Articles Posted in Cancer

Prostate-e1492269148971-483x1024A burst of bad headlines and not so great news reports may have confused some men. But to put it in lay terms:  The use of the common test for routine prostate cancer screening got a dim grade of C for many men, up from a dismal D, in a re-evaluation by independent experts who assess the nation’s preventive medical services.

That blunt review of regular prostate-specific antigen (PSA) tests, despite some reports to the contrary, keeps with how the influential U.S. Preventive Services Task Force (USPTF) looked at annual  screening for this most common form of cancer for men when it issued its first guidelines in 2012, notes

The health information site says the USPTF earlier had surprised many, downgrading routine prostate cancer screening to a D, and noting, “There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.” It now says it rates a C for many men younger than 70, meaning physicians should “Offer or provide this service for selected patients depending on individual circumstances,” and that “There is at least moderate certainty that the net benefit is small.” Americans ages 18 to 59 may be infected with the human papilloma virus (HPV) than previously had been known, with 1 in 4 men and 1 in 5 women carrying high-risk strains, federal experts say.

The new findings from the Centers for Disease Control and Prevention may become a key part of campaigns to get more parents to vaccinate youngsters against HPV infections. They have been found to cause cervical cancer and have been tied to cancers of the throat, anus, and male and female reproductive organs.

HPV-related cancers are on the rise, and it is concerning that the CDC found that almost half of Americans’ are infected. But public health leaders have confronted ignorance and adult prudery—by physicians, public officials, and parents—as they try to get boys and girls, ages 11 and 12, inoculated and protected against the virus.

Mick_Mulvaney_Official_Portrait_113th_Congress_cropped-249x300The  Trump budget for the federal government would be a huge step back from investment in medical research with consequences for many years in progress on promoting health and fighting disease.

The budget announcement, tilted so far toward guns over butter, proved so challenging to even members of Trump’s own controlling party that lawmakers hastened to underscore that Congress, and not the chief executive, theoretically, holds  the nation’s purse strings.

The president would boost allocations for the military by more than $50 billion, and significantly increase spending for homeland security, with billions for his proposed border wall as well as more customs and immigration agents nationwide. He would gut almost 80 federal programs, providing support for everything from the arts and public broadcasting to home weatherization, rural economic development, legal services for the poor, and meals on wheels food services for the old and sick.

vaping-300x200Some young users are experimenting with different ways to vape, modifying their e-cigarettes to increase the smoke and the high—and raising more concerns about the health harms of this hot pastime.

Researchers say they found that a quarter of the 1,800 or so of the youthful vapers they studied engaged in a practice dubbed “dripping.” They altered their e-cigarettes to expose the normally sealed heating element, and then they poured flavored vaping liquids directly on it. That created a bigger puff of smoke, which, when inhaled, produced a more intense high from the blast of nicotine and other chemicals vaporized from the flavored liquids.

This practice also potentially exposes them more to addictive nicotine and cancer-causing substances, especially byproducts that result from high-heat vaporizing of the flavored liquids, the researchers reported in their study, published in the medical journal Pediatrics. hear some powerful proponents tell it, Uncle Sam needs to really hurry up the government’s approval of drugs and medical devices. He’s got to make oversight over them easier, lighter, and less complex.

But consider just some of the health news in recent days:

Female_black_symbol-200x300Modern medicine isn’t addressing women’s distinctive health care needs as optimally as needed, with research further showing it may be time to dial down expectations about breast cancer screening, while heightening physicians’ awareness and best practices in eliminating gender biases.

Women also may want to keep close tabs on how changes with the Affordable Care Act affect them, and they may be well-served to remind themselves about Texas’ sudden surge in maternal deaths and one of health care’s major, gender-based debacles in hormone treatments for females.

Over-treatment tied to mammograms

breastIt’s described as an “aggressive, costly, morbid, and burdensome” surgery that often lacks “compelling evidence” that it contributes to patients’ “survival advantage.” So why are increasing numbers of women  deciding to have both their breasts removed when doctors detect early stage cancer in one breast?

New research, based on a questionnaire and follow-up with more than 2,400 women, recommends that surgeons be clearer and more direct about treatment options and outcomes with breast cancer patients. That’s because 17% of respondents said, incorrectly, that they think that removing the other healthy breast in a woman with cancer in one breast helps prevent the disease’s recurrence, while almost 40 percent said they didn’t know this procedure’s effects.

Researchers found that many women—including more than 40 percent of their respondents—with breast cancer contemplate the surgery known as contralateral prophylactic mastectomy (CPM), and that sufficient numbers of surgeons may not explain why it may be inappropriate for them. Their study has been published in the peer-reviewed Journal of the American Medical Association Surgery. As the Los Angeles Times reported:

Senators-on-aging-committee-300x172Congress must stop Big Pharma predators from ripping off American consumers by acting like hedge funds, buying up decades-old, off-patent drugs and jacking up prices on long-standing “gold standard” prescription medications, a Senate committee has recommended after a bipartisan industry investigation.

The Senate Special Committee on Aging, chaired by Maine Republican Susan M. Collins and with ranking member Claire McCaskill, the Democrat from Missouri, (both seen in photo above) ended 2016 by issuing its scathing critique of companies like Valeant, Turing Pharmaceuticals, Retrophin, and Rodelis Therapeutics. Those companies and their ilk buy out other firms to control drugs long on the market to treat conditions like: parasites that afflict HIV-AIDS patients, kidney stones in those with a rare disease, drug-resistant tuberculosis, and heart and other medications for those with an uncommon inherited ailment. As soon as they seize control from others, who often had borne the big costs to research and develop drugs for which patents had expired, Valeant, Turing, Retophin, and Rodelis sent the medications’ cost through the roof.

After examining their practices for a year and hearing from their sometimes smirking and resistant executives (notably the smug “pharma bro,” aka Turing’s Martin Shkreli), senators described their skyrocketing product pricing with words like: egregious, predatory, and immoral. As USA Today bluntly described the senators’ findings with its story headline: “Senate report shows Martin Shkreli is just as bad as you think he is.”

Celebrity is a powerful force in public opinion, and it often has been pursued by medical experts eager to tap its do-good potential. But a pair of recent star turns on preventive testing have caused consternation over their unintended and unwelcome outcomes. Have Angelina Jolie and Ben Stiller led their fans astray, prompting some to misunderstand the best, most current, evidence-based thinking on cancer care and others even to undergo unnecessary, invasive, and costly screenings?

New research, published in the peer-reviewed and well-respected British Medical Journal (aka the bmj), examined the aftermath of Jolie’s disclosure, in a New York Times Op-Ed three years ago, that she had been tested and found to carry the BRCA gene mutation that predisposes some women to breast and ovarian cancer.

She urged women to be screened for BRCA and told how, prophylactically, she had decided to undergo a double mastectomy and reconstructive surgery. She said she did not make this decision lightly and did so only based on her mother’s early cancer death and after Jolie received extensive medical counsel. To Jolie’s credit, her Op-Ed was thoughtful, careful, and nuanced. It was more disclosure than advocacy by one of the globe’s mega-stars, partly explaining her prolonged absence from the spotlight’s glare. Although the piece said the BRCA mutation is not common and the decisions can be complex about surgery and other means to deal with its potential effects, did that message get through?

cancer immunoThe news media enthusiasm for novel treatments, especially for cancer, has been on full display: Stat, the online health news site, has just written about one patient, a noted ophthalmologist, and how he had a favorable outcome with a lingering hospital acquired infection—not due to antibiotics but after  treatment with viruses a researcher found in a nearby pond. Multiple news organizations, meantime, have reported extensively on one woman with advanced colon cancer and how she benefited from her unique genetics and cultivation of her tumor-fighting cells to experience, for now, a recovery of rare extent. The New York Times devoted thousands of words in a multi-part series about the rise of immunotherapy, medical care in which the body’s own disease-fighting capacities (see illustration of T-cell attacking a cancer cell, right) are mobilized and which Washington Post has called the “hottest field in cancer treatments.

This isn’t a knock at any one reporter or news organization. It’s vital for the media to keep audiences advised about work on the frontiers of science and medicine. Gee-whiz stories can play a key function in capturing fickle public attention and keeping it focused on a critical concern like health care, a sector that comprises 17.5 percent of the U.S. GDP. But caution and skepticism may be in real order about therapeutic innovations, especially in cancer. As the health news watchdog organization points out, “too many [news] stories ignore or under-report the harms of cancer immunotherapies.” The New York Times deserves some credit for balancing its hefty reporting on this issue with a detailed report on unexpected outcomes, particularly harms, from this approach:

These so-called immunotherapy drugs have been hailed as a breakthrough in cancer treatment, attracting billions of research dollars and offering new hope to patients out of options. But as their use grows, doctors are finding that they pose serious risks that stem from the very thing that makes them effective. An unleashed immune system can attack healthy, vital organs: notably the bowel, the liver and the lungs, but also the kidneys, the adrenal and pituitary glands, the pancreas and, in rare cases, the heart.

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