Friday, May 27, 2022

New supply-chain shortage is heightening anxiety for many patients in U.S. worried about cancer

A Covid lockdown in China could cause long delays in cancer imaging in the United States.

According to a story by Reed Abelson in yesterday's editions of The New York Times, a nationwide shortage of iodinated imaging agents needed for CT scans — a procedure "that relies on a special dye often injected into patients to better visualize their blood vessels, intestines and organs like the kidney and liver" — may be prompting "hospitals to ration these tests except in emergencies."

The problem was the closing of one specific Shanghai plant stemming from a lockdown aimed at quelling a coronavirus outbreak, the latest example of the U.S.'s "vulnerability to disruptions in the global supply chain."

Abelson's article goes on to say that "as many as half the nation's hospitals are affected by the shortage." 

Some 50 million exams with contrast agents are performed annually in the United States.

The Times piece says that while noting that "someone with a stroke or heart attack" also may not be able to get an angiogram because of the dye shortage, Dr. Robert Califf, U.S. Food and Drug Administration commissioner, told a Senate committee the situation is "just unbelievable."

The article additionally quotes Dr. Jamie McCarthy, chief physician executive at Memorial Hermann Health System, a large Houston hospital group, as saying, "The hits just keep on coming in this pandemic in the supply chain."

Dr. William Dahut
And Dr. William Dahut, chief scientific officer for the American Cancer Society, also was quoted to the effect that the lack of contrast dye in an exam can make it more difficult to diagnose cancer.

Some patients, the Times piece contends, "may be able to have an MRI in place of a CT scan or have the exam performed without contrast. Still, for many patients, "the shortage leaves them in limbo."

Dr. Shikha Jain, a Chicago oncologist, says the shortage and resultant delays are "definitely causing more stress for patients." 

Dr. Matthew Davenport, vice chair of the commission on quality and safety for the American College of Radiology, likened the situation to the current scarcity of baby formula.

More information about treatment problems can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Tuesday, May 24, 2022

New study out of Stanford University suggests Covid brain fog and chemo brain might overlap

Researchers say Covid brain fog may mirror chemo brain — and Alzheimer's.

The major premise of a new study, according to a recent story by Ariana Eunjung Cha in The Washington Post, is that the brain inflammation in so-called long Covid is similar to that in cancer patients.

Dr. Michelle Monje
The study by Stanford University neuroscientist Dr. Michelle Monje, the article states, "is part of a crucial and growing body of research that suggests similarities in the mechanisms of post-covid cognitive changes and other long-studied brain conditions, including 'chemo brain,' Alzheimer's and other post-viral syndromes following infections with influenza, Epstein-Barr, HIV or Ebola."

Avindra Nath, intramural clinical director of the neurological disorders and stroke unit of the National Institutes of Health, declares that "there is humongous overlap" between long-Covid and those other conditions.

Monje, the Post article says, "was fascinated" to find similar brain changes among patients with chemo brain and Covid brain fog. "It was really quite striking," she's quoted as saying.

In cancer patients undergoing treatment, the article notes, a malfunction in brain cells that serve as the organ's surveillance and defense system, cells known as microglia, is "believed to be a cause of the fuzzy thinking that many describe. Scientists have also theorized that in Alzheimer's disease, these cells may be impeded, making it difficult for them to counteract the cellular war and tear of aging."

The study by Monje, a MacArthur "genius" grant recipient, involved her collaborating with Akiko Iwasaki, a Yale University immunobiologist who's become one of the leading voices on the coronavirus, and David Putrino, director of rehabilitation innovation for the Mount Sinai Health System in New York. 

The Post story also reports that "another team of researchers from Harvard and Johns Hopkins University School of Medicine have highlighted how both in Covid-19 and chronic fatigue syndrome, too many oxygen molecules pile up in a cell — possibly resulting in inflammation that leads to cognitive issues."

In addition, Cha's article points out that "an examination of brain autopsy tissue by a Columbia University professor from 10 patients who died of Covid-19 turned up a molecular change bearing the distinct signature of Alzheimer's." 

More information about chemo brain can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Saturday, May 14, 2022

Covid could be responsible for a future health-care crisis — not catching cancers early enough

The Covid pandemic has dramatically disrupted cancer screenings, putting thousands of lives in danger.

That's the conclusion of a recent story by Dylan Scott on the vox.com website.

Dr. Steve Serrao
The article quotes Dr. Steve Serrao, chief of gastroenterology and hepatology at Riverside University Health System in Loma Linda, California, as predicting that "the delayed diagnoses of various cancers and other chronic, life-threatening illnesses…will be the next crisis that overwhelms the U.S. health system."

In regard to the possible surge of advanced chronic diseases, Serrao says, "I don't think our systems are ready."

According to Scott's story, the pandemic "dealt a crushing blow to the preventive services that can catch potential health problems before they become life-threatening."

The piece cites figures from 2020, the most recent year for which complete statistics are available, that show colonoscopies dropped by nearly half from the year before, prostate biopsies fell more than 25 percent, and new diagnoses over all "declined by 13 percent to 23 percent, depending on the cancer."

Dr. Brian Englum
The story also quotes Dr. Brian Englum, a University of Maryland surgeon who co-authored a new study in "Cancer," an American Cancer Society journal, as saying that "I think we are in uncharted territory. There are no examples I know of where we have seen numbers change this dramatically."

Just how bad is the situation? Scott contends that "even a four-week delay in treatment is associated with a 6 to 13 percent higher risk of death."

He also maintains that research has shown that "people who have skipped appointments or didn't get screenings or care may be less likely to seek it in the future, and the problems could compound."

Englum says that while "we've already lost a lot of people," nobody knows "how many of these cases are out there."

More information about waves of disease can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.