Avastin - Worth the Cost?

I wanted to share these articles with you. Please give me your thoughts and comments.

New York Times July 6, 2008 - Despite a price that can reach $100,000 a year, Avastin has become one of the most popular cancer drugs in the world. In 2007, sales of the drug reached $3.5 billion, with $2.3 billion in the United States. But studies show the drug prolongs life by only a few months, if that. And some newer studies suggest the drug might be less effective against cancer than the FDA believed when the drug was approved. Avastin also has serious, if infrequent, side effects, some of which can be lethal. And because it is almost always used with standard chemotherapy, patients on Avastin also face chemotherapy’s side effects. If Avastin were inexpensive, or if it truly held cancer at bay, few might care. But Avastin raises troubling questions. What does it mean to say the drug works? Is slowing the growth of tumors enough if life is not significantly prolonged or improved? How much evidence should there be before billions of dollars are spent on a drug? And when should cost be factored into the equation? Some in the pharmaceutical industry believe that the price of Avastin will raise concerns about whether drugs are worth it, leading to a backlash like price controls or restrictions on use.

British Agency Impugns Value Of Four Costly Cancer Drugs
By JEANNE WHALEN August 8, 2008;
Page B5 LONDON --

An agency that advises Britain's health-care system has decided that a group of cancer drugs aren't worth the money, a move that highlights a growing debate over how to balance the interests of patients with soaring drug costs. The National Institute for Health and Clinical Excellence, or NICE, said in a preliminary ruling Thursday that four drugs used to treat advanced kidney cancer -- Roche Holding AG's Avastin, Bayer AG's Nexavar, Pfizer Inc.'s Sutent and Wyeth's Torisel -- aren't effective enough to warrant their high cost and shouldn't be prescribed to new patients in Britain. If the preliminary judgment holds, Britain's National Health Service won't pay for the drugs' use in treating a type of advanced kidney cancer known as renal cell carcinoma. The drugs are prescribed for this purpose in the U.S. and elsewhere in Europe. NICE's decisions are closely watched by governments and health insurers around the globe. Expensive cancer drugs present a particular dilemma for these health-care payers as they redouble their efforts to rein in drug spending. In a statement, Pfizer said it is "disappointed" and "committed to working with NICE to overturn this preliminary guidance." Bayer also expressed disappointment, noting that Nexavar is available in more than 70 countries. Roche and Wyeth didn't immediately respond to requests for comment. NICE will give drug companies, patient groups and others a chance to comment before making a final recommendation. In its preliminary findings, NICE said the drugs extended some patients' lives, but were ultimately not effective enough to justify their expense, which ranges from £3,100 ($6,036) to £6,100 for a six-week treatment cycle. Using data from clinical trials and complex financial models, NICE estimated that the drugs cost between £71,500 and £171,300 for each year of healthy life they give patients. NICE generally thinks that Britain shouldn't pay more than £30,000 for a year of healthy life gained -- also known as a quality-adjusted life year, or QALY.

How Will I Be Remembered?

I attended the memorial service for my good friend, Bobby Murcer this morning. I took the book "Grace Disguised" by Gerald Sittser with me to give to Bobby's wife Kay. It was a book that really helped me after my son Cade passed in 2000 and I always give a copy to anyone of our families that is grieving. I didn't get to see Kay personally to give it to her but hopefully the usher made sure she received it.

The service really made me stop and think about how I will be remembered. What will people say about me after I am gone? Bobby Murcer was such an amazing person, amazing baseball player, strong Christian man and really good father and husband. The New York Yankees baseball team was there and many of Bobby's closest friends. They told stories about Bobby that made you laugh and made you cry. They all talked of how he never met a stranger and had an uncanny way of making everyone feel important. If you ever met Bobby Murcer you probably called him a friend. That was the thing about Bobby, he never met a stranger. I know he sure made me feel that way the first time I met him. He was such a regular down to earth guy, always laughing and joking and genuinely interested in you and what you had going on.

I think sometimes I am to quick to judge, get irritated and impatient and sometimes just plain don't want to be bothered. I am sure Bobby felt that way sometimes, he just didn't show it. My problem is I wear my feelings and thoughts on my shirt. I just don't hide what I think or how I feel about people very well. If I am upset with you, you will know it. Well, at least I can say I am honest.

I try really hard to be the person that God has for me to be. I work every day to become more like Him. Some days I am more successful than others. Some days I just plain fail. I want and try to treat others with the same respect I want, the same consideration I want, the same kindness and compassion that I want. When Cade died the biggest lesson I learned was to not take life and those you love for granted. Every day is a gift from God.

Life is terminal. It really is. I could leave the office today and get hit by a truck and killed and those of you who are fighting brain cancer would out live me. It could happen to anyone. What is the old saying "there is only one thing guaranteed you will die and you will pay taxes". Funny but true. None of us know what tomorrow holds in store for us. But what is important is what we are doing with the time we have right now.

My question to you......What are you doing with your time? How will you be remembered? Something to think about....

Robert Novak diagnosed with Malignant Brain Tumor

Tumor forces columnist Novak to retire
He describes tumor prognosis as 'dire,' expects chemotherapy
MSNBC staff and news service reports
updated 1:12 p.m. CT, Mon., Aug. 4, 2008

BOSTON - Conservative political commentator Robert Novak on Monday announced his immediate retirement from the Chicago Sun-Times following the diagnosis of a brain tumor, a prognosis that he described as "dire."
"The details are being worked out with the doctors this week, but the tentative plan is for radiation and chemotherapy," Novak told the Sun-Times.
A week ago, Novak announced that he had been diagnosed with a brain tumor. Novak, 77, fell ill while visiting his daughter and was rushed to Brigham and Women’s Hospital, where he said he was diagnosed with the tumor.
A few days earlier, Novak was given a $50 citation after he struck a homeless man with his car in downtown Washington. Novak kept going until he was stopped by a bicyclist, who said the man was splayed on Novak’s windshield.
Dr. Lynne Taylor, a neuro-oncologist at Virginia Mason Medical Center in Seattle, said residents at the hospital are taught to check for brain tumors in patients who report having a recent car accident in which they didn’t realize they struck something.
“People get spatial and visual neglect of a certain part of their bodies and they don’t realize they’ve done what they’ve done,” said Taylor.
25 years on 'Crossfire'Novak is best-known as the longtime co-host of CNN’s “Crossfire,” where he jousted with liberal co-hosts from 1980 to 2005, when he left to join Fox News as an occasional contributor. Novak is also editor of the Evans-Novak Political Report.
Novak was criticized after he was the first to publicly reveal the name of CIA operative Valerie Plame in a 2003 column. His column came out eight days after Plame’s husband, Joseph Wilson, said the Bush administration had twisted prewar intelligence to exaggerate the Iraqi threat.
The Associated Press contributed to this report.

URL: http://www.msnbc.msn.com/id/26012351/?GT1=43001

Andrew Rice says everyone should have same health coverage as Congress

By John Greiner, Staff Writer for the Oklahoman

Saying America has a health care crisis, U.S. Senate candidate Andrew Rice called Monday for making health insurance affordable to every American.The Democrat state senator who is running for the post held by incumbent U.S. Sen. Jim Inhofe, R-Tulsa, said American needs leaders "willing to stand up to the special interests" and put the health-care needs of Americans and Oklahomans first."Every family, every child and every veteran should have access to the same health care options that taxpayers make available to members of Congress," Rice said. "This is one of the great moral issues of our time."Accompanying Rice was Nancy Thomason of the Oklahoma Brain Tumor Foundation, who worked on behalf of Steffanie's Law to require health insurance to cover routine medical care for patients in clinical trials.Also with Rice was Wayne Rohde, father of Nick Rohde, for whom the Nick's Law bill was named. It would have required insurance coverage for autism.Both bills died in the state House of Representatives.Rice said his health care solution for the nation would include ideas in those two state bills. He said his plan would:• Make health insurance affordable for all Americans.• Guarantee no one is denied coverage because of pre-existing conditions.• Continue to cover routine medical care for cancer patients who are undergoing clinical trials.• Extend coverage for autism and other mental health care treatments for children and adults.• Guarantee if you change jobs, your health insurance plan follows you.• Include same health care coverage options available to members of Congress• Provide economic incentives for health care providers based on quality of care, not volume of patients.

Cell Phones & Possible Adverse Effects

CELL PHONES AND POSSIBLE ADVERSE EFFECTS

The North American Brain Tumor Coalition (NABTC) has for a number of years carefully monitored the research related to the potential adverse effects associated with cell phone use. The NABTC urges these precautions in absence of definitive studies regarding the risks of cell phones.

· The Coalition urges the most expeditious possible completion of research studies, including one sponsored by the World Health Organization (WHO), to provide consumers better information about the risks created by their use of cell phones.
· In the absence of conclusive studies, we urge that individuals take simple precautions to limit their cell phone use and that they dramatically restrict the use of phones by children.

Background

It is estimated that almost 220 million Americans and nearly 2 billion people worldwide regularly use cell phones. If cell phones are convenient tools that have become an accepted way of life in the United States, they are the only reliable means of telephone communication in many parts of the world. Cell phone usage is expected to continue to grow worldwide.

Those who use cell phones are exposed to the radiofrequency (RF) energy, a non-ionizing form of radiation, emitted by the phones. Because of the widespread use of this relatively new technology, there is understandable concern about the health implications of use. When the WHO published a fact sheet on cell phones in 2000, it stated, “Given the immense numbers of mobile phones, even small adverse effects on health could have major public health implications.”

Research on Risks Associated with Cell Phone Use

Studies have been undertaken to determine whether RF exposure may increase the risk of cancer. To date, many of the studies have focused on whether RF energy can cause malignant or benign brain tumors.

A “Cell Phone Facts,” document for consumers developed by the Food and Drug Administration (FDA) and Federal Communications Commission (FCC) reviews the research on cell phones that has been completed to date. The document states:

The research done thus far has produced conflicting results, and many studies have suffered from flaws in their research methods. Animal experiments investigating the effects of radiofrequency energy (RF) exposures characteristic of wireless phones have yielded conflicting results that often cannot be repeated in other laboratories. A few animal studies, however, have suggested that low levels of RF could accelerate the development of cancer in laboratory animals. However, many of the studies that showed increased tumor development used animals that had been genetically engineered or treated with cancer-causing chemicals so as to be pre-disposed to develop cancer in the presence of RF exposure. Other studies exposed the animals to RF for up to 22 hours per day. These conditions are not similar to the conditions under which people use wireless phones, so we don’t know with certainty what the results of such studies mean for human health.

Three large epidemiology studies have been published since December 2000. Between them, the studies investigated any possible association between the use of wireless phones and primary brain cancer, glioma, meningioma, or acoustic neuroma, tumors of the brain or salivary gland, leukemia, or other cancers. None of the studies demonstrated the existence of any harmful health effects from wireless phone RF exposures. However, none of the studies can answer questions about long-term exposures, since the average period of phone use in these studies was around three years.

The FDA and FCC recommend additional research and note the challenges of completing the laboratory and epidemiological studies that might offer conclusive data on risks of cell phones. The agencies note that animal studies investigating cell phone use would need to be very large to offer meaningful data, and epidemiological studies might require ten or more years of follow-up. Finally, the agencies note difficulties in measuring actual RF exposure, including which model of phone is used and the angle of the cell phone during use.

A recently published meta-analysis by an Australian neurosurgeon has intensified concerns about the risks of cell phone use and created great interest in the completion of ongoing studies.

Recommended Precautions for Use

Although public health authorities are not in agreement regarding the issuance of public health advisories about cell phones in light of the inconclusive data regarding their risks, most governments have issued precautionary warnings regarding cell phone use. Many of the health agencies that have issued warnings note that the evidence does not necessarily support limitations on use but that the uncertainty regarding safety of cell phones and their widespread use support action.

In its 2000 Fact Sheet on cell phones, WHO stated:

Present scientific information does not indicate the need for any special precautions for use of mobile phones. If individuals are concerned, they might choose to limit their own or their children’s RF exposure by limiting the length of calls, or using “hands-free” devices to keep mobile phones away from the head and body.

The United Kingdom in 2000 urged that cell phone use among children be limited and undertook a leafleting campaign to distribute information about limiting use by children.

In 2006, the Canadian government urged adults to moderate their cell phone use and the cell phone use of their children until the science regarding the risks of cell phones is clear.

The FCC and FDA in the United States say:

If you must conduct extended conversations by wireless phone every day, you could place more distance between your body and the source of the RF, since the exposure level drops off dramatically with distance. For example, you could use a headset and carry the wireless phone away from your body or use a wireless phone connected to a remote antenna.

The US agencies state that the precautions that are employed by adults may also be adopted by children.

In a July 2008 memo to the University of Pittsburgh Cancer Institute faculty and staff, institute director Ronald Herberman, M.D. offered “Practical Advice to Limit Exposure to Electromagnetic Radiation Emitted from Cell Phones.” Dr. Herberman said that release of the ten “prudent and simple precautions” to reduce exposure was based on the recommendations of an international panel of experts convened by the University of Pittsburgh. Those experts stated that, “…electromagnetic fields emitted by cell phones should be considered a potential human health risk.” The memo from Dr. Herberman to his faculty and staff is available at http://www.upci.upmc.edu/news/upci_news/2008/072308_celladvisory.html. The analysis of the panel convened by the University of Pittsburgh is available at http://environmentaloncology.org/files/file/Publications/UPCICellPhonesAppeal.pdf.

Additional Information Regarding Cell Phones

The National Cancer Institute has posted a question and answer document that provides significant information regarding cell phone use and cancer. This document is available at http://www.cancer.gov/cancertopics/factsheet/Risk/cellphones.

The American Cancer Society describes cellular phones and the research on the risks of their use in a document available at http://www.cancer.org/docroot/PED/content/PED_1_3X_Cellular_Phones.asp?sitearea=PED.

The FDA and FCC provide a document called “Cell Phone Facts” at http://www.fda.gov/cellphones/qa.html.

A fact sheet on mobile phones, revised by WHO in June 2000, is available at http://www.who.int/mediacentre/factsheets/fs193/en/print.html. A Q&A document from WHO is available at http://www.who.int/features/qa/30/en/print.html.