Senator Ted Kennedy’s death from brain cancer underscores the urgent need for more funding of basic cancer research. Despite the best efforts of a team of top doctors, Kennedy died 15 months after the diagnosis of a malignant brain tumor called glioblastoma. Over the past ten years, some progress has been made against this deadly illness and the silhouettes of some promising new approaches are becoming visible. But our treatment options remain woefully inadequate.
With over 560,000 cancer deaths each year, that comes to less than $10,000 in research spent for every cancer death. That simply is not enough money spent on a problem that strikes almost 1.5 million Americans each year and causes nearly one of four deaths.
Research for certain cancers is especially under funded. Earlier this year, I helplessly watched a dear friend and patient die from esophageal cancer, both of us knowing that only 22 million dollars each year – about $1,500 per death – was being spent by the NCI on the disease annually. One reason is that patients with esophageal cancer don’t have a strong advocacy group to push for their fair share of the funding pie. Lung cancer, which tops the list of cancer killers in America, only gets about $1,500 per death. At the top of the list based on research spending per death are cervical cancer (about $19,000), breast cancer (about $14,000) and brain cancer (about $12,000).
Click here for a chart that I compiled with the help of statisticians at the NCI that breaks down government spending on the top cancers.
Of course, there shouldn’t have to be a competition among cancer advocacy groups. There should be adequate funding of basic medical research to help discover the underlying cellular mechanisms that many cancers share and that hold the key to prevention, early diagnosis and effective treatment. But there’s not enough money for our young researchers. In 1980, almost 25 percent of first independent government grants went to scientists under age 35; that figure has plummeted to only 4 percent as the first-grant age rose from 34 to 42.
Faced with increasing competition for shrinking dollars, many of our best and brightest are considering other careers.
My cancer patients desperately need a bailout. The best way to increase our spending on cancer research responsibly is through health care reform. The Institute of Medicine has estimated that about 20 percent of the annual $2.5 trillion in health care costs is unnecessary. That’s $500 billion annually or 100 times the current budget of the National Cancer Institute. There could be no better tribute to Senator Kennedy or wiser investment in our own futures than to fix a broken system that threatens to bankrupt us while inadequately addressing one of our most devastating health problems.
For this week’s CBS Doc Dot Com, I take you behind the scenes to an edit bay at the CBS Broadcast Center in New York. I talk to Dr. Henry Friedman, an expert on brain cancer. He is co-deputy director of the Preston Robert Tisch Brain Tumor Center at Duke University Medical Center. In addition to hearing about the latest treatments for the disease, you’ll see the secret behind how we do long-distance interviews for the CBS Evening News with Katie Couric.
Not anymore. Today, their front row partner is Coca-Cola. Diet Coke that is.
Dr. Val and I were among a small group of women’s health advocates who met last week to hear the latest on NHLBI’s campaign with Diet Coke and how the fashion industry is bringing an important public health message to women.
Diet Coke’s commitment to the Heart Truth campaign is unprecedented, one of the “largest public awareness initiatives we have ever undertaken,” said Celeste Bottoroff, VP Living Well, Coca-Cola North America.
Leading Diet Coke’s campaign? Endless-legs Heidi Klum and other fashion-conscious women who have revamped the little red dress campaign into a national symbol with guts, curves and most importantly results.
“In 2002, only 34% of the women in this country knew heart disease was the leading cause of death among American women,” Dr. Elizabeth Nabel, NHLBI director, told the group. “But we’re making progress. Today, as a result of the Heart Truth campaign and others like it, 65% of the women now know it’s the number one killer.”
Nabel led a discussion of the common myths associated with women’s heart heath and recalled her own experiences as a cardiology resident when women were caregivers who supported husbands, fathers and other male family members through heart ailments but often ignored or brushed aside their own symptoms for fear that treatment would interfere with domestic chores such as childrearing, cooking, and cleaning. “Even when older women came in with heart problems, they weren’t treated as aggressively as men,” Nabel admitted.
“Most women still need educating,” she remarked. “80% of middle-aged women still have at least one risk factor for heart disease. And just one, doubles your risk of actually having heart disease.”
Joining Nabel were Phyllis Greenberger, President and CEO of the Society for Women’s Health Research, Susan Bennett, MD, Clinical Director of the George Washington University Hospital’s Women’s Heart Program and Robyn Flipse, MS, RD, author and nutrition consultant to discuss the campaign’s most important messages. First, heart disease is not a man’s disease, a point often raised by group’s such as those headed by Greenberger who cited research indicating that only 17% of cardiologists and 8% of primary care physicians know that heart disease is the leading cause of death among women.
And it’s not just for the aged either. “When a 40 year old woman has heart disease it’s worse than a 40 year old man,” said Bennett recalling patients in their 20s and 30s in her practice. “It’s never too late to change your lifestyle,” Flipse added. “The body is very forgiving. Even a 10% drop in weight can have a positive impact on blood pressure, cholesterol and other important risk factors.”
The Heart Truth campaign, thanks to the vision of Dr. Nabel and the willingness of NHLBI to partner with a highly visible, social icon such as Diet Coke is just what’s needed to cut through the feel good messaging that most public health campaigns resort to. Having lived with heart disease my entire adult life (now well into middle age), it’s a welcome boost of energy and the visibility possible with this campaign is unparalleled. Along with it comes some very important information that can save women’s lives.
Look for the heart truth emblem on 6 Billion Diet Coke cans, at community public forms, at American Idol, and fashion shows across the country. Diet Coke, with Heidi’s help, has even designed a new red dress label pin which strongly resembles an hour-glass. And what woman doesn’t want that?
Kerri Morrone-Sparling is a whirlwind of energy. Not only is she the founder of one of the first diabetes blogs on the Internet: SixUntilMe, but she has devoted her career to helping others with diabetes. She works full time at dLife.com, a delightful and practical diabetes website and community. Kerri recently offered me some Halloween survival tips for people with diabetes, and today I had the chance to interview her about her life, her work, and the meaning of World Diabetes Day.
I’ve summarized some of our talking points below for those who don’t wish to listen to the dulcet tones of two very friendly ladies dishing about diabetes.
Dr. Val: Tell me a little bit about your blog.
Kerri: My blog is called SixUntilMe and I started it in May of 2005. I was looking for other people like me who were living with diabetes and since I couldn’t find a community like that I decided to start one myself. As it turns out I wasn’t the only one – there were 2 or 3 other diabetes bloggers out there at the time, and now there are more than 250 of us.
Dr. Val: What does “six until me” mean?
Kerri: My diabetes started when I was six years old – I had a viral illness on my birthday which probably triggered an autoimmune response, causing the disease. My blog is about my diabetes – which started when I was six and is ongoing until now. So I called it “sixuntilme.”
Dr. Val: How are you involved in diabetes advocacy?
Kerri: I work for a diabetes media company, (dLife in Westport, Connecticut) so my entire day is built around reaching out to people with diabetes, trying to make a difference in their life, and connecting them with up-to-date health information. Since I grew up without knowing any other kids who had diabetes, this job is like the holy land. I mean, this whole company was built to help people like me.
Dr. Val: What are some of the worst diabetes myths and what do you have to say about them?
Kerri: First of all, most people don’t know the difference between type 1 and type 2 diabetes, and to make matters worse, they believe that people “give themselves diabetes” by eating too much sugar. So they make it seem like it’s all our fault. Secondly, people often believe that insulin is the cure for diabetes. They don’t realize that a glucose meter, an insulin pump, or a continuous glucose monitor are just technology, not a cure. Sometimes people think there’s no need to donate to diabetes research anymore because these technologies are available. And finally, Halle Berry has promoted a myth that has done a lot of harm to the diabetes community. She claimed that she was able to wean herself off her insulin, and that other type 1 diabetics could do the same if they tried hard enough. Of course, that’s blatantly false.
Dr. Val: What’s your favorite new technology for diabetes management?
Kerri: My continuous glucose monitor (CGM). It doesn’t replace finger stick checks, but it helps you to see the trends in your blood sugar. For example, when you’re about to go to bed and you see that your glucose is 90, the CGM will give you some idea if that’s 90 on its way up, or 90 falling towards hypoglycemia, or 90 holding steady – you can go to bed and not worry about a thing. It’s like swinging on a trapeze only now I have a net.
Dr. Val: How does the machine work?
Kerri: It’s a small device that has a needle in it, and you stick it to a fleshier part of your body. There’s a small wire (introduced through the needle) that continuously samples the sugar level in your interstitial fluid. It’s easy to remove and should be rotated every 3-7 days.
Dr. Val: Is it painful?
Kerri: No, I don’t think so. I use the Dexcom Seven CGM. Occasionally I feel a little prick when I insert it but then I don’t even notice that I’m wearing it. Here’s a photo of me wearing it:
Dr. Val: Tell me about World Diabetes Day.
Kerri: It’s a global awareness campaign that was started in 1991 by the International Diabetes Federation. The United Nations recognized the event for the first time in 2007. It’s a day that directs the world’s attention to diabetes and the epidemic its become and the effort it takes to manage it. On World Diabetes Day bloggers want to spread the word that diabetes is not an invisible disease. It affects lives every day, and it deserves the world’s attention.
Dr. Val: What’s the most important thing for Americans to know about diabetes?
Kerri: They need to know that diabetes is not cured by insulin, and it’s not going away without their help. It’s a very difficult disease to manage. No matter how well you control your sugar levels, the effects of the disease take their toll eventually, and the effects can be devastating. We must not ease up on our research efforts, especially when the numbers of people living with diabetes are growing exponentially.
Following on the heels of the annual ACR scientific assembly (and my interview with Dr. Wallace), I reached out to Sandra Raymond, President and Chief Executive Officer of the Lupus Foundation of America, to discuss lupus from the patient perspective. Sandra’s rhinovirus infection (she had a cold) did not stop her from completing an excellent interview with me.
Dr. Val: Tell me about the Lupus Foundation of America (LFA).
Raymond: The Lupus Foundation of America is the nation’s leading organization dedicated to finding the causes and cure for lupus. We also provide services, support, and hope to all people living with lupus. We have a national research program called “Bringing Down The Barriers” and we fund grants to researchers in academic institutions across the country. We are also very active on Capitol Hill, lobbying for research and educational efforts. In a few months we’ll be launching a public awareness campaign to help Americans understand this disease.
Dr. Val: Of which key accomplishment of the LFA are you most proud?
Raymond: LFA has been able to expand medical research efforts for lupus. This not only gets us closer to finding a cure, but it offers hope to those who are living with the disease.
Dr. Val: In your view, what do patients with lupus need the most?
Raymond: They need safe, effective, and well-tolerated treatments. November the 20th, 2008, marks 50 years without a new, approved treatment for lupus. The treatments that patients are currently taking can be very harsh. They sometimes cause side effects that are worse than lupus itself! We must step up our research efforts to discover safe and effective treatments to bring this disease under control and provide patients with a better quality of life.
The good news is that there are quite a few pioneering biotech companies who are investing money in finding a cure for lupus. So there may be new drugs on the horizon.
Autoimmune diseases affect 23 million Americans. Lupus accounts for at least 1 million of those, but if we can figure out what causes lupus, there are implications for all disorders of the immune system. Read more »
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