Category: Health

Cancer Five-Year Survival Rates Still Discourage

I quote the discouraging cancer survival numbers below because too often “Cancer Inc.” allies itself with government regulators to slow the disruptive medical entrepreneurs who who would otherwise quickly make those numbers less discouraging.

(p. A15) Cancer Treatment Centers of America– . . . –has long raised eyebrows with its marketing. Currently, the group touts its “genomic testing,” which guides patient-specific chemotherapy. Unmentioned is the dismal success rate of such tests in trials: Only 6.4% of patients were successfully matched with a drug, according to a 2016 article in Nature.
Here, from the American Cancer Society, are five-year survival statistics for various cancers: cervical, 69%; leukemia, 63%; ovarian, 46%; brain and nervous system, 35%; lung, 19%; liver, 18%; pancreatic, 9%.
One wonders how such numbers justify the blue sky seen in today’s advertising.
. . .
. . . the war on cancer is not the place for pep talks and poetic license. We could do with more disclosure, less delusion.
Nor is this a question of depriving patients of hope. On the contrary, it’s about depriving Cancer Inc. of the ability to exploit false hope.

For the full commentary, see:
Steve Salerno. “In the War on Cancer, Truth Becomes a Casualty; The multibillion-dollar treatment industry appeals to emotion in misleading ads.” The Wall Street Journal (Saturday, April 21, 2018): A15.
(Note: ellipses added.)
(Note: the online version of the commentary has the date April 20, 2018.)

Entrepreneur Was Frustrated by Patients’ Pill Confusion

(p. B2) TJ Parker grew up working the counter for his father’s pharmacy in Concord, N.H., where he became frustrated by how much customers struggled to keep track of their medications.
He went to pharmacy school but rather than take up the family business, he and a friend set out to change it. In 2013, they launched an online pharmacy from Manchester, N.H. On Thursday, the 32-year-old CEO said he sold his startup to Amazon.com Inc. It was a roughly $1 billion deal, according to people familiar with the deal. Mr. Parker is expected to stay involved after the deal, said a person familiar with the matter.
. . .
One of the company’s earliest investors, David Frankel of Boston-based Founders Collective, wrote in a post on the website Medium Thursday that the company showed promise with two founders that complement each other.
“TJ cherishes beautiful design but has the bearing of a doctor,” he wrote of Mr. Parker, while Mr. Cohen was able to master the technical challenges behind an “indispensable pill dispensing solution.”
. . .
While attending the Massachusetts College of Pharmacy and Health Sciences in Boston, he started taking fashion-design classes at the nearby Massachusetts College of Art. “Pharmacy school was sooo boring,” he said in the interview.
His design-school stint was short-lived, but the expertise, he said, inspired PillPack’s concept of simplifying medication regimens by sorting pills into so-called “dose packets,” dispensed from a small box in baggies marked with the date and time they are to be taken.
It turned out to be a billion-dollar idea.

For the full story, see:
Eliot Brown and Sharon Terlep. “Frustrated Pharmacist Came Up With PillPack.” The Wall Street Journal (Friday, June 29, 2018): B2.
(Note: ellipses added.)
(Note: the online version of the story has the date June 28, 2018, and has the title “Behind PillPack’s $1 Billion Sale, a Frustrated 32-Year-Old Pharmacist.”)

“It’s Time for the FDA to Get with the Program”

(p. A14) Are eggs good for you or not?
It’s never been more confusing for consumers to answer that seemingly simple question. Vilified for years for their high cholesterol content, eggs more recently have broken back into dietary fashion. Nutrition experts today are touting eggs’ high levels of protein, essential vitamins and nutrients like brain-booster choline.
Government guidelines sometimes contradict nutrition experts’ advice as they play catch up with the latest scientific findings. Dietary advice from the U.S. departments of agriculture and health and human services includes eggs as part of a healthy diet, but also says cholesterol intake should be as low as possible. And the Food and Drug Administration says that eggs are too high in total fat, saturated fat and cholesterol to be labeled “healthy” by food marketers.
It’s such a scrambled issue that one egg brand is petitioning for an official government reassessment of eggs. “There’s so much new science out there about eggs, it’s time for the FDA to get with the program,” says Jesse Laflamme, chief executive of Pete and Gerry’s Organics, who filed a citizen’s petition urging the agency to rethink its ban on calling eggs “healthy.”

For the full commentary, see:
Ellen Byron. “The Great Egg Conundrum.” The Wall Street Journal (Wednesday, June 13, 2018): A14.
(Note: the online version of the commentary has the date June 12, 2018, and has the title “The Great Egg Debate: Are They Healthy or Not?”)

Fewer Regulations Allow Faster Chinese Cancer Innovation

(p. A1) HANGZHOU, China–In a hospital west of Shanghai, Wu Shixiu since March has been trying to treat cancer patients using a promising new gene-editing tool.
U.S. scientists helped devise the tool, known as Crispr-Cas9, which has captured global attention since a 2012 report said it can be used to edit DNA. Doctors haven’t been allowed to use it in human trials in America. That isn’t the case for Dr. Wu and others in China.
In a quirk of the globalized technology arena, Dr. Wu can forge ahead with the tool because he faces few regulatory hurdles to testing it on humans. His hospital’s review board took just an afternoon to sign off on his trial. He didn’t need national regulators’ approval and has few reporting requirements.
Dr. Wu’s team at Hangzhou Cancer Hospital has been drawing blood from esophageal-cancer patients, shipping it by high-speed rail to a lab that modifies disease-fighting cells using Crispr-Cas9 by deleting a gene that interferes with the immune system’s ability to fight cancer. His team then infuses the cells (p. A10) back into the patients, hoping the reprogrammed DNA will destroy the disease.
In contrast, what’s expected to be the first human Crispr trial outside China has yet to begin. The University of Pennsylvania has spent nearly two years addressing federal and other requirements, including numerous safety checks designed to minimize risks to patients. While Penn hasn’t received final federal clearance to proceed, “we hope to get clearance soon,” a Penn spokeswoman said.
“China shouldn’t have been the first one to do it,” says Dr. Wu, 53, an oncologist and president of Hangzhou Cancer Hospital. “But there are fewer restrictions.”

For the full story, see:
Rana, Preetika, Amy Dockser Marcus and Wenxin Fan. “China Races Ahead In Gene Editing.” The Wall Street Journal (Monday, January 22, 2018): A1 & A10.
(Note: the online version of the story has the date Jan. 21, 2018, and has the title “China, Unhampered by Rules, Races Ahead in Gene-Editing Trials.”)

Canada’s Single-Payer System Causes “Suffering and Deaths of People on Wait Lists”

(p. A17) Canada’s single-payer health-care system, known as Medicare, is notoriously sluggish. But private clinics like Cambie are prohibited from charging most patients for operations that public hospitals provide free. Dr. Day is challenging that prohibition before the provincial Supreme Court.
. . .
People stuck on Medicare waiting lists can only dream of timely care. Last year, the median wait between referral from a general practitioner and treatment from a specialist was 21.2 weeks, or about five months–more than double the wait a quarter-century ago. Worse, the provincial governments lie about the extent of the problem. The official clock starts only when a surgeon books the patient, not when a general practitioner makes the referral. That adds months and sometimes much longer. In November [2017] an Ontario woman learned she’d have to wait 4½ years to see a neurologist.
. . .
Dr. Day’s lawsuit aims to overturn these provisions. It alleges that the government’s legal restrictions on private care are to blame for the needless “suffering and deaths of people on wait lists.” Dr. Day argues that the current system violates citizens’ rights to “life, liberty, and security of the person,” as guaranteed by the Canadian Charter of Rights and Freedoms, the equivalent of the U.S. Bill of Rights.

For the full commentary, see:
Sally C. Pipes. “Single-Payer Health Care Isn’t Worth Waiting For; An orthopedic surgeon challenges Canada’s ban on most privately funded procedures.” The Wall Street Journal (Monday, January 22, 2018): A17.
(Note: ellipses, and bracketed year, added.)
(Note: the online version of the commentary has the date Jan. 21, 2018.)

No Known Maximum Life Span

(p. D3) Since 1900, average life expectancy around the globe has more than doubled, thanks to better public health, sanitation and food supplies. But a new study of long-lived Italians indicates that we have yet to reach the upper bound of human longevity.
“If there’s a fixed biological limit, we are not close to it,” said Elisabetta Barbi, a demographer at the University of Rome. Dr. Barbi and her colleagues published their research Thursday [sic] in the journal Science.
. . .
Dr. Barbi and her colleagues combed through Italy’s records to find every citizen who had reached the age of 105 between 2009 and 2015. To validate their ages, the researchers tracked down their birth certificates.
The team ended up with a database of 3,836 elderly Italians. The researchers tracked down death certificates for those who died in the study period and determined the rate at which various age groups were dying.
It’s long been known that the death rate starts out somewhat high in infancy and falls during the early years of life. It climbs again among people in their thirties, finally skyrocketing among those in their seventies and eighties.
. . .
Among extremely old Italians, they discovered, the death rate stops rising — the curve abruptly flattens into a plateau.
The researchers also found that people who were born in later years have a slightly lower mortality rate when they reach 105.
“The plateau is sinking over time,” said Kenneth W. Wachter, a demographer at the University of California, Berkeley, who co-authored the new study. “Improvements in mortality extend even to these extreme ages.”
“We’re not approaching any maximum life span for humans yet,” he added.

For the full story, see:
Zimmer, Carl. “What Is the Limit of Our Life Span?” The New York Times (Tuesday, July 3, 2018): D3.
(Note: ellipses added.)
(Note: the online version of the story has the date June 28, 2018, and has the title “How Long Can We Live? The Limit Hasn’t Been Reached, Study Finds.” The NYT article says the Science article was published on “Thursday,” but the citation for it that I found says it was published on Fri., June 29, 2018.)

The Science article mentioned above, is:
Barbi, Elisabetta, Francesco Lagona, Marco Marsili, James W. Vaupel, and Kenneth W. Wachter. “The Plateau of Human Mortality: Demography of Longevity Pioneers.” Science 360, no. 6396 (June 29, 2018): 1459-61.

“A Big Step Toward Regenerative Medicine”

(p. C9) Mr. Zimmer, a New York Times science columnist and author, is careful and well-informed. So when he says that research is overturning things you were taught in biology classes, he’s worth heeding. Acquired traits can be inherited. Biological time can turn backward.
. . .
The bigger breakthroughs are more fundamental. One is the development of induced pluripotent stem cells. By adding four proteins to adult cells, scientists have learned how to make them embryonic–“turning back developmental time,” as Mr. Zimmer puts it. This is a big step toward regenerative medicine, which can grow spare parts customized for your body. It also creates new ways of making babies.
. . .
Another breakthrough is gene editing. Through a process called Crispr, which tags DNA segments for deletion, we’re learning how to program cells to make specific changes to their genomes. We’re also learning how to program organisms to pass down these editing instructions to their progeny. Experiments have shown that this technology could, at some point, cure hereditary diseases such as cystic fibrosis. In addition, scientists think it could wipe out destructive rodents and malaria-carrying mosquitoes.

For the full review, see:
William Saletan. “‘Biology’s Strange New World. Acquired traits can be inherited. Biological time can turn backward. And monsters are real.” The Wall Street Journal (Saturday, June 30, 2018): C9.
(Note: ellipses added.)
(Note: the online version of the review has the date June 28, 2018, and has the title “”She Has Her Mother’s Laugh’ Review: Biology’s Strange New World. Acquired traits can be inherited. Biological time can turn backward. And monsters are real.”)

The book under review, is:
Zimmer, Carl. She Has Her Mother’s Laugh: The Powers, Perversions, and Potential of Heredity. New York: Dutton, 2018.

Experimental Immunotherapy Holds Hope of Curing Metastasized Solid Tumor Cancers

(p. B3) WASHINGTON–A novel immunotherapy method led to complete regression of breast cancer in a metastatic patient unresponsive to all other treatments, National Cancer Institute researchers said, suggesting a way to reverse some other internal-organ cancers.
The findings, from the NCI laboratory headed by Steven A. Rosenberg, were published Monday in the medical journal Nature Medicine.
The scientific report largely focused on the course of treatment for one patient, Judy Perkins of Port St. Lucie, Fla.
. . .
The research remains experimental, Dr. Rosenberg said in an interview.
“But because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is in a sense a blueprint we can use for the treatment of many types of cancer,” he said. “This could be the future of immunotherapy.”
Dr. Rosenberg, who has investigated for three decades how the immune system can be employed to fight cancer, said he is hopeful this approach “holds the best opportunities for finding effective immunotherapies for patients with the solid tumors that last year caused over 500,000 deaths in this country.”

For the full story, see:
Thomas M. Burton. “Cancer-Fighting ‘Blueprint’ Seen.” The Wall Street Journal (Tuesday, June 5, 2018): B3.
(Note: ellipsis added.)
(Note: the online version of the story has the date June 4, 2018, and has the title “Novel Immunotherapy Method Led to Complete Regression of Breast Cancer in Patient.”)

Hot Students Learn Less

More evidence on why air conditioning increases our mental acuity:

(p. A5) Hot weather makes it more difficult for high-school students to learn, a new study suggests.
. . .
The study was circulated by the National Bureau of Economic Research as a working paper by Mr. Goodman and three other researchers.
They found that, on average, every increase of 1 degree Fahrenheit in the average temperature during the school year reduced learning by about 1%.

For the full story, see:
Ben Leubsdorf. “Heat Found to Hurt Studies.” The Wall Street Journal (Friday, June 8, 2018): A5.
(Note: ellipsis added.)
(Note: the online version of the story has the date June 7, 2018, and has the title “American Students Don’t Learn Well When It’s Hot Outside.” The online version is substantially longer, and in some places has different wording, than the print version. Where the wording of a quoted passage differs, my quotation above follows the print version.)

The NBER paper, mentioned above, is:
Goodman, Joshua, Michael Hurwitz, Jisung Park, and Jonathan Smith. “Heat and Learning.” National Bureau of Economic Research (NBER) Working Paper Series, # 24639, May 2018.

Lack of “Air-Conditioning Can Be Deadly”

(p. A10) The number of air-conditioners worldwide is predicted to soar from 1.6 billion units today to 5.6 billion units by midcentury, according to a report issued Tuesday by the International Energy Agency.
. . .
While 90 percent of American households have air-conditioning, “When we look in fact at the hot countries in the world, in Africa, Asia, Latin America and the Middle East, where about 2.8 billion people live, only about 8 percent of the population owns an air-conditioner,” said Fatih Birol, executive director of the energy agency.
As incomes in those countries rise, however, more people are installing air-conditioners in their homes. The energy agency predicts much of the growth in air-conditioning will occur in India, China and Indonesia.
Some of the spread is simply being driven by a desire for comfort in parts of the world that have always been hot.
. . .
And when it gets hot, forgoing air-conditioning can be deadly. The heat wave that plagued Chicago in 1995 killed more than 700 people, while the 2003 European heat wave and 2010 Russian heat wave killed tens of thousands each.

For the full story, see:
Kendra Pierre-Louis. “World Tries to Stay Cool, but It Could Warm Earth.” The New York Times (Friday, May 18, 2018): A10.
(Note: ellipses added.)
(Note: the online version of the story has the date May 15, 2018, and has the title “The World Wants Air-Conditioning. That Could Warm the World.”)

Ancient Skeletons Harbor a Common Cause of Liver Cancer

(p. A9) Scientists reported on Wednesday [May 9, 2018] that they have recovered DNA from the oldest viruses known to have infected humans — and have succeeded in resurrecting some of them in the laboratory.
The viruses were all strains of hepatitis B. Two teams of researchers independently discovered its DNA in 15 ancient skeletons, the oldest a farmer who lived 7,000 years ago in what is now Germany.
Until now, the oldest viral DNA ever recovered from human remains was just 450 years old.
The research may provide clues to the continuing evolution of hepatitis B, a plague that infects an estimated 257 million people worldwide and contributes to an epidemic of liver cancer.
. . .
Chronic infections can lead to liver cancer. Each year, the World Health Organization estimates, hepatitis B kills 887,000 people. Researchers have long wondered how it became a worldwide menace.
. . .
. . . the skeletons in which the Cambridge geneticists found hepatitis range from 820 to 4,500 years old. The research, published in the journal Nature, demonstrates that hepatitis B existed across Europe and Asia as early as the Bronze Age.
. . .
Johannes Krause and his colleagues examined DNA extracted from the teeth of 53 ancient people in what is now Germany. Three of them were infected with hepatitis B, it turned out: one who lived about 1,000 years ago, a second person who lived 5,300 years ago and a third who lived 7,000 years ago.
. . .
Dr. Krause and his colleagues found that their Stone Age viruses were most closely related to strains of hepatitis B found today only in chimpanzees and gorillas.
He speculated that the virus jumped from apes to humans early in the history of our species in Africa. “It’s more likely this is really an old pathogen in humans for the last hundred thousand years or more,” he said.

For the full story, see:
Zimmer, Carl. “In Ancient Skeletons, Scientists Discover a Modern Foe: Hepatitis B.” The New York Times (Thursday, May 10, 2018): A9.
(Note: ellipses, and bracketed date, added.)
(Note: the online version of the story has the date MAY 9, 2018. The print version cited above is the National Edition.)

The paper by the Cambridge geneticists, mentioned above, is:
Mühlemann, Barbara, Terry C. Jones, Peter de Barros Damgaard, Morten E. Allentoft, Irina Shevnina, Andrey Logvin, Emma Usmanova, Irina P. Panyushkina, Bazartseren Boldgiv, Tsevel Bazartseren, Kadicha Tashbaeva, Victor Merz, Nina Lau, Václav Smrčka, Dmitry Voyakin, Egor Kitov, Andrey Epimakhov, Dalia Pokutta, Magdolna Vicze, T. Douglas Price, Vyacheslav Moiseyev, Anders J. Hansen, Ludovic Orlando, Simon Rasmussen, Martin Sikora, Lasse Vinner, Albert D. M. E. Osterhaus, Derek J. Smith, Dieter Glebe, Ron A. M. Fouchier, Christian Drosten, Karl-Göran Sjögren, Kristian Kristiansen, and Eske Willerslev. “Ancient Hepatitis B Viruses from the Bronze Age to the Medieval Period.” Nature 557, no. 7705 (May 9, 2018): 418-23.

The paper co-authored by Krause, and mentioned above, is:
Krause-Kyora, Ben, Julian Susat, Felix M. Key, Denise Kühnert, Esther Bosse, Alexander Immel, Christoph Rinne, Sabin-Christin Kornell, Diego Yepes, Sören Franzenburg, Henrike O. Heyne, Thomas Meier, Sandra Lösch, Harald Meller, Susanne Friederich, Nicole Nicklisch, Kurt W. Alt, Stefan Schreiber, Andreas Tholey, Alexander Herbig, Almut Nebel, and Johannes Krause. “Neolithic and Medieval Virus Genomes Reveal Complex Evolution of Hepatitis B.” eLife 7 (2018): e36666.