Monthly Archives: February 2011

Who Can You Turn To When Insurance Coverage Is Denied And There Is No Where To Turn? The Impact Of ERISA Plans

Sometimes we have moments which may help us focus our thinking on an issue, or perhaps clarify our understanding of a problem.  We can ponder large problems, but it is those experiences on a more “micro” basis that brings clarity to our thoughts.


A discussion I had this past week with a couple facing an insurance denial for cancer-related surgery was just such an experience.


I can’t go into all the details, but the bottom line for me is that if we don’t find some way to bring clarity and rationality to our health care non-system soon, many people are going to find themselves wondering what happened when they needed help the most. [more]


The events as recounted to me were pretty straightforward: a young lady had a strong history of ovarian cancer on both her mother’s and father’s sides of her family.  She had seen two reputable genetic counselors, both of whom told her she had a very high risk of developing ovarian cancer at some time in her life-with a significant probability that such a diagnosis would be at a late stage of disease and likely fatal.


There are two appropriate recommendations for a … Continue reading →

Less Surgery Is Better For Some Women With Breast Cancer–But Will Their Doctors Be Listening?

I wasn’t going to write this blog.   But after listening to some of the reports on the news yesterday (while I was trying to stay healthy on my elliptical) I realized I had to say something, if for no other reason that to provide some context on an interesting and important piece of clinical research.


This week’s Journal of the American Medical Association has a report indicating that many women no longer need to have the lymph nodes under their arm removed during breast cancer surgery-even if cancer is found in the single “sentinel lymph node” frequently removed as part of the surgical procedure.


This is one more piece of the puzzle that has been answered by clinical researchers and patients over decades, namely whether or not women diagnosed with breast cancer had to undergo radical disfiguring surgery to control their disease.


Now, this research shows that even less surgery is “more” when it comes to benefitting the patient.


The real question (which is the practical and important question) is whether doctors are going to listen to what the research tells them.  My concern-unfortunately-is that there are those docs who are simply going to ignore this … Continue reading →

World Cancer Day: The World Does Not Have To Go Where We Have Already Gone

As I write this, I am en route to New York to participate in the lighting of the Empire State Building tonight in honor and recognition of World Cancer Day.


Spearheaded by the Union for International Cancer Control (better known as UICC)–an international organization devoted to reducing the burden of cancer worldwide–and vigorously supported by the American Cancer Society and many other notable organizations, people, and governments worldwide, World Cancer Day is intended to highlight the growing number of cancer cases and deaths around the world and the need for us to pay serious attention to the problem and institute measures to reduce that burden.


As part of World Cancer Day, the American Cancer Society is releasing the second edition of Global Cancer Facts and Figures, a monograph that assembles in one place what we currently know about the worldwide burden of cancer. A special section in the booklet highlights the growing cancer burden in Africa, and what needs to be done to address what could well become an epidemic of cancer on that continent.


When you look at cancer globally, you begin to realize there are several parts to understanding and addressing the problem. … Continue reading →

A Progress Report On My “Groundhog Day Diet”: Yes, I Still See My Shadow

Today is February 2nd, and it’s Groundhog Day.


For me, it is the first anniversary of my Groundhog Day diet, so it’s a good time to reflect on whether or not I met my personal goal set last Groundhog Day not to repeat the diet mistakes of the past, and try to maintain my weight for a whole year.


Was I successful?  Partly yes, and partly no.  But the good news is I did better this year than I did in the past, so that’s a start-as long as one has a long term view of life. [more]


I won’t bore you again with the details surrounding the Groundhog Day diet.  You can go to last year’s blog for that information.  Let’s just say it’s a take-off on the movie “Groundhog Day” where Bill Murray relives the day again and again until he gets it right.


For me, my Groundhog Day diet moment came when I looked at my weight charts for the past 10 years (yes, Virginia, there are some of us who actually have that kind of information). 


What I noticed was a very disturbing trend: every year I … Continue reading →

The Lines Are Drawn, The Arguments Continue: How Safe Is Bevacizumab (Avastin)?

An article in today’s edition of the Journal of the American Medical Association is bound to raise a vigorous discussion-both pro and con-regarding the side effects and usefulness of one of the first targeted therapies approved to treat cancer.  Moreover, it is bound to add fuel to the firestorm that is developing over whether or not the drug bevacizumab-more commonly known as Avastin®–should or should not continue to be available in the United States for the treatment of advanced breast cancer.


Of particular interest to me are the comments of the expert who wrote the editorial which accompanied the report who directly calls out the question of whether bevacizumab adds value in cancer treatment while “exposing all treated patients, and society, to enormous costs and occasional life-threatening toxic effects.  These unfortunate circumstances are sad for those who pay the bills-and sadder for patients with solid tumors.”


The lines in the sand are drawn, the arguments will commence, and the outcome is uncertain.


What is undoubtedly clear is that 10 years ago, as we peered into the crystal ball of targeted therapies, enormous toxicities and questionable outcomes were not what we expected.[more]


Let’s talk first about … Continue reading →