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Plague of Prostate Cancer
October 7th, 2011
The lead article in today’s New York Times, “U.S. Panel Says No to Prostate Test for Healthy Men,” provides the latest scientific advice on a screening test for prostate cancer known as a P.S.A. blood test. Experts are now advising against the test as a routine measure for healthy men over 50 years old. The test can detect cancerous cells, but it also provides false positives that lead to unnecessary and often dangerous medical follow ups. In addition, prostate cancer is often very slow growing, and men often succumb to other diseases. That’s not to say that prostate cancer isn’t still a plague in our society. It’s the most common form of cancer among men after skin cancer. And one in three men generally develop it after age 50. Before then, it is very rare. The panel’s ruling is already getting tangled up in politics. Republicans are quick to complain about healthcare rationing, and they might suggest that failure to give a P.S.A. blood test is the first sign of it. On top of that, the P.S.A. screening process has become a lucrative business, and stopping the test will have negative economic implications. Whatever happened to those days when science was respected, and people followed scientists’ recommendations? Of course, I guess I shouldn’t be surprised when half our nation still doubts global climate change despite the unmitigated scientific evidence of its existence. When Doctors Do Too Much
February 9th, 2011
The lead article in today’s New York Times, “Lymph Node Study Shakes Breast Cancer Treatment,” shows what happens when doctors overtreat their patients. It describes a recent study that found a common procedure for breast cancer victims, the removal of lymph nodes in their armpits to prevent its spread, makes no difference in the survival rate for a large number of women. According to the article, women who are undergoing chemotherapy or radiation treatment for breast cancer show no difference in survival rates whether or not the lymph nodes are removed, a procedure that has been followed for 100 years. And the removal of these nodes can cause serious complications in about 20 percent of the cases, including numbness, shoulder pain and limitation of motion. Still, the article described a reluctance among many, both doctors and patients alike, to cut out the treatment. It appears a lot easier to add more procedures when indicated by a study than it is to remove them. Anyway, science marches on. The scientific method is no respecter of persons or opinions and is based solely on experimentation and neutral evaluation of the results. According to this process, the removal of armpit nodes for women undergoing radiation and chemotherapy for breast cancer is no longer necessary. A Cure for Cancer?
November 5th, 2010
The lead story in The New York Times this morning, “Scans Cut Deaths by Lung Cancer Among Smokers,” represents a major breakthrough in the ongoing struggle against this dread disease. While we all dream of waking up one day and reading the ultimate good news headline, “Cancer Cured,” in the real world, it has become more of an incremental situation. That makes today’s story very encouraging because the death rate by lung cancer outstrips every other in its prevalence, including breast cancer. Scientists found that subjects who underwent a regular CT scan experienced a death rate 20 percent below those who didn’t. As opposed to a regular chest x-ray, CT scans use coordinated x-rays to create a three-D image. They allow earlier detection of the disease, a key step for survivors of a disease that results in a 85 percent mortality rate. The study followed 53,000 people who smoked the equivalent of a pack of cigarettes every day for 30 years. Called the National Lung Screening Trial, it was conducted by the American College of Radiology Imaging Network and the Cancer Institute. Further analysis is required to determine more details about exactly what type of person the study helped, but it is an encouraging sign of progress. The only qualification represents a number of “false positives” generated by regular CT scans. These false positives are generally benign but can lead to a lot of anxiety and unnecessary exploratory surgery. Tainted Drugs
October 27th, 2010
The lead article in today’s New York Times, “$750 Million Fine for Drug Maker of Tainted Goods,” represents the first time a drug company, GlaxoSmithKline, has been held liable under a whistle-blower law for faulty medications. The questionable products include the popular Paxil, an anti-depressant medication, Avandia for diabetes and Tagamet for acid reflux. The problems occurred at a manufacturing plant in Puerto Rico. The drug industry has always presented itself in a high and mighty way, with one of the most powerful lobbyist groups in Washington. They avoided much taunted legislation for large health organizations to bargain and thus reduce the price of their products. The fact that, for the first time, they have been penalized for rather shocking conditions, will hurt the entire industry. This lawsuit represents the first decision of many pending cases and could represent the beginning of an avalanche of decisions upholding the rights of ordinary citizens for minimal quality control in this unique field. When you are not well, you at least want to have the assurance that the medication you get from the pharmacy will work as promised. The article also notes that whistle-blowers earn part of the award in any settlement. In this case, Cheryl Eckard, a former employee who was dismissed when she raised legitimate concerns about the Puerto Rico plant, will receive $96 million. Avandia Off the Shelf
September 24th, 2010
The lead article in today’s New York Times, “F.D.A. to Restrict a Diabetes Drug, Citing Heart Risk,” shows that consumer protections do work even if they take a little time to kick in. The article describes a coordinated, and simultaneous, decision by the European Union and the United States to severely restrict access to Avandia, a drug once widely used to control the sugar level of people with type two diabetes. The use of Avandia is totally suspended in Europe and severely restricted in the United States to those already taking it or who have testified they have tried everything else. The article finds that GlaxoSmithKline, the pharmaceutical company that developed Avandia, restricted information about its side effect of increasing the risk of heart attacks for years, and the data was only found after it had been legally forced to post the results of clinical trials on its web site. The F.D.A.’s decision occurred only after its powers over drug companies had been expanded in 2007 legislation, and the decision was seen as a continuation of the Obama administration’s effort to increase the focus on drug safety. One side note due to the impending elections — one wonders if the Republicans’ laissez-faire attitude towards big business would have led to this decision if they were in charge. There are some times when regulatory decisions are necessary in otherwise free markets. Stem Cell Research Shocker
August 24th, 2010
Lead article in today’s New York Times: Judge Calls Halt to Stem Cell Aid Backed by Obama The decision by a judge yesterday to halt embryonic stem cell research authorized by the Obama administration came as a shock to scientists in the field but represented a return to the rule of law passed by Congress regardless of your perspective on the debate. The ruling by Chief Judge Royce Lamberth of Federal District Court described the current practice of funding the creation of stem cells — through the destruction of embryos — with private money, then using federal funds for research, using those new stem cells, with public money. Judge Lamberth said that the distinction was meaningless since the research required the initial destruction of stem cells to proceed. It represented a direct interpretation of the law whatever your side in the stem cell debate. The law, the Dickey-Wicker Amendment, prohibits federal financing for “research in which a human embryo or embryos are destroyed, discarded or knowingly subjected to risk of injury or death.” It is passed every year by Congress. Those who support stem cell research, a highly controversial issue, should lobby to get the law changed. And much as I support the Obama administration, an executive order should not be used to contravene a law, only to interpret it. Alzheimer Scientists Don’t Forget
August 13th, 2010
The lead story in The New York Times this morning, “Rare Sharing of Data Led to Results on Alzheimer’s,” describes the unique collaborative efforts required to discover how to reach an early diagnosis of Alzheimer’s disease, basically a willingness to share all data and tests over the Internet, giving up any intellectual property or patent rights among a large group of scientists. The scientists worked with drug companies and government agencies to create an unprecedented full-court press and even allowed the public, whom they were previously afraid would misinterpret the data, to follow the experiments. The National Institute of Health helped to coordinate all the groups and Foundation for the National Institutes of Health helped to provide funding. The effort was labelled ADNI, the Alzheimer’s Disease Neuroimaging Initiative. The success of this effort so far — they’ve already discovered a 100-percent way to detect the disease using PET scans and spinal fluid — shows how far we can go when we work together instead of at cross-purposes. We can literally reach the moon. The research structure created for Alzheimer’s is already being considered as a model for a similar campaign on Parkinson’s disease. I think it should be considered in other areas of endeavor as well. How about the U.S. Senate for a start? If Republicans could just give up their blanket opposition to anything proposed by the President, we could negotiate and do wonders to improve and transform our society in a way we could all agree on. Hope Against H.I.V.
July 20th, 2010
The lead story in today’s New York Times, “2 African Studies Give Women Hope in Fighting H.I.V.,” describes a two-pronged approach in battling the disease in sub-Saharan Africa where the majority of people infected is women. The methods suggested are an internal microbicidal gel applied by women prior to sex and the institution of small monthly cash payments to poor girls that result in behavioral modifications. The new medication, called tenovir, can reduce infection by up to 54 percent. The cash payments of $4 to $10 a month to the parents plus $1 to $4 a month for the girls if they attend school reduce the prevalence of H.I.V. to 1.2 percent compared to 3 percent for the general population. This suggests the role of money and gifts in decisions by poor girls in African culture to have sex. This story provides the rare good news piece featured in The New York Times lead in recent memories, with the exception of the news about capping the oil gusher by BP. One must remember the very different nature and character of the disease in Africa, both in degree — where it has swept through the region like a plague — and the nature — where it does not carry the stigma of infecting primarily gay men. In some areas, up to 1 in 10 pregnant women are H.I.V. positive by the age of 16, and half have the disease by age 24. And the other good news concerns the cost. After final approval for public distribution in a year or two, the “semi-vaccine” — it’s not 100 percent effective — will cost about 25 cents per application. A Cure for Cancer?
August 14th, 2009
The lead article in today’s New York Times is titled, “Finding on Drugs May Help Fight Against Cancer.” It involves a new breakthrough on isolating and trapping cancer stem cells so they can be tested with a variety of medications. The discovery was made by a group affiliated with Harvard-M.I.T. genomics research. After its achievement, the group tested the isolated cancer stem cells with 16,000 chemicals, including those used in standard chemotherapy, and found 32 that went after cancer stem cells selectively. 31 of these 32 chemicals had never been used in any form of cancer therapy before. I guess most people dream about opening the paper one day and reading a headline that says “cancer cured.” I know a lot of progress has been made to fight specific types of cancer, such as breast cancer and lung cancer, and that’s why these generic treatments that go right to the root of the disease are so encouraging. According to the article, however, we should temper our optimism. The scientific camp is split about the importance of stem cancer cells versus cancer cells, especially whether you can just treat the stem cells while ignoring the regular ones. Some also think that, unlike other mature cells, mature cancer cells can revert back to the stem form. Personally, I’m an optimist. I’ve also read about other targeted approaches based on a person’s individual genome. The importance of these breakthroughs is their progress in our continuing fight to eliminate the scourge of cancer from mankind. This fight may seem slow and incremental, but the forward movement has been sustained for many years. |
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