December 21st, 2010 by Debra Gordon in Health Policy, Opinion
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“With this disappointing decision, the FDA has chosen to place itself between patients and their doctors by rationing access to a life-extending drug. . . We can’t allow this government takeover of health care to continue any longer.”
That quote, courtesy of this morning’s [Dec 17th] Washington Post, incensed me to such a degree that I am writing this blog despite the two deadlines I have today. The speaker is Sen. David Vitter (R-La). The “disappointing decision” he refers to: The FDA’s decision to remove the breast cancer indication for Avastin (bevacizumab).
I wrote about this earlier, and you can read the post here, but that was before yesterday’s [Dec 16th] decision. I’m not going to comment here on the benefits or risks of Avastin. . . except to say that I’m sure there are individual women who are alive today because of it, and, quite possibly, individual women who are dead today despite it. But that’s not how we do medical science, based on individual patients. We do medical science based on large clinical studies (which are often designed with and approved by FDA officials). It’s not a perfect system, but it’s the system we have. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
December 20th, 2010 by RyanDuBosar in Better Health Network, News, Research
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Emergency patients with acute abdominal pain feel more confident about medical diagnoses when a doctor has ordered a computed tomography (CT) scan, and nearly three-quarters of patients underestimate the radiation risk posed by this test, reports the Annals of Emergency Medicine.
“Patients with abdominal pain are four times more confident in an exam that includes imaging than in an exam that has no testing,” said the paper’s lead author. “Most of the patients in our study had little understanding of the amount of radiation delivered by one CT scan, never mind several over the course of a lifetime. Many of the patients did not recall earlier CT scans, even though they were listed in electronic medical records.”
Researchers surveyed 1,168 patients with non-traumatic abdominal pain. Confidence in medical evaluations with increasing levels of laboratory testing and imaging was rated on a 100-point scale. Then, to assess cancer risk knowledge, participants rated their agreement with these factual statements: “Approximately two to three abdominal CTs give the same radiation exposure as experienced by Hiroshima survivors,” and “Two to three abdominal CTs over a person’s lifetime can increase cancer risk.” Read more »
*This blog post was originally published at ACP Internist*
December 10th, 2010 by RamonaBatesMD in Better Health Network, Research
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Most medical centers routinely perform or require that breast tissue be sent to pathology for histologic examination. The authors of the article (referenced below) question whether this is useful when the breast tissue excised comes from an adolescent male with gynecomastia considering the benign nature of the condition.
Furthermore, the authors point out male breast cancer is rare and when it does occur it is most often in older males, not adolescent males:
In 2009, there were an estimated 1,910 new cases and 440 deaths related to male breast cancer, accounting for just 0.25% and 0.15% of all new cases of cancer and cancer deaths for males in the entire United States, respectively, with historical cohorts demonstrating that the peak incidence of male breast cancer occurs at approximately 71 years of age. More significantly, breast cancer becomes increasingly uncommon among younger age groups.
To look at the issue, the authors did a retrospective chart review of their patients younger than 21 years of age who had undergone subcutaneous mastectomy for gynecomastia between 1999 and 2010. A review of the literature was done, as was an informal survey of major children’s hospitals regarding their practice of histologic examination for adolescent gynecomastia. Read more »
*This blog post was originally published at Suture for a Living*
December 8th, 2010 by Linda Burke-Galloway, M.D. in Better Health Network, Health Policy, News
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The day Elizabeth Edwards announced that she had breast cancer, my heart sank. Finding a lump in the breast only heightens the suspicious that the prognosis may not be good and in Elizabeth’s case, it wasn’t.
We all admired Elizabeth for different reasons. In my case, it was her love for healthcare reform that quickly grabbed my attention. Elizabeth advocated universal healthcare and comprehensive insurance for all Americans, not a “compromised” version based on partisanship and politics. As the years wore on, she discussed her diagnosis of incurable breast cancer with passion stating that she knew that she had access to the best possible care, but empathized with women who were not as fortunate.
It is said that behind every successful man lies the power behind the throne, and we know this to be true about Elizabeth. She was an accomplished attorney in her own right who took a backseat to raise her kids and support the presidential candidacy of her husband. For a while I thought Elizabeth had won the battle against breast cancer during its remission, but then it resurfaced its ugly head in the midst of her husband’s presidential campaign and she handled it with dignity and grace. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
