If we can kill them, lets confuse them part 993

Once again we are faced with the vast conspiracy to kill off all the cancer patients through confusion. First they said mammograms for everyone over 40. Then they said no, not until 50. Then the UK said only every 2-3 year after 50. Then Canada said after 50. Now the radiologists say mammograms should be done annually for women over 40.

Call me confused.

But what this is really telling us is 1, there is a vast conspiracy out there to confuse us all and 2, the only way to decide what is best for you is to talk to your own doctors and see what the two of you decide is really right for you.

A good idea that doesn't work for cancer

Something else that works for everything but cancer. As yet another effort to control health insurance costs, in the past year tiered health insurance options have been introduced in Massachusetts. The point of them is to redirect patients to lower cost medical centers, thus reducing premiums for employers and patients. If you pay higher premiums you can have access to more hospitals and doctors. It kind of makes sense - send people for routine care to cheaper places.

People do complain with changes in health insurance particularly when it causes them to change doctors. And one of the biggest complaints with tiered health insurance is that people are forced to change doctors. I can understand that but I am not entirely sympathetic. If you have the same doctor for years you build a relationship with them and trust and like them. But we have to allow for change in our lives. We can't assume anything will last forever.

In the past four and a half years I have had my oncologist retire, fired my GI doctor and got a new one, found a new eye doctor, endocrinologist and primary care, had my long time dentist retire, and my dermatologist moved to another medical facility. I have also acquired an elbow doctor, an ankle doctor, therapist and meds therapist.. In fact the only doctors I have kept in the past four and a half years are my radiation oncologist, knee doctor, breast surgeon (and I only see his nurse practitioner these days). I may have stressed a little at the time of these changes but I am doing okay with all this. Change happens.

But the problem is with cancer and probably some other ailments, you quickly need to get to a specialist at an expensive place that specializes in cancer. This isn't a time to shop around for medical care. Yes you have a little time but if you need an oncologist don't sit there waiting to find the right one. You need to get an oncologist and a diagnosis so you have a basic idea of how aggressively you need treatment. If you don't like your oncologist you can find a new one at that point and then do some looking around if you want. But you don't want your insurance company telling you that you can't go to the specialized cancer center that could save your life.

Needed: Rocket Scientist Drugs who will work for cheap

We have smart drugs now. They are very smart. They outsmart tumor cells and the tumors disappear. But they aren't smart enough. The drugs work for months and then they eventually stop working and the cancers return. These drugs are not cheap either. One of them 'vemurafenib' costs a paltry $9400/month or over $100,000 for a year, if it works for that long. It works for an average of seven months.

Actually these drugs are pretty smart. They target a tumor's weaknesses and melts them away. But I have two problems with them. Cancer cells are sneaky b*stards (excuse my language here) and learn to outsmart these new drugs. We need rocket scientist drugs which will continue to outsmart cancer cells and can stay ahead of them. The worst thing we could do would be to end up with drug resistant cancers which become resistant to treatment like some germs are to antibiotics.

We also need rocket scientist drugs who will work for cheap. A drug that costs $9400/month and only lasts for an average of 7 months is a bit on the expensive side. It doesn't matter if insurance covers it or not because the cost works its way back down through the cost chain.

Wanted: Rocket scientist anti cancer drug which can stay ahead of the competition by out smarting the cancer cells. Low salary, long hours, repayment - saving millions of lives.

So where should you live?

It seems that it is important where you live in terms of rates of cancer and cancer survival rates. First I found a list of the top fifty towns and cities in Massachusetts with the highest rates of cancer - this data needs to be taken with a large grain of salt. The city with the highest rate of cancer is Nantucket - which is also home to lots of retirees and seniors. Cancer is more prevalent in older people so it would make sense where more old people live there would be more cancer.

Then I find an article on the UK talking about their great successes in increasing survival rates for some types of cancer but not others. One theory on why some blood cancers are have such high survival rates is that those patients are quick to be referred to a specialist. Now that's food for thought - if you have a cancer diagnosis, find an oncologist who specializes in your cancer.

Finally, as of 2007 cancer survival rates are increasing across Europe but still lag behind the US. And rates are worse in eastern Europe than in northern and western European countries. So location does matter. But also the best cancer survival rates are in Sweden, Norway, and Denmark. "The United Kingdom in particular comes out badly in the tables, showing cancer survival rates that are among the worst in Europe." I find this interesting in that it is sort of a rebuttal for the article above. I don't think this is a reflection on national health care because most of Europe has one form of it or another. Maybe its reflective of lifestyles.

But are their higher rates of other diseases in other places? Probably. This is only about cancer. We can all live in caves and stay out of the sun and eat raw food and never touch any chemicals...

Cancer isn't cheap

Cancer is a very expensive ailment - even with health insurance. I have relatively good health insurance and for the fifth year in a row, I will max out my allowable out of pocket expenses at $5000. That amount really only covers my co-payments and prescription costs. Everything else is additional - travel, parking fees, dentists, eye doctors, etc. And my income has gone down because I don't work full time anymore. I work two part time jobs which get me close to full time hours. Since they are part time, I get no benefits from either. No paid time off, no retirement, etc. If I am not there I do not get paid.

As someone lucky enough to be living with cancer who gets to go to the doctor all the time, my expenses definitely add up. This coming week I have four doctor appointments. Last week I had none - because it was a short week. The week before I had three or four. I probably average around 8 each month. Each usually has a $20 co-pay.And I am not in active treatment - I just have follow ups and other medical issues.

I think this is a side of cancer that is under reported. People with health insurance have hefty bills as well. I think I have good insurance because it has an out of pocket maximum. Many people do not have this benefit and their bills run into the thousands annually.

This morning I received an email announcing a new online webinar on Managing the Costs of Cancer Care on December 8. I am not sure I can go but I have signed up for it and will see about rearranging my schedule if needed. There are also two recorded webinars that I want to listen to soon: Managing the Costs of Recovery and Money Matters: Finding the Resources to Manage Cancer Costs.

Something about the whole thing irks me about this whole thing. I feel like the patient is the pawn in the scam of ridiculously expensive medications, big salaries for someone somewhere, and insurance companies deciding what they will and won't pay for. We can only afford to get cancer if we are rich.

Prevention vs. screening

We have been on the screening, screening, screening trip for a long time. Everyone is up on the controversy about mammograms at 40 or 50 and MRIs as a screening tool. We also are all up in arms every time the FDA changes a ruling on a cancer drug - is Avastin really helping breast cancer patients? But aren't we forgetting one teeny, tiny thing?

Prevention is important too. We all know the basics - eat your vegetables, don't get fat, be sure to exercise, don't smoke, don't drink, blah, blah, blah. But do we do that most of the time? Yesterday, being Thanksgiving doesn't count, in terms of taking care of ourselves. It was a holiday. We are not perfect people and we are allowed to overindulge once in a while in all the bad things - fatty foods, buttery sauces, gravy, ice cream, pie, cheese, wine, etc. But we can't do this every day. We need to be good most days. This means no fast food, nothing greasy, no big restaurant meals, etc.And we need to get our exercise.

There has been so much talk about research and screening and treatment but we also need to remember the bigger picture. Cancer has risk factors that you can reduce, even though we can't eliminate them, by taking care of ourselves. I think I have overlooked this as well until I was reminded by this article that I read this morning. As we live in a society with ever increasing waist lines, we need to remember that with increased weight comes increased risk of ailments - not just diabetes but also cancer and more.

So now that we have started to digest our big meals from yesterday, we need to get back on track and eat healthy, get moving, and think prevention.

Thanksgiving chaos

This morning is a bit of Thanksgiving chaos. We have my brother, sister in law and four children staying with us. They arrived last night and we stayed up until midnight playing scrabble. Then this morning the first one was up around 6. We have had the normal range of what to eat or more correctly, what the children decide they don't like any more because they really want to cut the mask out of the back of the cheerios box - but they have to eat all of them first.

I have also made mashed potatoes, chestnut stuffing, and cut up vegetables for veggies and dip. However I havve successfully conned my brother into making carrot sticks. I think. I am still looking at peeled but uncut carrots.What this has done has made my back hurt already. A lot. But I have drugs. Hmmm.... A sedated Thanksgiving. That may not be such a bad idea.

Otherwise the cat is all stressed because there are strangers in his house messing up his nap space and times. Soon we are off to eat lots of food but the key is to remember to bring everything we need. Because of my lack of brain cells, I made a list. And lost my list (and maybe my mind as well).

We will eat too much and pretend a short walk will enable digesting of the vast quantities of food we will eat. Just another normal American holiday.

Happy Thanksgiving everyone!