Charles Ornstein and Katie Thomas
The New York Times
Originally published September 8, 2018
One of the world’s top breast cancer doctors failed to disclose millions of dollars in payments from drug and health care companies in recent years, omitting his financial ties from dozens of research articles in prestigious publications like The New England Journal of Medicine and The Lancet.
The researcher, Dr. José Baselga, a towering figure in the cancer world, is the chief medical officer at Memorial Sloan Kettering Cancer Center in New York. He has held board memberships or advisory roles with Roche and Bristol-Myers Squibb, among other corporations, has had a stake in start-ups testing cancer therapies, and played a key role in the development of breakthrough drugs that have revolutionized treatments for breast cancer.
According to an analysis by The New York Times and ProPublica, Dr. Baselga did not follow financial disclosure rules set by the American Association for Cancer Research when he was president of the group. He also left out payments he received from companies connected to cancer research in his articles published in the group’s journal, Cancer Discovery. At the same time, he has been one of the journal’s two editors in chief.
The info is here.
Showing posts with label Cancer. Show all posts
Showing posts with label Cancer. Show all posts
Tuesday, October 9, 2018
Thursday, July 26, 2018
Number of Canadians choosing medically assisted death jumps 30%
Kathleen Harris
www.cbc.ca
Originally posted June 21, 2018
There were 1,523 medically assisted deaths in Canada in the last six-month reporting period — a nearly 30 per cent increase over the previous six months.
Cancer was the most common underlying medical condition in reported assisted death cases, cited in about 65 per cent of all medically assisted deaths, according to the report from Health Canada.
Using data from Statistics Canada, the report shows medically assisted deaths accounted for 1.07 per cent of all deaths in the country over those six months. That is consistent with reports from other countries that have assisted death regimes, where the figure ranges from 0.3 to four per cent.
The information is here.
www.cbc.caOriginally posted June 21, 2018
There were 1,523 medically assisted deaths in Canada in the last six-month reporting period — a nearly 30 per cent increase over the previous six months.
Cancer was the most common underlying medical condition in reported assisted death cases, cited in about 65 per cent of all medically assisted deaths, according to the report from Health Canada.
Using data from Statistics Canada, the report shows medically assisted deaths accounted for 1.07 per cent of all deaths in the country over those six months. That is consistent with reports from other countries that have assisted death regimes, where the figure ranges from 0.3 to four per cent.
The information is here.
Saturday, February 3, 2018
Can We Reimagine Our Approach To Treating Disease?
Siddhartha Mukherjee
TED Talk
Posted December 22, 2017
When it comes to medicine, one rule of thinking has generally prevailed: Have disease, take pill, kill something. But physician Siddhartha Mukherjee says treatment should take a broader approach.
TED Talk
Posted December 22, 2017
When it comes to medicine, one rule of thinking has generally prevailed: Have disease, take pill, kill something. But physician Siddhartha Mukherjee says treatment should take a broader approach.
Tuesday, September 26, 2017
Drug company faked cancer patients to sell drug
Aaron M. Kessler
CNN.com
Originally published September 6, 2017
When Insys Therapeutics got approval to sell an ultra-powerful opioid for cancer patients with acute pain in 2012, it soon discovered a problem: finding enough cancer patients to use the drug.
To boost sales, the company allegedly took patients who didn't have cancer and made it look like they did.
The drug maker used a combination of tactics, such as falsifying medical records, misleading insurance companies and providing kickbacks to doctors in league with the company, according to a federal indictment and ongoing congressional investigation by Sen. Claire McCaskill, a Democrat from Missouri.
The new report by McCaskill's office released Wednesday includes allegations about just how far the company went to push prescriptions of its sprayable form of fentanyl, Subsys.
Because of the high cost associated with Subsys, most insurers wouldn't pay for it unless it was approved in advance. That process, likely familiar to anyone who's taken an expensive medication, is called "prior-authorization."
The article is here.
CNN.com
Originally published September 6, 2017
When Insys Therapeutics got approval to sell an ultra-powerful opioid for cancer patients with acute pain in 2012, it soon discovered a problem: finding enough cancer patients to use the drug.
To boost sales, the company allegedly took patients who didn't have cancer and made it look like they did.
The drug maker used a combination of tactics, such as falsifying medical records, misleading insurance companies and providing kickbacks to doctors in league with the company, according to a federal indictment and ongoing congressional investigation by Sen. Claire McCaskill, a Democrat from Missouri.
The new report by McCaskill's office released Wednesday includes allegations about just how far the company went to push prescriptions of its sprayable form of fentanyl, Subsys.
Because of the high cost associated with Subsys, most insurers wouldn't pay for it unless it was approved in advance. That process, likely familiar to anyone who's taken an expensive medication, is called "prior-authorization."
The article is here.
Monday, April 24, 2017
How Flawed Science Is Undermining Good Medicine
Morning Edition
NPR.org
Originally posted April 6, 2017
Here is an excerpt:
A surprising medical finding caught the eye of NPR's veteran science correspondent Richard Harris in 2014. A scientist from the drug company Amgen had reviewed the results of 53 studies that were originally thought to be highly promising — findings likely to lead to important new drugs. But when the Amgen scientist tried to replicate those promising results, in most cases he couldn't.
"He tried to reproduce them all," Harris tells Morning Edition host David Greene. "And of those 53, he found he could only reproduce six."
That was "a real eye-opener," says Harris, whose new book Rigor Mortis: How Sloppy Science Creates Worthless Cures, Crushes Hope, and Wastes Billions explores the ways even some talented scientists go wrong — pushed by tight funding, competition and other constraints to move too quickly and sloppily to produce useful results.
"A lot of what everybody has reported about medical research in the last few years is actually wrong," Harris says. "It seemed right at the time but has not stood up to the test of time."
The impact of weak biomedical research can be especially devastating, Harris learned, as he talked to doctors and patients. And some prominent scientists he interviewed told him they agree that it's time to recognize the dysfunction in the system and fix it.
The article is here.
NPR.org
Originally posted April 6, 2017
Here is an excerpt:
A surprising medical finding caught the eye of NPR's veteran science correspondent Richard Harris in 2014. A scientist from the drug company Amgen had reviewed the results of 53 studies that were originally thought to be highly promising — findings likely to lead to important new drugs. But when the Amgen scientist tried to replicate those promising results, in most cases he couldn't.
"He tried to reproduce them all," Harris tells Morning Edition host David Greene. "And of those 53, he found he could only reproduce six."
That was "a real eye-opener," says Harris, whose new book Rigor Mortis: How Sloppy Science Creates Worthless Cures, Crushes Hope, and Wastes Billions explores the ways even some talented scientists go wrong — pushed by tight funding, competition and other constraints to move too quickly and sloppily to produce useful results.
"A lot of what everybody has reported about medical research in the last few years is actually wrong," Harris says. "It seemed right at the time but has not stood up to the test of time."
The impact of weak biomedical research can be especially devastating, Harris learned, as he talked to doctors and patients. And some prominent scientists he interviewed told him they agree that it's time to recognize the dysfunction in the system and fix it.
The article is here.
Friday, August 12, 2016
First CRISPR trial in humans is reported to start August 2016
By Sharon Begley @sxbegle
Stat News
Originally published July 21, 2016
Scientists in China plan to use the genome-editing technology CRISPR-Cas9 in patients as early as next month, Nature reported on Thursday. If they go ahead, it would be the first time people would be injected with cells whose DNA has been altered by CRISPR.
A US proposal to run a similar study received approval by a federal ethics and safety panel last month, but it faces months of additional regulatory hurdles before it can go ahead by the end of 2016 at the earliest. The Chinese scientists, led by oncologist Lu You of Sichuan University’s West China Hospital in Chengdu, received approval from the hospital’s review board on July 6, Nature reported, and plan to treat their first patient in August.
Both the US and Chinese scientists would use CRISPR to edit immune-system T cells in patients with cancer in an effort to make those cells destroy malignant cells.
The article is here.
Stat News
Originally published July 21, 2016
Scientists in China plan to use the genome-editing technology CRISPR-Cas9 in patients as early as next month, Nature reported on Thursday. If they go ahead, it would be the first time people would be injected with cells whose DNA has been altered by CRISPR.
A US proposal to run a similar study received approval by a federal ethics and safety panel last month, but it faces months of additional regulatory hurdles before it can go ahead by the end of 2016 at the earliest. The Chinese scientists, led by oncologist Lu You of Sichuan University’s West China Hospital in Chengdu, received approval from the hospital’s review board on July 6, Nature reported, and plan to treat their first patient in August.
Both the US and Chinese scientists would use CRISPR to edit immune-system T cells in patients with cancer in an effort to make those cells destroy malignant cells.
The article is here.
Saturday, July 16, 2016
Federal panel approves first test of CRISPR editing in humans
By Laurie McGinley
The Washington Post
Originally posted on June 21, 2016
A National Institutes of Health advisory panel on Tuesday approved the first human use of the gene-editing technology CRISPR, for a study designed to target three types of cancer and funded by tech billionaire Sean Parker’s new cancer institute.
The experiment, proposed by researchers at the University of Pennsylvania, would use CRISPR-Cas9 technology to modify patients’ own T cells to make them more effective in attacking melanoma, multiple myeloma and sarcoma.
The federal Recombinant DNA Advisory Committee approved the Penn proposal unanimously, with one member abstaining. The experiment still must be approved by the Food and Drug Administration, which regulates clinical trials.
The article is here.
The Washington Post
Originally posted on June 21, 2016
A National Institutes of Health advisory panel on Tuesday approved the first human use of the gene-editing technology CRISPR, for a study designed to target three types of cancer and funded by tech billionaire Sean Parker’s new cancer institute.
The experiment, proposed by researchers at the University of Pennsylvania, would use CRISPR-Cas9 technology to modify patients’ own T cells to make them more effective in attacking melanoma, multiple myeloma and sarcoma.
The federal Recombinant DNA Advisory Committee approved the Penn proposal unanimously, with one member abstaining. The experiment still must be approved by the Food and Drug Administration, which regulates clinical trials.
The article is here.
Wednesday, February 10, 2016
End-of-life care in U.S. not as costly as in Canada
By Jessica McDonald
newsworks.org
Originally posted January 10, 2016
The United States has a reputation for providing costly -- and often unwanted -- end-of-life care. But the first study to do an international comparison finds it's not as egregious as we thought.
Compared with patients in other developed nations, Americans diagnosed with cancer spend more time in the intensive care unit and get more chemotherapy in the last months of their lives.
But fewer patients are in the hospital when they die. And the overall bill, while high, isn't the steepest. That honor goes to Canada.
"We found that end-of-life care in the United States is not the worst in the world, and I think that surprises a lot of people," said Dr. Ezekiel Emanuel, a medical ethicist at the University of Pennsylvania.
The article is here.
newsworks.org
Originally posted January 10, 2016
The United States has a reputation for providing costly -- and often unwanted -- end-of-life care. But the first study to do an international comparison finds it's not as egregious as we thought.
Compared with patients in other developed nations, Americans diagnosed with cancer spend more time in the intensive care unit and get more chemotherapy in the last months of their lives.
But fewer patients are in the hospital when they die. And the overall bill, while high, isn't the steepest. That honor goes to Canada.
"We found that end-of-life care in the United States is not the worst in the world, and I think that surprises a lot of people," said Dr. Ezekiel Emanuel, a medical ethicist at the University of Pennsylvania.
The article is here.
Saturday, April 20, 2013
Physician-Assisted Suicide Program Wins Praise
By John Gever
Medscape News
Originally published April 10, 2013
Patients, their families, and physicians have been satisfied with a "death with dignity" physician-assisted suicide program made available to terminal cancer patients at a Seattle clinic, clinicians there reported.
Among 114 patients who asked about the program at the Seattle Cancer Care Alliance, the outpatient clinic for the city's major cancer treatment centers, 40 passed screening examinations and ultimately received lethal prescriptions for secobarbital, although only 24 actually took the drug, according to Elizabeth Trice Loggers, MD, PhD, and colleagues at the clinic and its affiliated centers.
"Patients, caregivers, and family members have frequently expressed gratitude after the patient obtained the prescription, regardless of whether it was ever filled or ingested, typically referencing an important sense of control in an uncertain situation," the authors wrote in the April 11 issue of the New England Journal of Medicine.
The entire story is here.
The primary source is here.
Medscape News
Originally published April 10, 2013
Patients, their families, and physicians have been satisfied with a "death with dignity" physician-assisted suicide program made available to terminal cancer patients at a Seattle clinic, clinicians there reported.
Among 114 patients who asked about the program at the Seattle Cancer Care Alliance, the outpatient clinic for the city's major cancer treatment centers, 40 passed screening examinations and ultimately received lethal prescriptions for secobarbital, although only 24 actually took the drug, according to Elizabeth Trice Loggers, MD, PhD, and colleagues at the clinic and its affiliated centers.
"Patients, caregivers, and family members have frequently expressed gratitude after the patient obtained the prescription, regardless of whether it was ever filled or ingested, typically referencing an important sense of control in an uncertain situation," the authors wrote in the April 11 issue of the New England Journal of Medicine.
The entire story is here.
The primary source is here.
Saturday, March 9, 2013
Ethics of 2 cancer studies questioned
India studies funded by Gates Foundation, National Cancer Institute draw scrutiny
By Bob Ortega
The Republic
Originally posted February 15, 2013
For more than 12 years, as part of two massive U.S-funded studies in India, researchers tracked a large group of women for cervical cancer but didn’t screen them, instead monitoring them as their cancers progressed. At least 79 of the women died.
One study, funded by the National Cancer Institute, did not adequately inform more than 76,000 women taking part about their alternatives for getting cervical-cancer screening; and those women did not give adequate informed consent, according to the Office of Human Research Protection, part of the U.S. Department of Health and Human Services.
The other study, funded by the Gates Foundation, is under review by the Food and Drug Administration, according to Kristina Borror, the OHRP’s director of compliance oversight. That study has raised similar concerns regarding 31,000 women who were tracked but not routinely screened or treated for cervical cancer.
Both studies continue today, though researchers for both told The Arizona Republic they have begun to offer screening to the women.
While the two studies differ in important respects, both included large numbers of women placed in “control groups” who were offered free visits with health-care workers, but who, until recently,were not screened for cervical cancer. Instead, researchers met with and tracked these women to monitor how many would develop cervical cancer and die, so their death rates could be compared with those of women who were being screened and treated for free.
The entire story is here.
By Bob Ortega
The Republic
Originally posted February 15, 2013
For more than 12 years, as part of two massive U.S-funded studies in India, researchers tracked a large group of women for cervical cancer but didn’t screen them, instead monitoring them as their cancers progressed. At least 79 of the women died.
One study, funded by the National Cancer Institute, did not adequately inform more than 76,000 women taking part about their alternatives for getting cervical-cancer screening; and those women did not give adequate informed consent, according to the Office of Human Research Protection, part of the U.S. Department of Health and Human Services.
The other study, funded by the Gates Foundation, is under review by the Food and Drug Administration, according to Kristina Borror, the OHRP’s director of compliance oversight. That study has raised similar concerns regarding 31,000 women who were tracked but not routinely screened or treated for cervical cancer.
Both studies continue today, though researchers for both told The Arizona Republic they have begun to offer screening to the women.
While the two studies differ in important respects, both included large numbers of women placed in “control groups” who were offered free visits with health-care workers, but who, until recently,were not screened for cervical cancer. Instead, researchers met with and tracked these women to monitor how many would develop cervical cancer and die, so their death rates could be compared with those of women who were being screened and treated for free.
The entire story is here.
Monday, April 23, 2012
Do Bioethics Really Matter?
By Arthur Kaplan
Book Review published in The Lancet
Malignant: Medical Ethicists Confront Cancer by Rebecca Dresser
Originally published April 14, 2012
Malignant is a book that I am sure will catch the eye of many readers of this journal. Not because it is a collection of essays by people who have either had cancer or who cared for loved ones who did. Many books cover that ground. Not because it is a collection of essays by distinguished American bioethicists, including Norman Fost, Leon Kass, Daniel W Brock, and Rebecca Dresser. There are lots of bioethics collections authored by eminent scholars around too. This book will command attention because the bioethicists writing the essays are also the very same people who had the cancer or helped loved ones who did.
The book thus raises the obvious question—in facing cancer, did the contributors fare any better for all their scholarly expertise in bioethics? Or, did cancer prove to be the great leveller, leaving all who talk for a living about moral theory and normative argument tongue-tied as each learned what the real world of serious sickness is all about? Did careers of offering opinions to others in and out of health care about how to behave, speak, and respond make a whit of difference to the personal experience each of the contributors had in their own intimate struggles with cancer?
Tuesday, August 23, 2011
Psychologists with Cancer: Clinical, Ethical, and Practical Challenges
Helen L. Coons, Ph.D., ABPP
Jana N. Martin, Ph.D.
From The Pennsylvania Psychologist
Psychologists living with cancer face clinical, ethical and practical challenges while coping with their own diagnosis and treatments. This brief article offers several suggestions to psychologists in practice and other professional settings who are coping with an early or advanced diagnosis of cancer. Seek support and supervision. While most individuals are remarkably resilient in coping with cancer and its treatments, a new or recurrent diagnosis and the complex treatment decisions which follow can be highly stressful and frightening. Reaching out to colleagues early for support and supervision is important for psychologists with cancer. Ask colleagues if they know psychologists (or other mental health providers) who have experienced cancer treatment. Practical, informational and emotional support from someone with an insiders’ view is invaluable. The PPA listserv and APA Division listservs may also be helpful in identifying other psychologists with cancer.
Formal supervision from a respected colleague is essential to address clinical, ethical and practical issues that emerge as psychologists cope with cancer, and to support them in developing a practice management plan during and after treatments.
Develop a practice management plan. A cancer diagnosis will typically be followed by treatment decisions related to surgery, chemotherapy, and/or radiation as well as acute, late, and long-term side effects. At any point in the treatment course, psychologists often face a series of challenging questions related to their practice and other professional roles. Some individuals are too ill, tired, or uncomfortable to work during treatment; some will have to work to maintain their income; and most will likely work part- or full-time with breaks for treatment. Psychologists undergoing cancer treatment are confronted with questions such as: (1) should they continue to see patients, teach, supervise, etc; (2) should they work full- or part-time; (3) if, how and when to disclose their diagnosis to patients, keeping in the mind their practice focus (e.g., children, teens, adults); (4) how to deal with breaks in treatment resulting from additional surgery or side effects of chemotherapy and/or radiation; (5) whether or not to treat patients who have or had cancer, are “at risk” for cancer, have lost a loved one to cancer, have significant attachment issues, or require a high degree of treatment consistency, etc; and (6) clinical, ethical and practical issues when closing a practice. Developing a practice management plan in consultation with a supervisor to address these and other questions can be helpful and empowering (Coons, 2010).
A practice management plan during and after cancer treatment may include creating flexibility in the psychologist’s schedule. For example, some psychologists reduce their patient and teaching load, and/or block their schedule after each chemotherapy cycle when side effects (e.g., nausea, fatigue, pain, low blood counts, etc.) are more likely to emerge and may adversely affect one’s ability to work. Some individuals undergoing chemotherapy have also shifted the focus of their clinical work to more testing or consultation so that they can schedule evaluations between cycles when they have more energy. Others have found that the familiarity of work is a healthy break from cancer treatment. A management plan should include finding colleagues to be on standby to call and re-schedule clients (who have provided informed consent) so that psychologists do not have to explain to patients how they are feeling.
Pace yourself during and after treatment. Throughout and after cancer treatment, psychologists need to be mindful of their physical, emotional and cognitive well-being. Psychologists have an ethical obligation to ensure that their own physical and psychological well-being is healthy enough to care for patients, teach, supervise, etc. Fatigue, pain, nausea and vomiting and the medications used to treat these symptoms or side effects may compromise some individuals’ ability to meet the demands of clinical practice. Chemotherapy and other medications used in cancer treatment, for example, can diminish cognitive functioning. While changes in concentration, memory, processing speed, and the ability to multitask are likely to be mild and time-limited, high level clinical decision-making is essential for differential diagnosis and treatment. Psychologists undergoing cancer treatment must evaluate if they are healthy enough to meet the demands of practice and other professional responsibilities.
Designate a clinical power of attorney. Consistent with the APA Ethical Principles of Psychologists and Code of Conduct (2002), psychologists are obligated to ensure that patients will be taken care of if they are not able to meet professional responsibilities because of personal problems or when there are interruptions in therapy or termination. While many psychologists with cancer will continue to practice during and after treatment, it is important to designate a clinical power of attorney in the event that the psychologist is unable to take care of patients. This colleague should be able to access the psychologist’s office (i.e., they have door and file keys), patient lists, appointment schedules, and records; will contact patients and can either reschedule or provide care to patients, or refer them to other colleagues with the appropriate clinical expertise. See Pope and Vasquez, (2007); Spayd & O’Leary Wiley (2009); and www.apapracticecentral.org for more detailed discussions on closing a practice.
Personal experience with cancer and expertise in psychosocial oncology. Psychologists who undergo their own cancer treatment will have a special understanding of the experience faced by so many adults across the life span. After treatment, they may even consider taking care of patients with cancer. While well meaning, the psychologist’s own treatment experience is very different from having the expertise in psychosocial oncology necessary to provide evidence-based assessment and treatment to adults with early and advanced cancers. Treating patients with cancer requires a highly specialized fund of knowledge and clinical competencies to ensure quality care and outcomes. While psychologists may want to help others deal with this challenge, they still have the ethical obligation to practice within their scope of expertise. Again, supervision from a respected colleague can be invaluable to sort out if and when a psychologist should treat others with or affected by cancer.
References
American Psychological Association (2002). Ethical principles of psychologists and code of conduct. Washington , DC: Author.
Coons, H. L. (2010). Psychologists with early and advanced breast cancer: Clinical, ethical and practical challenges. Manuscript submitted for publication.
Pope, K. S., & Vasquez, M. J. T. (2007). Ethics in psychotherapy and counseling: A practical guide. San Francisco: John Wiley.
Spayd, C. S., & O’Leary Wiley, M. (2009, December). Closing a professional practice: Clinical and practical considerations. The Pennsylvania
Jana N. Martin, Ph.D., is a licensed psychologist in independent practice in Long Beach, CA. Some of her work with children, adults, and families has focused on coping with chronic diseases such as cancer, and she is in remission from lymphoma. She may be reached at drjanamartin@verizon.net.
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