Thursday, October 20, 2016

Thursday, October 13, 2016

5 Best Fixes for Hair Loss


The real deal on what works—and what doesn’t—when it comes to fighting hair loss. Whether you’ve just noticed a thinning hairline or you're constantly wearing a baseball hat to hide your bald spot, there's a good chance you’ve tried at least one product to keep your hair.

And while there are myriad products designed to fight hair loss, it can sometimes be hard to tell which methods to trust and which to toss. One hard truth: Hair loss is mostly out of your control. “Baldness comes down to your genes,” says Frederick Joyce, M.D., founder of Rejuvenate! Med Spa and a member of the International Society for Hair Restoration Surgery. “If you have the baldness gene, there are some natural remedies that may make your hair stronger and healthier to slow your hair loss slightly—but they won’t prevent you from going bald. Still, maintaining hair health by eating well and using the right products—combined with medical-grade treatments—can really work all together to help you have a fuller, thicker head of hair.”

There are some solutions that address the problem (using stem cells to regrow hair is promising) but many are still years away from becoming available as a hair loss treatment. So here's the lowdown on which baldness solutions available now are truly effective—and which hair-loss fighters are merely snake oil.

1. Nutrition
2. Nioxin Shampoo
3. Laser Light Therapy
4. Propecia
5. Minoxidil

Wednesday, October 12, 2016

Arthritis drug may help with hair loss condition alopecia

For people who suffer from a condition that causes disfiguring hair loss, a drug used for rheumatoid arthritis might regrow their hair, a new, small study suggests. Alopecia areata is an autoimmune disease that causes patchy or complete hair loss, including on the head, body, eyebrows and eyelashes. Researchers found that more than 50 percent of 66 patients treated with the drug Xeljanz (tofacitinib citrate) saw hair regrowth in three months.

“There is hope now that we will have more to tell patients than get counseling and a wig,” said lead researcher Dr. Brett King, an assistant professor of dermatology at the Yale School of Medicine, in New Haven, Conn. Xeljanz appears to work by stopping the immune system’s attack on hair follicles, King said. In addition, the researchers have identified genes that might predict a patient’s response to treatment, he said. King said it is doubtful that Xeljanz will work for the most common types of hair loss (such as male pattern baldness), which are not the result of an autoimmune disease.

Whether the hair regrowth will last or how long someone would have to take the medication isn’t known, King noted. “It may be that if we can treat people for long enough the condition might go into remission, but we don’t know the answer to that,” he said. For the study, King and colleagues treated the patients with 5 milligrams of Xeljanz twice a day for three months. Over that period, more than 50 percent of the patients saw some hair regrowth and one-third recovered more than half of the lost hair on their head, King said. Side effects​ were mild, he added. King hopes that a big drug company will look at these results and sponsor larger trials to seek FDA approval for using Xeljanz as a standard treatment for the 4 million to 11 million Americans with alopecia areata.

Treatment with Xeljanz​ is expensive, costing as much as $40,000 a year. Because the drug is not approved for the treatment of alopecia areata, it may not be covered by insurance for that use, King said. Doctors, however, may be able to convince insurers to cover the cost, he added. The study was published Sept. 22 in the journal JCI Insight. Two dermatologists not involved with the study said the findings hold promise. “The results from this trial are very exciting,” said Dr. Katy Burris, an assistant professor of dermatology at Northwell Health in Manhasset, N.Y. “Alopecia areata is a frustrating condition for patients as well as physicians, and current treatment options have mixed results,” Burris said. Treatments included general immunosuppressants such as cortisone injected directly into the areas of hair loss, like the scalp or brows.

More-involved treatments include oral medications or skin creams to try to suppress the immune response or to stimulate the immune system to overcome the hair loss, said Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City. “Alopecia areata can strike at any age and can be devastating to the person suffering [from the disease],” Day said. “The great news is that Xeljanz has worked even in patients who had five or more years of hair loss. The hair begins to grow within a month, and the regrowth is significant, with the hair often regrowing at or near normal thickness and volume,” she said. More research needs to be done to see how safe the treatment is, especially in children, Burris said. “However, these results keep us hopeful that a new, safe, effective treatment may be on the horizon shortly.”

Tuesday, October 11, 2016

Breast Cancer Treatment Costs Vary Wildly, Study Finds

It should have been a no-brainer — a routine test to confirm that a 50-something teacher was now, officially, a breast cancer survivor. But the patient balked. The surprise encounter got Dr. Sharon Giordano curious and she embarked on a study that has found that the cost of cancer treatment varies wildly, with no apparent rhyme or reason.

The variation adds up to $1 billion a year that insurance companies, patients and government health plans are needlessly paying to treat breast cancer, Giordano and colleagues at the MD Anderson Cancer Center report on Monday in the journal Cancer. Patients often get stuck with thousands of dollars in bills that can take years to pay off. "One of the reasons I started on this project is I had a patient with triple-negative breast cancer," Giordano told NBC News. "She was just finishing her five-year follow-up after treatment and was transitioning into survivorship. We talked about ordering an additional test. She was reluctant to get it." Why would anyone want to skip a test that could put her in the clear? "She shared with me that she was still on a payment plan, still trying to pay off the debt from her breast cancer treatment five years earlier," Giordano said.

"That really shocked me. I didn't know. I think it cured her but it left her with this huge debt that I was completely unaware of." In fact, the costs can get so high that some patients may skip treatments. "If they have a higher copay and it costs more, then they are less likely to take it," Giordano said. "There are pretty clear data that show the more it costs, the less people take it." As a working oncologist, Giordano knew there are almost always a variety of choices for treating breast cancer. She wanted to see if there was an easy way for patients and their doctors to pick the least expensive treatment that would still be effective. She was stunned at what she found. The team went through insurance claims filed by more than 14,000 breast cancer patients between 2008 and 2012 and found expenses across a single class of drugs varied by as much as $46,000.

Dr. Regina Hampton prepares to insert a balloon catheter into a patient's breast for radiation treatment in Lanham, Maryland Marvin Joseph / The Washington Post/Getty Images
"There were big variations in the cost of treatments we could prescribe," Giordano said. Even more surprising: Some of the more effective and least toxic treatments were, in fact, cheaper. "There is one chemotherapy regimen called TAC," Giordano said. That's short for Taxotere plus adriamycin plus cyclophosphamide — three different chemotherapy drugs that hit the cancer in different ways. "It was both one of the highest cost and one of the highest toxicity regimens," she said. Swapping a related drug called paclitaxel for Taxotere cut both the side effects and the costs, Giordano said. "It's almost $15,000 cheaper," she said. "I think most people would think those pretty equivalent in terms of efficacy," she added. But it wasn't easy to find this out.

"For me, working at a hospital, I don't really see that at all. I don't have an easy way to access what the costs would be," she said. Even treatments that should be cheap varied widely in cost. "We give a pill called an aromatase inhibitor that blocks estrogen after chemotherapy. There are three different ones that are all approved and they are probably equivalent," Giordano said. These pills reduce the chance that tumors will come back in the other breast. "Depending on what insurance plan (a patient has) one would be more costly and one would be less costly.

Doctors should try to find out. The problem is, it is time-consuming," Giordano said. And how much a patient ended up paying herself varied wildly depending on which insurance plan she had. "I was somewhat surprised at the relatively high costs patients were bearing — around $3,000 out of pocket on average," she said. "What I think was more concerning was that top quarter, top 10 percent of patients are getting really hefty bills costing them $10,000 or more." Not surprisingly, people with so-called catastrophic health insurance plans, which charge low premiums but which also don't reimburse for much, paid the most out of pocket. It adds up.

"Expenditures for cancer care have grown from $72 billion in 2004 to $125 billion in 2010 and are estimated to reach $158 billion by 2020," Giordano's team wrote. "The costs of cancer care are increasing at an unsustainable rate — two to three times faster than other health care costs. Patients' out-of-pocket costs have also been rapidly increasing." The findings ring true to Peggy Johnson, a breast cancer survivor in Wichita, Kansas who's also an advocate for the breast cancer charity Susan G. Komen For the Cure. Johnson, who was a breast cancer advocate long before she herself was diagnosed, kept careful track of her own medical bills as she went through treatment. She had four rounds of chemotherapy for triple-negative breast cancer and 35 radiation treatments.

"The cost of my bills was $200,000 and a few cents," Johnson said. "The insurance company negotiated it down. They paid $60,000." Johnson ended up paying $3,000 out of pocket for co-insurance and counts herself lucky because she had insurance through her employer. "Many people in the United States who don't have health insurance would have been billed the full $200,000, and they would have been expected to pay the $200,000," she said. Related: Good Luck Finding Out What an MRI Costs Many patients would just delay treatment and wait until their cancer progressed, which ends up costing even more to treat. And patients may end up going on Medicaid and costing the state and federal government plan extra money for treating advanced cancer.

Both Giordano and Johnson say it's very difficult to find out ahead of time what each particular insurance plan will pay, and what each hospital, clinic or physician will charge, for various treatments. "This is everybody's problem," Johnson said. "I know women who have lost their homes because they couldn't pay their medical bills." Studies have shown that medical bills are one of the leading causes of personal bankruptcy.

Thursday, October 6, 2016

Crowdsourcing effort takes aim at deadliest breast cancers

TIMOTHY D. EASLEY, AP

Lara MacGregor, a participant in a new crowdsourcing project for metastatic breast cancer research, poses for a photo as she undergoes treatment at the Norton Cancer Center in Louisville, Ky., on Wednesday, Sept. 21, 2016.
Forget the pink ribbons. Spitting in a tube for science is what unites a growing group of breast cancer patients taking part in a unique project to advance treatment for the deadliest form of the disease. For many of the 150,000-plus patients nationwide whose tumors have spread to bones, brains, lungs or other distant organs, the hue heralding breast cancer awareness and survival each October is a little too rosy. They know cancer will likely kill them. And they’ve often felt neglected by mainstream advocacy and medical research. But now they have a way to get involved, with a big new project that aims to gather enormous troves of information about their diseases in hopes of finding new and better ways of treating patients like them -- women whose cancer has spread, or metastasized, and left them nearly out of options.

“Patients want to live and we know that research is the way that we’re going to be able to live,” said Beth Caldwell, a former civil rights attorney in Seattle diagnosed with metastatic disease in 2014. The idea is to gather molecular and genetic clues from as broad a group of metastatic breast cancer patients as possible. With data from thousands of people, researchers think they will be better able target treatments or come up with new ones by answering important questions about the disease. For example: Is there something unique about tumors that spread to the brain, or that recur many years after diagnosis?

What allows a very few women to outlive others by many years despite the same prognosis? Most breast cancer patients are treated at centers that don’t do research on tumors, so participating in studies at academic medical centers far from home is cumbersome at best. Patients sick or dying from their disease face additional hurdles. This project is different.

Patients sign up online, mail in saliva kits for genetic testing, and allow use of their tumor tissue samples and medical records. Researchers use social media to keep them posted about progress, and periodically invite participants to visit the Cambridge, Massachusetts, lab where their specimens are being analyzed. The Metastatic Breast Cancer Project is run by scientists at Harvard and Dana-Farber Cancer Institute and was launched last October with funding from the Broad Institute of MIT and Harvard, an independent nonprofit group.

Using word of mouth and social media, it has already enrolled more than 2,600 patients -- a pace nearly unheard of in medical research. “I enrolled from my recliner in my living room. I did my spit tube in bed,” Caldwell said. The mother of two turns 40 on Thursday, and cancer has reached her brain, lungs, bones and liver. She tries to stay positive, but October “is a month where I just want to hide under the covers and check out,” Caldwell said. “I just don’t want to be confronted with all this pink garbage.” Lara MacGregor, who runs a Louisville, Kentucky-based nonprofit group for cancer patients, said she feels the same way. “Everything about breast cancer is about survivors and beating cancer,” MacGregor said. “And we’re sitting in the wings saying, “I’m never going to celebrate the end of treatment.’”

MacGregor was pregnant when diagnosed with early-stage breast cancer in 2007. She had both breasts removed plus chemotherapy, and went on with her life thinking she was cured until two years ago, when tests for nagging back pain revealed cancer had returned and spread to her bones. Now 39, MacGregor read about the project online, decided immediately to take part, and emailed dozens of friends and connections who also signed on.

Before she mailed her saliva kit, “my 8-year-old drew a picture on the box and said, ‘thanks for helping my mom,’” MacGregor said. “I hope that real data about real people is going lead to better treatment options,” she said. “My life depends on it.” More than 200,000 people, mostly women, are diagnosed with breast cancer nationwide each year. Most are diagnosed when cancer is at an early, potentially curable, stage. For about 6 percent, or 15,000 patients, the disease has already spread at diagnosis.

And for about 30 percent of patients diagnosed with early-stage breast cancer, the disease will eventually recur in distant parts of the body. The average survival for patients with metastatic disease is about three years. According to a 2014 analysis from an alliance of breast cancer advocacy groups, less than 10 percent of government and nonprofit groups’ investment in breast cancer research in recent years went to studying metastatic disease. “Metastatic breast cancer in general is an understudied area,” says Marc Hurlbert of the Breast Cancer Research Foundation. “We don’t know, for example, how the tumor has changed. Is it the same makeup as it was before? Do cells have a different molecular profile than cancer that started first in the breast?”

By gathering large numbers of tissue samples and information about how the diseases progresses in different people, the project may be able to uncover useful trends. It has produced a few enticing clues already, including small groups of patients who’ve responded unusually well to standard chemotherapy or to new immunotherapy drugs -- some have survived for 10 years or more. The researchers hope DNA analyses will help explain why and lead to treatments that will improve the odds for all patients with the disease. Data will be posted on a special online site and with the National Cancer Institute’s genomic data program -- making it available to other scientists and boosting the odds of finding better ways to treat patients with metastatic disease.

And proof that crowdsourcing can draw thousands of patients to medical research is an important discovery itself, given how hard that can be, said Dr. Nikhil Wagle, a project leader and an assistant professor of medicine at Harvard and Dana-Farber. “This project makes them feel empowered, makes them feel like they are making a difference -- if not to help themselves, then maybe the next generation of patients,” Wagle said.

Tuesday, October 4, 2016

Young breast cancer survivor: Chemo Friday, back to work Saturday

It was just an ordinary September day, a year ago, and Tylithia Burks was home from her night shift as a nuclear pharmacist, vegging out on the couch. Somebody on TV was talking about breast self-examination. Even though she was only 33, not knowing of any family history of the disease, Burks decided self-examination was a good idea. She found a lump.

"Had I not done the exam, I would never have found it," she says now. "It could have been six months or a year." What happened after that discovery offers a look at the new face of breast-cancer treatment. Instead of immediate surgery, Burks embarked on a 16-round course of chemotherapy to reduce the size of the tumor. And instead of feeling sorry for herself, Burks went indoor skydiving at iFLY and posed for a set of glamour shots.

Over the five months, the chemo shrank the tumor from 3 centimeters to 4 millimeters. Burks worked her night shift at Triad Isotopes through the whole thing. Some nights, it was hard. "My co-workers knew," Burks says, "and they looked out for me." Enter Dr. Tejal Patel, Burks' doctor and a breast medical oncologist at the Houston Methodist Cancer Center. She doesn't think patients need to put their lives on pause for cancer. "There's not a lot out there about patients who do wonderfully," she says. "We can control the side effects, and it doesn't have to take away your life." For Burks, who is naturally bright-eyed and ebullient, keeping her life as routine as possible was the goal. "The thing is, prior to starting, I told myself I wanted to work and do other normal things, not just have cancer," she says. "I did it for normalcy." 

If she had chemo on a Friday, she was back to work on Saturday night. Burks also drew on her network of friends and fellow church members - she had people to take her to chemo, people to get food to her, people to pray for her. Burks' mother died of lung cancer in March 2008. "She tried to be private and keep it to herself," she says. "I'm very private, but this was not a time to do that." Because chemo can play havoc with a woman's reproductive organs, Burks' friends ran a GoFundMe crowd-funding campaign to raise money to freeze her eggs.

Burks, who is single, likes to joke that her children are on ice for now. She had her mastectomy in April and her reconstructive surgery in September. No cancer was found in her lymph nodes, and she has about a 15 percent chance of recurrence. She does not have the BRCA mutations that can be a signal for cancer. "Everyone has life happen to them," Burks says. "If you let it take you down, what are you living for?" Breast cancer in young women is relatively uncommon.

According to the Centers for Disease Control, only about 11 percent of new breast cancers are discovered in women younger than 45. Patel, who likes to point out that there are now 15.5 million survivors of breast cancer, says the new supportive treatments that make chemo more bearable work for patients at any age. "That's my goal," she says, "not to have to live in a bubble, but to work, go to church and go shopping." But care has to be ongoing, says Patel, because anxiety can surface, along with hot flashes and nerve pain. Fatigue, sexual dysfunction and, of course, financial worries can afflict survivors. Burks, who grew up in Killeen, the daughter of a career Army father, sees unusual symmetry between her cancer and her mother's.

Both were diagnosed in September. Her mother died in March; she finished chemo in March. She is looking forward to getting a tattoo of two ribbons: one white, for lung cancer; and one pink, for breast cancer. Right now, in memory of her Korean mother, she has a small tattoo of the Korean character for strength on the back of her neck. Burks is upbeat. "It's not the end of the world. You can beat it and have a normal life," she says. "Don't let it change you."

Monday, October 3, 2016

Beauty for Breast Cancer Awareness

When it comes to beauty's fight against breast cancer, there's always more to come!

1) Estée Lauder Advanced Night Repair: This longtime tried and trued nighttime serum is getting an upgrade with Estée Lauder’s pretty little Pink Ribbon Pin. 20% of each purchase will be donated to the BCRF until 6/30/17. $92

2) Estée Lauder Pink Perfection Color Collection: Perfect for quick travel touch ups, this makeup palette comes with four eyeshadow shades, blush, and even a full-size lipstick. 100% of profits will be donated to the BCRF until 6/30/17. $35

3) Lab Series Age Rescue + Face Lotion: Ginseng to the rescue for the guys. An Anti-age lotion that will help you fake that you’re not fatigued. 20% of each purchase will be donated to the BCRF until 12/31/16. $50

4) Tory Burch Eau de Parfum Rollerball: Roll on this sweet and floral fragrance for the next few months as Tory Burch joins in support of Breast Cancer Awareness. 20% of each purchase will be donated to the BCRF until 12/31/16. $29

5) Origins Overnight Mask: Prepare to seize the day (and to feel good doing it) after a night of using this hydrating mask. $5.00 from each purchase will be donated to the BCRF until 12/31/16. $26

6) Smashbox Photo Finish Primer Water: This fruity spritz will awaken and brighten your face so you are feeling fresh all day long. $5.00 from each purchase will be donated to the BCRF during the month of October. $32 Vanity Fair features in-depth reporting, gripping narratives, and world-class photography, plus heaping doses of Oscar-blogging, royal-watching, and assorted guilty pleasures.