Monday, February 9, 2015

Living cancer

Treating cancer is a race against time.
"It's one of those really challenging things for me as a physician. "I took an oath not to harm. And I worry about that in the back of my head, because it's a new drug. And we don't even know what dose to start him with."
[npr - listen]

Every once in a while, there's an experimental drug that's so promising it makes the race even more urgent. Patients and their families plead with pharmaceutical companies to get it before the Food and Drug Administration's approval.

The demand has been particularly high for a new class of drugs that harnesses the immune system to fight cancer.
Find other stories in the Living Cancer series at WNYC.org.
Find other stories in the Living Cancer series at WNYC.org. WNYC 
    
Kathy Liu first heard about immunotherapy for cancer two years ago at a conference focused on the rare renal cancer her 10-year-old son, Joey, was fighting. Liu had her son's tumors analyzed, and he seemed like a promising candidate for immunotherapy.

"That's why I'm so desperate, contacting the drug companies," she explained. "I told them I understand the policy, I understand the regulation and I understand all the risks, but my child just has no time to wait."

Clinical trials were underway for several of the new immunotherapy drugs, but there were no trials available for children.

Pharmaceutical companies rarely offer clinical trials of new cancer drugs for children. Several pediatric cancer specialists said that's because of a lack of financial incentives for the drug companies, as well as the complexity of organizing trials for so few people, given the rarity of childhood cancer.

Only 1 in 285 children will be diagnosed with cancer before the age of 20, yet cancer is the second-leading cause of death for people in that age group.
Joey in July 2013, after his diagnosis.i
Joey in July 2013, after his diagnosis.
 
By last fall, Joey's cancer had metastasized. After surgery, chemo, radiation and numerous drugs that turned out to be effective for only a month or two, the family had exhausted all available treatments.
The family's doctors advised Liu to "go home" with Joey to enjoy the rest of their time together.

"We can't just go home," she said. "For us, that means giving up. If that happened to me maybe I would make the decision we just go home, but it's my child. I can't just like do nothing and go home. I have to try everything."

Last spring with the help of a friend, Liu petitioned several pharmaceutical companies to gain access to one of a handful of immunotherapy drugs in development. The petition quickly received over 17,000 signatures, but was ineffective. And even if she could have gotten one of the drugs, their doctor, Dr. Joanne Lagmay, an oncologist at Shands Children's Hospital in Gainesville, Fla., was reluctant to give it to a child.

"It's one of those really challenging things for me as a physician," Lagmay said. "I took an oath not to harm. And I worry about that in the back of my head, because it's a new drug. And we don't even know what dose to start him with..."

(continues)

5 comments:

  1. Here are my questions:

    FQ's

    1. What is preventive medicine? (BB 138)
    Answer: medicine which devises measures to prevent or control disease

    2. What measures can be taken to prevent disease? (BB 139)
    Answer: screening, vaccination for immunization, compulsory notification of disease and controls on the movement of infected people

    3. What is equitable treatment? (BB 143)
    Answer: we should treat people in a way that is proportionate to their relative differences

    4. What is the paradox of healthcare? (BB 144)
    Answer: in higher income countries where infant mortality is reduced and life expectancy is increased, healthcare prices are going up and supply is less than demand.

    5. What method is used to determine who gets transplants first? (BB 151)
    Answer: Quality Adjusted Life Years

    6. John Rawls said society will only be gfair if we agree to which two principles? (BB 158)
    Answer: Liberty and Difference

    7. Four factors that are the cause of an individual's health and longevity are? (BB 162)
    Answer: biological endowments and needs, individual behaviors, physical environment and social conditions

    DQ's

    1. What can we do about the healthcare paradox today?

    ReplyDelete
  2. Wow I had no idea families went so far just to help their children. The last thing parents want to lose is their own children. I hope one day the day comes where drugs will be out just a bit sooner to meet the demands of children and or adults fighting cancer.

    ReplyDelete
  3. Justice Chapter
    FQ- what are heartsink patients (People in deprived areas with multiple problems)
    FQ- what are the three levels of determining distribution of health care fairly? (Macro-meso- and micro allocation)
    FQ- what are the 2 principles that john Rawls established for justice? (The Liberty Principle and the Difference Principle)

    ReplyDelete
  4. I think companies that are researching into new ways to treat disease should try to keep the idea within the scientific community for as long as possible to avoid false hope for people like this. When a child is diagnosed with a disease such as cancer, the family strives to find anything they can to help the child, which is natural. However, I do not think that they should look towards new drugs which have had little to no testing, as it could very well harm the child further.

    Speaking of new ways to treat diseases, here is a journal of treating cancer with antibiotics that target mitochondria: http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B%5D=3174

    DQ: Should heath care be provided by the government to all, or should we all be personally responsible for our own health care?

    ReplyDelete
  5. When I see a story like this, I always have to wonder if trying an experimental drug is the best way to go. In all reality, the drug could be doing more harm than it is good, and in this scenario, it could have made that child more miserable than he already was. I just think that it is a little dangerous to start a treatment on the basis of, " this might help."

    ReplyDelete