The New York Times.

Baumgaertner's piece maintains that although the fast-acting class of fentanyl drugs had  been approved only for cancer patients with high opioid tolerance, it was "prescribed frequently to patients with back pain and migraines, putting them at high risk of accidental overdose and death, according to documents collected by the Food and Drug Administration."

The FDA had established "a distribution oversight program in 2011 to curb inappropriate use of the dangerous medication, but entrusted enforcement to a group of pharmaceutical companies that make and sell the drugs," the article asserts.

The Times also notes that "some of the companies have been sued for illegally promoting other uses for the medications and in one case even bribing doctors to prescribe higher doses."

Some 5,000 page of documents were provided the Times after being "obtained by researchers at the Johns Hopkins Bloomberg School of Public Health through the Freedom of Information Act."

The story about the so-called offline prescribing quotes Dr. Andrew Kolodny, an opioid policy researcher at Brandeis University who wasn't involved in the investigation, as saying, "They had the fox guarding the heinous, people were getting hurt — and the FDA sat by and watched this happen."

FDA officials counter that stance by claiming they had only piecemeal data, which "made it difficult for the agency to measure potential harm to patients."

Dr. Janet Woodcock
One official — Dr. Janet Woodcock, the director of the Center for Drug Evaluation and Research at the FDA, was specifically quoted as believing a stricter oversight program "would be 'extremely onerous.'"

She contends, furthermore, that "all drugs have risks and cause harm."

The class of  drugs in question "contain a narcotic up to 50 times stronger than heroin and up to 100 times stronger than morphine," the Times story indicates.

The drugs are expensive. One prescription for a month's worth, Baumgaertner's story says, "can cost more than $30,000."

Details on investigations into other drugs 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.

Monday, February 18, 2019

Valsartan, larsartan, irbesartan risks cited

Finding cancer-causing contaminants causes FDA to recall blood-pressure drugs 

Millions of bottles of generic blood-pressure meds have been recalled after a contaminant that causes cancer was found.

According to a recent story on the website, the Federal Drug Administration (FDA) ordered the recall after determining that folks who've taken certain hypertension meds over the past four years may have been exposed to small amounts of impurities following a change in the way companies manufacture the active ingredient.

The carcinogens, the article continues, "are a chemical byproduct of the process used to synthesize the active ingredients in medicines, which includes valsartan, losartan and irbesartan."

Agency leaders, the story says, have estimated that "between 1 and 2 million people may have taken the drugs with the impurities."

The recalled products, a USA Today story says, "are part of a large class of drugs called angiotensin II receptor blockers, or ARBs, which relax blood vessels. Many of these commonly prescribed drugs are not part of the recall."

But, overall, "the risk to individual patients remains very small, although this doesn't diminish the significance of this episode or our concerns," read a joint statement from FDA Commissioner Scott Gottlieb and FDA Director Janet Woodcock.

David Light
David Light, founder and chief exec officer of Valisure, an online pharmacy that chemically validates the drugs before shipping them to consumers, said "companies may not be cleaning the active ingredients as a cost-saving measure," noting, too, that "it would not have been unexpected that the synthesis process would cause pollutants."

Details on risks of drugs that might worsen medical conditions can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a book that I, Woody Weingarten, aimed at male caregivers.

Tuesday, February 12, 2019

Bills can be as bad for patients as side effects

Lack of money may adversely impact health of cancer patients, says AARP article

Surviving cancer may depend on what's in your savings account.

At least that's the conclusion of an article by Peter Moore in an edition of "AARP: The Magazine" a while back.

The piece suggests that average costs for the disease "run in the $150,000 range."

Why so much?

Moore postulates that "containing the cancer and killing [the] abnormal cells without damaging nearby healthy cells often requires a range of treatments, over an extended period of time — lengthy radiation, complicated surgeries, costly chemotherapy, plus other strong medications to supercharge your immunity."

Although new treatments emerge with regularity, he writes, "with new hope comes even more cost: 11 or the 12 cancer drugs that the Food and Drug Administration approved in [a recent year] were priced at more than $100,000 [annually.]"

Even with a good insurance policy, "a patient is probably looking at a bill of more than $4,000 in deductibles and co-pays."

Patients, of course, must often cope as well with "loss of income during months of treatment and recovery," not to mention travel and lodging expenses "at a cancer-centric health facility."

Plus the costs of myriad follow-up tests.

Moore notes that "not only are cancer patients two and a half times as likely to declare bankruptcy as healthy people, but those patients who go bankrupt are 80 percent more likely to die from the disease than other cancer patients, according to studies from the Fred Hutchinson Cancer Research Center in Seattle."

Dr. Gary Lyman
The AARP story also quotes Dr. Gary Lyman of that center: "For many patients, when they get the bills, it can be as bad as some of the side effects of the disease or the treatment."

Moore entertains the idea that many patients don't discuss their financial fears with their doctors, fearing such action could "compromise their treatment."

The result of that silence and fears, or from a patient lying because he or she couldn't afford to follow a prescribed regimen?

"Doctors [don't] know that their patients might take their pills less often than prescribed [and/or] avoid follow-up therapies or tests."

More details about what else impacts cancer patients psychologically 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.

Tuesday, February 5, 2019

600 old medical tests, treatments still used

Physicians have big trouble unlearning outmoded practices, New York Times writer claims

The public is paying more because it's hard for physicians to unlearn what they were taught long ago.

That — along with the notion that "procedures live on even after they've been proved ineffective," which "can lead to harms and wasted resources" — is the contention of a recent story in The New York Times by Dr. Aaron E. Carroll, a pediatrician.

The article leans on a review in JAMA Pediatrics magazine of "medical literature related to overuse in pediatric care" — finding "that we still recommend that children consume commercial rehydration drinks [that] cost more, when their drink of choice would do," that we "give antidepressants to children too often," that "we induce deliveries too early, instead of waiting for labor to kick in naturally," and that "we get X-rays of ankles looking for injuries we almost never find."

Overuse, the article maintains succinctly, "is rampant. And it can harm patients."

The Times specifically cites an initiative of the American Board of Internal Medicine Foundation, "Choosing Wisely," which it says is "entirely focused on the identification of care that physicians routinely recommend but shouldn't."

Almost 600 tests, procedures or treatments collected over six years, it claims, "are currently listed on their website. Almost all the recommendations basically say 'don't do' them."

But the public "shares some culpability," Carroll's story says: "Americans often seem to prefer more care than less."

Professional organizations are also to blame, the piece contends, because they "seem better at telling physicians about new practices than about abandoning old ones."
David Niven
Carroll asks David Niven, lead author of an earlier study, why it's so tough for docs to "discontinue certain practices. The researcher says "physicians have a hard time unlearning what they have learned, even when there's newer and better science available [in part] because they work within a system that doesn't adapt well to changing evidence."

More details on medical community attitudes toward treatments and tests 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 26, 2019

'Precision medicine' altering treatment focus

FDA clears pricey oncology therapy drug for multiple cancers with a shared mutation

The federal Food and Drug Administration has approved a drug, Vitrakvi, for a wide range of cancers based on a shared mutation.

According to a recent Washington Post story by Laurie Mcginley that was reprinted in newspapers across the country, the decision shifts treatment focus away from tumor location, apparently "an advance for the sometimes controversial field of 'precision medicine.'"

The FDA action on Vitrakvi (aka larotrectinib) marks the second treatment to receive the agency's "clearance based on a common biomarker found in an array of cancers."

The approval was given simultaneously for adults and children, contrary to the more typical FDA action regarding oncology drugs whereby kids are not considered until much later than adults.

Vitrakvi is intended, Mcginley's story says, "for patients with advanced solid tumors containing what's called an NTRK gene fusion, a hybrid of two genes that can promote uncontrolled cell growth. Cancers of the thyroid, lung and head and neck, among others, can be caused by the defect."

Dr. Scott Gottlieb
According to a story in the online magazine Healio, Dr. Scott Gottlieb, a FDA commissioner, notes that approval of the new site-agnostic oncology therapy "marks another step in an important shift toward treating cancers based on their tumor genetics rather than their site of origin in the body."

The breakthrough drug (that was tested in three clinical trials), the Washington Post piece adds, "is for patients whose cancer has spread or who would experience severe complications by undergoing surgery and have no satisfactory alternatives."

Precision medicine has spawned both enthusiasm and skepticism, partially because both the drugs and the tests can be quite expensive.

The drug's manufacturer, Loxo Oncology, Inc., and its partner, Bayer, announced that "the wholesale acquisition cost will be $32,800 for a 30-day supply of capsules for adults. The cost for the liquid formulation for children…will start at $11,000 per month."

Patient affordability "is one of the big barriers to precision medicine right now," McKinley quotes Carolyn Presley, a geriatric oncologist at Ohio State University Comprehensive Cancer Center, as saying. "Show me the money — how are you going to pay for it?"

Elizabeth Jaffee, Johns Hopkins oncologist, nevertheless predicted that precision medicine "is going to be the way to treat cancer in the future," the Washington Post story reports.

More information on research into cancer 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, 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.