Friday, May 14, 2010
Friday, May 7, 2010
Cardiologist Stirs the Pot
http://www.msnbc.msn.com/id/35895682/ns/health-heart_health/
Doctor says heart groups too cozy with industry
‘It's time to draw the line’ on corporate funding, says prominent cardiologist
The news article spends the 1st half of the story talking about how he got it wrong with the whole coke a cola funding some heart awareness campaign. Let's see if we can find a copy of his speech somewhere....
Putting his name into google:
He helped put the smack down on a diabetes drug that raises heart attack risk. Wonder if that drug is related to Avandia?
I don't know, but Dr Nissen has also been in Avandia's business it seems http://spotlight.vitals.com/2010/02/dr-steven-nissen-on-diabetic-drug-avandia-shown-to-damage-the-heart/
Oh man and Vytorin too http://blog.cleveland.com/medical/2008/01/clinics_dr_steven_nissen_stirs.html
And the FDA user fees too!
Ok, I have a new hero.
Still haven't found a copy of his speech!
Friday, April 9, 2010
Prostate
Sometimes referred to as the prostrate which is fine since the prostrate position protects the prostate. Anyway, there's a new twist in the marketing for this much maligned little organ.
Cancer prevention through a pill! Woohoo! What can possibly go wrong?
This is the craziest headline ever.
Heart failure risk linked to prostate drug
FDA recently approved Avodart as a cancer preventive medication for men
I have a copy of the study they're referring to in the article. They took men with elevated PSA tests and a set of negative prostate biopsies and labelled them high risk. These men were then placed on a prostate shrinking drug called Avodart or a placebo. They had another set of biopsies at 2 years and at 4 years.
There were more men with a positive biopsy for cancer at both 2 and 4 years in the placebo group.
Turns out that 70% of the benefit was in slow growing cancers. You can try and predict which cancers are slow growing and unlikely to spread and those which are fast growing based on how abnormal the cells look under the microscope, it's called a Gleason's score. Most of the benefit was in preventing or delaying or masking the more benign cancers. When men are diagnosed with the slow growing prostate cancers there's a lot of treatment options including "watchful waiting". Where you can tell a man that his cancer is so slow growing that we can't make you any healthier treating it with radiation or surgery only harm you.
Well what about the cancers that have already spread did Avodart prevent them? No sir, there weren't any like that found in this study.
What about the more aggressive looking ones on the biopsy, with a high Gleason's score?
Well the highest scores the last 2 years of the study were found more often in the Avodart group. And of the most aggressive looking cancers found on biopsy those last 2 years of the study, 14 were in the Avodart group and 1 in the placebo group.
So what will happen is this "prevention" will be applied to all men with a high PSA or with a family history or certain races. Sure looks like it might be causing aggressive prostate cancers and why are we trying to use a "prevention" when the PSA test has been proven to harm about 48 men for every 1 it saves?
Don't get me started on the rate of side effects
Tuesday, April 6, 2010
National Breast Cancer Coalition
Sometimes I hear that there are no breast cancer advocacy groups who question the benefits of screening mammography. Well here's a rather large one:
The National Breast Cancer Coalition (NBCC)* is a powerful voice, speaking for women and men across the country, demanding victory in the war against breast cancer. In 2003 it was named one of the twenty most influential groups in health policy based on a survey of congressional staff-the only grassroots group and the only breast cancer organization to make that list.
NBCC has grown to include hundreds of organizations, representing several million patients, professionals, women, their families and friends. Coalition members include cancer support, information and service groups, as well as women's health and provider organizations.
Check out what they have to say about the recent Preventive Task Force Services screening mammography recommendations
To Overhaul the System, ‘Health’ Needs Redefining
http://www.nytimes.com/2009/07/28/health/views/28essa.html?partner=rss&emc=rss
Great Essay
ends with:
If you are one of the millions of Americans adversely affected by the unrelenting growth of health costs — an employer that can’t afford insurance or a patient who can’t afford prescription drugs or can’t find insurance at all — you have to take back responsibility for deciding what health really means, not surrender that decision to “experts” with strong financial incentives.
And even if you are one of the few who doesn’t need to worry about money, you still need to take back this responsibility. Your health may depend on it.
Tuesday, March 30, 2010
Crestor and the Jupiter Trial
A main steam news article talks about absolute risk reduction, this is almost unheard of!
So here's what the Jupiter trial showed, if you have an elevated CRP and have 1 risk factor for heart disease (what we formerly called "low risk") and you take Crestor for 2 years you might be the one person out of 500 taking the pill that had a heart attack prevented. Doesn't that sound less glamourous than "50% reduction"?
The problem with that, among many, is that statins in general seem to raise the diabetes rate. This was shown in the Jupiter trial but that study was pretty short-lived. Other studies of statins show that taking the pill for 4 years will give you the chance of being the one person out of 250 that gets diabetes from taking the pill. Now maybe Crestor is a little lower or a little higher (it IS more potent that other statins so it's probably worse than 1 in 250 but no proof on that yet).
And this is just interesting with all the Vitamin D tests we're ordering now.
Again this all boils down to a highly lucrative experiment. We have no idea what taking Crestor for 3 years , 4 years or 20 years does to someone with a low risk of heart attacks. It's kind of despicable for a study that's supposed to be about heart attack prevention in relatively young healthy people to just run for 2 years. But it's par for the course.
It's really amazing to see the media talking about the down sides to these fads. The world is a changing my friends.
Sunday, March 28, 2010
Quitting smoking
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000216
Research shows that two-thirds to three-quarters of ex-smokers stop unaided. In contrast, the increasing medicalisation of smoking cessation implies that cessation need be pharmacologically or professionally mediated.
Most published papers of smoking cessation interventions are studies or reviews of assisted cessation; very few describe the cessation impact of policies or campaigns in which cessation is not assisted at the individual level.
Many assisted cessation studies, but few if any unassisted cessation studies, are funded by pharmaceutical companies manufacturing cessation products.
Health authorities should emphasise the positive message that the most successful method used by most ex-smokers is unassisted cessation.
Oh my goodness! So let me get this straight. Most people who quit smoking, do it without using ANY pharmaceutical products or "professional" help.
So when folks want to quit smoking, we should tell them the best thing for it is for them to just do it. We can charge you some money but it is your efforts that will determine success.
Change all the ads for Chantix to ads stating "most ex-smokers quit without paying a dime to the medical system"
I guess that'd be bad for business.
Subscribe to:
Posts (Atom)
