Friday, October 9, 2009

Needle Biopsy Is Gold Standard For Breast Cancer Diagnosis

ScienceDaily (2009-10-08) -- A new report indicates that an alarming 35 percent of initial diagnostic breast biopsies in the United States are still being done using unnecessary open surgical techniques. This in spite of the fact that it costs as much as three times more than the much less invasive and equally accurate needle biopsy technique. ... > read full article
Note to women: If your physician is recommending a surgical biopsy instead of offering you a needle biopsy, get a second opinion from another doctor.  Surgical biopsies are not only expensive and invasive, requiring you to undergo surgery with anesthesia, they also leave scars and sometimes disfigure your breast unnecessarily.

Wednesday, October 7, 2009

Side-by-Side Comparison of Major Health Care Reform Proposals - Kaiser Family Foundation#

Health care reform is a critical issue in helping end breast cancer.

Kaiser Family Foundation, one of our favorite resources in tracking health care reform public policy, has updated their resource for comparing the health care reform plans under consideration in Washington DC.

Follow the link below to view the latest updates comparing plans from the House and Senate committees.

Side-by-Side Comparison of Major Health Care Reform Proposals - Kaiser Family Foundation#

Shared via AddThis

NBCC - Myths About Breast Cancer

National Breast Cancer Coalition has launched a great new web site.  For the month of October, Breast Cancer Awareness Month, they are revealing a new myth about breast cancer every day.  Its critical, important information helpful in dispelling rumors and hype about breast cancer risk and treatment.

Check it out, sign up for their Twitter feed and read something new every day in October about breast cancer.

You can also read the myths by clicking on the widget we've posted at right.

Today's Myth #7

We don’t know how to prevent breast cancer.

TRUE. There are factors associated with increasing risk of breast cancer and certain factors that decrease the risk of breast cancer, but we do not know how to prevent breast cancer. Don’t eat red meat. Eat a low fat diet. Don’t wear deodorant. Don’t sleep in a bra. Women are bombarded constantly on what they can do to prevent breast cancer. Unfortunately, at this time, there is no known way to prevent the disease

Current factors known to contribute to overall breast cancer risk are mostly uncontrollable, including: age, personal and family breast cancer history, certain genetic factors, first menstrual period before age 12, menopause after 55, breast density and race. A few factors that can be controlled that have shown increased risk include: obesity, alcohol consumption and lack of physical activity. More

Insured or Uninsured,Women Forgo Necessary Health Care Due to Cost

The Commonwealth Fund recently released a new study showing more than 52% of US women have problems getting necessary health care because of cost. In addition, 45% of women had medical debt or reported problems with medical bills.

These problems apply to women across all income levels and were significantly greater than the percentage of men experiencing problems:

Problems paying medical bills & medical debt/ women vs. men:

45% vs. 36%  - all income levels
57% vs 48% - low income
61% vs 50% - moderate income
46% vs 32% - middle income
29% vs 21% - high income

Nearly half (45%) of all women delayed cancer screening and dental services.

Why are women experiencing problems getting necessary health care?  A major reason is the fact that women are charged as much as 50% more than men for health insurance coverage, while their incomes are lower.

Among the new health care reform proposals, HR 3200 will prohibit health insurance companies from charging women higher premiums than men.  It will also reduce out of pocket expenses by requiring no cost coverage for preventive care like cancer screening and prohibit them from denying coverage by treating pregnancy, c-sections, breast cancer and genetic testing as pre-existing conditions.

Get on board.  Join our e-newsletter list and receive legislative alerts to contact your member of Congress for health care reform and funding for breast cancer research.

Link here

Monday, September 14, 2009

NEJM - Doctors Support Public/Private Plans for HCR

The New England Journal of Medicine today reported results of a survey of over 5,000 physicians preferences for proposals under consideration for health care reform in the U.S. The surverys were taken between June 25 and September 3, 2009 and indicate most physicians (62.9%) prefer a reform plan with both public and private options for health insurance coverage.  Only 27.3% supported a system of private insurance only.

It doesn't seem surprising, considering physicians are well aware the difficulties their patients face in getting and keeping good private health insurance, not to mention the time and expense for physicians in processing health insurance claims.

The survey also indicated 58.3% of physicians support expansion of Medicare to cover Americans between ages 55 & 65.  More at the link below..

Doctors on Coverage — Physicians’ Views on a New Public Insurance Option and Medicare Expansion

Saturday, September 12, 2009

New Charts On Health Care Reform HR 3200

Health Care for America Now has some new fact sheets available about HR 3200, the U.S. House of Representative's bill that NOBCCF supports for health care reform.

It explains a little more clearly the options that will be available for everyone.

Link to charts (pdf)

Thursday, September 10, 2009

Ohio Health IT Meeting Sept. 25 in Columbus

Breast cancer advocates should stay involved and provide input into how new electronic medical records programs are developed. Patient privacy is an important issue.

Governor Ted Strickland has issued a statement announcing health information technology efforts aimed at reducing health care costs and improving the quality of health care in Ohio. A public forum will be held on Friday, September 25 from 10 a.m.- 11:30 a.m. to discuss the state’s health IT vision and to solicit feedback. The public forum is open to all interested parties and will be held at the Riffe Studio One Theatre, 77 S. High Street, 4th floor. Speakers at this event will include state leaders, the Ohio State Medical Association, the Ohio Hospital Association, the Ohio Osteopathic Association, and By Ohio. There will also be plenty of time for Q&A following the presentation.

Please click here to view the release issued by the Governor’s office regarding the Health IT effort. Please contact with specific questions regarding Health IT.

Wednesday, September 9, 2009

Sen. Harkin Appointed Chair of Senate HELP Committee

Congratulations to Senator Tom Harkin who has been appointed chair of the Senate Health, Education, Labor & Pensions (HELP) Committee in the US Senate. He is filling the vacancy resulting from the recent passing of Senator Ted Kennedy, who chaired the committee for many years.

Senator Harkin, of Iowa, has been a passionate, dedicated advocate for many years on cancer and health care-related issues. He has experienced the loss of his own sister and niece to breast cancer and has vowed to do everything in his power to help end the disease. One of his most significant accomplishments was helping create and establish the Dept. of Defense Breast Cancer Research Program, which has provided over $2 billion for innovative breast cancer research in the US.

Those who have attended National Breast Cancer Coalition's Annual Advocacy Conference & Lobby Day have likely met Sen. Harkin. He has received numerous awards from NBCC for his work and loves to visit with advocates and encourage their work. His fiery, passionate speeches at NBCC's Lobby Day reception are the highlight of everyone's trip, leaving everyone to wipe away a few tears as they shout and cheer.

Congratulations, Senator Harkin!

Monday, August 31, 2009

Updated Summaries Provide Patients with Information to Accompany Professional Guidelines

National Comprehensive Cancer Network provides one of the most critical and helpful resources to breast cancer patients. Their patient-centered Professional Guidelines provide the most up to date information about best practices for breast cancer screening, risk assesment, diagnosis, treatment and follow-up care.

If you're a newly diagnosed patient, NCCN's Guidelines are a critical resource in understanding what diagnostic tests you may need and what kinds of treatment are most recommended for your type of breast cancer. Its an enormously helpful tool in helping you make decisions about surgery, chemotherapy/hormonal therapy, and radiation therapy.

Take the time to check out the guidelines and share the link with others. Mention this resource to your oncologist, too.

NCCN eBulletin - Updated Summaries Provide Patients with Information to Accompany Professional Guidelines

Shared via AddThis

Great cartoon!

More Mastectomies, Fewer Lumpectomies - Not A Positive Trend

A recent editorial in the Journal of Clinical Oncology asks some valid questions about the troubling trend of increases (31% to 43% from 2003 to 2006) in mastectomies for patients who could benefit from breast-conserving therapy (BCT). The editorial raises the question of whether increased use of MRI at time of diagnosis is creating undue fear resulting in women with early stage breast cancers choosing mastectomy when their breast could be preserved without increasing risk of recurrence. Are MRI's at the time of diagnosis really helpful?

More Mastectomies: Is This What Patients Really Want?

The obvious question is: What has changed? Increased awareness of and testing for BRCA1 and BRCA2 mutations indicating breast cancer predisposition are often cited as factors that have appropriately increased use of mastectomy. But these mutations occur in only 5% to 10% of patients with breast cancer, and the proportion of women in the Mayo Clinic series with a first-degree relative with breast cancer did not increase over time, whereas the mastectomy rate did, making this an unlikely explanation for a large part of the effect observed in this and other studies.


On the basis of these performance characteristics, it had been widely assumed that use of breast MRI for the selection of patients for BCT would reduce the need for re-excision, reduce local recurrence, and even improve long-term survival. At present, no studies have provided support for any of these improved clinical outcomes.12–14 However, breast MRI has been shown to result in additional biopsies and costs, increased patient anxiety, and delays in the start of definitive treatment. Although it is accepted that MRI-detected abnormalities should be biopsied before altering surgical treatment plans, it has been documented that some patients have chosen to forgo these biopsies or additional work-ups and proceed with mastectomy because of concerns about delaying definitive therapy.15 A recent prospective randomized clinical trial16 demonstrated no reduction in the rate of re-excision in women randomly assigned to undergo preoperative MRI compared with those who were not.17 Despite these known disadvantages and the lack of established improvement in any clinical outcome, use of breast MRI at time of diagnosis has been—in our judgment, regrettably—increasing.


Thus, despite the many intuitively obvious advantages of breast MRI in aiding surgical planning, there are no established benefits and several substantial disadvantages, one of which includes the needless increase in mastectomy rates. The history of breast cancer treatment is replete with interventions that seemed intuitively obvious but were eventually shown to be ineffective or harmful. The use of high-dose chemotherapy with bone marrow transplantation rescue is just one glaring recent example; an accumulating body of evidence suggests that use of MRI in selecting patients for surgical therapy is another.

Read more

I must say I agree with the authors, increased use of mastectomy in early stage cancers is cause for concern, particularly in an era of more "personalied medicine" for breast cancer and when there appears to be no benefit in long term survival. Women today know far more about their risk of recurrence at the time of diagnosis and can benefit more from having less invasive surgery. It appears use of MRI at the time of breast cancer diagnosis is showing no benefit and some harm to patients.

What do you think?

Fiscal Responsibility and Health Care Reform

Fiscal Responsibility and Health Care Reform

Posted using ShareThis

Sunday, August 30, 2009

Women In Ohio Falling Behind

As we celebrate Women's Equality Day, we need a reminder that women in Ohio are still behind the curve on income, health care, education and a multitude of factors. A study by the Institue On Women, Gender and Public Policy at Ohio State University highlights many of the areas in which Ohio lags behind other states.

The article also mentions that Ohio ranks 44th in breast cancer mortality, meaning only 5 other states have higher rates. It continues to be a striking statistic, given Ohio ranks favorably low on breast cancer incidence, and ranks favorably on mortality rates for other cancers. NOBCCF has been drawing attention to this problem for many years; we're happy to see other organizations finally recognizing the problem.

Share me

Posted using ShareThis

Tuesday, August 18, 2009

Roger Ebert's Journal: Health Care Reform

A great essay from someone with personal knowledge of making "end of life" care decsions...

"Death panels" is such an excellent term. You know exactly what it means, and therefore you know you're against them. Debate over. This term more than anything else seems to have unified the opposition to the Obama health care proposals. It fuels the anger that has essentially shut down "town hall" meetings intended for the discussion of the issues.

Of course the term is inspired by a lie. There are no conceivable plans to form "death panels" or anything like them. The Obama plan, which has some bipartisan support, doesn't seek or desire to get involved in any decisions about who should live and who should die. But now we hear "death panel" repeated so often that the term has taken on a sort of eerie reality, as if it really referred to anything.

Roger Ebert's Journal: Archives

Shared via AddThis

Monday, August 17, 2009

Army of Women: Call To Action For Young African American Breast Cancer Survivors

The latest bulletin from Dr. Susan Love/Avon Army of Women:

When a young woman is facing a breast cancer diagnosis, how the cancer treatments she needs may affect her fertility—and what might be done to help safeguard her ability to have a baby—all too often is not discussed.

By interviewing younger women who have had breast cancer and the physicians who treat them, the researchers conducting this study hope to learn more about the concerns of young women diagnosed with breast cancer in regards to their ability to have children and how they make treatment decisions.

To be sure the findings apply to all women, the researcher included women of all races and ethnicities. The researcher still needs to hear from more young African-American women who have had breast cancer.

If you think you might fit this study, please read on. And, as always, please pass this study on to anyone you think might be interested!

What’s the study about?
This study is exploring how younger women (18- 40 years old) and their doctors discuss cancer treatments and fertility, how newly diagnosed women make treatment choices (including fertility conserving treatment options), and how fertility issues impact these women’s lives after cancer. The study is also examining how having a breast cancer diagnosis influences a woman’s life after cancer, including her future family plans and family relationships. The researchers need 15 African-American women who were diagnosed with breast cancer in the past 3 years.

What’s involved?

If you join this study you will be asked to participate in a phone interview and be asked questions related to your breast cancer diagnosis, treatment decisions, and family planning. The phone interview will last approximately 60 minutes.

Who is conducting the study?

Karrie Snyder, PhD, at Northwestern University, Chicago, IL
(IRB Approval STU00012672)


Anywhere in the United States
Who can participate?
You can join the study if you match ALL of these main categories:

•You are an African-American woman

•You were diagnosed with breast cancer within the last three years

•You were between the ages of 18 – 40 when you were diagnosed with breast cancer

•You live in the United States

More information

Dr. Dean Encourages Pres. Obama to Stand By Public Option

Dr. Dean is a great leader and expert voice in the health care reform debate. Northern Ohio Breast Cancer Coalition Fund supports HR 3200, the House health care reform bill, because it most closely matches a quality framework for health care reform and provides the best mechanism to ensure competition among insurance providers to keep costs down. HR 3200 includes provisions to allow uninsured Americans to choose a government managed public health insurance plan if they wish.

"Dean urged the Obama administration to stand by statements made early on in the debate in which it steadfastly insisted that such a public option was indispensable to genuine change, saying that Medicare and the Veterans Administration are "two very good programs that have been around for a long time."

"On MSNBC's "Morning Joe," Dean said he believes the public option might be added to the legislation during the Senate's budget reconciliation process between the two chambers, when it would need only 51 votes to pass, instead of the 60 usually required for contentious bills. "

"You can't really do health reform without it," he said. Dean maintained that the health insurance industry has "put enormous pressure on patients and doctors" in recent years.

"He called a direct government role "the entirety of health care reform. It isn't the entirety of insurance reform ... We shouldn't spend $60 billion a year subsidizing the insurance industry."

Read more

Penn Medicine News: Lifting Weights Reduces Lymphedema Symptoms Following Breast Cancer Surgery

Personally, I've always found a moderate routine of lifting hand weights has helped control my lymphedema. Consult w/ your doctor for instructions as its important to lift in a way that doesn't pull on the affected arm.

“Our study challenges the historical medical recommendations for women who get lymphedema after breast cancer, and is another example of well-meaning medical advice turning out to be misguided,” says lead author Kathryn Schmitz, PhD, MPH, an associate professor of Epidemiology and Biostatistics and a member of Penn's Abramson Cancer Center. “For instance, we used to tell those who had back pain to rest, but we know now that in many cases, inactivity can actually make a bad back worse. Too many women have missed out on the health and fitness benefits that weight lifting provides, including building bone density. Our study shows that breast cancer survivors can safely participate in slowly progressive weight lifting and gain those benefits without any increase in their lymphedema symptoms. In fact, this type of exercise may actually help them feel better.”

Penn Medicine News: Lifting Weights Reduces Lymphedema Symptoms Following Breast Cancer Surgery

Cancer Mortality Rates Experience Steady Decline: Conventional Method May Underreport Declining Death Rate For All Age Groups

Researchers are examining whether use of composite age-adjusted rates to measure cancer mortality may not accurately reflect improved survival rates in younger cancer patients. Because most people who get cancer are older, adjusting mortality rates to reflect older aged individuals may skew results.

"As an alternative to age-adjustment, Kort examined cancer mortality rates stratified by age and found that for individuals born since 1925, every age group has experienced a decline in cancer mortality. The youngest age groups have experienced the steepest decline at 25.9 percent per decade, but even the oldest groups have experienced a 6.8 percent per decade decline."

Cancer Mortality Rates Experience Steady Decline: Conventional Method May Underreport Declining Death Rate For All Age Groups

Shared via AddThis

Monday, August 10, 2009

NOBCCF Supports H.R. 3200 for Health Care Reform

Northern Ohio Breast Cancer Coalition Fund announces its support of HR 3200, "America's Affordable Health Choices Act of 2009", the bill introduced by the US House of Representatives Tri-Committee group. Like National Breast Cancer Coalition, we believe that HR 3200, in its current form, comes closest to meeting principles and framework for guaranteed access to quality health care for all Americans.

To read the Framework for Guaranteed Access to Affordable Health Care for All Link

We are joined by numerous other health care organizations in supporting HR 3200, including the American Medical Association (AMA), AARP and others.

Information About America's Affordable Health Choices Act of 2009 (HR 3200)

Get the facts about health care reform in Congress

America's Affordable Health Choices Act of 2009 (bill text, PDF) Link

America's Affordable Health Choices Act of 2009 (summary, PDF) Link

Energy & Commerce Committee HR 3200 Information (includes amendments) Link

Tell us what you think....

Get the facts about the stability and security you get from health insurance reform | Health Insurance Reform Reality Check

Get the facts about the stability and security you get from health insurance reform | Health Insurance Reform Reality Check

Shared via AddThis

Monday, August 3, 2009

Cancer Clinical Trial Volunteers Essential To Finding A Cure

The New York Times' Gina Kolata continues her excellent series about cancer, Forty Years' War, highlighting the difficult task of enrolling patients in clinical trials for new cancer therapies.

Lack of Study Volunteers Hobbles Cancer Fight

Not long ago, at a meeting of an advisory group established by Congress to monitor the war on cancer, participants were asked how to speed progress.

“Everyone was talking about expanding the cancer work force and getting people to stop smoking,” said Dr. Scott Ramsey, a cancer researcher and health economist, who was participating in that January 2008 meeting of the President’s Cancer Panel. “Lots of murmurs of approval.”

Then it was his turn.

The biggest barrier, in his opinion, was that almost no adult cancer patients — just 3 percent — participate in studies of cancer treatments, mostly new drugs or drug regimens.

“To me it was obvious,” Dr. Ramsey said. “We can’t improve survival unless we test new treatments against established ones.”

The room fell silent.

“It was one of those embarrassing moments,” said Dr. Ramsey, an associate professor at the Fred Hutchinson Cancer Center in Seattle. He had brought up the subject he said no one wanted to touch.

Low enrollment rates for clinical trials is disappointing, but more so is the fact that many trials that enroll patients do little to advance the search for cures...

Even worse, many (clinical trials) that do get under way are pretty much useless, even as they suck up few patients willing to participate. These trials tend to be small ones, at single medical centers. They may be aimed at polishing a doctor’s résumé or making a center seem at the vanguard of cancer care. But they are designed only to be “exploratory,” meaning that there are too few patients to draw conclusions or that their design is less than rigorous.

“Unfortunately, many patients who are well intentioned are in trials that really don’t advance the field very much,” said Dr. Richard Schilsky, an oncologist at the University of Chicago and immediate past president of the American Society of Clinical Oncology.

Refreshing honesty.

Read more

Sunday, August 2, 2009

ACS Releases Health Care Affordability Poll

American Cancer Society has released the results of a national poll taken last May of cancer survivors age 18 and over measuring health care access and affordability.

Of their key findings:

41% of people with a cancer diagnosis have had difficulty paying for health care costs in the last couple of years

52% of those under age 65 have difficulty affording medical costs

28% have used up all or most of their personal savings

21% have incurred thousands in medical debt

24% of those in active cancer treatment have delayed a recommended cancer test or treatment in the last year

26% of those with a cancer diagnosis (34% of those under age 65) report putting off needed health care because of cost in the past year

32% of those with cancer who are under age 65 have been uninsured at some point since their diagnosis. 67% couldn't find an affordable plan

69% of those with a cancer history say the health care system needs a complete overhaul or major reform

More at link

Friday, July 31, 2009

Patients Under Pressure: Profiles of How Families Affected by Cancer Are Faring in the Recession - Kaiser Family Foundation

Patients Under Pressure: Profiles of How Families Affected by Cancer Are Faring in the Recession - Kaiser Family Foundation

The report shows many of the problems cancer patients face during a recession including:

• The obstacles to continuing coverage through COBRA;
• The difficulty in finding an insurer who will sell them non-group coverage;
• The limited availability of public coverage;
• The medical debt that patients can incur and the delays in care they often suffer if they are uninsured even for short periods of time.

Shared via AddThis

Adult Cancer Survivors & Psychological Distress

Adult Cancer Survivors At Increased Risk Of Psychological Distress

ScienceDaily (2009-07-29) -- Long-term survivors of cancer that developed in adulthood are at increased risk of experiencing serious psychological distress, according to a new report. ... > read full article

Thursday, July 30, 2009

In Their Own Voice

A great way to understand the current debate on health care reform is to listen to your own elected leaders discuss the need for real reform. We'll post links to interviews with Ohio leaders in Congress as they become available.

Below are links to recent interviews with Ohio's senators, George Voinovich and Sherrod Brown with their takes on finding ways to make health care affordable and available to all Americans.

Click here to watch interview with Sen. George Voinovich

Click here to watch interview with Sen. Sherrod Brown

Wednesday, July 29, 2009

Obama's 8 Points About Health Care Reform

President Obama has developed an 8 point list of key requirements for a new health insurance system to provide affordable coverage for all Americans.

* No Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.

* No Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.

* No Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.

* No Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.

* No Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.

* No Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.

* Extended Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.

* Guaranteed Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.

There are many additional details being worked out and it appears we may not see progress until after the August recess, but he probably felt it was important to get these points out to counter all the misconceptions and myths circulating about health care reform.

Thursday, July 23, 2009


The House Defense Appropriations Committee has once again voted to support renewed funding of $150 million for the DoD Breast Cancer Research Program for 2010!

From National Breast Cancer Coalition

We have wonderful news! Yesterday, the House Appropriations Full Committee passed the Fiscal Year 2010 Defense Appropriations bill and included $150 million for the Department of Defense (DOD) peer-reviewed Breast Cancer Research Program (BCRP). The bill now moves to the full House of Representatives for a vote. As always, we will keep you informed, and let you know about any actions you may need to take.

Please call Rep. Marcy Kaptur (OH-9), Rep. Tim Ryan (OH-17) and Rep. Steve LaTourette (OH-14) and give them a big thank you for their help in securing these important research funds for 2010.

Rep. Marcy Kaptur (OH-9) Phone: 202-225-4146 Fax: 202-225-7711

Rep. Tim Ryan (OH-17) Phone: 202-225-3031 Fax: 202-225-3393

Rep. Steve LaTourette (OH-14) Phone: 202-225-5732 Fax: 202-225-3307

NOBCCF members will be visiting these members local offices next month for a meeting about breast cancer issues and health care reform. If you live in their districts and would like to attend, please send an email to Please include your name, address and phone so we can contact you.

Please call Reps. Kaptur, Ryan and LaTourette's offices and thank them today!

Wednesday, July 22, 2009

Millions in U.S. Can't Afford Health Insurance - ABC News

A recent report from the Commonwealth Foundation, "Failure to Protect: Why the Individual Insurance Market Is Not a Viable Option for Most U.S. Families" shows the difficulty so many Americans are experiencing in finding affordable health care coverage.

From the survey:

57% said it was hard or even impossible to find coverage they could afford

47% said it was difficult or impossible to find a plan with the coverage they needed

36% said they were charged more or denied coverage because of a pre-existing condition or had the condition excluded from their coverage.

Read more

Millions in U.S. Can't Afford Health Insurance - ABC News

Shared via AddThis

Public Insurance Choice Cuts Costs by $265 Billion

The Commonwealth Fund has a new report that projects a savings of $265 billion over 10 years if Congress adopts a health care plan that includes a choice between public and private health insurance plans.

"Health reform can help pay for itself, but both private and public insurance choices are critically important," said Commonwealth Fund President Karen Davis, who coauthored the new report. "A public insurance plan can help drive new efficiencies in the system that will produce large cost reductions. Without a public plan, much of those potential savings will be lost."

The Commonwealth Fund Commission on a High Performance Health System has put forward a comprehensive set of policy options to achieve near-universal health insurance coverage while reforming the U.S. health care system to achieve nearly $3 trillion in savings by 2020. Central to this proposal is the creation of a national insurance exchange that would largely replace the individual and small-group insurance markets, offering families and business a choice of private or public plans with a benchmark standardized-benefit package.

Read the report here and tell us what you think...

Northern Ohio Breast Cancer Coalition Fund supports H.R. 3200, the House bill which provides a choice between public and private health insurance plans and will provide universal coverage to all Americans.

Saturday, July 18, 2009

Support NOBCCF at the Bridgestone Invitational Golf Tournament

Tickets Fore Charity - Bridgestone Invitational World Golf Championship

Firestone Country Club
Akron, OH
August 4 - 9, 2009

Support Northern Ohio Breast Cancer Coalition Fund through TICKETS Fore CHARITYTM
Northern Ohio Breast Cancer Coalition Fund is proud to partner with the Bridgestone Invitational golf tournament through TICKETS Fore CHARITY, a fundraising program designed to generate revenue for local charities where PGA TOUR tournaments are held.

Northern Ohio Breast Cancer Coalition Fund is promoting the sale of tournament tickets with 100% of the net proceeds from the ticket sales going to charity. 75% of the proceeds will benefit Northern Ohio Breast Cancer Coalition Fund and 25% will benefit The First Tee of Akron, Canton and Cleveland, a program which teaches young people life skills through golf.

Showing your support is as easy as 1-2-3:

1. Click to purchase tickets to the Bridgestone Invitational golf tournament on behalf of Northern Ohio Breast Cancer Coalition Fund.

2. Select the quantity of tickets you would like to purchase (please note that these are for any day of the tournament and that tickets are $35 each). Be sure to enter code NOBCCF to designate Northern Ohio Breast Cancer Coalition Fund as the benefiting charitable organization.

3. Provide payment information and you will receive a confirmation email, with your e-ticket attached, shortly thereafter. Please be sure to print out this ticket and present it at the gate in order to gain entry!

For more information or if you have any questions, please visit or call Misty Laforet at 330.644.2299.

Order Your Tickets Today!

Friday, July 17, 2009

AMA Endorses House Health Care Bill

Great news for the America's Affordable Health Choices Act 2009 (HR 3200)! For the first time in its history, the American Medical Association has endorsed this health care reform bill.

Link to AP story

Link to AMA Announcement

If you would like to learn more about HR 3200, you can read a summary at the Kaiser Family Foundation web site:


Limited Benefits, High Costs of Cancer Screening

Yesterday's article from the New York Times "Forty Years' War - In Push for Cancer Screening, Limited Benefits" we learn that blanket screening of large numbers of people can come with a high cost.

...For example, Americans spend an estimated $4 billion annually on mammograms, according to Dr. David H. Newman, author of the book “Hippocrates’ Shadow: Secrets from the House of Medicine.” Some of those tests cause false alarms that lead to unnecessary follow-up surgery on normal breasts, at a cost of $14 billion to $70 billion over a decade, according to Dr. Newman, the director of clinical research in the department of emergency medicine at St. Luke’s Roosevelt Hospital Center in Manhattan....

We need better, more accurate screening tools.

Wednesday, July 15, 2009

Research & News Update

Heart Scans Can Raise Cancer Risks


Cancer & Supplements - What They Can and Can't Do


Post-Menopausal Use of Hormone Replacement Therapy Increases Ovarian Cancer Risk

"The increase in risk was found regardless of the hormone dose or formulation, whether hormones were taken by mouth, transdermal patch, or vaginally, or whether the treatment included just estrogen or estrogen and progestin, the researchers say."


The trend for ovarian cancer incidence in the U.S. does show a decline since the first study reported risk of HRT and cancer in women

Free Health Care Clinic

Saturday, July 25 and Sunday, July 26, 2009
8:00 am - 4:00 pm
W.O. Walker Center
10524 Euclid Avenue.
Cleveland, OH 44106

How to Sign Up:
Pre-registration only!

Stay tuned to Channel 3 WKYC, the week of July 13. Channel 3 will be hosting a phone bank starting Monday, July 13. Phone lines will be open daily from 6:00 pm - 8:30 pm until all spots are full. The phone number will be available on this site starting Monday, July 13.

NOTE: The phone bank will be accepting appointments for
All DENTAL AND VISION spots have already been filled.

Appointment Information:
Patients will be given a specific check-in time. Patients should arrive at the surface parking lot (on 105th, between Euclid and Carnegie, directly across from the W.O. Walker Center

This is a program of Medworks, a volunteer program of the Ohio nonprofit organization, MobileMed 1. We are committed to delivering free healthcare to Ohio's uninsured and underinsured population. Volunteer doctors, dentists, eye specialists, general healthcare providers and support workers donate their time to help provide free healthcare services for their community. Medworks' sponsors and partners donate medical supplies, equipment and facilities for the Medworks Health Brigades.

2026 Murray Hill Road Suite 03
Cleveland, OH 44106
Phone: 216.231.5350

Tuesday, July 14, 2009

Ohio Survivors - Yoga Study

A reminder from the Susan Love/Avon Army of Women about the Yoga Study at Ohio State University. They still need women to enroll:

If you are a breast cancer survivor in the Columbus, Ohio area, READ ON.

If you know a friend who might be interested in this study, PASS IT ON.

And if you don't fit and don't know anyone who does, HANG ON...the next study might the one for you!

What's the study about?

Breast cancer survivors can have a lot of post-treatment problems, such as fatigue, depression, and a decrease in physical function. It is possible that physical activities, like yoga, could help ease these symptoms. This is a study about how yoga affects fatigue, immune function, and mood of women treated for breast cancer. Two hundred women are needed for this study.

What's involved?

If you join the Yoga for Breast Cancer Survivors Study, you will be assigned to one of two groups: yoga or wait-list. The yoga group will attend yoga sessions twice a week for 12 weeks. The wait-list group will have the opportunity to take yoga after the study participation is complete. In addition you will be scheduled for 4 visits over 6-10 months. These visits include blood draws, questionnaires & completion of mild stress tasks. All study activities will take place at the Ohio State University campus. The researcher will discuss scheduling details with each individual.
Who is conducting the study?

Janice Kiecolt-Glaser, Ph.D. , Ohio State University


Ohio State University, Columbus, Ohio

Who can participate?

You can join the Yoga for Breast Cancer Survivors Study if you match ALL of these MAIN categories:

•You are a breast cancer survivor who was treated for stage I, II, or IIIa disease within the last two years

•You do not have inflammatory breast cancer

•You have not had a recurrence of breast cancer (this is the first time you were diagnosed with breast cancer)

•You have never had any other cancer diagnosis besides skin cancer

•You have never been diagnosed with diabetes or an autoimmune disease

•You live close enough to the Ohio State University campus in Columbus, Ohio to be able to go to yoga there two times a week

The researcher may ask you additional questions to determine if this study is the right fit for you.

Click here to get more information from Army of Women

Getting Health Insurance In Ohio

The Plain Dealer has some helpful tips today on getting and keeping health insurance on your own. The downside is that people who have pre-existing conditions like a history of cancer aren't eligible for most individual policies. Open enrollment to purchase health insurance is an option, but can be prohibitively expensive.

Don't forget to visit our web site for more information

Plain Dealer Articles here and here

More help from the Ohio Dept. of Insurance here

Above all, don't forget to call or write to your Congresspersons and ask them to support quality health care reform to provide affordable care for all Americans.

Friday, July 10, 2009

Research & News Update

Hormone Receptor Negative Breast Cancer Survivors Have Higher Risk of Second Primay Breast Cancers


1 in 3 Breast Cancer Patients Are Overtreated



Urban vs Rural Reductions in BC Incidence - HRT Use Linked?


Monday, June 29, 2009

Oral PARP Inhibitor Shows Anti-Tumor Results

In an early, Phase 1 trial at Royal Marsden Hospital in London and Netherlands Cancer Institute, an oral PARP inhibitor drug (part of a new generation of anti-cancer drugs being developed) showed anti-tumor activity against BRCA1 and BRCA2 related breast, prostate and ovarian cancers. It also showed acceptable side effects and low toxicity.

Read the article in NEJM - its a freebie! Link

Health Industry Spends $1.4 Million A Day On Lobbying

Yes, you read that correctly. The health industry (insurance, pharmaceutical, medical equipment, health care providers and all sorts of companies in the health industry) are now spending in excess of $1.4 million a day lobbying your elected representatives. Full report here

Sometimes members of our grassroots newtwork get a little discouraged when they meet with and call their members of Congress about issues important to eradicating breast cancer. I always explain to them that as soon as they've left the member's office or hung up the phone, their congressperson is being visited by lobbyists promoting policies that run counter to patients' needs.

You just have to keep going back and calling again and again to remind legislators to do what's right for the people they serve.

Friday, June 26, 2009

African American Women Needed for GAP Study

Received an email this morning from Susan Love/Avon Army of Women sending the message that the GAP study needs to recruit more African American breast cancer patients.

More information at this link:

What's the study about?

This is a research study designed to better understand the differences in breast cancer treatment experiences between African American women and Caucasian women. Four hundred African American women are needed for this study.

What's involved?

If you join the Gap Study you will be asked to complete a 30-40 minute telephone survey about your health related experiences and to allow your medical records to be reviewed by the doctor conducting this study.

Who is conducting the study?

Vanessa Sheppard, PhD, MA Assistant Professor of Oncology at Georgetown University in Washington, DC


Anywhere in the United States

Who can participate?

You can join the Gap Study if you match ALL of these main categories:

•You consider yourself to be Black/African American

•You are newly diagnosed with breast cancer (within 20 weeks of your diagnosis)

•Your breast cancer is stage I, II, or III

•This is the first time you have been diagnosed with breast cancer (this is not a recurrence)

•You live in the United States

The researcher may ask you additional questions to determine if this study is the right fit for you.

Tuesday, June 23, 2009

Legislative Alert

Ohio's Governor & Legislators plan to cut the budget for Ohio's Breast & Cervical Cancer Screening Program.

This critical health program provides free screening for breast & cervical cancer and Medicaid coverage if diagnosed for uninsured Ohio women. BCCP Screening is already struggling with severely limited funds to meet the needs of the growing number of uninsured women.

We need your help to protect funding for this critical program!

Call your state legislators today with the following message:

"Help save Ohio women's lives by restoring full funding for Ohio's Breast & Cervical Cancer Screening Program. Ohio women are counting on you!"

Click the links below to find your representative's name and contact information.

Contact information for your Ohio Senator

Contact information for your Ohio State Representative

Call Governor Strickland - (614) 644-4357

Urgent! Please call today or tomorrow!

If they are unavailable, leave a message and call them later.

Please help us keep funding for Ohio's BCCP Screening Program!

Senate HELP Committee Working on HC

The Senate HELP Committee is working on their version of a health care reform bill this week as they prepare to pass it out of committee. It continues tomorrow, so make sure to tun in and watch.

Follow this important work at the following link:

For a helpful guide to comparing the various health plans proposed by President Obama, the Senate committees and the House, go to the link below. Click on "Side by Side Comparisons".

Side by Side Comparison of Health Care Plans

Kaiser Family Foundation has published a handy, detailed yet easy to understand tool for comparing the health care reform plans currently proposed by the White House, Senate committees and the House.

Follow this link an compare the plans to see how they stack up.

Tell us what you think!

Monday, June 22, 2009

NBCC Concerns About EARLY Act

From National Breast Cancer Coalition's Analysis of the EARLY Act, recently introduced in Congress:

Analysis of “Breast Cancer Education and Awareness Requires Learning Young Act of 2009” (EARLY Act)

It is laudable that Congress continues to care deeply about breast cancer and strives to address it. However, it is vital that Congressional action is the right action that helps and does not harm the public and is a responsible use of federal funding and outreach. Unfortunately, the bill at issue is based on several false premises, contains incorrect information, and will not achieve these goals. The bill is addressed to a population of women in whom breast cancer is rare, and presumes we know what to tell these women about prevention, risk reduction and early detection. We do not. If we believe a public campaign to this population is important, we need scientific inquiry to find the answers to these questions before we launch any public campaign.

Our concerns center on the following:

1.) That breast cancer in women under 40, an admittedly rare occurrence, necessitates a broad public health campaign and education in secondary schools and universities;

2.) That we know what women should do to prevent or lower their risk of breast cancer;

3.) That breast self examination and clinical breast examination are effective in saving lives in this age group;

4.) That ethnicity is sufficient to trigger genetic counseling and testing

5.) That there are significant differences in what we know and what we should tell women under 40 years old versus over 40 years old.

The above concerns certainly justify a review of this legislation to determine if there are better, more scientifically-based ways to address the need to reduce incidence and mortality from pre-menopausal breast cancer. As a survivor who was diagnosed with breast cancer at an early age, I can say I had no family history, received regular breast screening, had a healthy diet and lifestyle and was a long distance runner, but still managed to get the disease. Pre-menopausal breast cancer is a much different type than the more common breast cancer diagnosed in post-menopausal women.

Its not only important to base public health messages about breast cancer risk on the best scientific evidence, its wrong to send mixed messages to women about whether they can prevent pre-menopausal breast cancer or instill a sense of guilt that they could have controlled the outcome.

More info

Sunday, June 21, 2009

Breast Cancer in Young Women - Concerns About the EARLY Act

The EARLY Act (Education and Awareness Requires Learning Young Link to text of bill )has been introduced in Congress. The bill calls for $45 million to fund programs teaching young girls and women BSE (Breast self-exam) and promotes education about prevention as well as genetic testing for inherited risk of breast cancer. It has been supported by a number of national organizations, including Susan G. Komen for the Cure, the Young Survival Coalition and Living Beyond Breast Cancer, but not by National Breast Cancer Coalition or Northern Ohio Breast Cancer Coalition.

NBCC's analysis of the EARLY Act is at this link:

Among other others, epidemiologist Dr. Leslie Bernstein and Dr. Barnett Kramer, director of the NIH Office of Disease Prevention, have also taken strong positions against the EARLY Act.

What follows is a letter from Dr. Otis Brawley, chief medical officer of the American Cancer Society, to ACS volunteers about the controversial EARLY Act recently introduced in Congress.

Dr. Brawley's letter:

"I want to put in writing my concerns regarding the EARLY Bill. So many
emotions are flying, some folks can better understand if they have something in writing. You might use this letter to at least help people understand where I am
coming from. This is an opportunity for dialogue and an opportunity to do something positive. I truly would like to work with others to make a bill that is scientifically sound.

"The authors of the bill clearly want to do the right thing and that should not be doubted. As I do not question the good intentions of those writing this bill, I ask that people not question my good intentions.

"Unfortunately the bill as introduced is a public health bill that does not recognize public health as a legitimate scientific discipline. It applies diagnostic information from the American Cancer Society and National Comprehensive Cancer Network websites as if it is screening information. It calls for an advisory committee with expertise in every discipline having to do with breast cancer except public health and screening.

"This bill is unfortunate in that it represents a wasted opportunity to do good for a population that deserves attention, the very population that the authors want to help. If implemented as written, it can actually cause harm. If implemented, a number of women will seek genetic testing and find out that they have "mutations of unknown significance." Some of these women will seek a bilateral mastectomy. Many of these women will in reality have mutations of no significance, but our science cannot determine most of these yet. There are already scientific data to show that many women getting these messages will suffer significant emotional and mental harms.

"The overall tone of the bill makes the problem of breast cancer in young women and genetic causes of breast cancer seem far simpler than it is. It accepts as fact things that public health experts think of as research questions. For example, my public health colleagues would overwhelmingly agree that we do not know if screening programs using examination, mammogram, magnetic resonance, or genetics save the lives of young women (less than age forty) with breast cancer. Fooling ourselves into
accepting that these interventions have been proven to save lives does a disservice to young women with breast cancer.

"This program, if implemented, will diminish the effect of more pertinent public health messages on tobacco avoidance, good nutrition and physical activity. These are messages that have the potential to save far more lives than a breast cancer awareness campaign. These messages aimed at young women can save far more lives from
cancer compared to a breast cancer awareness campaign and will prevent deaths from diabetes and cardiovascular disease. The doubling of the obesity rate in young women over the past thirty years is the greatest threat to their health.

"I do realize the desire to do something in breast cancer and I accept the need to do the right thing regarding breast cancer. We need far more psychological and medical support for young women who have breast cancer. We have data to show that there are women who need treatment and cannot get it. We need more research to develop and validate the lifesaving abilities of screening technologies.

Please note, I stress validate the lifesaving abilities of screening technologies, because too much emphasis has been put on early diagnosing disease and not on if that diagnosis saves lives. Of course, we also need to find and validate ways of preventing the disease. All we can do now is encourage early pregnancy and do bilateral mastectomy. Neither is one hundred percent effective. I will also agree that most physicians do not understand the complexities of the issue.

"I have consulted a number of experts in breast cancer screening, diagnosis, treatment and outcomes in coming to my opinion. I realize that I will be criticized for not supporting this bill. I will be criticized primarily by those who refuse to realize I am truly concerned about the health of young women and I really want to do the right thing. Too often I have seen the easy, feel-good path in medicine result in harm."

NOBCCF commends Dr. Brawley for speaking out on this important issue.

Friday, June 19, 2009

Senate Finance Committee Releases Details of HCR Plan

The Senate Finance Committee, one of 2 key committees in the Senate charged with developing health care reform legislation, has released an outline of its new health care proposal. You can view the document (PDF) here. Columnist Ezra Klein of the Washington Post, who has been following the health care reform discussion closely, discusses the new plan here.

Contrary to prior discussions, the Finance Committee plan doesn't include a public option - the option of allowing consumers and employers to purchase health insurance from a plan administered by the federal government similar to Medicaid. Many analysts agree that such a plan would be able to provide the same coverage as private insurance at a lower cost and would be essential in keeping the health insurance market competitive.

Some key items:

  • Mandates individuals purchase health insurance. It allows exceptions if the cost of insurance exceeds 15% of annual income
  • Requires insurance companies to cover everyone who applies, regardless of pre-existing conditions, etc.
  • No health status rating - meaning no higher prices based on health condition
  • Proposes 4 levels of insurance coverage plans and limits some out of pocket costs
  • Offers federal subsidy on insurance premiums via tax credit to individuals and families earning up to 300% of the FPL.
  • Offers small businesses tax credits for 3 yrs to help pay for group insurance for employees.
  • Increases Medicaid eligibility to include parents and childless adults at or below 100% of FPL (like most states, Ohio doesn't allow childless adults to be eligible for Medicaid) Eligibility increases will be phased in over 3 years and states will get some help during that period to pay their share of Medicaid.
On quick review, the plan has some problems. It places a financial burden on states by increasing Medicaid eligibility at a time when most states are having budget problems. It also has too many loopholes that make insurance coverage unaffordable for low income people. There's an exception to the individual mandate that allows people to opt out of purchasing insurance if they can't afford it. Seems like it would make more sense to make it more affordable for them.

While there are incentives for employers to provide health coverage for their employees, there are also big loopholes that allow them to avoid penalties if they don't.

Cost control for both health insurance premiums and health care costs appears to be based solely on trust. While there are caps on the amount of premiums low to middle income individuals must pay, they aren't real caps. Premium costs above 15% of a person's annual income will be absorbed by the federal government through tax cuts. Its a pass-through of the premium cost, not a real price cap.

Here's hoping the Senate HELP Committee can come up with a better proposal. The House has already agreed their version of HCR will include a public option.

Tell us what you think....

Thursday, June 18, 2009

Sen. Sherrod Brown Introduces HC Bill

Ohio Senator Sherrod Brown has co-sponsored a bill (S. 1278) with WV Senator Jay Rockefeller to create the Consumer's Choice Health Plan - a public health insurance plan that provides an affordable and accountable health insurance option for consumers.

Link to Bill Text

It creates a public health insurance plan option that can compete with private health insurance plans to provide low cost, quality health insurance coverage to everyone in the US.

It provides comprehensive health care coverage for adults and children, regardless of pre-existing conditions.

Individuals and employers can enroll in the plan, its open to everyone.

All health care providers who provide health care services under Medicare, Medicaid and SCHIP will also participate in the Consumer's Choice Plan.

The Consumer's Choice Plan will adopt Medicare reforms - allowing patients to access the same quality, coordinated care now provided to Medicare patients.

The Consumer's Choice Plan will provide the same subsidies as the Health Exchange plan to help individuals and employers pay for premiums.

All aspects of the Consumer's Choice Plan will be transparent and enrollees will receive a personal annual statement about the services they received and payments made in the previous year.

Enrollees will receive all the information they need about their benefits coverage, providers in their area, and fee schedules.

The Plan will be managed by the Dept. of Health & Human Services and will be overseen by a newly created non-profit organization called "America's Health Insurance Trust". The Trust will be governed by board members, including members representing consumers. Individuals affiliated with private health insurance companies, pharmaceutical companies and others who may have a similar conflict of interest will not be allowed to serve on the board.

It sounds like an interesting plan, one worth considering and one likely to provide much cheaper health insurance coverage to Americans.

Wednesday, June 17, 2009

Affordable Health Choices Act - On the Move

The Affordable Health Choices Act, the template for health care reform promoted by the Senate Health, Education, Labor and Pensions (HELP) Committee is scheduled for markup today.

You can view the markup hearing at Sen. Chris Dodd's web site here:

This markup hearing is critical because there is a possibility that changes could be made to the Act which would water down provisions to make insurance affordable and available to everyone.

More information on the AHCC Act here

Link to text of the bill here

Northern Ohio Breast Cancer Coalition supports the inclusion of a strong public insurance option to provide consumers with affordable choices in health care insurance plans. A well funded, well regulated government controlled health insurance plan that provides coverage for all, similar to Medicare, should be an available choice for consumers and businesses. A public option is essential to:

  • ensuring competition among health insurance providers and
  • lowering health care costs for the long term

Here's hoping we don't see good provisions for a public option watered down or deleted during this markup session.

Stay tuned for action alerts.

Sunday, May 31, 2009

More on BSI-201 PARP Inhibitor

From Bloomberg News

An experimental cancer drug made by Sanofi-Aventis SA helped patients with
advanced breast tumors live more than 60 percent longer using a new method that
stops diseased cells from healing themselves, a new study found.
Sanofi will begin enrolling 400 patients in the next two months for an
expanded trial to confirm the results. That could take as little as a year to
complete before submitting to regulators for marketing approval, Chew said.

The drugmaker believes the new trial "will be sufficient" for approval,
he said.


Healthy human cells have six different mechanisms
to repair DNA. As cancer develops, many of those mechanisms break down, leaving
the cell reliant on PARP to fix genetic damage from cancer treatments.
Researchers have found that severe forms of cancer in the ovaries, uterus, lungs
and pancreas all have unusually high PARP enzyme activity, meaning they could
make good targets for the new therapies, according to Barry Sherman, BiPar’s
chief medical officer.


The cancer in the study is called
triple negative breast cancer because it lacks the three genetic targets needed
for the most effective medicines. It is responsible for about 15 percent of all
breast cancers and sickens younger women more than other forms. If the cancer is
detected early enough, treatment with a PARP inhibitor may be able to
permanently destroy the tumors, Sherman said in an interview at the conference

“There is an opportunity here to actually use the term ‘cure’
when it’s applied to early-stage disease,” Sherman said. “That is perhaps one of
the most exciting notions to come out of this. This is the forefront of a field
that is about to open up, about DNA repair.”

Link to article

ASCO Conference This Week

News about results of a study on PARP inhibitors and triple negative breast cancer. This study compared Gemzar and Carboplatin with and without BSI-201 in women with triple-negative metastatic breast cancer as either the first chemo for metastatic disease, or after one or two prior chemo regimens. BiPar announded interim safety data from this trial at the San Antonio Breast Cancer Symposium, finding NO additional signigicant toxicity attributed to the experimental drug.

Quick note from Musa Mayer who is attending the Conference:

While the full presentation won't occur until tomorrow afternoon, today they released some of the findings, and I just had to tell you what I know, so far:

"Analyzes of the first 86 patients of a planned 120 patients showed that BSI-201 + G/C (Gemzar and Carboplatin) had improved CBR (clinical benefit rate, those with tumor shrinkage or stable disease), median PFS (progression-free survival) and median OS (overall survival), compared with G/C alone. The frequency and nature of adverse events (AEs) did not differ between arms."

How much of an improvement is what's impressive.

* CBR is 12% with G/C vs. 52% with G/C+BSI-201.

* Median PFS is 87 days with G/C and 211 days with G/C+BSI-201 with a HR (hazard ratio) of 0.30. In case these numbers don't mean anything to you, this amounts a 70% improvement in progression-free survival.

* Median OS: patients in the G/C arm had a median survival of 169 days, but patients on the G/C arm of the study had a median survival of more than 254 days, for a HR of 0.24. That means that patients exposed to the experimental drug lived 76% longer.

If these findings hold up in the completed study and in a full-scale Phase III trial of sufficient size to be definitive--and that's a big if, of course--this magnitude of benefit will be beyond any breast cancer drug we've seen in the 15+ years I've been following drug development. However, this is a small number of patients, not even the full number enrolled in the study, and the study itself isn't sufficiently powered to show a definitive difference.

The results of the entire study, with all 120 patients along with some studies of PARP expression will be presented tomorrow afternoon--you'll be hearing about it on the news. I'm excited!

Great news, Musa! Thanks for sharing.

Wednesday, May 13, 2009

Women At Tisk - Health Care System Fails Many Women

This is National Women's Health Week and what better way to celebrate women's health than by focusing on the current debate in Congress about health care reform. Let's take some time to learn about barriers to affordable care that women face in this country and contanct our legislators to demand change..

The US Dept. of Health & Human Services has issued a special report about problems women face called "Roadblocks to Health Care: Why The Current Health Care System Does Not Work For Women"

Roadblocks to Health Care
Women are more vulnerable to high health care costs than men.

Women’s reproductive health requires more regular contact with health care providers, including yearly pap smears, mammograms, and obstetric care.

Women are also more likely to report fair or poor health than men (9.5% versus 9.0%).1

While rates of chronic conditions such as diabetes and high blood pressure are similar to men, women are twice as likely to suffer from headaches, more likely to experience joint, back or neck pain, and more likely to suffer from psychological distress.2 These chronic conditions often require regular and frequent treatment and follow-up care.

A Patchy System of Health Insurance
The current health insurance framework leaves too many women uncovered.

Twenty-one million women and girls went without health insurance in 2007, and another 14 million relied on coverage through the individual insurance market.3

Women are less likely to be employed full-time than men (52% versus 73%), making them less likely to be eligible for employer-based health benefits themselves. In fact, less than half of women have the option of obtaining employer-based coverage on their own.4

Even when they work for an employee that offers coverage, one in six is not eligible to take it, often because they are part-time workers. They end up either covered through a spouse (41%), purchasing insurance directly through the individual market (5%), on public programs (10%), or uninsured (38%).5

And even among women with the option to get health coverage through their employer, they are twice as likely as men to go on their spouse’s plan (15% versus 7%).6

This dynamic has several effects. Single women are twice as likely to be uninsured than married women (24% versus 12%).7

Married women in the 55 to 64 age group are particularly vulnerable to a discontinuity of coverage as their spouses go on Medicare. Among this age group, there is a drop in dependent employer-sponsored coverage from 39% to 34%.8

When employer-based coverage is not an option, some women turn to the individual insurance market. In the 55 to 64 age group, the decline in employer-based coverage is coupled with a rise in the purchase of individual insurance from 5% to 8%. This trend is not seen with men.9

The Failure of the Individual Insurance Market
Higher costs and inadequate benefits make the individual insurance market an unreliable choice for women.

Important state and federal laws that protect individuals with employer-sponsored insurance do not apply to health insurance sold in the individual market. These include anti-discrimination protections in the Civil Rights Act of 196410 and the Pregnancy Discrimination Act of 1978,11 as well as the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), which prohibits covered employers from charging different premiums or denying coverage based on age or health status.12

In contrast, in the individual insurance market, many states allow insurance companies to calculate premiums based on an individual’s characteristics such as existing health problems, age, and gender.13

Data from e-health insurance show that there is a wide variation in premiums by state, by plan, and by age and gender of the policyholder. A search for single coverage plans with similar underlying benefits for a nonsmoker living in a large city found premiums that ranged from $700 to all the way to $8000.14

In particular, women are often charged higher premiums than men during their reproductive years. Holding other factors constant, a 22 year old woman can be charged one and a half times the premium of a 22 year old man. This difference largely disappears – and sometimes reverses – by age 64.15

The high cost of health insurance in the individual market impedes a woman’s ability to obtain coverage at a time when she needs it most. Of the 8 million middle-income nonelderly women who do not have employer-sponsored coverage, more than half remain uninsured and only a fifth obtain insurance through the individual market. In comparison, more than one-third of high-income women without employer-sponsored insurance manage to purchase individual coverage – but 43% still go uncovered.16

Beyond cost, the coverage in the individual market is woefully inadequate. A recent survey by the National Women’s Law Center found that the vast majority of individual market health insurance policies did not cover maternity care (a limited number of insurers sell a separate maternity “rider.”)17

Moreover, it is still legal in 9 states for insurers to reject applicants who are survivors of domestic violence.18

The Price of Access
As a result, women are more likely than men to experience difficulty accessing care.

In a recent national survey, more than half of women (52%) reported delaying or avoiding needed care because of cost, compared with 39% of men.19

Women face a higher financial burden from medical care than men. Nearly one-third of women aged 50 to 64 are in households that have spent more than 10% of their income on health care, compared with one quarter of men of similar age.20

Almost half of women report problems paying medical bills, compared with 36% of men, and one-third of women were forced to make a difficult tradeoff such as using up their savings, taking on debt, or giving up basic necessities.21

Comprehensive health care reform is needed to level the playing field, and make health care accessible and affordable for all women.

Monday, April 13, 2009

Hope vs Reality - Health Care Reform

A key tenet of providing universal access to health care for all in the US involves controlling health care costs. While our current system is fiscally unsustainable due to the high cost of caring for a growing population of uninsured Americans, some of the cost - savings strategies offered in the UHC discussion (health information technology, preventive care, comparative effectiveness, etc.) may not be as effective as we think.

The Annals of Internal Medicine have published an interesting essay on the topic of the "Politics of Cost Control". To some extent, I agree with them. We're probably going to face much tougher choices in finding ways to lower the high cost of US health care, but we have many good examples to learn from.

All other rich democracies concentrate purchasing power to counter the medical industry's efforts to increase costs (34). If, as in Canada and Sweden, overall medical costs are on public budgets, then officials have powerful incentives to restrain increases in medical costs to avoid reducing the funds for other public programs or having to raise taxes (36). In other countries, such as Germany and France, insurers are nongovernmental entities (sickness funds) that are financed through payroll contributions from employers and employees. The governments of these countries regulate insurers and help them control costs (34). Germany, for example, regulates the level of social insurance contributions (taxes) paid by employers and workers, thereby limiting the budget for all sickness funds.


The Obama team's approach to health reform does not, however, fully embrace the central lesson of international cost-control experience. Effective cost control requires strong government leadership to set targets or caps for spending in the various sectors of medical care (hospital, pharmaceutical, and physicians), either directly or through insurers. The targets may not always be binding, and these caps would be on total expenditures, not services. But without explicit targets and continual efforts to enforce them, no health care system can control costs. That lesson is evident in countries ranging from Canada, Sweden, and the United Kingdom to France, Germany, and Japan (34). In Germany, for example, caps adopted in 1986 had a dramatic effect on spending for physician services.

Link to article

Tough choices ahead, but well worth the effort.

Thursday, April 9, 2009

National Breast Cancer Coalition 2009 Policy Agenda

National Breast Cancer Coalition 2009 Legislative & Public Policy Priorities

LEGISLATIVE Priority #1 Guaranteed access to quality health care for all.

We will not achieve our mission of eradicating breast cancer until everyone has guaranteed access to quality health care. NBCC's Board of Directors adopted a Framework for a Health Care System Guaranteeing Access to Quality Health Care for All in 2007, after extensive analysis and deliberation. This Framework builds on NBCC's longstanding principles and core values for quality health care. NBCC will use this framework to educate and mobilize grassroots advocates to demand political leadership and action towards comprehensive health care reform.

LEGISLATIVE Priority #2 $150 million for FY10 for the Department of Defense Breast Cancer Research Program.

As a result of NBCC's advocacy and strong bipartisan leadership on Capitol Hill, more than $2 billion has been invested in this competitive peer-reviewed research Program. This innovative Program has changed the world of breast cancer research. The inclusion of consumers in every aspect of decision-making and the Program's unique grant opportunities have led to groundbreaking scientific advances.


Breast Cancer and Environmental Research Act.

The strategies outlined in the NBCC supported Breast Cancer and Environmental Research Act (BCERA) would result in an overarching plan to look at the links between the environment and breast cancer and a new model of resource allocation at the National Institutes of Health (NIH). NBCC is looking at various strategies to achieve the intent of BCERA.

Quality Breast Cancer Care.

While we advocate for guaranteed access through a framework for a system governing coverage for health care, we must also push for quality care. One step toward quality is determining how to measure whether the public is getting the right care for breast cancer. NBCC is working on quality measures that will become the basis of our campaign for regulatory and legislative reform in this area. Preservation of the Medicaid Breast and Cervical Cancer Treatment Program (BCCTP). While NBCC pursues its work on guaranteeing access to quality health care for all, we are committed to making sure women with breast cancer have access to the care they need. The BCCTP provides enhanced matching funds to states to provide full Medicaid coverage to low-income, uninsured women screened and diagnosed with breast and/or cervical cancer through a federal program. All 50 states and the District of Columbia have opted into the program, but efforts to reduce funding for Medicaid or dramatically alter the program threaten the future of the BCCTP. NBCC will work to protect and preserve the BCCTP.

Transparency and Accountability at the National Institutes of Health (NIH) and National Cancer Institute (NCI).

NBCC strongly believes that the enterprise of clinical and scientific research at NIH could be vastly improved with greater participation from educated health care consumers and trained advocates who can help to inform all aspects of decision making at NCI and across the Institutes. NBCC also has deep concerns about the lack of transparency, external oversight and accountability in research priority-setting, decision-making and evaluation. What is needed is to determine the right process for and atmosphere within which biomedical research will be prioritized and conducted. We must make certain that the process is inclusive and maximizes our ability to get the right research done in the right way.

More info

Update - Legislative Agenda

Great News! National Breast Cancer Coalition has announced their 2009 Legislative Agenda. For those who will be traveling to Washington DC May 2-5, this is the legislative agenda we will be working with on Capitol Hill.

NBCC consistently develops high quality, forward thinking public policy agendas. We'll discuss the 2009 Agenda during our Conference Call Monday, March 23.
The 2009 agenda is broader in scope as Congress and the White House focus more on our future and place greater emphasis on providing quality health care for all and increasing funding for cancer research. While we often see appeals to pass legislation on specific areas of breast cancer research and treatment, we feel its better to take a systemic approach to advancing research and improving health care for breast cancer patients.

I'm pleased to see the Breast Cancer & Environmental Research Act included on the agenda. All of you worked incredibly hard during the last several years to gain passage of this important bill, only to see it significantly weakened and damaged prior to passage last fall.

Preservation of the Breast & Cervical Cancer Treatment Program is another important priority. While NBCC's number one legislative priority is guaranteed access to quality health care for all, there remains some uncertainty about whether the various strategies for health care reform being considered at the federal level will accomplish full, affordable coverage for all in the near term. Cancer care is expensive and cancer patients are often last on the list of groups that legislators want to cover. Its vital to continue supporting BCCTP until a plan is in place that covers everyone.

Guaranteed Access to Health Care For All remains the number one priority. NBCC was one of the first health advocacy groups to adopt this agenda and define core principles and values to help shape strategies for accomplishing this goal. You can read more about NBCC's Framework here.

There are many other details to learn and discuss related to this agenda. NBCC is working on Capitol Hill to ensure breast cancer advocates are part of the decision-making process. More details will be available soon.

Monday, April 6, 2009

60 Minutes On Lack of Cancer Care

The nation's economic recession is having a devastating impact on cancer care as more uninsured cancer patients find themselves unable to get the treatment they need.

Thursday, March 19, 2009

ProjectLEAD Workshop April 3-5 in Philadelphia, PA

Learn the Science of Breast Cancer

If you've ever thought you may be interested in research advocacy, here's an opportunity to learn more.

National Breast Cancer Coalition is featuring a ProjectLEAD Workshop in Philadelphia, PA April 3-5.

The Project LEAD workshop is a new two-day training program for advocates interested in an introductory education in the science of breast cancer. Students will study the biological and molecular concepts that explain how breast cancer works and the research methods and study designs that allow scientists to discover newinformation and test their ideas. This workshop, open to everyone interested in learning about breast cancer, will teach students how to be critical thinkers and how to better understand the breast cancer science in the media every day. Graduates of this program will be better able to explain this information to their colleagues, friends, and family. Taught by renowned scientific faculty, this is a unique opportunity. For those who are excited about learning even more and working in research advocacy, applying for the Project LEAD Institute (see below) could be the next challenge. There is no registration fee for this workshop and travel and lodging scholarships are available for NBCC members in financial need.

Links to more information about ProjectLEAD including scholarship info click here

Wednesday, February 11, 2009

Breast Cancer News Digest 2/11/2009

Following are links to some of the latest news about breast cancer:

Cochrane Collaboration Releases Two New Reviews* of Breast Cancer Research

Post-operative radiotherapy for ductal carcinoma in situ of the breast (Radiation Benefits Women With Early Breast Cancer):

Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery:

* What is a systematic review?

Pregnancy Has No Impact on Breast Cancer Survival, Delays Treatment & Diagnosis

When Informed, All Women Do Not Prefer Breast Conservation

New Genomic Test Can Personalize Breast Cancer Treatment
"Unlike a widely used genomic test that applies only to lymph-node negative, estrogen-receptor positive breast cancer, this new genomic test is broadly applicable for all women diagnosed with breast cancer," says breast cancer specialist Matthew Ellis, M.D., Ph.D., a member of the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University.

"They found that luminal A was not sensitive to the chemotherapy, suggesting that patients with this good-prognosis type can forgo chemotherapy in favor of hormone-based therapy. They showed that among the poor-prognosis tumor types, basal-like breast cancer was the most sensitive to the chemotherapy and luminal B the least."

Editorial: Barriers to Delivery of Psychosocial Care for Cancer Patients

Predictors of Referral for Psychosocial Services: Recommendations From the Institute of Medicine Report—Cancer Care for the Whole Patient

Multivitamin Use and Risk of Cancer and Cardiovascular Disease in the Women's Health Initiative Cohorts

Pathway for cancer chemotherapy unveiled

Tuesday, February 10, 2009

Use of Off Label Cancer Drugs for Medicare Patients

The New York Times has an insightful editorial about problems associated with the recent change adopted by the Bush Administration allowing "off-label" use of certain cancer drugs. The change makes it possible for cancer patients covered by Medicare to have coverage for use of cancer drugs that haven't been approved by the FDA for their cancer.

The editorial points out the most likely outcome of this change will be higher costs for Medicare without additional benefit to patients. In addition, there are concerns that treating patients with drugs not approved for their specific cancer could raise safety risks.

NYT Editorial Link

"That might be fine if one could be confident that the compendiums were
authoritative and unbiased, but analysts have found that compendium
recommendations are often supported by little clinical evidence and are
by experts with financial ties to the drug industry.

Off-label uses are vitally important in cancer care and probably
constitute a majority of cancer drug treatments. But the danger in expanding
usage without strong evidence of safety and effectiveness is that patients
be harmed — and costs may be driven up

The solution — and an essential component of
health care reform — is to
establish centers for comparing the effectiveness
of drugs and treatments and
the cost-effectiveness of using them. That would
help make coverage decisions
more rational for all patients."

Current data for the drugs included in this rule change were reviewed by the Agency for Healthcare Research and Quality and found there was no evidence of benefit for their use for cancers other than the ones FDA has approved .

Breast cancer patients considering the use of off label drugs for treatment should have a thorough discussion with their oncologist about the potential benefits and risks of doing so.

Monday, February 9, 2009

Managing the Cost of Cancer Care

The American Society of Clinical Oncology (ASCO) has developed a new guide to help cancer patients learn about how to deal with insurance and medical expenses related to cancer care. It has some very helpful information for patients to help them learn how to talk to their oncologist about financial issues as well as links to resources, questions to ask and information about how to keep track of medical bills and insurance claims.

Managing the Cost of Cancer Care

Link here

"Medical Homes" - Latest Health Care Fad?

We're hearing lots of talk lately about the "medical home" model in health care reform. What is it exactly? Its hard to say.

United Health & IBM recently announced a new pilot program for the model, according to this article in the New York Times.

"UnitedHealth will try giving doctors more authority and money than usual in return for closely monitoring their patients’ progress, even when patients go to specialists or require hospitalization. The insurer will also move away from paying doctors solely on the basis of how many services they provide, and will start rewarding them more for the overall quality of care patients receive.

The new approach, which is also being tested in various guises by other insurers around the country, is known as the “medical home” model of health care. Many experts hope it will prove one of the best ways to rein in the nation’s runaway medical costs, while making people healthier. The theory is that by providing a home base for patients and coordinating their treatment, doctors can improve care, prevent unnecessary visits to the emergency room, reduce hospitalizations and lower overall medical spending. "

The plan seems short on details and some policy experts see it as just another fad. It may reduce costs for employers in the short term, but likely to not yield long term results.

What does this mean to breast cancer survivors?

  • Cancer coverage - Many insurers these days sell "cafeteria" plans - health plans that cover only a few health care services and may exclude coverage for chemotherapy, breast reconstruction, etc. Will the "medical home" model of health care reform include coverage for all types of health care services, or just primary care - the area of medical care they focus on?
  • Uninsured - The "medical home" model does nothing to provide coverage for those who have no health insurance. How does it make insurance available to workers whose employers don't offer it or to self-employed individuals who can't afford individual insurance?
  • Underinsured - What about medical co-payments, prescription coverage and pre-existing condition exclusions - problem areas that increasingly make cancer treatment unaffordable even for those with insurance?
  • Choice - The model described contracts with primary care physicians, restricting patients to a list of providers. How will this work for specialists, especially for cancer care?

I've just listed a few concerns, I'm sure there are others. Many of the solutions being proposed for health care reform are vague on details about how much health care coverage patients will receive when it comes to cancer care. Breast cancer diagnostic and treatment are highly specialized areas of medical care that aren't provided through community clinics and primary care practices. Beware of proposals that focus only on those areas.