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Postmastectomy pain most troubling problem for breast cancer survivors

Postmastectomy pain most troubling problem for breast cancer survivors | Cancer Survivorship | Scoop.it

"Nov. 6, 2013 — More than 40 percent of 200,000 U.S. women diagnosed with breast cancer every year undergo surgery. Though treatment advances have significantly reduced mortality from breast cancer, a study published in The Journal of Pain reported that persistent postmastectomy pain is rated by survivors as their most troubling symptom. The Journal of Pain is published by the American Pain Society, www.americanpainsociety.org.

Researchers from the University of Pittsburgh evaluated 611 women who had undergone total or partial mastectomy and were treated with chemotherapy, radiation and/or hormone therapy. Their objective was to determine which factors -- demographics, tumor size, pain severity, treatments, stress, and psychological factors -- contribute to postmastectomy pain.


Via Susan Zager, Tambre Leighn
Tambre Leighn's insight:

More and more data pointing to the impact of psycho-social stressors, yet the emphasis in survivorship remains on physical symptoms, side effects.

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Susan Zager's curator insight, November 7, 2013 6:50 PM

It's interesting to note the psychosocial variables of "anxiety, depression, impaired sleep, somatization and catastrophizing"  as contributing factors to postmastectomy pain . 

Partial Abstract:: http://www.jpain.org/article/S1526-5900%2813%2901027-4/abstract


Heather Swift's curator insight, November 7, 2013 7:19 PM

It's interesting to note the psychosocial variables of "anxiety, depression, impaired sleep, somatization and catastrophizing"  as contributing factors to postmastectomy pain . 

Partial Abstract:: http://www.jpain.org/article/S1526-5900%2813%2901027-4/abstract

Tambre Leighn's curator insight, November 8, 2013 3:57 PM

More and more data pointing to the impact of psycho-social stressors, yet the emphasis in survivorship remains on physical symptoms, side effects.

 

Wellbeing is holistic and involves physical, mental, emotional and spiritual...from a 7th Level perspective. 

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The young survivors, fighting on

The young survivors, fighting on | Cancer Survivorship | Scoop.it
Tiffany Nardella was engaged to be married, living in South Philadelphia, and loving life when she was diagnosed with stage 3 breast cancer at 35 in 2010.
Tambre Leighn's insight:

Great story on how amazing non-profits like Young Survival Coalition can help create connections and support. For more information, go to:

http://www.youngsurvival.org/

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Programs for Survivorship

Programs for Survivorship | Cancer Survivorship | Scoop.it
I am lucky to have been treated a major cancer center where clinicians take a holistic approach to fighting disease, providing referrals for help with emotional issues and to foster general well-being.
Tambre Leighn's insight:

Yes, yes, and yes. Yes, there are significant challenges for long term survivors and, yes, studies attest to the value of care plans...and, yes, organizations like Livestrong, Journey Forward, and others have medically based care plans survivors can use with their oncologists.

 

Yet, there is still a huge gap between these existing plans and a plan that can help survivors address everything beyond the medical that has been impacted. What if there was a plan that helped survivors create a plan for living, not just surviving? Stay tuned.

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Deborah A. Boyle - Cancer's Price Tag Under the Microscope | TheONC | A Gated Community for Oncology Nurses and Cancer Care Teams

Deborah A. Boyle - Cancer's Price Tag Under the Microscope | TheONC | A Gated Community for Oncology Nurses and Cancer Care Teams | Cancer Survivorship | Scoop.it

TheDeborah Boyle explains that contemporary cancer treatment costs may be out of reach for many Americans.

Tambre Leighn's insight:

The financial cost of cancer...a burden for sure...and, as author Deborah Boyle points out, not the complete picture. The effects are far-reaching, beyond the bank account and beyond the cancer survivor. Great article.

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Meet the couple battling male and female breast cancer together

One of the most overlooked aspects of breast cancer, in its sea of pink, is that breast cancer doesn't just affect women. It's a fact...
Tambre Leighn's insight:

This is for the 80% of men who are not aware that they, too, are at risk for breast cancer. ACS estimates more than 2,000 men in the US will be diagnosed with cancer this year. Pass it on...

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Some Key Facts About Your Immune System and Cancer

Many people ask me about the immune system. So here are a few key facts for your information.


Via Graham Player Ph.D.
Tambre Leighn's insight:

Interested in prevention? Consider starting with your immune system as a first line of defense.

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Graham Player Ph.D.'s curator insight, October 17, 4:35 AM

Your Immune System


Your first line of defense against pathogens.

Your own inner personal ‘military-force’ to deal with unwanted invaders.

Its objective is always to fight, fix, repair, promote detoxification, and maintain your health

Inflammation is one of the instruments used by the immune system to regulate health, usually in acute situations. However chronic and uncontrolled inflammation can have devastating effects on the immune system and your health. Contributors to chronic inflammation include chemicals, pollutants, heavy metals, emotional state, depression, stress levels, certain foods, pathogens, improper lifestyle, inadequate nutrition, etc.

The immune system is a learning system and able to recognize previous infections and eradicate them in the future.

People who have never been ill throughout life with the typical infections we all get from childhood onwards and other disease states, will have a less prepared and ready immune system to fight off future disease.

Many doctors may worry more about the people who have never been sick, due to their potentially less developed immune systems.

We are designed to fight infection, to stay healthy into old age, and to keep brain function into old age. If we treat our body correctly our immune system will work well to ensure we function well as designed.

We need to put the right fuel in our bodies so that our immune system can function optimally. The body and its immune system needs the right nutrients, vitamins and minerals, proper hydration, sleep, exercise, and attention to healthy emotional state, social interaction and lowered stress levels.

We need to remove the stressors that impede our immune system from working optimally.

When the immune system becomes disrupted that’s when bad things can begin to happen that compromise our health, including cancer.


Immune System and Cancer:

We all produce cancer cells everyday as part of our normal metabolism. Our healthy immune system identifies and removes these cancer cells quite adequately.

You cannot have cancer if you have an in-tact optimally functioning and healthy immune system.

If you have cancer then by definition your immune system has been compromised, and your immune system has missed dealing with the cancer.Many people see cancer as a disease of the immune system. A weakened immune system allows cancer cells to grow better. A consequence of chemotherapy and radiation is a weakened immune system.

Conventional cancer treatments, chemotherapy and radiation, compromise the immune system.

Conventional cancer treatment is focused on killing cancer cells, and not addressing the cause of cancer.

Cancer is an ‘obligate glucose metabolizer’, meaning it thrives on sugar (carbohydrate, glucose). Sugar compromises the immune system. A recent study showed that within 15-minutes of eating a predominantly carbohydrate meal (pizza, pasta, etc) the leukocyte index (the number of pathogens a white blood cell can destroy in 1-hour) fell from the normal 16 to 1.9, and maintained that lower level for many hours afterwards. That means a reduction to 10% of normal immune capacity for several hours.

A century ago sugar was a delicacy, and the average person consumed 5 pounds of sugar per year. Today in the US people consume an average of 150 pounds of sugar per person per year.

Cancer cells have certain characteristics – they only survive on sugar (glucose); they are anaerobic (do not need or thrive in an oxygenated environment); and they thrive in an acidic environment (as opposed to an alkaline environment).

Sugar contributes to free radical damage, damage to the mitochondria, and weakens our body’s innate immune system resulting in an environment where cancer cells can continue to grow and strengthen without being checked.

Normal cells go through a process called ‘oxidative phosphorylation’ which means they use oxygen and sugar and make 32 molecules of ATP (our body’s energy-currency). If cells use anaerobic metabolism (don’t utilize oxygen – i.e. cancer cells) they cannot produce 32 molecules of ATP, and perhaps produce only 2. That is the reason cancer cells with their altered metabolism need more sugar – so they can continue to produce some ATP for their own survival.

The anaerobic metabolism of cancer cells produces a lot of waste products, particularly lactic acid.

Reduce the intake of sugar (carbohydrate, glucose) and you will reduce the food supply of cancer cells, and reduce compromising your own immune system.

42%-46% of cancer patients die of cachexia (malnutrition). Conventional therapies for cancer don’t address this adequately.

Excessive sugar intake has been linked to increased risks of obesity, inflammation and chronic diseases. Chronic inflammation is one of the main contributing factors to many of the chronic diseases in our society today. It also is one of the causes of metastases of cancer that spreads throughout the body to form tumors.


Cells of the Immune System

The largest number of immune system cells in the body are neutrophils, representing from 50%-70% of your body’s army of immune cells. Neutrophils cannot detect cancer. Natural killer cells are constantly surveying all the cells in the body for intruders and other problem abnormal cells, and destroying them.

The immune system can be regarded as having two arms – specific and non-specific. In the non-specific arm there are neutrophils, macrophages, and eosinophils which are basically front-line defenders whose purpose is to identify all cells as belonging to self (i.e. friendlies). In the specific arm there are B-cells and T-cells. B-cells borne from the bone marrow, make antibodies against antigens, develop into memory B cells after activation by antigen interaction, and release cytokines (proteins), which are used for signaling immune regulatory functions. T-cells mature mainly in the thymus (some in the tonsils), and play a central role in cell-mediated immunity. There are several subsets of T-cells, each with a distinct function – including helper, cytotoxic, memory, regulatory (suppressor), and natural killer T-cells.

80% of your immune system is in the mucosal lining of our intestinal tract. If you don’t have a healthy intestinal tract and are feeding your body a lot of the wrong things it will compromise your immune system. If we add excessive burdens to our immune system it prevents it from doing its important function of protecting us.

In 1 cubic-centimeter of tumor there is approximately 1 billion cancer cells. 65% of those cells are usually dormant (in the resting phase of the cell cycle), and 35% are active (in the synthesis phase of the cell cycle).

99% of all cancer cells are non-cancer-stem-cells. Meaning about 1% of cancer cells are cancer-stem-cells. Cancer-stem-cells survive in the blood stream, are immortal, and not usually affected by chemotherapy and radiation. Non-cancerous stem cells cannot metastasize. Only cancer-stem-cells can metastasize. The immune system cannot recognize cancer-stem-cells because they have a protein on their cell surface that shields them from the immune system.

There is a small list of substances that have been shown scientifically to attack cancer-stem-cells. These include metformin and ellagic acid (found in berries and green tea extract).
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Post cancer treatment is an important phase of cancer care | Bluegrass Moms | Kentucky.com

Post cancer treatment is an important phase of cancer care | Bluegrass Moms | Kentucky.com | Cancer Survivorship | Scoop.it
Cancer care doesn't end when treatment for it is over. It is important for all survivors to know that the follow-up care after the completion of cancer treatment is important for their health and may affect their survival.
Tambre Leighn's insight:

Not only is it important, it is being mandated for Comprehensive Cancer Treatment Centers by the Commission on Cancer starting in January 2015! Time for a change with more tools and resources invested in survivorship. Quantity of days must also include quality of life!

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Beth A. Williams's curator insight, October 14, 6:40 PM

Given how many survivors there are, with the numbers steadily browning, this will truly be a value-add to our healthcare system in 2015.

Beth A. Williams's curator insight, October 14, 6:43 PM

This is so needed! Coming in 2015 will be welcomed.

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Angelika Dark, cancer survivor | The Stringer

Angelika Dark, cancer survivor | The Stringer | Cancer Survivorship | Scoop.it
Young Yamatji cancer survivor Angelika Dark is working towards her goals of becoming a digital artist and in creating a game for people to play while in...
Tambre Leighn's insight:

We need more programs like this for cancer survivors who often have almost every area of life devastated by the disease. Hooray for Ms. Dark who plans to use this opportunity to create a way to help others going through it.

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How to talk to a patient with terminal cancer? Not like this.

How to talk to a patient with terminal cancer? Not like this. | Cancer Survivorship | Scoop.it
There is a healing power in a doctor's words that has allowed doctors to be useful over the millennia even when their treatments were ineffective.
Tambre Leighn's insight:

The value of emotional intelligence in physicians...and of knowing the impact of cortisol and how to communicate with patients consciously.

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Cancer survivor aided by radiation technique

Cancer survivor aided by radiation technique | Cancer Survivorship | Scoop.it
Fighting breast cancer can be physically and emotionally draining for patients. However, a local survivor attributes much of her success in the battle to a relatively new technique.
Tambre Leighn's insight:

In meditation and yoga, it's not uncommon to hear that connecting with breath is a way to connect with life. Amazing to read of an oncologist who has survivors do the same thing - for very practical reasons - reduce the amount of radiation exposure to heart and lungs.

 

Breast cancer survivor, Cari Marshall, shares her story of how coaching, breath work, and taking control made the difference for her.

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Cancer advocacy is daily tribute to her late daughter

Cancer advocacy is daily tribute to her late daughter | Cancer Survivorship | Scoop.it
Never a day passes that Ronna Levy doesn’t think about her late daughter Angela — or “Angie,” as her friends and loved ones called her.
Tambre Leighn's insight:

Advocacy and legacy in action. What an incredible way to honor a daughter lost to cancer.

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Terminally Ill 29-Year-Old Woman: Why I'm Choosing to Die on My Own Terms

Terminally Ill 29-Year-Old Woman: Why I'm Choosing to Die on My Own Terms | Cancer Survivorship | Scoop.it
Next month Brittany Maynard will end her own life – but not before fighting for the right for others to do the same
Tambre Leighn's insight:

Absolutely humbling story about advocacy and the right to choose. There is no right or wrong - whether someone decides to do everything possible, including demand right to compassionate use of available pharmaceutical interventions or decides to choose a conscious death on their own terms. Thanks to Brittany Maynard for being a voice for choice.

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Avoiding the Breast Cancer ‘Warrior’ Trap

Avoiding the Breast Cancer ‘Warrior’ Trap | Cancer Survivorship | Scoop.it
Let's get real: Cancer doesn't make you stronger.
Tambre Leighn's insight:

Great, refreshing perspective from physician/husband who sees both sides. While the reporter in question has had her own experience of breast cancer and most likely, only best intentions to inspire readers, messaging to this community has room for greater consciousness.

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When TODAY Said I Was 'Not Bald Enough'

When TODAY Said I Was 'Not Bald Enough' | Cancer Survivorship | Scoop.it
Fueled by our fury over the responses we were getting because we weren't BALD, a lot of us wrote TODAY back to explain how gutted we by the fact that a lot of women are getting left out of the conversation, by the media perpetuation that you must LOO...
Tambre Leighn's insight:

We must put a stop to judging what illness - or for that matter, health - looks like. And perhaps it is time for the media to take some sensitivity training. 

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Anne Loeser: Reverse trends about breast cancer

Anne Loeser: Reverse trends about breast cancer | Cancer Survivorship | Scoop.it

"Imagine that you have an acquaintance in Springfield, Massachusetts, a city best known as the birthplace of basketball and home of the Basketball Hall of Fame. The fourth largest city in New England, Springfield boasts 155,000 residents of various ethnicities and religious beliefs.

Now envision that over the next five years, 120,900 (78 percent) of Springfield’s citizens pass away, and only 3,100 (2 percent) survive a normal life span.

In the event of such a situation, you’d expect considerable media coverage and public outrage. But the deaths continue mostly unnoticed.

If you believe such a circumstance to be unthinkable, think again.

Including myself, an estimated 155,000 Americans — the population of Springfield, — are living with metastatic breast cancer (MBC). MBC is cancer that has traveled from the breast and underarm lymph nodes to other parts of the body. Although we're in the midst of October's Breast Cancer Awareness Month (BCAM), you may not be aware that:

• 98 percent of people with MBC will die of it, and 78 percent will perish within five years of diagnosis.

• Average survival with MBC is three years.

• The number of women dying annually hasn’t varied since the mid-1980s when BCAM was initiated. In 1988, approximately 40,000 women perished and in 2011, 40,931 women died of MBC.

• Each year, roughly 220,097 women and 2,078 men are diagnosed with breast cancer, with no improvement in 10 years."


Via Susan Zager
Tambre Leighn's insight:

Realities far beyond the pink...

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Susan Zager's curator insight, October 20, 3:01 PM

This article really shows the true facts about metastatic breast cancer. 

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Truth Teller | A Woman's Health - Women Magazine

Truth Teller | A Woman's Health - Women Magazine | Cancer Survivorship | Scoop.it
Tambre Leighn's insight:

One of my favorite survivor bloggers. Sharing her story has made a very challenging road much easier for others...in knowing they are not alone. #inspiration

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Finding The Light Before The End Of The Tunnel

Finding The Light Before The End Of The Tunnel | Cancer Survivorship | Scoop.it
"Cured" is not necessarily the opposite of cancer. It is not the end we should necessarily be searching for. The opposite of cancer is life....
Tambre Leighn's insight:

Powerful article on stepping toward life instead of being defined by a diagnosis.

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7 Tips on Coping With Chemo Brain - WhatNext

7 Tips on Coping With Chemo Brain - WhatNext | Cancer Survivorship | Scoop.it
There are always questions on the site about that annoying thing we like to call "chemo brain." Here are a few more tips on what you can try if you are experiencing chemo brain, memory fog, or other mind-related side effects from chemotherapy or other cancer treatment.
Tambre Leighn's insight:

Some excellent strategies...but number one thing to address is stress. Stress has a huge impact on our ability to focus, make clear decisions, create and complete our task list, and more.

 

I find practical tips like these 7 can be used to support stress reduction but according to this study, http://ecancer.org/news/3621.php,

“Our initial findings showed that the level of worry interfered with patients’ ability to do a task,” Cimprich said. “The level of worry had a key role in the cognitive problems with these women before treatment, and this worry was related to fatigue.”


So reducing stress and worry, and paying attention to getting enough sleep are also additional strategies that may help.

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Lost in Translation: Communicating with Newly Diagnosed Cancer Patients - Cancer Therapy Advisor

Lost in Translation: Communicating with Newly Diagnosed Cancer Patients - Cancer Therapy Advisor | Cancer Survivorship | Scoop.it
Dr. Dizon and patient advocate Katherine O'Brien discuss the difficulty of communicating cancer and give advice on common miscommunications.

Via Heather Swift
Tambre Leighn's insight:

Medical professionals need to understand that the moment most patients and their loved ones hear the word 'cancer' they are thrown into a high state of stress. It becomes challenging to process information, think clearly, or communicate well. Asking questions along the way - what have you understood so far in what I've share with you? What do you most need from me right now?  Here are the next steps - which ones do you need help with or more information on?

 

Asking questions and checking it to see what actually has been heard vs. what you've said is key to knowing how much/little is being absorbed.

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What Caught Our Eye This Week: Elevating the Discussion on Living Well Until the End of Life - National Coalition for Cancer Survivorship (NCCS)

What Caught Our Eye This Week: Elevating the Discussion on Living Well Until the End of Life - National Coalition for Cancer Survivorship (NCCS) | Cancer Survivorship | Scoop.it
Tambre Leighn's insight:

More evidence of growing awareness and attention to more patient centered conversations around quality of life and end of life.

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Turning the Tide Against Cancer: NCCS CEO Speaks

Turning the Tide Against Cancer: NCCS CEO Speaks | Cancer Survivorship | Scoop.it
NCCS CEO Shelley Fuld Nasso spoke at the 2014 Turning the Tide Against Cancer Conference in Washington, DC yesterday in a session addressing the role of payment reforms in supporting innovative cancer care.
Tambre Leighn's insight:

“We need truth telling so patients understand the full influences on their care” Shelley Fuld Nasso 


Yes. Yes, we do.

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Pinkwashing: Fracking Company Teams Up With Susan G. Komen to 'End Breast Cancer Forever' » EcoWatch

Pinkwashing: Fracking Company Teams Up With Susan G. Komen to 'End Breast Cancer Forever' » EcoWatch | Cancer Survivorship | Scoop.it
Susan G. Komen has teamed up with fracking company Baker Hughes. As Susan G. Komen hands out pink ribbons for breast cancer awareness, a pink drill bit heads
Tambre Leighn's insight:

There isn't one saving grace about any of this. Nothing can justify this partnership. Simply jaw-dropping.

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The Best Possible Day - NYTimes.com

The Best Possible Day - NYTimes.com | Cancer Survivorship | Scoop.it
Tambre Leighn's insight:

Awareness, consciousness, compassion, and choice. 

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Not the time to cut funding for cancer research

Not the time to cut funding for cancer research | Cancer Survivorship | Scoop.it
Cuts to funds for biomedical research threaten to jeopardize an emerging breakthrough in cancer treatment.
Tambre Leighn's insight:

Researcher with an inside track on why now is not the time to cut funding for cancer research.

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The Cost of Cancer Drugs

The Cost of Cancer Drugs | Cancer Survivorship | Scoop.it
Lesley Stahl discovers the shock and anxiety of a cancer diagnosis can be followed by a second jolt: the astronomical price of cancer drugs.

Via Graham Player Ph.D.
Tambre Leighn's insight:

More evidence of the far reaching impacts cancer diagnosis and treatment has on survivors, their families, and our economy. When we bankrupt people and add things like financial stress, job loss, navigating complex insurance environments, and more to an already heavy burden of life threatening and, often, chronic disease we are causing injury to our communities and our country.

 

Survivorship coaches know very well how many aspects of life survivors struggle with - career, intimacy, fertility, fears of recurrence, relationships, physical energy. We must begin to address the whole person and provide tools and resources for all of the major challenges - and addressing the sticker shock when it comes to the escalating cost of treatments is an essential area to focus on.

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Graham Player Ph.D.'s curator insight, October 6, 5:49 AM

Perhaps we need to start treating the cost of cancer drugs almost as a financial toxicity side-effect of cancer. Watch this 60-Minutes broadcast to learn more. I have summarized below for those who prefer to read.

The investigator for this report was surprised to find:
- just how expensive cancer drugs were, and
- that many oncologists receive a commission when they prescribe cancer drugs

Most cancer drugs are targeted at extending life rather than curing cancer. That life extension likelihood is sometimes suggested as days rather than years. So for patients it may be difficult to decide whether life extension for an additional 42 days is worth the high cost of the drug – such as Zaltrap (for advanced colon cancer) discussed in the report.

The pharmaceutical companies do make a significant contribution to the treatment of cancer. They are entitled to make a profit which continues to fuel innovation. However the high cost of these drugs can result in bankruptcy of the patient’s family. A cancer diagnosis is one of the leading causes of personal bankruptcy today. It is not unusual for patients to take 2 or 3 different drugs for their cancer treatment, each costing $100,000. An entry-level cost of drug treatment probably is around $250,000 in costs.

We may be in a situation where people’s fear and anxiety is being taken advantage of by the cancer industry. Many oncologists believe the cost of the cancer drugs are too high. Drug companies assert that the cost of bringing a new drug to market is $1 billion. So prices reflect the cost of innovation.

Dr Leonard Saltz, Chief of Gasto-Intestinal Oncology at Memorial Sloan Kettering, compared the clinical trial costs of Zaltrap (mentioned above) approved in 2012 to those of another drug already on the market – Avastin. Both drugs target the same patient population, work essentially in the same way, and deliver the identical result of extending median survival by 1.4 months (42 days) when given as chemotherapy. The two drugs look to be the same. Although the Zaltrap study showed it to be a little more toxic than Avastin. So why does Zaltrap cost more than $11,000 per month which is more than twice the cost of Avastin at $5,000 per month?

Together with Dr. Saltz, Dr. Peter Bock, Sloan Kettering’s in-house expert on cancer drug prices, decided to reject Zaltrap based on its high price. This was reported in the New York Times. This raised the issue that the drug companies are permitted to charge whatever they want and there are no controls on this as part of the approval process. The pricing system for drugs is dictated by those who make the drugs. The prices seem to be decided on their own views only, and according to Dr. Brock are based on how brave they are and how little they want to end up being criticized in the New York Times or on 60-Minutes programs.

Media criticism does seem to work. Right after the New York Times article reporting on Zaltrap, the pharmaceutical manufacturer of Zaltrap, Sanofi, cut the price of their drug by half. This was irrefutable evidence that the original price had no basis, and was only profit oriented to meet the company’s financial greed. As a consequence all those arguments heard for decades from the pharmaceutical companies – we have to recoup our money, we are good for society, trust us to set the right price, etc – simply no longer had any credibility. Sanofi lowered the price of Zaltrap in a way that doctors could get the drug for less. But patients were still paying as if it was high priced. According to Dr. Bock, doctors were buying the drug for $11,000 and the company sent the doctors a cheque for $6,000. Then the doctor gets to bill the patient’s insurance company as if it costs $11,000. This made it extremely profitable for the doctors. Basically doctors could double their money if they used Zaltrap.

The commission based approach provides an incentive for the doctors to choose and recommend the most expensive drugs for patients. While this may be advantageous for the drug companies and doctors, it is a system that should be carefully considered in terms of its morality and fairness to patients.

All of this is currently accepted industry practice. John Castellani, President and CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA) – the Trade and Drug Industry’s lobbying group in Washington - comments that the price of the drug needs to reflect the cost of development, and the value it can provide. When asked how it can be that a patient can be taking a drug that is no better than another drug on the market, yet costs twice as much, Castellani responded that “we don’t set the prices; what a patient pays is determined by the patient’s insurance company.”

Another drug example is Glevec, from Novartis, which treats a common blood cancer and requires patients to keep taking the drug indefinitely. This is the top-selling drug for Novartis, bringing in more than $4 billion per year in sales, and $35 billion since the drug came to market. There are several other similar drugs that compete with Glevec. Such competition would normally bring down the prices in a typical marketplace. But the price of Glevec has tripled from $28,000 per year in 2001 to $92,000 per year in 2012. So drug companies are also raising their prices on their older drugs, not just the new ones.

According to Hagop M. Kantarjian, Professor at Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, the drug companies are setting prices that are unreasonable, unsustainable and immoral. He believes that the law needs to change that currently prevents Medicare from negotiating for lower prices, which now results in American patients paying two to three times more for the same drug compared to the cost for the same drug in other countries.

To complete the picture, the single biggest source of income for private practice oncologists is the commission they make on prescribing cancer drugs. They buy the drugs wholesale from the pharmaceutical companies and sell them retail to their patients. This fuels the incentive for oncologists to use more expensive drugs for their own financial gain.

Dr. Saltz believes that the challenge is knowing where to draw the line between how long drugs may extend life and how much they cost. We as a society have been unwilling to discuss this topic, and as a result the only people that are setting the line are the people selling the drugs.

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MISSION: REMISSION: CT Scan Results and....yeah....

MISSION: REMISSION: CT Scan Results and....yeah.... | Cancer Survivorship | Scoop.it
Tambre Leighn's insight:

Sometimes the what to do is to bake a cake...

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