What could be wrong with IBM's supercomputer "Watson" helping physicians care for patients?
What could be wrong with IBM's supercomputer "Watson" helping physicians care for patients?
Posted at 07:23 AM in Clinical Trials, Current Affairs, Doctor-Patient Communication, Knowledge, Web/Tech | Permalink | Comments (0) | TrackBack (0)
Here are more reflections on the December 11th NYTimes article about the 11th-hour rescue of a dying 6-year-old girl with an investigational treatment. I hope you find them useful in the pursuit of Healthy Survivorship.
Continue reading "Altered Immune Cells Beat Leukemia - Part II" »
Posted at 07:29 AM in Clinical Trials, Current Affairs, Dictionary of Healthy Survivorship, Finances, Healthy Survivorship | Permalink | Comments (0) | TrackBack (0)
Yesterday's NYTimes article about the 11th-hour rescue of a dying 6-year-old girl with an investigational treatment created a lot of buzz. Here are a few reflections on the story that might be useful to Healthy Survivors.
Posted at 08:29 AM in Clinical Trials, Current Affairs, End-of-Life, Family illness, Hope, Treatment Decisions, Uncertainty | Permalink | Comments (2) | TrackBack (0)
In my last post I asked: Would I complete a clinical trial if researchers came up with a sure cure for me? Or would I drop out and go for the cure?
Posted at 06:43 AM in Clinical Trials, Healthy Survivorship | Permalink | Comments (1) | TrackBack (0)
In my post about a promising technology for cancer patients, I expressed concern about a mother's comment that if the treatment her son is now receiving doesn't work, "'we have the home run in the back pocket.'”
What's wrong with hoping for a home run?
Posted at 08:22 AM in Clinical Trials | Permalink | Comments (1) | TrackBack (0)
In my last post, I introduced the Obesity Paradox: Overweight patients with certain chronic diseases do better than normal- or underweight patients with the same disease.
I wish we could do this trial:
Posted at 06:49 AM in Clinical Trials, Knowledge, Science | Permalink | Comments (0) | TrackBack (0)
An Oncology Times article caught my eye: "Relieving Major Depression in Cancer Patients: Specific 'Biopsychosocial' Method Found Useful." It reviewed a study that addressed the impact of an intervention developed to treat depression, reduce stress and help patients develop coping strategies.
Continue reading "Relieving Major Depression in Cancer Patients" »
Posted at 04:20 PM in Action, Clinical Trials, Complementary Therapies, Family illness, Grief, Happiness | Permalink | Comments (3) | TrackBack (0)
Did you know that when you take a generic drug, you essentially forfeit the ability to sue the company making the drug for damages if you experience an adverse event?
Posted at 08:34 AM in Action, Clinical Trials, Current Affairs, Health care system, Health Marketing and Media, Healthy Survivorship, Treatment Decisions | Permalink | Comments (4) | TrackBack (0)
The FDA revokes approval of Avastin for breast cancer. What's a survivor to do?
Posted at 09:18 PM in Clinical Trials, Current Affairs, Family illness, Healthy Survivorship, Hope, Knowledge, Meaning of life, Revoking FDA Approval, Treatment Decisions | Permalink | Comments (1) | TrackBack (0)
In my last post, I asked, "Why not, at least, make Avastin available to breast cancer patients who are doing well on it?"
Continue reading "Revoking FDA Approval: Right or Wrong? - Part IX" »
Posted at 01:49 PM in Clinical Trials, Current Affairs, Health care system, Revoking FDA Approval | Permalink | Comments (3) | TrackBack (0)
The case of the FDA revoking approval of Avastin for the treatment of breast cancer is complicated by the urgency of the need for better therapies. We’re not talking about treatments to decrease the sniffles of the common head cold. At issue is a drug to help patients who are suffering -- and dying -- from metastatic breast cancer.
Continue reading "Revoking FDA Approval: Right or Wrong? - Part VIII" »
Posted at 07:56 PM in Clinical Trials, Revoking FDA Approval, Science, Treatment Decisions, Uncertainty | Permalink | Comments (0) | TrackBack (0)
Let's tease apart some of the sticky-wicket issues of FDA approvals and revocations. For one, how does the FDA measure success?
Continue reading "Revoking FDA Approval: Right or Wrong? - Part VII" »
Posted at 08:12 AM in Clinical Trials, Dictionary of Healthy Survivorship, Revoking FDA Approval, Science, Treatment Decisions, Uncertainty | Permalink | Comments (0) | TrackBack (0)
In light of recent events in my personal life forcing uncharacteristic delays between posts, I'll review briefly what I've discussed so far before continuing the discussion about the FDA's recent revocation of approval Avastin for treatment of breast cancer.
Continue reading "Revoking FDA Approval: Right or Wrong? - Part VI" »
Posted at 06:28 AM in Clinical Trials, Revoking FDA Approval | Permalink | Comments (0) | TrackBack (0)
Now let's look at the players who influenced the FDA's decision to revoke approval of Avastin for breast cancer. The complex process requires a book-length manuscript to fully explain. Rather than abandon my effort, here are the bare bones:
Continue reading "Revoking FDA Approval: Right or Wrong? - Part V" »
Posted at 09:25 AM in Clinical Trials, Current Affairs, Health care system, Health Marketing and Media, Revoking FDA Approval, Science, Treatment Decisions | Permalink | Comments (2) | TrackBack (0)
My last post provided an outline of the FDA's approval process. I cringed while writing it, knowing 250 words couldn't capture the investment of time, people and capital.
Continue reading "Revoking FDA Approval: Right or Wrong? - Part IV" »
Posted at 07:22 AM in Action, Clinical Trials, Current Affairs, Health care system, Health Marketing and Media, Revoking FDA Approval, Science | Permalink | Comments (1) | TrackBack (0)
In my November 28th and December 3rd posts I introduced the media storm regarding the FDA's recent revocation of approval of Avastin for the treatment of breast cancer. Today I'll provide an overview of the FDA approval process to help us talk about the controversy.
Continue reading "Revoking FDA Approval: Right or Wrong - Part III" »
Posted at 10:09 AM in Clinical Trials, Health care system, Health Marketing and Media, Revoking FDA Approval, Science, Treatment Decisions, Uncertainty | Permalink | Comments (1) | TrackBack (0)
To judge the FDA's recent revocation of approval for Avastin for breast cancer, let's go back to basics. What is the job of the FDA?
Continue reading "Revoking FDA Approval: Right or Wrong? Part II" »
Posted at 06:11 PM in Clinical Trials, Current Affairs, Health care system, Revoking FDA Approval | Permalink | Comments (0) | TrackBack (0)
Recently the FDA revoked approval of a best-selling drug, Avastin, for treatment of breast cancer. Ever since, arguments for and against the removal have been voiced in blogs and major media by a wide variety of people with different points of view. Let's look at some of the issues in the context of Healthy Survivorship.
Posted at 09:02 PM in Clinical Trials, Health care system, Revoking FDA Approval | Permalink | Comments (4) | TrackBack (0)
My recent posts have discussed some of the difficulties of modern medical decision-making in the context of PSA testing for prostate cancer. A new book by Harvard oncologist Jerome Groopman and Harvard endocrinologist Pamela Hartzband offers help to Healthy Survivors: Your Medical Mind: How to Decide What is Right for You.
Posted at 09:59 PM in Action, Books, Clinical Trials, Current Affairs, Doctor-Patient Communication, Health care system, Knowledge, Uncertainty | Permalink | Comments (2) | TrackBack (0)
My August 6th post shares a report on a new technology for breast cancer screening. I confess: I did not check out the story.
Patients are not Healthy Survivors if they believe the promises of charlatans. What about patients who receive treatment from of team of professionals at a major university in a clinical trial that turns out to be based on wrong information?
Posted at 07:21 AM in Clinical Trials, Health care system, Health Marketing and Media, Hope, Treatment Decisions, Uncertainty | Permalink | Comments (1) | TrackBack (0)
In 2006, leaders in the state of Washington created the Health Technology Assessment (HTA) program to evaluate the cost-effectiveness of various medical therapies. With our country facing a huge budget deficit, what could be better than determining which treatments are worth paying for?
Posted at 08:29 AM in Clinical Trials, Current Affairs, Health care system | Permalink | Comments (4) | TrackBack (0)
A NYTimes op-ed piece entitled A Fighting Spirit Won't Save Your Life concludes, "Linking health to personal virtue and vice not only is bad science, it’s bad medicine."
Posted at 10:31 AM in Action, Clinical Trials, Complementary Therapies, Family illness, Happiness, Healthy Survivorship, Hope, Post-treatment Recovery, Spirituality | Permalink | Comments (5) | TrackBack (0)
My recent posts are about the trouble of defining "rare cancers." The attention these cancers are now getting gives Healthy Survivors many reasons for hope.
Posted at 12:23 PM in Action, Clinical Trials, Current Affairs, Health care system, Hope | Permalink | Comments (0) | TrackBack (0)
My recent posts discuss the trouble with the adjective "rare" when talking about types of cancer. What's a researcher, clinician or patient to do?
Good news for Healthy Survivors! Now, along with ultra-strong hairsprays and ultra-rich ice-creams, we have:
Posted at 10:56 AM in Action, Clinical Trials, Current Affairs, Healthy Survivorship, Science | Permalink | Comments (0) | TrackBack (0)
I'm an outlier. Of all the patients diagnosed in 1990 with Stage III follicular lymphoma, I'm one of a small minority who are still kickin'. Why me?
Today I am not asking "What in the grand plan of the divine explains my extraordinary survivorship?" Rather, I'm asking "What is it about my physical body and/or my particular cancer that I've had a much-better-than-average response to the treatments?"
Posted at 04:48 PM in Clinical Trials | Permalink | Comments (4) | TrackBack (0)
In "The Cancer Sleeper Cell," oncologist Mukherjee shares his insights about the future of cancer research.
Posted at 07:06 AM in Clinical Trials, Current Affairs, Healthy Survivorship, Science | Permalink | Comments (0) | TrackBack (0)
On my recent post about clinical trials, commenter Steve Walker wrote, "The Phase III trial is being run primarily to satisfy the rigid, formulaic and in many cases scientifically obsolete requirements imposed by the FDA's Office of Oncology Drug Products for most cancer drugs...."
Is the randomized clinical/controlled trial (RCT) obsolete?
Posted at 07:50 AM in Action, Clinical Trials, Current Affairs, End-of-Life, Family illness, Health care system, Knowledge, Science, Uncertainty | Permalink | Comments (2) | TrackBack (0)
Recently, I've pointed out the clashes between business and ethical considerations and beween clinicians' obligations to their individual patients and to the method that leads to advances. What if researchers can find ways to satisfy both the science and today's patients?
Posted at 11:34 AM in Clinical Trials, Current Affairs, Health care system, Healthy Survivorship, Science, Treatment Decisions | Permalink | Comments (0) | TrackBack (0)
In Phase I trials researchers test an experimental treatment in a few patients for the first time. The purpose is NOT to see if the treatment kills cancer cells, but only to:
What if the patients in a Phase I trial experience shrinkage of their tumors? Should this speed up FDA approval of the trial drug?
Continue reading "The Problem with Accelerated FDA Approval" »
My last post introduced a dilemma regarding modern clinical trials: Is it ethical to randomize some patients to the "control arm" of a trial where they will NOT receive the trial drug?
According a NYTimes article, one particular trial of a therapy (called PLX4032) for malignant melanoma "ignited an anguished debate among oncologists about whether a controlled trial that measures a drug's impact on extending life is still the best method for evaluating hundreds of genetically targeted cancer drugs being developed."
Continue reading "Anguished Debate on Witholding Rx for the Control Arm" »
Sunday's NYTimes ran an article tackling a complex ethical dilemma in cancer care: The witholding of treatment in clinical trials. Because I was treated in 3 clinical trials in the 1990s, the topic is close to my heart.
Posted at 09:45 AM in Clinical Trials, Current Affairs, End-of-Life, Family illness, Healthy Survivorship, Hope, Knowledge, Science, Treatment Decisions | Permalink | Comments (2) | TrackBack (0)
People who hear my story often say, "You had an advantage getting into those clinical trials, because you were a doctor with connections." Given the paucity of patient-centered resources in 1993, this was true.
Today a plethora of excellent resources can help patients and families learn about clinical trials and find any available trials that might be right for you. Resources include:
Posted at 07:10 AM in Action, Clinical Trials, Current Affairs, Family illness, Health care system, Treatment Decisions | Permalink | Comments (2) | TrackBack (0)
As a scientist, I credit clinical trials with advancing our understanding of cancer and ability to treat it effectively. As a patient, I credit clinical trials with playing an essential role in my survival.
From both perspectives it troubles me greatly that only ~3% of adult cancer patients participate in clinical trials.
Continue reading "The Treatment Option You May Be Missing" »
Posted at 07:41 AM in Action, Clinical Trials, Current Affairs, Health care system, Healthy Survivorship, Hope, Knowledge, Treatment Decisions | Permalink | Comments (7) | TrackBack (0)
Posted at 10:00 AM in Clinical Trials | Permalink | Comments (0) | TrackBack (0)
How can Healthy Survivors get good care -- the first criterion of Healthy Survivorship -- if the data needed to make sound choices in their particular situation is not yet available?
Posted at 08:28 PM in Action, Clinical Trials, Dictionary of Healthy Survivorship, Healthy Survivorship, Hope, Knowledge, Post-treatment Recovery, Uncertainty | Permalink | Comments (0) | TrackBack (0)
We need to revisit a prior post, so I can qualify what I said. On my June 22nd post, I mentioned the high incidence of changes in the carotid arteries in patients who received radiation years earlier. But I didn't provide any details.
Posted at 01:59 PM in Action, Clinical Trials, Current Affairs, Healthy Survivorship, Knowledge, Post-treatment Recovery, Treatment Decisions | Permalink | Comments (0) | TrackBack (0)
Technorati Tags: late effects, post-treatment cardiovascular disease, premature carotid disease, radiation therapy and risk of stroke
Posted at 08:16 PM in Action, Clinical Trials, Dictionary of Healthy Survivorship, Doctor-Patient Communication, Happiness, Healthy Survivorship, Knowledge, Post-treatment Recovery, Science, Treatment Decisions, Uncertainty | Permalink | Comments (0) | TrackBack (0)
Technorati Tags: carotid disease, late effects, post-radiation
Many of my friends and family assume that the further away I get from the mini-mantle irradiation I received in 1992, the more I can relax about my developing any complications of that treatment. Not so.
What a three days I've had here at the 2010 Biennial Conference. While packing my suitcase for the return home, I'm thinking about all I've heard.
Continue reading "Cancer Survivorship Research: Recovery and Beyond" »
Tomorrow begins a conference entitled "Cancer Survivorship Research: Recovery and Beyond." And I have a job to do.
Posted at 07:27 PM in Clinical Trials, Doctor-Patient Communication, Health care system, Healthy Survivorship, Post-treatment Recovery | Permalink | Comments (2) | TrackBack (0)
NBC News health correspondent Robert Bazell introduces his report on a sensational new drug for the treatment of melanoma.
But then he explains that the new drug -- ipilimumab -- improves life expectancy from 6 months to 10 months. And it works well in only 20-30% of patients, the other 70-80% of patients showing no benefit at all. And it carries serious side effects, such as colitis and rheumatoid arthritis.
Is the fanfare hype? Are we celebrating too soon?
Continue reading "Breakthrough Melanoma Drug: Hope or Hype?" »
Posted at 08:16 PM in Action, Clinical Trials, Current Affairs, Health Marketing and Media, Hope, Science | Permalink | Comments (1) | TrackBack (0)
Your doctors evaluate your pain and conclude it is due to something benign (i.e., you don't have cancer, a broken bone or other health-threatening condition). Then they give you a prescription for a placebo. Should you sue these doctors? Or thank them?
Posted at 09:17 PM in Clinical Trials, Current Affairs, Doctor-Patient Communication, Health care system, Science | Permalink | Comments (1) | TrackBack (0)
Imagine being diagnosed with cancer and having your doctor recommend you not undergo treatment and, instead, "Watch and wait."
What? Do nothing but watch and worry?
Will someone please explain this to me: Clinical trials are the modern tool for finding truths about preventing and treating cancer. Yet our system puts obstacles in the path of clinicians who might participate in designing and running trials and in the path of patients who might enroll in trials.
Posted at 06:48 AM in Clinical Trials, Health care system, Healthy Survivorship | Permalink | Comments (0) | TrackBack (0)
Technorati Tags: clinical trials, efficiency, funding, obstacles to participation, trial activation
Posted at 08:17 PM in Books, Caregiving, Clinical Trials, Current Affairs | Permalink | Comments (2) | TrackBack (0)
Technorati Tags: clinical trials, IOM, NCI, progress in cancer care




