Sunday, April 19, 2015

April 19, 2015 — Blood Test for Cancer?

This is huge.

Today’s New York Times tells of some research now under way that could lead to a simple blood test that could be used to diagnose cancer, particularly blood cancers like lymphoma (Gina Kolata, “Blood Test Shows Promise as Alternative to Cancer Biopsy,” New York Times, April 19, 2015)

From the article:

“The hope is that a simple blood draw — far less onerous for patients than a traditional biopsy or a CT scan — will enable oncologists to quickly figure out whether a treatment is working and, if it is, to continue monitoring the treatment in case the cancer develops resistance....

‘This could change forever the way we follow up not only response to treatments but also the emergence of resistance, and down the line could even be used for really early diagnosis,’ said Dr. José Baselga, physician in chief and chief medical officer at Memorial Sloan Kettering Cancer Center....

A National Cancer Institute study published this month in The Lancet Oncology, involving 126 patients with the most common form of lymphoma, found the test predicted recurrences more than three months before they were noticeable on CT scans.”

The new test follows a novel approach: searching for tiny snippets of cancer DNA that the body sheds into the bloodstream. The DNA shards are tiny and short-lived (they last for only a few hours), but extremely sophisticated blood tests are evidently now able to pick out this particular needle-in-a-haystack.

Early signs are that the test may be more useful for follow-up with existing patients who are known to have had tumors than for first-time diagnoses. It doesn’t appear to be the sort of test that could successfully be given as a routine screening for healthy patients:

“Another possible application — early diagnosis of cancer — is trickier. If a blood test showed cancer DNA, what would that mean? Where is the tumor, and would it help to find and treat it early? Some cancers stop growing and even go away on their own. With others, the outcome is just as good if the cancer is found later.”

If this blood test is successfully developed for clinical use, it could greatly reduce the need for CT and PET scans in monitoring patients during and after treatment.

As I’ve said, this is huge (although, admittedly, still just a theory at this point). I’ll be watching for further news on this.

Monday, April 13, 2015

April 13, 2015 — Bankruptcy Fears

Here’s a factoid I ran across today, in an article in Cure magazine. Over one-third of cancer patients, in a recent study, identified bankruptcy as one of the worst fears they’re facing as a result of their treatment.

Think about that: one-third! (Actually, it was a little worse than that: 37.1 percent). That’s an awful lot of worried, seriously-ill people, who are obsessing over something not directly connected to their disease.

Now, here’s the real kicker. From the article:

“Most of the [480] patients were covered by an employer-based plan or some form of Medicare; 18 participants had purchased their coverage through a health insurance marketplace; and five patients reported not having insurance of any kind and being unable to afford a plan.”

Most of the people who such worries about going bankrupt have insurance! So much for insurance providing peace of mind. What does that say about the quality of the insurance safety net so many are depending on?

Even worse than worrying about inadequate insurance is the worry about having no insurance at all. A great many survey respondents spoke of certain trade-offs they’ve had to make, to keep their medical funding in place, “such as choosing doctors based on co-pays, cutting back on food, activities — including education — to save money, and becoming isolated from family members. 'Even if I starve to death, I will not let go of my insurance. That is my life,' said one woman.”

It’s a sad commentary when a seriously-ill person is reduced to describing her insurance policy as her life.  For far too many in our country, medical insurance is indeed a life-or-death matter.

Time for national single-payer health insurance — such as nearly every other industrialized nation already has — wouldn’t you say?

Thursday, April 09, 2015

April 9, 2015 — Obscenity and Glory

Easter’s come and gone. The day, anyway. For Christians who follow the liturgical year, the season lives on, in the forty days between Easter Day and Pentecost.

Today I ran across this quotation from a collection of sermons by Frederick Buechner, The Magnificent Defeat (HarperCollins, 1985). Buechner is a preacher’s preacher. Although he doesn’t step into a pulpit that often, his influence as a writer is widespread, and much-appreciated by those who craft sermons week in and week out.

Here’s the excerpt:

“Anxiety and fear are what we know best in this fantastic century of ours. Wars and rumors of wars. From civilization itself to what seemed the most unalterable values of the past, everything is threatened or already in ruins. We have heard so much tragic news that when the news is good we cannot hear it. But the proclamation of Easter Day is that all is well. And as a Christian, I say this not with the easy optimism of one who has never known a time when all was not well but as one who has faced the Cross in all its obscenity as well as in all its glory, who has known one way or another what it is like to live separated from God. In the end, his will, not ours, is done. Love is the victor. Death is not the end. The end is life. His life and our lives through him, in him. Existence has greater depths of beauty, mystery, and benediction than the wildest visionary has ever dared to dream. Christ our Lord has risen.”

What I like about this expression of Easter faith is its realism. There no illusions, here, that life is never hard. There’s no attempt to sell the idea that God offers the baptized a “Get out of suffering free” card. There are plenty of purveyors of spiritual snake oil out there who carry around whole stacks of such cards, and hand them out as a come-on. (It works. They always seem to be surrounded by hopeful hordes waving dollar bills.)

Buechner’s got too much integrity for that. For him, the cross is not an item of sparkly gold jewelry, but an “obscenity” that — paradoxically — leads to glory.

For people with cancer, or anyone else who’s on a hard road, there’s hope in that vision. Hope doesn’t come from finding a way around life’s struggles and heartaches. It comes from resolutely forging on through them — knowing that, on the other side, someone’s waiting for us. Someone who’s been through it, too.