One Giant Leap for Lung Cancer

As one of Washington DC’s leading healthcare communications companies, SRxA is pleased to support an upcoming local event that aims to raise awareness and funds for more effective treatments for the nation’s most fatal cancer.

The LUNGevity Foundation, the nation’s largest lung cancer-focused nonprofit has teamed with Over The Edge, a company that creates signature rappelling fundraising events for nonprofit organizations. Together they will host Breathe Deep and Jump DC.

During this inaugural event, participants will rappel 11 stories down from the Woodward and Lothrop BuildingWashington, DC’s first department store, dating back to 1887.

The Foundation will host the event on Saturday, September 29, 2012, from 9:00 a.m. to 5:00 p.m.

So, if you’re going to be in, or near, our nation’s capital that day, why not join LUNGevity for an exciting day of rappelling and fundraising. Registration is limited to 92 participants, so be sure to sign up early.  Each would-be rappeller must have raised or contributed a minimum of $1,000 and weigh greater than 100 and less than 300 pounds. Rappelling experience is not required, but participants should arrive on-site at least an hour in advance of their rappel time for training and set-up, and completion of required forms.

And even if rappelling is not your thing, there are numerous volunteer opportunities for those who wish to support the effort to raise funds for lung cancer research. Word on Health particularly likes the “toss your boss” feature where company teams can raise funds to see their supervisors dangling above the DC sky.

To learn more about fundraising, sponsorship or to register, click here.

Over the Edge is one of two Breathe Deep events occurring in Washington, DC this fall.  LUNGevity’s fourth annual Breathe Deep DC 5k walk to raise funds and critical awareness for lung cancer research is happening Sunday, November 4 on the National Mall. The walk offers a place for those impacted by the disease to share, remember, hope and heal. The course is friendly to strollers, wheelchairs and pets. Participants will enjoy a festive atmosphere with music, free refreshments and kids’ activities. Awards will be given to the largest team, top fundraising team and best team name.

Breathe Deep DC was started by Jerry Sorkin. Sorkin, a 46-year-old Bethesda father of two, was diagnosed with stage IV lung cancer in 2007. The first Breathe Deep DC was held in November 2009. In three years the event has hosted thousands of participants and raised over $800,000.  If you’d like to be part of the  Breathe Deep DC event to help end lung cancer, please click here.

Through the support of critical research for the early detection and successful treatment of lung cancer, as well as providing information, resources and a community to patients and caregivers, LUNGevity is creating and sharing hope for cures, treatments and enhanced quality of life for lung cancer patients.

While You Were Sleeping

As students all over the globe head back to school, we imagine many of them are looking for ways to make learning a little easier and studying a little less onerous. Imagine, for example, how cool it would be if you could study for that upcoming chemistry exam while you were sleeping?

Sadly, that’s not yet a reality. But, as SRxA’s Word on Health learned this week, scientists are getting closer to understanding sleep learning.

Older studies of sleep learning (think of the old tape recorder-under-the-pillow experiments) pretty much failed to demonstrate that it’s possible to absorb information while sleeping. In most cases the trials themselves were flawed. In some cases the subjects were briefly woken during the trials, or else they took place during unnatural sleep, with the subjects drugged.

More recently however, a number of studies have suggested that there may be some sort of connection between sleep and learning and memory consolidation. Anat Arzi, a PhD student working with Prof. Noam Sobel  at the Weizmann Institute of Science in Israel was intrigued and set out to find the right teaching method. “In spite of all the previous research, we thought that some kind of sleep learning should be possible. The question was: which kind?”

Tones and smells turned out to be ideal. They don’t wake the sleepers, yet they are sensed during sleep. And sniffing – the reflexive response to the odors – occurs whether asleep or awake. That meant that instead of relying on reported memories, the researchers only had to watch for the long, deep sniff we automatically take when we smell a good smell, or the short, shallow one associated with a bad smell. When this occurred they knew that their subjects had been conditioned to associate a tone with a particular odor – even though the subjects themselves had no recall, whatsoever, of the “lesson” they had learned while asleep.

Imagine that you wake up in the morning feeling nothing special, yet you find yourself inexplicably behaving just a bit differently during the day. For example, you take a sniff every time you hear a tone,” said Sobel.

This may be the first incontrovertible demonstration of sleep learning in human adult brains.

So what’s next? Sobel and Arzi found that the conditioning is best retained when it takes place during non-REM sleep and plan to explore this further.  Whether or not they find the magic connection that will one day enable us to memorize the periodic table as we sleep, finding proof for one type of sleep learning suggests that others might be possible.

Incy Wincy Spiders could kill cancer

Do tarantulas terrify you?  Are funnel web spiders your foe?  These eight-legged, multi-eyed critters – all venom and sticky webs – have long provoked fear and loathing.  And while we can’t promise this blog will cure your arachnophobia, we can perhaps give you one good reason to be a little less afraid.

SRxA’s Word on Health learned this week that Australian scientists are looking at the use of spider venom to fight breast cancer.

Researchers from James Cook University in Cairns, Queensland will determine if venom from funnel web spiders and tarantulas can kill breast cancer cells.

Queensland Science Minister Ros Bates said the research was initiated on the back of international studies that suggested certain toxins in spider venom could offer an untapped suite of natural molecules to kill breast cancer cells.

With more than 40,000 species of spiders, it’s estimated there are more than four million  different toxins in spider venom,” Bates said.  “Those toxins will now be screened, to look at their potential to treat cancer in humans.”

Venom molecules are already used to prevent chronic pain, and scorpion venom has already been shown to bind to cancer cells in mice.

The minister said the work being done by James Cook University researchers had cemented Queensland’s place as a global scientific leader.

SRxA’s Word on Health applauds any  move that will put these heinous creatures to good use and we’ll keep you informed on any developments in this story.

Is Your Doctor Burned Out?

Is life / work stressing you out?  Thinking about going to see your doctor for help?  Before making that appointment you may want to think again.

According to a national survey of physicians, released this week nearly 1 in 2 US doctors are themselves suffering from burnout.  That’s more than any other US workers.

Overtaxed doctors are not only at risk for personal problems, like relationship issues and alcohol misuse, but their job-related fatigue can also erode professionalism, compromise quality of care, increase medical errors and encourage early retirement – a potentially critical problem as an aging population demands more medical care.

Survey participants completed a 22-item Burnout Inventory questionnaire, which measured emotional exhaustion, depersonalization (treating patients as objects rather than human beings) and low sense of personal accomplishment. Of the 27,276 physicians asked to participate, 26.7% responded. They had to report only one symptom to be included among those reporting burnout.

Differences in burnout rate varied by specialty: While most people assume that the surgical or cancer specialties would be at highest risk, the researchers from the Mayo Clinic found that emergency medicine, internal medicine, neurology and family medicine reported the highest rates.

Nearly 60% of physicians in those specialties had high levels of burnout,” says says lead author Tait Shanafelt MD. “This is concerning since many elements critical to the success of health care reform are built upon increasing the role of the primary care providers.”

On the other hand, doctors practicing pathology, dermatology, general pediatrics and preventive medicine had the lowest rates of burnout.

In other words, it’s the physicians on the front line of care who are most likely to burn out.

And that’s not all. When asked about emotional exhaustion, 37.9% of physicians reported signs, compared with 27.8% reported by other workers surveyed.

The rates are higher than expected,”. Commented Shanafelt “We expected maybe 1 out of 3.

Being asked to see more patients and not having enough time to spend with them creates an atmosphere of being on a hamster wheel, says physician Jeff Cain, president-elect of the American Academy of Family Physicians.

While the current prevalence of burnout is alarming many predict it could get worse as health care reform takes hold and the medical profession has to take on the additional workload associated with the millions of patients who will be newly insured under the health care law.

While the Affordable Care Act will put more pressure on the front lines, this new study could be an important wake-up call. The country needs to hear to build multidisciplinary health care teams to meet the need and help unburden our poor put-upon physicians, so they in turn can help us.

Pharma Advertising Gone Dotty?!?

With the banning of promotional give-away’s, decreasing pharmaceutical marketing budgets, escalating regulation, and an ever-more sophisticated consumer, spare a thought for pharma marketing execs charged with getting their message across.

Enter Genus Pharmaceuticals who probably thought they’d struck a home run with their new UK advertising campaign for their eczema cream Cetraben.

The print ad featured the back view of a young woman walking down a street with the wind lifting her short skirt to reveal red-and-white polka dot underwear…along with the headline “Confidence to live life their way. However that may be.

Turns out that’s not how one British doctor wanted to live his life!  He complained to the Prescription Medicines Code of Practice Authority (PMCPA), which was created by the Association of British Pharmaceutcial Industry (ABPI) to act as an industry watchdog.

With his stiff upper lip clearly quivering the enraged physician claimed that the advertisement was “offensive and degrading due to its sexual and titillating picture”.  Furthermore, he “despaired of the industry’s standards and culture” if they thought such an advertisement should be considered appropriate.

Following an investigation, PMCPA said that the ad did indeed breach Clause 9.2 of the Code, adding it is unacceptable to “display naked or partially naked people for the purpose of attracting attention and the use of sexual imagery for that purpose”.

Genus argued that the woman photographed was only embarrassed that her skirt had blown up in the wind. They claimed that the ad merely demonstrated that because of successful treatment of her eczema, she now had the confidence to wear a skirt and not cover her legs. The firm added that it had taken Clause 9.2 into account when considering the image, but believed that it was suitable for its intended audience, i.e.,adults and doctors.

The PMCPA countered suggesting that female adults and children would also be using this cream, and would likely also be offended.

Genus has since updated the image removing the view of the underwear, and  lengthened the skirt. Sadly, we can’t bring you a picture of the old advert, as it has been pulled from journals and all but disappeared from cyberspace.

Instead why not tell us your thoughts on pharmaceutical advertising.  Would a panty clad tush make you tusk? Would the polka dots drive you dotty?

We’d love to know.

The Doctor Won’t See You Now

US Pharma reps think they have it bad?  Then they should spare are thought for their poor beleaguered colleagues on the other side of the Pond!

According to an article in the industry journal PM Live,  time-pressured doctors in the UK are increasingly refusing to see pharmaceutical sales reps altogether.

A study undertaken by Doctors.net.uk in April 2012 surveyed more than 1,000 General Practitioner’s (GPs). They found that 52% of GPs did not see any pharmaceutical sales representatives in a typical week, while 26% saw only one pharma sales rep during that period.

Lack of time was the most common reason cited by GPs for not seeing pharma sales reps (38%). Other reasons included a practice “no-see” policy and a perceived lack of reps’ impartiality.

At the same time, they learned that doctors are turning to digital channels for independent product information. Nearly a quarter (23%) of the GPs surveyed said they preferred to find their own product information via independent online resources.

Doctors.net.uk said its findings follow earlier studies it conducted that show only 3% of doctors think online pharma resources are credible. Worse still 42% said they never visit pharmaceutical websites.

This research would appear to be in line with other trends among healthcare professionals.  European doctors’ use of iPads and other mobile devices is increasing and US pharma execs expect to increase their future spending on digital marketing channels.

SRxA can help Pharma companies to navigate the promotional maze and get the best bang for those pharma dollar bucks. Contact us today to find out more.

Ugly Shades of Gray

Ever thought you were paying too much for your meds?

A new report just released by the US House Committee on Oversight and Government Reform’s entitled  “Shining Light on the Gray Market” has examined the how’s and why’s of this.

The House staff investigation examined a group of companies that buy and sell prescription drugs used by hospitals and other health care providers. As SRxA’s Word on Health has previously reported, over the past several years there have been a growing number of supply shortages of prescription drugs. Operating outside of authorized distribution networks, “gray market” companies take advantage of these shortages to charge exorbitant prices for drugs used to treat cancer and other life-threatening conditions.

These companies’ questionable business practices put patients at risk and cost the US health care system hundreds of millions of dollars each year.

Here’s how it works. During drug shortages, hospitals find themselves unable to buy drugs from their normal trading partners – usually one of the three large national “primary” distributors, AmerisourceBergen, Cardinal Health, or McKesson.

At the same time, hospitals are deluged by sales solicitations from gray market companies offering to sell the same drugs for prices that are often hundreds of times higher than normal.  Not surprisingly, hospital pharmacists want to know why the hospitals can’t get these products but the ‘scalpers’ can.

The drug pedigree documents reviewed in the investigation show that some short-supply injectable drugs do not reach health care providers through the manufacturer-wholesaler distributor-dispenser chain.  Instead, these drugs leak into gray market distribution networks, in which a number of different companies – some doing business as pharmacies and some as distributors – buy and resell the drugs to each other before one of them finally sells the drugs to a hospital or other health care facility.

And this is not happening at nights, in dark alleys.  In 69% of the 300 drug distribution chains reviewed, prescription drugs leaked into the gray market through pharmacies. Instead of dispensing the drugs in accordance with their professional duties and state laws, these pharmacies re-sold the drugs to gray market wholesalers. Some pharmacies sold their entire inventories into the gray market. The wholesalers in turn sold the drugs, usually at significant markups, to other gray market companies.

As the drugs pass through these gray market distribution chains, they are significantly marked up, sometimes to prices that are hundreds of times higher than the prices that hospitals and other health care providers normally pay. The markups in these chains often bear no relation to the companies’ cost of purchasing, shipping, or storing the drugs. Instead, they reflect an intent to take advantage of the acute demand for short supply drugs.

In the example above, each company in the chain marked up the meds, even if they never took physical custody of them. The hospital that purchased the drug ended up paying $600 per vial for a drug that a pharmacy had purchased for $7 per vial.

Hospitals say they have no choice but to pay exorbitant prices for short-supply drugs because they need to take care of their patients.

Carmen Catizone, executive director of the National Association of Boards of Pharmacy has called for federal legislation to control pharmacies that are re-selling drugs on the gray market.

We need to take some steps to remove pharmacies’ ability to act as wholesalers, in the way that they are. The end point of these transactions should be to patients and not to wholesalers,” Catizone said.

While some of the pharmacies that are selling drugs on the gray market are not necessarily doing anything illegal, according to Catizone it is a moral and ethical issue. “There are provisions in state laws in which pharmacies can wholesale up to 5% of their product. The intent was that, if you have a situation where a pharmacy runs short on a product, they can buy it from another pharmacy or wholesaler for that patient. They are violating the intent of those laws, morally and ethically.”

Well said, Mr. Catizone, well said.

Good Fat, Bad Fat

There is so much talk about fat these days.  Hardly a day goes buy when we’re not bombarded with news headlines and statistics such as these:

  • Childhood obesity rates have more than tripled in the past 30 years
  • More than 155 million children worldwide are now considered obsese
  • 70% of overweight youth will remain obese in adulthood
  • An overweight individual carries an increased chance of diabetes, cardiovascular disease, bone and joint problems, and even cancer
  • In the US, additional medical spending due to obesity related issues is $190 billion a year (>more than 20% of total health care expenditure)

But as these statistics grow, so does the confusion.  especially when it comes to good and bad fats.

When it comes to the dietary stuff, monounsaturated fats and polyunsaturated fats are the good fats because of their overall impact on your heart, cholesterol, and overall health.  Conversely, saturated fats and trans fats are known as the “bad fats” because they increase your risk of disease and elevate cholesterol.

And in case that’s not clear, appearance-wise, saturated fats and trans fats tend to be solid at room temperature (think of butter or stick margarine), while monounsaturated and polyunsaturated fats tend to be liquid (think of olive or corn oil).

Now we’ve got that straight, we also have to consider good and bad body fat.

Essentially there are two types of fat in the human body: white fat, which stores calories and can lead to weight gain, and brown fat which burns calories and generates heat in the process.

But to most of us, fat is unfortunately just fat. Although looking in the mirror might suggest we should shed a few pounds it’s not able to tell us if our problem is the good or bad stuff.

But now in an effort to tackle the global obesity epidemic, scientists at the University of Nottingham, UK have identified a technique to distinguish between the fat types. The non-invasive method uses a thermal imaging camera.  And because brown fat produces 300 times more heat than any other tissue type, heat-sensitive technology can not only identify it, but can also measure how much heat it is producing.

By using the new technique on children as well as adults, the researchers demonstrated that children have larger stores of brown fat and produce heat much more rapidly than adults. Potentially the more brown fat you have or the more active your brown fat is, the more heat you produce  and as a result you might be less likely to lay down excess food as white fat.

Study lead Michael Symonds, Professor of Developmental Physiology in the School of Clinical Sciences at the University of Nottingham, hopes that with these insights, they can learn how to make brown fat more active.

Another of the investigators, Dr Helen Budge said: “Brown fat does appear to be present in higher amounts in larger people than in people of lower body weight, but we think the key difference is in how active it is from person to person.The reason this is exciting is that if you “switch on” brown fat and it uses up energy, then potentially that is one way of controlling body weight.”

It’s long been known that activities such as weightlifting can boost fat-burning capabilities by increasing metabolic rate through lean muscle mass creation.  What if fat could be harnessed in the same way? Knowing what foods to eat to increase energy expenditure from brown fat, coupled with an active lifestyle could help more obese children and adults find a healthy weight.  The results could increase the overall health of a nation by decreasing risk factors for disease and reducing costs associated with obesity.

Further studies of how brown fat responds to different food groups could enable food manufacturers to include a new category of health advice – thermogenic potential – on food packaging. Whereas today we probably look at calorie content or carb content, a thermogenic index on food labels could show whether that product would increase or decrease heat production within brown fat…in other words whether it would speed up or slow down the amount of calories we burn.

Now that really would be useful.

Back-to-school lesson on food allergies

According to the Food Allergy & Anaphylaxis Network (FAAN), nearly six million children across the United States suffer from food allergies. Of those, more than 300,000 were admitted to hospital in the last year alone. To help ensure your food allergic child doesn’t suffer the same fate, SRxA’s Word on Health offers some simple Back-to-School tips for parents. The key to preventing allergic reactions and anaphylaxisis preparation:

  • Contact the school well in advance of the first day of class and let your child’s teachers, coaches and school nurse know about their allergies
  • Provider the school with a copy of your Child’s Anaphylaxis Action Plan
  • Find out about field trips, parties, and special events such as Halloween or Valentine’s to ensure that allergens don’t sneak in along with other treats
  • Meet with key personnel that will take care of your child if a reaction occurs
  • Find out what plans are already in place for children with food allergies and what steps will be taken if an allergic reaction occurs at school
  • Ensure that any medication, such as an EpiPen, on that plan has a physician’s order to cover it at school and that medication is readily available to personnel if it needs to be administered
  • Teach your child what foods are off limits
  • Teach your child to recognize symptoms and let an adult know immediately if they think they might be suffering an allergic reaction.
  • Make sure your child understands not to trade food with others or eat anything with unknown ingredients.

Schools and teachers can also prepare themselves for the food allergic children in their class.  FAAN produces some excellent resources as part of its Safe@School campaign. For example, they offer expert in-service training to school districts to prepare staff to confidently CARE™ for students with food allergies by teaching them how to: In addition, FAAN provides training presentations, suitable for elementary and secondary schools as well as colleges and universities. So whether you’re a child, parent or teacher dealing with food allergies, be prepared, be safe and CARE this back-to-school season.

Putting the squeeze on anti-cancer drugs?

For years, doctors have warned patients that grapefruit juice can cause overdoses when combined with anything from cholesterol medication to antihistamines. Now, researchers at the University of Chicago medicine have discovered that drinking one glass of grapefruit juice a day can actually reduce the dosage, cost and side effects of certain drugs, including those used to treat cancer.

Doctors were interested in studying the sirolimus, a drug approved to prevent rejection after kidney transplant, on patients with incurable cancer. Knowing that only 14% of the drug is absorbed into the blood stream, and that higher doses can cause nausea and diarrhea, they went about searching for a supplement that would boost sirolimus absorption.

That was when lead researcher Dr. Ezra Cohen remembered grapefruit juice can increase blood levels of certain drugs.  “We saw that not as a problem but as an opportunity to enhance the pharmacology to not only sirolimus but to a wide range of drugs.”

Grapefruit juice’s potential pharmaceutical prowess stems from its ability to inhibit enzymes in the intestine that break down certain drugs. The effect begins within a few hours of drinking it and  wears off gradually over a few days.

So Cohen and his team gave some patients grapefruit juice to see if they could get more sirolimus into their bloodstreams. At first, Cohen gave his patients grapefruit juice, but nothing happened. That was when the Florida Department of Citrus got wind of the study and offered to test a sample of the grapefruit juice Cohen’s team was using.

Dr. Cohen didn’t realize that the compound that enhances drug absorption can be degraded kind of drastically,” said Dan King PhD, the director of scientific research at the department. “This juice he was using didn’t have a whole lot of this compound present.”

The compound is furanocoumarin, and it works by inhibiting enzymes in the intestine that would otherwise limit drug absorption. Cohen’s juice had almost none because it was canned and stored in the non-refrigerated section of the grocery store.  Such juice is heated to temperatures that degrade the furanocoumarin.

Having identified the problem, the Department of Citrus supplied “potent” grapefruit juice for the rest of the study. It worked, increasing sirolimus levels by an incredible 350% and lowering the necessary doses from 90 mg per week to between 25 and 35 mg per week.

Sure enough, what they sent was very potent,” Cohen said. “It allowed us to reduce the dose of sirolimus dramatically.”  It could also reduce the cost of cancer treatments which are problematic for a lot of patients.

Unfortunately, the study didn’t show that the sirolimus-grapefruit combo was completely effective against cancer. None of the 138 patients in the study had a complete response, but about 30% achieved stable disease, meaning a period when their cancers did not advance. And one patient in the grapefruit juice group experienced significant tumor shrinkage that lasted for more than three years.

Jerry Avorn MD, chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston, did not work with researchers on the study, but said he is excited about the results.  “It’s important not to see this as a new cure for cancer, but rather, it’s a very interesting way of using a known food-drug interaction as a means of getting better drug levels into cancer patients.”

SRxA’s Word on Health believes this is the first cancer study to harness a grapefruit-drug interaction rather than warn against it. We look forward to more.