Category Archives: Cancer

Pre-hab: Rehabilitation before cancer treatment

Share

prehab-570By Michelle Andrews
KHN

Cancer patients who do rehabilitation before they begin treatment may recover more quickly from surgery, chemotherapy or radiation, some cancer specialists say.

But insurance coverage for cancer “prehabilitation,” as it’s called, can be spotty, especially if the aim is to prevent problems rather than treat existing ones.

It seems intuitive that people’s health during and after invasive surgery or a toxic course of chemo or radiation can be improved by being as physically and psychologically fit as possible going into it. But research to examine the impact of prehab is in the beginning stages.

Early research suggests prehab may improve people’s ability to tolerate cancer treatment and return to normal physical functioning more quickly. 

Prehabilitation is commonly associated with orthopedic operations such as knee and hip replacements or cardiac procedures.

Now there’s growing interest in using prehab in cancer care as well to prepare for treatment and minimize some of the long-term physical impairments that often result from treatment, such as heart and balance problems.

“It’s really the philosophy of rehab, rebranded,” says Dr. Samman Shahpar, a physiatrist at the Rehabilitation Institute of Chicago. Continue reading

Share

Skin cancer: 9 things to know to lower your risk

Share

Blue sky and white clouds (Panorama)

The how-to’s of skin cancer prevention haven’t changed much in recent years — avoid too much ultraviolet light via sun or tanning beds and take care not to burn or tan — but that message is clearly not reaching enough people, according to Fred Hutch researchers.

  

With climbing rates of skin cancer in the U.S., including the deadly form, melanoma, it’s time to get serious about prevention, experts say.

The how-to’s haven’t changed much in recent years — avoid too much ultraviolet light via sun or tanning beds and take care not to burn or tan — but that message is clearly not reaching enough people, said Fred Hutchinson Cancer Research Center cancer prevention researcher Dr. Margaret Madeleine.

A recent study by researchers from the Centers for Disease Control and Prevention found that nearly 5 million U.S. adults are treated every year for all types of skin cancer to the tune of $8.1 billion. Melanoma rates have doubled in this country since 1982, according to a CDC report earlier this month. The majority of these cancer cases are preventable.

Last summer, the U.S. Surgeon General issued a call to action to prevent this too-common disease: Non-melanoma skin cancers, chiefly basal cell carcinoma and squamous cell carcinoma, are the most common cancers in this country by far, afflicting an estimated 4.3 million people per year.

That report, the first time the surgeon general had come out against sunbathing and tanning beds, is a great step, Madeleine said. But we need to do more.

“The message needs to be louder,” Madeleine said. “There are some really serious public health tactics that could be used.”

For example, tanning beds don’t carry as high a tax rate as cigarettes do, Madeleine said. We could also be teaching kids about skin cancer prevention in schools and doing more to combat the pervasive idea among teenagers and young adults that indoor tanning is harmless.

Nine things to know to reduce your skin cancer risk right now

Continue reading

Share

Cancer quackery fuels concern among doctors, FDA

Share

Photo Credit:  Bo Jungmayer / Fred Hutch News Service

Be wary of possible side effects, drug interactions when using alternative health supplements, physicians caution

By By Bill Briggs
Fred Hutch News Service

One potentially fake cancer drug sold online can actually cause malignancies. One enema machine, purported to treat ovarian cancer under the FDA banner, was never cleared for sale in the U.S., federal health officials assert.

Those products and more were targeted last week in a global crackdown on more than 1,000 websites that sell possibly dangerous and bogus medicines and medical devices. The bust, conducted by the U.S. Food and Drug Administration and Interpol, coincides with the surge of unproven cancer “cures” hawked by Internet sellers, the FDA warns.

For curious consumers, the FDA posts a running list of “fake cancer cures” that currently spans 187 oils, drinks, plants and animals parts sold by web merchants from North Carolina to Oregon.

Cancer-treatment fraud is “particularly heartless,” FDA officials say, because it preys on the desperation of patients who are tempted “to jump at anything that appears to offer a chance for a cure.” At Fred Hutchinson Cancer Research Center, some doctors are equally leery when patients ask to add claimed “natural” remedies to their treatment regimens.

“We’re quite clear: No over-the-counter herbal treatments – the things people get that are supposed to help their immune system, [or] whatever scams that people come across,” said Dr. George Georges, a hematopoietic cell transplant doctor at Fred Hutch. Continue reading

Share

Melanoma rate doubled over past three decades – CDC

Share

img1Melanoma rates doubled between 1982 and 2011 but comprehensive skin cancer prevention programs could prevent 20 percent of new cases between 2020 and 2030, according a new report from the US Centers for Disease Control and Prevention (CDC).

Skin cancer is the most common form of cancer in the U.S., and melanoma is the most deadly type of skin cancer. More than 90 percent of melanoma skin cancers are due to skin cell damage from ultraviolet (UV) radiation exposure.

The report says that without additional community prevention efforts, melanoma will continue to increase over the next 15 years, with 112,000 new cases projected in 2030.

More than 65,000 melanoma skin cancers are diagnosed and more than 9,000 die from the disease in the US each year.

Successful programs feature community efforts that combine education, mass media campaigns, and policy changes to increase skin protection for children and adults.

“If we take action now, we can prevent hundreds of thousands of new cases of skin cancers, including melanoma, and save billions of dollars in medical costs,” said Lisa Richardson, MD, MPH, Director of the Division of Cancer Prevention and Control.

This report highlights the recommendations for communities from the Community Guide for Preventive Services. According to these guidelines, communities can: Continue reading

Share

The gray areas of assisted suicide

Share
jd-falk-2-570 (1)

When J.D. Falk was dying of stomach cancer in 2011, his wife says doctors would only talk about death in euphemisms. (Photo: courtesy of Hope Arnold)

By April Dembosky, KQED

SAN FRANCISCO — Physician-assisted suicide is illegal in all but five states. But that doesn’t mean it doesn’t happen in the rest. Sick patients sometimes ask for help in hastening their deaths, and some doctors will hint, vaguely, how to do it.

This leads to bizarre, veiled conversations between medical professionals and overwhelmed families.

Doctors and nurses want to help but also want to avoid prosecution, so they speak carefully, parsing their words. Family members, in the midst of one of the most confusing and emotional times of their lives, are left to interpret euphemisms.

Doctors and nurses want to help but also want to avoid prosecution, so they speak carefully, parsing their words.

That’s what still frustrates Hope Arnold. She says throughout the 10 months her husband J.D. Falk was being treated for stomach cancer in 2011, no one would talk straight with them.

“All the nurses, all the doctors,” says Arnold. “everybody we ever interacted with, no one said, ‘You’re dying.’”

Until finally, one doctor did. And that’s when Falk, who was just 35, started to plan. He summoned his extended family. And Hope made arrangements for him to come home on hospice. Continue reading

Share

Video explains panel’s new mammography recommendations

Share

FACTS AND MYTHS –

By the US Preventive Services Task Force

MYTH: The Task Force recommends against screening for breast cancer in women younger than 50.

FACT: Evidence shows that mammography screening can be effective for women in their 40s. Based on the science, the Task Force’s draft recommendation states that the decision to start regular mammography screening before age 50 is an individual one and should be made by a woman in partnership with her doctor. Continue reading

Share

So you have dense breasts. Now what?

Share
catharine-becker-2

Catharine Becker at her home in Fullerton, California on April 14, 2014. Becker started to get mammograms at age 35 because she had a family history of breast cancer (Photo by Heidi de Marco/Kaiser Health News).

By Barbara Feder Ostrov
KHN

Earlier this year, Caryn Hoadley received an unexpected letter after a routine mammogram.

The letter said her mammogram was clean but that she has dense breast tissue, which has been linked to higher rates of breast cancer and could make her mammogram harder to read.

“I honestly don’t know what to think about the letter,” said Hoadley, 45, who lives in Alameda, Calif. “What do I do with that information?”

Millions of women like Hoadley may be wondering the same thing. Twenty-one states, including California, have passed laws requiring health facilities to notify women when they have dense breasts. Eleven other states are considering similar laws and a nationwide version has been introduced in Congress.

The laws have been hailed by advocates as empowering women to take charge of their own health. About 40 percent of women have dense or extremely dense breast tissue, which can obscure cancer that might otherwise be detected on a mammogram.

But critics say the laws cause women unnecessary anxiety and can lead to higher costs and treatment that doesn’t save lives or otherwise benefit patients. Continue reading

Share

Fewer U.S. Children Getting Melanoma: Study – WebMD

Share

Blue sky and white clouds (Panorama)The incidence of deadly melanoma skin cancer is falling among American children, a new study finds.

Researchers led by Dr. Lisa Campbell, of Case Western Reserve University and University Hospitals (UH) Case Medical Center in Cleveland, looked at national cancer registry data from 2000 to 2010.

They found that the overall number of new melanoma cases among children fell 12 percent each year from 2004 to 2010.

The reasons? Campbells team cited effective public outreach on the danger of UV rays from the sun or tanning beds, more kids playing indoors rather than outdoors and a rise in parental awareness of the importance of sunscreen and other sun-protective measures.

via Fewer U.S. Children Getting Melanoma: Study – WebMD.

Share

Inviting patients to help decide their own treatment

Share

By Anna Gorman
KHN

SAN FRANCISCO — Rose Gutierrez has a big decision to make.

Gutierrez, who was diagnosed with breast cancer last spring, had surgery and 10 weeks of chemotherapy. But the cancer is still there.

Now Dr. Jasmine Wong, a surgeon at UC San Francisco, is explaining the choices – Gutierrez can either have another lumpectomy followed by radiation, or she can get a total mastectomy.

shared-decisions-3

Rose Gutierrez (Photo by Heidi de Marco/KHN).

 

“I think both options are reasonable,” Wong said. “It’s just a matter of how you feel personally about preserving your breast, how you feel about having radiation therapy.”

“I’m kind of scared about that,” said Gutierrez, 52, sitting on an exam table with her daughter on a chair beside her.

“Well if you made it through chemo, radiation is going to be a lot easier,” Wong told Gutierrez, who is from Merced, Calif.

In many hospitals and clinics around the country, oncologists and surgeons simply tell cancer patients what treatments they should have, or at least give them strong recommendations.

But here, under a formal process called “shared decision making,” doctors and patients are working together to make choices about care. Continue reading

Share

Two out of 3 people diagnosed with cancer survive 5 years or more – CDC

Share

A Norwegian study estimates that a many as 25 percent of cases of invasive breast cancers diagnosed by mammography screening are cases of overdiagnosis. (Photo/NCI)Two out of 3 people diagnosed with cancer survive five years or more, according to a study by the US Centers for Disease Control and Prevention published in today’s Morbidity and Mortality Weekly Report.

The report found that the most common cancer sites continue to be prostate, breast, lung, and colorectal cancer.

Among these common cancer sites 5-year relative survival was:

  • 97 percent for prostate cancer,
  • 88 percent for breast cancer,
  • 63 percent for colorectal cancer, and
  • 18 percent for lung cancer.

The authors noted that disparities in cancer incidence still persist, with greater rates among men than women and the highest rates among blacks.

Additionally, 5-year relative survival after any cancer diagnosis was lower for blacks (60 percent) than for whites (65 percent).

Data by state show incidence rates for all cancer sites ranged from 374 cases per 100,000 persons in New Mexico to 509 cases per 100,000 persons in the District of Columbia.

“These data are an important reminder that a key to surviving with cancer is making sure everyone has access to care from early diagnosis to treatment,” said Lisa Richardson, M.D., director of CDC’s Division of Cancer Prevention and Control.  “We know, for example, that early detection of colorectal cancer has had the largest impact on long-term survival rates.”’

Through the Affordable Care Act, more Americans will qualify to get health care coverage that fits their needs and budget, including important preventive services, including screening for some cancers, that may be covered with no additional costs.

Visit Healthcare.gov or call 1-800-318-2596 (TTY/TDD 1-855-889-4325) to learn more.

The full report, “Invasive Cancer Incidence and Survival – United States, 2011,” can be found at www.cdc.gov/mmwr. For more information about CDC’s efforts in cancer prevention and control, visit www.cdc.gov/cancer.

Share

Some dementia can be treated, but my mother waited 10 years for a diagnosis

Share
Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

Pauline Rabin with granddaughters Emma and Aviva Rabin-Court near the C&O Canal in Great Falls, Md. (Photo courtesy of Roni Rabin).

By Roni Caryn Rabin
KHN

When my mother, Pauline, was 70, she lost her sense of balance. She started walking with an odd shuffling gait, taking short steps and barely lifting her feet off the ground. She often took my hand, holding it and squeezing my fingers.

Her decline was precipitous. She fell repeatedly. She stopped driving and she could no longer ride her bike in a straight line along the C& O Canal. The woman who taught me the sidestroke couldn’t even stand in the shallow end of the pool. “I feel like I’m drowning,” she’d say.

A retired psychiatrist, my mother had numerous advantages — education, resources and insurance — but still, getting the right diagnosis took nearly 10 years. Each expert saw the problem through the narrow prism of their own specialty. Surgeons recommended surgery. Neurologists screened for common incurable conditions.

The answer was under their noses, in my mother’s hunches and her family history. But it took a long time before someone connected the dots. My mother was using a walker by the time she was told she had a rare condition that causes gait problems and cognitive loss, and is one of the few treatable forms of dementia.

“This should be one of the first things physicians look for in an older person,” my mother said recently. “You can actually do something about it.” Continue reading

Share

More states adopting law allowing terminal patients to try experimental treatments

Share

One dye showing 2By Michelle Andrews
KHN

Earlier this month, Arizona voters approved a referendum that allows terminally ill patients to receive experimental drugs and devices. It’s the fifth state to approve a “right-to-try” law this year.

Supporters say the laws give dying patients faster access to potentially life-saving therapies than the Food and Drug Administration’s existing “expanded-access” program, often referred to as “compassionate use.”

Supporters say the laws give dying patients faster access to potentially life-saving therapies. Critics charge such ‘right-to-try” acts are  feel-good laws that don’t address some of the real reasons patients may not receive experimental treatments.

But critics charge they’re feel-good laws that don’t address some of the real reasons patients may not receive experimental treatments.

The legislatures in Colorado, Louisiana, Michigan and Missouri also passed right-to-try laws this year as part of a nationwide effort spearheaded by the conservative Goldwater Institute, which hopes to get right-to-try laws on the books in all 50 states.

The measures generally permit a patient to get access to an experimental drug after it’s passed through phase 1 of a clinical trial, the initial testing in which a drug is given to a small group of people to evaluate its safety and side effects. Continue reading

Share

Washington state to offer breast cancer license plates

Share

BC-MountainRibbonOLYMPIA – There’s a new way to donate and show your support for breast cancer screening and testing. Starting Oct. 16, you have a chance to bid on the first batch of breast cancer license plates before they go on sale to everyone, starting in January.

Money raised from the sale of the plates will pay for breast cancer screenings and follow up tests for women with limited or no insurance through the state Department of Health’s Breast, Cervical, and Colon Health Program.

Money raised from the sale of the plates will pay for breast cancer screenings and follow up tests for women with limited or no insurance.

The auction runs through the end of the month. More information about the auction and how to bid can be found online. After this month’s auction, breast cancer license plates will be available for purchase in January 2015 for $60 through the state Department of Licensing. Continue reading

Share

States negotiate for better drug prices

Share

Because of skyrocketing prescription drug prices, some state Medicaid programs and prison systems are limiting certain drugs to only the sickest patients. Some states are negotiating better pricing.

By Michael Ollove
Stateline

Twenty-dollar bill in medicine bottleThe new hepatitis C drug Sovaldi promises a cure rate of well over 90 percent, compared to 45 percent (at best) for older drugs. But when Sovaldi went on the market earlier this year for as much as $84,000 for a single course of treatment, critics blasted the cost as “exorbitant” and “gouging.”

It is estimated that between 3.2 million and 5.2 million Americans have hepatitis C, an infectious illness that can eventually compromise the liver.

The disease falls disproportionately on the poor and the incarcerated, which makes it a particular challenge for Medicaid, the federal-state health plan for the poor, and for state prison systems.

One study by Express Scripts, a drug benefits management company, estimated it would cost states $55 billion to provide Sovaldi to all prisoners and Medicaid beneficiaries with hepatitis C.

Because of its high cost, some state Medicaid programs and prison systems are refusing to provide Sovaldi to any but the sickest patients. Most recently, Oregon last month threatened to limit access to the drug unless it can get Sovaldi at a deeply discounted price.

“Sovaldi is a seminal event,” said Matt Salo, executive director of the National Association of Medicaid Directors. “It’s clear that states are not equipped to handle this. They simply do not have the tools to maintain control.”

But Sovaldi is only the beginning. Expensive new treatments for certain cancers, rheumatoid arthritis and other conditions also have rattled Medicaid officials, patients and health care providers.

What can states do to hold down drug costs? Drug pricing is a complicated and opaque process. Here are some of the basics.

Question: Is each state Medicaid program on its own when it comes to drug pricing?

Answer: Not completely. The federal Omnibus Budget Reconciliation Act of 1990 mandates that drug makers give all Medicaid programs a 23 percent rebate off the Average Manufacturers Price (AMP) for all prescription drugs purchased, or the difference between the AMP and the best price given to a private payer. (Prisons aren’t covered by this discount provision and have to negotiate drug prices as any retailer does.)

In return for the rebates, Medicaid programs must carry all drugs approved by the U.S. Food and Drug Administration on their “formularies,” which is the list of the medications each health plan will pay for.  That guarantee means that the drug makers get access to substantial markets in all 50 states and the District of Columbia. Continue reading

Share