US News and World Report recently published an article summarizing the results of a study of Veterans Affairs hospitals. The study found that patients with cancer or dementia received better end-of-life counseling, more palliative care, and better end-of-life planning on the … Continue reading
No industry has aligned itself more closely with the breast cancer movement than the cosmetics industry. It’s long flooded the market with pink ribbon products: pink ribbon lipstick, pink ribbon nail polish, pink ribbon perfume. Yet while they prominently claim … Continue reading
Oliver Sacks gave the Beatty lecture on the mysteries of the brain at McGill University in Montréal in October of 1997. I had the pleasure of being one of the many attending this exciting lecture. I write “exciting” as Sacks … Continue reading
I’m winding down my time in Mexico City at the FAB conference and the International Association of Bioethics — my first ever on both counts. It was exciting to meet so many folks in person, especially at my first meeting … Continue reading
Predictions made ten years ago about the proposed ban on smoking in Irish pubs turned out to be dead wrong. An article in the New York Times provides details about compliance with the ban, noting that not only was it … Continue reading
New from the New York Times … Continue reading
This version of this post originally appeared on the Albert Einstein College of Medicine’s blog. The debate over e-cigarettes has been heating up. Are the smokeless, battery-powered, nicotine-dispensing devices a gateway to smoking for young people or a helpful way … Continue reading
“Even More Addictive Cigarettes” from the NYTimes … Continue reading
From the New York Times: In Uganda stigma, poverty, and familial obligations frequently prevent women from getting the treatment they need for breast cancer before the disease becomes lethal. … Continue reading
In the era of biocitizenry—when how you manage your medical risk is part and parcel of good citizenship—identity is a crucial mediator. Who you are is who you are like, and who you are like is whose narrative you can slip into: celebrity greases the deal. Whether that narrative is a comfortable glove that fits you just right, or a bus you jump on in a hurry, only to realize later that it took you just where you needed to go—or in the opposite direction—may be both a metaphysical question, and one with real consequences.
Angelina Jolie’s revelation in the NY Times of her carrier status for the BRCA mutation and of her choice of prophylactic double mastectomy was well-measured. She highlighted several important facts that frame the diversity of people’s experience and choices to set a context for her own moving personal narrative, such as that the BRCA gene mutation is responsible for a small share of breast cancers, that access to the test is hindered by its cost (Myriad’s patent as the most significant driver of that cost went unnamed), that the biggest disease burden is borne in lower-income countries, that the choice of approaches to prevention is personal and best discussed with your physician. Her physician blogged the treatment regime, but only after the news cycle and blogosphere were forced to content themselves for a day with the policy issues of patents (read Leila Jamal at The Berman Institute’s Bioethics Bulletin on the Myriad patents and the case before the Supreme Court), access (read s.e. smith’s harrowing account at xojane of knowing her BRCA status but being unable to afford preventive treatment), and what may have been the source of her self-reported 87% lifetime risk of breast cancer (Tiffany O’Callaghan interviewing Allison Kurian at The New Scientist), as well as the misogyny flung Jolie’s way (you may want to skip the tumblrs filling with variants of the “poor Brad” meme from twitter).
Most women choosing double mastectomy as a prophylaxis for breast cancer are not women with the BRCA mutation. If there were a sweepstakes for bravery, Jolie’s worthy competitor would be Peggy Orenstein, who wrote two weeks ago in the NY Times Magazine about how her advocacy for early detection via mammography screening was transformed as she came to understand the depth and extent of breast cancer overdiagnosis. The issue of overdiagnosis, to be clear, isn’t about the distress and uncertainty that comes with false positives. It’s about unnecessary medical treatment: surgery, radiation, and chemotherapy for breast cancers that would never have killed if left alone. The recent Canadian Task Force on Preventive Health Care update of the similar US body’s guidelines quantifies overdiagnosis for women undergoing screening in their 40s as 10 cancers treated unnecessarily for every life saved. Jolie faces visceral misogyny from her so-called fan base; Orenstein faces the ire of the screening advocates. I’m not sure which is worse.Continue reading
From Democracy Now – Ten Years Later, U.S. Has Left Iraq with Mass Displacement & Epidemic of Birth Defects, Cancers … Continue reading
India’s Supreme Court has recently denied an appeal by the Swiss pharmaceutical company Novartis, which was seeking patent protection for its cancer drug, Glivec. India’s Commerce and Industry Minister, Anand Sharma, claims that it’s necessary to strike a balance between the social obligation to provide affordable medicine and supporting innovation in research and development through providing patent protection.Continue reading