May 18th, 2012
Image credit: Getty Images North America via @daylife
Honestly, cancer isn’t good for you. Actually, it’s very, very bad for you. In fact, it can kill you.
But some good things have happened since I got diagnosed with breast cancer and chemo turned me bald.
Here they are.
1. It makes you more productive.
I don’t know how it happened, but I earned almost as much in the first quarter of 2012 as I did in all of 2011.
I mean, I don’t even know what to really say about that because it is so bizarre.
I was dealing with a breast cancer diagnosis, I had two surgeries, and I started chemo.
One thing that was great for me about working from home is that it was easier for me to deal with my treatment and recovery and keep working. I didn’t feel good? I lay on the sofa. I felt good at some weird hour of the evening? I worked then.
I have never been more happy to be a telecommuter than I am now.
Also, I think cancer helped me reprioritize. When I realized what was really important, I stopped worrying about work so much. When I stopped worrying about work so much, I worked more efficiently.
2. It makes you more creative.
At the same time, I seem to have written 20,000 words of a novel. It’s about a woman who has breast cancer. Which sounds like the worst elevator pitch ever, but it’s also about marriage and love, life and death, and those sorts of things. Plus, it’s funny.
Again, I don’t really know how that happened. Except to say that I was pretty much going to go insane if I didn’t take everything that was happening to me and get it down on (virtual) paper.
In the novel, it’s happening to someone else. Writing it, I get to do something other than internalize, or worry about, or have anxiety over all the weird things that happen along the way. Like the crazy things people say to you. Or the time you almost knock over the stand that the chemo bag hangs from when you’re in the bathroom because you’re trying to flush the toilet with your foot but you’re too high on Xanax and Benadryl to stay upright.
I was talking to a cancer social worker the other day, and he said he was a realist.
“I’m a surrealist,” I said.
3. It makes you walk the walk.
Boy, is it easy to talk the talk. It’s a lot harder to walk the walk. Take, for example, the fact that I don’t wear anything to cover up my bald head so I’ll look less like some freak of nature who has cancer.
Well, yeah, sure, it’s easy to be cavalier when you work at home, and you go outside when you want to, and you don’t have 50 coworkers staring at you and wondering what the hell is wrong with you.
That said, I had a meeting downtown the other day. It really would’ve been better if I’d worn a wig. I wouldn’t have looked so odd. I wouldn’t have stood out so much. I probably wouldn’t have looked so vulnerable. So shorn.
I went to the meeting with my head exposed because I wanted to be the kind of person who looks back at those moments and says, That’s who I am. I don’t cover things up. I let it all hang out.
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May 18th, 2012
FRIDAY, May 18 (HealthDay News) — Inflammation caused by chronic
heartburn may increase the risk of esophageal cancer, a new study
finds.
The condition — formally known as gastroesophageal reflux disease
(GERD) — occurs when a muscle at the end of the esophagus doesn’t close
properly, allowing stomach contents to leak back into the esophagus and
irritate it.
GERD can lead to changes in the tissue lining the esophagus, a
condition called Barrett’s esophagus, often a precursor to esophageal
cancer.
In the study, researchers looked at nearly 34,000 GERD patients in
Denmark and found that 77 percent had inflammation of the lining of the
esophagus, a condition called erosive reflux disease. During an average
follow-up time of 7.4 years, 0.11 percent of patients developed esophageal
cancer.
The incidence of esophageal cancer among GERD patients with erosive
disease was much higher than that of the general population, the team
noted.
In contrast, esophageal cancer was diagnosed in only 0.01 percent of
GERD patients without erosive disease after 4.5 years of follow-up.
The study appears in the May issue of the journal Clinical
Gastroenterology and Hepatology.
“Our research shows that damage to the esophageal lining … is
important in the progression from normal cells to cancer, and Barrett’s
esophagus is likely to be an intermediate step,” lead author Dr. Rune
Erichsen, of Aarhus University Hospital in Denmark, said in a journal news
release.
The incidence of esophageal cancer in the United States and Europe has
increased dramatically in the past three decades. About 10,000 new cases
of esophageal cancer are diagnosed each year in the United States.
Although the study identified an association between inflammation
caused by GERD and increased incidence of esophageal cancer, it could not
prove a cause-and-effect relationship.
More information
The U.S. National Institute of Diabetes and Digestive and Kidney
Diseases has more about GERD.
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May 16th, 2012
Editor’s note: CNN conditions expert Dr. Otis Webb Brawley is the chief medical officer of the American Cancer Society, a world-renowned cancer expert and a practicing oncologist. He is also the author of the book, “How We Do Harm: A Doctor Breaks Ranks About Being Sick in America.”
(CNN) — Q: This week the U.S. Preventive Services Task Force issued preliminary guidelines for ovarian cancer screening. It recommends against routine screening saying that the risk of false positive diagnoses outweighs the benefits. How can this be and why is it so hard to find a good screening test for ovarian cancer?
A: The U,S. Preventive Services Task Force is a group of medical experts who assess the scientific literature on an issue, such as ovarian cancer screening, before making a recommendation. They do influence how doctors practice medicine.
The statement recommends against routine ovarian cancer screening because they find the evidence of harm associated with screening is greater than the evidence of benefit.
Unfortunately we do not have a good screening test for ovarian cancer, the fifth leading cause of cancer death in women. We need something as effective for ovarian cancer screening as pap smears are for cervix cancer screening.
It is a surprise to many that a screening test could be considered more harmful than helpful. The problem is routine ovarian cancer screening starts a cavalcade of medical procedures associated with harms that are greater than the ultimate benefits. Importantly, it is not that there is no benefit to ovarian cancer screening. The problem is there is not a “net benefit.”
The blood test CA 125 is elevated in about half of women who are known to have ovarian cancer. If effectively treated by surgery or chemotherapy, the CA 125 level in the blood goes down. It has been used for nearly three decades to follow progress in treatment.
This test was suggested for screening in the late 1980s. Screening is doing a test in asymptomatic patients who are not suspected of having the disease but are at risk because of age and gender. Very early on, many thought CA 125 would not work well as a screening test.
A teacher gave me this example more than 20 years ago and it still holds. It is dense in numbers, but I think it is followable. It illustrates how a public health physician thinks of a screening test and the trouble with CA 125.
A group of investigators tested the CA 125 blood test for screening in a group of 915 women average age 55, and a total of 36 or 3.9% were abnormal (a level greater than 35 U/ml). These women were evaluated for ovarian cancer and followed. Ultimately none had ovarian cancer.
What if one was to screen 100,000 women? That means 3.9% of the 100,000 or 3,900 women will have false positive findings. Using U.S. cancer incidence data, 13 women in the 100,000 would have ovarian cancer in a given year.
Given that most of the 13 women will be diagnosed with incurable advanced ovarian cancer, a fair assumption is six of the 3,900 will be diagnosed with a potentially curable ovarian cancer.
Given that CA 125 is positive in half of ovarian cancer patients, one would reasonably estimate that three of the six women with curable disease would be identified. That is three potential cures in the more than 3,900 women screened.
Of the 100,000 women, we expect 148 will die of cancer and nine of the 148 will be die because of ovarian cancer within a year of the screen.
That might sound worthwhile at face value, but lets look at the harms of screening. Most of the 3,900 women will get further testing. This consists mostly of ultrasounds and CAT scans. Several hundred will need to get laparoscopy or more invasive abdominal surgery for evaluation.
This is the area of greatest concern. One survey shows 14% of women over the age of 65 have complications after abdominal surgery. Surgical complications cause death in 1% to 2% of women over 65 and one-half of 1% of women over 50, Several hundred women will get abdominal surgery.
When done as a routine test it is quite easy to see that ovarian cancer screening could actually cause the death of more women than the number of women saved. Most of the women who have bad outcomes will not have ovarian cancer.
The gold standard for proving effectiveness of a screening test is a prospective randomized clinical trial comparing a screened group to a group that is not screened over time.
The U.S. National Cancer Institute began such a study in 1993 and published the result in 2011. The trial included 78,216 women aged 55 to 74. It randomly assigned 39,105 to screening and 39,111 to usual care. After an average of more than 12 years of follow-up, the groups had no difference in the ovarian cancer death rate. This means that the trial showed no evidence of routine screening saving lives.
CA 125 is not a good test for ovarian cancer screening, and ovarian cancer may not be a good cancer for screening. What we need is a test that flags fewer people who do not have the disease as suspicious of having the disease. It would be even better if the test found more than half of the women who have the disease. Screening also works better in cancers that tend to stay localized for longer periods of time. Many ovarian cancers spread throughout the abdomen very early in the life of the cancer when the tumor is still very small.
It is important to note that the task force addressed routine screening. The test can be appropriate for screening a woman known to be at high risk for ovarian cancer because of a family history. The test may also be appropriate in assessing a woman who has lower abdominal discomforts.
The opinions expressed in this article do not necessarily represent those of CNN, The American Cancer Society, or Emory University.
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May 16th, 2012
By: Jason Kane
Editor’s Note: As the nation marks National Women’s Health Week, the PBS NewsHour will share the stories of three women — and their doctors — who refused to allow a cancer diagnosis to interfere with a successful pregnancy. These are their stories of hope, perseverance and, ultimately, success.
It’s the kind of pain Gina Danford had spent decades dreading — a cramping, twisting pain in her core that could mean almost anything. Earlier in her life, it had been the first sign of cancer.
Now she prayed for it. Cramping might mean she was finally pregnant despite the odds — that the embryo had implanted successfully. This was her third attempt at in vitro fertilization, and it would probably be her last.
“I thought that having cancer was the hard part,” Danford said. “I wasn’t prepared for the emotional ups and downs of fertility treatment.”
For decades, two statistics had dominated Danford’s life. Close to 120,000 women under the age of 50 are diagnosed with cancer each year. Danford became one of them at age 19. But it wasn’t until her third tumor, at age 30, that she joined a much more exclusive number.
Only 10 percent of women facing cancer treatment take steps to preserve their fertility, according to Dr. Mitchell Rosen, Danford’s reproductive endocrinologist and the director of the UCSF Reproductive Laboratories and Fertility Preservation Program.
Gina Danford’s story ends well — with a little girl who’s playful and stubborn and looks a lot like her. But it very easily could have gone the other way. If not for Rosen and his colleagues, Danford says she might have been part of the 90 percent of women who fail to do anything about their fertility until it’s too late.
The “Whole Shebang”
The tumor was the size of a small basketball — far larger than the size necessary to turn a 19-year-old’s life of “college classes, papers, and midterms to a world of oncologists, diagnostic tests, and an impending surgery.” It was also enough to destroy her long-term hopes for a husband and a baby and a dog — “the whole shebang.”
Danford spent the next 10 years “healthy and happy.” Then the abdominal pain began, gradually growing so intense she couldn’t get out of bed or stand up straight.
Tests confirmed a second mass — this one situated near her left ovary. It would require immediate surgery.
“I didn’t even consider fertility preservation prior to the surgery. I just wanted the pain to stop,” she said.
Nationwide, those emotions are one of the primary barriers to fertility treatment. Rosen refers to it as the “double blow.”
“Infertility’s bad enough and cancer’s bad enough, but both of them together is quite significant,” he said.
Make that a triple blow. Between the consultations, clinical services, procedures necessary to retrieve eggs, produce embryos and freeze them, the costs can range anywhere from $8,000 to $24,000. And most insurance plans don’t cover a penny of it.
Research developments over the past several decades have made it possible for fertility clinics “to take care of almost anybody,” Rosen said. “So the issue now becomes more of access and cost.”
Roadblocks
To find out just how significant the barrier is today, Rosen and his colleagues surveyed 1,041 randomly selected women from the California Cancer Registry between 1993 and 2007. Each was between the ages of 18 and 40 and all suffered from one of five different types of cancer: leukemia, Hodgkin’s disease, Non-Hodgkin Lymphoma, breast cancer, and gastrointestinal cancer.
A total of 918 of the women underwent treatment that could impact fertility, and 61 were told that their ability to conceive in the future might be compromised. But only 1 to 10 percent of them took steps to ensure they could become pregnant in the future, with the rate varying based upon the year of treatment.
In a recent focus group, Rosen asked a collection of women why so many of them hesitated.
“After the fact, all of these women were wishing they had taken more steps to preserve their fertility, but it didn’t even register in their mind when they were preparing for cancer treatment,” he said. “The oncologist might have mentioned it — it just wasn’t in their purview to think about the possibility of what it was going to be like as a survivor.”
Danford can vouch for that feeling. She remembers sitting in Rosen’s fertility clinic in 2006, “completely shell-shocked” after learning she was facing the possibility of cancer for a third time.
The thought of dying nearly blacked out all hopes of being a mother.
Access
In his consultation with Danford, Dr. Rosen laid out the basics: Not every woman with cancer needs to go through fertility preservation, but freezing eggs or freezing embryos is a good option for many. He showed her charts and percentages, and described when the treatment works and when it doesn’t.
All signs pointed toward the likelihood that this would be Danford’s last chance. Her upcoming surgery would require the removal of her remaining ovary, and a complete hysterectomy “was a distinct possibility.”
“I could barely get my head around facing cancer again — let alone facing infertility and menopause at 30,” she said.
So she went for it. Danford and her husband borrowed money from family and put the rest on credit cards.
Having decided upon egg retrieval and embryo cryopreservation, the entire process took about four weeks, fitting like a puzzle piece inside her surgery preparation period.
The typical time span between a cancer diagnosis and treatment is about 50 days. And because Danford’s oncology doctor referred her straight to the fertility clinic — and the two departments coordinated care in the weeks after — there was no delay in her surgery. Egg retrieval took place on a Friday and Danford was in the operating room for her surgery on Monday.
“If that kind of coordination between oncologists and reproductive endocrinologists occurred for every patient, there would never be a delay, there would never be a second thought about whether preserving fertility would jeopardize the health of the patient,” Rosen said. “Cost would still be an issue, but we would be one step closer to getting everybody access.”
Danford may have been among the lucky few, but she wasn’t prepared for the difficulty of fertility treatment.
“I thought, I’m alive and healthy and this is the easy part, and it’s absolutely not,” she said. “It takes a huge emotional toll.” There were more needles, sonograms and blood tests. Lots of waiting. Two failed attempts.
Then one day Rosen’s assistant called and asked Gina to come down to the clinic. And there it was: “a tiny fetus on the fuzzy sonogram screen.”
Nine weeks passed before Danford sat down to write a letter. It was addressed to other women who find themselves “shell-shocked” in Dr. Rosen’s office, wondering if the future is even worth considering.
“Your experience will undoubtedly leave scars,” she wrote, “physical, mental and/or emotional. It took me years to come to peace with the jagged nine-inch scar on my abdomen. What I finally realized is that my scars, visible and invisible, represent who I am. Those scars saved my life.”
They made her a survivor, she wrote. And in a roundabout way, they brought her Samantha.
Read Danford’s letter, along with those shared by two of Rosen’s other patients, below. If you have questions for Danford or Rosen, leave them in the comments section below or send them to onlinehealth@newshour.org. We’ll post their answers in the days ahead.
Gina Danford Fertility Letter
Dr. Lynette Leighton Fertility Treatment Letter
Jennifer Ebrahimi Fertility Treatment Letter
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May 14th, 2012
A video featuring cancer-stricken children, their nurses, doctors and parents lip-synching and dancing to the popular Kelly Clarkson song "Stronger" has become an online sensation. Clarkson is calling their rendition "amazing." (May 11) Subscribe to the Associated Press: bit.ly Download AP Mobile: www.ap.org Associated Press on Facebook: apne.ws Associated Press on Twitter: apne.ws Associated Press on Google+: bit.ly
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May 14th, 2012
MONDAY, May 14 (HealthDay News) — Widely used blood pressure
medications called beta blockers do not cut a person’s odds of developing
colon cancer, a new study contends.
Beta blockers, which include drugs such as alprenolol, carvedilol,
propranolol and atenolol, are commonly prescribed to older adults for high
blood pressure and heart conditions.
Prior research has also linked use of the drugs to a decreased risk of
cancer. This theory is based on animal and laboratory studies that found
that the stress hormone norepinephrine can promote the growth and spread
of cancer cells. Beta blockers inhibit this hormone’s action.
“One of the holy grails in the war on cancer is preventing
angiogenesis, which is the growth of new blood vessels to feed tumor
cells,” explained Dr. David Robbins, associate chief of the Center for
Advanced Therapeutic Endoscopy at Lenox Hill Hospital in New York
City.
“Some investigators have speculated that an indirect benefit of certain
blood pressure medicines may be to help curb the growth of new blood
vessels in breast and perhaps colon cancer,” said Robbins, who was not
involved in the new study.
In this study, published online May 14 in the journal Cancer, a
team led by Michael Hoffmeister, of the German Cancer Research Center in
Heidelberg, compared the beta blocker use of more than 1,700 colon cancer
patients to that of about the same number of cancer-free people.
After accounting for weight, smoking status and other patient factors,
the researchers found no link between beta blocker use and colon cancer
risk.
The finding held true even after the researchers broke down their
analyses by duration of beta blocker use, specific types of beta blockers,
and sites within the colon or rectum where colorectal cancer developed in
patients.
The authors conclude that their findings do not support the theory that
using beta blockers cuts colon cancer risk.
That didn’t surprise Robbins. “The few studies on this matter have been
contradictory and it’s unlikely that we’ll ever see this sort of
protective effect, since cancer is an incredibly complex disease driven by
a myriad of unique biologic pathways,” he said.
Another expert added that even though beta blockers might not help
prevent colon tumors, people have other means of doing so.
“Men and women at average risk should start getting screened at age
50,” said Dr. Mark Pochapin, director of the division of gastroenterology
at NYU Langone Medical Center in New York City. “Those with certain risk
factors, such as a family history of colorectal polyps or cancer, should
talk to their doctors about screening at a younger age.”
Pochapin also added that “lifestyle modifications — such as quitting
smoking, avoiding excess intake of red or processed meats, ensuring
adequate vitamin D intake, and maintaining a healthy body weight and
regular exercise — can be very beneficial in reducing one’s risk for
colorectal cancer.”
More information
The U.S. National Cancer Institute has more about colorectal cancer risk factors and prevention.
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May 14th, 2012
NEW YORK (Reuters Health) – People getting checked for signs of colon cancer may not need to take a laxative if they choose a CT scan for their cancer screening over a tradition colonoscopy, according to a new study.
The findings suggest a so-called CT colonography is almost as good at identifying certain polyps as a traditional colonoscopy, and researchers said eliminating the need for laxatives may encourage more people to get screened.
“The results of this study open the door to a more patient-friendly screening,” said Dr. Michael Zalis, the study’s lead author and director of CT colonography in the department of imaging at Massachusetts General Hospital in Boston.
Zalis added, however, that CT colonography is not yet covered by government insurance programs — like Medicare and Medicaid — and more research is needed before people switch to a laxative-free method of screening.
In traditional colonoscopy, a doctor uses a camera called an endoscope to look for signs of cancer within the colon and rectum. The procedure usually requires sedation.
During a CT colonography, the colon is filled with a gas and the patient is told to hold their breath while images are taken.
For both tests, patients typically take a laxative the night before the screening to eliminate any digested food that might be in the colon.
Zalis and his colleagues wanted to test whether or not a CT colonography remained accurate even when the patient did not use a laxative. Instead, people were told to reduce their fiber intake and periodically drink liquids with an added substance that tags the feces in a person’s colon.
After the images are taken, a computer program — like software invented by Zalis and two of his coauthors — removes the feces from the picture, which leaves an empty colon and any polyps.
Between June 2005 and October 2010, Zalis and his fellow researchers recruited 605 people — all between 50 to 85 years old and at average risk of colon cancer — for their study.
Each person underwent a laxative-free CT colonography and then a traditional colonoscopy about five weeks later.
Overall, the laxative-free method identified 91 percent of polyps one centimeter or larger, compared to 95 percent with traditional colonoscopy. The difference between the two, according to the researchers, could have been due to chance.
That wasn’t the case for smaller polyps, however. The researchers found that a traditional colonoscopy was better at identifying polyps under a centimeter in size, compared to the laxative-free CT colonography.
ADVANTAGES AND DISADVANTAGES
Colonography “does have some advantages and disadvantages and I think it’s important for people to know what those are,” said Dr. Perry Pickhardt, of the department of radiology at the University of Wisconsin School of Medicine and Public Health in Madison.
Pickhardt, who was not involved with the new study, told Reuters Health that some doctors may not be okay with relying on a test that only consistently finds larger polyps.
Although it may spot fewer small, pre-cancerous polyps, Zalis said CT colonography is still better than no screening — and eliminating the laxative preparation may increase the number of people who get the test.
“The prep, it turns out, is highly objectionable to many people, and it deters people from getting screened,” he said.
In his team’s study, 290 people said they’d prefer a CT scan for screening in the future, and 175 picked the traditional colonoscopy.
“If this gets a few people through the door, it’s worth it, but it shouldn’t be our first option,” said Pickhardt. “There is a downside; you’re trading one thing for another.”
Pickhardt said that at his center, the laxative-free method is usually reserved for frail, older patients who have a higher risk for complications.
Zalis said another benefit to CT colonography might be the cost. He said the scan could be done for about 30 percent of what a traditional colonoscopy costs — between $400 and $700 — by eliminating things like anesthesia.
BETTER PREP
In another recent article, researchers came up with a different way to reduce the unpleasantness of the standard laxative preparation by using a combination of the laxative MiraLAX and Gatorade.
That study, published in the American Journal of Gastroenterology, looked at a sample of 222 patients who took a single dose or split dose of Golytely, the traditional pre-colonoscopy laxative beverage, or the MiraLAX/Gatorade combination.
MiraLAX has to be paired with Gatorade or a similar drink, researchers said, because it flushes electrolytes from the body.
Overall, a split dose of the MiraLAX and Gatorade combination appeared to be an “effective, safe and tolerable” option for patients undergoing a traditional colonoscopy. The patients also said they tolerated it better than Golytely.
Dr. M. Mazen Jamal, the study’s senior researcher from the department of gastroenterology at the Long Beach Veterans Affairs Healthcare system in California, said Golytely has been known to have unpleasant side effects like stomach aches, vomiting and nausea.
“I feel confident that this is a viable alternative for low-risk patients or for patients who could not tolerate Golytely,” said Jamal.
As for when a person should be screened for colon cancer, the U.S. Preventive Services Task Force (USPSTF), a government-backed advisory group, recommends screening starting at age 50 in average-risk people, and typically stopping at age 75.
The USPSTF doesn’t endorse any particular type of test over others. It recommends screening either with colonoscopy every 10 years, with another invasive test called a sigmoidoscopy every five years or using an annual at-home test called a fecal occult blood test.
Zalis’s study was partially funded by the American Cancer Society and GE Healthcare.
SOURCE: http://bit.ly/JOLDrc Annals of Internal Medicine, online May 14, 2012 and http://bit.ly/JOLLGZ American Journal of Gastroenterology, online May 8, 2012.
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May 12th, 2012
Here I want to show you how to prepare green and white tea (packed with healthy anti-oxidants that may lower cancer risk) in ways that aren’t just healthy, but tasty too! For more information and scientific references, see my recent blog post here: www.psychologytoday.com or the section on green tea in Zest for Life. (Sorry it’s been a while since my last video — I’m currently working on several new videos that will be out soon!)
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May 12th, 2012
SEATTLE (AP) — A video featuring cancer-stricken children, their nurses, doctors and parents lip-synching and dancing to the popular Kelly Clarkson song “Stronger” has become an online sensation.
Clarkson, in her own video message to the children at Seattle Children’s Hospital, said it was “amazing.”
“It made my day. I know it’s making everybody else’s day online,” Clarkson said in a message posted on her website. “I just can’t wait to meet you.”
The youngsters, many attached to IVs and holding signs that say “Stronger,” “Fighter” and “Hope,” dance along with parents and medical staff. One child even rides a bike through the hallways of the hematology oncology floor. The video is part of a creative arts program with cancer patients at Seattle Children‘s.
The kids’ video went online May 6. It was the idea of 22-year-old Chris Rumble, a patient at the hospital who was diagnosed with leukemia in April. He wanted to do something to share with his old hockey team in the central Washington town of Wenatchee
“I’m everyone’s big brother and I have a lot of friends here at Seattle Children’s,” Rumble said on the hospital’s blog.
Dr. Douglas Hawkins said the patients and staff at Seattle Children’s have been thrilled by the response.
“This morning it was over 900,000 views. It’s really incredible,” he said Friday.
Hawkins said such projects help the kids maintain their spirits.
“When a child or young adult is treated for cancer, it puts their whole life on hold in a way that doesn’t seem fair at all,” Hawkins said. “It’s a fight for their life. But there are all these other normal things they want to be doing too, or things they want to focus on other than the medicine or the illness or their time in the hospital.”
___
Online:
http://www.youtube.com/watch?v=ihGCj5mfCk8
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May 12th, 2012
The top scientific officer of Texas’ $3 billion cancer-fighting initiative is resigning, citing concerns about the review process that allocated $20 million of taxpayer money to two Houston institutions.
Dr. Alfred Gilman, the Cancer Prevention and Research Institute of Texas‘ chief scientific adviser since its 2009 launch, appealed in a resignation letter for the agency to revise its rules to keep further awards from going to programs that “were not described and therefore could not have been reviewed.” The big award in question involved a joint proposal by the University of Texas M.D. Anderson Cancer Center and Rice University.
“I will stay until (the Oct. 5th Scientific Review Committee meeting) to be certain that those who are preparing applications to be submitted by May 31 will still encounter a functional peer review system,” Gilman, a Nobel Prize-winning biochemist, wrote Tuesday in his letter to William Gimson, the organization’s executive director. “Negative action (in a July meeting) would in addition be extremely harmful to the research community’s view of science in Texas, and thus on the ability to recruit scientists to the state.”
He wrote that Gimson’s most critical concern will be to keep the external peer review systems intact and says Gimson’s ability to do that is “dependent on the attitude of CPRIT leadership, particularly the oversight committee.” The tone suggested anxiety that the grant-judging system he set up – composed of “some of the best cancer researchers and physicians in the country, free of conflicts of interest and all coming from outside of Texas” – is threatened.
The oversight committee, the institute’s governing board, is appointed by the governor, lieutenant governor and speaker of the House.
Gimson called the matter a difference of opinion over which committee should have reviewed the joint M.D. Anderson-Rice proposal, a kind of business plan to accelerate the availability of life-saving treatment now in development. Gimson said the proposal was evaluated by the CPRIT committee that reviews commercialization grants; Gilman, he said, wanted it evaluated by the committee that reviews scientific grants.
Says advice not sought
In an email Thursday night to the Chronicle, Gilman called Gimson “polite in saying we had a ‘difference of opinion’ ” and added that he is “entitled to put whatever interpretation on the situation he desires.”
But Gilman asked why CPRIT’s biggest grant ever was given to M.D. Anderson for a proposal that was submitted very late in the process and included only 6.5 pages of “non-scientific description of a plan to conduct early-stage, preclinical drug discovery?”
“Drug discovery is research,” Gilman wrote in the email. “The advice of CPRIT’s excellent, out-of-state research reviewers was not sought.”
The provosts at M.D. Anderson and Rice said they submitted their application in response to a CPRIT request for proposals in the commercialization category and that the funding decision was then up to CPRIT judges. Rice Provost George McLendon said the review of commercialization proposals by business experts is just as rigorous as the review of research proposals by science experts.
Search for successor
In the email, Gilman also asked why “seven very highly regarded and highly scored multi-investigator collaborative research applications (selected by competitive peer review from a group of 40) were not even brought to the oversight committee for consideration?”
Gimson said he has “no concern whatsoever” about the oversight committee’s commitment to the integrity of peer-review committees. He said the committees’ attrition rates, 20 percent, are in keeping with most peer-review committees and assured that future members would continue to come from outside Texas.
Gilman, 70, who came to CPRIT from the University of Texas Southwestern Medical Center in Dallas, wrote that he plans to resign Oct. 12. Gimson said CPRIT will start looking for a successor as early as next week.
Under Gilman’s direction, CPRIT has invested $500 million in cancer research projects and attracted almost 40 cancer research scholars to Texas.
todd.ackerman@chron.com
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