Diplomat Special Section
In the February 2013 Issue
Inova Fills Critical Gap
Comprehensive Cancer Care Coming to Northern Virginia
by Gina Shaw
It's a surprising gap. For years now, the only National Cancer Institute-designated comprehensive cancer center in the Washington metropolitan area has been the Lombardi Cancer Center at Georgetown University. Both of Maryland's NCI-designated cancer centers are in Baltimore (the University of Maryland's Greenebaum Cancer Center and Johns Hopkins University's Sidney Kimmel Cancer Center). Virginia's are in Charlottesville and Richmond.
That's only one comprehensive cancer center to serve a metropolitan area of some 5.8 million people, an area that is growing faster than any other Eastern Seaboard city, according to the 2010 census (3 percent between 2007 and 2009, compared with just about 1 percent for New York, Philadelphia and Baltimore). The Philadelphia metropolitan area, by contrast, has four cancer centers for a similarly sized population; greater Boston, with about 4.5 million people, has two.
Human Subjects
African Bioethicist Urges More Oversight for Clinical Trials
by Carolyn Cosmos
A few years ago, medical ethics expert Paul Ndebele, a noted African scholar, saw something at a malaria research site in Malawi that disturbed him: The project was using junior staff as bait to collect mosquitoes for research colonies and feeding the malaria-carrying insects human blood — straight from the source.
When the staffers offered their arms at mosquito mealtimes, they naturally risked infection, Ndebele said, warning that those who continued doing this while taking drugs to prevent or treat malaria were potentially sparking malarial drug resistance in mosquito populations.
Using humans as insect bait — a practice that has its own scientific label, Human Landing Catch (HLC) — is considered the most effective way to capture adult mosquitoes, but Ndebele questioned the ethics of it in an article for the Malawi Medical Journal in 2011.
In the August 2012 Issue
Almost...
For Pregnant Women, 40, Not 37, Is Magic Number
by Gina Shaw
When I was preparing to deliver my younger daughter in 2010 at New Jersey's Morristown Hospital, my midwife told me about a new rule there: no elective inductions of labor or C-sections before 39 completed weeks of pregnancy. If a woman or doctor wanted labor induced or a C-section scheduled before the magic 39-week mark, they would have to present the hospital with a legitimate medical reason why it was better to evict the baby early instead of letting things get closer to the 40 weeks that constitutes a completed pregnancy.
In the May 2012 Issue
Critical Activity
For Mother's Day, Doctors Advise Women to Take Exercise to Heart
by Gina Shaw
How much "moderate to vigorous" exercise do you get a day? According to new research, if you're an average woman, you get about 18 minutes, compared with 30 minutes for men. That relative inactivity puts women at an increased risk for a nasty constellation of factors known as the "metabolic syndrome," including high blood pressure, high cholesterol and excess weight around the waistline. In turn, the metabolic syndrome boosts your risk of life-threatening conditions like type 2 diabetes, stroke and heart disease.
In a study published March 31 online in the journal Preventive Medicine, researchers from Oregon State University in Corvallis reported the results of a national study of physical activity, depression and other symptoms in more than 1,000 men and women, using data collected between 2005 and 2006 as part of the well-known National Health and Nutrition Examination Survey (NHANES).
In the February 2012 Issue
Targeted Progress
Breast Cancer Research Holds Potential for Subsets of Patients
by Gina Shaw
During the month of October, everything from tennis balls to eyelash curlers to handguns is painted pink for "breast cancer awareness." (Is there anyone left who isn't aware of breast cancer?) Newspapers, websites and broadcast outlets run ceaseless headlines about the latest breast cancer stories.
But the real news in breast cancer doesn't come in October. Instead, it comes two times a year: in June, at the annual meeting of the American Society of Clinical Oncology (ASCO), and in December, when researchers converge on Texas for the San Antonio Breast Cancer Symposium. Let's take a look at what exciting new findings came out of San Antonio at the end of 2011.
Protection, Not Promiscuity
Research Debunking Fears That HPV Vaccine Leads to Sexual Activity
by Gina Shaw
Good news, parents of teenage girls: If you and your daughter make the decision that it's a good idea for her to get the vaccine against the human papillomavirus (HPV), a sexually transmitted infection that is the leading cause of cervical cancer, she's probably not going to turn into a raging nymphomaniac.
OK, so they didn't put it exactly like that, but that's the basic conclusion of a new study published in the American Journal of Preventive Medicine. Researchers involved with the Centers for Disease Control and Prevention's National Survey of Family Growth (NSFG) studied 1,200 women between the ages of 15 and 24 regarding their sexual education and behaviors, and found that young women who've had the vaccine are no more likely to be sexually active, or to have had multiple partners, than those who didn't get the vaccine.
In the November 2011 Issue
Wounds of War
U.S. Soldiers on Front Lines Of Traumatic Brain Injury Research
by Gina Shaw
Photo: Emrah Turudu / iStock
A land mine explodes near an armored vehicle on the battlefield in Afghanistan. The soldiers inside see a blinding flash and hear a deafening noise. Dazed, they grab their weapons and continue the battle. They assume they're fine. But they might not be.
Over the next few days and weeks, the soldiers may realize that they're having trouble with their memory and concentration, suffering from mood swings, feeling constantly irritable and having trouble sleeping — all hallmarks of a condition called traumatic brain injury.
Traumatic brain injury has become known as the "signature injury" of the Iraq and Afghanistan wars, due in large part to blast exposures from improvised explosive devices (IEDs), suicide bombers, land mines, mortar rounds and rocket-propelled grenades.
Heart of the Matter
Statins: Widespread and Beneficial, But Not Benign Wonder Drugs
by Gina Shaw
Photo: David Watkins / BigStock
Statin drugs are big business in America — and all over the world. These cholesterol-lowering medications can be found in millions of medicine cabinets. Indeed, half of all men over 65, and about 36 percent of women in the same age group, take a statin drug, according to the National Center for Health Statistics. The Centers for Disease Control and Prevention reports that one out of every four Americans over 45 is taking a statin. That's more than 30 million people.
Statins appear to have a host of benefits beyond just lowering "bad" (LDL) cholesterol levels and reducing the risk of heart disease. Two major studies published in the journal Cancer Causes and Control recently suggest that high cholesterol is linked to the development of prostate cancer, and that men taking statins have a decreased risk of getting prostate cancer.
In the August 2011 Issue
Promise of PARP
Enzyme Inhibitor Offers Exciting New Option in Ovarian Cancer Treatment
by Gina Shaw
Photo: Andy Nowack / iStock
Ovarian cancer is extremely difficult to diagnose and treat. Its symptoms are often confused with other, more benign conditions like gastrointestinal problems, and by the time the disease is recognized, seven or eight out of every 10 patients already have advanced-stage cancer where survival rates are low.
Last year, according to the National Cancer Institute, there were more than 21,000 estimated new cases of ovarian cancer in the United States and 13,850 deaths. Unfortunately, even when there is a good response to initial treatment, between 70 percent and 90 percent of women with ovarian cancer eventually have a recurrence of their disease. "Ovarian cancer is often a chronic disease," said Dr. Barbara Goff, director of gynecologic oncology at the University of Washington and the Seattle Cancer Care Alliance. "So we need to find agents that keep the disease from growing, and at the same time are relatively nontoxic."
Out of This World
Space-Pioneered Ultrasound Technology Sparks Terrestrial Health Care Advances
by Carolyn Cosmos
Photo: NASA
While the end of NASA's 30-year space shuttle program that carried astronauts into orbit is mourned, or perhaps applauded by some, its demise may be greatly exaggerated. Not only does NASA have its eye on deep-space missions to places like Mars, private companies, largely funded by the space agency, will still propel astronauts into Earth's orbit. But perhaps one of the most indelible imprints the program has left on mankind is the science developed aboard shuttle flights and the International Space Station — which may be transforming the lives of people back on Earth.
In fact, as the Atlantis space shuttle lifted off from Florida's coast on July 8, a remarkable scenario was unfolding along the Pacific coast of Nicaragua in a region called Tola. Two days after the launch, an international team descended on the rural town of Las Salinas to deliver a health care technology that had its genesis on the International Space Station.
In the May 2011 Issue
RoboDoc
Meet the Machine Who May Be Performing Your Next Surgery
by Carolyn Cosmos
Photo: Boulder Community Hospital
Dr. Christopher Pohlman, a physician at Boulder Community Hospital in Colorado, specializes in minimally invasive surgery, operating through tiny openings in his patients. But those incisions aren't done with a traditional scalpel by hand. And Pohlman doesn't hover over the body when the cuts, exploration and surgical repair are done inside his patients.
Rather, his second-hand man — or in this case, machine — does the work while Pohlman guides the robotic "hands" from a high-tech console nearby. The hardest part of doing general surgery with a robot is positioning the patient, Pohlman told The Washington Diplomat. The robot's four long instrument-like arms stretching down from its towering body have to be placed just so. "It's like docking a space station."
Price Palpitations
Exorbitant Drug Costs May Price Out Patients
by Gina Shaw
Photo: BigStock
In January, an injectable form of the drug progesterone, a synthetic hormone used to prevent preterm labor in some 130,000 pregnant women every year, cost as little as $10 from your local pharmacy.
Just three months later, the same drug skyrocketed to $1,500 per dose — although after a public outcry, the price tag dropped to $690 per dose. That's still a 69-fold price increase. Why? Did the drug magically get better? Did manufacturers discover a brand new indication? Nope.
The Food and Drug Administration granted exclusive approval to KV Pharmaceutical to produce the drug under the brand name Makena, designating it an "orphan drug" with seven years of monopoly protection. The agency decided that because the drug is a sterile injectable drug, granting specific approval to a manufacturer under FDA guidelines would offer a greater assurance of safety.
