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The Cancer Drug Shortage Is A Serious Problem

Last Sunday’s New York Times featured an op-ed by Dr. Ezekiel Emanuel, on the oncology drug shortage. It’s a serious problem that’s had too-little attention in the press:

Of the 34 generic cancer drugs on the market, as of this month, 14 were in short supply. They include drugs that are the mainstay of treatment regimens used to cure leukemia, lymphoma and testicular cancer.

Emanuel considers that these cancer drug shortages have led to what amounts to an accidental rationing of cancer meds. Some desperate and/or influential patients (or doctors or hospitals) get their planned chemo and the rest, well, don’t.

Unfortunately, Read more »

*This blog post was originally published at Medical Lessons*

Individualizing “The Fight Against Cancer”

You have heard it countless times, “The War on Cancer.” President Nixon announced it. The National Cancer Institute has spearheaded what TV and radio commercials always talk about as “the fight against cancer.” Singular. But we really need to start thinking about it as a plural.  Wars on cancer. Fights against cancer. Taking it one step further, we need to see each person’s fight as an individual battle.  Not just individualized to the patient’s spirit or age or sense of hope, but individualized to his or her particular biology, matched up with the specific cancer and available treatments. That is the nature of “personalized medicine” applied to cancer. We’ve been talking about it for a few years around here, but what’s exciting now is that even more super smart people in the cancer scientific community are devoting themselves to it.

I met two people like that today near the research labs at the University of Washington in Seattle. Without giving too much away (they’ve got big plans), these two hematologist-oncologists, with many advanced degrees between them and decades of experience, are trying to build something really big that could lengthen lives and save many too.

What they’re trying to do is Read more »

*This blog post was originally published at Andrew's Blog*

Lessening Cancer Care Costs: Oncologists Should Speak Openly About The Possibility of Death

We’ve reached the second half of our discussion on Bending the Cost Curve in Cancer Care. The authors of the NEJM paper, Drs. T. Smith and B. Hillner, go on to consider how doctors’ behavior influences costs in Changing Attitudes and Practice. Today’s point on the list: “Oncologists need to recognize that the costs of care are driven by what we do and what we do not do.”

In other words (theirs): “The first step is a frank acknowledgment that changes are needed.” A bit AA-ish, but fair enough –

The authors talk about needed, frank discussions between doctors and patients. They emphasize that oncologists/docs drive up costs and provide poorer care by failing to talk with patients about the possibility of death, end-of-life care, and transitions in the focus of care from curative intent to palliation.

They review published findings on the topic: Read more »

*This blog post was originally published at Medical Lessons*

Columbia University Medical Center To Hold All-Day Event Covering Pancreatic Cancer Research

On Thursday, October 20, The Pancreas Center of NewYork-Presbyterian Hospital/Columbia University Medical Center will be holding the 2011 Gigi Shaw Arledge Conference on Pancreatic Diseases. This all-day event is targeted for clinicians and scientists, covering pancreatic cancer research from basic, translational, clinical and epidemiological perspectives and will feature distinguished guest lecturers and leaders in the field of pancreatic diseases.

The conference is being held due to the generous support of the Gigi Arledge Foundation. Giselle (Gigi) Arledge, the late wife of Columbia Trustee and benefactor Roone Arledge, passed away from pancreatic cancer in 2010. According to foundation President Catherine Shaw, ” Now is the time to move pancreatic cancer research forward. Dr. Chabot, Dr. Wang and the team at The Pancreas Center are leaders in this battle. With their focus on research, treatment and prevention, they are helping develop society’s knowledge of pancreatic cancer. In my mother’s honor, I have donated a research and endowment fund that will support the Center’s scientific research”.

*This blog post was originally published at Columbia University Department of Surgery Blog*

Mammogram Frequency Should Be Dependent On More Than A Woman’s Age

I read the LA Times article by Shari Roan, Study urges more individual mammogram guidelines, with interest.  As Roan notes, guidelines to date have mainly focused on a woman’s age and not her other risks factors.

The American Cancer Society recommends that healthy women undergo screening mammograms every one to two years beginning at age 40 regardless of risk factors. In 2009, the U.S. Preventive Services Task Force recommended a different schedule which urged the inclusion of an individual’s personal risks:  screening for women ages 40 to 49 should be based on individual risk factors and women ages 50 to 74 should be screened every two years.

Monday, a paper was published in the Annals of Internal Medicine (full reference below) which argues for a more personalized approach to screening mammograms.

The study by Dr. Steven R. Cummings, senior author and senior researcher at the California Pacific Medical Center Research Institute, and colleagues was based on a computer model comparing the lifetime costs and health benefits for women who got mammograms every year, every two years, every three to four years or never. Read more »

*This blog post was originally published at Suture for a Living*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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