Lisa DeFerrari

Learning about progress against cancer has been a main theme here on After Twenty Years since I started this blog about five years ago. One of my first posts in 2013 was a look back at progress against breast cancer in the twenty years since I had been diagnosed

Earlier this month, the long-awaited results of the TAILORx clinical trial were announced. The findings from this study are important for early stage breast cancer patients with hormone receptor-positive breast cancer

The category of immune system therapies known as PD-1 inhibitors or checkpoint inhibitors, which “release the brakes” on the immune system to attack cancer cells, have been shown to be very effective for some patients with advanced cancer. Another major form of immunotherapy is CAR T-cell therapy, in which a patient’s own immune cells are withdrawn from a blood sample, engineered to attack cancer cells and then injected back into the patient’s bloodstream. The study looked at whether, for patients with HER2-positive breast cancer, adding an ACE inhibitor or a beta blocker to treatment could reduce risk for heart disease. This ground-breaking work is not only helpful for women from families with many cases of breast cancer, it will improve breast cancer risk prediction for all women, and pave the way for the development of epigenetic therapeutics for breast cancer.

Rosenthal walks us through egregious changes that have occurred in recent decades in the role of health insurance, the management of hospitals and physician practices, and the development and marketing of drugs and medical devices–all geared toward increasing profits generally without regard to the impact on patients. For example, in the chapter on pharmaceuticals, Rosenthal refers to the changes in regulations in the 1990s that led to tremendous growth in direct-to-consumer drug advertising and points out that drug companies now claim that such advertising expenditures are part of the “cost” of a bringing a new drug to market. She says: Pharmaceutical companies like to say it takes well over $1 billion to bring a new drug to market: the costs of the basic science, developing a new compound, figuring out the right dose, and the FDA process of human testing for safety and efficacy. In chapters addressing doctors’ bills, hospital bills, insurance costs, and drug and medical device costs, she lists both practical steps we can take now and system reforms we can demand of the medical industry and our elected and appointed officials responsible for regulating its practices.