DNA trials may end mammograms, colonoscopies

Doc expects blood tests that predict cancer recurrences to have major effect on millions

In the not-so-distant future, a single blood test may be able to locate cancer.

Dr. Salvatore Iaquinta

At least that's the prediction of Dr. Salvatore Iaquinta, "Highway to Health" columnist for the Marin Independent Journal and a surgeon at Kaiser Permanente San Rafael.

Noting in a recent piece headlined "Closing in on cancer" that "we already have blood tests to monitor for cancer recurrences," Iaquinta forecasts the end of mammograms and colonoscopies.

Biomarkers "that expose the presence of otherwise invisible recurrences," he indicates, are already known for "certain ovarian, prostate, breast, liver and pancreatic cancers."

The same applies to some thyroid cancers.

But researchers at Johns Hopkins, he notes, have now "announced their success developing a 'liquid biopsy' — a blood test to screen for cancer DNA."

And "for patients with colon cancer, the screening test found about 90 percent of all stage 2, 3 and 4 cancers."

Iaquinta adds that it was almost as important that false positives didn't result.

And although the experimental tests for breast, lung and ovarian cancers didn't fare as well, they did find "at least 45 percent of stage 1 cancers for each of these tumor types," he writes.

Researchers at Stanford, the doctor maintains, "have done the same sort of profiling with some types of lymphoma."

And the "Institute of Cancer Research in London also found a tumor DNA for breast cancer and has announced they can detect recurrent disease eight months before standard tests reveal it."

In the meantime, a different group at Stanford "used a similar test to detect the effect of chemotherapy on women being treated for breast cancer. They found that a blood test could predict how the tumor was responding to treatment within two weeks of the start of treatment, far earlier than the standard methods."

The experimental process is not yet available to the general public and is still expensive, Iaquinta explains, "because of the cost of DNA sequencing. But like everything else tech, the price will come down as scientists find easier, faster ways to run the tests."

He concludes that "the ability to detect multiple cancers from a simple blood draw will have a profound effect on millions, and ultimately billions, of lives."

More information about experimental drugs and treatments can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

New chemotherapy plan echoes AIDS deal

2 major drug manufacturers slash prices to help fight cancer in six poor African countries

In a deal similar to the one that turned the tide against AIDS, manufacturers and charities will make chemotherapy drugs available at steep discounts, according to a recent story by Donald G. McNeil Jr. in The New York Times.

Two major pharmaceutical companies —  Pfizer and Cipla, based respectively in New York and Mumbai— are working with the American Cancer Society to make it happen, the story indicates. 

They've apparently agreed to charge "rock-bottom prices for 16 common chemotherapy drugs," McNeil's piece says — "just above…manufacturing costs."

As an add-on, top American oncologists plan to "simplify complex cancer-treatment guidelines for under-equipped African hospitals, and a corps of IBM programmers will build those guidelines into an online tool available to any oncologist with an internet connection," the story continues.

Dr. Anthony S. Fauci

The piece also quotes Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, that "this gave me goose bumps. I think this is a phenomenal idea, and I think it has a good chance of working."

Fauci said it reminded him "of his work in 2002 helping design the President's Emergency Plan for AIDS Relief" — a plan that's been successful (24 million Africans are currently on HIV drugs).

Cancer, the story says, "now kills about 450,000 Africans a year. By 2030, it will kill almost 1 million annually, the World Health Organization predicts." 

Most common African cancers, it continues, "are the most treatable, including breast, cervical and prostate tumors."

But in contrast to the United States, where 90 percent of women with breast cancer survive at least five years, in Uganda, "only 46 percent do; in Gambia, a mere 12 percent,"  McNeil's story asserts.

One major African problem is that there are few cancer specialists. 

For example, in Ethiopia, one of the six countries that will be covered by the new agreement, there are "only four oncologists for its 100 million citizens," according to the Times piece. "Nigeria has about 40 for its population for 186 million."

Uganda has only 16 oncologists "and its only radiotherapy machine…has been broken for over a year. Before its 21-year-old gears gave out, the machine's cobalt source had become so week that irradiation sessions meant to last minutes took an hour."

Caution about how well the program will work is being urged.

According to McNeil's story, "even with cheaper drugs, progress against cancer in Africa will be slower than it was against AIDS, all parties to the deal warned" — partially because cancer "comprises an entire family of diseases," unlike AIDS, which "is caused by a single pathogen that can be suppressed, albeit not cured, with a daily three-drug pill."

More information on cancer drugs and treatments 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.

Recurrence foils woman's try to thank med team

Breast cancer survivor buys 26 Gaga tickets to thank support system but dies before concert

Life is filled with sad ironies.

Such as the recent case of a breast cancer survivor spending $10,000 to buy 26 tickets to a Lady Gaga concert in Washington, D.C., to thank her medical team and family-and-friends support system, only to die three months before she could attend.

According to news reports, Melissa Anne Dabas, 42, passed away listening to a Lady Gaga song while holding hands with her anesthesiologist husband, Jay.

Melisa Anne Dabas and her sons.

The Virginia mother of two boys, a super-fan of the pop singer, had been diagnosed with triple-negative breast cancer in the spring of 2016, underwent a double mastectomy and chemotherapy, and was declared cancer-free.

But the disease returned.

The tickets included 18 box seats valued at $1,500 each. Her family decided to raffle off 10 of them to benefit their newly established Melissa Ann Dabas Charitable Trust, an adjunct of the Winchester Medical Center Foundation's Angel Fund.

The aim? To help cancer patients with non-medical expenses.

The concert is scheduled for Nov. 19. Jay is planning to go with their two sons — Avinash, 11, and Sajan, 8 — and is planning to take a large photo of his late wife so she, in a sense, can be there.

Jay wrote on his Facebook page that raising funds via the raffle may "help me keep her voice and spirit and legacy alive."

A story by Petula Dvorak in The Independent, a British publication, quotes him as saying, "I'd get home from work, and she'd tell me all these stories — not about herself but how these people were having a hard time buying food. Or who's going to pay the rent? These people were all having a difficult time covering the non-medical expenses of cancer. Cancer doesn't discriminate, it doesn't only affect people who are able to pay. And this really bothered her. And it was something she never got to do anything about."

To learn more about the disease, its treatments and its aftermath, check out "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

Cheat misspells doc's name on fraudulent form

Woman who feigned disease owes 652 hours of community service to cancer facilities

You could call it poetic justice.

A Colorado judge has imposed, in my opinion, a fitting sentence (and fine) on a female postal worker who faked cancer and was convicted of fraud.

Judge Raymond Moore

According to a story by Alex Horton in the Washington Post that was reprinted in many newspapers across the country, U.S. District Judge Raymond Moore recently sentenced Caroline Boyle to "serve 652 hours of community service at a cancer treatment center, cancer research center or hospice — which is precisely how many hours of falsified sick leave she took" from the U.S. Postal Service office in Aurora, Colorado.

The judge also imposed five years of probation (including six months of home confinement with an electronic monitor, "along with a $10,000 fine and restitution of exactly $20,798.38, acting U.S. Attorney for Colorado Bob Troyer said in a statement."

The figure represented what the 60-year-old Boyle, who had worked for the postal service since 1991, was paid for administrative sick leave while missing two years of work after claiming "that cancer attacked her white blood cells and ravaged her immune system, leaving Boyle too weak to come into work."

Bob Troyer

Boyle's illegal acts were discovered partially because she'd misspelled a doctor's name and botched the signature when she scribbled a note "presumably detailing [her] non-Hodgkin's lymphoma," Horton's story said.

She reportedly confessed when confronted with proof of her misdeeds.

Boyle had intended "to continue defrauding the government with sick leave until her retirement in April, which she planned to celebrate with a Hawaiian cruise."

Real facts about real diseases, their real treatments and real aftermaths are contained in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

'Veep' star finishes 2nd round of chemotherapy

Julia Louis-Dreyfus utilizes Instagram to update followers about breast cancer treatments

Julia Louis-Dreyfus, the Emmy-winning star of "Veep" and "Seinfeld," has borrowed pop sensation Katy Perry's lyrics from the 2013 hit "Roar" to update fans about her breast cancer treatments.

Louis-Dreyfus, who'd announced in September that she'd been diagnosed with the disease, had used her condition to call for universal health care in the United States. 

Now, giving credit to Perry and "Veep" co-stars Timothy Simons and Tony Hale "for their hilarious and loving inspiration," she used Instagram to spread the news — comically — that she'd finished her second round of chemotherapy and is ready to continue her battle.

Her posting included a photo of her wearing a black hoodie, sunglasses and a hand-drawn mustache, and she wrote, "'I've got the eye of the tiger. The Fighter dancing through the fire cuz I am a champion and you're going to hear me ROAR."

Her initial announcement had asserted that "1 in 8 women get breast cancer. Today, I'm the one," then cited a support system led by her family and friends and noted that she had "fantastic insurance through my union."

The 56-year-old star's declaration came a day after this year's Emmy award ceremony in which she won her sixth consecutive statue, setting the record for the most victories for a performance by the same actress in the same series.

The five-year survival rate for breast cancer is now 90 percent, according to the American Cancer Society.

More information about cancer treatments 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.

$373,000 per regimen for new treatment

FDA gives its okay to a second gene therapy that can send blood cancer into remission

The FDA has approved a new gene therapy for adults with aggressive non-Hodgkin's lymphoma.

According to a recent story by Denise Grady in The New York Times, Yescarta was okayed for patients who've undergone two regimens of chemotherapy that failed.

The Times article notes that the therapy "is part of the rapidly growing field of immunotherapy, which uses drugs or genetic tinkering to turbocharge the immune system to fight disease. In some cases the treatments have led to long remissions."

The therapy, which turns cells into "living drugs," is made by Kite Pharma.

Approval by the Federal Drug Administration was its "second in a radically new class of treatments that genetically reboot a patient's own immune cells to kill cancer."

The first was Kymriah, made by Novartis. It was okayed in August "for children and young adults with an aggressive type of acute leukemia."

That one costs $475,000 per dose, although the company has said "it will not charge patients who do not respond within the first month after treatment."

Yescarta isn't quite as expensive — $373,000 per treatment.

Dr. Frederick L. Locke

Dr. Frederick L. Locke, a leader of a study of Yescarta (and a specialist at the Moffitt Cancer Center in Tampa in blood cancers), is quoted as saying, "We're excited. We think there are many patients who may need this therapy."

Grady's story says "about 3,500 people a year in the United States may be candidates for Yescarta," which is intended "to be given once, infused into a vein, and must be manufactured individually for each patient."

Side effects, as with many therapies, can be daunting.

Life-threatening issues that stem from the Yescarta treatment can include "high fevers, crashing blood pressure, lung congestion and neurological problems," the story indicates.

According to Grady, two patients in the study that led to the drug's approval, "died from side effects," although doctors — through training and experience — apparently "have learned to manage them better."

The study, which was conducted at the Dana-Farber Cancer institute and Brigham and Women's Cancer Center in Boston, involved 111 patients at 22 hospitals.

"Initially," Grady's piece delineates, "54 percent [of the 101 who received Yescarta] had complete remissions…Another 28 percent had partial remissions [and] after six months, 80 percent…were still alive. With a median follow-up of 8.7 months, 39 percent of the 101 were still in complete remission — a much higher rate that achieved with earlier treatments — and 5 percent still had partial remissions."

Dr. Caron A. Jacobson

Says Dr. Caron A. Jacobson, who helped do the study: "You're really seeing people get their life back. After a couple weeks in the hospital and a couple weeks at home, they go back to work. On its face, it's quite remarkable and revolutionary."

The treatment, the Times explains, "was originally developed at the National Cancer Institute, by a team Dr. Steven Rosenberg led. The institute entered an agreement with Kite in 2012, in which the company helped pay for research and received rights to commercialize the results."

The drug giant Gilead reportedly bought Kite two months ago for $11.9 billion.

"In just several decades, said Dr. Scott Gottlieb, the FDA commissioner, "gene therapy has gone from being a promising concept to a practical solution to deadly and largely untreatable forms of cancer."

A look at many treatments and clinical trials can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

African-American health care being undermined

Breast cancer mortality rate remains higher for whites than blacks, new study shows

Despite strides in meds and treatments, black women are still at a much greater risk of dying from breast cancer.

A recent story on the Huffington Post website by Suzy Strutner points out that while total survival rates for the disease are improving, a new study shows a huge gap remains. 

The new report, from the American Cancer Society, finds that "breast cancer death rates declined 39 percent between 1989 and 2015" but whites have a 39 percent greater chance of survival than blacks."

The gap, the study says, "emerged in the early '80s, widened through 2015 and has remained steady since."

Why the gap?

Because of "biological differences in breast cancer tumors, along with health care policy."

Regarding the latter, Strutner's story indicates that "unequal access to preventive screenings and treatment" includes black women getting mammograms "slightly more often than white women nowadays, but they had lower screening rates in the past, which 'may be one possible reason for the difference in survival rates today,' according to the Susan G. Komen website."

Not to mention "access to follow-up care [possibly differing] among the races."

Beth Glenn, Ph.D.

The HuffPost story goes on to explain that "less screening means black women might wait longer between  mammograms, be diagnosed late or be unable to follow up altogether when a mammogram comes back abnormal," according to Beth Glenn, Ph.D. associate director for the UCLA Kaiser Permanente Center for Health Equity.

Besides, "for black women who live in poverty, clinics might be too far away," the story adds. 

Christine Ambrosone, Ph.d.

The story also quotes Christine Ambrosone, cancer prevention chair at the Roswell Park Cancer Institute, about poverty blocking black women from care: "Things like transportation for cancer treatment can be a barrier, particularly for women who need radiation therapy, a treatment that needs to be given daily, and who cannot get that time off from work."

Strutner also cites "racial discrimination in health care settings."

As to the biological differences, her HuffPost story says "black women are twice as likely to be diagnosed with triple negative breast cancer, an aggressive form that's harder to treat. And tamoxifen, a drug that's hugely responsible for the overall improvement in death rates, treats another type of breast cancer, called hormone-receptor-positive breast cancer, that black women are less likely to get."

At the same time, Strutner's story indicates, Native American, Latina and Asian women all have lower rates of breast cancer and death from the disease than white women.

It also cites the report mentioning the states of Massachusetts, Connecticut and Delaware as managing to "close the gap, likely by widening health care access so it's easier for everyone to get treatment when they need it" — including Massachusetts passing "a health care reform that requires all residents to have health insurance and offering free health insurance to poor residents who qualify."

The story quotes Glenn as saying that "in general, states with more coverage for low-income women tend to have better outcomes."

Further information on different situations for different races 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.

How high-risk men's lives may be extended 37%

UK clinical trial shows that two prostate cancer therapies can be much better than one

Can combining two existing therapies extend the life of men with advanced, high-risk prostate cancer by 37%?

A new study seems to answer that question with a "yes."

Nicholas James

"These are the most powerful results I've seen from a prostate cancer trial," reported Nicholas James, professor of clinical oncology at Queen Elizabeth Hospital in Birmingham, United Kingdom, lead author of an abstract presented to the American Society of Clinical Oncology, in a recent story by Jessica Glenza in The Guardian. 

It's a "once in a career feeling," he noted. "This is one of the biggest reductions in death I've seen in any clinical trial for adult cancers."

Researchers, the Glenza story indicated, "combined standard hormone therapy with a drug called abiraterone, which is typically used only for cancer patients whose disease has stopped responding to standard hormone therapy."

Patients who received both medications did have "slightly stronger side effects," however — "especially cardiovascular and liver problems."

The study, which looked at a group of 2,000 men, was done as part of an ongoing randomized trial conducted in the United Kingdom and Switzerland.

James also was quoted as saying that "abiraterone not only prolonged life, but also lowered the chance of relapse by 70% and reduced the chance of serious bone complications by 50%."

More than 27,000 men in the United States, and 11,000 men in the UK, die of prostate cancer each year.

Details about many clinical studies on cancer 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.