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June 13, 2013 | 11:20 AM | By

San Francisco Breast Cancer Advocates Jubilant Over Supreme Court Human Genes Ruling

(William West/AFP/Getty Images)

(William West/AFP/Getty Images)

In a unanimous decision, the U.S. Supreme Court ruled Thursday morning that human genes are not patentable.

The case centered around Myriad Genetics, the holder of patents on two genes, BRCA1 and BRCA2. Some mutations of these genes are associated with an increased risk of breast and ovarian cancer. For women with a strong family history of these cancers, the only place they could be tested was Myriad Genetics, which sometimes charged more than $3,000 for the test.

Breast Cancer Action, an advocacy group based in San Francisco, was a plaintiff in the case, and executive director Karuna Jaggar sounded jubilant in a phone call Thursday morning.

“From our perspective, these patents never should have been granted in the first place,” Jaggar said. “There’s no question that DNA is a product of nature, and so it’s very affirming to see the court rule in our favor.”

BRCA1 and 2 mutations became international news when actress Angelina Jolie revealed that she’d had a preventive double mastectomy after testing showed that she had a specific mutation that put her at very high risk of developing breast cancer.

Continue reading →

FILED UNDER: Policy, BRCA1, BRCA2, Breast Cancer, Breast Cancer Genes, Science
May 24, 2013 | 8:05 AM | By

Young Adults Will Make or Break Obamacare in California

By Mina Kim, KQED

David Kim, brother of KQED health reporter Mina Kim, is 29-years-old and uninsured. (Mina Kim/KQED)

David Kim, brother of KQED health reporter Mina Kim, is 29-years-old and uninsured. He is considering whether to buy insurance on the health care marketplace if he doesn’t have employer-based coverage next year. (Mina Kim/KQED)

Most of us know someone who doesn’t have health insurance. In my case, it’s my little brother, David Kim.

David is 29-years-old and recently earned an advanced degree in international relations. He hasn’t been able to land a full-time job with health benefits. The two jobs he has now are temporary, and with such a precarious work situation, he just doesn’t think he can afford health insurance.

“I’m totally aware that if I get sick then I’m doomed financially,” Dave told me over a lunch break. “And maybe that’s not a very financially sound decision to make, but it is nonetheless a risk that, for the time being, I’m prepared to take.”

Young adults —18 to 34-year-olds — make up more than 40 percent of California’s uninsured, though they make up less than 30 percent of the population. And according to many health reform advocates, they’re the ones who could make or break Obamacare.

“If we get only sick people, and don’t get the young, healthy people into the insurance system, it’s going to mean premiums are much higher.” 
“The success of this law really does depend on getting young people insured, and frankly getting everyone insured,” said Larry Levitt, a health policy and insurance expert for the Kaiser Family Foundation.

In less than five months, a key piece of Obamacare will go live: state-based insurance marketplaces, called Covered California here. That means millions of Californians looking for coverage for themselves or their families will be able to go online and enroll in qualified health plans regardless of their medical history. Many will get help from federal subsidies. But if the exchange doesn’t enroll enough young, healthy people, insurers will have to hike everyone’s premiums. Continue reading →

FILED UNDER: Obamacare, You're the Boss, Affordable Care Act, Obamacare, Science, Young Adults
May 22, 2013 | 10:23 AM | By

More Single Boomers Share Homes — and Health Support

By Julie Rovner, NPR

Lorene Solivan moved into the "Golden Girls" house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)

Lorene Solivan moved into the “Golden Girls” house in October after seeing an ad on Craigslist. An event manager at a food company, Solivan says she often cooks dinner for the group. (Maggie Starbard/NPR)

Today more than 1 in every 3 baby boomers — that huge glut of people born between 1948 and 1964 — is unmarried. And those unmarried boomers are disproportionately women. As this vast generation rushes into retirement, there’s a growing concern among experts on aging: Who will take care of all these people when they’re too old to care for themselves?

It’s a question many of the experts take personally. “That is what scares me,” says Sara Rix, who works for the AARP Public Policy Institute, studying the economic prospects of women in the workforce. “Because I am one of those people,” she says, “and I do think about it.”

“Oh, I’ve got wonderful nieces and nephews,” Rix says, noting that’s what a lot of her boomer peers claim, too. “Well, in fact, they’ve got their families. They’ve got their in-laws. They’ve got their parents. And I don’t think it’s reasonable to expect much out of them.”

Kathleen Kelly, who runs the Family Caregiver Alliance and the National Center on Caregiving in San Francisco, says she’s seeing the same sort of concern in her social circle. “I’m in my 50s, and my friends are all talking about, ‘Could we all move in together? Could we buy an apartment building and all live together?’ There are all sorts of permutations of this conversation,” Kelly says. “But it really is something that people are thinking about, particularly women.”

And, because boomers are boomers, some are doing more than just thinking about it. Already, there’s a small but apparently growing movement of boomer women forming group houses with their single peers. Continue reading →

FILED UNDER: You're the Boss, Aging, Boomers, Long Term Care, Science
May 20, 2013 | 11:32 AM | By

Easy to Do, Inexpensive; Music Calms Some ICU Patients

By Leslie Harris O’Hanlon

(Getty Images)

(Ryan McVay/Getty Images)

The adage stems from the 18th century: music has charms to sooth the savage breast. It’s probably safe to say that someone in an intensive care unit, who needs a machine to help them breathe, is in need of soothing. Usually, doctors and nurses administer drugs, powerful sedatives to help calm patients. Now, a study shows that a different kind of intervention might help: music. The study, published Monday in the Journal of the American Medical Association, adds to a growing body of research on how listening to music has a host of health benefits.

Patients in the music group received 38 percent fewer doses of sedatives.
Researchers at Ohio State University looked at ICU patients on mechanical ventilators for respiratory failure. Those who listened to the music of their choice not only had greater reduction in anxiety but also used fewer sedation drugs and lower doses compared to patients who did not have access to music — they received usual ICU care. Mechanical ventilation, or ventilatory support, is when a patient is connected to a machine, called a ventilator, to help him or her breath.

Researchers call this “patient-directed music” because patients could select their own music and put headphones on whenever they wanted.

The “intervention empowered patients to use music to manage their own anxiety whenever they felt they needed the use of music to help them relax or when they desired some quiet time,” said lead author Professor Linda L. Chlan at Ohio State. “Music does not induce adverse side effects, which are sometimes evident with sedative agents administered to these patients.” Continue reading →

FILED UNDER: You're the Boss, ICU, Music, Science
May 15, 2013 | 5:39 PM | By

What’s a BRCA Gene Anyway?

(Gage Skidmore/Flickr)

(Gage Skidmore/Flickr)

The first thing you need to know about the BRCA gene is that you have it.

Don’t panic. Everyone does. In fact, we all have two of them — the BRCA1 and 2 genes. They are normal genes that “have an important function in the cell. They are involved in repairing DNA damage,” explained Dr. Robert Nussbaum, a medical geneticist at UCSF. “When they’re functioning normally, they do a good job for us.”

We all have two copies of the BRCA genes. Men, too.
The problem is what happens when they don’t function normally. We’ll get to that in a minute. But first, in our call, Nussbaum gave me a helpful primer in basic genetics.

For starters, we all have two copies of each of the BRCA genes. Men, too. We get one copy from each parent.  These genes are “like sentences,” Nussbaum said. ”They are made up of words.” When they’re spelled right, all is well.

But “you can have all kinds of misspellings,” Nussbaum said. “Red becomes reed. All kinds of things can happen that will alter the meaning of that sentence.” Continue reading →

FILED UNDER: You're the Boss, Angelina Jolie, BRCA Genes, Breast Cancer, Science
May 14, 2013 | 12:22 PM | By

Why Angelina Jolie’s ‘Medical Choice’ Is Likely Not Yours

(Foreign and Commonwealth Office/Flickr)

(Foreign and Commonwealth Office/Flickr)

Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation — putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times piece, “My Medical Choice.”

But the key here is a specific BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolie is very careful to walk through all her personal decisions stemming from her unusually high risk, but emphasizes that “the risk is different in the case of each woman.”

About 10 percent of all breast cancers are due to those many BRCA mutations. Dr. Otis Brawley, chief medical officer with the American Cancer Society, explains in more detail what individual women should consider, in a response to Jolie’s piece:

This does not mean every woman needs a blood test to determine their genetic risk for breast and/or ovarian cancer. What it does mean is women should know their cancer family history and discuss it with their regular provider. If appropriate, they should be referred to and have the opportunity to discuss their risk and their options with a genetic specialist. Continue reading →

FILED UNDER: Tests & Treatments, You're the Boss, Angelina Jolie, Breast Cancer, Mastectomy, Science
May 13, 2013 | 8:40 AM | By

Valley Fever Cases Soar in West, Yet ‘Off The Radar’ of East Coast Policymakers

By Rebecca Plevin, NPR

(Daniel Casarez/Vida en el Valle/Reporting on Health Collaborative)

(Daniel Casarez/Vida en el Valle/Reporting on Health Collaborative)

When she was just 6, Emily Gorospe became very tired and sick. The spunky girl, now 8, developed a fever that wouldn’t go away, and red blotches appeared across her body.

“She’s got so much energy usually,” says Emily’s mother, Valerie Gorospe. “Just walking from one part of the house … she was drained.” The little girl was also very pale. “She just didn’t look like herself,” Valerie recalls.

Emily, who lives in the Central Valley town of Delano, was eventually diagnosed with valley fever, also known as coccidioidomycosis. She’s one of an estimated 150,000 people nationwide who get the fungal disease every year. There is no cure and no vaccine.

Valley fever has afflicted about four times more people than West Nile virus, with thousands more going undiagnosed.

Valley fever is well known in the Central Valley and other areas of California and Arizona. Tiny fungal spores live in the soil throughout much of this arid region. When the spores are disturbed, they can be inhaled into the lungs.

James McCarty, the medical director of infectious diseases at Children’s Hospital Central California, says most people feel nothing, or experience symptoms similar to the flu. Common symptoms include fever, night sweats, weight loss, chest pain, cough and sometimes skin rashes.

Valley fever can be a very serious disease for some people, McCarty says. It can spread from the lungs to other parts of the body, like the central nervous system, bones or skin. It can be life-altering or even fatal. Continue reading →

FILED UNDER: Policy, Science, Valley Fever
May 10, 2013 | 1:41 PM | By

Mark Bittman Talks Up Part-Time Veganism (and Delivers 3 Easy Recipes)

(Getty Images)

(Getty Images)

It all started with a prescription from his doctor, but not for a drug.

“You should probably become a vegan,” New York Times food writer Mark Bittman says his doctor told him. That was six years ago. Then 57, Bittman says he was 40 pounds overweight, and his cholesterol and blood sugar which had always been normal, had moved into the “danger zone.”

Bittman had built his career around food, and being a vegan didn’t appeal to him, as he recounted this week on KQED’s Forum. “I wanted … something do-able, something I could stick with,” he said.

He hatched the idea of being vegan until dinner — “you’re only postponing gratitude” until then.

It seems to have worked. Today, he’s 35 pounds lighter and he says his blood sugar and cholesterol are back in the normal range.

Now he has recounted his experience in a new book, “VB6: Eat Vegan Before 6:00 to Restore Your Health and Lose Weight … for Good.” Continue reading →

FILED UNDER: You're the Boss, Diet, Science, Vegan
May 9, 2013 | 11:22 AM | By

Open-Campus Policies Eat Away at School Nutrition

By Katharine Mieszkowski, Center for Investigative Reporting

Scott Sowko, a sophomore at Berkeley High School, leaves Bongo Burger after lunching off-campus. School officials say one-tenth of the students take advantage of the healthy lunch served in the school cafeteria. (Noah Berger/Center for Investigative Reporting)

Berkeley High School students have lunch off-campus at Bongo Burger. School officials say one-tenth of the students take advantage of the healthy lunch served in the school cafeteria. (Noah Berger/Center for Investigative Reporting)

At lunchtime, hundreds of Berkeley High School students rush off campus, leaving behind healthy meals served in the cafeteria. Many of them head to Bongo Burger, Top Dog and other joints selling high-fat, high-sugar alternatives.

Six miles away at Oakland High School, the cafeteria is mobbed. There are not enough seats for everyone, so some students eat lunch outside on picnic tables while others eat in classrooms. No one goes off campus to pick up food from Wingstop or the AMPM convenience store.

The difference? The Oakland High students are no longer allowed to leave campus during lunch.

At Berkeley High, where famed chef Alice Waters’ nonprofit, the Edible Schoolyard Project, has consulted on the menu, school officials say one-tenth of the students take advantage of the healthy lunch on campus.

“Kids could be eating a good meal for free, or they could be running off campus, and in a hurry … they’re going to buy the Flamin’ Hot Cheetos and a Coke.”

In recent years, lawmakers, regulators and school districts have tried to improve students’ health by curbing the sale of junk food and tightening nutritional standards for school food. But those efforts are undermined when students can leave campus to eat whatever they want, as they can at dozens of Bay Area high schools. Based on the experience in Oakland, closing campuses while offering free lunches can be an effective strategy.  

First lady Michelle Obama has made improving what students eat a signature cause. Just this school year, cafeterias nationwide have been implementing new nutritional standards for the lunches they serve. The U.S. Department of Agriculture is working on new regulations for all other foods sold in schools, including from vending machines. But the idea of keeping kids on campus so that they eat healthy lunches is not part of the national debate.

The Oakland Unified School District closed the Oakland High campus last fall to cut down on absenteeism after lunch and reduce break-ins, drug use and trespassing in surrounding neighborhoods, said then-Principal Jeffrey Rogers.

Continue reading →

FILED UNDER: Policy, School Lunches, Science
May 7, 2013 | 12:04 PM | By

Rarely Mentioned Medical Mistake: Patients Harmed by High Rates of Misdiagnosis

By Sandra G. Boodman, Kaiser Health News

(Getty Images)

(Getty Images)

Until it happened to him, Dr. Itzhak Brook, a pediatric infectious disease specialist at Georgetown University School of Medicine, didn’t think much about the problem of misdiagnosis.

That was before doctors at a Maryland hospital repeatedly told Brook his throat pain was the result of acid reflux, not cancer. The correct diagnosis was made by an astute resident who found the tumor  –  the size of a peach pit  –  using a simple procedure. The experienced head and neck surgeons who regularly examined Brook had never tried it. Because the cancer had grown undetected for seven months, Brook was forced to undergo surgery to remove his voice box, a procedure that has left him speaking in a whisper. He believes that might not have been necessary had the cancer been found earlier.

“I consider myself lucky to be alive,” said Brook, now 72, of the 2006 ordeal, which he described at a recent international conference on diagnostic mistakes held in Baltimore. A physician for 40 years, Brook said he was “really shocked” by his misdiagnosis.

Misdiagnosis “happens all the time … This is an enormous problem.”

But patient safety experts say Brook’s experience is far from rare. Diagnoses that are missed, incorrect or delayed are believed to affect 10 to 20 percent of cases, far exceeding drug errors and surgery on the wrong patient or body part, both of which have received considerably more attention.

Recent studies underscore the extent and potential impact of such errors. To cite just two examples: Continue reading →

FILED UNDER: Policy, Medical Error, Patient Safety, Science