Jul. 28th, 2009

joreth: (Silent Bob Headbang)
First, the obviously-good article:

HPV Vaccine Success - 8 Years and Counting
by Angela Bowen

A lot of controversy exists over the Gardasil® vaccine for human papilloma virus (HPV) approved for women 9-26 to prevent cancer causing HPV strains 16 and 18, and genital wart causing strains 6 and 11. In 2002, at age 19, I myself received the vaccine as part of the human clinical trial for approval by the FDA.

Studies are now available after presentation at the 25th International Papilomavirus Conference in Sweden with more than 8 years of data collection highlighting very encouraging results. Not only have the majority of women vaccinated remained protected, but the number of procedures for abnormal Pap tests have been greatly reduced. Data of a subset of over 9,500 women were analyzed in the results presented. The original combined studies for approval of the vaccine were participated in by over 17,000 women.

There is great controversy on how and when to use the vaccine in young women. Here are some links for facts concerning HPV and recommendations for use.

The vaccine is recommended for girls aged 11-13 but approved for use in girls as young as 9 and as old as 26. For some, this seems like a very young age to vaccinate for a primarily sexually transmitted disease, and hopefully, this is correct. However, by the age of 15, 26% of girls in the United States have had sexual intercourse and by age 18 that number has increased to 70%. An additional 11% have had oral or non penetrative sexual contact. HPV does not require sexual penetration to be passed, nor are condoms entirely effective in preventing HPV.

The Good News for the Vaccine

HPV 16 Follow-up

No vaccinated women were infected with HPV 16 or HPV 16 related cervical lesions.
6 unvaccinated women had HPV 16 infection and 3 developed related cervical lesions.
The combined treatment length (1998-2004) and follow up (2006-2008) yielded similar tracked results.
1 vaccinated woman developed HPV 16 infection but did not develop related cervical lesions.
21 unvaccinated women developed HPV 16 infection and 8 developed related cervical lesions.

Breaking down these numbers into simple percents based on the women participating:

0.3% developed HPV 16 infection.
0.0% developed HPV 16 related cervical lesions

7.2% developed HPV 16 infection
2.8% developed HPV 16 related cervical lesions

Strain 16 of the HPV virus is regarded as the most virulent strain and accounts for the greatest number of illnesses and abnormalities. Additional information is now available indicating a reduction in the number of medical interventions resulting from HPV illnesses and pre-cancerous lesions in women who have been vaccinated.

And second, an article that might sound like bad news on the face, but is actually good news:

Does HPV Cause Lung Cancer as Well as Cervical Cancer
Tuesday July 21, 2009

Does HPV (human papilloma virus) – the virus we know to be responsible for most cases of cervical cancer – cause lung cancer?
Human Papilloma Virus (HPV), National Cancer Institute

The answer is – it may.

As many of us grow weary of the controversy over the HPV vaccine, we now have another variable thrown into the expanding equation. According to the authors of a study published in the journal Lung Cancer, HPV may even be the 2nd most important cause of lung cancer after smoking.
How did they come to that conclusion?

As the link between HPV and cervical cancer was discovered by finding HPV in cervical cancer cells, HPV has been found in roughly 20-25% of lung cancers in the United States. Whether this frames HPV as a cause of lung cancer, however, is another question. People with lung cancer are more likely to use oxygen than the general public, yet nobody would theorize that oxygen causes lung cancer. But it is a question we need to look at very closely.

According to current thought, HPV most likely works as a cofactor in the development of lung cancer, that is, something that works together with another risk factor such as smoking or radon to cause cancer. If this turns out to be the case, learning about HPV prevention might be something we need to add to our efforts to prevent lung cancer in the future.

Read more about HPV and lung cancer:

Now, before anyone freaks out, remember, this article is GOOD NEWS.  First, we don't know that HPV *causes* lung cancer, just that it's been found in lung cancer cells.  This is not the first article I've read on the subject, and I've also seen other articles about a discovery of HPV found in skin cancer cells.  What seems to be the more popular theory is that the presence of HPV might encourage the development of a cancer that is already present or lower the body's ability to fight a cancer caused by another factor.

Second, the rate of lung cancer has not gone up with this discovery.  The chances of lung cancer are the same as they've always been, and the overwhelming cause is still smoking.  Roughly 80% of lung cancer cases still don't have any HPV, so not smoking is still the best way to avoid getting lung cancer.

And third, the real reason why this is Good News is that this is yet one more bit of information that will be used to combat cancer.  Now that we know there is a portion of lung cancer cases that have HPV present, we can learn what the HPV has to do with it and that might give us additional tools for combating it.  If it turns out that the HPV encourages the cancer growth, for instance, then knowing to look for HPV, and then finding it, means we can treat the HPV in order to prevent a relapse or to enable treatments to work that might otherwise have not worked and we had no idea why a treatment wouldn't work on some patients and not others.

So, remember, this is not cause for panic.  Smoking is still the number one cause of lung cancer, and the cases of lung cancer have not increased with this discovery.  This discovery means we have a better chance when treating lung cancer in the future, and this is GOOD NEWS!

So start encouraging your personal physicians to do the HPV DNA test when they give you a pap smear, get checked regularly, and pay attention to your diet and excercize routine.  If you have the money for it, ask for the vaccine, off-label if necessary, and keep up with your metamours' health records.

As to that, I re-recommend Google Health, a resource that allows you to organize all your medical records into one place, that allows your doctors to access all your records even if you change doctors or health plans so you don't have to re-take tests when your doctor can't get your records from your old doctor, allows your pharmacy to keep track of your prescriptions, keeps up with your medications to automatically detect possible conflicts, AND lets you share your profile with other individuals, such as partners, metamours, and Emergency Contact people.

joreth: (Nude Drawing)
Here's an article about Google Health and privacy. And to be honest, I don't understand what the concern is about here. In this article, they talk about 2 issues. The first is how "creepy" it is that Google Health has a section where you can put your Last Wishes, so your doctor and family are absolutely clear on what they should and shouldn't do when you die. Why is this creepy? We write Last Will And Testaments, don't we? Why shouldn't we want to make sure that as many people as relevantly possible know our last wishes so that no one can take over and trump what we requested?

That's actually a concern of mine. I'm afraid my parents will take over and do something religious or stupid regarding my remains (or worse yet, my not-quite-remains) because I'm not married and I don't have a will. But even if I were married, my parents could still cause trouble if they wanted to (I don't really think they would go against a legal document, but it has been known to happen to other people). Look at poor Maria Schiavo. She and her husband discussed, at length, her last wishes, yet her parents managed to tie her body up for years in legal and political battles, prolonging her and her husband's pain, drawing out the process. Because of her, there is suddenly an intense interest in this country for Living Wills.

But then the article goes on to say that "some people will find this [feature] sinister" and immediately follows it up with the fear that Google will tailor its advertising to you.


First of all, Google *does* have to make money somehow. If we're not paying them for all their wonderful services, they have to get funding from somewhere to provide all those wonderful free services. I don't see that as inherenly a bad thing. But good regulation to keep it under control is in order too.  The concern here is that "the customer is always right", which, in this case, makes the Customer the Advertiser, not the end-user.  And that's a very valid concern, but that's where regulation of policy comes in, where Google's policy does explicitly state that they won't use the data in the Health section to determine medical advertisers when you're trying to search for medical information.

Second, I'm supposed to be upset that Google wants to know what kind of advertising I would want and don't want? I would be THRILLED to have my time no longer wasted for ads for penile enhancements or children's college investments. PLEASE tailor your ads to me and stop wasting my time!  And to do it on a personalized basis, not on a demographic bases would be fantastic!  That way they won't withold their ads for power tools just because I'm a girl.

No one seemed to have any problems when regular network television offered their programming "for free" because it was paid for by advertisers.  Well, OK, some people do have a problem with that, which is why there's Public Access, but PBS is constantly struggling to find funding and remain on the air because too many people feel entitled to free programming and are not willing to pay PBS.  And no one has any problems that the advertisers do demographic surveys to make sure that their ads for Sexy Singles are not played during Spongebob, and Super Duper Playdoh isn't advertized during the football game, and feminine hygene products are not advertized during The Man Show.  In fact, every time the advertisers guess wrong, even "wrong" by a minority viewpoint, it makes headlines with a lengthy legal battle started by people who wish to be protected from seeing or experiencing anything they don't like or agree with.

But media and entertainment that I don't have to pay for, in exchange for limited advertising and having the advertising content match the content of the media, I think these are Good Things.

I *do* think we ought to be vigilant about making sure that when Google says they will not sell ad space during a medical information search, that's exactly what happens. I think there are reasonable and necessary regulations that ought to be in place. I'm not in favor of a Free Market when it comes to the medical field, for a number of reasons that [livejournal.com profile] aclaro defends much more adequately than I do, so I do not want my medical information to come only from the highest bidder. I am NOT advocating a regulation-free service.

But I AM advocating a switch from a mindset that says we must guard our information so intently that, when it's necessary for someone else to have the information, they can't access it. Unmarried, civil-unioninzed, or only-legally-married-in-some-other-place people face all kinds of difficulties in emergency situations with getting the proper information to those who need to know. A work-around is assigning someone as a Medical Power of Attorney, but you still have to *prove* that, and that could take time that you don't have. And if a parent or biological relative disagrees, they can stop you even if you have total legal rights, or at least they can gum up the works for so long that they might as well have stopped you.

And a doctor who doesn't know something specific about you because your records are being held hostage by another doctor, or your Medical Power of Attorney hasn't arrived yet, can do just as much damage. How many times could death or illness have been prevented if the doctor had a program that kept track of all your medications and warned him when he prescribed something that conflicted with something that person was already taking? How many times could that have been prevented if the pharmacy double checked the patient history for the same reason?  My aunt died because, when she fell ill, a doctor prescribed an MRI for her and refused to listen to her half-coherent mumblings that she had some condition that made it inadvisable to have an MRI.  Her family didn't know about it and she wasn't coherent enough to make any sense and this was an emergency doctor, not the physician who was responsible for whatever it is she had that conflicted with the MRI.  So she had an MRI and she died 24 hours later.  That wouldn't have happened if the doctor had a handheld device that had her complete medical records, that when he put in his recommendation for an MRI, the device beeped at him and said "this conflicts with a previous treatment", which is exactly what Google Health does.

And how many people could have avoided being infected with an STD if our society did not discourage the open discussion of sexual history and test results? If we didn't persist in the illusion that it's not "romantic" to discuss these things, or that it takes the "spontaneity" out of the sex (which is a whole other issue that sex is dirty and bad and only justifiable if you're so overwhelmed with passion that you cannot make logical, rational decisions that say you *intend* to have sex and to do it safely), or that learning about your partner's history makes you feel icky because you have "specialness" issues wrapped up in your ranking as sex partner?

These are much bigger problems than whether or not Google will try to show me ads in a sidebar, and are easily solved with more accessible and easily shared data. The policy of denying healthcare to people with pre-existing conditions is a real problem, and that goes along with the issues of Free Market and privitized healthcare that I alluded to earlier and I won't get into now. And that should be addressed, but Google Health and other information databases are not the point at which we should be addressing them. Those problems are much deeper in the system and should be attacked at the source.

Security should always be a concern, but what are you trading for your illusion of security?

joreth: (Dobert Demons of Stupidity)
This is for all those people who insist that Big Pharma is only interested in profits, even to the point that they will release drugs for the purpose of killing us, and that the government cannot be trusted to regulate Big Pharma because the FDA is in Big Pharma's pocket.


Study: 'Accelerated' FDA approval too slow for cancer drugs

"Cancer therapies in the FDA's "accelerated approval" program — created in 1992 to help patients with life-threatening diseases such as AIDS — get to market no more quickly than other drugs"

"New cancer drugs took about seven years to get approved, whether they were part of the accelerated process or not, "

"The accelerated approval program is supposed to allow promising drugs to go on the market early, in order to save the lives of people with a short time to live, Bennett says. People with advanced cancer are often willing to accept a higher level of risk — and the potential for serious side effects — if they have no other hope for extending their lives, he says.

"We're not talking about people with skin conditions," Bennett says. "These people are going to die.""

"Today, the agency prefers that companies perform larger studies with comparison groups, although it may accept interim results ... But with so many more patients, these large-scale studies, which measure results such as overall survival, may cost more than $600 million and take an additional five years to complete,"

It's an imperfect process, but the regulatory agencies do not haphazardly push through dangerous treatments or outright poisons in an effort to make more money.  At the very, very least, killing off the population means there aren't any more people around to give you money.  The FDA and agencies like it, are extremely rigorous in their analysis and protection methods of the public.  Of course some things slip through, but for every Phen-fen on the market, how many bottles of Asprin did not kill people?  Drugs are also not without their non-lethal side-effects, but these are all clearly labeled, as per regulations.  Of course there is a chance that you might you might vomit when you do chemotherapy, and it's a pretty good chance too, but without it, you'll almost certainly die when you have cancer.  The point is that the side-effects are disclosed and people can choose (and do choose) to risk it because the alternative is worse.

But reactionaries' anti-government propaganda has much bigger drawbacks.  The deliberate spread of misinformation, and the exaggeration, omission, and outright lies about the products and the regulatory procedures have created a public misconception that has resulted in the FDA being even more cautious than it used to be, which means that dying people cannot have access to the medications they need to prolong their life or improve their quality of life.  All the wonderful advancemens in science that I write about are little comfort to the people on their deathbeds when they learn that this treatment will not be available for 7 more years.

It is still possible to obtain these non-approved treatments and take your chances but without the federal approval process, the patient has to pay through the nose to get it, which means that the best healthcare is reserved for the wealthy (not to mention the fact that it has not even been established yet that it is "the best" because it hasn't gone through the approval process yet) and the poor are just shit out of luck.


September 2017

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