Finding breast cancer early through screening major tool for beating disease

Breast cancer is the second most common cancer diagnosis in the United States. Dr. Srinath Sundararajan, an oncologist and hematologist with Texas Oncology-Katy, says early detection saves lives and that screening is important, even during the pandemic.

“Delaying cancer screenings will lead to detecting cancer at a later stage, and definitely that leads to more aggressive disease, more lengthy treatment and an increased healthcare cost,” Sundararajan said. “Cancer when identified early, there is a better chance of it being a curable cancer and better chance of having less intensive treatment. Screening cancer and finding it early is the single most effective way of improving cancer survival rates.”

He explained that since the 1980s, advances in breast cancer treatments have improved mortality rates, but screening has played a major role because it allows patients to seek treatment earlier in the disease.


While Sundararajan said mammograms are the main breast cancer detection tool, women talking with their health care providers about how to do a proper self-breast exam can enhance their breast health awareness and act as another tool. He said they should look for unusual changes in their breasts, including lumps, changes in the contour of the nipple, skin color changes, puckering of the skin or a new nipple discharge that occurs without apparent reason. Women should seek immediate medical attention with their health care provider if any of these symptoms occur.

While the age that a woman should get her first mammogram depends on several factors such as family history, Sundararajan explained that a woman with average risk should have a discussion with her doctor when she is between 40 and 50 years old. He said the frequency for mammograms will vary based on the results of that first one. Women should certainly have mammograms from age 50 to age 75, Sundararajan said.

The pandemic has had a large impact on cancer. A study showed that diagnoses of breast, cervical and colon cancer were down about 90 percent at one point. Sundararajan said the numbers have improved but are still down overall by about 30 percent since before COVID-19.

“It doesn’t mean that cancer was not happening or that new cancer was not occurring during those times,” he said. “Those are all missed diagnoses, which would probably impact them later in the future. Once they’re diagnosed, they might be at a later stage.”

Sundararajan explained that 90 to 95 percent of patients whose breast cancer is detected early respond well to treatment and are still living five years later. Those survival rates decrease when the cancer is found later.

Sundararajan emphasized that it is safe to go out for cancer screenings. He said clinics, diagnostic offices and doctors’ offices are taking precautions so that people do not catch or spread the novel coronavirus. Many medical facilities require masks and temperature checks to enter and are

Trump’s Drug-Discount Cards Expected to Reach Medicare Recipients After Election

President Trump’s plan to send 33 million Medicare beneficiaries a card that can be used to help pay for as much as $200 in prescription drug costs won’t be completed until after the election, according to a person familiar with the plan.

The cards will be mailed in phases, with some likely going out later in October but most not until after the Nov. 3 presidential election, the person said. The Centers for Medicare and Medicaid Services is spending an estimated $20 million for administrative costs to print and send letters to Medicare beneficiaries informing them that they will be getting cards, the person said.

Plans for the overall drug-discount program have been sent to the Office for Management and Budget, the person said. It is unclear if or when the office will approve the program, which could cost $8 billion, the person said. The Centers for Medicare and Medicaid Services, which oversees Medicare designed for people 65 and older, is unable to say exactly when the cards will go out because the proposal is still at OMB. Beneficiaries will have two years to use the discount cards, the person said.

Low-income beneficiaries who don’t already get financial assistance for medications would likely get the cards, according to the person familiar with the planning, rather than everyone in Medicare Part D, which helps cover prescription drug costs for people 65 and older.

Mr. Trump surprised his own health-administration leaders on Sept. 24 when he announced the plan to mail out prescription drug cards. The discount cards were proposed by White House chief of staff Mark Meadows, said an administration official.

CMS officials rushed to figure out how the program could be structured and designed, according to two people familiar with the planning.

The proposed plan calls for funding the cards from two Medicare trust funds, according to the administration official. It would run out of a CMS office that tests new models for providing or paying for health care.

The program lets officials waive Medicare’s laws or standards to test if new initiatives increase efficiency and “economy of programs” without adversely affecting quality, according to CMS. These waiver programs have generally been required to show they won’t increase federal spending beyond what would have occurred without the test.

The drug-discount-card plan, for example, could be designed to test if people are more adherent to medications if they are given a discount, according to the administration official.

Democrats and other critics have said providing discounts doesn’t fit with the parameters or goals of the program, and they say it is unwise to tap the Medicare trust funds at the same time one of the funds is facing insolvency concerns.

Medicare is funded by two trust funds held by the U.S. Treasury. The trusts pay for hospital care and to administer the federal health-insurance program for people 65 and older and the disabled. They are funded through payroll taxes, income taxes paid on Social Security benefits and other sources.

The Medicare trust

‘Please Say a Prayer for Me’

Brittany Cartwright/instagram Sherri (L) and Brittany Cartwright

Vanderpump Rules star Brittany Cartwright’s mother, Sherri Cartwright, is back in the hospital four months after she was admitted to the intensive care unit “due to serious complications from bladder surgery.”

Sherri shared a video from her hospital bed in her Instagram Stories on Monday, asking fans to “say a prayer for me” as she recovers from kidney issues.

“Well, guys, I’m back in the hospital again,” she began the clip. “This time, I went septic with my kidneys. I had kidney stones — can’t pass them.”

The matriarch — who has made several cameos on Vanderpump Rules and her daughter’s spinoff with Jax Taylor, Vanderpump Rules Jax and Brittany Take Kentucky — went on to reveal that she recently had a “partial operation” and will undergo more surgery in the future.

“I’m gonna finish some rest in about a week to let everything get cleared up before I have the rest of my surgery,” Sherri explained. “I know one thing: This has been a hard year, definitely, on me and a lot of other people, I’m sure. So, if you all could please say a prayer for me, I really need it.”

Sherri Cartwright/instagram Sherri Cartwright

RELATED: Vanderpump Rules Star Brittany Cartwright Has ‘Been Beside Herself’ as Her Mother Is Hospitalized

In June, Brittany’s rep told PEOPLE that Sherri was hospitalized and remained in the ICU. At the end of the month, the family’s Kentucky-based pastor, Ryan Dotson, confirmed that Sherri was out of the ICU and “improving daily.”

Brittany spoke about her mother’s hospitalization in August, writing in an Instagram post that Sherri “has made an amazing recovery and is doing so so much better.”

“For those of you who don’t know her story, she went in for a bladder surgery, stayed a couple nights in the hospital and was sent home,” Brittany shared alongside a mother-daughter selfie. “She was feeling horrible and days later she was rushed to the hospital for emergency surgery. Her 45 minute surgery turned into 4 1/2 hours.”

RELATED: Vanderpump Rules Stars Jax Taylor and Brittany Cartwright Expecting Their First Child

The reality star described her mom’s health event as “the scariest moments and a horrible time to be so far away in California.”

“We found out after that they had tore her bowel during her bladder surgery, they didn’t notice and she had gone septic,” she said. “The emergency doctors were amazing and they literally saved her life. She fought on life support for a couple days and woke up days later with no idea what had happened to her. I flew straight to Kentucky and stayed by her side.”

Brittany added of her mother, “She is so strong and has come so far from the first days I stayed with her in the hospital. This was a very scary time but she is bouncing right back!! Please keep her in your prayers as she continues to heal for her next surgery.”

S

Black Doctors Work to Make Coronavirus Testing More Equitable

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

When the coronavirus arrived in Philadelphia in March, Dr. Ala Stanford hunkered down at home with her husband and kids. A pediatric surgeon with a private practice, she has staff privileges at a few suburban Philadelphia hospitals. For weeks, most of her usual procedures and patient visits were canceled. So she found herself, like a lot of people, spending the days in her pajamas, glued to the TV.

And then, at the beginning of April, she started seeing media reports indicating that Black people were contracting the coronavirus and dying from COVID-19 at greater rates than other demographic groups.

“It just hit me like, what is going on?” said Stanford.

At the same time, she started hearing from Black friends who couldn’t get tested because they didn’t have a doctor’s referral or didn’t meet the testing criteria. In April, there were shortages of coronavirus tests in numerous locations across the country, but Stanford decided to call around to the hospitals where she works to learn more about why people were being turned away.

One explanation she heard was that a doctor had to sign on to be the “physician of record” for anyone seeking a test. In a siloed health system, it could be complicated to sort out the logistics of who would communicate test results to patients. And, in an effort to protect health care workers from being exposed to the virus, some test sites wouldn’t let people without cars simply walk up to the test site.

Stanford knew African Americans were less likely to have primary care physicians than white Americans, and more likely to rely on public transportation. She just couldn’t square all that with the disproportionate infection rates for Black people she was seeing on the news.

“All these reasons in my mind were barriers and excuses,” she said. “And, in essence, I decided in that moment we were going to test the city of Philadelphia.”



Dr Ala Stanford and her staff on duty a coronavirus testing site in Pennsylvania. Stanford created the Black Doctors COVID-19 Consortium and sends mobile test units into neighborhoods.

Black Philadelphians contract the coronavirus at a rate nearly twice that of their white counterparts. They also are more likely to have severe cases of the virus: African Americans make up 44% of Philadelphians but 55% of those hospitalized for COVID-19.

Black Philadelphians are more likely to work jobs that can’t be performed at home, putting them at a greater risk of exposure. In the city’s jails, sanitation and transportation departments, workers are predominantly Black, and as the pandemic progressed they contracted COVID-19 at high rates.

The increased severity of illness among African Americans may also be due in part to underlying health conditions more prevalent among Black people, but Stanford maintains that unequal access to health care is the greatest driver of the disparity.

“When an elderly funeral home director in West Philly tries to get tested

Lilly Covid-19 antibody treatment trial paused. Experts say that’s normal

Drugmaker Eli Lilly and Co. said Tuesday that the government-sponsored clinical trial of its Covid-19 antibody treatment has been paused because of a safety concern.

“Out of an abundance of caution, the ACTIV-3 independent data safety monitoring board (DSMB) has recommended a pause in enrollment,” Lilly spokeswoman Molly McCully said in an emailed statement. “Lilly is supportive of the decision by the independent DSMB to cautiously ensure the safety of the patients participating in this study.”

The Lilly drug, called LY-CoV555, is similar to the Regeneron antibody treatment President Donald Trump received after his Covid-19 diagnosis. It is currently being tested in hospitalized patients.

Full coverage of the coronavirus outbreak

The pause in the Lilly trial comes a day after Johnson & Johnson paused its Covid-19 vaccine trial after a volunteer had an unexplained illness. J&J said the participant’s condition was being reviewed and evaluated by the Data Safety Monitoring Board. It’s unclear whether the volunteer who had an adverse event had received the actual vaccine or a placebo.

It’s not uncommon for late-stage trials to hit bumps.

“Pauses are not infrequent in a clinical trial, and in these studies, they are going to be probably a bit more frequent as the development line for a product is significantly truncated,” Dr. Carlos del Rio, infectious diseases expert at Emory University School of Medicine, said.

Just last week, Lilly requested emergency use authorization from the Food and Drug Administration for the antibody treatment, using data from a separate clinical trial — not the trial that was just paused.

No published or peer-reviewed results have been released about the treatment, but last month the company released partial results from a trial of the drug, which suggested it could help keep patients with mild to moderate forms of the illness from progressing to a point where they would need to be hospitalized.

The paused trial is sponsored by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. When the phase 3 trial was announced in August, Lilly had planned to enroll approximately 300 volunteers hospitalized with mild to moderate illness with fewer than 13 days of symptoms, according to the NIH. Participants were also given the antiviral remdesivir.

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Advocates Stand Up Against AstraZeneca to Save Drug Discount Program for Vulnerable Populations

Wilmington Protest, Wed., Oct. 14th – 12 noon – 1:00 pm ET

Dozens of concerned healthcare advocates from across the northeast region protest AstraZeneca, one of five U.S. based pharmaceutical companies that have cut back on the number of drugs they provide through the 340B federal drug discount program

Please replace the release with the following updated version due to multiple revisions.

The updated release reads:

DELAWARE PROTEST: ADVOCATES STAND UP AGAINST ASTRAZENECA TO SAVE DRUG DISCOUNT PROGRAM FOR VULNERABLE POPULATIONS

Wilmington Protest, Wed., Oct. 14th – 12 noon – 1:00 pm ET

Dozens of concerned healthcare advocates from across the northeast region protest AstraZeneca, one of five U.S. based pharmaceutical companies that have cut back on the number of drugs they provide through the 340B federal drug discount program.

Healthcare advocates from across the northeast region will protest the recent actions of AstraZeneca, in cutting back the number of critical life-saving drugs provided at discounted rates to non-profit healthcare providers, through the federal 340B drug discount program.

WHAT:

Protest against AstraZeneca

 

 

WHERE:

AstraZeneca’s Corporate Office

 

1800 Concord Pike, Wilmington, DE 19803

 

NOTE: The protest will take place at the intersection of Powder Mill Road & Route 22

 

 

WHEN:

Tomorrow, Wednesday, October 14, 2020

 

12noon – 1pm (EDT)

 

 

WHO:

Healthcare advocates from across the Northeast Region

The federal 340B Drug Discount Program is a lifeline that allows safety net providers, including HIV/AIDS clinics receiving funding through the Ryan White program, to obtain prescription drugs at below-retail prices. The program was established with bipartisan support as part of the Veterans Health Care Act of 1992. With 340B savings, Ryan White clinics are able to stretch their grant funds, offer a wider range of services, and improve the quality of care persons living with HIV/AIDS receive. The program also benefits qualified 340B covered entities such as non-profit rural health facilities, community clinics and children’s hospitals that serve vulnerable populations.

Tomorrow’s protest, led by healthcare advocates from AIDS Healthcare Foundation (AHF), follows a lawsuit filed by Ryan White Clinics for 340B Access (RWC-340B) against the U.S. Department of Health and Human Services (HHS), in U.S. District Court for the District of Columbia, to require the HHS secretary to take action against AstraZeneca and three other pharmaceutical companies, including Eli Lilly, Novartis and the U.S. division of Sanofi-Aventis which are illegally withholding drugs they are required to sell through the 340B program. With tomorrow’s protest, AHF is demanding that these greedy pharmaceutical companies stop their bullying tactics that will have a devastating impact on the healthcare and well-being of our most vulnerable populations (see LITIGATION PRESS RELEASE). RWC340B also recently released a study on the potential adverse impact of policies reducing resources to Ryan White clinics, see WHITE PAPER, PRESS RELEASE, and FACT SHEET.

“AstraZeneca has launched an assault on a federal drug discount program essential to the safety net of our nation’s health care,” stated John Hassell, AHF’s national director of advocacy. “They are messing with the numerous health care centers

Study: Many older Americans with heart failure take 10 or more meds

When older people hospitalized for heart failure are sent home, they are often given a whopping 10 medications to take for a variety of conditions.

But is this “polypharmacy” practice necessary, or does it just place a bigger burden on already frail patients?

It’s not a question so much of the quantity of the medications, but whether the medications patients are taking are the right ones for them, said senior study author Dr. Parag Goyal, a geriatric cardiologist at NewYork-Presbyterian in New York City.

“It’s not just that we’re not starting the right medications, there may be situations where we’re not stopping the wrong medications as well,” Goyal said. “I think we need to look at the medication that older adults with heart failure take in a more holistic fashion.”

For the study, Goyal’s team examined the medical charts of 558 adults aged 65 and older who were hospitalized in the United States between 2003 and 2014.

When admitted, 84% of the patients were taking five or more medications and 42% were taking 10 or more. When discharged, those numbers had risen to 95% of patients prescribed five or more medications and 55% taking 10 or more.

Most of the prescribed medicines were not for the patients’ heart failure or heart conditions, the researchers said.

A larger medication burden increases the risk of adverse drug reactions, which could lead to patients ending up in the hospital, Goyal explained. It can also require more work for the patient, which can have an impact on quality of life.

“It’s a big challenge,” Goyal said. “How exactly do you reconcile the fact that a lot of these medications are meant to prevent events and to help patients feel better with the concept that as the number of medications rise, you might be negatively affecting these parameters?”

The study found that about 90% of older adults with heart failure have at least three other medical conditions. More than 60% have at least five other conditions.

The findings were published online Oct. 13 in the journal Circulation: Heart Failure.

The researchers concluded that there is a need to develop strategies that can alleviate the negative effects of polypharmacy. Among the drugs that may be overused are proton-pump inhibitors, which reduce stomach acid.

There are a host of medications patients may have been taking for years that could be reviewed, Goyal noted.

However, the study suggested that the benefits of medication may outweigh the risks of polypharmacy for people with certain conditions, including chronic obstructive pulmonary disease COPD and diabetes.

Some medications already are multipurpose, including one that treats diabetes and heart failure, said Dr. Gregg Fonarow, chief of the University of California, Los Angeles, division of cardiology.

“That doesn’t mean there are not some medications that are not necessary and could be either reduced or consolidated, but that for patients with heart failure that have a number of other comorbid conditions there are a number of medications that are proven in randomized trials, proven in

California releases guidelines for private gatherings with friends

Ahead of the Halloween and Thanksgiving holidays, California Health and Human Services Secretary Dr. Mark Ghaly addressed new guidelines the state released this week allowing private outdoor gatherings with friends if specific conditions are met.

Ghaly said attendees must be from no more than three separate households and gatherings should last no more than two hours.

Gatherings “should be and must be done outside,” he added. People are also expected to take safety precautions, including wearing masks, practicing physical distancing and washing hands.

In the past, the state discouraged any gatherings outside of a single household.


Ghaly said the guidelines are meant to recognize that many close friends and relatives have been apart a long time and increasingly want to be together, especially with the holidays ahead.

The intention of the guidelines is not to encourage gatherings, but to inspire people to socialize safely when they do.

“Guidance here does not mean go,” he said. “It does not mean that we’re endorsing or suggesting small gatherings happen. We just want to provide important ways to reduce your risk, so you protect yourselves, your families and your communities.”

“We believe and still really support the messaging that spending time with your household alone is the way we can reduce transmission the best,” he said.

While much of the country and European nations are seeing a resurgence, coronavirus indicators in California are near their record lows. Hospitalizations are at their lowest level since early April and those in intensive care at their second-lowest level since officials began keeping track in late March. The rate of positive tests has been hovering at 2.6% for two weeks.

“We don’t see the surge other parts of the country are experiencing and other parts of the globe,” he said. “We don’t want to see the spike that could rightfully happen.”

The Associated Press contributed to this story.

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Vaccine development process is safe, claims of the contrary are baseless

All of our lives have been drastically impacted by the ongoing coronavirus pandemic — and we know all of us are eager to return to the way things were before the pandemic began. However, that simply won’t be possible without a safe, effective vaccine. Fortunately, due to the strength of American innovation and unprecedented public-private partnerships, a COVID-19 vaccine is on the horizon. We, as the top Republican on the House Energy and Commerce Committee’s Oversight and Investigations Subcommittee and a physician on the Energy and Commerce Health Subcommittee, have been closely following our nation’s progress — and we are confident that we will have a safe, effective vaccine soon.

On July 21, 2020, the House Energy and Commerce Committee’s Oversight and Investigations Subcommittee held a hearing on vaccine development. The subcommittee heard from AstraZeneca, Johnson & Johnson, Merck, Moderna, and Pfizer. All five companies are working on various vaccines and therapeutics for COVID-19 and have received federal funding. Moderna, Pfizer, AstraZeneca, and Johnson & Johnson are all now conducting “phase 3” clinical trials for their COVID-19 vaccine candidates, which is the last stage of testing prior to regulatory approval. AstraZeneca and Johnson & Johnson both recently paused their studies to examine an illness in one of the participants. This is standard protocol, and should give us even more confidence that vaccine companies are following standard safety procedures in their trials — not rushing through the process.

Currently, the Trump administration is working with many pharmaceutical companies to assist in two ways: To advance research and development and to ensure that when a COVID-19 vaccine is approved for safety and efficacy, it is ready to be shipped and distributed across the United States. 

Through “Operation Warp Speed” and the “Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV)” partnership, the federal government is doing everything it can to ensure that the private companies developing a vaccine have the resources they need. This assistance is also helping companies to begin establishing manufacturing capability and to initiate the purchasing of necessary raw materials including glass vials for packaging and needles and syringes for the administration of the vaccines. These programs are also facilitating the condensing of the regulatory timeline. For example, the government is currently providing financial support to a number of companies to allow for simultaneous development and production of a vaccine before it receives final approval from the Food and Drug Administration (FDA). Usually, companies will not begin to invest in producing a vaccine or treatment until it has first completed testing and received regulatory approval. We need to ensure that any COVID-19 vaccine is available as soon as it receives the final approval from the FDA.

All five companies assured the subcommittee that any vaccine they produce will meet all safety standards set by the FDA. They also vowed to be transparent about the testing and development process so there are no questions about safety or efficacy.

Many who are working closely on vaccine development are cautiously optimistic that we will

As Dr. Javaid Perwaiz faces trial, the women he treated question decades of care

CHESAPEAKE, Va. — The last time Brittni DuPuy-German saw her trusted gynecologist, she once again explained that the stabbing, mystery pain in her abdomen had not gone away.

It first appeared two years earlier, after she said her doctor, Javaid Perwaiz, surgically tied her tubes. To fix it, he had proposed more surgery — three additional procedures in nine months that she said included a hysterectomy when she was 29. But the pain persisted.

So on Nov. 8, 2019, at his private-practice office, Perwaiz and DuPuy-German discussed the possibility of yet another surgery, she said. He scheduled an ultrasound for just days later, a sign of the efficiency that DuPuy-German had come to expect from her family’s longtime gynecologist. He was her mother’s doctor, her sister-in-law’s doctor, her best friend’s doctor. Perwaiz had delivered DuPuy-German and delivered her children.

Which is why, when her phone buzzed the day after her appointment, she was shocked by the headline she was reading: “Chesapeake doctor tied women’s tubes, performed hysterectomies without their consent, feds say.”

She absorbed the details of the FBI investigation. Her doctor, the news report said, was accused of lying to patients and persuading them to have life-altering surgeries they didn’t need. DuPuy-German began doubting everything Perwaiz had told her about her own body.

“That’s when all of the things that I didn’t question before started popping up,” she said.

As Perwaiz faces trial this week, a year after his arrest, DuPuy-German has received few answers to those questions — even as the FBI’s investigation expanded and the list of alleged victims grew. There are 29 patients specified in court documents and hundreds of others who contacted authorities after the doctor’s arrest.

DuPuy-German, now 32, is not cited in the criminal case but has filed a lawsuit against Perwaiz.

The U.S. attorney’s office for the Eastern District of Virginia would not say how many women in total were allegedly mistreated by Perwaiz, but in a recent trial memorandum prosecutors wrote that “the identified patients are only ‘examples’ of the scheme to defraud.”

The case, which authorities said was launched in 2018 after a hospital employee’s tip, first hinged on one charge each of health-care fraud and false statements. Federal prosecutors now allege that Perwaiz executed an “extensive scheme” spanning nearly a decade that endangered women’s pregnancies, robbed their ability to conceive and pressured them into unnecessary procedures based on unfounded cancer diagnoses and exams using broken equipment.

The more procedures Perwaiz performed, authorities said, the more money he made off insurance companies. He used the profits, according to prosecutors’ trial memorandum, “to support his lavish lifestyle.”

Perwaiz, who is jailed without bond, pleaded not guilty. He has not spoken publicly about the allegations but defense attorneys said in a court document he is “prepared to defend himself at trial.” His lawyers in the criminal case have not responded to multiple requests for comment, but have argued unsuccessfully in numerous motions to dismiss that, among other things, some charges were duplicative.