Monday, June 26, 2023

Because of shortage of $15 drug, doctors being forced to choose which cancer patients will live

"The shortage of a $15 cancer drug is upending treatment," says a story by Christina Jewitt in today's editions of The New York Times.

The result, the story indicates, is that physicians are being forced "to put a priority on the patients who have the best chance of survival." 

Oncologists fear "that the alternatives to two crucial chemotherapy drugs [cisplatin and carboplatin] are far less effective in treating certain cancers, and are sometimes more toxic," the article continues. 

Patients with ovarian, testicular, breast, lung, and head and neck cancers are particularly at risk.

The two main drugs, the story says, "are deployed in frontline medicines in cocktails used to shrink or eliminate tumors [but] more than a dozen cancer drugs are also officially in short supply, as well as hundreds of other medications, including antibiotics and sterile injectable fluids." 

It is likely that the shortages will continue for some time, probably "through the fall or later" — despite the easing on restrictions on imported drugs from China. 

Part of the reason for the shortages was the closing of a plant that was a main producer of the more popular drugs.

Dr. Angeles Alvarez Secord
The Times piece quotes Dr. Angeles Alvarez Secord, a professor at the Duke University School of Medicine and president of the Society of  Gynecologic Oncology, as saying, "We're in a situation where patients are being left behind."

Although cisplatin and cargoplatin are inexpensive ($15 and $23 per vial), few companies make them because their manufacture "requires a reliable supply of platinum…as well as a sterile plant and special controls to protect workers from the drugs' toxic effects."

Patients with ovarian cancer face "the worst outlook," according to Dr. Ravi Rao, an oncologist at the cCare Center in Fresno, California, where the absence of the drugs means a patient with an extensive case "has odds of survival that fall to the single digits from about 30 percent."

The shortage "will lead to people dying," he added. "There is no way around it. You cannot remove these lifesaving drugs and not have bad outcomes." 

More information on crucial drugs 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, June 17, 2023

Author/N.Y. Times essayist points to possibility of lengthy extended life for cancer patients

A revolution in cancer treatment — involving multiple drugs — may be within the grasp of modern medicine. 

That's what's posited in a guest essay in The New York Times this week by Kate Pickert, author of Radical: The Science, Culture, and History of Breast Cancer in America.  

The author starts off by citing as an example a woman who's been kept alive, despite having metastatic cancer, for nine years by taking "a series of eight drug regimens…including three as part of clinical trials." The patient in question, she reports, "switches from one medication to another when it becomes clear that a treatment doesn't work or has stopped working because her cancer has figured out how to resist its efforts."

This approach, the writer says, "is increasingly becoming a standard of care for patients facing diagnoses that were once death sentences." For those patients, she adds, "cancer is more like a chronic disease than a one-time catastrophic event."

What's happening now is in no way proclaiming that a cure for cancer is imminent, but acknowledging instead that "the landscape for many cancer patients has changed tremendously in just the past five years," her Times essay declares.

Dr. Jedd Wolchok
The article quotes Dr. Jedd Wolchok, oncologist and director of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine: "The pace of progress is most certainly accelerating. There are so many things converging."

At the end of her piece, Pickert talks about her own situation (she's had chemotherapy, drug treatment, and radiation for breast cancer) and notes that if her cancer returns, "which is unlikely at this point, I will benefit from a wide array of drugs — many of which were approved in the past five years."

Within 24 hours of the Times column, a story by Katherine Ellison appeared in The Washington Post that totally supports the idea of cancer becoming a chronic, treatable disease. 

That concept alone can lower anxiety, and that relief is crucial for cancer patients who are all too aware that more than 600,000 Americans are expected to die of the disease this year.

Despite that statistic, the Post story proclaims, "even some of the most fearful cancers today are increasingly survivable — provided they're addressed with care and vigilance that may span months to years to a lifetime."

That notion's addressed by positive numbers, the article proffers, explaining that of the 18 million U.S. residents with a history of the disease, "for many of them, cancer has become less an imminent threat than a chronic illness, serious but not necessarily deadly."

More good news? The death rate from all cancers, according to an American Cancer Society report released in January, is down almost a third since 1991.

Ellison's story quotes Lidia Chapira, breast-cancer expert and medical professor at Stanford University: "We're not quite there yet, but we're moving closer to the situation we have with HIV patients, in that today even people with incurable cancers may be living for decades. I'm still treating patients who were diagnosed decades ago, while my colleagues are seeing people in their 50s and 60s who had cancer as children."

Information on newer drugs 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 caregivers. 

Monday, June 12, 2023

Uterine cancer, and its deaths, increasing — particularly among Blacks, Hispanics and Asians

Uterine cancer is on the rise, especially among black women.

That's the conclusion of a study reported by Toni Caryn Rabin in editions of The New York Times a while back.

According to the story, "cancer of the uterus, also called endometrial cancer, is increasing so rapidly that it is expected to displace colorectal cancer by 2040 as the third most common cancer among women, and the fourth-leading cause of women’s cancer deaths."

The study, published in JAMA Oncology, showed that the "mortality rate has been increasing by almost 2 percent a year overall, with even sharper spikes among Asian, Hispanic and Black women," Rabin's article notes.

Uterine cancer, she continues, "was long believed to be less common among Black women. But newer studies have confirmed that it is not only more likely to strike Black women, but also more likely to be deadly."

According to a report from an expert panel convened by the American college of Obstetricians and Gynecologists, "Black women die of uterine cancer at twice the rate of White women," the story asserts.

One of the major problems blocking early detection is that "few women are aware that a change in menstrual bleeding, before or after menopause, is one of the main warning signs, along with pelvic pain and painful urination and intercourse," the article says.

Dr. Shannon Westin
Dr. Shannon Westin, a gynecologic oncologist at the university of Texas MD Anderson Cancer Center in Houston, is reported as saying that "when she first started caring for women with uterine cancer, there were about 39,000 new cases a year. Now, there are more than 65,000 — and she has been in practice only 15 years."

Those figures, she indicates, present "a clear indicator we should be ringing the alarm bells."

Dr. Carol Brown, a gynecologic oncologist, senior vice president and chief health equity officer at Memorial Sloan Kettering Cancer Center in New York, calls the surge in cases an epidemic. 

"The striking statistic is that right now…the number of women who will lose their lives to endometrial cancer in the U.S. is almost the same as those who will die of ovarian cancer, which is unbelievable to those of us in practice for the last 30 years," she's quoted as saying.

More information on studies with surprising results 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 5, 2023

Cancer patients are confronting widespread shortages of chemotherapy drugs, paper reports

The lives of cancer patients are being put at risk by record-high shortages of effective chemotherapy.

That's the main point of a story by Rene Ebersole in today's editions of The Washington Post.

Dr. Satyajit Kosuri
The story quotes Dr. Satyajit Kosuri, clinical director of the stem cell transplant and cellular therapy program at the University of Chicago, to the effect that the "majority are cheap, generic drugs that have been utilized in cancer medicine for decades." 

At the end of 2022, the story says, "there were 295 active medication shortages, ranging from antibiotics and anesthetics to cardiac medications and chemotherapy drugs." 

The increase was 30 percent above the previous year, according to a Homeland  Security and Governmental Affairs report.

Chemo drugs, "particularly those used to treat kids' cancers," Ebersole's piece asserts, "are among those medications experiencing some of the most prolonged shortages, says Dr. Yoram Unguru, a pediatric hematologist-oncologist at the Children's Hospital at Sinai and the core faculty, Johns Hopkins Berman Institute of Bioethics."

Unguru also is quoted as saying, "We don't have alternatives…This isn't strep throat or some other infection where if I don't have amoxicillin, I can swap it out for something that's probably if not as good, almost as good."

The drug shortage crisis stems in part from "low profit margins on generic drugs, an overreliance on foreign manufacturing, increasing quality risks, and brittle supply chains," the story contends. 

Dr. Yoram Unguru
Drugs in short supply, Unguru notes, are "older, generic injectable drugs that companies don't get a huge profit on." 

Because of that low profit factor, few companies make them.

"One recent meta-analysis found that a four-week treatment delay," the story continues, "can be associated with increased sickness or mortality for more than 40 percent of common cancers, including bladder, breast, colon, and lung cancer."

More information about Big Pharma and drugs 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.