Articles Posted in Cancer

brca-cancer-risk-261x300Even as a pair of prominent researchers saw their reputations crumble over controversies connected to their work, a University of Washington team showed anew the importance of rigorous, transparent, independent, and widely shared medical science  to patients, in this case those with cancer.

Let’s start with the seemingly positive take that’s accompanying publication in the journal Nature of research regarding an open database with prospectively valuable information on BRCA1 variants, what some have dubbed the “cancer risk” gene.

Everybody carries both BRCA-1 and BRCA-2 genes, named because BR stands for breast and CA for cancer. All of us have two copies of each gene, one passed down from our mother, the other from our father. The genes make proteins that help repair errors in our DNA that pop up from time to time when our cells divide and duplicate their genetic code.  Mutations in either BRCA gene can disable the repair process and make both women and men carriers of the defect susceptible to certain kinds of cancer.

juulcig-300x159Has one of the nation’s top health watchdogs awoken too late, barked too little, and, maybe won’t bite enough as Big Tobacco and its allies have addicted a generation of young people to nicotine?

Scott Gottlieb, commissioner of the federal Food and Drug Administration, captured extensive media attention by hitting the alarm button about “epidemic” vaping and teens’ use of e-cigarettes, notably the wildly trendy Juul device and others of its kind.

He said the FDA has acted against 1,300 retailers for peddling e-cigarettes and their liquid flavorings to underage customers. More key: The agency has told Juul and other leading makers that they have 60 days to show how they can keep their products out of the hands of customers 18 and younger — or the FDA may ban them from the market.

theater-228x300What’s an internist to do when an 81-year-old patient, already in failing health with advanced emphysema, seeks a second opinion because he’s been told his prostate specific antigen (PSA) levels are unacceptably high? This senior also has been advised to schedule a prostate biopsy urgently to determine if he has cancer. Can this discussion with both a scared patient — and his bright, concerned personal doctor — be any tougher?

For Andrew Lazris, who is also a geriatric specialist practicing in Maryland, this was a hard, complicated case because it involved his dying dad.

It also exemplified for him the work that he has undertaken with Eric Rifkin, an environmental scientist and adjunct researcher at Johns Hopkins University, in ensuring that patients retain their fundamental and critical right to have a say in their care. And, in doing so, they have developed what they argue is a clear, comprehensible way to help patients grasp and deal with the inevitable uncertainties, risks, and complexities of the array of medical treatments they can get overwhelmed with by doctors, hospitals, Big Pharma, medical device makers, and others in health care.

cdcvape-300x200
Big Tobacco and its allies long have exploited evolving media to hawk harmful products, promoting them as desirable and sexy in print, movies, radio, television, and online. So, it’s not exactly a surprise that these merchants of death have become masters of marketing on social media, targeting young consumers worldwide.

Their latest campaigns may let cigarette- and e-cigarette-makers skirt regulations, some of them tough and aimed at protecting naïve, vulnerable kids from lifetime addictions.

The tobacco hype may be working all too well, with researchers at Johns Hopkins and elsewhere finding that 10.8 million adults in the United States are “vaping,” with 54.6 percent of e-cigarette users also smoking cigarettes. “About 15 percent of vapers had never smoked cigarettes, and 30.4 percent had quit smoking them,” the newspaper reported.

hennepin-300x200Big Pharma howls often about the federal Food and Drug Administration path to get prescription drugs approved for markets, complaining current regulatory processes take too long and, with their requirement for rigorous clinical trials, are too tough.

Even as drug makers seem to be finding sympathetic officials to make these regimens faster and laxer, some voices want the FDA to consider costlier and what they say is more realistic and useful scrutiny of drugs that goes beyond current attempts  to find if they are safe and effective.

Shouldn’t regulators — at the FDA or elsewhere in the federal bureaucracy — help consumers much more to know the answers to “two crucial questions: How do … new therapies compare with already known ones? What are the relative benefits and harms in a particular situation, for a person like you?”

cdc-opi-aug-300x227When Big Pharma pursues rapacious profits and regulators snooze, patients suffer terrible consequences, as new revelations about the opioid crisis show.

Kaiser Health News Service , via the Washington Post, and The New York Times both have done excellent investigative digging into drug makers’ role in fueling the prescription painkiller mess that authorities estimate claims 116 lives a day due to overdoses.

Fred Schulte, writing for the independent, nonpartisan Kaiser service, reported that rival makers — seeing how much money Purdue Pharma was making with its powerful and addictive OxyContin drug and that it was encountering law enforcement and regulatory challenges — stepped in with “similarly dangerous painkillers, such as fentanyl, morphine and methadone.”

colonoscopy-300x214More than 15 million Americans each year undergo an invasive medical test, roughly once a decade and starting at age 50. If some medical experts had their way, more patients would get this cancer checkup, beginning at an even younger age. But as Emily Bazar, a senior editor and consumer columnist (Ask Emily) for the independent, nonprofit Kaiser Health News service, points out, physicians may want to heal themselves and their hygiene practices before pushing even more patients to get colonoscopies and endoscopies (procedures to examine the upper gastrointestinal tract).

That’s because a growing body of research shows that the switch by doctors, hospitals, and specialty centers to reusable scopes to peer into various parts of the body have resulted in rising infection rates among colonoscopy and endoscopy patients, among others.

Inspections show that the reused scopes don’t get cleaned properly and all the time. The more complex the medical device, the greater the risk, as clinicians and patients learned when complex and dirty duodenoscopes were tied to the deaths of 35 patients since 2013 and the sickening of dozens of others, leading to congressional investigations, lawsuits, and product recalls.

livercancer-300x173Summer tipplers may want to steer away from that second glass of  sangria, or rethink that next round of beers.  That’s because there’s yet more bad news about Americans and booze abuse: Liver disease deaths are spiking, with fatalities tied to cirrhosis jumping by 65 percent between 1999 and 2016, while those connected with liver cancer doubled in the same time span.

Americans 25- to 34-years-old saw the steepest increases in alcohol-related liver disease, with the number of annual deaths in seven years, as studied by Michigan experts, nearly tripling.

“Alcohol misuse and its complications” is striking down a new generation of Americans, Elliot Tapper, a University of Michigan liver expert and lead author of a newly published study on liver cancer, told the Washington Post.

water-300x200Families dropping into Baltimore restaurants may be surprised by what is no longer on the children’s menu, thanks to an official mandate: sugary soft drinks.

At the behest of public health officials, Baltimore has become the largest US city and an East Coast pioneer in enforcing a new restaurant ordinance that makes water, milk, and 100 percent fruit juices the default drinks for youngsters.

Parents who really want their kids to have a sugar-laden soft drink can still get them, but the parent has to place the order. The idea is to get parents to pause and think, and nudge them toward healthier choices.

horse-200x300Big Tobacco seems to have a shiny new billion-dollar Trojan horse. The question now: Will medical scientists be savvy enough to avoid a credibility catastrophe by rejecting funding from  Tobacco’s wealthy new foundation?

Rita Rubin, a seasoned health care writer, reported in the Journal of the American Medical Association that Philip Morris, a global hawker of tobacco wares, has pledged in the next dozen years to pump $960 million into the Foundation for a Smoke Free World. That group, purportedly, aims to fund research “that advances the field of tobacco harm reduction and reduces the public health burden of smoking-related diseases,” Rubin reported.

But this gambit, often referred to in political parlance as “astroturfing,” has been slammed by respected medical and scientific organizations, including the World Health Organization. They have declared it unacceptable for groups that aim to advance the health and well-being of patients to take  “profits from a product responsible for about 1 in every 5 US deaths to fund health research.”

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