Tag Archives: Mayo Clinic
But why has it taken so long to help with drug side
Especialhy those with heart problems
Today, anyone battling with long term side effects from cancer treatment, is finally being listened to. If you have heart problems, neuropathy, osteoporosis, lymphoedemia, dry dry skin, and other problems which turned up after treatment, and one dealt with alone, you are being taken seriously.
No longer do oncologists pooh pooh these conditions and blame them on your age, the menopause, or anything else to fob us off.
BBC asks question
on their Website
Top story on website (4.9.11) said
“Senior officials discussed handing the management of up to 20 English NHS hospitals to overseas companies, emails released by the government indicate.
Talks included plans to hand over one hospital at a time due to “political restraints”, the Observer reports.
It comes as Lib Dem peer Shirley Williams said she has “huge concerns” over the NHS reform plans.
Health Secretary Andrew Lansley says claims the government aims to privatise the NHS are “ludicrous scaremongering”.
The emails were released after a Freedom of Information request by non-profit investigations organisation Spinwatch.
They are reported to show that consulting firm McKinsey was acting as a broker between the Department of Health and “international players” for contracts worth hundreds of millions of pounds.
One email talks about “interest in new solution for 10-20 hospitals but starting from a mindset of one at a time with various political constraints”.
The Department of Health said it was not unusual to hold meetings with external organisations and that NHS staff and assets would always remain wholly owned by the NHS. Er – does PFI spring to mind?
Would it work?
Predictably, Christina McAnea, head of health at the union Unison, said: “People are rightly proud of an NHS that puts patient need before private profit, and voting through this Bill will be the end of the NHS as we know it.”
But today’s NHS is NOT putting ‘patient need before private profit’. Already organisations and charities are expressing concern that patients are suffering because of measures designed to save money, by contracting out services.
Andrew Lansley must be concerned at the way the Health Bill will be hauled apart this week in Parliament.
Handing over a sample hospital to a foreign company to run might – just might – shake up the NHS to provide a better service to patients.
Who should be involved?
If the NHS selected three hospitals to try this out, we could learn from other country’s practices.
An Interpreter friend who spends her working day in NHS hospitals commented on the excellence of hospitals in India. Here, the best hospitals have a system where patients’ test results, together with doctor’s comments, are emailed to them at home.
If anyone has tried to get test results from scans, X-ray, Ultrasound, blood tests, etc. out of a hospital here this sounds like Utopia – but is normal at some hospitals in India.
Many UK patients are now flying to India for operations; whilst I question if a long haul flight is best undertaken by someone recovering from anaesthesia etc. there is no doubt that this service is expanding. So what are hospitals doing better in India? And what could we copy?
From David Cameron downwards, the Coalition Government constantly talks about the benefits of French health care. So why not let us see if it is better by getting a French team to take over one of our hospitals? Perhaps Mid-Stafford, or one of those recently in the news for the worst reasons?
For a start, we would learn you don’t need referral letters; French medics think we do have a brain and can self-refer (under certain guidelines).
Yes, there are horror stories – but there are also many success ones. Researching new treatments for Diabetic Neuropathy, I am told by top UK doctor that the Mayo Clinic in the States is world leader in diabetes treatment. They seem to have excellent results by using exercise, so I contact Diabetes UK to ask them what they know of this exercise programme. Back shoots email: “what is the Mayo Clinic?” Makes one weep.
But we are supposed to have over two million patients with diabetes in UK – why not let Mayo Clinic take over one of our diabetic outpatient departments at least? So our doctors could learn from them.
Under its ‘one size fits all’ policy, the government is trying to overhaul the way the NHS in England works, giving GPs and other clinicians much more responsibility for spending and encouraging greater competition with the private sector.
Lansley has said: “The reality is that we’re giving more power and choice to patients over how they get treated, keeping waiting times low and cutting bureaucracy so more cash gets to the front line”.
Meanwhile, Lady Williams said the battle over the Health Bill was “far from over” and the reforms “need not mean upheaval and disintegration”. Writing in the Observer, she said: “I am not against a private element in the NHS, which may bring innovation and good practice, provided it is within the framework of a public service – complementary but not wrecking”.
But most observers fear that, instead of listening to informed opinion, Lansley will go about introducing reform across the board, not waiting to see if something works in one hospital, then gradually rolling this out across the board.
If La La and his cohorts could be made to think of the benefits to patients, rather than massaging their political egos, it would be very, very interesting to hand over – say – three of our underperforming hospitals to three providers from three different countries, and monitor what happens.
should be part of your healthcare
Especially now the Health Bill
- doctors cutting down on time allocated to give you advice
- doctors prescribing the cheapest drug – often not bothering to check if you might not be able to tolerate this
- doctors may have no time to check if a drug they prescribe will counter re-act with another
Role of pharmacists in cancer care
Neal Patel, MRPharmS, spokesperson for the Royal Pharmaceutical Society says
“We’d like to see pharmacists as a key part of the multi-disciplinary healthcare team in order to optimise the use of medicines and ensure patients get the best possible care.
The NHS reforms offer scope for pharmacists to be more involved in the commissioning and the delivery of services and we want to see pharmacists playing a more central role in improving the health of a wide range of patients, including those with experience of cancer. Pharmacists are the experts in medicines and we know that their expertise contributes significantly to the treatment plan for cancer patients.”
Speaking to Lajja, the Pharmacist in my local Boots, I mentioned I had been prescribed yet another drug to take, and she frowned. Went back to look at my list on her computer, then told me “I think you should check this up”.
Of course, she was right. The ‘new’ drug should not have been prescribed alongside one of my ‘old’ ones. But without her vigilance I could be having more problems.
So when a survey commissioned by the American Pharmacists Association (APhA) and sent by Johns Hopkins, landed in my inbox, I paid attention.
Johns Hopkins forging ahead
Since the massive American research and hospital centre, Johns Hopkins, has been awarded plaudits for the 21st year, they have been bouncing around with ideas – one of which is a survey that says they found people who know their pharmacists by name
- tend to keep them up to date on all the medications they take
- read the labeling information on their prescriptions
- know their medications’ active ingredients
- ask questions about their drugs more often
Survey: Your Pharmacist: An Underutilised Resource
We tend to forget that Pharmacists are trained experts on pharmaceuticals.
- They know about the chemical composition of drugs
- how they function in the body
- the diseases and conditions they are used to treat
- how drugs are absorbed and metabolized by the body.
As patients, we tend to think that doctors are trained in drugs and how they react with us and our other medications. Sorree – you would be horrified if you knew how much – er – how little time is allocated to this important aspect in doctors’ training – and I am not going to tell you because I still don’t believe the little amount of time allocated can be sufficient.
So it makes complete sense to make a friend of your pharmacist; if they offer a service to review your medicines – take it – and talk to them about
- the potential for harmful interactions between your prescription medications and over-the-counter drugs
- dietary/herbal supplements, foods or alcohol
- negative side effects you are most likely to encounter when taking medications and what you can do about them
- activities that might be a problem while you take certain medications
- what to do if you miss a dose
- how to store your medications so that they retain their potency
- ways you might be able to cut your medication costs
- how to properly administer drugs not in pill form, such as inhalers, skin patches and nose- and eyedrops
- advice on over-the-counter medications
Help your pharmacist help you.
If you can, use one pharmacy to fill all of your prescriptions. This allows the pharmacist to keep a complete record of all the drugs you are taking. Pharmacists’ computer systems can identify potential interactions among your medications.
Tell your pharmacist if you start a new drug obtained from a different pharmacy, by mail order or on the Internet.
Finally, when filling a new prescription, inform your pharmacist about what over-the-counter medications and dietary or herbal supplements you are taking along with your prescription drugs.
US hospitals are incredibly helpful, and are a resource I turn to again and again. They are much more inclined to think that patients have a brain, than some of the dodos I come across in British hospitals; most of whom have never heard of Johns Hopkins, or MD Anderson, Dana-Farber, or Mayo Clinic, or any of the massive, ground breaking US cancer centres.
But if you are stuck and want to find out more about your condition – go on to their websites (in Contacts section). You will probably find them incredibly helpful.
Johns Hopkins Health Alerts
500 Fifth Avenue
New York, NY 10110
This information is not intended to substitute for the advice of a physician, nurse or doctor.
Food of the Month
Pink, Red, yellow or ‘white’ – it has been highlighted as being highly nutritious, low in calories and low GI
Grapefruit has a bad name, as it can inter-react with certain drugs. But as long as the medics say it’s OK for you to eat, new research from the world-famed team at the University of Sydney suggests that we should make sure it is included regularly in our diet – particularly if trying to lose weight.
It is University of Sydney that are world leaders into research on GI (Glycemic or Glycaemic Index) foods, with tables showing the amount of GI in foods; the lower the better.
“The tang of fresh grapefruit (GI 25) will not only start your day with zest, just half a medium-sized one will deliver around 70% of your daily dose of vitamin C. Canned grapefruit segments (GI 47) and commercial grapefruit juice (GI 48) are easy year-round options when fresh fruit isn’t available, but as you can see they have higher GI values. In fact, fresh grapefruit has the lowest GI value of all fruit tested so far. It’s not just the acid that has a blood glucose-lowering effect, it’s also the pectin (a type of soluble fibre).
Grapefruit can play a smart part in helping you to reach your weight-loss goals as part of an overall healthy balanced diet being a nutrient-rich food that’s low in calories and high in volume (they are very juicy). A 2006 study in the Journal of Medicinal Food found that ‘half of a fresh grapefruit eaten before meals was associated with significant weight loss (an average of 1.6kg [3½lb] over twelve weeks).’ Insulin resistance also improved.
Writing in the Journal of Agricultural and Food Chemistry Israeli researchers report that a heart-healthy diet supplemented with fresh red grapefruit was effective in lowering triglycerides, a blood fat that’s a risk factor for heart disease. They divided 57 post-operative bypass patients with atherosclerosis (not taking statins) into three groups who were served a standard diet for 30 days with either a single serving of fresh red grapefruit, or a single serving of fresh white grapefruit, or no grapefruit (the control group). The men and women who consumed fresh red or white grapefruit had significant decreases in total and LDL cholesterol levels compared with the control group.
*Eat Red grapefruit and muesli for breakfast
*Toss segments in salads with chickpeas; or fennel and rocket/arugula; smoked salmon and avocado; prawn and avocado; or witlof, radicchio, beets and avocado; or simply add to Asian greens with a citrus dressing.
* Whip up a winter fruit salad with grapefruit and orange segments, a sprinkle of raisins and a drizzle of honey.
* Spritz tangy grapefruit juice and soda for a fresh and fruity drink with fewer calories.
Grapefruit and medication:
Grapefruit and grapefruit juice can interact with a number of medications, either making them work too strongly or causing unpleasant side effects. Mayo Clinic nutritionist Katherine Zeratsky, R.D. says: ‘If you’re concerned about the effect grapefruit juice may have on your medications, talk to your doctor or pharmacist.’
Doctors admit that those who understand and research their cancer treatment, often recover better and more quickly.
As a patient, I found that using the Internet sensibly, I was able to work out more effective treatment and find which cancer centres could give me better advice. When all my UK hospital could offer to deal with skin lesions caused by tamoxifen, was to tell me “it’s your age”, and no advice given at all; thanks to the Internet I found that La Roche Posay in France deals with around 8,OOO cases similar or worse than mine every year, so went there. Thanks to their advice and prescriptions, I was able to stay on the drug; and my skin cleared up almost immediately. And they told me my lesions were certainly NOT due to age!
If you read stories on this website, many of them concern research being carried out at US cancer hospitals and research centres. Recently US News has published their annual list of top cancer hospitals, and highlights the fact that all the top ones have excellent research facilities, and produce patient-friendly websites that are easy for lay people to understand.
So if you have a problem or query, it is worthwhile going onto a US website for more information. Some of the addresses are mentioned in the Contacts pages, but otherwise Google the name of the hospital for the contact. Don’t be frightened – their websites are written in remarkably clear English – and generally very easy to understand, explaining even the most complex problem in a way that comes over as sensible and informative.
Here is list of top 2O, together with ranking allocated by US News – don’t pay too much attention to these rankings – all the centres in the top 2O are worth looking at. If you have a rare cancer, there are 9OO listed in their list, all of which have received plaudits:
University of Texas M.D. Anderson Cancer Center, Houston
Memorial Sloan-Kettering Cancer Center, New York
Johns Hopkins Hospital, Baltimore
Mayo Clinic, Rochester, Minn.
Dana-Farber Cancer Institute, Boston
University of Washington Medical Center, Seattle
Massachusetts General Hospital, Boston
University of California, San Francisco Medical Center
Duke University Medical Center, Durham, N.C.
Stanford Hospital and Clinics, Stanford, Calif.
Ronald Reagan UCLA Medical Center, Los Angeles
Vanderbilt University Medical Center, Nashville
Hospital of the University of Pennsylvania, Philadelphia
Brigham and Women’s Hospital, Boston
Moffitt Cancer Center
University of Chicago Medical Center
Ohio State University James Cancer Hospital, Columbus
University of Michigan Hospitals and Health Centers, Ann Arbor
Fox Chase Cancer Center, Philadelphia
New Breast Cancer Treatment Recommended at San Antonio
Every year, the world’s top Oncologists gather at the San Antonio symposium, in Texas. This year, CancerCompass reports that Doctors at the symposium have found a new protocol for treating breast cancer shows possibly paradigm-shifting results, they say.
Dr. Edith Perez, a breast cancer researcher at a Mayo Clinic campus in Jacksonville, Fla., presented findings showing that administering Herceptin with chemotherapy, instead of after, can result in a 25 percent reduction in cancer recurrence or death, according to a report in Science Daily.
“The results of this trial have been eagerly awaited in the [United States]. and in many nations as this is the only trial developed to define the optimal way to incorporate Herceptin in the context of adjuvant chemotherapy,” Dr. Perez said. “The goal was to decrease the risk of cancer recurrence, and we have shown that concurrent use is the best way to achieve that.”
The study was conducted in collaboration with several cancer-research institutes, the Mayo Clinic said in a release. Perez indicated the results could shift the cancer treatment paradigm.
“This could mean that up to 10,000 women around the world each year may have a better outcome if Herceptin is used along with chemotherapy. Given that, I believe this study will lead to a global re-evaluation of how Herceptin is used,” she said.
So what does this mean for you, if you are receiving Herceptin? First, discuss this with your Oncologist. As background you might like to Google and delve into results from San Antonio – get onto Mayo websites, and ask the makers of Herceptin. The treatment you are having may be the best for you and your circumstances – but it’s worth asking – because San Antonio has a reputation for introducing ground-breaking treatments – and is never ignored by top Oncologists. Just this week New York papers carried an authoratative article by one of their top Cancer doctors, on “what I am changing in my practice after San Antonio this year”.
(According to Wikipedia, a Paradigm shift (or revolutionary science) is the term first used by Thomas Kuhn in his influential book The Structure of Scientific Revolutions (1962) to describe a change in basic assumptions within the ruling theory of science. It is in contrast to his idea of normal science.
INTERNET PROVES A BOON FOR CANCER PATIENTS
Get cancer – and all of a sudden you become an expert Internet surfer.
There is no doubt that Internet Information has improved by leaps and bounds recently, and today there is a lot of very, very useful information available. Best sites I have found are Cancer Research UK – their latest posting gives helpful information about what to look for if you are an Internet ‘baby’:
And the American websites such as Dana-Farber, MD Anderson, Sloane-Ketting, Mayo Clinic, etc.
These American and Canadian websites are excellent and written in patient-friendly language. Look up website addresses in the Contacts category – especially the Canadian Cancer Assn’s helpful site on ‘Cancer Myths’ – guaranteed to explain why you don’t need to worry about anything from deodorants to plastic bottles!
Don’t worry about ‘bad’ sites – it is surprising how quickly one develops an understanding of what websites to avoid – but anything that starts with “How I cured cancer by ……. ” Or “What doctors don’t want you to know…… ” I avoid!