RELATED MEDICAL ISSUES RIGHT NOW! #8: Racial Disparities in Alzheimer’s and Breast Cancer Treatments

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

From the first moment I discovered my dad had been diagnosed with Alzheimer’s, it seemed like I was alone in this ugly place. Even ones who had loved ones suffering in this way; even though people TALKED about the disease, it felt for me like they did little more than mumble about the experience. Not one to shut up for any known reason, I added a section to this blog…

The immediate crises that were Breast Cancer and Alzheimer’s have passed. There are, however ancillary issues like testing and treatments that may not be directly related to BC or A but intersect with them. Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: Racial Disparities in Alzheimer’s and Breast Cancer Treatments (See also: https://breastcancerreaper.blogspot.com/2022/01/related-medical-issues-right-now-4.html)

There are countless resources, news reports, and investigative pieces that clearly and concisely delineate the problem – if you are any race but white and have anything but comprehensive health insurance, your treatment for a breast cancer diagnosis or one of Alzheimer’s Disease will be far, far, far away LESS effective and virtually unaffordable.

I placed sources sources below, all of them CURRENT (2022). So, let’s just not argue. The facts speak for themselves. If you disagree, don’t bother trying to justify or argue, just leave peaceably. If you leave a stupid comment, I won’t bother reading it, delete it, and you won’t bug me AT ALL.

I have nothing to say to fools.

So, what’s being done to address this monstrous inequity?

Some things ARE being done!

Breast Cancer: “Sisters Network Inc. is committed to increasing local and national attention to the devastating impact that breast cancer has in the African American community.” They host events, an important one? STOP THE SILENCE Walk, https://www.stopthesilencewalk.org/. Held annually in Houston, Texas; this event is a major fund raiser for Sisters Network Inc. As well, “In 1999, Sisters’ broke new ground by hosting the nation’s first national Breast Cancer Conference to specifically address the impact of breast cancer among African American women. Now in its 12th year, the conference, which attracts more than 600 participants, including nationally recognized medical experts, has been held in metropolitan cities such as Houston, Atlanta, Detroit, Richmond Virginia and Chicago.” They also have a specific outreach program: “Sisters’ national branding campaign, "STOP THE SILENCE®," speaks directly to the nations, African American communities, long-standing history of not discussing cancer and other life-threatening health concerns.”

Evidence shows that the precipitous drop of breast cancer screenings hit ALL women, but was especially devastating among lower socioeconomic groups: “The COVID-19 pandemic has disrupted…cancer screening…in the United States and Europe have shown that cancer screening dropped dramatically during the pandemic…a modeling study estimated that delayed and missed screenings would likely increase breast cancer deaths…by 7.9% to 9.6%...This adverse impact…may differ among sociodemographic groups, given the disproportionate impact the pandemic has had on underserved racial and ethnic groups and other vulnerable population groups.”

Alzheimer detection and treatment among lower socioeconomic groups was low to begin with, “Alzheimer’s…the most frequent cause of dementia, is a progressive degenerative brain disorder affecting approximately 5.5 million people in the US, 24 million people worldwide…The average post-diagnosis AD survival rate is typically 5 to 8 years. However, this tends to vary among patients due to other factors such as age, gender, ethnicity, socioeconomic status, and additional health complications…”

The study concludes, “…socio-economic disparities exist worldwide between countries, influencing the validity of results in cross-cultural research. These disparities are reflected in the variability of educational levels and the quality of education. A universal socio-economic and educational assessment approach would improve reliability in comparing AD risk and progression in diverse groups, between and within countries.” A UNIVERSAL APPROACH??? How would that even be possible? It boggles the mind – and most of all, who would possibly pay for it? Insurance companies? Most likely not because there would be no profit in it – though that might NOT be true…

Lastly, the study below also points out that there are multiple issues even defining who and what they are looking for. How can you equitably screen a white, wealthy, Harvard graduate and a black, poor Haitian for Alzheimer’s symptoms – separated by 2400 kilometers? It boggles my mind to even consider DEVELOPING a tool, let alone using it…

There is so much here, I may write a science fiction story about it. It seems like that might be the only place this could be solved.

Resources:
https://www.sistersnetworkinc.org/index.html, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780067, https://link.springer.com/article/10.1007/s13311-022-01193-z
Image: https://cdn.mos.cms.futurecdn.net/zsbWK9QgLFjUJwawbWaYnW-970-80.jpg.webp

ENCORE #185! – NO Benadryl Redux!

From the first moment my wife discovered she had breast cancer in March of 2011, there was a deafening silence from the men I knew. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry first appeared in June of 2017…

When my wife began her chemotherapy in 2014, we knew she was going in for the most aggressive treatment. The first day, we checked in, and after the nurses “hooked her up”, they added a Benadryl drip.

We all know that Benadryl is supposed to dampen an allergic reaction, but what was it supposed to do during chemo? Here’s what I found: “Diphenhydramine works by blocking the action of histamine, a substance in the body that causes allergy-type symptoms. It has also been found to be slightly effective against the nausea and vomiting that can be caused by chemotherapy and/or help prevent side effects from other anti-nausea medications.”

So, in order to reduce nausea, they gave her Benadryl. Cool.

The effect in HER, however overshadowed any possible lessening of the nausea. Her legs began to wildly spasm – a sort of “SUPER-restless-leg-syndrome” (Which see here: http://breastcancerreaper.blogspot.com/2017/03/encore-58-dealing-with-restless-limb.html).

So what does this (thankfully!) long-past reaction have to do with today?

Rashes. She’s discovered that she gets hives on her head and chest. It’s a reaction that actually has a name: Sun Allergy (http://www.health.harvard.edu/allergies/sun-allergy-photosensitivity)

Chemo drugs – in fact ANY drug – can cause some form of photosensitivity. “Photosensitivity is an enhanced skin response to ultraviolet radiation (sunlight). There are three types of photosensitivity reactions phototoxic, photoallergic and UV recall reaction. Phototoxic reactions are common photosensitivity reactions and can be produced in most individuals given a high enough dose of drug and sufficient light exposure. These photosensitivity reactions are usually evident within 5-20 hours of exposure and resembles an exaggerated sunburn (redness, swelling, blistering, weeping and peeling). The rash is confined to areas exposed to light. Drugs associated with these photosensitivity reactions are dacarbazine, fluorouracil, methotrexate and vinblastine. Photoallergic reactions are less common than phototoxic reactions. A photoallergic reaction is similar to a phototoxic reaction but the reaction may spread beyond area's exposed to light. A drug that may have this photosensitivity reaction is flutamide.”

Do we KNOW this is what happened? No. Does it seem possible? Yes. Maybe we can move forward from here, eh – that is, “Just one MORE thing to think about post-cancer!”

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

ALZHEIMER’S RESEARCH RIGHT NOW! #18: FDA Approves First In Vitro Test for Early Alzheimer’s Disease!!!

From the first moment I discovered my dad had been diagnosed with Alzheimer’s, it seemed like I was alone in this ugly place. Even ones who had loved ones suffering in this way; even though people TALKED about the disease, it felt for me like they did little more than mumble about the experience. Not one to shut up for any known reason, I added a section to this blog…

Every month, I’ll be highlighting Alzheimer’s research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: In VITRO test for Alzheimer’s markers in Cerebrospinal Fluid!

Up until recently, the only way researchers could detect biomarkers that indicated the accumulation of proteins that are likely the primary cause of Alzheimer’s Disease was to via a spinal tap – or examine the brain tissue after a patient had died. (Such a clinical way to state it…my father passed away three-and-a-half years ago from Alzheimer’s complications from a head injury he got falling off his bed…)

They could also shoot radiation at their heads as well, using Positron Emission Tomography (a PET scan). That’s not the number one choice of doctors and patients everywhere.

So now, the procedure known by the extremely clumsy name Fujirebio Diagnostics’ Lumipulse G β-Amyloid Ratio (1-42/1-40) Test. I’d call it the FDL Test…

But it doesn’t matter what it’s called as long as it does what it’s supposed to do. In this case: “Alzheimer’s is marked by the presence of plaques, or tangles, of beta-amyloid protein in the brain. We can test for them, but until now, the only way to do it was using a PET scan. The new test will do that as well, but requires a spinal tap (which involves inserting a long, thin needle into the lower back, and sucking up a sample of the fluid that’s in the sack around the spine.)

If there’s a strong suspicion of Alzheimer’s in a patient, the doctor can order the test. “The test measures two forms of the protein, referred to as beta-amyloid 42 and beta-amyloid 40. By comparing the amount of each kind, they get a ratio of the two forms of the beta-amyloid. Doing some calculations then can give an idea of whether a person is likely to have amyloid plaques. According to the FDA, using the new test gives results similar to what would be seen in a PET scan.”

Your average PET/CT scanner cost runs between 1.7 million and 2.5 million dollar. Needless to say, your average hospital in Mexico City isn’t going to have one; and if it does, it’s doubtful that the grandmother of a middle-income family would be able to afford it. The new test is much more affordable and will also be more portable.

So, you find out that the patient is likely to have Alzheimer’s. Then what?

“The importance of early diagnosis is essential to effective treatment. But there’s never been an approved biomarker test anyone could use. With it, more efficient clinical trials for new therapies might be developed, and patients, families, and their doctors might take action much earlier in the disease process.”

It’s not widely available yet, but that’s just a matter of time. The efficacy? Hmmm. If you have a spouse, sibling, parent, or grandparent suffering the early stages of Alzheimer’s, you’ll be holding your breath to see if this new test helps!

Resources: https://pharmaphorum.com/news/fda-approves-first-in-vitro-test-for-early-alzheimers-disease/, https://alzheimersnewstoday.com/2022/05/16/alzheimers-diagnostic-test-lumipulse-given-fda-marketing-permission/
Image: https://i.insider.com/605cf658106eb50019d05b11?width=1000&format=jpeg&auto=webp

ENCORE #184! – Chemo Killed Colds…and Other Weird Thoughts

From the first moment my wife discovered she had breast cancer in March of 2011, there was a deafening silence from the men I knew. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry first appeared in December of 2012 – almost a decade ago…

My wife’s down with a coughing, miserable, fever-full something-or-other, most likely the most recent form of the noravirus...

Working in an elementary school, she’s usually immune to whatever plague is making its way through the general population. But when something smacks into the school and it’s new, and the kids are staying home in droves…well, the staff usually gets it and it wipes them out, too.

So she’s down for the last day before Christmas Vacation.

It wasn’t like that during chemo. We’ve talked about it before. All of the normal illnesses seemed to give way in front of the onslaught of Taxotere (http://breastcancerreaper.blogspot.com/2011/10/whats-it-do.html), Adriamycin (http://breastcancerreaper.blogspot.com/2011/10/adriamycin-whats-it-do.html), and Cytoxan (http://breastcancerreaper.blogspot.com/2011/11/cytoxan-whats-it-do.html), grouped with Neulasta (http://breastcancerreaper.blogspot.com/2011/11/neulasta-whats-it-do.html).

But was that truth or only appearance?

Appearance, I guess (http://www.cdc.gov/cancer/preventinfections/patients.htm); though the FACT was that my wife got sick with garden-variety colds and infections less often while she was taking chemo and a reasonable conclusion would be that her blood would be highly toxic to anything else that got into her.

BUT…what about neulasta (the brand name of a compound called PEG-filgrastim)? If white blood cells fight off disease and neulasta BOOSTS the white blood cell count…

I did a lengthy search, but can find virtually NOTHING regarding people who have taken neulasta without having some sort of disease. While one of the side effects of using neulasta is a decrease in mineral bone density, there don’t seem to be any other consistent and wide-spread reactions (of course, there are isolated incidences of nausea, etc. One person even reacted by getting horrible pocks of dead and dying flesh (called Sweets Syndrome)).

It would be interesting to find out if there have been instances of people who took neulasta without having any sort of illness. Would they have a super-immune system? Would they sail through life without illness? Don’t know. The intent of neulasta injections coupled with chemotherapy is to boost the immune system’s response in order to ward of infections during the treatment. That’s what it did for my wife.

The question I have is that if it did that during chemotherapy when the immune system was weak; what would it do for a HEALTHY immune system?

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg