Disease rates plummet to lowest point since 1988

Where does Marin, once home of the worst breast cancer rate in the world, stand now?

I've been waiting a year for yet another shoe to drop.

That, I learned long ago, is what happens with almost every bit of research, but especially those concerning breast cancer. 

Flip-flopping in the cancer industry has become de rigueur.

The most recent shoe drop came at the tail of 2015 when a then-new report indicated breast cancer rates in Marin County — which previously had been believed to be a cluster of the disease — had plummeted to their lowest level since tracking began in '88.

That decreased rate, a county report had noted, matched (instead of topping) the statewide average.

That study, of course,  contradicted earlier reports dating back to the first fallen clodhopper in 1994. The Marin rate then was called the highest in the world, according to a study by the Northern California Cancer Center (since renamed the Cancer Prevention Institute of California).

Marin's rate actually peaked in 2001, when the numbers for non-Hispanic white women had climbed 60 percent. 

Since that year, it's dropped 31 percent.

Why? 

Well, risk factors for Marin's white women have been listed as outgrowths of their being affluent — including higher alcohol consumption and the delayed age of childbearing, not necessarily in that order. 

And, until 2002, a heightened use of hormone therapy (especially an estrogen/progestin combination).

When those hormones were abandoned as treatment, the cancer rates began to descend. 

Quickly.

Despite the obvious connection, few would risk verbally pinpointing why the severe dips had occurred — or why the rates had actually been so high in the first place.

Dr. Mary Mockus, a principal researcher with the Marin Women's Study, long-term, county-led breast cancer research involving nearly14,000 women, did say she thought earlier detection and increased patient awareness had helped.

At the same time, authors of the study discounted any influence changes in mammography screenings might have had. 

Rose Barlow

The decade-old Women's Study, according to its website, is currently researching established risk factors, effects of pregnancy, adolescent risk factors, environmental agents and risk prediction.

That research organization, not incidentally, won a reprieve last year after my adopted home county chose not to finance additional work.

Dr. Mark Powell of Greenbrae rescued it by leaning on crowdfunding and the Avon Foundation — and partnering with several groups, including Zero Breast Cancer, a Marin nonprofit headed by Rose Barlow that I wholeheartedly endorse. 

Still, there's been no updates from the researchers recently, so I wait.

And wait. And wait.

I have a vested interest in knowing if there's a root cause in Marin — monolithic or not — because here's where my wife was diagnosed with the disease more than two decades ago.

Meanwhile, frequent flip-flopping results stemming from cancer research are well documented in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

Blacks, Hispanics, Asians lose 'huge advantages'

Minorities underrepresented in drugmaker-sponsored clinical trials on immunotherapy

Cancer patients who are people of color apparently are disproportionately being left out of experimental trials on immunotherapy.

According to a piece by Denise Grady last week in The New York Times, researchers are aware folks getting the treatments "have been overwhelmingly white."

But scientists claim they're trying to remedy the situation.

Some cancer centers are attempting to bring the trials to black, Hispanic and Asian patients instead of making those potential clinical trial participants come to them.

Immunotherapy, which the article calls "the hottest area in cancer research and treatment," involves drugs that help immune systems fight cancer.

The Times piece focuses on two major 2015 studies of "nivolumab, a type of checkpoint inhibitor, one of the most promising drug classes for cancer," and says that "patients taking it [in both tests] lived significantly longer than those given chemotherapy."

In the first case, 92 percent of the patients were white; 88 percent were in the second. Census figures for 2015 show Caucasians make up only 77 percent of the U.S. population.

According to the Times piece, researchers say studies of nivolumab may omit minority patients "because it can take longer to find and enroll them," an obstacle disliked by drug makers such as Bristol-Myers Squibb, which financed the lung and kidney studies of that particular med.

Testers, the Times article notes, claim that one major cause of the problem is that "people in minority groups tend to have lower incomes and less education, and therefore less awareness of medical studies and how to find them."

Another reason may be that many live in areas that don't have easy access to a prime cancer center.

Dr. Julie R. Brahmer

Moreover, the piece goes on to quote Dr. Julie R. Brahmer of the Johns Hopkins Kimmel Cancer Center as saying, "minority patients with cancer are more likely to have other, poorly controlled chronic diseases like diabetes, that make them ineligible for studies."

In addition, some financial hurdles may be impossible to surmount — "frequent trips to the hospital, requiring time off work and expenses for travel, parking and child care. Some doctors simply assume that lower-income, minority patients could not afford it."

The irony, the Times indicates, is that clinical trials, which usually provide expensive drugs and treatments without charge, "can be a lifeline" that offer "huge advantages" such as "new treatments that may otherwise be unavailable."

Information about cancer research 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.

BRCA1 tests increase but results are questioned

Did Angelina Jolie op-ed in N.Y. Times help women find breast cancer gene mutations?

Angelina Jolie

Although celebrities can spur women to gather information about breast cancer, the question remains how valuable resultant data will turn out to be.

Angelina Jolie is a case in point.

According to a story by Carolyn Y. Johnson this week in The Washington Post, a new study published in the British Medical Journal has indicated that additional thousands of women in the United States were tested for breast cancer gene mutations right after the actress went public about her decision to get a double mastectomy.

Her choice was based on the fact that she had BRCA1, one of the mutations that increases chances of developing breast and ovarian cancers.

The Post piece noted that "testing rates increased 64 percent in the three weeks after Jolie's [op-ed in The New York Times went viral in 2013].

But that stat, based on research at Harvard Medical School, also showed it cost about $13.5 million to do the additional 4,500 genetic tests.

Unfortunately, researchers concluded, "mastectomy rates among women who had a genetic test actually declined after the [New York Times] piece was published, suggesting the women who got the tests done weren't as likely to have the mutation."

More information about the BRCA1 and BRCA2 genes 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.

18 million premature deaths predicted

Number of smokers dips again, but addiction is now linked to 40 percent of all cancers

Smoking has now been linked to 40 percent of all cancers despite the number of smokers continuing to decline dramatically.

Malignancies, in addition to lung cancer, include throat, stomach, pancreas and liver, according to a recent story by Laurie McKinley in The Washington Post.

Tom Frieden

McKinley quotes Tom Frieden, director of the Centers for Disease Control and Prevention, as saying that although smoking rates are "at all-time lows…nearly half (the current 36 million smokers) could die prematurely from tobacco-related illnesses, including 6 million from cancer."

The article also quotes the CDC's Morbidity and Mortality Weekly Report to the effect that the number of smoking adults declined 1.7 percent last year — down to 15.1 percent.

In 2005, there were 45.1 million adult American smokers.

Ernest Hawk, vice president for cancer prevention at MD Anderson Cancer Center in Houston, also was quoted by McKinley: "Smoking is more than just a habit. It's an addiction, and it's very hard to get off any addictive substance."

I cerainly know all about that — I smoked more cigarettes than I care to remember. 

For more than 30 years.

When I finally quit, I dug a hole in my back yard, inserted an unfinished pack of Pall Malls, and declared to the skies, "I'm burying these cigarettes so I can live."

The American Lung Association, by the way, has called on Congress "to fully fund smoking-cessation efforts in states," according to the Post story.

"Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at caregivers, details a vast variety of cancer causes, proving that cancer is hardly monolithic.

Hallucinogen aids 80 percent, two studies signal

Clinical tests of shrooms show psilocybin can ease depression and anxiety in cancer patients

The salient ingredient of "magic mushrooms," it's just been discovered, can ease depression and anxiety in cancer patients.

In a story by Jan Hoffman in last week's editions of The New York Times, two studies of psilocybin are cited.

The hallucinogen, it said, significantly reduced both psychological disorders in about 80 percent of the 80 cancer patients studied.

With minimal side effects.

The response, according to the story, was "sustained some seven months after the single dose."

In both clinical trials, the Times piece indicated, "the intensity of the mystical experience described by patients correlated with the degree to which their depression and anxiety decreased."

The studies, published in the Journal of Psychopharmacology, took place at New York and Johns Hopkins universities.

Psilocybin's been illegal in the United States for more than four decades. But trials of the substance — "for alcoholism, tobacco addiction and treatment-resistant depression" — are underway in both the United States and Europe.

Trials of other illegal drugs are also underway.

Just this week, the Times said, "the Food and Drug Administration approved a large-scale trial investigating MDMA, the illegal party drug better known as Ecstasy, for post-traumatic stress disorder."

Cancer-related psychological distress, "which afflicts up to 40 percent of patients, the story went on, "can be resistant to conventional therapy."

Hoffman's article also stated that "in the 1940s and 1950s, hallucinogens were studied in hundreds of trials. But by 1970, when those drugs were placed in the most restricted regulatory category, research ground to a near halt."

However, "since about 2000, investigators have begun studying them [again], mostly with private funding."

Dr. Stephen Ross

Dr. Stephen Ross, the lead investigator and chief of addiction psychiatry at NYU, was quoted as saying, "Cancer patients with anxiety and depression need help immediately, especially if you consider that they are at elevated risk for completed suicide."

According to the Associated Press, Dr. Roland Griffiths of Johns Hopkins said "it's not clear whether psilocybin would work outside of cancer patients, although he suspects it might work in people facing other terminal conditions."

But Dr. George Greer, co-founder of the Heffter Research Institute, which funded the two studies, apparently doesn't see a commercial use for psilocybin, which is also called shrooms, purple passion or little smoke, "because these patients needed only one dose."

Instead, according to The Times, "he envisions a nonprofit manufacturer, with distribution restricted to specialized clinics."

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