YCLOAK

People seeking dubious, potentially harmful treatment for cancer and other ailments raised nearly $7 million over two years from crowdfunding sites, a study found.

Echoing recent research on campaigns for stem cell therapies, the findings raise more questions about an increasingly popular way to help pay for costly, and sometimes unproven, medical care. 

Soliciting money on GoFundMe and other sites eliminates doctors, hospitals, insurance companies and other “gatekeepers” that can be a barrier to expensive treatment, said lead author Dr. Ford Vox, an ethicist and brain injury expert at Shepherd Center rehabilitation hospital in Atlanta. He calls it “the democratization of economic power through social media” but says it can pose an ethical dilemma.

Online fundraising “has a big bright side” when it helps patients pay for legitimate care, he said. “Communities are really being able to rally around people in rough times. That’s fantastic, but there is this very clear dark side” when treatments sought are worthless or even dangerous.

His study was published Tuesday in the Journal of the American Medical Association. 

GoFundMe says campaigns for medical care are increasing and are among the most numerous on its site. They include solicitations for conventional treatment and for unproven alternative therapies.

“We always encourage people to fully research whatever it is they are raising money for and to be absolutely transparent on their GoFundMe page, so donors can make an informed decision on what they’re donating to,” GoFundMe said in an emailed statement.

The researchers examined campaigns posted from November 2015 through mid-December 2017, mostly on GoFundMe. They focused on five treatments sought in about 1,000 campaigns: homeopathy or naturopathy for cancer; hyperbaric oxygen for brain injuries; stem cells for brain or spinal cord injuries; and long-term antibiotics for persistent Lyme disease.

While some patients swear they’ve benefited from some of the treatments, there is no rigorous scientific evidence that any of them work for the conditions involved, the researchers said.

The most numerous were solicitations for homeopathy or naturopathy for cancer — 474 requests seeking more than $12 million. About one-quarter of that was raised.

Homeopathic products typically contain heavily diluted drugs, vitamins or minerals said to promote healing, although some have been found to contain toxic amounts. Naturopathy, another alternative medicine practice, sometimes uses homeopathic products, herbs and dietary supplements or body cleanses.

Michelle Drapeau has raised about $7,000 on GoFundMe for homeopathy and other alternative remedies since being diagnosed with advanced stomach cancer in February 2017. The 45-year-old investment banker from West Palm Beach, Florida, credits them with keeping her alive since she stopped chemotherapy over a year ago.

“I wanted to make sure I explored every and all options,” Drapeau said. “It’s vital for everyone to have that opportunity.”

Dr. Leonard Lichtenfeld, the American Cancer Society’s deputy chief medical officer, said it’s important to consider what may drive some patients to turn to unproven remedies. U.S. health care costs are exorbitant and many patients run out of money trying to pay them.

And despite considerable progress against cancer and other illnesses, conventional treatment can’t cure every patient, he noted.

“We should not be judgmental and come out and say this is terrible,” Lichtenfeld said.

“No one wants to hear, ‘You have cancer,’ and especially no one wants to hear that there’s no treatment available that can help you,” he said. “You begin to understand why people may turn to unproven treatments and you can understand why others reach out to try to support them.

“What we need to do is to better inform, even better care for our patients and their families, so they don’t feel this is what they need to do.”
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In the first study of its kind, Austrian researchers have tracked the movement of microplastics into human beings. The results show that the plastic that is a ubiquitous element of human life is now also a constant element in the human body.

The research was presented at this week at UEG Week in Vienna, Austria, the largest gastroenterology meeting in Europe.

Follow the plastics

Two Austrian researchers, Dr. Philipp Schwabl from the Medical University of Vienna, and Dr. Bettina Liebmann, from the Environment Agency Austria, studied  participants from countries including Finland, Italy, Japan, the Netherlands, Poland, Russia, the UK and Austria.

Microplastics are particles of plastic less than 5 mm in size. They are often tiny plastic beads that are put in cosmetic products. A few nations, including the U.S., the UK and South Korea, have banned microbeads. But microplastics also are created when larger pieces of plastic break down over time, and plastic in general is everywhere. The U.N. estimates that about 8 million metric tons of plastic end up in the world’s oceans every year. And the World Economic Forum estimated that Americans threw away over 33 million metric tons of plastic in 2014.

But this study, which was small, suggests that plastic, whether it’s bad for us or not, is already in all of us.

Study participants were asked to keep a food diary for seven days prior to taking part in the test. Then they turned over stool samples to the researchers who then looked for microplastics.

And they found them. Every single stool sample tested positive for the presence of microplastic, and up to nine different plastic types were identified.

Where is the plastic coming from? In the cases of this study, the plastic that showed up in people is associated with eating plastic wrapped foods, and drinking from plastic bottles. But most of the participants also ate fish, so Schwabl says that right now, “no exact conclusion on plastic origin can be made” on exactly where the plastic is coming from. Future studies should narrow that down.

What is it doing to us?

So is all that plastic making us sick?  Schwabl says, for now, there are no definitive studies that suggest a danger to humans. But he says that in “animal studies, it has been shown that microplastics may cause intestinal damage, remodeling of the intestinal villi, distortion of iron absorption and hepatic stress.”

And the concern is “what this means to us, and especially patients with gastrointestinal diseases,” Schwabl says. “While the highest plastic concentrations in animal studies have been found in the gut, the smallest microplastic particles are capable of entering the blood stream, lymphatic system and may even reach the liver.”

He was surprised, he says, to find that plastic is apparently showing up in all of us, and he expects the amount collecting in our bodies to keep increasing, unless the world drastically changes its use of plastic.
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Zimbabwe’s economic crisis has resulted in an acute shortage of essential medical drugs. Officials say the shortage has pushed some people to turn to the black market for medicines — and authorities are worried those drugs do more harm than good. Columbus Mavhunga reports from Harare for VOA News.
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Several possessions of the late physicist’s Stephen Hawking will be included in an upcoming auction at Christie’s, the famed auction house.

Included among the items belonging to the iconic scientist will be one of his wheelchairs, one of five copies of his Cambridge University Ph.D. thesis “Properties of Expanding Universes,” and a script from one of his appearances on the television show “The Simpsons.”

At age 22, Hawking was diagnosed with amyotrophic lateral sclerosis, or ALS, just as he was beginning his doctoral work at Cambridge.

Thomas Venning, head of books and manuscripts at Christie’s, said Hawking was so despondent over the diagnosis that he “gave up his studies for a time.”

Hawking, however, returned to school, Venning said, and his thesis “was the fruit of his reapplying himself to his scientific work.” Hawking kept his thesis beside him for the rest of his life, according to Venning.

Hawking was one of the few scientists who have reached celebrity status. He is probably best known for his best-selling book “A Brief History of Time” and for his appearances on “The Simpsons.”

His daughter Lucy said the auction gives “admirers of his work the chance to acquire a memento of our father’s extraordinary life in the shape of a small selection of evocative and fascinating items.”

The physicist’s children hope to preserve his scientific archive.

The Associated Press reports that Christie’s is handling negotiations to hand over the archive to British authorities in lieu of inheritance tax.

Hawking’s items will be featured in a science sale that also includes papers by Isaac Newton, Charles Darwin and Albert Einstein.

Hawking’s items will be on display for several days in London, beginning October 30.

Hawking died in March at age 76.

 
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Typhus, a bacterial infection that is sometimes life threatening, is on the rise in Los Angeles and several other U.S. cities. Public health officials say homelessness is making the problem worse and that the disease, which is associated with poverty and poor sanitation, is making a comeback in the United States.

Los Angeles County has seen 64 cases of typhus this year, compared with 53 at the same point last year and double the typical number, with a six-case cluster among the homeless in L.A. this year. Two cities in the county that have separate counts are also seeing higher numbers: Long Beach with 13 cases, up from five last year, and Pasadena with 20, a more than three-fold increase from 2017.

At a clinic in the L.A. neighborhood called Skid Row, Dr. Lisa Abdishoo of Los Angeles Christian Health Centers is on the lookout for symptoms. 

“It’s a nonspecific fever,” she said, “body aches, sometimes a headache, sometimes a rash.”

This kind of typhus is spread by fleas on rats, opossums, or even pets and is known as murine typhus, from the Latin word for “mouse.”

The risk is higher when people live on the streets in proximity to garbage, but the disease seems to be spreading through the Southern United States.

Not the typhus of WWI

“It’s never been considered a very common disease,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, “but we seem to see it more frequently. And it seems to be extending across from Southern California all along the Mexican border into southeastern Texas and then into the Gulf Coast in Florida.”

Texas had 519 cases last year, said spokeswoman Lara Anton of the Texas Department of State Health Services. That’s more than three times the number in 2010, with clusters in Houston and Galveston. No figures for this year have been released.

This is a separate disease from typhoid fever and is not the epidemic form of typhus that caused hundreds of thousands of deaths in war time. That type, called epidemic typhus, is carried by body lice and often spreads in conflict zones. It led to millions of deaths in World War I alone.

Flea-borne typhus, the kind seen in California and Texas, is serious but often clears up on its own and responds to an antibiotic, Abdishoo said.

“It seems to get better a little faster if you have the treatment,” she said. “But there are cases where people have had more severe complications — it’s rare, but getting meningitis, and even death,” she cautioned.

Migration, urbanization, climate change

The reason for increased typhus numbers is uncertain, but it may be linked to migration, urbanization and climate change, said Hotez, the disease specialist. In some parts of the world, typhus is still linked to war and instability, “in the conflict zones in the Middle East, in North Africa, Central Asia, East Africa, Venezuela, for instance with the political instability there,” he said.

Murine typhus is one of several diseases on the rise in the southern United States, Hotez said. 

“Others include dengue, now emerging in southern Texas and Florida, the Zika virus infection, Chikungunya. We have a huge problem with West Nile virus,” he added, and Chagas disease, a condition usually seen in Latin America.

A report in May from the U.S. Centers for Disease Control and Prevention found that such “vector-borne” diseases, transmitted by ticks, fleas or mosquitoes, more than doubled in the United States between 2004 and 2016.

Hotez says they are on the rise in many industrial nations with crowded cities and pockets of poverty.

Skid Row physician Abdishoo says flea-borne typhus is still uncommon on the streets of Los Angeles, but “it has us all on high alert for this illness that we don’t necessarily think too much about. We want to be vigilant,” she added, “when you see a communicable disease on the rise.”

Officials in Los Angeles say they are working toward housing for the county’s 53,000 homeless residents to relieve conditions that help give rise to typhus and other diseases. Voters approved funding in 2016 and 2017 to finance the efforts.
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Typhus, a bacterial infection that is sometimes life-threatening, is on the rise in Los Angeles and several other U.S. cities. Public health officials say homelessness is making the problem worse. Mike O’Sullivan reports that this disease associated with poverty and poor sanitation is making a comeback in the United States.
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The ability to fight any future outbreaks of disease could be at risk, following a huge loss of public confidence in vaccines in the Philippines. That’s according to a new report from the London School of Hygiene and Tropical Medicine. The drop in trust could also affect the rollout of future vaccination programs, and researchers say the case of the Philippines holds lessons for other countries trying to tackle deadly diseases, as Henry Ridgwell reports.
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For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. But the benefit for most women was small, raising questions about whether the treatment is worth its high cost and side effects.

Results were discussed Saturday at a cancer conference in Munich and published by the New England Journal of Medicine. 

Drugs called checkpoint inhibitors have transformed treatment of many types of cancer by removing a chemical brake that keeps the immune system from killing tumor cells. Their discovery recently earned scientists a Nobel Prize. Until now, though, they haven’t proved valuable against breast cancer.

In the study

The new study tested one from Roche called Tecentriq plus chemo versus chemo alone in 902 women with advanced triple-negative breast cancer. About 15 percent of cases are this type, their growth is not fueled by the hormones estrogen or progesterone, or the gene that Herceptin targets, making them hard to treat.

Women in the study who received Tecentriq plus chemo went two months longer on average without their cancer worsening compared with those on chemo alone, a modest benefit. The combo did not significantly improve survival in an early look before long-term follow-up is complete.

Failed protein test

Previous studies found that immunotherapies work best in patients with high levels of a protein that the drugs target, and the plan for the breast cancer study called for analyzing how women fared according to that factor if Tecentriq improved survival overall.

The drug failed that test, but researchers still looked at protein-level results and saw encouraging signs. Women with high levels who received the combo treatment lived roughly 25 months on average versus about 15 months for women given chemo alone.

That’s a big difference, but it will take more time to see if there’s a reliable way to predict benefit, said Dr. Jennifer Litton of the MD Anderson Cancer Center in Houston. She had no role in running the study but enrolled some patients in it and oversees 14 others testing immunotherapies.

“We’re really hopeful that we can identify a group of women who can get a much bigger and longer response,” she said.

Another breast cancer specialist with no role in the study, Dr. Michael Hassett at Dana-Farber Cancer Institute in Boston, said he felt “cautious excitement” that immunotherapy may prove helpful for certain breast cancer patients.

Side effects and cost

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts, but serious ones were more common with the combo treatment and twice as many women on it stopped treatment for that reason.

Three of the six deaths from side effects in the combo group were blamed on the treatment itself; only one of three such deaths in the chemo group was.

Cost is another concern. Tecentriq is $12,500 a month. The chemo in this study was Celgene’s Abraxane, which costs about $3,000 per dose plus doctor fees for the IV treatments. Older chemo drugs cost less but require patients to use a steroid to prevent allergic reactions that might interfere with the immunotherapy. Abraxane was chosen because it avoids the need for a steroid, said one study leader, Dr. Sylvia Adams of NYU Langone Health.

The study was sponsored by Roche and many study leaders consult or work for the company or own stock in it.
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