Paying a high price for cancer drugs

The Lancet recently published an editorial “Paying a high price for cancer” bringing attention of their readers to a large problem of growing cost of cancer therapies as discussed in the Mayo Clinic Proceedings commentary and co-signed by 118 US cancer physicians. There was a 5-10 fold increase in new cancer drugs prices during the past 15 years. For example the cost of a cancer drug that was approved in 2014 exceeds $120,000 per year of use. A post approval pricing review by Medicare which may include negotiating drug prices and importing drugs from neighboring countries are two possible suggested solutions to reduce the cost of cancer drugs. Moreover, a recently published research from Oxford, UK showed positive results for the use of widely available, inexpensive class of medications for the treatment of early breast cancer in postmenopausal women that could reduce disease recurrence and mortality. The WHO updated its’ list of “Essential Medicines” to include 16 new cancer drugs such as the costly imatinib, however the high cost of such essential drugs is an obstacle that restricts health systems from providing hope to their cancer patients.  What are your thoughts about this dilemma? How often do you dispense the costly cancer treatments?

For additional information please see The Lancet.

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Heartburn ‘possible cancer sign’ warning

People should go to their doctor if they have persistent heartburn or difficulty swallowing food for three weeks or more as this could be a sign of stomach or oesophageal cancer, according to Public Health England. The “Be Clear on Cancer” campaign is focusing on how to spot the signs of oesophageal or stomach cancer. This includes, but is not limited to: indigestion on and off for three weeks or more, feeling food sticking in your throat when you swallow, and feeling full very quickly when eating. As with any cancer, early detection is key in treating and preventing future problems. The good news for Public Health England is that the health campaign appears to encourage people to seek help. How successful do you think this campaign would be in the United States?

 

For more information, please click here.

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Ramping up e-cigarette voltage produces more formaldehyde: study

Smoking e-cigarettes at a higher voltage can can people to have more exposure to formaldehyde, according to a recent study published in the New England Journal of Medicine. Researchers from Portland State University took flavored nicotine liquid made by Halo Cigs and tested it in a personal vaporizer from Innokin. The vaporizer allows consumers to adjust the voltage from 3.3V to 5.0V. The higher the voltage the greater the nicotine kick, but also the greater the amount of formaldehyde. Inhaled as a gas, formaldehyde has been linked to an increased risk of nasopharyngeal cancer and leukemia. Researchers concluded that the life-time risk of developing formaldehyde-related cancer was roughly 1 in 200 for high-voltage e-cigarettes versus 1 in 1,000 for cigarettes – at least five times higher. They found no increased risk for people smoking at a low voltage. What are you thoughts on smoking cigarettes vs. e-cigarettes? How often do you counsel patients about e-cigarettes?

For more information, please click here.

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Blood test to help smokers ‘find best way to quit’

In a new research conducted on 1,240 patients at the University of Pennsylvania was published in the Lancet Respiratory Medicine Journal. It shows that taking a blood test could give smokers the best option to quit smoking. Doing these blood tests can measure how quickly a person breaks down nicotine, and could boost the chances of successfully quitting. Some scientists suggest people who break it down more quickly may crave cigarettes more and in turn find it harder to quit. During the study volunteers were placed on a nicotine patch, varenicline, or a placebo pill. Scientists found people who broke down nicotine at a normal rate had a better chance of quitting while using varenicline than those using nicotine replacement patches. Meanwhile, volunteers who broke nicotine down more slowly had similar success rates in whichever method they used, though they reported more side-effects with the varenicline. How do you feel about this example of personalized medicine? Do you believe that most smokers interested in increasing their chance of quitting successfully would agree to get this blood test?

For more information please click here.

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Tea, citrus products could lower ovarian cancer risk, new research finds

According to new study from the Brigham and Women’s Hospital and Harvard Medical School, consuming tea and citrus juices could correspond to a lower risk of developing ovarian cancer. This was the first large-scale study to determine the role of flavanoids on ovarian cancer, and followed 172,000 patients over three decades. The research team found that women who consumed flavonols and flavanones, which are two sub-types of flavanoids, experienced much less of a risk of developing epithelial ovarian cancer. Since these flavanoids are found in tea and citrus juices and fruits, it is fairly easy to incorporate them to get the associated benefits. This was a promising find, as roughly 20,000 women are diagnosed with ovarian cancer in the United States each year and it also happens to be the fifth leading cause of death from cancer among women. What other dietary sources of flavanoids do you recommend to your patients for health benefits?

For additional information, go to ScienceDaily.

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Scientists find lung cancer can lie hidden for 20 years

Until now, scientists have been puzzled as to why lung cancer is one of the hardest malignancies to treat. Findings show that there are multiple mutations which occur very slowly, yet simultaneously in different parts of the same tumor. This means that by the time the cancer has been detected, the malignancy has become genetically diverse, and thus harder to treat with the medications we currently have available. This is especially true because current diagnostic tools do not detect growths until they reach a certain size. New approaches to detecting lung cancer at an earlier stage are now being explored in order for actions to be taken sooner. How do you talk to your patients about the risks of lung cancer? What do you recommend in terms of prevention?

For additional information, go to Reuters.

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Bristol immune drug shows strong effect in melanoma study

Opdivo, the immunotherapy drug that has been developed by Bristol-Myers Squibb, has showed a promising effect for treatment of melanoma with few toxic side effects comparing to the standard chemotherapy. In the Phase III clinical trial, tumors was found to shrink in patient given Opdivo. Moreover, the duration of the response was found to be more extended, more than six months, in comparison to 3.6 months for other therapies. Opdivo, or nivolumab, works by blocking the Programmed Death receptor (PD-1), a protein that used by tumors to elude disease-fighting cells of the immune system. Observing this trend of chemotherapy development, how would you interpret that on the clinical practice?

 

For more reading, please see Reuters.

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SkinCeuticals’ sunscreen is for your eyes only

SkinCeuticals’ new product called Physical Eye UV Defense claims to protect your skin around the eyes, a location on your face that is typically recommended to avoid during sunscreen application. The product is made of oil base ingredients to stick to skin without running off into the eyes. Cancer of the eyelids is non-life-threatening but can result in surgery or defects. With the sunscreen safety and efficacy controversy what suggestions do you typically follow and what products do you use and recommend?

For Additional Information, please see LA Times.

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The Little Blue Pill May Boost Risk of Deadly Skin Cancer

A recent preliminary study has found that men taking the popular medication, Viagra, for erectile dysfunction are more likely to develop melanoma than those that did not. Although more information needs to be gathered, it is believed that the medication affects a genetic pathway making melanomas more invasive. It has been suggested that primary care doctors discuss this risk especially with patients that have family history of skin cancers. As the active ingredient sildenfil is in two different formulations (Viagra for ED and Revatio for Pulmonary Arterial Hypertension), do you feel that we now see an increased risk of melanomas in the next generation? What could we try to prevent this from occurring?

For additional information, please see the article in NBC News.

Click on the link for the study in JAMA.

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