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Scientists Discover Genetic Mutations Linked to Salivary Gland Tumours

Wed, Aug 6, 2014

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Source: scicasts.com
Author: Staff
 

Juniper, FL — Research conducted at the Florida campus of The Scripps Research Institute (TSRI) has discovered links between a set of genes known to promote tumour growth and mucoepidermoid carcinoma, an oral cancer that affects the salivary glands.

The discovery could help physicians develop new treatments that target the cancer’s underlying genetic causes.

The research, recently published online ahead of print by the Proceedings of the National Academy of Sciences, shows that a pair of proteins joined together by a genetic mutation—known as CRTC1/MAML2 (C1/M2)—work with MYC, a protein commonly associated with other cancers, to promote the oral cancer’s growth and spread.

“This research provides new insights into the molecular mechanisms of these malignances and points to a new direction for potential therapies,” says TSRI biologist Dr. Michael Conkright, who led the study.

The C1/M2 protein is created when the genes encoding CRTC1 and MAML2 mutate into a single gene through a process known as chromosomal translocation. Such mutant “chimera” genes are linked to the formation of several forms of cancer. The team discovered that the C1/M2 protein further activates genetic pathways regulated by MYC, in addition to CREB, to begin a series of cellular changes leading to the development of mucoepidermoid carcinoma.

“The identification of unique interactions between C1/M2 and MYC suggests that drugs capable of disrupting these interactions may have therapeutic potential in the treatment of mucoepidermoid carcinomas, ” said Dr. Antonio L. Amelio, first author of the study who is now assistant professor with the University of North Carolina (UNC) School of Dentistry and member of the UNC Lineberger Comprehensive Cancer Center.

Researchers have known about the role of C1/M2 and its interactions with another protein, CREB, in the development of mucoepidermoid carcinoma, and physicians screen patients for the presence of the C1/M2 protein when testing for this cancer. These new findings deepen the understanding of C1/M2’s role by revealing that it works with a family of cancer-associated genes known as the MYC family to drive the cellular changes necessary for a tumour to develop.

The discovery of these new protein interactions may also reveal insights into the mechanisms behind other cancers that arise due to other genetic mutations involving the CREB and MYC pathways.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

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Quick, low-cost blood test detects early signs of oral cancer

Sat, Aug 2, 2014

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Source: www.drbicuspid.com
Author: DrBicuspid Staff

Australian researchers have developed a quick, low-cost blood test to detect the early signs of oral cancer. The diagnostic test examines the profile of small molecules called microRNA in the blood and can be done at the same time as other routine checks, such as for cholesterol.

At present, no routine screening tests for oral cancer are on the market. The researchers hope that a simple blood test could change that and, in doing so, help stem the global increase of various oral cancers.

About 300,000 new cases of oral cancer were reported globally in 2012, according to the researchers. The main barriers to treatment remain late detection and low disease awareness. Warning symptoms include pain, swelling, a hoarse voice, and difficulty swallowing — symptoms that are often dismissed or misdiagnosed as a common cold.

The test, called miLIFE, was developed by researchers Nham Tran, PhD, and doctoral candidate Samantha Khoury from the University of Technology, Sydney (UTS) Centre for Health Technologies. The blood-based test can be administered by healthcare providers to screen microRNA to reveal the oral cancer’s early warning signs. The turnaround time for the test is about 48 hours at present.

The levels of five specific microRNA molecules are detected with miLIFE and compared with those of healthy, noncancerous individuals. An overabundance or expression of these specific microRNAs would designate people at high risk for oral cancer. These patients would then be referred to a specialist for further examination.

“You don’t need a specialist to administer the test,” Khoury noted. “When you visit your GP [general practitioner] for routine checks of cholesterol, vitamin D, hemoglobin, and so on, the same blood sample can be used to check for the presence of microRNA biomarkers.”

The majority of oral cancer patients who go to the doctor have already developed an advanced lesion, but by then it is too late, Tran stated.

“At this stage, their diagnosis option is to undergo a tumor biopsy or a fine-needle aspiration, both highly invasive and painful procedures,” he noted. “We hope that through miLIFE we can provide early intervention to decrease the number who are diagnosed with oral cancer each year.”

The test is being filed under a UTS provisional patent, and Tran hopes it will be available within two to three years.

The technology, in development since 2006, has evolved via an ongoing collection of consenting cancer patient samples from surgeons based at several Sydney hospitals. The researchers collaborated with the Sydney Head and Neck Cancer Institute, the Cancer Council Australia, and Mount Sinai Hospital in New York.

Next the researchers plan to expand the project with the Vellore Christian Medical College Foundation in India. They targeted India because that country has the world’s highest rates of oral cancer, with 40,000 cases diagnosed annually.

“The introduction of a robust cancer screen will provide a platform for effective cancer management in low-resourced countries,” Tran noted.

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Blood test could predict oral cancer recurrence

Sat, Aug 2, 2014

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Source: www.livescience.com
Author: Rachael Rettner, Senior Writer

A new blood and saliva test that looks for traces of the human papillomavirus (HPV) can predict whether some people with oral cancers will have their cancer come back, early research suggests.

It helps to know as soon as possible that cancer has returned, because tumors that are caught early are easier to treat.

In the study, the researchers analyzed blood and saliva samples from 93 people with head and neck cancers; about 80 percent of these patients had cancers that tested positive for HPV. All of their cancers had previously been treated with surgery, radiation or chemotherapy.

The researchers looked for fragments of DNA from HPV-16, a strain of the virus that is strongly linked with head and neck cancer. The virus may be found in cancer cells that linger in the body after treatment, the researchers said.

Among people with HPV-positive tumors, the new test identified 70 percent of those whose cancer returned within three years, the researchers said.

“Until now, there has been no reliable biological way to identify which patients are at higher risk for recurrence, so these tests should greatly help [to] do so,” study researcher Dr. Joseph Califano, professor of otolaryngology at Johns Hopkins School of Medicine, said in a statement.

Patients with head and neck cancer typically visit the doctor every one to three months during the first year after their diagnoses to check for cancer recurrence. But new tumors in the tonsils, throat and base of the tongue can be difficult to spot, and are often not detected early, the researchers said.

Still, more research is needed to confirm the findings, Califano said. Because HPV infection is common, the test may identify HPV infections that are not related to the cancer. “We can’t be sure our test results are cancer-specific, and not due to other forms of HPV infection or exposure,” Califano said.

The researchers are now looking for additional genetic markers that would increase the accuracy of their test.

Note:
The study is published today in the journal JAMA Otolaryngology–Head & Neck Surgery.

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University of Michigan researchers find protein that fuels repair of treatment-resistant cancer cells

Sat, Aug 2, 2014

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Source: http://www.dentistryiq.com/
Author: DentistryIQ Editors

Imagine that you’re fighting for your life, but no matter how hard you hit, your opponent won’t go down.

The same can be said of highly treatment-resistant cancers, such as head and neck cancer. During radiation and chemotherapy, some cancer cells repair themselves to survive and thrive. Head and neck cancer is the sixth most common cancer in the world, but the late detection and treatment resistance result in a high mortality rate.

Now, University of Michigan researchers have found that a particular protein – TRIP13 – encourages those cancer cells to repair themselves, and they have identified an existing chemical that blocks this mechanism for cell repair.

protein1

Left: Untreated head and neck cancer cells are tagged fluorescent green. Right: Shows cells treated with the chemical inhibitor that blocks TRIP13, which results in a dramatically smaller tumor.

“This is a very significant advance because identifying the function of the protein that fuels the repair of cancer cells and having an existing chemical that blocks the process could speed the process of moving to clinical trials,” said principal investigator Nisha D’Silva, University of Michigan professor of dentistry and associate professor of pathology.

Typically, if scientists discover a promising drug therapy target, it takes years to develop drug compounds from scratch and move these into clinical trials.

protein2

Top: Cancer cells with TRIP13, the protein that encourages cancer cells to repair themselves. Bottom: Cancer cells in which researchers have removed or decreased TRIP13, which results in fewer cells due to cell death.

If cell DNA is damaged, and the cell cannot repair the damage, the cell dies. In head and neck cancers, D’Silva and colleagues showed how cancer cells that overexpress TRIP13 were able to repair their DNA enough to survive and continue to grow as cancer.

“Targeting this repair mechanism with specific drugs could increase effectiveness of treatment and improve survival of cancer patients,” D’Silva said. “And given the overexpression of TRIP13 in several treatment-resistant cancers, this strategy will likely be important for multiple cancers.”

Note:
Rajat Banerjee of the University of Michigan School of Dentistry is the first author of the study, “TRIP13 promotes error-prone nonhomologous end joining and induces chemoresistance in head and neck cancer,” which appeared online on July 31 in Nature Communications.

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Anti-vaccine fears aren’t only for vaccines anymore

Wed, Jul 30, 2014

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Source: http://m.dailykos.com
Author: Staff member – Hunter
 

The anti-vaccination forces are gaining new victims:

In May, the Tennessean reported on a truly shocking medical problem. Seven infants, aged between seven and 20 weeks old, had arrived at Vanderbilt University’s Monroe Carell Jr. Children’s Hospital over the past eight months with a condition called “vitamin K deficiency bleeding,” or VKDB. This rare disorder occurs because human infants do not have enough vitamin K, a blood coagulant, in their systems. Infants who develop VKDB can bleed in various parts of their bodies, including bleeding into the brain. This can cause brain damage or even death.

Which is why newborns usually get a vitamin K shot immediately after birth, just in case. It’s not a vaccine, it’s a vitamin, and odds are good that many of the same people objecting to the this vitamin pop vitamin pills regularly. The problem is that yes, it’s an injection, and so parents are assuming (with the help of anti-vaccine groups, not-at-all-coincidentally) there must be something devious about that.

A quick Google search returns a number of dire warnings about vitamin K shots circulating on the Internet. One of the top results is an article at TheHealthyHomeEconomist.com, which urges readers to “Skip that Newborn Vitamin K Shot,” before going on to list an array of “dangerous ingredients in the injection cocktail.” (The site also calls vaccines “scientific fraud.”) [...]And then there’s physician Joseph Mercola (whose popular website calls vaccinations “very neurotoxic” and suggests they are associated with a list of conditions, including autism).

I can only presume that somebody’s keeping track of the body count on these things. Being an informed medical consumer is one thing, risking your child’s health based on paranoid/fringe internet theories is something entirely different.

 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
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Hard-to-watch commercials to make quitting smoking easier

Sat, Jul 26, 2014

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Source: www.nytimes.com
Author: Andrew Adam Newman

Telling smokers that their habit shortens life expectancy by at least 10 years might seem like an effective way to get them to quit. But it turns out there is something even scarier: living with disfiguring disease.

Dr. Tim McAfee, the director of the Office on Smoking and Health at the Centers for Disease Control and Prevention, was overseeing focus groups of smokers to help shape a smoking-cessation advertising campaign in 2011 when this became clear.

“Telling smokers that you’re going to lose 11 to 12 years of your life expectancy if you continue to smoke, and that if you quit in your 30s you can gain 10 of those back, seemed pretty powerfully motivating to us,” said Dr. McAfee.

But smokers’ response to such messages was that it would not happen to them, Dr. McAfee said. What they feared more than an untimely death, it turned out, was chronic illness.

stoma

“They were less motivated by the fear of dying than the fear of suffering, of disability, of disfigurement, and of being a burden to those around them,” Dr. McAfee said.

Introduced in 2012, the C.D.C. campaign, “Tips From Former Smokers,” by Arnold Worldwide in Boston, features people who did not quit until smoking had taken a grave toll. The ads ostensibly offer practical advice about how to function with smoking-related ailments, but the real message is to avoid such predicaments by kicking the habit.

A new series of commercials includes one featuring Shawn Wright, a chef who lives in Spokane, Wash., who was 50 at the time it was shot. Mr. Wright, who started smoking at around age 14 and had a pack-and-a-half-a-day habit, lost his larynx to throat cancer in his late 40s and now has a dime-size stoma, a hole in his throat.

The commercial opens with a title card, “Tips from a former smoker,” and Mr. Wright in the shower, the water running behind him. Mr. Wright, who has a voice prosthesis implanted in his throat and must cover his stoma with a finger to speak, says with a gravelly voice, “When you have a hole in your neck, don’t face the shower head.” He is also filmed pushing a lawn mower (“Keep the stoma covered when you’re outside”) and sitting at a dining room table (“Get used to eating only soft foods”).

At the close of the spot, as he looks in a mirror, he sticks a tool with a brush on the end into the hole in his neck, saying, “Clean out your speech valve twice a day.”

Another new commercial features Amanda Brenden, of Eau Claire, Wis., who attributes smoking throughout her first pregnancy to her daughter’s being born two months prematurely and weighing only three pounds.

In the commercial, she demonstrates how she could not hold her newborn daughter, who was confined to a neonatal incubator. As she opens a small oval door on the incubator, tears well in her eyes. “My tip to you,” she says, “is speak into the opening so your baby can hear you better.”

Public service announcements generally rely on donated ad space, and they run infrequently and during programming with lower viewership. But the federal effort gets its funding through the Affordable Care Act, with the C.D.C. spending a total of $102.5 million to produce and place the ads in 2012 and 2013, and it is budgeted to spend an additional $60.2 million this year.

Kenneth E. Warner, a public health professor at the University of Michigan and founder of the university’s Tobacco Research Network, said funding made a big difference in the success of antismoking campaigns.

“Campaigns that are mounted by an organization that is paying for them are hugely different from other P.S.A.s, which typically rely on donated ad space and get very little time and not much coverage,” Mr. Warner said. His research suggests that well-funded antismoking campaigns are the third-most-effective measure for reducing smoking levels, behind high cigarette taxes and laws against smoking in certain places.

The 2012 C.D.C. campaign was the subject of a 2013 article in The Lancet, which credited the ads with motivating 1.6 million smokers to try to quit — with more than 100,000 of them successfully doing so. The telephone number promoted in the campaign, 1-800-QUIT-NOW, received about 365,000 calls during the 12 weeks that the ads ran in 2012, more than twice the number of calls in the same period of 2011.

To date, the campaign has featured 26 people, including a few nonsmokers who had asthma attacks because of secondhand smoke. Some of the smokers had conditions like Buerger’s disease, which may result in the amputation of limbs and extremities; oral and lung cancer; and gum disease that resulted in the loss of most or all of their teeth.

One subject of the ads, Terrie Hall, who was first featured in 2012, appeared in another ad in 2013 as her throat cancer spread to her brain. She died in September 2013, at age 53. Graphic commercials and online videos featuring Ms. Hall, who is featured posthumously in the current ads, have been viewed more than 5.5 million times on YouTube.

Mr. Wright, the throat cancer survivor shown in current ads, was filmed in 2012, when he was featured in an ad that included others with stomas, but this year marks the first time he appears solo.

Now 53, Mr. Wright said it could be difficult to watch himself in the ad.

“When I see myself in a compromising position, it does get to me a little bit,” he said. “But if people see me and know a little bit about my story, they might have second thoughts about even starting to smoke, and you just put your modesty aside when you’re doing the right thing.”

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CDC finds coverage for HPV vaccination among teens is still low

Fri, Jul 25, 2014

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Source: medicalnewstoday.com
Author: staff
 

Although there has been a slight increase in human papillomavirus vaccination coverage among adolescents since 2012, a new report from the Centers for Disease Control and Prevention states that vaccine coverage in this population remains “unacceptably low”.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the US. There are more than 150 types of HPV, 40 of which can be contracted through skin-to-skin contact during vaginal, anal or oral sex.

Low-risk HPV types, such as HPV-6 and HPV-11, can cause warts around the genitals or anus. But high-risk types, including HPV-16 and HPV-18, account for approximately 5% of all cancers worldwide.

Specifically, HPV-16 and HPV-18 account for around 70% of all cervical cancers and almost 50% of all vaginal, vulvar and penile cancers. HPV-16 is also accountable for more than 50% of throat cancers.

There are currently two vaccines available for HPV, which are administered in three shots over 6 months. Cervarix and Gardasil are used for the prevention of cervical cancer, while Gardasil can also protect against anal, vulvar andvaginal cancers and genital warts.

The Advisory Committee on Immunization Practices (ACIP) recommends that preteen girls and boys aged 11 or 12 are vaccinated against HPV. The vaccination is also recommended for teenage girls and young women up to the age of 26 who did not receive it when they were younger, and teenage boys and young men up to the age of 21.

HPV vaccination coverage increased in 2012-13, but remains too low

But despite these recommendations, a new report from the Centers for Disease Control and Prevention (CDC) – published in this week’s Morbidity and Mortality Weekly Report - estimates that in 2013, only 57% of girls and 35% of boys ages 13-17 years received one or more doses of the HPV vaccine.

The figures came from results of the CDC’s National Immunization Survey-Teen (NIS-Teen), which includes vaccine information via telephone surveys for adolescents aged 13-17 years from across the US.

The CDC investigators did, however, find that HPV vaccination coverage increased slightly among girls between 2012-13, from 53.8% to 57.3%, although only a third received the complete three doses. Teenage boys saw a greater increase in vaccination coverage, from 20.8% to 34.6%.

But still, the CDC say HPV vaccination coverage among adolescents is too low, particularly when compared with coverage to other vaccination types. For example, another report from the CDC found that almost 86% of adolescents received one dose of the Tdap vaccine last year, which protects against tetanus, diphtheria and whooping cough.

A 10-year national objective in the US – set in 2010 by Healthy People 2020 – is to reach 80% HPV vaccination coverage among adolescents. These latest statistics suggest there is a lot of work to be done. But lead author of the report, Shannon Stokley, assistant director for science at the CDC’s Immunization Services Division, says they also show the 80% vaccination coverage target is realistic:

“The data on missed vaccination opportunities tells us that it is possible. When we look at the most recent cohort of girls that turned 13, 91% of them had a health care encounter where they could have started the HPV vaccine series before their 13th birthday.

Also, 86% of 13-17 year-olds have received the Tdap vaccine. What these numbers tell us is that preteens and teens are getting to the doctor and they are getting vaccinated, but they aren’t always receiving the HPV vaccine.” 

Why is HPV vaccination coverage still low?

From NIS-Teen, the CDC investigators were also able to establish some reasons as to why HPV vaccination coverage remains low among adolescents.

They found that clinicians’ recommendations significantly influenced a parent’s decision of whether to have their children vaccinated against HPV.

Of parents whose daughters were vaccinated, 74% said they received a recommendation from their doctor, while 52% of parents who did not have their daughters vaccinated received a doctor’s recommendation. Among parents whose sons were vaccinated, 72% received a recommendation, while only 26% of parents whose sons were not vaccinated received a recommendation.

Based on these findings, Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunization and Respiratory Diseases, believes health care professionals are key in boosting HPV vaccination coverage among adolescents in the US.

“Pediatricians and family physicians are uniquely situated to prevent missed opportunities by giving HPV vaccine during the same visit they give Tdap and meningococcal vaccines,” she adds.

Parents also revealed that concerns over the safety of the HPV vaccine deterred them from vaccinating their children. However, the CDC stress that – after analyzing national postlicensure vaccine safety data – no serious safety concerns have been linked to the HPV vaccine in the 8 years it has been available.

The investigators point out that the most commonly reported side effects of the vaccine include dizziness, fainting, nausea and headache, and injection-site reactions – including pain, redness and swelling.

When we asked Stokely what needs to be done to alleviate parents’ concerns about vaccinating their children against HPV, she replied:

“Parents need to see information in mainstream media that HPV vaccination is very effective at preventing infection with the types of HPV that cause the most cancers. Parents also need to hear that the HPV vaccine is safe and that it is recommended to be given when their children are 11 or 12 years old, before their risk of acquiring an HPV infection increases.”

In conclusion to the report, the CDC say they will continue efforts to team up with state and local immunization programs, cancer organizations, professional organizations and other stakeholders in an attempt to educate parents and health care professionals about the importance of the HPV vaccine, adding:

“Collaborative efforts remain critical to promoting HPV vaccination so that the nation’s adolescents are protected against vaccine-preventable, HPV-associated cancers.”

Earlier this year, Medical News Today reported on a study claiming that two thirds of healthy American adults areinfected with one or more of 109 strains of HPV.

 
*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
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Former LA Laker Michael Cooper diagnosed with tongue cancer

Tue, Jul 22, 2014

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Source: insidesocal.com
Author: Mark Medina
 

Former Laker Michael Cooper will take a leave of absence as the head coach of the WNBA’s Atlanta Dream because of early stage tongue cancer. Cooper plans to have a surgical procedure this week at the Winship Cancer Institute of Emory University in Atlanta and is expected to recover in two weeks. Assistant coach Karleen Thompson will assume head coaching duties during Cooper’s absence.

“The doctors and staff at Emory have been tremendous, and I know I’m in good hands,” Cooper said in a statement. “I’m fortunate that my condition was diagnosed early, and this episode illustrates the importance of screening and early detection. I know the team will be in good hands with Coach Thompson at the helm during my absence, and I look forward to returning to the court soon.”

Cooper has guided Atlanta to an Eastern Conference best 15-6 record in his first season. He also coached the East to a 125-124 overtime win at the WNBA All-Star game on Saturday.

Cooper is best known as a defensive specialist with the Showtime Lakers (1978-90) where he won five NBA championships. He also coached the Los Angeles Sparks to two WNBA championships (2001, 2002). Cooper left his second stint with the Sparks to coach the USC’s women’s basketball team. But he resigned in March after finishing 11-20, his first losing record in four seasons.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

 
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Health Insurance providers still take advantage of consumers despite Obamacare

Mon, Jul 21, 2014

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Source: huffingtonpost.com
Author: Jeffrey Young
 

No law has done more to reform health insurance and protect consumers against the industry’s most heinous practices than the Affordable Care Act. But Obamacare didn’t magically transform insurers into benevolent entities solely devoted to taking care of sick people.

Health insurance companies, even those that are not-for-profit, have to collect more money in premiums than they shell out in claims for medical care. That means they have a financial incentive not to pay for things.

And since health insurance companies can no longer shun the sick to maximize profits — either by denying coverage to people based on their medical histories or by rescinding the policies of paying customers who fall ill and rack up bills — insurers are employing other tactics to shift costs to sick people and make it harder to get health care, consumer advocates say.

“One of the things that occurred to me, even as the bill was working its way through Congress, was that once it was passed, insurers would do all they could to try to preserve profit margins,” said Wendell Potter, a former Cigna executive turned industry critic.

Here are a few of the tactics that consumers and advocates have complained about:

Refusing to pay for medical care that should be covered

Nothing in Obamacare says insurance companies have to pay any bill that comes their way. That’s fine, because doctors and patients want things all the time that are wasteful and unnecessary, and everyone shares the cost for that.

Zoë Keating is a musician with more than 1 million followers on Twitter. Her husband, Jeffrey Rusch, had been diagnosed with cancer at the emergency room, hospitalized and given chemotherapy. The insurance company refused to cover it – until Keating told her story to a San Francisco television station, according to reports on KPIX.

While the Affordable Care Act beefed up patients’ right to appeal denials by insurance companies, people still have to fight, which is to the insurer’s advantage. “A lot of people just simply don’t understand their appeals rights and don’t appeal, or think that they just don’t have a chance of getting something overturned,” Potter said. “The insurance companies know that.” Most people don’t have a million Twitter followers, either.

Making patients pick up a bigger share of the bill

To keep premiums as low as possible, insurance companies are pushing more of the cost of actual care on to their customers in the form of things like high deductibles and “coinsurance,” which requires patients to pay a percentage of the cost of their care, instead of making a flat copayment.

And it’s virtually impossible to learn in advance how much medical care will actually cost, meaning patients are left in the dark.

“What this means for someone with cancer is that they may end up being directed away from a plan because they can’t find out whether their doctor is in the network, or whether the plan covers their drugs, on what tier and how much they have to pay out of pocket,” said Kirsten Sloan, senior director policy at the American Cancer Society Cancer Action Network. Sending a cancer patient to a competitor would count as a win in the insurance industry.

Designing benefits to make the sickest patients pay more for drugs

Advocates for patients with serious medical conditions have been incensed by the practice of “tiered” drug lists, which have become a popular way for insurers to limit their expenses. Under this mechanism, the amount patients pay at the pharmacy is generally lower for cheap generic medicines and “preferred” brand-name drugs, higher for other brand-name drugs and higher still for the most expensive specialty medications.

High cost-sharing and top-tier status for drugs that treat ailments like HIV and multiple sclerosis are common in insurance policies bought via the Obamacare exchanges, the consulting firm Avalere Health reported last month. That looks an awful lot like insurers discriminating against sick people, the AIDS Institute claimed in a complaint filed against four Florida insurers with the federal government in May.

“Where we’ve seen the problems is putting every single HIV drug, including generics, on the highest tier, and that with very high coinsurance, like 40 or 50 percent,” said Carl Schmid, deputy executive director of the AIDS Institute. “There’s plenty of plans in Florida that don’t do this, and charge $10, $20 a copay for the same drugs.”

Limiting access to doctors and hospitals

Health insurance plans sold via Obamacare exchanges often have “narrow networks,”or shorter lists of medical providers that accept those plans than people with job-based insurance or Medicare might expect. Insurers need to keep costs down, and tough negotiating with high-priced doctors and hospitals can do that. This ends up saving the whole health care system money, including insurance customers.

The trouble is, when those networks don’t include enough of the specialty care providers that take care of the sickest, most expensive patients – like, say, cancer centers – it has the effect of denying care to those very sick people because they can’t get appointments.

“Insurers might try to avoid people with HIV or cancer or expensive conditions by avoiding the doctors that tend to treat those people, but otherwise their network looks robust,” said Karen Pollitz, a senior fellow at the Henry J. Kaiser Family Foundation. “Whether it’s happening — no way to know yet.” The Obama administration and state regulators are poised to take action to compel insurers to beef up their networks, The New York Times reported.

Rolling out the red tape

To save money, insurance companies will be stricter about approving and paying for medical treatments, said Carmen Balber, executive director of the nonprofit organization Consumer Watchdog. “I have no doubt that claims denials or delays will be the new discriminatory tactic of the industry,” she said.

In Seattle, one doctor said she has to work harder to get treatments approved this year. “There are more hoops that the provider has to jump through,” said Grace Wang, the medical director of the International Community Health Services Holly Park Medical and Dental Clinic.

Wang returned to the clinic after Memorial Day weekend and attempted to follow up on a request she’d made to refer a patient to a specialist. The insurance company said her request already had been rejected because she hadn’t called back quickly enough.

“Their clock started ticking on Sunday. Monday was a national holiday, and so when 48 hours went by, they denied,” said Wang. “A conspiracy theorist would wonder.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
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Florida jury awards $23 billion for punitive damages to widow in lawsuit against R.J. Reynolds

Mon, Jul 21, 2014

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Source: reuters.com
Author: Barbara Liston
 

A Florida jury has awarded the widow of a chain smoker who died of lung cancer punitive damages of more than $23 billion in her lawsuit against the R.J. Reynolds Tobacco Company, the nation’s second-biggest cigarette maker.

The judgment, returned on Friday night, was the largest in Florida history in a wrongful death lawsuit filed by a single plaintiff, according to Ryan Julison, a spokesman for the woman’s lawyer, Chris Chestnut.

Cynthia Robinson of Florida Panhandle city of Pensacola sued the cigarette maker in 2008 over the death of her husband, Michael Johnson.

Johnson, a hotel shuttle bus driver who died of lung cancer in 1996 at age 36, smoked one to three packs a day for more 20 years, starting at age 13, Chestnut said.

“He couldn’t quit. He was smoking the day he died,” the lawyer told Reuters on Saturday.

After a four-week trial and 11 hours of jury deliberations, the jury returned a verdict granting the widow $7.3 million and the couple’s son $9.6 million in compensatory damages.

The same jury deliberated for another seven hours before deciding to award Robinson the additional sum of $23.6 billion in punitive damages, according to the verdict forms.

Lawyers for the tobacco company, a unit of Reynolds American Inc [RAI.N] whose brands include Camel cigarettes, could not immediately be reached for comment.

But J. Jeffery Raborn, vice president and assistant general counsel for R.J. Reynolds, said in a statement quoted by the New York Times that the company planned to challenge “this runaway verdict.” Such industry appeals are often successful.

Chestnut countered, “This wasn’t a runaway jury, it was a courageous one.”

Robinson’s lawsuit originally was part of a large class-action litigation known as the “Engle case,” filed in 1994 against tobacco companies.

A jury in that case returned a verdict in 2000 in favor of the plaintiffs awarding $145 billion in punitive damages, which at the time was the largest such judgment in U.S. history.

That award, however, was tossed out in 2006 by the Florida Supreme Court, which decertified the class, agreeing with a lower court that the group was too disparate and each smoker smoked for different reasons.

But the court said the plaintiffs could file lawsuits individually. Robinson was one of them.

The Florida high court also let stand the jury’s findings that cigarettes are defective, dangerous and cause disease, and that Big Tobacco was negligent, meaning those issues did not have to be re-litigated in future lawsuits.

 
*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
 
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