Ever heard of this concept, called "The Law of Diminishing Returns"? Surely there is a concept that is the equal and opposite version of that notion. I can't for the life of me think of what that could be.
Think of yourself at a copy shop. You take a really poor quality paper and you reproduce it at a copy machine. Which in turn makes an even worse reproduction, and then you take that version and copy it, which in turn makes a version that is three times as bad. And each time you make a copy of the new, latest copy of that poor quality paper, the flaws become more exaggerated so that whatever was originally written or typed on the original document is barely legible.
That sort of thing came to mind when I found the following information. That, and the concept of a "leadership vacuum."
Yesterday I received the latest installment of Discover Magazine. I mostly order it for the kids, but I also enjoy reading it. And they had an article about cancer research that made my hair stand on end.
It was about Imposter Cell Lines, that have been used in Cancer Research, for drug and treatment development. The Dirty Little Secret of Cancer Research, by Jill Neimark.
Apparently there is and has been a big problem since the 1960s, with cell lines that were contaminated or worse yet, entirely mislabeled.
For Example:
Imagine that you are a cancer patient. You have Breast Cancer. And you have been losing the battle against this disease. Your Oncologist talks you into entering a human drug trial, so that you can begin taking an experimental drug that was supposedly developed to treat only Breast Cancer. In fact, in Vitro, (in the lab in a petri dish with cell lines) these drugs produced promising results.
Then you and some other volunteers take it, and success rates are nil or on par with an error rate in a study, and all the doctors and scientists stand around scratching their head wondering what went wrong, while you die a slow, painful death.
Years later, it is discovered that the cells used in-vitro were actually melanoma cells, or colon cancer cells, but not Breast Cancer Cells.
A geneticist all the way back in the 1960s tried to raise the alarm on this, but was professionally destroyed for his efforts. And I can see why too (leadership vacuum). I mean I am sure a lot of grant money, and careers were at stake.
"There are about 10,000 citations every year on false lines--new publications that refer to or rely on papers based on imposter (human cancer) cell lines."
qtd by Geneticist, Christopher Korch, Discover Magazine Nov 2014 pp46
This following quote also made my blood run cold:
"Today, cell lines known for nearly 50 years to be imposters are still in wide use under their assumed names--wrong identities regularly invoked in peer-reviewed publications." Discover Magazine, Nov 2014, pp 48
If you know, or have ever been or are a cancer patient, one of the things that about drives a person insane is the constant, uncertainty about the nature of your condition. You always imagine that medical personnel are going to go all CSI on your case and tell you everything, but, the fact of the matter is, that doesn't always happen. Many cases, even the identity of the kind of cancer is not always cut and dry, and I cannot help but wonder how this new information, plays a part in those mysterious pathology results, that some of us receive from the lab.
And given the stories in the past about promising new drugs for various forms of cancer, that at the time turned out to be duds, I have to wonder if the drugs were ACTUALLY developed for the right kind of cancer. If the labs were using imposter or contaminated cell lines, then who knows what the drug was developed to treat, until they get a DNA fingerprint of the cell lines used in the drug development.
For those that don't know, when you or a loved on is diagnosed with something terrible or chronic like cancer, it isn't unusual for the patient and family members to begin researching papers on the diagnosis in question. My advice to those folks is to check out International Cell Line Authentication Committee ICLAC, which has set up a public database of all known false lines of cell cultures. That way, if you are reading research that doesn't add up, or that cites older papers, you can check the source and that may help the patient make better decisions regarding their treatment options.
I will let you read the whole article to see what positive actions have been taken. But judging from what I have read, we aren't out of the woods yet. How many modern peer reviewed papers cited other peer reviewed papers, that used imposter cell lines. This to me is like running down the source of an urban modern myth, only life and death hang in the balance.
The next issue--I have been running into articles that discuss the cost of chemotherapeutic drugs. I know you think that with insurance, that such concerns are supposed to be all behind us now. Well even with a co-pay, those drugs can cost a person tens of thousands of dollars a pop. For me who lives in a tiny victory home, my treatments, even with a catastrophic cap have been a hardship. Even though I am dealing with cancer, my kids still need braces, and clothes, (they grow up fast) I would still some day like to send these two extremely intelligent children to college and not to work in a paper hat. I would like to be able to stay in my own home and not have to live some day in Section 8 Housing, and yet:
The diagnosis for cancer is still the leading cause of personal bankruptcy.
I have found two articles. One from 60 Minutes that states:
"...according to an independent study, the single biggest source of income for private practice oncologists is the commission they make from cancer drugs. They're they ones who buy them wholesale from the pharmaceutical companies, and sell them retail to their patients. The mark-up for Medicare patients is guaranteed by law." qtd by Dr Peter Bach. 60 Minutes, The Cost of Cancer Drugs.
The story even described something that to me looked like fraud or a kickback scheme:
"They said to the doctor, "Buy Zaltrap from us for $11,000 dollars and we'll send you a check for $6,000." Then you give it to your patient and you get to bill the patient's insurance company as if it cost $11,000." qtd by Dr Peter Bach. 60 Minutes, The Cost of Cancer Drugs.
.
Basically what it comes down to, are that patients are not taking their treatments correctly, or forgoing them entirely because of the crazy costs involved.
Other papers blamed Hospitals for buying up private Oncology Practices, and stated that you often are charged at least twice as much for the same treatment in a hospital that you would receive in an private oncologist's practice. And these same articles indicated that even though nonprofit hospitals could negotiate for lower prices on their drugs, that they were not required to pass the savings on to the patient, and most do not. Of course we the patient would never know, because we don't know the true cost of anything.
I found this in an older article at the Charlotte Observer:
Large nonprofit hospitals in North Carolina are dramatically inflating prices on chemotherapy drugs at a time when they are cornering more of the market on cancer care, an investigation by the Observer and The News Observer of Raleigh has found.
Prices soar as hospitals dominate cancer market; Sept 2012.
Costs go up, but quality of care doesn't. And if you are forced to go into bankruptcy just to buy a couple of months or years of life, a financially devastating situation that will affect your kids--then really, how is that not a Quality of Care issue too. The incredible chronic stress of those financial dire straights that will go on long after your demise, will negate a lot of the pleasure one has in simple living and spending time with loved ones. After all, I couldn't look at my kids with that over my head, without feeling like a tremendous burden on them, an anchor that will keep them from achieving their dreams just as surely as out of control student loan costs could or a third world type economic collapse.
A similar story appeared in Bloomberg Businessweek:
When Hospitals Buy Clinics, Prices Go Up.
What I see here, between these articles: Finger Pointing. It's the private practice oncologists, no it's the hospitals---the common denominator though?
Pharmaceutical Companies. No matter whose at fault, they still make money hand over fist. And I cannot help but wonder what part they played in the Imposter Cell Line issue. After all who funds those researchers?
Keep in mind, we pay 50 to 80 percent more for drugs in the US, than people pay in Canada or the EU. Drug companies are mostly based out of the EU if the articles are to be believed. And our hospitals and doctors should not be prohibited by law from negotiating lower costs, but also, they should be required to pass those savings on to the people getting the care.
The Affordable Health Care Act was supposed to be the beginning of the end of going bankrupt due healthcare costs.
Related Stories:
Hospital Prices No Longer Secret, As New Data Reveals Bewildering System, Staggering Cost Differences. Huffpo
When you have cancer or any serious, chronic disease, you become very emotionally vulnerable. You fear for the future, not just for yourself, but your family. You are thrust into a mind boggling maze of options, tests, outcomes, and you have to decide at some point who your doctor is, and where you get treatment. And all of this is subject to change.
As a person who is quite at home in the Alternative Healthcare Community, I am used to seeing the accusation that alternative providers are quacks, taking advantage of people like me by giving us false hope.
It appears that whatever I think of such statements, there are others who see just that happening in main stream medicine as well.
"I do worry that people's fear and anxiety are being taken advantage of." qtd by Dr Saltz. 60 Minutes, the Cost of Cancer Drugs.
Wed Dec 10, 2014 at 7:14 AM PT: National Public Radio just ran with a similar story about imposter cell lines:
http://www.npr.org/... Lots more interesting information about this issue that appears to be a big issue in our Scientific Community.