The Hill on Wednesday published opinion pieces by lawmakers and federal officials discussing health care policy. Summaries appear below. Rep. Lois Capps (D-Calif.): Although “the diagnosis of cancer is not the automatic death sentence that it once was” as a result of medical advances, “troubling health disparities still persist and many patients are not afforded access to … the type of comprehensive cancer care planning that has been so effective in improving the lives of cancer patients,” Capps, vice chair of the House Energy and Commerce Subcommittee on Health and co-chair of the House Cancer Caucus, writes in The Hill.

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The study of dark-skinned mice has led to a surprising finding about a common protein involved in tumor suppression, report researchers at the Stanford University School of Medicine. The results may lead to new treatments for bone marrow failure in humans.
The protein, called p53, has been dubbed the “guardian of the genome” for its ability to recognize DNA damage and halt the division of potentially cancerous cells. However, in a new twist, it appears that p53 also responds to disruptions in the cell’s protein factories, leading to changes in skin color and causing anemia in mice.

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Introgen Therapeutics, Inc. (NASDAQ:INGN), a developer of targeted molecular therapies for cancer, announced that the company will present the results from its recently completed Phase 3 trial of ADVEXIN in recurrent head and neck cancer at the American Association for Cancer Research (AACR) Centennial Conference on Translational Cancer Medicine 2008: Cancer Clinical Trials and Personalized Medicine. The conference will be held July 20-23, 2008 at the Hyatt Regency Monterey in Monterey, CA.

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GPs risk legal action if they fail to follow GMC guidance - as well as NICE guidelines - when they treat skin cancers, warns the Medical and Dental Defence Union of Scotland (MDDUS) today (Wednesday, 16 July 2008). GMC guidance in Good Medical Practice advises doctors to “recognise and work within the limits of [their] competence”. The GMC also advises: “You should be familiar with relevant guidelines and developments that affect your work.”

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As cancer treatment improves and more people with cancer survive, general practitioners must become more involved in all stages of the cancer journey, according to an editorial by experts in general practice in the latest issue of the Medical Journal of Australia.
Professor David Weller of the Division of Community Health Sciences at the University of Edinburgh and Professor Mark Harris, Director of the Centre for Primary Health Care and Equity at the University of New South Wales, said increasing numbers of cancer patients are living for prolonged periods with the disease, placing growing emphasis on the concept of survivorship.

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A research paper in the latest issue of Medical Journal of Australia has provided the first insight into the prevalence and patterns of multimorbidity in Australia. About three in 10 people who saw a GP in 2005, and one in four Australians have multimorbidity (two or more types of chronic conditions).
Professor Helena Britt, Director of the Family Medicine Research Centre at the University of Sydney, and her co-authors studied the multimorbidities of more than 9,000 patients who attended GPs between July and November 2005.

Prof Britt said knowing the common combinations of multimorbidity may help in planning the health services needed for our ageing population.

“The current health care system in Australia focuses on single diseases - creating challenges for GPs, who care for the ‘whole’ person, rather than on only one body system. “Calls are growing for a more holistic consideration of the patient, because multimorbidity has a negative impact on quality of life and increases health service use” she said.

Prevalence of multimorbidity was estimated at 37.1 per cent of surveyed patients, which translates to 29 per cent of people who attended a GP in 2005 and 25.5 per cent of the Australian population. Among the elderly, 83% of the surveyed patients had multimorbidity.

The most common morbidity combinations were: arthritis/chronic back pain and vascular disease (15 per cent); a psychological problem and vascular disease (10.6 per cent); and arthritis/chronic back pain plus a psychological problem (10.6 per cent)

The most common combination among patients with four or more types of morbidity was arthritis/back pain, vascular disease, gastro-oesophageal reflux and a psychological problem.

Prof Britt said some multimorbidity combinations were particularly problematic for both clinician and patient, particularly where the drug therapy for one problem may have negative effects on the other.

“These issues are often not considered in management guidelines for individual conditions,” she said.

In a separate research paper in the latest issue of Medical Journal of Australia, Prof Britt and her co-authors estimated the prevalence of selected diagnosed chronic diseases and compared their findings to those of the National Health Survey (NHS).

“Reliable estimates provide a marker of the health of a community and assist planning of health services and health promotion,” Prof Britt said.

Some results aligned with the National Health Survey: one in five Australian have a cardiovascular problem, one in 10 had asthma, and 15% arthritis. However this study suggests that one in five Australians have a diagnosed psychological problem, and one in nine have high cholesterol problems, about double the prevalence estimates from the NHS.

“Our method has the benefit of the input of a medical practitioner, which probably leads to greater accuracy than self-report alone. This study could be repeated annually to augment other data sources and better define existing health needs in the population,” she said.

Source:

1. Defining Health Care Needs For Chronic Illness, Medical Journal Of Australia

A method that could be applied widely to explore genetic basis of cancer drug resistance
Why do cancer patients develop resistance to chemotherapy drugs, sometimes abruptly, after a period in which the drugs seem to be working well to reduce tumors or hold them in check? Although largely a mystery to scientists, the result when this occurs is all too familiar: patients relapse and in many cases die when their cancers become resistant.

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The world’s top engineers, physicians and scientists are joining forces to conceptualize, develop and bring to reality the future tools and treatments of 21st century health care through UC San Diego’s new Institute of Engineering in Medicine. Nanoparticle bombs to kill cancer, molecular-sized bridges to repair damaged hearts, and scarless surgery techniques are now on the frontier of medical innovations in California with the new Institute leading the way.

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The National Human Genome Research Institute, one of the National Institutes of Health, has announced grants expected to total about $31 million over the next four years for research aimed at gaining a better understanding of how specific genetic variants act to influence the risk of diabetes, heart disease, cancer and other common diseases.
Over the past two years, genome-wide association studies (GWAS) have allowed researchers to uncover more than 300 novel genetic variants associated with common diseases.

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More than 100 physicians and scientists from around the country will discuss the latest findings in pancreatic research at PancreasFest 2008 at the Hillman Cancer Center July 24 through 26.
Topics to be covered at the event will include the challenges of determining whom to screen for pancreatic cancer, new therapeutic approaches for treating pancreatic cancer, how to manage complications after pancreas surgery, and the current status and utility of biomarkers.

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