Monthly Archives: November 2011

Living With (Not Fighting) Terminal Cancer

Editor’s Note: This post originally appeared in the health AGEnda blog. On the day the FDA revoked its approval of Avastin, Ms. Berman’s perspective is particularly insightful.

Amy Berman

Amy Berman

I have been celebrating Breast Cancer Awareness month. This isn’t just because I had the good fortune to celebrate my birthday in October, but because one year after being diagnosed with a terminal illness and choosing to treat it non-aggressively, I feel great. I have less pain than I did one year ago. The shooting pains I often felt last year in my right breast have almost entirely vanished, thanks to my hormone-suppressing drugs. My lower spine—the site of metastasis—aches only occasionally, and only when I overdo it. If I get plenty of rest and fluids, eat right, and avoid standing for long periods or lifting heavy objects, I remain pain free. Although I may take a few more breaks than I used to or find myself more tired at night, I can still fill each day with meaningful activities, just as I always have.

I can honestly say that this has been the best year of my life, both personally and professionally.
I have been able to spend quality time with my family, while taking advantage of numerous opportunities to speak and write about the importance of individuals being involved in decisions about their own health care, in addition to my ongoing work as senior program officer for the John A. Hartford Foundation. I have been more loving, more accepting of love, and I believe more effective personally and professionally than at any other point in my life.  And I feel good.

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FDA Says “No” to Avastin for Breast Cancer

(Courtesy: Genentech)

(Courtesy: Genentech)

FDA Commissioner Dr. Margaret Hamburg announced this morning that the agency is revoking approval of Avastin as a treatment for metastatic breast cancer. The Agency had “fast tracked” the approval of the drug in 2008, based on results of one study, but had requested additional research. Those follow up studies did not support the initial findings, the FDA has decided.

NPR’s Shots blog reports on today’s events as well as the history behind the decision.

Hamburg lays out the reasoning for the rare move in a 69-page decision. In a news briefing Friday morning, she said of the drug: “It’s clear there is no benefit to breast cancer patients that would justify its risks.” She said she didn’t “come to this decision lightly but as a result of a rigorous process.”

Roche’s Genentech unit, maker of Avastin said in a statement, “We are disappointed with this outcome.” The company said it will help women “who may be facing obstacles to receiving their treatment” with the drug through a patient-support program. It’s also continuing research on the use of the drug for breast cancer.

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Mamma Mia! Is Pizza a Vegetable or Not?

The secret, or in this case, the vegetable, is in the sauce. (Jyoti Das/Flickr)

The secret, or in this case, the vegetable, is in the sauce. (Jyoti Das/Flickr)

Health advocates are outraged. Corporate suppliers of school lunches are pleased and, presumably, kids are thrilled.

Earlier this week, Congress blocked the U.S. Department of Agriculture’s proposed rule changes for school lunches. Congress was worried about potential changes in starchy vegetables (think French Fries), sodium and whole wheat.

But more than anything else, pizza is getting all the attention. To clarify, it’s the tomato paste on the slice of pizza that has counted as a vegetable. That’s not new. The new proposal would have increased the tomato paste requirement from the current two tablespoons to half a cup.  Industry said that much tomato paste would render a slice of pizza inedible. So, two tablespoons per slice of pizza stands as a vegetable serving.

The San Francisco Chronicle’s Inside Scoop rounded up the best bits of outrage, starting with Food Politics author and NYU Professor Marion Nestle.

“Does the Senate think this can pass the laugh test? … The Senate’s action has nothing to do with public health and everything to do with political posturing and caving in to lobbyists.”

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Healthy SF: Not So Healthy Financially

(Flickr:a.drian)

(Flickr:a.drian)

Four years ago, the City of San Francisco launched an ambitious attempt at health care coverage for all. Today, the San Francisco Public Press devotes its winter edition to an analysis of how well “Healthy San Francisco” is working. While tens of thousands of previously uninsured people have enrolled, and now have health care access they did not have before, the costs have been daunting.

In the Public Press report Stephen Shortell, Dean of the UC-Berkeley School of Public Health appropriately summarized the problem, “Healthy San Francisco is a model for health care delivery, but not for payment.”

“The program is very, very important, but I think we should recognize that it does not pay for the care of the population.”
Healthy SF is not insurance. Instead, it is access to community clinics and other safety net providers, but only those in San Francisco. Participants are not covered if they visit providers outside San Francisco. It is largely uninsured adults, people who earn too much money to qualify for Medi-Cal, who have signed up. In a state where more than 20 percent of people lack health insurance, only three percent of San Franciscans now are without health care. The Public Press reports that many people who had not seen a doctor in years are now receiving treatment.

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U.S. Supreme Court to Rule on Health Care Law

(Mike Renlund/Flickr)

(Mike Renlund/Flickr)

NPR’s Julie Rovner had the best opening line: “Who didn’t see this coming?”

To no one’s surprise, the U.S. Supreme Court will decide the Constitutionality of the sweeping health care reform bill passed last year. Rovner sums up the timing of oral arguments and the possible outcomes.

Following her report, be sure to scroll down to Scott Hensley’s round up of tweets of bipartisan support for the Supreme Court’s announcement.

Kaiser Health News includes analysis on the Supreme Court’s options and background on the challenges to the health care reform law so far.

 

 

Walmart: Get Clothes, Food and… a Health Check Up?

(Illustration by Kaiser Health News from photo by Walmart via Flickr)

(Illustration by Kaiser Health News from photo by Walmart via Flickr)

Walmart, the retailing behemoth with nearly 3,500 stores in the U.S., is angling to get into the even more mammoth health care business.

NPR and Kaiser Health News obtained a 14 page document, a “Request for Information,” which indicates Walmart is looking for partners in “becoming the largest provider of primary healthcare services in the nation.”

But, this afternoon, a Walmart executive said that the document had been “overwritten.”

You can listen to NPR’s story, as reported by KQED’s Sarah Varney, here.

Or you can read the Kaiser Health News story here.

Appeals Court Judge Upholds Individual Health Insurance Mandate

President Obama signs the Patient Protection and Affordable Care Act into law. March, 2010.

President Obama signs the Patient Protection and Affordable Care Act into law. March, 2010.

One of the most contested aspects of President Obama’s Affordable Care Act is the “individual mandate,” the requirement that nearly all Americans have health insurance.

Today, the Washington, D.C. Court of Appeals upheld the constitutionality of mandated insurance. The decision was written by Laurence Silberman, a Reagan appointee.

Today’s decision may mean little as the U.S. Supreme Court is likely to take up the issue, but Silberman is the second conservative judge to back the legality of the individual mandate.

Kaiser Health News summarizes coverage from across the country.

5 Things to Know Before Starting a New Drug

(Paul Wilson/Flickr)

(Paul Wilson/Flickr)

Say you were worried about having a heart attack. Which drug would you rather take:

  • Magic Drug A: reduces your risk of a heart attack by 50%
  • Magic Drug B: reduces your risk of a heart attack by 1%

Presumably, you’d pick Magic Drug A.

But, what if you found out Magic Drug A and Magic Drug B were really the same drug?

Huh? How can that be? It has to do with something Graham Walker, an emergency department physician at Stanford, calls “statistical trickery.” Continue reading

3 Different Vaccines with 1 Thing in Common

(Blake Patterson/Flickr)

(Blake Patterson/Flickr)

There’s news today about three different vaccines–HPV for boys, varicella vaccine (against chickenpox) and flu vaccines.

The common thread? Public health officials repeat the recommendations to get them.

First, a study in today’s Pediatrics shows why the 2009 H1N1 pandemic was so lethal in previously healthy children. If those children were simultaneously carrying MRSA, a common staph infection, they were eight times more likely to die. The New York Times summarizes the story.

The authors conclude the study with this plea, “New therapies for treating severe influenza and new treatment strategies for MRSA pneumonia complicating influenza are urgently needed for children.”

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FAQs of Health Savings Accounts

(Photo: Kaiser Health News)

(Photo: Kaiser Health News)

For millions of Americans with employer-sponsored health insurance, it’s open enrollment time. Today, Kaiser Health News offers this helpful FAQ on Health Savings Accounts. HSAs, when teamed with a High-Deductible Health Plan, is on the list of choices consumers are looking at. According to the trade group America’s Health Insurance Plans, the number of people using HSAs has increased over the last year.

Still, many people can find this option confusing. So, for starters, what is an HSA?

HSAs have two basic elements:

  • A tax-preferred savings account where money is set aside by the consumer (employers can also contribute) to pay for medical expenses and prescription drugs.
  • A high-deductible health insurance plan. In 2012, that deductible will be at least $1,200 for an individual and $2,400 for a family and as high as $6,050 and $12,100, respectively, according to the Treasury Department.

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