MEDICARE, GENETIC TESTING, AND YOU

Linda in Quito, Ecuador

I have been asked several times if Medicare will pay for genetic testing; specifically, for BRCA mutations.  Such is the extent of my rattle-brainishness that I just now got around to checking.  The short answer is: no.  Until recently, you could be tested if a family member had breast or ovarian cancer.  Not any more; now you actually have to HAVE cancer to get tested!  Seems monumentally short-sighted to me, but what do I know?  I’m just a dumb geologist.

Needless to say, FORCE* is not pleased with this situation.

http://www.facingourrisk.org/understanding-brca-and-hboc/publications/newsletter/archives/2007winter/stricter-medicare-guidelines.php

Neither am I.

*Facing Our Risk of Cancer, Empowered.  Look ,’em up.

CURE

A young Linda

I have been writing this cancer blog for something like five years – and I just now discovered that there is a magazine wholly devoted to cancer: what it is, what it does, and what to do about it.  I am going to explore the magazine more intensely this week-end (no use starting now; Friday beer is less than an hour away.)  But in the meantime, why don’t you form your own opinions.  Just click on

http://www.curetoday.com/

and go from there.

STARVE YOURSELF HEALTHY

At home in Evanston, 1984

As we get older our DNA accumulates epigenetic changes, especially methylation.  (See blog http://ljb-quiltcutie.blogspot.com/2013/08/epigenetic-apocalypse-now-i-warned-you.html, for instance.)   New research demonstrates that “caloric restriction” minimizes these changes.  Thus, cutting lifetime caloric intake by 30% or so is associated with significantly slower ageing, at least in mice and some particularly ugly brand of monkey; the article implies a similar benefit to humans, but no evidence is provided.  The experiment indicates that diet restriction has no effect on telomere shortening, another contributor to senescence (see http://ljb ljb-quiltcutie.blogspot.com/2012/07/relaxing-on-beach-somewhere-1988.html). 

Well, heck, at 84 my DNA is certain to be crowded with methyl groups, and my telomeres mere nubbins.  Thus, caloric deprivation is unlikely to do me much good.  However, to be on the safe side I hereby vow to give up broccoli, cauliflower, raw celery, and humus.  That should so the trick.

https://www.nih.gov/news-events/nih-research-matters/calorie-restriction-slows-age-related-epigenetic-changes

IMMUNOTHERAPY FOR THE REST OF US

Linda and an early quilt

NCI produces a lot of video clips, most of which I consider only marginally worthwhile, or even a bit dumb.  Here, however, is one that vastly repays the effort to create it.  You might call it Cliff Notes – Immunotherapy”.  Watch it.

https://www.youtube.com/watch?v=UOowq2GXN7A

IMPORTANT INFORMATION

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Two kids in the Olympics

This is largely for guys.

Linda was diagnosed with ovarian cancer about nine years ago.  After she had undergone her truly terrible “debulking” operation, her surgeon met with me to explain the situation.  I am positive that he was a good, well-intentioned man and a surgeon of outstanding skill and experience – but I understood little of what he said, and retained even less.  His explanation did Linda, and me, no good whatsoever.  The fault lay with me:  I didn’t know what to ask.  If, God forbid, your female partner finds herself one if the 22,000 American women diagnosed with ovarian cancer each year, I don’t want you to be at a loss for background and understanding.  We can’t all be research biochemists, but there are certain lay-person summaries that are of great help.  The latest and best was just published in The Economist:

https://www.economist.com/news/leaders/21728893-science-will-win-technical-battle-against-cancer-only-half-fight-closing.

I implore you to read this article.  You may have to buy the current issue (maybe $5.00, you cheapskate!).  Do so, then give it to a friend.  An added benefit would be to enjoy a fresh, British-cynical take on the clown show maturing in Washington.

Of course, if you have studied all 531 of my cancer blogs you would know all this already.  But you haven’t, and I don’t blame you.  After all, who wants to think about cancer when the sun is shining, there are trails to be hiked, and Facebook is filled with cute pictures of crows and little kids?  But read them and think about cancer nonetheless.  Cancer will not go away by itself.

VOODOO MEDICINE

Linda and Ella, a few years ago.

One is now a beautiful little girl.

The other is a beautiful memory

God knows, cancer is a tough beast to kill.  Society has invested prodigious sums of money warring on cancer for at least half a century – with, overall, disappointing results.  As I wrote earlier, with immunotherapy in our quiver, I am feeling cautiously optimistic, but we still have a long way to go.  In the meantime, don’t abandon science for voodoo “cures”.  As this article makes clear, they just don’t work.

https://www.cancer.gov/news-events/cancer-currents-blog/2017/alternative-medicine-cancer-survival

MORE ON DRUG PRICING

Guess where

When I first signed on as a Research Advocate with Fred Hutch I was astonished to learn that they carried economists on their staff.  And even paid them!  My astonishment arose from the fact that, although an honor student in economics at Stanford, I couldn’t remember ever learning anything useful.  But now maybe I get it.

The NYTimes article (below) deals with a new study of drug pricing.  New drugs cost us (society) a lot, as is well known.  The conventional defense against charges of price gouging is: drug development is costly, because costs arising from failed drugs must be included.  Critics respond that in fact all the basic research is handed to Big Pharma gratis, by publically funded research outfits (NIH, Fred Hutch, Sloan Kettering, U. W. Medicine, etc.)  As the article (which you should read) makes clear, the case is complicated.  How, for instance, do you calculate costs when a researcher blunders on something patentable, quits to form his or her own company to exploit it,  runs a few small but encouraging trials, and then is bought out by by Big Pharma for enough money to fund the North Korean nuclear program?

So read the article and tell me what you think.

The article ends with the following chilling observation:

When it comes to drug prices, it does not matter what companies spend on research and development, Dr. Kesselheim said.  The price is based on what the market will bear.

https://www.nytimes.com/2017/09/11/health/cancer-drug-costs.html?em_pos=medium&emc=edit_sc_20170912&nl=science-times&nl_art=2&nlid=69247603&ref=headline&te=1

Ovarian Cancer Awareness Month

Aw, nuts!

September is ovarian cancer awareness month.  Let's be more than aware; let's exterminate the damned disease!

http://www.kulr8.com/story/36315924/what-you-need-to-know-for-ovarian-cancer-awareness-month

COSTS OF CANCER

How could I sell this house and lose this tree?

Especially when I can remember this lady being there.

As if getting cancer is not painful enough to the body and spirit, when it happens you get whacked in the wallet, too.  Copays, deductibles, medicines, etc., are compounded by lost income.  Your hard-working public servants at the NCI refer to this as “financial distress” or, in more extreme cases, “financial toxicity”.  The bottom line is that living can cost you a lot more if you get cancer.  See below:

https://www.cancer.gov/about-cancer/managing-care/track-care-costs/financial-toxicity-pdq

The obvious moral here is – don’t get cancer.  But since that can’t be guaranteed, maybe we ought to look into reorganizing our health care system.