March 19, 2008
Cancer is difficult. In every sense of the word. It is difficult to detect early(in some forms), it is difficult to treat, it is difficult to deal with. Individuals and families are devastated by the effects of the disease and even by the treatment. It is particularly heart wrenching to read stories about childhood cancers. But it is important. The things learned from the study of end stage cancer is often among the most cutting edge research. People will be open to may treatment courses when the alternative is death. While the vast majority of last minute experiments fail, and no magic cure is discovered, there are always exceptions. Those exceptions are beautiful to read and I encourage you to read the following article.
From a human stand point, it is always refreshing to see the triumphant story of an underdog that overcomes some great challenge. From clinical stand point, the same holds. Many of the greatest achievements and breakthroughs in science have been laughed at originally and dismissed too quickly. While the antiangiogenic chemotherapy may or may not go on to play a significant role in the treatment of cancer in the future, its pioneers like Dr. Judah Folkman who change the course of history. Taking a different approach, trying new combinations of existing medicines, and being innovative in the treatment of cancer Dr. Judah Folkman saved Melanie McDaniel. The McDaniel family is sharing her story as a tribute to Dr. Folkman who passed away in January.
February 23, 2008
In a controversial move, the FDA has approved Avastin for breast cancer. The drug is already used in lung and colon cancer. For the FDA to approve a late stage cancer drug it needs to either extend patient’s lives or import the quality of life. Avastin has shown neither and so the advisory committe recommended against its use in breast cancer. The FDA went against the recommendation of its advisory committee. The drug does shrink tumors effectively, but there is a debate if that alone is reason to approve a drug.
If you still die in the same amount of time in the same painful way was having smaller tumors worth whatever adverse effects or side effects come from the medicine? There are pros and cons to the decision. The pros are the approval will stimulate even more research and development into tumor shrinking medicines. The decision will also be good for business, stimulating development and growth. But there are also cons. First there is the obvious problem if a drug does not extend life or improve quality of life what is the purpose. Tumor shrinking is important, but only as a part of the overall picture of improving health. But what I find to be a more glaring problem is, the advisory committees are designed to have more knowledge and to have looked at a topic more carefully to give the FDA an intelligent recommendation. Why have them if you don’t listen to the recommendation? I think that sets bad precedent.
Hopefully the next large study of Avastin will show marked improvement in combination with other drugs in the treatment of breast cancer.
October 20, 2007
Bras soon won’t just be fighting the sag. A British researcher is working on a prototype bra that could detect early stages of breast cancer. The “smart bra” uses microwave antennae to pick up on temperature changes that happen when there’s an increase in blood flow to a developing tumor. The same types of passive microwaves are used to pinpoint submarine and distant star locations.
An audible or visual alarm would be built into the bra alerting wearers that they should head to the doctor. This seems like it would be a bit stressful. Especially if it happened during a business meeting or an interview! “Sorry, gotta run. I may have cancer.”
Some docs aren’t too psyched on the whole idea either, citing that many benign growths and nonmalignant inflammatory changes can also increase blood flow. But hey, any research helping women find and fight breast cancer is worth looking into in my breast opinion!
I think it is at least a step in the right direction. The right direction is prevention and early detection. I bet Japan has a working prototype in 6 months. And in 9 months there will be a recall of bras manufactured with cancer causing lead from China.
October 5, 2007
A tragic story of careless medicine in Florida was reported on the CNN website today. A woman was told she had a very serious breast cancer, and decided based on that information to have a double mastectomy. The bigger tragedy is the patient who actually had the serious cancer went undiagnosed for months. This article just reinforces how important because careful, and double checking are in the medical field. But since tests are carried out by humans they are subject to error. I feel that additional costs of running repeat tests before serious procedures (if time applicable) would be smaller than the costs caused by such serious mistakes. Here is the story:
(Florida): A woman had both of her breasts mistakenly removed after a lab headquartered out of Florida apparently switched her tissue specimens with a patient suffering from cancer. Darrie Eason, a 35-year-old single mother from Long Beach, said she was recently diagnosed with a highly aggressive form of breast cancer.Eason said she did all the right things after the cancer diagnosis. “I had a second opinion and saw specialists,” Eason said. “Then, I had a radical mastectomy.”
Two weeks after the operation, her doctor called and told her about the mistake, Local 6 reported. Eason’s tissue sample was apparently mislabeled by a lab technician at the CBL Path medical lab in Rye Brook. CBL Path is headquartered in Ocala, but the tests were done in New York. The real cancer patient in the apparent mix-up went undiagnosed for months, the report said.
Eason filed a lawsuit against CBL Path Inc. The company is defending its labs and said the New York Health Department found no other major problems. The technician involved in the incident is no longer with the company, according to CBS News.
As cliche as it sounds, cancer is something that touches all of us. Everyone knows someone affected by cancer, whether you yourself have dealt with the disease or a friend or family member. I think we tend to think of ourselves as invincible and think it couldn’t happen to us, but knowing how common it is we aren’t completely shocked when someone else has it. That attitude allows mistakes to be common in cancer patients. For example in this case, no one bother to stop and think “wait that is rare, what are the odds lets double check”. In extremely aggressive cancers without a family history the testing should be even more vigorous. Its not to say the doctor ordered the wrong tests, he didn’t and it is not his fault there was a lab error. But the doctor does know human error is possible so why didn’t he seek confirmation either in a follow up or in another test before such a radical procedure.