With cancer rates soaring - an estimated 1.5 million Americans were diagnosed with cancer in 2010, according to the National Cancer Institute - there's an increasing need for better cancer treatments. But fewer than 1% of cancer patients join clinical trials.
In an article just published in the Annals of Surgery, Waddah B. Al-Refaie, MD and colleagues found that just 0.64% of patients with solid tumors enrolled in clinical trials. They analyzed data on 244,528 cancer patients from the California Cancer Registry from 2001-2008 ("Cancer Trials Versus the Real World in the United States").
The authors point out that the few patients who do join trials do not represent the wide range of U.S. cancer patients. Patients who do enroll in clinical trials tend to be white, younger than 65 years old, and have late-stage cancer, the authors state. This lack of diversity makes it hard to assess how well a new drug might work on other types of patients.
There are many reasons why cancer patients don't join clinical trials. Some of the barriers are financial: doctors don't always tell patients about clinical trials for fear of losing patient revenue to the trial, and insurers don't always cover the cost of clinical trials for patients (although that should change with reform in 2014), explains Betsy de Parry on Candid Cancer ("Low enrollment in clinical trials is hampering progress"). Some barriers are more complex: patients might not live near clinical trial sites, and minority patients might distrust medical authorities, particularly around clinical trials, points out the National Cancer Institute, in a web page on trial participation that is older but still relevant.
The bottom line is that trial participation is inadequate to develop better, potentially life-saving treatments that so many cancer patients need. Information about joining cancer clinical trials is available online at the National Cancer Institute's website.
Showing posts with label cancer. Show all posts
Showing posts with label cancer. Show all posts
Monday, August 29, 2011
Friday, April 22, 2011
Why it Matters How VCs Spend Their Money
In the biotechnology sector, when non-profit and government organizations can't or don't provide funding, venture capital firms (VCs) often do. The for-profit VCs, of course, want a good return on their investment -- first through promising clinical trials that lead to FDA approval for a product, then through wide and profitable adoption of the product by patients and their health care providers.
But because this process can take a decade or even longer, many VCs are putting their investment dollars into other projects with a quicker payout, particularly social networking, according to a recent Fierce Biotech post by John Carroll that cites a Reuters survey on the topic ("VCs: Chill sets in on biotech as social networking gets hot"). "Why invest in biotech companies which face years of risky clinical trial work," writes Carroll, "when you can grab a stake in a social networking company and potentially cash out in a year or two?"
This investment fickleness is one reason why we need government agencies like the NIH to fund promising research. But we also need VCs, because they have the deep pockets and the business expertise to bring needed health products to market, as long as their investors are willing to make long-term investments.Venture capital-funded companies are developing new vaccines, pain medications, gene therapies, and cancer treatments, to name just a few products.
Venture capital firms invested $5.9 billion in the first quarter of this year, and $784 million of that went to biotechnology, according to the MoneyTree (tm) Report created by PricewaterhouseCoopers, the National Venture Capital Association (NVCA), and Thomson Reuters. The software industry ($1.1 billion) and "Internet-specific companies" such as social networking sites ($1.2 billion) received the biggest pieces of the VC pie in the past quarter, according to an April 15 press release from the NVCA.
Venture capital firms invested more money in biotechnology over the past quarter than in the last quarter of 2010. But the NVCA press release stated that the money is divvied up among far fewer biotechnology companies now than in the past. This means that VCs are funding a smaller range of potential therapies.
It's hard to predict which therapies will succeed, but we need better treatments for widespread problems such as cancer and chronic pain. Ultimately we all benefit when VCs patiently fund the greatest possible number of promising therapies, instead of diverting funds to look for the next FaceBook.
But because this process can take a decade or even longer, many VCs are putting their investment dollars into other projects with a quicker payout, particularly social networking, according to a recent Fierce Biotech post by John Carroll that cites a Reuters survey on the topic ("VCs: Chill sets in on biotech as social networking gets hot"). "Why invest in biotech companies which face years of risky clinical trial work," writes Carroll, "when you can grab a stake in a social networking company and potentially cash out in a year or two?"
This investment fickleness is one reason why we need government agencies like the NIH to fund promising research. But we also need VCs, because they have the deep pockets and the business expertise to bring needed health products to market, as long as their investors are willing to make long-term investments.Venture capital-funded companies are developing new vaccines, pain medications, gene therapies, and cancer treatments, to name just a few products.
Venture capital firms invested $5.9 billion in the first quarter of this year, and $784 million of that went to biotechnology, according to the MoneyTree (tm) Report created by PricewaterhouseCoopers, the National Venture Capital Association (NVCA), and Thomson Reuters. The software industry ($1.1 billion) and "Internet-specific companies" such as social networking sites ($1.2 billion) received the biggest pieces of the VC pie in the past quarter, according to an April 15 press release from the NVCA.
Venture capital firms invested more money in biotechnology over the past quarter than in the last quarter of 2010. But the NVCA press release stated that the money is divvied up among far fewer biotechnology companies now than in the past. This means that VCs are funding a smaller range of potential therapies.
It's hard to predict which therapies will succeed, but we need better treatments for widespread problems such as cancer and chronic pain. Ultimately we all benefit when VCs patiently fund the greatest possible number of promising therapies, instead of diverting funds to look for the next FaceBook.
Sunday, January 30, 2011
What to Do About Household Toxins
Chemicals in paints and household cleaners might be contributing to a rise in childhood cancers, according to the toxin watchdog group Safer Chemicals, Healthy Families. The group is a coalition of individuals and organizations such as Physicians for Social Responsibility, the Environmental Defense Fund, and Moms Rising.
A recent WebMD article, "Childhood Leukemia, Brain Cancer on the Rise," explained that Safer Chemicals, Healthy Families believes that chlorinated solvents (used in paints and spot removers, for example) and lindane (a chemical sometimes used to treat scabies) might be contributing to rising childhood cancer rates. The number of childhood leukemia and brain cancer diagnoses has been increasing about 1% a year over the past 20 years, according to Boston University environmental health professor Richard Clapp.
The article states that improved diagnostic techniques might mean that these cancers are not really becoming more common, they are just being diagnosed more accurately. Some experts also believe that the chemicals and pesticides used today are more targeted, and thus less harmful, than those used in the past.
Still, it is worth thinking about our day-to-day exposure to toxins and their impact on our health. Safer Chemicals, Healthy Families would like to expand the 1976 Toxic Substances Control Act to better regulate the wide range of chemicals now in use in everyday products. Their website includes a resource page with links to nontoxic tips.
Surely everyone can take a few steps to decrease their household exposure to potentially harmful substances: replace a cleaner with a non-toxic alternative, switch out some standard produce for organic alternatives (start with the Environmental Working Group's dirty dozen, the most pesticide-laden fruits and vegetables), or order the Oregon Environmental Council's Eco-Friendly Home Checkup Guide.
A recent WebMD article, "Childhood Leukemia, Brain Cancer on the Rise," explained that Safer Chemicals, Healthy Families believes that chlorinated solvents (used in paints and spot removers, for example) and lindane (a chemical sometimes used to treat scabies) might be contributing to rising childhood cancer rates. The number of childhood leukemia and brain cancer diagnoses has been increasing about 1% a year over the past 20 years, according to Boston University environmental health professor Richard Clapp.
The article states that improved diagnostic techniques might mean that these cancers are not really becoming more common, they are just being diagnosed more accurately. Some experts also believe that the chemicals and pesticides used today are more targeted, and thus less harmful, than those used in the past.
Still, it is worth thinking about our day-to-day exposure to toxins and their impact on our health. Safer Chemicals, Healthy Families would like to expand the 1976 Toxic Substances Control Act to better regulate the wide range of chemicals now in use in everyday products. Their website includes a resource page with links to nontoxic tips.
Surely everyone can take a few steps to decrease their household exposure to potentially harmful substances: replace a cleaner with a non-toxic alternative, switch out some standard produce for organic alternatives (start with the Environmental Working Group's dirty dozen, the most pesticide-laden fruits and vegetables), or order the Oregon Environmental Council's Eco-Friendly Home Checkup Guide.
Thursday, August 5, 2010
Adults and Kids Harmed by CT Scans
Radiation overdoses in both adults and children from computed tomography (CT) scans have lead to a lot of worry and finger-pointing in the news recently.
The issue was uncovered in a New York Times investigation by Walt Bogdanich of patients who experienced strange side effects after receiving CT scans to measure blood flow to their brain. CT scanners take a series of X-rays to create three-dimensional images of the body.
Bogdanich reported that over 400 patients at hospitals in California, Alabama, and Florida received as much as 13 times the recommended radiation doses from CT scanners. After the scans, the patients developed symptoms such as hair loss, confusion, and memory loss, and might now be at increased risk of developing cancer and brain damage.
Most of the scanners in question were made by GE Healthcare, Bogdanich reported. Hospital staff blame the overdoses on faulty training about how to use a new feature of the CT scanners designed to reduce the radiation dose. They say that a glitch in the scanners' software unintentionally lead to radiation overdoses. GE Healthcare, on the other hand, blames the hospital staff for misusing and misunderstanding this feature, and for not tracking the radiation doses more carefully for each patient.
The FDA had been investigating this issue over the past year, but "was unaware of the magnitude of those overdoses until The Times brought them to the agency's attention," Bogdanich wrote.
Meanwhile, Chicago Tribune reporter Judith Graham wrote that many children are receiving unnecessary adult-sized doses of radiation when they get CT scans. Because children often receive CT scans at hospitals for adults, the radiation doses are not always adjusted for the child's weight and size.
The issue was uncovered in a New York Times investigation by Walt Bogdanich of patients who experienced strange side effects after receiving CT scans to measure blood flow to their brain. CT scanners take a series of X-rays to create three-dimensional images of the body.
Bogdanich reported that over 400 patients at hospitals in California, Alabama, and Florida received as much as 13 times the recommended radiation doses from CT scanners. After the scans, the patients developed symptoms such as hair loss, confusion, and memory loss, and might now be at increased risk of developing cancer and brain damage.
Most of the scanners in question were made by GE Healthcare, Bogdanich reported. Hospital staff blame the overdoses on faulty training about how to use a new feature of the CT scanners designed to reduce the radiation dose. They say that a glitch in the scanners' software unintentionally lead to radiation overdoses. GE Healthcare, on the other hand, blames the hospital staff for misusing and misunderstanding this feature, and for not tracking the radiation doses more carefully for each patient.
The FDA had been investigating this issue over the past year, but "was unaware of the magnitude of those overdoses until The Times brought them to the agency's attention," Bogdanich wrote.
Meanwhile, Chicago Tribune reporter Judith Graham wrote that many children are receiving unnecessary adult-sized doses of radiation when they get CT scans. Because children often receive CT scans at hospitals for adults, the radiation doses are not always adjusted for the child's weight and size.
Thursday, July 29, 2010
Health Care Reform Basics Explained
The family issues activist group MomsRising met with HHS Secretary Kathleen Sebelius in a web chat recently to ask questions that they had gathered from their million-plus membership of mothers. Since I've questioned MomsRising's tactics in the past, I was curious to see how this chat would go. It's certainly an important topic: a HealthDay/Harris Poll of 2,100-plus Americans, released today, showed that many are deeply confused about what changes to expect from the Affordable Care Act that passed in March.
Actress Fran Dreschler, who survived uterine cancer and now works to improve cancer awareness among women through her website Cancer Schmancer, joined Sebelius and MomsRising's National Campaign Director Donna Norton in the web chat.
It was an odd collection of personalities: the articulate, calm Sebelius; the passionate and occasionally off-topic Dreschler; and the smiling, friendly Norton, who wore a MomsRising T-shirt (as MomsRising representatives do when meeting publicly with government officials, a habit that I dislike) in contrast to the smartly-dressed Sebelius and Dreschler.
The web chat touched on some changes coming in 2014 (the health insurance exchange), but focused on what will change in 2010. Changes to expect this year include:
A timeline of when various benefits will begin is available on the new healthcare.gov site, which also has an interactive section that lists health insurance options for different groups of people.
It's unclear to me whether health insurance will become less complicated under the new law. Billing paperwork from health care insurers and providers is currently so complex and error-prone that Quicken has developed Health Expense Tracker software that interacts electronically with certain health insurance companies to help consumers keep track of everything. The 1996 HIPAA bill was designed (in part) to reduce and streamline insurance paperwork; instead, it has increased it.
On the other hand, the Affordable Care Act offers Americans assurances that their medical expenses will be covered more fairly. To pay for this, the bill is structured to provide financial incentives for insurers (and other organizations) to focus on preventing disease, rather than dropping patients when their diseases become too expensive. With more than half of all U.S. bankruptcies caused by unpaid medical expenses, it's about time for the change.
Actress Fran Dreschler, who survived uterine cancer and now works to improve cancer awareness among women through her website Cancer Schmancer, joined Sebelius and MomsRising's National Campaign Director Donna Norton in the web chat.
It was an odd collection of personalities: the articulate, calm Sebelius; the passionate and occasionally off-topic Dreschler; and the smiling, friendly Norton, who wore a MomsRising T-shirt (as MomsRising representatives do when meeting publicly with government officials, a habit that I dislike) in contrast to the smartly-dressed Sebelius and Dreschler.
The web chat touched on some changes coming in 2014 (the health insurance exchange), but focused on what will change in 2010. Changes to expect this year include:
- preventative care coverage without out-of-pocket costs to the consumer
- new insurance pools for people denied coverage due to pre-existing conditions
- expanded health care coverage for adults up to age 26
- elimination of annual caps on insurance coverage for individuals
A timeline of when various benefits will begin is available on the new healthcare.gov site, which also has an interactive section that lists health insurance options for different groups of people.
It's unclear to me whether health insurance will become less complicated under the new law. Billing paperwork from health care insurers and providers is currently so complex and error-prone that Quicken has developed Health Expense Tracker software that interacts electronically with certain health insurance companies to help consumers keep track of everything. The 1996 HIPAA bill was designed (in part) to reduce and streamline insurance paperwork; instead, it has increased it.
On the other hand, the Affordable Care Act offers Americans assurances that their medical expenses will be covered more fairly. To pay for this, the bill is structured to provide financial incentives for insurers (and other organizations) to focus on preventing disease, rather than dropping patients when their diseases become too expensive. With more than half of all U.S. bankruptcies caused by unpaid medical expenses, it's about time for the change.
Friday, June 4, 2010
Superfood Burnout
I think that the Baby Boomers, concerned about preserving their health as they age, are responsible for our obsession with "superfoods" that can protect us from disease. A while ago, the superfood of choice was antioxidant-packed pomegranate juice - particularly when marketed as the Pom Wonderful drink - which might prevent hardening of the arteries and prevent Alzheimer's disease (although the Pom Wonderful website is careful not to make these claims).
More recently, the acai berry, whose antioxidants might prevent cancer and heart disease, has pushed aside pomegranates as the food of choice. Other holier-than-thou, nutrient-rich foods that we should be eating include quinoa, spelt, and heirloom tomatoes.
Of course it's important to think about what you eat. This Sunday's New York Times had a cover article on the horrifying amount of salt in many processed foods, and salt's role in increasing the rates of high blood pressure in Americans. The food industry, meanwhile, is fighting to keep the salt in their foods to cover up the true flavor of their products' ingredients.
I support the slow food movement, avoid processed foods, and cook from scratch as much as I can. I prowl for stone fruit, corn on the cob, strawberries, and figs at the local farmers' markets when I have time. I have a budget, though, and I don't have hours to cook, or shop for the perfect ingredients, each day.
When exactly did eating healthy morph into an obsession with eating the perfect foods? I want my family to eat well, but that doesn't mean I'm sprinkling acai berries on their oatmeal in the morning.
And can you really enjoy your meals if you're too busy either feeling guilty for eating the wrong things, or self-righteous for eating the right ones? What does this superfood obsession say about us as Americans, who always seem to demand simple answers for complex problems such as heart disease?
More recently, the acai berry, whose antioxidants might prevent cancer and heart disease, has pushed aside pomegranates as the food of choice. Other holier-than-thou, nutrient-rich foods that we should be eating include quinoa, spelt, and heirloom tomatoes.
Of course it's important to think about what you eat. This Sunday's New York Times had a cover article on the horrifying amount of salt in many processed foods, and salt's role in increasing the rates of high blood pressure in Americans. The food industry, meanwhile, is fighting to keep the salt in their foods to cover up the true flavor of their products' ingredients.
I support the slow food movement, avoid processed foods, and cook from scratch as much as I can. I prowl for stone fruit, corn on the cob, strawberries, and figs at the local farmers' markets when I have time. I have a budget, though, and I don't have hours to cook, or shop for the perfect ingredients, each day.
When exactly did eating healthy morph into an obsession with eating the perfect foods? I want my family to eat well, but that doesn't mean I'm sprinkling acai berries on their oatmeal in the morning.
And can you really enjoy your meals if you're too busy either feeling guilty for eating the wrong things, or self-righteous for eating the right ones? What does this superfood obsession say about us as Americans, who always seem to demand simple answers for complex problems such as heart disease?
Tuesday, February 9, 2010
Can Twitter Save Your Life?
I recently heard about a local 8-year-old girl with leukemia whose parents are looking for a bone marrow donor match for her. Because the girl, Natalie, is Asian, a match (i.e., someone whose cells are similar enough to the girl's cells for her immune system to accept the transplant) is most likely with an Asian donor.
There is an ongoing shortage of ethnic minority donors of bone marrow and stem cells for blood cancer patients (stem cells are extracted from the donor's blood in an outpatient procedure). As a result, Caucasian patients are about twice as likely to find a donor match as minority patients.
I looked at the site for the girl, www.hopefornatalie.com, and looked at a related bone marrow donation site, www.dkmsamericas.org, then tweeted the information to spread the word, because you never know who might be able to help. And perhaps Natalie's case will encourage more people to register as potential bone marrow donors so that patients with blood cancer will have a larger group of donors to search within the National Marrow Donor Program. Donating bone marrow, if you're the right match for a patient, is relatively simple and painless.
To spread the word and find a donor, Natalie's parents created a web page, Facebook page, and Twitter account, using social media to its fullest extent; I heard about Natalie on a Yahoo listserve. Natalie's website includes links to volunteer, register, and make donations, and a media contact number.
Thinking about Natalie's case, however, I am haunted by a number of questions. First of all, I wonder about the families who need bone marrow or blood donors for their ill children but who don't have the tech savvy, access, or language skills to look for much-needed donors through social media.
These families can't cast a wide net looking for donors as Natalie's family has. They are less likely than Natalie's family to find a donor who can save their child. On the other hand, these families do benefit from the additional donors in the national registry who sign up when they hear about children such as Natalie. But to what degree does the surge of new registrants created by cases such as Natalie's mitigate this digital divide?
A while ago, when Twitter was quite new, I stopped to chat with the father of my daughter's classmate at pick-up time. He worked at Twitter, and I asked him what exactly Twitter was supposed to be used for - griping about your day? planning a night out with friends?
Now I know that Twitter is not just a tech toy. It played such a big role in documenting the Iranian election in 2009, for example, that the State Department asked Twitter to change its maintenance schedule in order to keep Twitter online during the protests. Twitter, Facebook, blogs, and other online media are, in fact, extremely powerful for spreading the word about any number of different causes -- political, medical, or personal. Powerful, that is, for people who have access to the technology.
There is an ongoing shortage of ethnic minority donors of bone marrow and stem cells for blood cancer patients (stem cells are extracted from the donor's blood in an outpatient procedure). As a result, Caucasian patients are about twice as likely to find a donor match as minority patients.
I looked at the site for the girl, www.hopefornatalie.com, and looked at a related bone marrow donation site, www.dkmsamericas.org, then tweeted the information to spread the word, because you never know who might be able to help. And perhaps Natalie's case will encourage more people to register as potential bone marrow donors so that patients with blood cancer will have a larger group of donors to search within the National Marrow Donor Program. Donating bone marrow, if you're the right match for a patient, is relatively simple and painless.
To spread the word and find a donor, Natalie's parents created a web page, Facebook page, and Twitter account, using social media to its fullest extent; I heard about Natalie on a Yahoo listserve. Natalie's website includes links to volunteer, register, and make donations, and a media contact number.
Thinking about Natalie's case, however, I am haunted by a number of questions. First of all, I wonder about the families who need bone marrow or blood donors for their ill children but who don't have the tech savvy, access, or language skills to look for much-needed donors through social media.
These families can't cast a wide net looking for donors as Natalie's family has. They are less likely than Natalie's family to find a donor who can save their child. On the other hand, these families do benefit from the additional donors in the national registry who sign up when they hear about children such as Natalie. But to what degree does the surge of new registrants created by cases such as Natalie's mitigate this digital divide?
A while ago, when Twitter was quite new, I stopped to chat with the father of my daughter's classmate at pick-up time. He worked at Twitter, and I asked him what exactly Twitter was supposed to be used for - griping about your day? planning a night out with friends?
Now I know that Twitter is not just a tech toy. It played such a big role in documenting the Iranian election in 2009, for example, that the State Department asked Twitter to change its maintenance schedule in order to keep Twitter online during the protests. Twitter, Facebook, blogs, and other online media are, in fact, extremely powerful for spreading the word about any number of different causes -- political, medical, or personal. Powerful, that is, for people who have access to the technology.
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