I has been 3 years...

since Danielle rescued Zoey and brought her to us to foster. Fred still believes we are fostering her and no one has come to adopt her. I guess we should let him in on the truth--Zoey found her fur-ever home 3 years ago.  (Although, sometimes it feels like 30 years!) She has come a long way in the time she has been with us. 

Arrival Dec 10, 2013

2013

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2015

2013

2016

Congress Passes Bill with Billions for Cancer Research

But some consumer groups say new standards for drug approvals could put patients at risk

Consumer Reports / Teresa Carr / December 7, 2016

Congress has passed the most expensive and far-reaching health reform bill since the Affordable Care Act in 2010.

The 21st Century Cures Act, which garnered widespread, bipartisan support in both the House and Senate, is expected to be signed into law by President Obama soon.

The bill signifies an investment of billions of dollars over the next decade to fight cancer, prevent and treat brain disorders, and harness enormous amounts of data to develop individualized treatments based on person’s environment, genes, and lifestyle.

But the bill also lowers the bar for the kind of scientific evidence companies must provide to gain the Food and Drug Administration’s (FDA) approval for their products. It would mean, for instance, that in some circumstances the FDA could rely in part on individual patient experiences with a drug or device, instead of evidence from large-scale, randomized controlled clinical trials.

Rep. Fred Upton, the Republican from Michigan who chairs the House Energy and Commerce Committee and co-sponsored the bill, says the Cures Act "expedites the approval of drugs and devices and includes literally billions of dollars in additional spending for health research so that we can find a cure and the answers to what patients are demanding today.”

Consumer groups, including Consumers Union, the policy and moblization arm of Consumer Reports, have deep concerns that this effort to speed medical innovation comes with a potentially harmful tradeoff for consumers.

“The unfortunate consequence of 21st Century Cures is that less thoroughly tested medications and medical devices will reach the market,” says Lisa McGiffert, director of Consumer Reports’ Safe Patient Project. “And that means that consumers will have less assurance that a new treatment will help and not harm them.”

More Research Dollars

The bill directs $4.8 billion over the next decade to research, in part, to fight cancer.

“Considering that one in two men and one in three women will be diagnosed with cancer in their lifetime, cancer research funding is an investment in yours, mine, and everyone’s health,” says David Pugach, vice president of federal relations at the American Cancer Society Cancer Action Network, the advocacy arm of the ACS.

Pugach says 21st Century Cures represents a “historic opportunity” to accelerate cancer research. “This includes devoting more resources to improve and use new treatments like immunotherapy,” he says, “where the body’s own defenses are used against cancer—as well as creating ways for researchers to more easily share data so they can see patterns across studies more quickly.”

The bill also allocates funds to treat brain disorders, combat opioid abuse, improve suicide prevention programs, and provide mental health care to children. It establishes a task force for research on women who are pregnant or breastfeeding because these women are typically excluded from medical studies.

Faster Drug Approvals, But Lower Standards

The Cures Act loosens requirements for how drugs are studied and approved that have been in place since 1962.

Here's how it usually works: A company submits evidence from studies done under controlled conditions, comparing patients who received the treatment with those who didn't. The studies typically have to show that people who were given the new drug lived longer or felt better than those who didn't get it.

This kind of research can be expensive and time-consuming for drug companies to collect, says Diana Zuckerman, Ph.D., president of the National Center for Health Research, a nonprofit think tank focused on health research. Cancer drugs, for example, can take several years to show that a drug improves survival.

The Cures Act calls on the FDA to approve some drugs more quickly, based on less thorough testing. The problem with this, says Zuckerman, is that “getting drugs to market faster doesn’t help consumers at all if they turn out not to work or causes them harm.”

What Consumers Should Know

Once the Cures Act takes effect, consumers must be especially careful when considering a new medication or medical device, says Orly Avitzur, M.D., Consumer Reports’ medical director.

"When you have a choice, you may want to consider treatments with a proven track record, as you'll have more assurance that they work and are safe," Avitzur says. "Always make sure someone has taken the time to thoroughly explain all the options to you, and the possible risks and benefits of each."

Editor's Note: These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

Halloween past

Mammograms--when & how often should you get one

It is great timing for me that this article came to my attention. Not only is it Breast Cancer Awareness month but it also happens to be time for my annual exam. 

I met a new provider who specializes in Women's Health. We spoke about my confusion regarding how often I should get a mammogram. I know I am not alone when I say there isn't a woman out there that would rather do anything else then stand at the imaging machine and have their body parts squeezed and handled. In short, the doctor gave me her recommendation and I left the office with prescription in hand. 

Now I have to decide if I should or should not schedule the test. I want to make an informed decision and choose wisely. I am going to consider the information posted below, research a little more, and consider my personal situation before deciding to greet the big, cold machine once again. 

When to Get a Mammogram

Consumer Reports untangles all the conflicting advice about when 

to start getting them, and how often to have them done

Consumer Reports / By Catherine Roberts / October 01, 2016

Women have been urged for the last 50 years to have regular mammograms. So you probably think that by now experts agree on the best way to do that. They don’t.

In the past year, the American Cancer Society and the U.S. Preventive Services Task Force came out with new advice, and the American College of Obstetricians and Gynecologists responded by reaffirming its old recommendations.

The three groups disagree on some key questions. When should you start screening? How often should you undergo mammography? At what age should you stop, if ever? They also have different takes on the benefits of clinical breast exams, or having a doctor manually examine breast tissue for lumps or other possible signs of cancer.

In the face of such inconsistent advice, what should you do?

First, don’t use the squabble as an excuse to skip breast-cancer screening. “Yes, the groups differ on some particulars, but they agree on this: Regular screening saves lives,” says Consumer Reports’ chief medical adviser, Marvin M. Lipman, M.D.

And while our experts lean toward the task force’s more conservative approach to breast-cancer screening—mammograms every other year, starting at age 50—they acknowledge that personal preference matters, too. “Women need to understand the evidence, and they should consider their own cancer worries so they make informed choices that are right for them,” Lipman says.

The questions below summarize the positions of the three groups, as well as our take. First, we discuss the other factors you should consider when choosing your breast-cancer-screening strategy.

Weigh the Benefits and Harms

Breast-cancer experts all look at essentially the same evidence, and all want to help women. So how do they end up with such different advice?

One reason is that some of them focus more on the benefits of screening while others are more concerned about the possible risks. Your approach also depends on how you balance those two issues.

The benefits of the test are obvious: fewer deaths from breast cancer. The American Cancer Society, for example, in its new recommendations points to research involving hundreds of thousands of women showing that regular screening has cut breast-cancer deaths by 35 to 50 percent.

The risks of breast cancer screening, while less familiar to many women and even some doctors, are of increasing concern to many experts. Here are the two main ones for you to consider:

• False alarms. Mammograms often cause false positives, or results that initially seem worrisome but prove to be harmless after follow-up tests. For example, a recent review by the task force found that 42 percent of women who get screened every two years for 10 years starting at age 50 will have at least one false positive mammography. Getting screened every year makes it more likely that you'll experience a false alarm, as does starting in your 40s. False alarms are worrisome not only because they can cause needless anxiety, but also because they can lead to more mammograms, which expose you to more radiation, and sometimes biopsies, which can cause infection.
• Overtreatment. Some cancers detected by mammography and then treated are unaggressive tumors that would have never harmed a woman. That's a problem, because treating those cancers exposes women to the potential harms of cancer therapy—surgery, chemotherapy, radiation, and the stress of a cancer diagnosis—with any benefits. While it's hard to know exactly how often that happens, the task force estimates that at least one in eight tumors detected by mammography are unaggressive ones that would never spread, and that for every woman whose life is save by mammography, two or three will be treated unnecessarily.

Factor In Your Risks

Your approach to breast cancer screening can depend not only on how you balance those risks and benefits but also on your chance of developing breast cancer, based on your personal and family health history.

The greater your risk, the more aggressive you may want to be by, for example, starting at age 40 or 45 instead of 50, or getting screened once a year instead of every two years.

What puts you at greater risk? Here are some of the most important risk factors:
• A family history of breast cancer.
• A personal history of noncancerous breast conditions, including atypical hyperplasia or dense breasts.
• Menstrual periods that started before age 12 or continued after 55, or not having a child before 30.
• A history of hormone replacement therapy.
• Obesity, smoking, or excessive alcohol consumption.
• A history of multiple chest X-rays to diagnose, for example, pneumonia or an injury.

4 Key Questions to Consider

Below are the key questions to think about when considering your approach to breast cancer screening, along with the positions of leading health groups on each issue, plus our advice.

1. When Should You Start Screening?

American College of Obstetricians and Gynecologists: 40
American Cancer Society: 45
U.S. Preventive Services Task Force: 50
Comments: Breast cancer becomes much more common after age 50, and starting sooner increases the chance of having false alarms and possibly unnecessary treatment. On the other hand, cancers that develop before menopause tend to be more aggressive, making it more important to catch them early.
CR's take: The more risk factors you have for breast cancer, the more reasonable it is to start getting the exams in your 40s.

2. How Often Should You Have a Mammogram?

American College of Obstetricians and Gynecologists: Every year.
American Cancer Society: Every year from 45-54, then every two years.
U.S. Preventive Services Task Force: Every two years.
Comments: Breast cancer that appears before menopause tends to spread faster. But frequent tests make false alarms and unnecessary treatment more likely.
CR's take: If you opt to screen in your 40s because you are at high risk, annual tests make sense, switching to tests every other year when you reach age 50 or so. People who start screening in their 50s may be better off with testing every other year.  

3. When Should You Stop?

American College of Obstetricians and Gynecologists: Women 75 or older should talk with their doctor about whether testing makes sense for them.
American Cancer Society: Continue as long as you have a life expectancy of 10 or more years.
U.S. Preventive Services Task Force: 74
Comments: There's little hard evidence about the benefits of breast cancer screening in women 75 and older. While researchers know that about a quarter of breast-cancer deaths occur in women over that age, they also say that the older and sicker you are, the less likely it is that mammography will extend your life.
CR's take: The Cancer Society’s advice to factor in your overall health and life expectancy makes sense. A woman already diagnosed with a different kind of cancer or dealing with another serious health problem such as COPD or heart failure might want to focus more on managing those problems; someone in good health, on the other hand, might prefer to continue screening, especially if she has risk factors for breast cancer.

4. What About Breast Exams?

American College of Obstetricians and Gynecologists: Every year starting at 19.
American Cancer Society: Not recommended.
U.S. Preventive Services Task Force: Not enough evidence for or against to make a recommendation.
American College of Obstetricians and Gynecologists: Every year starting at 19.
American Cancer Society: Not recommended.
U.S. Preventive Services Task Force: Not enough evidence for or against to make a recommendation.
Comments: Though checking your breasts for lumps or having your doctor do it may seem sensible, little research backs up the practice. Instead, it may create anxiety and lead to needless follow-up tests.
CR's take: They make most sense for women at high risk. And if you notice something abnormal, tell your doctor.

Click for more info about a variety of screenings: 

www.consumerreports.org / www.consumerhealthchoices.org / www.choosingwisely.org/