Doctor Shares Q&A for Cancer Patients Seeking
Experimental Treatments

The basic problem researchers seek to overcome in finding a cure for cancer is the body's general inability to fight the disease. Immune systems can do very little to penetrate the robust molecular shield found in tumors.

But those shields may no longer be so impenetrable, thanks to a new experimental drug called BMS-936558, according to the American Society of Clinical Oncology. Studies show it produces significant shrinkage when used in fighting specific forms of lung, skin and kidney cancers.

"Clinical trials with new drugs like BMS-936558 offer hope for patients battling advanced cancers and those that are difficult to treat," says physician Stephen Garrett Marcus, a senior biotechnology research executive, and author of a comprehensive new reference book, Complications of Cancer (www.complicationsofcancer.com).

"While experimental treatments are not the best option for everyone with cancer, they can be a very good one for people for whom current treatments offer poor outcomes. And, in the greater scheme of things, trial participants are making an important contribution to others with the disease. While they may not be cured, their involvement can significantly move research forward."

Marcus shares tips for patients and family members interested in investigating, and perhaps enrolling in, a clinical trial.

• How can a person with cancer rapidly identify promising clinical trials? The National Institute of Health's website (www.clinicaltrials.gov) maintains the most comprehensive registry of cancer clinical trials. The site includes information regarding significant clinical trials in progress. Each listing features the name of the clinical trial, the purpose of the study, the criteria that make a person eligible to participate, the study locations and contact information.

• How does a person enroll in an experimental program? When a good fit in a program is identified, a physician's referral will help expedite an evaluation. If necessary, self-referral can be accomplished by calling the medical center directly and making an appointment to see the physician running clinical trials. Details for making an appointment can be found on the NIH's website.

• What preparations can be made prior to being seen at the medical center?A complete package of information that gives a clear story of a person's medical illness can be very useful and should be brought to the clinic at the time of the first appointment. The center at which a person is evaluated for experimental treatment may give a person a checklist of what to bring to the appointment. This may include a letter from the person's physician; surgical, pathology and radiology reports; and other test results. Having all relevant information organized for the first visit streamlines the process for a comprehensive evaluation, and decisions regarding the best treatment option can be made more quickly.

• How does a person make a decision about whether or not to enter a clinical trial? This decision is made with a thorough understanding of standard treatments and experimental options. Information about these standard and experimental treatments can be provided by the physicians and other caregivers; details are also included in Complications of Cancer.

• Who pays for the experimental medication? The experimental treatment itself should generally be free. Almost all true experimental treatment programs will pay for the experimental medication. Legitimate research almost never asks for money from subjects. Be very wary of treatments advertising high-cost, "cash only" payments; experimental treatment for a very high price is usually not associated with legitimate research.

About Stephen Garrett Marcus, M.D.

Stephen Garrett Marcus, M.D. received his medical degree from New York Medical College and completed a medical oncology fellowship at the University of California in San Francisco. As a senior research executive in the biotechnology and pharmaceutical industry since 1985, he played a lead role in developing Betaseron as the first effective treatment of multiple sclerosis, as well as several new cancer treatments. Marcus is the president and CEO of a biotechnology company developing new treatments for cancer and its life-threatening complications. He is the author of "Complications of Cancer" (www.complicationsofcancer.com), a book written for everyone about serious complications of common cancers and "When Life is in Jeopardy", a book providing comprehensive information about common life-threatening illnesses, injuries and complications.

The Scott County Health Department has been notified by the Medical Entomology Laboratory at Iowa State University that chickens from Scott County's sentinel flock have tested positive for West Nile Virus.  This was not unexpected, despite this summer's hot, dry conditions, and low mosquito population.  Detection of virus exposure in the chickens indicates that there is West Nile Virus transmission activity in the area.  Late summer and early fall are the times when the majority of human cases of West Nile Virus typically are reported.  The risk of contracting West Nile Virus remains high until the first frost when mosquito activity declines.The Scott County Health Department is urging individuals to take steps to reduce the mosquito population and protect themselves when outside.  Some things to do to reduce the mosquito population are:Change the water in birdbaths, pet bowls, and wading pools at least twice a week.Turn over plastic wading pools and buckets.Properly dispose of old tires.  Dispose of tin cans, plastic containers, ceramic pots, and other water-holding containers.  Check for clogged rain gutters and clean them out.Clean and chlorinate swimming pools and drain the water from the pool cover.Some ways to prevent mosquito bites: Wear light colored clothing with long sleeves and long pants.Repair tears in window and door screens.Limit the time spent outdoors at dawn and dusk when mosquitoes are most likely to bite.Do not wear perfume or fragrances when outdoors.Apply insect repellents to exposed skin.  Those containing DEET, picaridin, or oil of lemon eucalyptus have been found to be effective. (Carefully read and follow all directions on the label before use).  Do not use DEET on infants under two years of age, pregnant women, or children's bedding or clothing.The Scott County Health Department, along with the State Hygienic Laboratory and Iowa State University, has participated in mosquito surveillance with the Iowa Department of Public Health for more than 30 years.For more information, visit the Health Department's website at www.scottcountyiowa.com/health.

As ObamaCare becomes ever more unpopular, the single payer idea keeps coming up. So let's consider what a single-payer system would look like. There are so many places to look it's a little confusing. Here's a partial list.

Canada tends to come up first, and I think about it a lot. That's because lots of Canadians come to our facility in Oklahoma for their care. Do I really need to say anything else? These are people who have been told to wait for years before they can see a specialist because there are budget "caps." When the money is gone, the doctor's office is closed. Surgeons are allowed only so much time in the operating room in a month. When they have used up their time, they can do no more surgery. Rather than have the market determine the allocation of resources, a Canadian bureaucrat creates a budget and that's that. Presto! The "right" to healthcare is defined. It might not feel too much like a right, however, to those who have to travel to the U.S. for timely surgery, or for those who die waiting in line for care.

Then there's Britain. The Brits harbor such nationalistic pride in their healthcare system that they celebrated it in the opening ceremonies for the London Olympics. It is based on the same faulty economic premise as the Canadian system. The Brits not only euthanize their sick citizens to free up scarce hospital beds (do you wonder how this shortage of beds came about?), but they are proud of this and have even given this highway to the cemetery a fancy name: the Liverpool Care Pathway.British patients that become extremely ill have a better chance of survival at home, surrounded by family and friends, as no one stands a chance once on the LCP. Recovery from severe illness can occur without the help of modern medicine, but recovery of the very sick isn't likely when the hospital staff is actively murdering them.

But there is no need to go outside of the U.S. to see the wonders of socialism in medicine. The VA hospitals and the Indian hospitals provide examples of efficiency brought to us in medicine from government bureaucrats.

Our local paper's lead article recently informed us that the Department of Public Safety (DPS) was closing the office administering driver's tests for the day to train their employees. Zeke Campfield of The Oklahoman writes that the "operator of a local Chick-fil-A restaurant will teach examiners how to be patient and courteous."

What would happen to an employee at Chick-fil-A that was not patient with and courteous to customers? What would patrons of Chick-fil-A do if they were not treated in a timely manner and with respect? What would happen to Chick-fil-A if this treatment of customers were widespread?

Campfield's article also talks about a mother getting in line outside the DPS testing center at 4:15 A.M., only to be turned away at the end of the day because there were simply not enough examiners to get to her son. Three mornings in a row. The spokesman for the DPS muttered something about budget cuts, so I'm guessing we'll see government's usual response, that of throwing even more money at failure.

Try to imagine the DPS in charge of your medical care. Rude and inefficient staff. No competitive fears. Hospitals working together to institutionalize mediocrity so no one stands out as better, eliminating troublesome comparisons. Long waiting lines. Always blaming the lack of funding or budget caps.

The efficiencies and quality of the private sector cannot be superimposed on government agencies for one simple reason: without competitors, government doesn't have to care. Ever. Our state government wants to introduce private sector ideas into a failed government organization. Ironic, isn't it, that health care bureaucrats are increasingly embracing the business plan of the DPS, even as the DPS is looking for private-sector answers? At least the DPS hasn't started euthanizing applicants waiting in line to free up examination spots.

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WASHINGTON -- Leaders of the Senate Judiciary Committee and the House Oversight and Government Reform Committee continued their examination of Minnesota's inappropriate and possibly illegal misuse of federal tax dollars to cross-subsidize its state-only health programs.

The issue has been under the close inspection of Senate Judiciary Ranking Member Chuck Grassley, R-Iowa, House Oversight Committee Chairman Darrell Issa, R-Calif., and House Oversight Subcommittee on Health Care Chairman Trey Gowdy, R-SC.

A state legislative audit report found that Minnesota was underpaying managed care companies in the state for state-only health programs and overpaying insurance companies for Medicaid.  Since federal taxpayers pay half of Minnesota's Medicaid expenditures, federal taxpayers were inappropriately cross-subsidizing managed care companies in Minnesota for state-only health plans.

In March 2011, UCare, the smallest of Minnesota's four managed care companies operating in the state, returned $30 million to the state.  UCare's CEO attributed this contribution to excess 2010 operating margins, which largely resulted from Medicaid overpayments.

It appears that the Minnesota Department of Human Services attempted to disguise this repayment as a "donation" in order to keep all of it in state coffers, as opposed to returning the appropriate amount to the federal taxpayer. Minnesota finally agreed to return the federal share to the U.S. Treasury the day before a April 2012 House Oversight Committee hearing.

However, because of conflicting statements at the hearing from Minnesota Department of Human Services Commissioner Lucinda Jesson and other contradictory information, questions remain about whether or not the state agency was attempting to defraud the federal taxpayer.

"The State's agreement with UCare to count UCare's $30 million repayment toward the 2011 profit cap raises serious questions regarding your insistence that half of UCare's $30 million "donation" was not subject to federal recoupment," write Grassley, Issa, and Gowdy.

The letter directs Commissioner Jesson to clarify contradictory testimony, given under oath, before the House Oversight Committee; clarify the timeline and decision-making process on the remission to the U.S. Treasury; and to produce documents inappropriately withheld from earlier requests.

The text of the letter is available here. The House Oversight Committee held a hearing in April, and issued a staff report.

 

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