Reducing Cancer Costs by Giving One Drug at a Time, Sequentially

This is the third in a series of posts on Bending the Cost Curve in Cancer Care, based on the late-May NEJM health policy piece. Today we’ll consider the second of the authors’ suggestions: to limit second and third-line treatments to sequential monotherapies for most solid tumors. This particular suggestion, one of the few proposed with which I […]

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Patients’ Words, Unfiltered, Medical Journalism and Evidence

Yesterday’s post was not really about Avastin, but about medical journalism and how patients’ voices are handled by the media. L. Husten, writing on a Forbes blog, cried that the press fawned, inappropriately, over patients’ words at the FDA hearing last week, and that led him to wonder why and if journalists should pay attention to […]

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Vicious Verbiage Targets Cancer Patients’ Voices, at Cardiobrief

A journalist who covers medical matters of the heart grabbed my attention on the Fourth of July. In The Voice of the Patient: Time To Bring Out the Muzzle?, Larry Husten at Forbes’ Cardiobrief blog, insinuates that the women who spoke at the FDA’s Avastin hearings are simpletons. In his short strip, Husten skips the possibility […]

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No Room For Emotion or Exceptions to the Rule (on Avastin)

My cousin testified before the FDA oncology advisory board on Tuesday about her experience taking Avastin. This is a tragedy, to deny the only drug that is keeping a 51 year old woman alive. You have to wonder, are the advisory panel members so rational in all their behavior and choices? Are they always so […]

Posted in Breast Cancer, cancer survival, cancer treatment, clinical trials, from the author, health care costs, Medical News, Oncology (cancer), PolicyTagged , , , , , , , , , 12 Comments on No Room For Emotion or Exceptions to the Rule (on Avastin)

Cathy Wants a New Doctor and a Second Opinion

Last night the Big C returned, not surprisingly with an opening dream sequence. Laura Linney, portraying Cathy Jamison in the Showtime series, is running. The scene turns out to be a nightmare, and she awakens with a headache and her husband by her side. OK so far. Within a few minutes, Cathy’s young oncologist informs […]

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Gregg Allman Stars in Hepatitis C Awareness Campaign, with Merck

This weekend I learned that Gregg Allman, of the Allman Brothers, has hepatitis C. Not just that; he underwent a liver transplant last year for treatment of liver cancer. This information came my way via CNN, in a clip narrated by Dr. Sanjay Gupta. The cable TV crew filmed the old rocker in Macon, Georgia, […]

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Looking Back on ‘The Normal Heart,’ and Patients’ Activisim

They were impatient with the pace of research and physicians’ protocols, and spoke out emphatically about their needs: for more research; for prevention and treatment; for easier access to new drugs; and, simply, for good medical care.

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Taking Care of Yourself When Someone You Love is Ill

This week a close relative was hospitalized and turns out to have a serious condition.  He’s not a blog-lover, so I’ll keep this abstract: When a loved one gets sick, you have to take care of yourself. It’s hard to do your work, and to be there 24/7 for the rest of your family, and […]

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What’s Next on the Big C? (Hopefully a Second Opinion)

(Hopefully a second opinion) When I last wrote on The Big C, a Showtime series in which the actress Laura Linney portrays a woman in her forties with advanced melanoma, I considered some of the options she might choose when the series resumes next Monday night. At the end of Season 1, she elected to […]

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Lowering Cancer Care Costs by Reducing Tests After Treatment

This is the second in a series of posts on Bending the Cost Curve in Cancer Care. We should consider the proposal, published in the NEJM, gradually over the course of this summer, starting with “suggested changes in oncologists’ behavior,” #1: 1. Target surveillance testing or imaging to situations in which a benefit has been […]

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Don Berwick, Head of CMS, on the Value of Patient-Centered Care

A few weeks ago I had the opportunity to hear Dr. Don Berwick speak at the annual meeting of the Association of Health Care Journalists. Berwick now heads the Centers for Medicare & Medicaid Services. When he spoke in April, on transparency and how we might simultaneously cut costs and improve care, I thought his […]

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FDA Approves New Assay for Her2 in Breast Cancer

This week the FDA approved a new assay for Her2 expression in breast cancer biopsies. The technology, Inform Dual ISH, is manufactured by Ventana Medical Systems, a Roche subsidiary. Inform Dual ISH works like this: technicians, typically working under the supervision of a pathologist, expose a tiny bit of a breast biopsy specimen, fixed on […]

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Running 2 Lists That Might Lessen the Costs of Oncology Care

Recently the NEJM ran a Sounding Board piece on Bending the Cost Curve in Cancer Care. The authors take on this problem: Annual direct costs for cancer care are projected to rise — from $104 billion in 20061 to over $173 billion in 2020 and beyond.2…Medical oncologists directly or indirectly control or influence the majority […]

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Give Doctors a Break

In a heartless op-ed in yesterday’s paper, an anesthesiologist argues that medicine shouldn’t be a part-time endeavor. Dr. Sibert makes a firm introduction: “I’m a doctor and a mother of four, and I’ve always practiced medicine full time,” she boasts. “When I took my board exams in 1987, female doctors were still uncommon, and we […]

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A Recipe for Fresh, Low-Fat Blueberry Muffins

This morning I noticed we had too many blueberries in the fridge. So while my husband went out for a run, I opened the windows wide (to cool the apartment), turned on the oven and made some fresh breakfast food. It had been two decades or so since I’d baked anything like these. My recollection, […]

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Quotes on Oncology, Via Forbes, and a Spiraling Helix

Forbes kept a close eye on the annual ASCO meeting in Chicago. On THE MEDICINE SHOW, Forbes’ Matthew Herper provides a précis of a speech by outgoing ASCO President Dr. George Sledge. Here are my two favorite parts: “So what happens when, a few years from now, a patient walks into a doctor’s office and […]

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Human Milk For Sale, Where’s the FDA?

The June issue of Wired carries a feature on the Booming Market for Human Breast Milk. You can read about the under-the-counter and over-the-Internet sale of “liquid gold” with a typical asking price in the range of $1 to $2.50 an ounce. Here’s a taste, from the article: …“rich, creamy breast milk!” “fresh and fatty!”… […]

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Considering Aromasin for Healthy Women, and the New Breast Cancer Prevention Study

I’m minding the annual meeting of the American Society of Clinical Oncology from a distance this year. So far, the big breast cancer story syncs with a NEJM paper published yesterday on-line, on the use of exemestane (brand name: Aromasin, manufactured by Pfizer) to prevent invasive breast cancer. These patent-protected pills block the body’s normal […]

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A New E. Coli Outbreak, Hemolytic-Uremic Syndrome, and Eating In or Out

There’s a newly-identified E. coli strain that’s causing a serious illness called hemolytic uremic syndrome (HUS). The recent cases, mainly in northern Europe, have been attributed to eating raw vegetables like cucumbers, lettuce and tomato. So far, authorities aren’t sure of the exact source. Like any stomach bug, these bacteria can cause diarrhea, fever and […]

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Faking the News (and Informational Chaos)

I read in the paper this morning that some hackers successfully (?) broke into the PBS website on Saturday night and posted a story that is untrue. According to multiple sources, the fabricated article stated that Tupac Shakur, a rap performer who died in 1996, is alive and living in New Zealand. Fox “News” (quotations […]

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