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.

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.

Why? 

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.

Jury verdict against agribusiness is upheld

Judge slashes punitive award against Monsanto but still blames its Roundup for cancer

A San Francisco Superior Court judge has drastically cut a monetary award against Monsanto but kept a verdict that can mean real trouble for the St. Louis-based agribusiness.

Judge Suzanne Bolanos 

Judge Suzanne Bolanos upheld a jury's verdict that its weed killer, Roundup, "caused a groundskeeper's cancer" through its active chemical ingredient, glyphosate. 

She did so at the same time, according to a recent Associated Press story by Paul Elias, that she slashed the amount of money to be paid to the man from $289 million to $78 million."

While denying Monsanto's request for a new trial, Elias' piece says, she cut the jury's punitive damage award from $250 to $39 million.

His story says that her decision in effect confirms the jury's view that Monsanto "had purposely ignored warnings and evidence that its popular Roundup product causes cancer, including DeWayne Johnson's lymphoma."

In a tentative ruling on Oct. 11, Bolanos had said it appeared to her that the jury had overreached with punitive damages.

She also had indicated, the AP story says, that she might erase the entire $250 million judgment — because she found "no compelling evidence presented at trial that Monsanto employees ignored evidence that the weed killer caused cancer."

But Bolanos clearly reversed herself in yesterday's ruling "and said the jurors appeared to agree with Johnson's expert witness, Dr. Chadi Nahban, who concluded that [Roundup] caused the groundskeeper's cancer."

Some jurors had been "so upset by the prospect of having their verdict thrown out that they wrote to Bolanos," the AP story reported.

"I urge you to respect and honor our verdict and the six weeks of our lives that we dedicated to this trial," the San Francisco Chronicle quoted juror Gary Kitahata as writing.

And Robert Howard, another juror, said he and his fellow jurors had paid "studious attention" the evidence and "any decision to overturn its verdict would shake his confidence in the judicial system," the Associated Press story again quotes the Chronicle.

The final $39 million for punitive damages was the same amount the jury had awarded Johnson for other damages.

Monsanto now faces the prospect of going to trial in hundreds of other cases already filed that allege Roundup has caused cancer — and upwards of 5,000 other instances.

Elias' story notes that "Johnson had sprayed Roundup and a similar product, Ranger Pro, at his job as a pest control manager at a San Francisco Bay Area school district, according to his attorneys. He was diagnosed with non-Hodgkin's lymphoma in 2014 at age 42."

He allegedly had applied the weed killer as many as 30 times a year.

Bolanos gave Johnson until Dec. 7 "to accept the reduced amount or demand a new trial," the AP article reports. The plaintiff's spokesperson, Diane McKinley, said that "although we believe a reduction in punitive damages was unwarranted and we are weighing the options, we are pleased the court did not disturb the verdict."

Punitive damages, the story adds, "are designed to punish companies that juries determine have purposely misbehaved and to deter others from operating similarly."

More information on lawsuits about products allegedly causing 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.

When are drug costs and side effects too much?

Study shows new hope for some breast cancer patients through immunotherapy drugs

Breast cancer for a long time was in effect immune from immunotherapy. That apparently is no longer the case.

According to an Associated Press story by Marilynn Marchione this week, one of the new immunotherapy drugs "has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease."

For the first time.

There's a big caveat lurking in the researchers' labs, however: "The benefit for most women was small."

And that, according to Marchione's story, raised questions "about whether the treatment is worth its high cost and side effects."

Results of the new study — which tested a drug from Roche called Tecentriq — were discussed at a cancer conference in Munich and published by the New England Journal of Medicine.

The type of drugs in question, called checkpoint inhibitors, have previously been found helpful in treatments of many other cancers "by removing a chemical brake that keeps the immune system from killing tumor cells."

Their discovery, in fact, recently earned scientists a Nobel Prize.

Dr. Michael Hassett

Side effects of the chemo and Tecentriq, which costs $12,500 a month, included nausea and low blood cell counts, similar to other treatments.

The story quoted Dr. Michael Hassett of the Dana-Farber Cancer Institute in Boston, who didn't take part in the study, as saying "he felt 'cautious excitement' that immunotherapy may prove helpful for certain breast cancer patients."

Details about other research on and treatments for 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.

Fighting the virus that spreads through sex

Federal regulators boost their OK on use of cervical cancer vaccine from age 26 to age 45

U.S. regulators have expanded the use of Merck's cervical cancer vaccine, Gardasil 9, to adults up to age 45.

The vaccine, according to a recent story by Linda A. Johnson of the Associated Press, was previously approved only for preteens and young adults through 26.

Johnson's article notes that the vaccine protects against the human papilloma virus, or HPV, which can cause cervical cancer, certain other cancers and genital warts — and that the virus is "very common and is spread through sex."

HPV, it goes on to say, "doesn't cause any problems, but some infections persist and eventually lead to cancer."

Johnson also writes that the Centers for Disease Control and Prevention estimated about 14 million people become newly infected with HPV each year, mostly teens and young adults" — and adds that 33,700 are diagnosed annually with a cancer caused by an HPV infection.

The latest version of the pharmaceutical giant's vaccine protects "against nine strains of HPV, four more than the original" did in 2006, the story indicates.

Details about other new vaccines and drug, and other Federal Drug Administration action, 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.

'Fundamental change' in treating tumor cells

Nobel Prize goes to American, Japanese working separately on cancer immunotherapies

Two researchers who worked on game-changing therapies that unleash brakes against cancer have won 2018's Nobel Prize for medicine.

James P. Allison (left) and Tasuko Honjo

The pair — Dr. James P. Allison of the MC Anderson Cancer Center in Houston and Dr. Tasuko Honjo of Kyoto University in Japan — found "checkpoint inhibitor" therapies that "greatly increased survival of cancer patients and may produce even greater results when combined with traditional therapies," according to an online story this week by Tina Hesman Saey in ScienceNews, the nonprofit magazine of the Society for Science & the Public.

The article indicates that "all previous types of cancer therapy were directed at the tumor cell, but Allison's and Honjo's approach was to remove brakes that keep the immune system in check."

The two, who were working separately, will equally share the prize of just over $1 million.

An earlier piece by Saey and Aimee Cunningham in ScienceNews noted that they had identified proteins that act as brakes on tumor-fighting T cells.

A Reuters story said the "scientists' work in the 1990s has since swiftly led to new and dramatically improved therapies for cancers such as melanoma and lung cancer, which had previously been extremely difficult to treat."

Treatments known as immune checkpoint blockade that resulted from their work, the piece added, "'have fundamentally changed the outcome' for some advanced cancer patients," the Nobel institute said."

The discoveries consequently spawned a multi-billion dollar market for new cancer medicines.

Reuters quoted a professor at the Institute of Cancer Research in London, Kevin Harrington, as contending the two scientists' work had revolutionized cancer treatment:

"We've gone from being in a situation where patients were effectively untreatable to having a range of therapy options that, when they work, work very well indeed," he said in a statement. "For some patients we see their tumors shrink or completely disappear and are effectively cured."

More information on 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.

New insights, treatments, tests in disease 'war'

Medical community is starting to believe less is more when it comes to cancer treatments 

More and more doctors and patients apparently are using less aggressive weapons to fight cancer these days.

Dr. Justin Bekelman

A story by Laurie McKinley in yesterday's Washington Post quotes Dr. Justin Bekelman, a radiation oncologist at the University of Pennsylvania, about the medical community's focus on the "war on cancer."

Historically, he says, that phrase "implied that more is better and decimation is desired."

McKinley's story contends, however, that the idea is "falling out of favor," not only because it "subtly blames patients" who die "but also because it doesn't capture a world of new biological insights, improved treatments and molecular tests that are transforming how cancer is treated."

According to Bekelman, "Knowing when not to treat" can be "great medicine" — because, the story charges, oncologists equipped with new tools and evidence can cut back on toxic and costly approaches likely do more harm than good.

Cancer, nevertheless, is not monolithic, the story indicates.

Rather, some cancers "need to be bludgeoned, but others can be treated with more tailored therapies or simply watched."

Although the latest mindset of "doing less in the face of danger" can be "emotionally difficult" for both patients and physicians, the article notes, proof that less is more has been frequently popping up lately, including a landmark clinical trial published in June that found more than "two-thirds of women with early-stage breast cancer can safely avoid chemotherapy." 

Not to mention the fact, according to the piece, that "men with early-stage, low-risk prostate cancer are rapidly embracing 'active surveillance' over surgery — and avoiding possible complications such as incontinence and sexual dysfunction," and that throat cancer caused by human papilloma virus, because it varies from other types of the disease, allows a cutback "in a brutal treatment regimen and [reduces] the risk of potentially devastating disfigurement."

The Post story also mentions the emergence of immunotherapy, usually less toxic than chemo, "as a first-line treatment for many patients," and cites a recent study showing that "people with advanced kidney cancer can skip surgery to have their kidneys removed and instead go right to drug treatment."

De-escalation isn't happening universally, however. 

McKinley contends that the "most common form of thyroid cancer, which poses little risk, is often still treated with unnecessary surgery, experts say. And some malignancies, such as pancreatic cancer, are so lethal that doctors are racing to find ways to ramp up treatment."

Details on trends and clinical trials in treatment 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.

TV star joins disease-awareness initiative

Julia Louis-Dreyfus happily returns to  Emmy-winning 'Veep' role after breast cancer

Instagram selfie with 'Veep' crew.  

TV stalwart Julia Louis-Dreyfus, who'll undoubtedly remember her breast cancer diagnosis and treatments for the rest of her life, is happily back at work at HBO's satirical "Veep."

And she's also involved in her first cancer-awareness initiative.

According to an Associated Press story by Leanne Italie today, the 57-year-old star says it feels "fantastic" to be acting again.

Louis-Dreyfus disclosed her cancer diagnosis last September, shortly after having garnered her sixth consecutive Emmy Award for her Selina Meyer role.

According to the AP, the seventh and last season of "Veep," which will air in the spring, evoked this from the former "Seinfeld" co-star: "I feel good. I feel strong. I've got energy and, yeah, back o my old tricks. It feels like I never left."

Her wading into the cancer-awareness waters, the piece continues, comes through her "helping Carolina Herrera designer Wes Gordon design a flower-adorned T-shirt as part of Saks Fifth Avenue's 20th year raising money through its Key to the Cure program."

Over two decades, the program has donated almost $40 million to cancer research and treatment organizations.

All proceeds from the shirt that will sell for $35 during October, which for decades has served as Cancer Awareness Month, reportedly will go to the AiRS Foundation, which the AP describes as "a nonprofit Louis-Dreyfus supports for its work in helping women with the costs of breast reconstruction after mastectomy."

The shirt features three poppies (in red and pine tones) and a slogan: "We are fighters & we are fighting for a cure."

Noted the actor about the design process, "It was a super-fun endeavor," elaborating that she "wanted it to have a sort of femininity and a powerful message at the same time because I believe the two can go hand in hand. I liked the idea of talking about fighting."

Regarding reconstruction, she'd noted that "up to 70 percent of breast cancer survivors who have had a mastectomy are really unsure or unaware of their reconstruction options, and many of those women who desire to have surgery don't have sufficient insurance or other resources to cover it."

Regarding her participation in the awareness program, she said that while she now was "putting my whole self into Key to the Cure," she'd previously been "very careful about managing my time and conserving my energy. You can't spread yourself too thin."

After going under the knife for breast cancer, Louis-Dreyfus had been perhaps a bit less eloquent and a bit more dramatic. She'd written on Instagram, "Hoorah! Great doctors, great results, feeling happy and ready to rock after surgery. Hey cancer, f**k you!"

More details about both reconstruction and awareness 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.