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And his mood could go from ebullient to dark in a matter of minutes.\u003c/p>\n\u003cp>Ketamine \"helped me get my life back,\" says James, who asked that we not use his last name to protect his career.\u003c/p>\n\u003cp>Ketamine was developed as a human and animal anesthetic in the 1960s. And almost from the time it reached the market it has also been used as a mind-bending party drug.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But ketamine's story took a surprising turn in 2006, when researchers at the National Institutes of Health \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16894061\">showed\u003c/a> that an intravenous dose could relieve severe depression in a matter of hours. Since then, doctors have prescribed ketamine \"off label\" to \u003ca href=\"https://www.npr.org/sections/health-shots/2017/03/20/520169959/ketamine-for-severe-depression-how-do-you-not-offer-this-drug-to-people\" target=\"_blank\" rel=\"noopener\">thousands of depressed patients\u003c/a> who don't respond to other drugs.\u003c/p>\n\u003cp>And pharmaceutical companies are \u003ca href=\"https://www.npr.org/sections/health-shots/2015/05/28/409800015/ketamine-depression-treatments-inspired-by-club-drug-move-ahead-in-tests\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> several new ketamine-related drugs to treat depression. Johnson & Johnson expects to seek approval for its nasal spray \u003ca href=\"https://www.jnj.com/media-center/press-releases/new-phase-3-data-show-esketamine-nasal-spray-demonstrated-rapid-improvements-in-depressive-symptoms-in-patients-with-treatment-resistant-depression\" target=\"_blank\" rel=\"noopener\">esketamine\u003c/a> later this year, though the approval would be limited to use in a clinical setting.[contextly_sidebar id=\"WxNsPZS18b7j3a9u3SqMCjwKimnR3LX8\"]\u003c/p>\n\u003cp>Meanwhile, doctors have begun trying ketamine on patients with a wide range of psychiatric disorders other than depression. And there is now growing evidence it can help people with anxiety, bipolar disorder, post-traumatic stress disorder, and perhaps even obsessive-compulsive disorder.\u003c/p>\n\u003cp>\"I think it's actually one of the biggest advances in psychiatry in a very long time,\" says Dr. \u003ca href=\"https://www.mcleanhospital.org/biography/martin-teicher\" target=\"_blank\" rel=\"noopener\">Martin Teicher\u003c/a>, an associate professor of psychiatry at Harvard Medical School and director of the Developmental Biopsychiatry Research Program at McLean Hospital.\u003c/p>\n\u003cp>Ketamine may also offer new hope for people like James who have symptoms of several different psychiatric disorders.\u003c/p>\n\u003cp>James had a happy childhood, he says. But his thoughts were out of control. \"I always felt like I was crossing a freeway and my thoughts were just racing past me,\" he says.\u003c/p>\n\u003cp>He spent much of his childhood terrified of \"an unknown, an ambiguous force out there.\" The fear was \"overwhelming,\" he says. \"I literally slept with the cover over my head with just room to breathe through my mouth until I went to college.\"\u003c/p>\n\u003cp>And there was something else about James: his body temperature.\u003c/p>\n\u003cp>\"I overheated constantly,\" he says. \"I would wear shorts all year long. In my 20s in my apartment I would sleep with the windows open in the middle of the winter.\"\u003c/p>\n\u003cp>In his late 20s, James saw a doctor who told him he had attention deficit hyperactivity disorder. So he started taking stimulants.[contextly_sidebar id=\"IjfTHMEjzV27TicYbrGolDFdASO5y6qG\"]\u003c/p>\n\u003cp>At first, the pills helped him focus. Then they didn't, no matter how many he took.\u003c/p>\n\u003cp>He'd done well as an idea guy in the advertising industry. But now James was trying to work at home, and it wasn't going well.\u003c/p>\n\u003cp>\"ADHD pills will make you interested in anything,\" he says. \"So I was putting the desk together and taking the desk apart. I was putting a laptop stand together and taking it apart. I was going in a massive downward spiral.\"\u003c/p>\n\u003cp>James had always suffered from mood swings. But now they were rapid and extreme. And he couldn't stop thinking about gruesome scenarios, like a murderer coming for his family.\u003c/p>\n\u003cp>\"My wife took a summer off to be with me because she was scared of what was going to happen to me,\" he says. \"She would go to work for a few hours, then rush home. There would be times I'd call her just screaming, 'Please come home. I can't get through another minute.' \"\u003c/p>\n\u003cp>Eventually, James found his way to Dr. \u003ca href=\"http://bipolarchild.com/about/authors/\" target=\"_blank\" rel=\"noopener\">Demitri Papolos\u003c/a>, an associate professor of clinical psychiatry at Albert Einstein College of Medicine.\u003c/p>\n\u003cp>\"He was like a whirling dervish when he came into my office,\" Papolos says. \"He was extremely fearful and scanning the environment all the time and he overheated at the drop of a hat.\"\u003c/p>\n\u003cp>Papolos diagnosed James with a variant of bipolar disorder he calls the \"fear of harm phenotype.\" It typically appears in childhood and often doesn't respond to traditional psychiatric drugs.[contextly_sidebar id=\"ONPRitNVz88O9pFNNVQ7htlsCs7xWv0w\"]\u003c/p>\n\u003cp>But Papolos has found that the condition does respond to ketamine. \"It's been transformational,\" he says.\u003c/p>\n\u003cp>In January, Papolos published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28866299\">study\u003c/a> of 45 children with the problem. They inhaled a nasal mist containing ketamine about twice a week. Nearly all got dramatically better.\u003c/p>\n\u003cp>Scientists still aren't sure why ketamine works, but there's \u003ca href=\"https://www.npr.org/sections/health-shots/2012/10/04/162299564/ketamine-relieves-depression-by-restoring-brain-connections\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that it encourages the brain to rewire, to alter the connections between cells. That process has been linked to recovery from depression. And it may also explain why ketamine helps people who have symptoms associated with several different psychiatric disorders.\u003c/p>\n\u003cp>\"I think it's having multiple effects, and that means it's probably useful for multiple different disorders,\" Teicher says.\u003c/p>\n\u003cp>One of those effects involves a part of the brain involved in temperature regulation. And that could explain why patients like James usually stop overheating once they are taking ketamine.\u003c/p>\n\u003cp>James started taking a ketamine nasal spray every other day. He says his response was dramatic.\u003c/p>\n\u003cp>\"One day I turn to my wife and I'm like, 'I feel calm today. I don't know if it's the sun coming in, I don't know if it's just the way we're sitting here, but I feel like I could go and sit at the computer and work.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The next day, James did sit down at his computer. A month later, he was back at work.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=From+Chaos+To+Calm%3A+A+Life+Changed+By+Ketamine&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For six years now, life has been really good for James. He has a great job as the creative director of an advertising firm in New York City. He enjoys spending time with his wife and kids.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And it has all been possible, he says, because for the past six years he has been taking a drug called\u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/28/443203592/club-drug-ketamine-gains-traction-as-a-treatment-for-depression\" target=\"_blank\" rel=\"noopener\"> ketamine\u003c/a>.\u003c/p>\n\u003cp>Before ketamine, James was unable to work or focus his thoughts. His mind was filled with violent images. And his mood could go from ebullient to dark in a matter of minutes.\u003c/p>\n\u003cp>Ketamine \"helped me get my life back,\" says James, who asked that we not use his last name to protect his career.\u003c/p>\n\u003cp>Ketamine was developed as a human and animal anesthetic in the 1960s. And almost from the time it reached the market it has also been used as a mind-bending party drug.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But ketamine's story took a surprising turn in 2006, when researchers at the National Institutes of Health \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16894061\">showed\u003c/a> that an intravenous dose could relieve severe depression in a matter of hours. Since then, doctors have prescribed ketamine \"off label\" to \u003ca href=\"https://www.npr.org/sections/health-shots/2017/03/20/520169959/ketamine-for-severe-depression-how-do-you-not-offer-this-drug-to-people\" target=\"_blank\" rel=\"noopener\">thousands of depressed patients\u003c/a> who don't respond to other drugs.\u003c/p>\n\u003cp>And pharmaceutical companies are \u003ca href=\"https://www.npr.org/sections/health-shots/2015/05/28/409800015/ketamine-depression-treatments-inspired-by-club-drug-move-ahead-in-tests\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> several new ketamine-related drugs to treat depression. Johnson & Johnson expects to seek approval for its nasal spray \u003ca href=\"https://www.jnj.com/media-center/press-releases/new-phase-3-data-show-esketamine-nasal-spray-demonstrated-rapid-improvements-in-depressive-symptoms-in-patients-with-treatment-resistant-depression\" target=\"_blank\" rel=\"noopener\">esketamine\u003c/a> later this year, though the approval would be limited to use in a clinical setting.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Meanwhile, doctors have begun trying ketamine on patients with a wide range of psychiatric disorders other than depression. And there is now growing evidence it can help people with anxiety, bipolar disorder, post-traumatic stress disorder, and perhaps even obsessive-compulsive disorder.\u003c/p>\n\u003cp>\"I think it's actually one of the biggest advances in psychiatry in a very long time,\" says Dr. \u003ca href=\"https://www.mcleanhospital.org/biography/martin-teicher\" target=\"_blank\" rel=\"noopener\">Martin Teicher\u003c/a>, an associate professor of psychiatry at Harvard Medical School and director of the Developmental Biopsychiatry Research Program at McLean Hospital.\u003c/p>\n\u003cp>Ketamine may also offer new hope for people like James who have symptoms of several different psychiatric disorders.\u003c/p>\n\u003cp>James had a happy childhood, he says. But his thoughts were out of control. \"I always felt like I was crossing a freeway and my thoughts were just racing past me,\" he says.\u003c/p>\n\u003cp>He spent much of his childhood terrified of \"an unknown, an ambiguous force out there.\" The fear was \"overwhelming,\" he says. \"I literally slept with the cover over my head with just room to breathe through my mouth until I went to college.\"\u003c/p>\n\u003cp>And there was something else about James: his body temperature.\u003c/p>\n\u003cp>\"I overheated constantly,\" he says. \"I would wear shorts all year long. In my 20s in my apartment I would sleep with the windows open in the middle of the winter.\"\u003c/p>\n\u003cp>In his late 20s, James saw a doctor who told him he had attention deficit hyperactivity disorder. So he started taking stimulants.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At first, the pills helped him focus. Then they didn't, no matter how many he took.\u003c/p>\n\u003cp>He'd done well as an idea guy in the advertising industry. But now James was trying to work at home, and it wasn't going well.\u003c/p>\n\u003cp>\"ADHD pills will make you interested in anything,\" he says. \"So I was putting the desk together and taking the desk apart. I was putting a laptop stand together and taking it apart. I was going in a massive downward spiral.\"\u003c/p>\n\u003cp>James had always suffered from mood swings. But now they were rapid and extreme. And he couldn't stop thinking about gruesome scenarios, like a murderer coming for his family.\u003c/p>\n\u003cp>\"My wife took a summer off to be with me because she was scared of what was going to happen to me,\" he says. \"She would go to work for a few hours, then rush home. There would be times I'd call her just screaming, 'Please come home. I can't get through another minute.' \"\u003c/p>\n\u003cp>Eventually, James found his way to Dr. \u003ca href=\"http://bipolarchild.com/about/authors/\" target=\"_blank\" rel=\"noopener\">Demitri Papolos\u003c/a>, an associate professor of clinical psychiatry at Albert Einstein College of Medicine.\u003c/p>\n\u003cp>\"He was like a whirling dervish when he came into my office,\" Papolos says. \"He was extremely fearful and scanning the environment all the time and he overheated at the drop of a hat.\"\u003c/p>\n\u003cp>Papolos diagnosed James with a variant of bipolar disorder he calls the \"fear of harm phenotype.\" It typically appears in childhood and often doesn't respond to traditional psychiatric drugs.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But Papolos has found that the condition does respond to ketamine. \"It's been transformational,\" he says.\u003c/p>\n\u003cp>In January, Papolos published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28866299\">study\u003c/a> of 45 children with the problem. They inhaled a nasal mist containing ketamine about twice a week. Nearly all got dramatically better.\u003c/p>\n\u003cp>Scientists still aren't sure why ketamine works, but there's \u003ca href=\"https://www.npr.org/sections/health-shots/2012/10/04/162299564/ketamine-relieves-depression-by-restoring-brain-connections\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that it encourages the brain to rewire, to alter the connections between cells. That process has been linked to recovery from depression. And it may also explain why ketamine helps people who have symptoms associated with several different psychiatric disorders.\u003c/p>\n\u003cp>\"I think it's having multiple effects, and that means it's probably useful for multiple different disorders,\" Teicher says.\u003c/p>\n\u003cp>One of those effects involves a part of the brain involved in temperature regulation. And that could explain why patients like James usually stop overheating once they are taking ketamine.\u003c/p>\n\u003cp>James started taking a ketamine nasal spray every other day. He says his response was dramatic.\u003c/p>\n\u003cp>\"One day I turn to my wife and I'm like, 'I feel calm today. I don't know if it's the sun coming in, I don't know if it's just the way we're sitting here, but I feel like I could go and sit at the computer and work.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The next day, James did sit down at his computer. A month later, he was back at work.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=From+Chaos+To+Calm%3A+A+Life+Changed+By+Ketamine&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Sues Two Makers of Baby Formula For Lead Contamination",
"title": "California Sues Two Makers of Baby Formula For Lead Contamination",
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"content": "\u003cp>The state of California is suing two companies, Nutraceutical Corp. and Graceleigh Inc., whose toddler formulas contain dangerous levels of lead that exceed both state and federal standards.[contextly_sidebar id=\"dDFZfxJC6DngGGIurpGHrevnbYYzKMAg\"]\u003c/p>\n\u003cp>State \u003ca href=\"https://www.oag.ca.gov/news/press-releases/attorney-general-becerra-issues-cease-and-desist-letters-and-files-suit-over\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> revealed that the two products -- Peaceful Planet Toddler Supreme and Sammy’s Milk Free-Range Goat Milk Toddler Formula – contained between 13 and 15 times the maximum allowable dose level under California law.\u003c/p>\n\u003cp>California Attorney General Xavier Becerra told reporters on Thursday that after the state Department of Justice issued cease-and-desist orders, the companies voluntarily agreed to stop selling the contaminated baby formulas in California.[contextly_sidebar id=\"A1OKE7foNBL4C7EMCs4DtnAcdEd76Tw8\"]\u003c/p>\n\u003cp>\"Parents across America, and certainly in California, on a daily basis rely on the representations made by companies,\" said Becerra during the press conference, \"to make sure that what our children are eating is not only good for them, but is safe as well.\"\u003c/p>\n\u003cp>In\u003ca href=\"https://www.oag.ca.gov/news/press-releases/attorney-general-becerra-issues-cease-and-desist-letters-and-files-suit-over\" target=\"_blank\" rel=\"noopener\"> a statement\u003c/a> accompanying the announcement, the department called the findings a “parent’s worst nightmare\" and said the lawsuit is intended to put all manufacturers on notice.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The California Department of Justice will hold you accountable for gambling with our children’s health,\" the agency warned.\u003c/p>\n\u003cp>The lawsuit, which seeks monetary penalties, alleges that the companies violated California’s Unfair Competition Law, False Advertising Law, and Proposition 65, which requires companies to adequately warn consumers that their products expose them to toxic chemicals.\u003c/p>\n\u003cp>\"Parents across America, and certainly in California, on a daily basis rely on the representations made by companies,\" said Becerra during today's presser, \"to make sure that what our children are eating is not only good for them, but is safe as well.\"\u003c/p>\n\u003cp>And when it comes to lead consumption, there really isn't a tolerable level for children, according to Dr. Timur Durrani, a toxicologist at UCSF.[contextly_sidebar id=\"2INd1f7DezHFZVXzQK6VbkQZUIqMUhE2\"]\u003c/p>\n\u003cp>\"One message I would put to you is that there really is no safe level of lead, particularly for children,\" he told reporters at the announcement.\u003c/p>\n\u003cp>According to the Mayo Clinic, \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/syc-20354717\" target=\"_blank\" rel=\"noopener\">even small amounts\u003c/a> of lead can cause serious health problems in children, affecting their mental and physical development. Chronic lead exposure can seriously impair brain development and lead to learning and behavioral problems.\u003c/p>\n\u003cp>The presence of lead in baby formula is especially concerning, said Becerra, since toddlers consume it daily.\u003c/p>\n\u003cp>Lead, a naturally occurring chemical, is found in the environment in small amounts. The majority of human exposure to it is through activities such as ceramics, or products such as cosmetics, paint and toys, according to the \u003ca href=\"https://www.epa.gov/lead/learn-about-lead\" target=\"_blank\" rel=\"noopener\">Environmental Protection Agency.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Becerra has urged parents of toddlers who consumed the contaminated formulas to get them tested for lead exposure.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The state of California is suing two companies, Nutraceutical Corp. and Graceleigh Inc., whose toddler formulas contain dangerous levels of lead that exceed both state and federal standards.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>State \u003ca href=\"https://www.oag.ca.gov/news/press-releases/attorney-general-becerra-issues-cease-and-desist-letters-and-files-suit-over\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> revealed that the two products -- Peaceful Planet Toddler Supreme and Sammy’s Milk Free-Range Goat Milk Toddler Formula – contained between 13 and 15 times the maximum allowable dose level under California law.\u003c/p>\n\u003cp>California Attorney General Xavier Becerra told reporters on Thursday that after the state Department of Justice issued cease-and-desist orders, the companies voluntarily agreed to stop selling the contaminated baby formulas in California.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Parents across America, and certainly in California, on a daily basis rely on the representations made by companies,\" said Becerra during the press conference, \"to make sure that what our children are eating is not only good for them, but is safe as well.\"\u003c/p>\n\u003cp>In\u003ca href=\"https://www.oag.ca.gov/news/press-releases/attorney-general-becerra-issues-cease-and-desist-letters-and-files-suit-over\" target=\"_blank\" rel=\"noopener\"> a statement\u003c/a> accompanying the announcement, the department called the findings a “parent’s worst nightmare\" and said the lawsuit is intended to put all manufacturers on notice.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The California Department of Justice will hold you accountable for gambling with our children’s health,\" the agency warned.\u003c/p>\n\u003cp>The lawsuit, which seeks monetary penalties, alleges that the companies violated California’s Unfair Competition Law, False Advertising Law, and Proposition 65, which requires companies to adequately warn consumers that their products expose them to toxic chemicals.\u003c/p>\n\u003cp>\"Parents across America, and certainly in California, on a daily basis rely on the representations made by companies,\" said Becerra during today's presser, \"to make sure that what our children are eating is not only good for them, but is safe as well.\"\u003c/p>\n\u003cp>And when it comes to lead consumption, there really isn't a tolerable level for children, according to Dr. Timur Durrani, a toxicologist at UCSF.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"One message I would put to you is that there really is no safe level of lead, particularly for children,\" he told reporters at the announcement.\u003c/p>\n\u003cp>According to the Mayo Clinic, \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/syc-20354717\" target=\"_blank\" rel=\"noopener\">even small amounts\u003c/a> of lead can cause serious health problems in children, affecting their mental and physical development. Chronic lead exposure can seriously impair brain development and lead to learning and behavioral problems.\u003c/p>\n\u003cp>The presence of lead in baby formula is especially concerning, said Becerra, since toddlers consume it daily.\u003c/p>\n\u003cp>Lead, a naturally occurring chemical, is found in the environment in small amounts. The majority of human exposure to it is through activities such as ceramics, or products such as cosmetics, paint and toys, according to the \u003ca href=\"https://www.epa.gov/lead/learn-about-lead\" target=\"_blank\" rel=\"noopener\">Environmental Protection Agency.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Becerra has urged parents of toddlers who consumed the contaminated formulas to get them tested for lead exposure.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "CDC Says U.S. Suicide Rates Have Climbed Dramatically",
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"content": "\u003cp>Suicide rates have increased in nearly every state over the last two decades, and half of the states have seen suicide rates go up more than 30 percent.[contextly_sidebar id=\"A9fL4YSxBETMe1qdZ5dnjcQFo9ddiBPf\"]\u003c/p>\n\u003cp>Suicide is a major public health issue, accounting for nearly 45,000 deaths in 2016 alone. That's why the Centers for Disease Control and Prevention in Atlanta decided to take a comprehensive look at suicides from 1999 to 2016.\u003c/p>\n\u003cp>\"Suicide in this country really is a problem that is impacted by so many factors. It's not just a mental health concern,\" says \u003ca href=\"https://www.researchgate.net/profile/Deborah_Stone6\" target=\"_blank\" rel=\"noopener\">Deborah Stone\u003c/a>, a behavioral scientist at the CDC and the lead author of the new study. \"There are many different circumstances and factors that contribute to suicide. And so that's one of the things that this study really shows us. It points to the need for a comprehensive approach to prevention.\"\u003c/p>\n\u003cp>She and her colleagues collected data on suicide deaths from all states. In addition, to better understand the circumstances surrounding suicide, they turned to more detailed information collected by 27 states on suicides that occurred in 2015.\u003c/p>\n\u003cp>The rise in suicide rates was highest in the central, northern region of the U.S., with North Dakota, for example, seeing a 57.6 percent increase since 1999. Nevada was the only state that saw no increase, and Delaware saw the smallest increase which was 5.9 percent.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The findings are being published in the CDC's \u003cem>Morbidity and Mortality Weekly Report.[contextly_sidebar id=\"W7mWOW1ymDgCsEZ1nDOxImxApsaWP7Mj\"]\u003c/em>\u003c/p>\n\u003cp>Guns were the most common method used for suicide, accounting for almost half of the people who died.\u003c/p>\n\u003cp>Often, the suicide seemed to happen without warning: 54 percent of the people who killed themselves didn't have a previously known mental health issue. \"Instead, these folks were suffering from other issues, such as relationship problems, substance misuse, physical health problems, job or financial problems, and recent crises or things that were coming up in their lives that they were anticipating,\" says Stone.\u003c/p>\n\u003cp>Researchers and advocacy groups who work to prevent suicide say the report shows that much more needs to be done to tackle this growing problem.\u003c/p>\n\u003cp>\"None of this is surprising information, which is not to trivialize its importance. I think it captures a lot of trends that we've been becoming more and more aware of over recent years,\" says psychologist \u003ca href=\"https://www.usm.edu/clinical-psychology/faculty/michael-anestis-phd\" target=\"_blank\" rel=\"noopener\">Michael Anestis\u003c/a> at the University of Southern Mississippi, who researches suicide and is the author of \u003cem>Guns and Suicide: An American Epidemic\u003c/em>.\u003c/p>\n\u003cp>He thinks the general public commonly pictures someone like fashion designer \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/06/05/617145848/fashion-designer-kate-spade-found-dead-in-apparent-suicide\" target=\"_blank\" rel=\"noopener\">Kate Spade\u003c/a>, who was getting treatment for a long period before killing herself, but that's often not the case.[contextly_sidebar id=\"DJiLLeU2OyVA8kW6VrllWebbJaUGwQhC\"]\u003c/p>\n\u003cp>That means any public health effort to reduce suicides can't solely focus on those who have reached out for help. It has to be paired with measures that would make suicidal people less likely to die even if they never went to see a doctor.\u003c/p>\n\u003cp>The CDC report cites several different approaches that could work, such as working to stabilize housing and teaching coping and problem-solving skills early in life.\u003c/p>\n\u003cp>The report also cites the need to reduce \"access to lethal means,\" but without explicitly mentioning firearms or controversial issues such as gun control legislation. Asked if that was a deliberate omission, because of the political climate surrounding gun control, Stone said that suicide rates have been increasing across all methods.\u003c/p>\n\u003cp>\"So it's not just about firearms, it's also about other methods of suicide such as hanging, suffocation, poisoning and the like,\" she said. \"We are concerned with all aspects of suicide prevention, including access to lethal means, and so we do include that in a comprehensive approach to suicide prevention.\"\u003c/p>\n\u003cp>But Anestis believes that it's important to not beat around the bush when it comes to guns, and to talk about the importance of things like waiting periods for purchase, and storing guns locked and unloaded.\u003c/p>\n\u003cp>\"American suicide is predominantly a firearm issue. Anytime we want to resolve something that involves firearms, we've need to talk about firearms explicitly,\" he says. \"The conversation about firearms and suicide doesn't have to be a debate about the Second Amendment. It could be a debate about where can we find some common ground that doesn't simply involve only talking about people with mental illnesses, because as this paper shows, that's not going to get the job done.\"\u003c/p>\n\u003cp>Research shows that the decision to attempt suicide is often made quickly, in an impulsive way, says \u003ca href=\"https://afsp.org/about-afsp/robert-gebbia/\" target=\"_blank\" rel=\"noopener\">Robert Gebbia\u003c/a>, the head of the American Foundation for Suicide Prevention.\u003c/p>\n\u003cp>\"You may be thinking about it over time, but that moment when you actually make an attempt is a very short window,\" he explains. \"If you could make it harder to make that attempt by not having access to the means, often what happens is the feelings will pass, it gives people time for someone to intervene and get them help, so that is a really important preventative step that can be done. And there's good research to support that.\"\u003c/p>\n\u003cp>Suicide researchers already know a lot of the information in this new report, says Gebbia, \"but the public doesn't. And so a report like this really draws attention to the fact that we need to do a whole lot more to prevent suicide, to save lives.\"\u003c/p>\n\u003cp>He points out, for example, that the nation currently has no federally funded suicide prevention program for adults. \"There are some for youth, but they're very, very tiny,\" says Gebbia. \"We can't expect a major public health problem like this to be addressed unless we see the investment.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The CDC said that people can learn about warning signs of suicide to help people at risk. One resource is the website: \u003ca href=\"http://www.bethe1to.com/\" target=\"_blank\" rel=\"noopener\">www.BeThe1to.com\u003c/a>. To reach the \u003ca href=\"https://suicidepreventionlifeline.org\" target=\"_blank\" rel=\"noopener\">National Suicide Prevention Lifeline\u003c/a>, call 1-800-273-TALK (8255).\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=CDC%3A+U.S.+Suicide+Rates+Have+Climbed+Dramatically&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Suicide rates have increased in nearly every state over the last two decades, and half of the states have seen suicide rates go up more than 30 percent.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Suicide is a major public health issue, accounting for nearly 45,000 deaths in 2016 alone. That's why the Centers for Disease Control and Prevention in Atlanta decided to take a comprehensive look at suicides from 1999 to 2016.\u003c/p>\n\u003cp>\"Suicide in this country really is a problem that is impacted by so many factors. It's not just a mental health concern,\" says \u003ca href=\"https://www.researchgate.net/profile/Deborah_Stone6\" target=\"_blank\" rel=\"noopener\">Deborah Stone\u003c/a>, a behavioral scientist at the CDC and the lead author of the new study. \"There are many different circumstances and factors that contribute to suicide. And so that's one of the things that this study really shows us. It points to the need for a comprehensive approach to prevention.\"\u003c/p>\n\u003cp>She and her colleagues collected data on suicide deaths from all states. In addition, to better understand the circumstances surrounding suicide, they turned to more detailed information collected by 27 states on suicides that occurred in 2015.\u003c/p>\n\u003cp>The rise in suicide rates was highest in the central, northern region of the U.S., with North Dakota, for example, seeing a 57.6 percent increase since 1999. Nevada was the only state that saw no increase, and Delaware saw the smallest increase which was 5.9 percent.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The findings are being published in the CDC's \u003cem>Morbidity and Mortality Weekly Report.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/em>\u003c/p>\n\u003cp>Guns were the most common method used for suicide, accounting for almost half of the people who died.\u003c/p>\n\u003cp>Often, the suicide seemed to happen without warning: 54 percent of the people who killed themselves didn't have a previously known mental health issue. \"Instead, these folks were suffering from other issues, such as relationship problems, substance misuse, physical health problems, job or financial problems, and recent crises or things that were coming up in their lives that they were anticipating,\" says Stone.\u003c/p>\n\u003cp>Researchers and advocacy groups who work to prevent suicide say the report shows that much more needs to be done to tackle this growing problem.\u003c/p>\n\u003cp>\"None of this is surprising information, which is not to trivialize its importance. I think it captures a lot of trends that we've been becoming more and more aware of over recent years,\" says psychologist \u003ca href=\"https://www.usm.edu/clinical-psychology/faculty/michael-anestis-phd\" target=\"_blank\" rel=\"noopener\">Michael Anestis\u003c/a> at the University of Southern Mississippi, who researches suicide and is the author of \u003cem>Guns and Suicide: An American Epidemic\u003c/em>.\u003c/p>\n\u003cp>He thinks the general public commonly pictures someone like fashion designer \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/06/05/617145848/fashion-designer-kate-spade-found-dead-in-apparent-suicide\" target=\"_blank\" rel=\"noopener\">Kate Spade\u003c/a>, who was getting treatment for a long period before killing herself, but that's often not the case.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That means any public health effort to reduce suicides can't solely focus on those who have reached out for help. It has to be paired with measures that would make suicidal people less likely to die even if they never went to see a doctor.\u003c/p>\n\u003cp>The CDC report cites several different approaches that could work, such as working to stabilize housing and teaching coping and problem-solving skills early in life.\u003c/p>\n\u003cp>The report also cites the need to reduce \"access to lethal means,\" but without explicitly mentioning firearms or controversial issues such as gun control legislation. Asked if that was a deliberate omission, because of the political climate surrounding gun control, Stone said that suicide rates have been increasing across all methods.\u003c/p>\n\u003cp>\"So it's not just about firearms, it's also about other methods of suicide such as hanging, suffocation, poisoning and the like,\" she said. \"We are concerned with all aspects of suicide prevention, including access to lethal means, and so we do include that in a comprehensive approach to suicide prevention.\"\u003c/p>\n\u003cp>But Anestis believes that it's important to not beat around the bush when it comes to guns, and to talk about the importance of things like waiting periods for purchase, and storing guns locked and unloaded.\u003c/p>\n\u003cp>\"American suicide is predominantly a firearm issue. Anytime we want to resolve something that involves firearms, we've need to talk about firearms explicitly,\" he says. \"The conversation about firearms and suicide doesn't have to be a debate about the Second Amendment. It could be a debate about where can we find some common ground that doesn't simply involve only talking about people with mental illnesses, because as this paper shows, that's not going to get the job done.\"\u003c/p>\n\u003cp>Research shows that the decision to attempt suicide is often made quickly, in an impulsive way, says \u003ca href=\"https://afsp.org/about-afsp/robert-gebbia/\" target=\"_blank\" rel=\"noopener\">Robert Gebbia\u003c/a>, the head of the American Foundation for Suicide Prevention.\u003c/p>\n\u003cp>\"You may be thinking about it over time, but that moment when you actually make an attempt is a very short window,\" he explains. \"If you could make it harder to make that attempt by not having access to the means, often what happens is the feelings will pass, it gives people time for someone to intervene and get them help, so that is a really important preventative step that can be done. And there's good research to support that.\"\u003c/p>\n\u003cp>Suicide researchers already know a lot of the information in this new report, says Gebbia, \"but the public doesn't. And so a report like this really draws attention to the fact that we need to do a whole lot more to prevent suicide, to save lives.\"\u003c/p>\n\u003cp>He points out, for example, that the nation currently has no federally funded suicide prevention program for adults. \"There are some for youth, but they're very, very tiny,\" says Gebbia. \"We can't expect a major public health problem like this to be addressed unless we see the investment.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The CDC said that people can learn about warning signs of suicide to help people at risk. One resource is the website: \u003ca href=\"http://www.bethe1to.com/\" target=\"_blank\" rel=\"noopener\">www.BeThe1to.com\u003c/a>. To reach the \u003ca href=\"https://suicidepreventionlifeline.org\" target=\"_blank\" rel=\"noopener\">National Suicide Prevention Lifeline\u003c/a>, call 1-800-273-TALK (8255).\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=CDC%3A+U.S.+Suicide+Rates+Have+Climbed+Dramatically&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "He Started Vaping As A Teen And Now Says Habit Is 'Impossible To Let Go'",
"title": "He Started Vaping As A Teen And Now Says Habit Is 'Impossible To Let Go'",
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"content": "\u003cp>The debate over the health risks of Juul, vaping and e-cigarettes is now spilling into the public square. In one of the most restrictive measures nationwide, San Francisco voters this week upheld by what looks to be a large majority — \u003ca href=\"https://sfelections.sfgov.org/june-5-2018-election-results-summary\" target=\"_blank\" rel=\"noopener\">nearly 70 percent\u003c/a> in a preliminary tally — a ban on the sale of flavored vaping products, as well as conventional menthol cigarettes.[contextly_sidebar id=\"f4ObtobpmJx1JqJ3EOiZHg8edyJcXLTQ\"]\u003c/p>\n\u003cp>Even before that, federal agencies had launched a wave of \u003ca href=\"https://www.npr.org/sections/health-shots/2018/05/02/607466204/federal-government-sends-warning-to-vaping-companies\">crackdowns\u003c/a> against retailers that sell e-cigarettes, including the popular Juul brand, to minors. Public health advocates and officials worry these sales could be an emerging disaster, reversing years of declines in smoking.\u003c/p>\n\u003cp>E-cigarettes are tiny — they look like a pen or flash drive. When someone vapes, there's no fire, ash or smoky odor. Instead, the devices heat up and vaporize a liquid or solid. And vaping appears to have taken off among young people.\u003c/p>\n\u003cp>\"Believe it,\" says 21-year-old Julien Lavandier. \"It's a habit for me, you know — all the time when I set down my schoolwork to do homework, take a rip of the Juul. When I get in my car, take a rip of the Juul.\"\u003c/p>\n\u003cp>Lavandier, now a student at Colorado State University, started vaping when he was a sophomore in high school. He says he'd go to parties where it was common to smoke an e-cigarette.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"At first,\" he says,\"it was a lot of, you know, chasing flavors, or doing smoke tricks and that was really what impressed me. I thought, you know, this is cool, this looks like something fun.\"\u003c/p>\n\u003cp>He says students at his high school vaped in class without teachers knowing. He estimates a quarter of his classmates were habitual e-cigarette users. Lavandier started vaping regularly and later began smoking traditional cigarettes.\u003c/p>\n\u003cp>When Juul arrived on the market, he took that up too, and found it habit-forming. He liked it more than marijuana or alcohol.\u003c/p>\n\u003cp>\"It's impossible to let go once you started using,\" Lavandier says. \"I'll tell you — after even an hour and a half or two, I am chomping at the bit to find my Juul.\"\u003c/p>\n\u003cp>Stores aren't supposed to sell e-cigarettes to minors, but Lavandier says he has been buying them for years and was never once carded. In April, the \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm605432.htm\">FDA asked\u003c/a> the firm behind Juul for documents to see if it's intentionally marketing to underage teens.\u003c/p>\n\u003cp>The company has online testimonials \u003ca href=\"https://www.juul.com/community\" target=\"_blank\" rel=\"noopener\">and has built an online community\u003c/a> around their product. In one video, a woman in her 30s named Lauren says she's constantly \"encouraging people to use this and not smoke your cigarettes.\"[contextly_sidebar id=\"nM2YyjbFQ2MokyLZppniNnryAeUzoXp3\"]\u003c/p>\n\u003cp>Representatives from Juul Labs declined repeated requests for an interview. In a written statement, the company said its product offers a \"true alternative to adult smokers, not anyone else, not minors.\"\u003c/p>\n\u003cp>Other companies that make e-liquids also say their products are not for minors. The companies do offer a wide range of sweet flavors, however, like cotton candy, caramel, cherry, cookies and milk and \u003ca href=\"https://www.electrictobacconist.com/juul-cr%C3%A8me-br%C3%BBl%C3%A9e-flavor-pods-pack-of-4-p831\" target=\"_blank\" rel=\"noopener\">crème brûlée\u003c/a>.\u003c/p>\n\u003cp>\"If it tastes good and a kid might get their hands on it — that's not our goal,\" says Jameson Rodgers, the VP of business development for \u003ca href=\"https://www.newhere.com/\" target=\"_blank\" rel=\"noopener\">NEwhere Inc\u003c/a>, a California-based maker of e-cigarette and vaping products.\u003c/p>\n\u003cp>\"Also,\" Rodgers says, \"I feel like some of the responsibility has to fall on some of the parents of any kid that's deciding to walk into an adult store, whether that's a liquor or a tobacco store.\"\u003c/p>\n\u003cp>The head of Colorado's health department, \u003ca href=\"https://www.colorado.gov/pacific/cdphe/larry-wolk-md-msph\" target=\"_blank\" rel=\"noopener\">Dr. Larry Wolk\u003c/a>, finds it hard to believe industry claims that it isn't marketing to kids.\u003c/p>\n\u003cp>\"I have to call BS on that,\" he says, \"because the flavors are cotton candy, Frutti Tutti and they have cartoon characters on their labels and you can mix flavors and strengths. It's really appealing to kids, whether or not they are intentionally marketing to kids.\"\u003c/p>\n\u003cp>Wolk also points to research that suggests youth vaping leads to traditional smoking. A January \u003ca href=\"http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=24952\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the National Academy of Sciences, Engineering and Medicine makes that conclusion. \"Among youth — who use e-cigarettes at higher rates than adults do — there is substantial evidence that e-cigarette use\u003ca href=\"https://www.cpr.org/news/story/e-cigarettes-a-gateway-to-tobacco-addiction-colorados-chief-health-official-says\" target=\"_blank\" rel=\"noopener\"> increases the risk\u003c/a> of transitioning to smoking conventional cigarettes,\" the report finds.\u003c/p>\n\u003cp>One of the benefits of e-cigarettes, according to the industry, is that the devices can help people quit their use of tobacco products. When it comes to that habit, the advice from Ray Story, the founder and CEO of the \u003ca href=\"https://www.tveca.com/about-tveca\" target=\"_blank\" rel=\"noopener\">Tobacco Vapor Electronic Cigarette Association\u003c/a> is \"don't start at all.\"\u003c/p>\n\u003cp>\"But if you're going to smoke or do e-cigarettes, then certainly take an e-cigarette because it's vastly less harmful,\" Story says,\"if you consider both of them contain nicotine, and both of them are addictive. It's vastly less harmful than conventional tobacco.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.childrenscolorado.org/doctors-and-departments/physicians/l/deborah-liptzin/\" target=\"_blank\" rel=\"noopener\">Dr. Deborah Liptzin\u003c/a>, a pediatric pulmonologist at Children's Hospital Colorado, sees the evidence differently. E-cigarettes, she says, have become \"the new way to get kids addicted to nicotine.\" There's been scant e-cigarette research, she notes, including on Juul and the ingredients in the e-liquids used in the devices.\u003c/p>\n\u003cp>\"They specifically use nicotine salts,\" Liptzin says. \"We have no research that I could find on nicotine salts that are inhaled, because it's so new.\"\u003c/p>\n\u003cp>Data from the 2015 Healthy Kids Colorado Survey found nearly half of Colorado high schoolers \u003ca href=\"https://www.colorado.gov/pacific/sites/default/files/PF_Youth_HKCS_Tobacco-Infographic-Digital.pdf\" target=\"_blank\" rel=\"noopener\">reported that they've vaped\u003c/a>. One in four said they had used an e-cigarette in the last month. That's three times the rate of traditional cigarettes, and has raised concerns among public health officials.\u003c/p>\n\u003cp>\"The Juul has definitely been a game changer,\" says Jen Bolcoa, a health education coordinator with Jefferson County Public Schools. The tiny pod of e-liquid in a Juul has the \u003ca href=\"https://support.juul.com/home/learn/faqs/juulpod-basics\" target=\"_blank\" rel=\"noopener\">equivalent nicotine of approximately 20 cigarettes\u003c/a> — an entire pack — according to the company's website.\u003c/p>\n\u003cp>Most educators, parents and students \"don't realize how much nicotine is in there, or that there's even any nicotine,\" she says. \"That's what the research tells us.\"\u003c/p>\n\u003cp>Bolcoa works with students as part of the \u003ca href=\"https://www.denverpost.com/2015/12/01/teens-get-involved-in-anti-tobacco-campaign-through-breathe-easy/\" target=\"_blank\" rel=\"noopener\">Breathe Easy\u003c/a> team, a club at high schools backed by Jefferson County's Tobacco-Free Youth program, to educate students, parents and administrators about the larger risks of tobacco use and Juuls. An educational video the team posted on Facebook tells viewers that \"Juuls and other e-products are disguised to look like pens, flash drives.\"\u003c/p>\n\u003cp>But their video competes with others posted by teens on social media sites. On YouTube, there's a \u003ca href=\"https://www.youtube.com/watch?v=gnM8hqW_2oo\" target=\"_blank\" rel=\"noopener\">video\u003c/a> called the Juul Challenge. Two guys sit in the smoke-filled front seat of a car, competing, pulling on Juuls.\u003c/p>\n\u003cp>\"Cheers guys. Let's see how many hits I can do? You got five,\" one of video performers says. \"How many hits can you do? Write in the comments.\"\u003c/p>\n\u003cp>That video had more than 230,000 views, and 380 comments in seven weeks. Teresa Kenison, a volunteer on the Breathe Easy team, says social media helps drive the vaping trend. She's seen frequent use of the devices in classrooms, bathrooms, and parking lots. All sorts of students are using e-cigarettes and Juuls, from those in AP classes to athletes.\u003c/p>\n\u003cp>\"It's really everywhere,\" she says. \"Students are getting hooked.\"\u003c/p>\n\u003cp>She's even noticed older kids making runs to the convenience store for younger ones.\u003c/p>\n\u003cp>Lavandier can attest to the power of e-cigarettes as a gateway to tobacco use. The college student says he's now hooked on both cigarettes and e-cigarettes. He has tried to quit, but says he now can't go three days without using a Juul. On a typical day, he'll take upwards of 300 puffs.\u003c/p>\n\u003cp>\"So my biggest concern,\" he says, \"is, you know, right now I'm puffing, puffing, happy, worry-free, and then in 20 years I'll have to explain to my kids why I've developed popcorn lung — or some new form of lung cancer,\" Lavandier says. \"Because I didn't know what the risks were of e-cigarettes. It terrifies me.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with Colorado Public Radio and \u003c/em>\u003ca href=\"http://www.kaiserhealthnews.org\" target=\"_blank\" rel=\"noopener\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 CPR News. To see more, visit \u003ca href=\"http://www.cpr.org/news\">CPR News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=He+Started+Vaping+As+A+Teen+And+Now+Says+Habit+Is+%27Impossible+To+Let+Go%27+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Public health officials worry vaping is an emerging disaster that could reverse years of decline in smoking by young people. What's the latest evidence that e-cigarettes are a gateway to tobacco?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The debate over the health risks of Juul, vaping and e-cigarettes is now spilling into the public square. In one of the most restrictive measures nationwide, San Francisco voters this week upheld by what looks to be a large majority — \u003ca href=\"https://sfelections.sfgov.org/june-5-2018-election-results-summary\" target=\"_blank\" rel=\"noopener\">nearly 70 percent\u003c/a> in a preliminary tally — a ban on the sale of flavored vaping products, as well as conventional menthol cigarettes.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Even before that, federal agencies had launched a wave of \u003ca href=\"https://www.npr.org/sections/health-shots/2018/05/02/607466204/federal-government-sends-warning-to-vaping-companies\">crackdowns\u003c/a> against retailers that sell e-cigarettes, including the popular Juul brand, to minors. Public health advocates and officials worry these sales could be an emerging disaster, reversing years of declines in smoking.\u003c/p>\n\u003cp>E-cigarettes are tiny — they look like a pen or flash drive. When someone vapes, there's no fire, ash or smoky odor. Instead, the devices heat up and vaporize a liquid or solid. And vaping appears to have taken off among young people.\u003c/p>\n\u003cp>\"Believe it,\" says 21-year-old Julien Lavandier. \"It's a habit for me, you know — all the time when I set down my schoolwork to do homework, take a rip of the Juul. When I get in my car, take a rip of the Juul.\"\u003c/p>\n\u003cp>Lavandier, now a student at Colorado State University, started vaping when he was a sophomore in high school. He says he'd go to parties where it was common to smoke an e-cigarette.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"At first,\" he says,\"it was a lot of, you know, chasing flavors, or doing smoke tricks and that was really what impressed me. I thought, you know, this is cool, this looks like something fun.\"\u003c/p>\n\u003cp>He says students at his high school vaped in class without teachers knowing. He estimates a quarter of his classmates were habitual e-cigarette users. Lavandier started vaping regularly and later began smoking traditional cigarettes.\u003c/p>\n\u003cp>When Juul arrived on the market, he took that up too, and found it habit-forming. He liked it more than marijuana or alcohol.\u003c/p>\n\u003cp>\"It's impossible to let go once you started using,\" Lavandier says. \"I'll tell you — after even an hour and a half or two, I am chomping at the bit to find my Juul.\"\u003c/p>\n\u003cp>Stores aren't supposed to sell e-cigarettes to minors, but Lavandier says he has been buying them for years and was never once carded. In April, the \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm605432.htm\">FDA asked\u003c/a> the firm behind Juul for documents to see if it's intentionally marketing to underage teens.\u003c/p>\n\u003cp>The company has online testimonials \u003ca href=\"https://www.juul.com/community\" target=\"_blank\" rel=\"noopener\">and has built an online community\u003c/a> around their product. In one video, a woman in her 30s named Lauren says she's constantly \"encouraging people to use this and not smoke your cigarettes.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Representatives from Juul Labs declined repeated requests for an interview. In a written statement, the company said its product offers a \"true alternative to adult smokers, not anyone else, not minors.\"\u003c/p>\n\u003cp>Other companies that make e-liquids also say their products are not for minors. The companies do offer a wide range of sweet flavors, however, like cotton candy, caramel, cherry, cookies and milk and \u003ca href=\"https://www.electrictobacconist.com/juul-cr%C3%A8me-br%C3%BBl%C3%A9e-flavor-pods-pack-of-4-p831\" target=\"_blank\" rel=\"noopener\">crème brûlée\u003c/a>.\u003c/p>\n\u003cp>\"If it tastes good and a kid might get their hands on it — that's not our goal,\" says Jameson Rodgers, the VP of business development for \u003ca href=\"https://www.newhere.com/\" target=\"_blank\" rel=\"noopener\">NEwhere Inc\u003c/a>, a California-based maker of e-cigarette and vaping products.\u003c/p>\n\u003cp>\"Also,\" Rodgers says, \"I feel like some of the responsibility has to fall on some of the parents of any kid that's deciding to walk into an adult store, whether that's a liquor or a tobacco store.\"\u003c/p>\n\u003cp>The head of Colorado's health department, \u003ca href=\"https://www.colorado.gov/pacific/cdphe/larry-wolk-md-msph\" target=\"_blank\" rel=\"noopener\">Dr. Larry Wolk\u003c/a>, finds it hard to believe industry claims that it isn't marketing to kids.\u003c/p>\n\u003cp>\"I have to call BS on that,\" he says, \"because the flavors are cotton candy, Frutti Tutti and they have cartoon characters on their labels and you can mix flavors and strengths. It's really appealing to kids, whether or not they are intentionally marketing to kids.\"\u003c/p>\n\u003cp>Wolk also points to research that suggests youth vaping leads to traditional smoking. A January \u003ca href=\"http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=24952\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the National Academy of Sciences, Engineering and Medicine makes that conclusion. \"Among youth — who use e-cigarettes at higher rates than adults do — there is substantial evidence that e-cigarette use\u003ca href=\"https://www.cpr.org/news/story/e-cigarettes-a-gateway-to-tobacco-addiction-colorados-chief-health-official-says\" target=\"_blank\" rel=\"noopener\"> increases the risk\u003c/a> of transitioning to smoking conventional cigarettes,\" the report finds.\u003c/p>\n\u003cp>One of the benefits of e-cigarettes, according to the industry, is that the devices can help people quit their use of tobacco products. When it comes to that habit, the advice from Ray Story, the founder and CEO of the \u003ca href=\"https://www.tveca.com/about-tveca\" target=\"_blank\" rel=\"noopener\">Tobacco Vapor Electronic Cigarette Association\u003c/a> is \"don't start at all.\"\u003c/p>\n\u003cp>\"But if you're going to smoke or do e-cigarettes, then certainly take an e-cigarette because it's vastly less harmful,\" Story says,\"if you consider both of them contain nicotine, and both of them are addictive. It's vastly less harmful than conventional tobacco.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.childrenscolorado.org/doctors-and-departments/physicians/l/deborah-liptzin/\" target=\"_blank\" rel=\"noopener\">Dr. Deborah Liptzin\u003c/a>, a pediatric pulmonologist at Children's Hospital Colorado, sees the evidence differently. E-cigarettes, she says, have become \"the new way to get kids addicted to nicotine.\" There's been scant e-cigarette research, she notes, including on Juul and the ingredients in the e-liquids used in the devices.\u003c/p>\n\u003cp>\"They specifically use nicotine salts,\" Liptzin says. \"We have no research that I could find on nicotine salts that are inhaled, because it's so new.\"\u003c/p>\n\u003cp>Data from the 2015 Healthy Kids Colorado Survey found nearly half of Colorado high schoolers \u003ca href=\"https://www.colorado.gov/pacific/sites/default/files/PF_Youth_HKCS_Tobacco-Infographic-Digital.pdf\" target=\"_blank\" rel=\"noopener\">reported that they've vaped\u003c/a>. One in four said they had used an e-cigarette in the last month. That's three times the rate of traditional cigarettes, and has raised concerns among public health officials.\u003c/p>\n\u003cp>\"The Juul has definitely been a game changer,\" says Jen Bolcoa, a health education coordinator with Jefferson County Public Schools. The tiny pod of e-liquid in a Juul has the \u003ca href=\"https://support.juul.com/home/learn/faqs/juulpod-basics\" target=\"_blank\" rel=\"noopener\">equivalent nicotine of approximately 20 cigarettes\u003c/a> — an entire pack — according to the company's website.\u003c/p>\n\u003cp>Most educators, parents and students \"don't realize how much nicotine is in there, or that there's even any nicotine,\" she says. \"That's what the research tells us.\"\u003c/p>\n\u003cp>Bolcoa works with students as part of the \u003ca href=\"https://www.denverpost.com/2015/12/01/teens-get-involved-in-anti-tobacco-campaign-through-breathe-easy/\" target=\"_blank\" rel=\"noopener\">Breathe Easy\u003c/a> team, a club at high schools backed by Jefferson County's Tobacco-Free Youth program, to educate students, parents and administrators about the larger risks of tobacco use and Juuls. An educational video the team posted on Facebook tells viewers that \"Juuls and other e-products are disguised to look like pens, flash drives.\"\u003c/p>\n\u003cp>But their video competes with others posted by teens on social media sites. On YouTube, there's a \u003ca href=\"https://www.youtube.com/watch?v=gnM8hqW_2oo\" target=\"_blank\" rel=\"noopener\">video\u003c/a> called the Juul Challenge. Two guys sit in the smoke-filled front seat of a car, competing, pulling on Juuls.\u003c/p>\n\u003cp>\"Cheers guys. Let's see how many hits I can do? You got five,\" one of video performers says. \"How many hits can you do? Write in the comments.\"\u003c/p>\n\u003cp>That video had more than 230,000 views, and 380 comments in seven weeks. Teresa Kenison, a volunteer on the Breathe Easy team, says social media helps drive the vaping trend. She's seen frequent use of the devices in classrooms, bathrooms, and parking lots. All sorts of students are using e-cigarettes and Juuls, from those in AP classes to athletes.\u003c/p>\n\u003cp>\"It's really everywhere,\" she says. \"Students are getting hooked.\"\u003c/p>\n\u003cp>She's even noticed older kids making runs to the convenience store for younger ones.\u003c/p>\n\u003cp>Lavandier can attest to the power of e-cigarettes as a gateway to tobacco use. The college student says he's now hooked on both cigarettes and e-cigarettes. He has tried to quit, but says he now can't go three days without using a Juul. On a typical day, he'll take upwards of 300 puffs.\u003c/p>\n\u003cp>\"So my biggest concern,\" he says, \"is, you know, right now I'm puffing, puffing, happy, worry-free, and then in 20 years I'll have to explain to my kids why I've developed popcorn lung — or some new form of lung cancer,\" Lavandier says. \"Because I didn't know what the risks were of e-cigarettes. It terrifies me.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with Colorado Public Radio and \u003c/em>\u003ca href=\"http://www.kaiserhealthnews.org\" target=\"_blank\" rel=\"noopener\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 CPR News. To see more, visit \u003ca href=\"http://www.cpr.org/news\">CPR News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=He+Started+Vaping+As+A+Teen+And+Now+Says+Habit+Is+%27Impossible+To+Let+Go%27+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "U.S. Screens More Staff in China Over Mystery Health Issues",
"title": "U.S. Screens More Staff in China Over Mystery Health Issues",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>A U.S. medical team was screening more Americans who work at the consulate in southern China as the State Department confirmed evacuating a number of government employees who experienced unexplained health issues like those that have hurt U.S. personnel in Cuba and China.[contextly_sidebar id=\"7CkyzwzKuv3WHlXibNMNiakYleGV6oAv\"]\u003c/p>\n\u003cp>The evacuations of workers in Guangzhou followed medical testing that revealed they might have been affected. State Department spokeswoman Heather Nauert said “a number of individuals” had been brought to the U.S. but didn’t say how many were affected or evacuated. A previous case in Guangzhou, disclosed last month, prompted the tests.\u003c/p>\n\u003cp>Nauert also said that remaining U.S. government personnel and their families in Guangzhou would also be able to request testing if they “noted concerning symptoms or wanted baseline screening.”\u003c/p>\n\u003cp>The incidents have raised fears the unexplained issues that started in Cuba in 2016 have expanded. The U.S. government has deemed those incidents “specific attacks” on American workers but hasn’t publicly identified a cause or culprit. Most of the incidents were accompanied by bizarre, unexplained sounds that initially led U.S. investigators to suspect a sonic attack.\u003c/p>\n\u003cp>Symptoms have included dizziness, headaches and an inability to concentrate. The American government worker who previously was removed from China reported “subtle and vague, but abnormal, sensations of sound and pressure,” the Guangzhou consulate reported last month\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Security guards outside the Guangzhou consulate on Thursday told reporters to leave the area and not attempt to talk to consulate staff.\u003c/p>\n\u003cp>Asked about the latest incidents, Chinese Foreign Ministry spokeswoman Hua Chunying said the U.S. had not formally raised the matter with Beijing.\u003c/p>\n\u003cp>“If the U.S. makes formal contact with us, China will continue necessary investigations in an earnest and responsible manner and maintain close communication and cooperation with the U.S.,” Hua said at a regularly scheduled news conference.[contextly_sidebar id=\"kD7HyExDaX6bPoHIJ2EyalwLhMsGc6Yg\"]\u003c/p>\n\u003cp>China earlier said it had looked into the case announced last month but came up with no clues about the cause of the symptoms.\u003c/p>\n\u003cp>The New York Times identified the latest American employee evacuated as Mark A. Lenzi, a security engineering officer at the consulate who left Wednesday night with his wife and two children.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lenzi told the Times he resided in the same apartment tower as the officer evacuated in April and suffered in recent months from what he called “neurological symptoms.”\u003c/p>\n\u003cdiv id=\"div-gpt-ad-1470255291270-1\" class=\"ad-placeholder\">\n\u003cdiv id=\"google_ads_iframe_/15786418/APNews/site/article/midarticle2_0__container__\">\n\u003cp>Lenzi’s apartment was in one of several high-rise buildings in The Canton Place featuring restaurants and galleries spaced around a central plaza. Another diplomat who reported symptoms was at a different upscale building near the consulate, the paper said.\u003c/p>\n\u003cp>A U.S. official, who wasn’t authorized to discuss the situation publicly and requested anonymity, said the evacuated American government workers were being brought from China for testing to the University of Pennsylvania. That’s where doctors have been treating and studying patients previously evacuated from the U.S. Embassy in Havana.\u003c/p>\n\u003cp>The preliminary findings of the medical reports on the 24 personnel affected in Cuba showed they had sensory and memory problems similar to the brain dysfunction seen with concussions.\u003c/p>\n\u003cp>The Penn team said the patients from Cuba experienced persistent disability though rehabilitation therapy customized for them seemed to help.\u003c/p>\n\u003cp>Canada in April also ordered families of diplomatic staff in Cuba to return home after mysterious health symptoms were detected in 10 Canadians stationed on the island. Canada said the 10 continued to show unexplained brain symptoms and that “medical information raised concerns for a new type of a possible acquired brain injury.”[contextly_sidebar id=\"yqjMydejhDpIpH1sD1HMACrcUU3kDG2I\"]\u003c/p>\n\u003cp>In testimony before the Senate Foreign Relations Committee last month about the first case in China, U.S. Secretary of State Mike Pompeo said China had “said all the right things and have demonstrated their willingness to help us identify the vector which led to this medical incident.”\u003c/p>\n\u003cp>The China incidents affect one of the most important of the seven U.S. diplomatic outposts in the country. The Guangzhou consulate opened months after the establishment of diplomatic relations between Beijing and Washington in 1979 and moved to its new purpose-built facility in 2013.\u003c/p>\n\u003cp>It serves four southern provinces with a combined population of more than 204 million and processes more than 1 million visa applications of all types annually. It is also the only U.S. diplomatic installation in China authorized to process immigrant visas and handle adoptions.\u003c/p>\n\u003cp>People working in The Canton Place complex, a few kilometers (miles) from the consulate, said they were just hearing about the incidents, reflecting a lack of coverage in China’s entirely state-controlled media.\u003c/p>\n\u003cp>Aled Williams, a British teacher at a kindergarten said Thursday that the reports sounded “sci-fi-ish.”\u003c/p>\n\u003cp>“Hard to get my head around how it works,” he said. “Better watch myself.”\u003c/p>\n\u003cp>Linda Chen, who runs a coffee shop in the area, said she was mystified as to why only certain people seemed to have been affected in an area known for its comfort and safety.\u003c/p>\n\u003cp>“For me I feel it’s very strange. But I don’t feel that there’s something to be very afraid of because it’s probably a very special case,” Chen said.\u003c/p>\n\u003c/div>\n\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A U.S. medical team was screening more Americans who work at the consulate in southern China as the State Department confirmed evacuating a number of government employees who experienced unexplained health issues like those that have hurt U.S. personnel in Cuba and China.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The evacuations of workers in Guangzhou followed medical testing that revealed they might have been affected. State Department spokeswoman Heather Nauert said “a number of individuals” had been brought to the U.S. but didn’t say how many were affected or evacuated. A previous case in Guangzhou, disclosed last month, prompted the tests.\u003c/p>\n\u003cp>Nauert also said that remaining U.S. government personnel and their families in Guangzhou would also be able to request testing if they “noted concerning symptoms or wanted baseline screening.”\u003c/p>\n\u003cp>The incidents have raised fears the unexplained issues that started in Cuba in 2016 have expanded. The U.S. government has deemed those incidents “specific attacks” on American workers but hasn’t publicly identified a cause or culprit. Most of the incidents were accompanied by bizarre, unexplained sounds that initially led U.S. investigators to suspect a sonic attack.\u003c/p>\n\u003cp>Symptoms have included dizziness, headaches and an inability to concentrate. The American government worker who previously was removed from China reported “subtle and vague, but abnormal, sensations of sound and pressure,” the Guangzhou consulate reported last month\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Security guards outside the Guangzhou consulate on Thursday told reporters to leave the area and not attempt to talk to consulate staff.\u003c/p>\n\u003cp>Asked about the latest incidents, Chinese Foreign Ministry spokeswoman Hua Chunying said the U.S. had not formally raised the matter with Beijing.\u003c/p>\n\u003cp>“If the U.S. makes formal contact with us, China will continue necessary investigations in an earnest and responsible manner and maintain close communication and cooperation with the U.S.,” Hua said at a regularly scheduled news conference.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>China earlier said it had looked into the case announced last month but came up with no clues about the cause of the symptoms.\u003c/p>\n\u003cp>The New York Times identified the latest American employee evacuated as Mark A. Lenzi, a security engineering officer at the consulate who left Wednesday night with his wife and two children.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lenzi told the Times he resided in the same apartment tower as the officer evacuated in April and suffered in recent months from what he called “neurological symptoms.”\u003c/p>\n\u003cdiv id=\"div-gpt-ad-1470255291270-1\" class=\"ad-placeholder\">\n\u003cdiv id=\"google_ads_iframe_/15786418/APNews/site/article/midarticle2_0__container__\">\n\u003cp>Lenzi’s apartment was in one of several high-rise buildings in The Canton Place featuring restaurants and galleries spaced around a central plaza. Another diplomat who reported symptoms was at a different upscale building near the consulate, the paper said.\u003c/p>\n\u003cp>A U.S. official, who wasn’t authorized to discuss the situation publicly and requested anonymity, said the evacuated American government workers were being brought from China for testing to the University of Pennsylvania. That’s where doctors have been treating and studying patients previously evacuated from the U.S. Embassy in Havana.\u003c/p>\n\u003cp>The preliminary findings of the medical reports on the 24 personnel affected in Cuba showed they had sensory and memory problems similar to the brain dysfunction seen with concussions.\u003c/p>\n\u003cp>The Penn team said the patients from Cuba experienced persistent disability though rehabilitation therapy customized for them seemed to help.\u003c/p>\n\u003cp>Canada in April also ordered families of diplomatic staff in Cuba to return home after mysterious health symptoms were detected in 10 Canadians stationed on the island. Canada said the 10 continued to show unexplained brain symptoms and that “medical information raised concerns for a new type of a possible acquired brain injury.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In testimony before the Senate Foreign Relations Committee last month about the first case in China, U.S. Secretary of State Mike Pompeo said China had “said all the right things and have demonstrated their willingness to help us identify the vector which led to this medical incident.”\u003c/p>\n\u003cp>The China incidents affect one of the most important of the seven U.S. diplomatic outposts in the country. The Guangzhou consulate opened months after the establishment of diplomatic relations between Beijing and Washington in 1979 and moved to its new purpose-built facility in 2013.\u003c/p>\n\u003cp>It serves four southern provinces with a combined population of more than 204 million and processes more than 1 million visa applications of all types annually. It is also the only U.S. diplomatic installation in China authorized to process immigrant visas and handle adoptions.\u003c/p>\n\u003cp>People working in The Canton Place complex, a few kilometers (miles) from the consulate, said they were just hearing about the incidents, reflecting a lack of coverage in China’s entirely state-controlled media.\u003c/p>\n\u003cp>Aled Williams, a British teacher at a kindergarten said Thursday that the reports sounded “sci-fi-ish.”\u003c/p>\n\u003cp>“Hard to get my head around how it works,” he said. “Better watch myself.”\u003c/p>\n\u003cp>Linda Chen, who runs a coffee shop in the area, said she was mystified as to why only certain people seemed to have been affected in an area known for its comfort and safety.\u003c/p>\n\u003cp>“For me I feel it’s very strange. But I don’t feel that there’s something to be very afraid of because it’s probably a very special case,” Chen said.\u003c/p>\n\u003c/div>\n\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Clinic Claims Success In Making Babies With 3 Parents' DNA",
"title": "Clinic Claims Success In Making Babies With 3 Parents' DNA",
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"content": "\u003cp>In a clinic on a side street in Kiev, the capital of Ukraine, doctors are doing something that, as far as is publicly known, is being done nowhere else in the world: using DNA from three different people to create babies for women who are infertile.[contextly_sidebar id=\"hJp3PK3nX6Xp23jBK7povAqNM584M314\"]\u003c/p>\n\u003cp>\"If you can help these families to achieve their own babies, why it must be forbidden?\" \u003ca href=\"http://nadiyaclinic.com/about-the-clinic/our-team/valery-zukin/\" target=\"_blank\" rel=\"noopener\">Valery Zukin\u003c/a>, director of the \u003ca href=\"http://nadiyaclinic.com/\" target=\"_blank\" rel=\"noopener\">Nadiya Clinic\u003c/a>, asks as he peers over his glasses. \"It is a dream to want to have a genetic connection with a baby.\"\u003c/p>\n\u003cp>I traveled to Ukraine because Zukin promised unusual access to his private fertility clinic, including the first demonstration for a U.S. journalist of how scientists create \"three-parent\" babies — a procedure prohibited by the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>Zukin also arranged the first-ever interview with a mother of a 15-month-old boy who is one of the four children he says he has produced this way.\u003c/p>\n\u003cp>Three more of his patients are pregnant, Zukin says, including a woman from Sweden. Women from several other countries including Britain, Brazil and Israel are going through the process, he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Leading ethicists and genetics researchers criticize the clinic for rushing ahead to use this method for infertility. No one knows whether children produced this way will be healthy, they say. And some worry the procedure may open the door to \"designer babies.\"\u003c/p>\n\u003cp>\"This is pretty troubling,\" says \u003ca href=\"https://www.geneticsandsociety.org/user/25\" target=\"_blank\" rel=\"noopener\">Marcy Darnovsky\u003c/a>, who heads the Center for Genetics and Society, a U.S.-based watchdog group.\u003c/p>\n\u003cp>But Zukin dismisses those criticisms.\u003c/p>\n\u003cp>\"As a doctor I understand only one thing: We have parents who couldn't have children and now they have their own biological child. That's all,\" Zukin says.[contextly_sidebar id=\"e9qixdqsJYlqHyn9aCm0jBm9SiC8DfaI\"]\u003c/p>\n\u003cp>Zukin has helped form a \u003ca href=\"http://www.dl-nadiya.com/\" target=\"_blank\" rel=\"noopener\">company\u003c/a>, Darwin Life-Nadiya, with a \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New York clinic\u003c/a> to market the service to U.S. women willing to travel to Ukraine. Ukrainian women pay about $8,000 for the procedure; for foreigners, it's about $15,000.\u003c/p>\n\u003cp>\u003cstrong>Transferring DNA From Egg to Egg\u003c/strong>\u003c/p>\n\u003cp>To show how the procedure works, Zukin sends me upstairs to the embryo lab. After putting on a sterile blue gown and booties, I meet Pavlo Mazur, a clinic embryo scientist.\u003c/p>\n\u003cp>\"We will begin,\" Mazur says, as he takes a clear plastic dish out of an incubator.\u003c/p>\n\u003cp>The dish contains a 1-day-old embryo. It was created by fertilizing the egg of a woman with sperm from her male partner.\u003c/p>\n\u003cp>The dish also holds a second embryo. This was made using the same man's sperm to fertilize an egg from another woman, who was paid to donate eggs.\u003c/p>\n\u003cp>After sliding the embryos under a large microscope, Mazur starts a timer. He has only 15 minutes to complete the delicate procedure without risking damage to the embryos.\u003c/p>\n\u003cp>A monitor nearby displays what Mazur sees through the microscope. A round structure comes into focus on the screen. It's one of the embryos.[contextly_sidebar id=\"lH4aHr8bWw920dNDT3zPx9BxxYAHoA23\"]\u003c/p>\n\u003cp>\"You see?\" Mazur says, pointing to two smaller round structures inside. They contain the DNA of the man and woman trying to have a baby.\u003c/p>\n\u003cp>\"One is from sperm. It's paternal,\" Mazur says. \"And the second one is maternal.\"\u003c/p>\n\u003cp>Mazur slowly inserts a tiny, hollow glass needle into the fertilized egg. Even though Mazur is under pressure to work fast, he can't move too quickly.\u003c/p>\n\u003cp>\"Very steady and slow,\" Mazur says. \"We don't want to damage it, right? We want it to survive.\"\u003c/p>\n\u003cp>He uses the needle to extract the would-be parents' DNA. Mazur does the same thing with the second fertilized egg, removing all the DNA — except for 37 genes known as \u003ca href=\"https://ghr.nlm.nih.gov/mitochondrial-dna\" target=\"_blank\" rel=\"noopener\">mitochondrial DNA\u003c/a>.\u003c/p>\n\u003cp>Mitochondria provide energy for eggs. A defect in the patient's mitochondrial DNA might be what's preventing her from getting pregnant. So using the donor's mitochondrial DNA may be what enables the patient to produce healthy embryos and babies.\u003c/p>\n\u003cp>\"It's like an universal currency for a cell,\" Mazur says. \"It helps for all processes within the cell.\"\u003c/p>\n\u003cp>The next step is to transfer the DNA of the woman and man trying to have a child into the donor's mostly gutted embryo — empty except for the other woman's mitochondrial DNA.\u003c/p>\n\u003cp>\"And now we will just try to put the genetic material of our patient inside,\" Mazur says as he gently inserts the needle holding the couple's DNA and injects the genes.\u003c/p>\n\u003cp>\"That's it,\" he says, glancing at his timer to see there are still two minutes left.\u003c/p>\n\u003cp>\"So, you see? It's inside,\" Mazur says, pointing to the couple's DNA. \"It will develop into embryo.\"\u003c/p>\n\u003cp>The Nadiya clinic is transferring embryos reconstructed this way into the wombs of women trying to become pregnant.\u003c/p>\n\u003cp>So far, the clinic has tried the procedure on 21 women. Fourteen attempts failed, probably because the women were older, the clinic staffers say.\u003c/p>\n\u003cp>But the other women either had babies or are pregnant. They were younger, but could never produce viable embryos on their own.\u003c/p>\n\u003cp>\"I adore that such technology exists. I adore that it can help some people,\" says Mazur.\u003c/p>\n\u003cp>These babies end up with DNA from three different people: the woman trying to have a baby; her male partner; and the egg donor who has provided 37 mitochondrial genes. That's why they're called three-parent babies.\u003c/p>\n\u003cp>But Mazur says that label is wrong.\u003c/p>\n\u003cp>\"These babies — they have DNA from mother and from father. So they are genetically related to their parents,\" Mazur says.[contextly_sidebar id=\"epZCsHoOtfaC0xfJUpdgovxcZOsKlTBF\"]\u003c/p>\n\u003cp>The overwhelming majority of the baby's DNA comes from the nucleus of the cell. And those are the genes responsible for the traits that most people consider their genetic inheritance, such as their eye and hair color, height, weight and personality.\u003c/p>\n\u003cp>The bit of mitochondrial DNA is \"incomparable,\" Mazur says. \"These children are more like their parents — not donor.\"\u003c/p>\n\u003cp>Mazur will present the clinic's latest results at the \u003ca href=\"https://www.eshre.eu/\" target=\"_blank\" rel=\"noopener\">European Society of Human Reproduction and Embryology\u003c/a>'s annual meeting in Barcelona in July.\u003c/p>\n\u003cp>\u003cstrong>Moving too fast?\u003c/strong>\u003c/p>\n\u003cp>Some scientists are welcoming this as a potentially exciting new option for some women.\u003c/p>\n\u003cp>\"It is pioneering work,\" says \u003ca href=\"http://cumc.p.cumcweb.org/mdphd/profile/degli\" target=\"_blank\" rel=\"noopener\">Dietrich Egli\u003c/a>, an assistant professor of developmental biology at Columbia University Medical Center in New York. The procedure is technically known as \"pronuclear transfer.\"\u003c/p>\n\u003cp>\"What we can learn from their work is that pronuclear transfer may be useful for some cases of infertility,\" says Egli.\u003c/p>\n\u003cp>But critics say it's far too soon to be attempting this procedure to create children.\u003c/p>\n\u003cp>\"This is really an irresponsible kind of human experimentation,\" Darnovsky of the Center for Genetics and Society says.\u003c/p>\n\u003cp>Not nearly enough laboratory and animal research has been done to know if the procedure is safe, Darnovsky and others say.\u003c/p>\n\u003cp>\"We just don't know what's going to happen to these children,\" Darnovsky says.\u003c/p>\n\u003cp>In the 1990s, a doctor in New Jersey injected fluid from healthy eggs into the eggs of infertile women, and some babies were born with mitochondrial DNA from three people. But that was discontinued after the FDA intervened.\u003c/p>\n\u003cp>Only one other baby is known to have been produced using a technique similar to the one being used by Zukin. \u003ca href=\"https://www.newhopefertility.com/about-us/fertility-doctor/john-zhang/\" target=\"_blank\" rel=\"noopener\">John Zhang\u003c/a> of the \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New Hope Fertility Center\u003c/a> in New York performed a related procedure for a Jordanian couple to try to prevent their child from having \u003ca href=\"https://ghr.nlm.nih.gov/condition/leigh-syndrome\" target=\"_blank\" rel=\"noopener\">Leigh syndrome\u003c/a>, a disorder caused by defects in mitochondrial DNA.\u003c/p>\n\u003cp>That's why the procedure was developed — to help women carrying \u003ca href=\"https://medlineplus.gov/mitochondrialdiseases.html\" target=\"_blank\" rel=\"noopener\">mitochondrial disorders\u003c/a> have healthy children. In severe cases, these disorders can be fatal.\u003c/p>\n\u003cp>A U.S. National Academy of Sciences panel \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/03/465319186/babies-with-genes-from-three-people-could-be-ethical-panel-says\" target=\"_blank\" rel=\"noopener\">concluded\u003c/a> it could be ethical to attempt the procedure for this purpose. But because the FDA \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm570185.htm\">won't allow\u003c/a> it at all in the United States, the baby of the Jordanian couple whom \u003ca href=\"https://www.npr.org/sections/thetwo-way/2016/09/27/495668299/new-york-fertility-doctor-says-he-created-baby-with-3-genetic-parents\" target=\"_blank\" rel=\"noopener\">Zhang helped was born in Mexico in 2016.\u003c/a>\u003c/p>\n\u003cp>Doctors in the United Kingdom have started trying the technique to prevent mitochondrial disorders. But the British doctors are being \u003ca href=\"https://www.npr.org/2015/02/03/383578221/u-k-lawmakers-allow-scientists-to-attempt-dna-transplants\">allowed\u003c/a> to try to make only one baby at a time as part of a tightly regulated \u003ca href=\"https://www.npr.org/sections/health-shots/2014/11/10/360342623/combining-the-dna-of-three-people-raises-ethical-questions\" target=\"_blank\" rel=\"noopener\">research program\u003c/a>.[contextly_sidebar id=\"2QVJm0WQxeuB5lotTMLysQyqrPHpvncJ\"]\u003c/p>\n\u003cp>Zukin says he received approval for a five-year research program from the Ukrainian Postgraduate Medical Academy, which is under the auspices of the Ukrainian Ministry of Public Health. But Zukin concedes the procedure is far less regulated in his country. Nevertheless, he makes sure all the women understand they are undergoing an experimental procedure.\u003c/p>\n\u003cp>\"We explain everything to the families. And not all families give permission for providing this experimental procedure,\" he says.\u003c/p>\n\u003cp>Because mitochondrial DNA can be inherited, Darnovsky worries the procedure is crossing a line that long has been considered taboo: making changes in human DNA that can be passed down to future generations. One fear is that a mistake could create a new disease that could be inherited.\u003c/p>\n\u003cp>Mitochondrial DNA is inherited from the mother. Zukin already has used the procedure to produce one baby girl — a girl who could one day pass the mitochondrial DNA to her own children.\u003c/p>\n\u003cp>Darnovsky worries the procedure could also open the door to creating babies who are genetically modified for other reasons.\u003c/p>\n\u003cp>\"What we're seeing is a fast slide down a very slippery slope toward designer babies,\" Darnovsky says. \"We could see parents feeling eager to give their children traits like greater strength, needs less sleep. Some people are saying that, 'Yes, there are genes for IQ and we could have smarter babies.' \"\u003c/p>\n\u003cp>Zukin dismisses speculation about designer babies. He says he's interested only in helping women who are infertile have genetically related children or prevent mitochondrial diseases. And so far, all the babies he has created appear to be perfectly healthy, he says.\u003c/p>\n\u003cp>The only way to know whether the procedure works and is safe is to try it, he argues. He hopes to figure out how to make the procedure work for women suffering from age-related infertility as well, which would help far more women.\u003c/p>\n\u003cp>\"If you would like to swim,\" he says, \"then, first of all, you must jump in the water.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>A second story on Wednesday afternoon features an exclusive interview with a mother and her three-parent son.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Clinic+Claims+Success+In+Making+Babies+With+3+Parents%27+DNA+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "A clinic in Kiev, Ukraine, stirs controversy by making babies with DNA from three different people to help women who are infertile bear children. It's the only clinic known to be doing this right now.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a clinic on a side street in Kiev, the capital of Ukraine, doctors are doing something that, as far as is publicly known, is being done nowhere else in the world: using DNA from three different people to create babies for women who are infertile.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"If you can help these families to achieve their own babies, why it must be forbidden?\" \u003ca href=\"http://nadiyaclinic.com/about-the-clinic/our-team/valery-zukin/\" target=\"_blank\" rel=\"noopener\">Valery Zukin\u003c/a>, director of the \u003ca href=\"http://nadiyaclinic.com/\" target=\"_blank\" rel=\"noopener\">Nadiya Clinic\u003c/a>, asks as he peers over his glasses. \"It is a dream to want to have a genetic connection with a baby.\"\u003c/p>\n\u003cp>I traveled to Ukraine because Zukin promised unusual access to his private fertility clinic, including the first demonstration for a U.S. journalist of how scientists create \"three-parent\" babies — a procedure prohibited by the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>Zukin also arranged the first-ever interview with a mother of a 15-month-old boy who is one of the four children he says he has produced this way.\u003c/p>\n\u003cp>Three more of his patients are pregnant, Zukin says, including a woman from Sweden. Women from several other countries including Britain, Brazil and Israel are going through the process, he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Leading ethicists and genetics researchers criticize the clinic for rushing ahead to use this method for infertility. No one knows whether children produced this way will be healthy, they say. And some worry the procedure may open the door to \"designer babies.\"\u003c/p>\n\u003cp>\"This is pretty troubling,\" says \u003ca href=\"https://www.geneticsandsociety.org/user/25\" target=\"_blank\" rel=\"noopener\">Marcy Darnovsky\u003c/a>, who heads the Center for Genetics and Society, a U.S.-based watchdog group.\u003c/p>\n\u003cp>But Zukin dismisses those criticisms.\u003c/p>\n\u003cp>\"As a doctor I understand only one thing: We have parents who couldn't have children and now they have their own biological child. That's all,\" Zukin says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Zukin has helped form a \u003ca href=\"http://www.dl-nadiya.com/\" target=\"_blank\" rel=\"noopener\">company\u003c/a>, Darwin Life-Nadiya, with a \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New York clinic\u003c/a> to market the service to U.S. women willing to travel to Ukraine. Ukrainian women pay about $8,000 for the procedure; for foreigners, it's about $15,000.\u003c/p>\n\u003cp>\u003cstrong>Transferring DNA From Egg to Egg\u003c/strong>\u003c/p>\n\u003cp>To show how the procedure works, Zukin sends me upstairs to the embryo lab. After putting on a sterile blue gown and booties, I meet Pavlo Mazur, a clinic embryo scientist.\u003c/p>\n\u003cp>\"We will begin,\" Mazur says, as he takes a clear plastic dish out of an incubator.\u003c/p>\n\u003cp>The dish contains a 1-day-old embryo. It was created by fertilizing the egg of a woman with sperm from her male partner.\u003c/p>\n\u003cp>The dish also holds a second embryo. This was made using the same man's sperm to fertilize an egg from another woman, who was paid to donate eggs.\u003c/p>\n\u003cp>After sliding the embryos under a large microscope, Mazur starts a timer. He has only 15 minutes to complete the delicate procedure without risking damage to the embryos.\u003c/p>\n\u003cp>A monitor nearby displays what Mazur sees through the microscope. A round structure comes into focus on the screen. It's one of the embryos.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"You see?\" Mazur says, pointing to two smaller round structures inside. They contain the DNA of the man and woman trying to have a baby.\u003c/p>\n\u003cp>\"One is from sperm. It's paternal,\" Mazur says. \"And the second one is maternal.\"\u003c/p>\n\u003cp>Mazur slowly inserts a tiny, hollow glass needle into the fertilized egg. Even though Mazur is under pressure to work fast, he can't move too quickly.\u003c/p>\n\u003cp>\"Very steady and slow,\" Mazur says. \"We don't want to damage it, right? We want it to survive.\"\u003c/p>\n\u003cp>He uses the needle to extract the would-be parents' DNA. Mazur does the same thing with the second fertilized egg, removing all the DNA — except for 37 genes known as \u003ca href=\"https://ghr.nlm.nih.gov/mitochondrial-dna\" target=\"_blank\" rel=\"noopener\">mitochondrial DNA\u003c/a>.\u003c/p>\n\u003cp>Mitochondria provide energy for eggs. A defect in the patient's mitochondrial DNA might be what's preventing her from getting pregnant. So using the donor's mitochondrial DNA may be what enables the patient to produce healthy embryos and babies.\u003c/p>\n\u003cp>\"It's like an universal currency for a cell,\" Mazur says. \"It helps for all processes within the cell.\"\u003c/p>\n\u003cp>The next step is to transfer the DNA of the woman and man trying to have a child into the donor's mostly gutted embryo — empty except for the other woman's mitochondrial DNA.\u003c/p>\n\u003cp>\"And now we will just try to put the genetic material of our patient inside,\" Mazur says as he gently inserts the needle holding the couple's DNA and injects the genes.\u003c/p>\n\u003cp>\"That's it,\" he says, glancing at his timer to see there are still two minutes left.\u003c/p>\n\u003cp>\"So, you see? It's inside,\" Mazur says, pointing to the couple's DNA. \"It will develop into embryo.\"\u003c/p>\n\u003cp>The Nadiya clinic is transferring embryos reconstructed this way into the wombs of women trying to become pregnant.\u003c/p>\n\u003cp>So far, the clinic has tried the procedure on 21 women. Fourteen attempts failed, probably because the women were older, the clinic staffers say.\u003c/p>\n\u003cp>But the other women either had babies or are pregnant. They were younger, but could never produce viable embryos on their own.\u003c/p>\n\u003cp>\"I adore that such technology exists. I adore that it can help some people,\" says Mazur.\u003c/p>\n\u003cp>These babies end up with DNA from three different people: the woman trying to have a baby; her male partner; and the egg donor who has provided 37 mitochondrial genes. That's why they're called three-parent babies.\u003c/p>\n\u003cp>But Mazur says that label is wrong.\u003c/p>\n\u003cp>\"These babies — they have DNA from mother and from father. So they are genetically related to their parents,\" Mazur says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The overwhelming majority of the baby's DNA comes from the nucleus of the cell. And those are the genes responsible for the traits that most people consider their genetic inheritance, such as their eye and hair color, height, weight and personality.\u003c/p>\n\u003cp>The bit of mitochondrial DNA is \"incomparable,\" Mazur says. \"These children are more like their parents — not donor.\"\u003c/p>\n\u003cp>Mazur will present the clinic's latest results at the \u003ca href=\"https://www.eshre.eu/\" target=\"_blank\" rel=\"noopener\">European Society of Human Reproduction and Embryology\u003c/a>'s annual meeting in Barcelona in July.\u003c/p>\n\u003cp>\u003cstrong>Moving too fast?\u003c/strong>\u003c/p>\n\u003cp>Some scientists are welcoming this as a potentially exciting new option for some women.\u003c/p>\n\u003cp>\"It is pioneering work,\" says \u003ca href=\"http://cumc.p.cumcweb.org/mdphd/profile/degli\" target=\"_blank\" rel=\"noopener\">Dietrich Egli\u003c/a>, an assistant professor of developmental biology at Columbia University Medical Center in New York. The procedure is technically known as \"pronuclear transfer.\"\u003c/p>\n\u003cp>\"What we can learn from their work is that pronuclear transfer may be useful for some cases of infertility,\" says Egli.\u003c/p>\n\u003cp>But critics say it's far too soon to be attempting this procedure to create children.\u003c/p>\n\u003cp>\"This is really an irresponsible kind of human experimentation,\" Darnovsky of the Center for Genetics and Society says.\u003c/p>\n\u003cp>Not nearly enough laboratory and animal research has been done to know if the procedure is safe, Darnovsky and others say.\u003c/p>\n\u003cp>\"We just don't know what's going to happen to these children,\" Darnovsky says.\u003c/p>\n\u003cp>In the 1990s, a doctor in New Jersey injected fluid from healthy eggs into the eggs of infertile women, and some babies were born with mitochondrial DNA from three people. But that was discontinued after the FDA intervened.\u003c/p>\n\u003cp>Only one other baby is known to have been produced using a technique similar to the one being used by Zukin. \u003ca href=\"https://www.newhopefertility.com/about-us/fertility-doctor/john-zhang/\" target=\"_blank\" rel=\"noopener\">John Zhang\u003c/a> of the \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New Hope Fertility Center\u003c/a> in New York performed a related procedure for a Jordanian couple to try to prevent their child from having \u003ca href=\"https://ghr.nlm.nih.gov/condition/leigh-syndrome\" target=\"_blank\" rel=\"noopener\">Leigh syndrome\u003c/a>, a disorder caused by defects in mitochondrial DNA.\u003c/p>\n\u003cp>That's why the procedure was developed — to help women carrying \u003ca href=\"https://medlineplus.gov/mitochondrialdiseases.html\" target=\"_blank\" rel=\"noopener\">mitochondrial disorders\u003c/a> have healthy children. In severe cases, these disorders can be fatal.\u003c/p>\n\u003cp>A U.S. National Academy of Sciences panel \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/03/465319186/babies-with-genes-from-three-people-could-be-ethical-panel-says\" target=\"_blank\" rel=\"noopener\">concluded\u003c/a> it could be ethical to attempt the procedure for this purpose. But because the FDA \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm570185.htm\">won't allow\u003c/a> it at all in the United States, the baby of the Jordanian couple whom \u003ca href=\"https://www.npr.org/sections/thetwo-way/2016/09/27/495668299/new-york-fertility-doctor-says-he-created-baby-with-3-genetic-parents\" target=\"_blank\" rel=\"noopener\">Zhang helped was born in Mexico in 2016.\u003c/a>\u003c/p>\n\u003cp>Doctors in the United Kingdom have started trying the technique to prevent mitochondrial disorders. But the British doctors are being \u003ca href=\"https://www.npr.org/2015/02/03/383578221/u-k-lawmakers-allow-scientists-to-attempt-dna-transplants\">allowed\u003c/a> to try to make only one baby at a time as part of a tightly regulated \u003ca href=\"https://www.npr.org/sections/health-shots/2014/11/10/360342623/combining-the-dna-of-three-people-raises-ethical-questions\" target=\"_blank\" rel=\"noopener\">research program\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Zukin says he received approval for a five-year research program from the Ukrainian Postgraduate Medical Academy, which is under the auspices of the Ukrainian Ministry of Public Health. But Zukin concedes the procedure is far less regulated in his country. Nevertheless, he makes sure all the women understand they are undergoing an experimental procedure.\u003c/p>\n\u003cp>\"We explain everything to the families. And not all families give permission for providing this experimental procedure,\" he says.\u003c/p>\n\u003cp>Because mitochondrial DNA can be inherited, Darnovsky worries the procedure is crossing a line that long has been considered taboo: making changes in human DNA that can be passed down to future generations. One fear is that a mistake could create a new disease that could be inherited.\u003c/p>\n\u003cp>Mitochondrial DNA is inherited from the mother. Zukin already has used the procedure to produce one baby girl — a girl who could one day pass the mitochondrial DNA to her own children.\u003c/p>\n\u003cp>Darnovsky worries the procedure could also open the door to creating babies who are genetically modified for other reasons.\u003c/p>\n\u003cp>\"What we're seeing is a fast slide down a very slippery slope toward designer babies,\" Darnovsky says. \"We could see parents feeling eager to give their children traits like greater strength, needs less sleep. Some people are saying that, 'Yes, there are genes for IQ and we could have smarter babies.' \"\u003c/p>\n\u003cp>Zukin dismisses speculation about designer babies. He says he's interested only in helping women who are infertile have genetically related children or prevent mitochondrial diseases. And so far, all the babies he has created appear to be perfectly healthy, he says.\u003c/p>\n\u003cp>The only way to know whether the procedure works and is safe is to try it, he argues. He hopes to figure out how to make the procedure work for women suffering from age-related infertility as well, which would help far more women.\u003c/p>\n\u003cp>\"If you would like to swim,\" he says, \"then, first of all, you must jump in the water.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>A second story on Wednesday afternoon features an exclusive interview with a mother and her three-parent son.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Clinic+Claims+Success+In+Making+Babies+With+3+Parents%27+DNA+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"slug": "sf-voters-may-ban-vape-flavors-menthol-cigarettes",
"title": "San Francisco Passes First-in-the-Nation Flavored Tobacco, Vaping Ban",
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"content": "\u003cp>\u003cem>Update June 6, 2018: \u003c/em>\u003c/p>\n\u003cp>San Francisco is on its way to becoming the first city in the nation to ban all flavored tobacco products from store shelves.\u003c/p>\n\u003cp>With all precincts now having reported their results, Measure E is passing with a whopping 68 percent of the vote. The final results won’t be tallied until all vote-by-mail ballots are counted.\u003c/p>\n\u003cp>The R.J. Reynolds Tobacco Company spent nearly $13 million on a campaign to stop the ban. The company sells the nation’s best-selling menthol cigarette. All that money was appalling to Patrick Reynolds, his grandfather founded the company, but he’s now an anti-tobacco advocate because he lost his father to emphysema.\u003c/p>\n\u003cp>“The only memory I have of him is a man lying down dying gasping of breath,” Reynolds said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Reynolds stridently opposes adding flavors to e-cigarettes like berry, nacho cheese or gummy bear.\u003c/p>\n\u003cp>“It is an obscene, outrageous brazen ploy by the tobacco industry and by the vaping industry to ensnare another generation to be addicted,” Reynolds said. “And it’s just got to stop.”\u003c/p>\n\u003cp>The citywide ban will go into effect 10 days after the election is certified.\u003c/p>\n\u003cp>\u003cem>Original post\u003c/em>\u003c/p>\n\u003cp>San Francisco could became the first city in the nation to ban flavored tobacco products from all store shelves. This includes everything from candy flavored e-cigarettes to conventional menthol smokes.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘The industry recognized decades ago that if they don’t get kids to start, they [the industry] will die out.’ \u003ccite>Dr. Pam Ling, UCSF \u003c/cite>\u003c/aside>\n\u003cp>City supervisors last year unanimously approved a \u003ca href=\"http://sfgov.org/elections/sites/default/files/Documents/candidates/Legal_Text_Repeal_of_Flavored_Tobacco_Products_Ban.pdf\" target=\"_blank\" rel=\"noopener\">ban\u003c/a> on the products, but the tobacco industry funded a referendum, \u003ca href=\"https://ballotpedia.org/San_Francisco,_California,_Proposition_E,_Ban_on_the_Sale_of_Flavored_Tobacco_(June_2018)\" target=\"_blank\" rel=\"noopener\">Proposition E\u003c/a>, to put the issue before voters. Residents will decide in the June 5 election whether the ordinance goes into effect. Voting by mail has already begun.\u003c/p>\n\u003cp>\u003cstrong>Nearly $10 Million And Counting\u003c/strong>\u003c/p>\n\u003cp>The R.J. Reynolds Tobacco Company is \u003ca href=\"https://sfethics.org/ethics/2018/03/campaign-finance-dashboards-june-5-2018-and-november-6-2018-elections.html\" target=\"_blank\" rel=\"noopener\">blanketing\u003c/a> the city in radio, television and direct mail advertisements urging a “no” vote on Proposition E. The tobacco giant has shelled out nearly $10 million to save Newport menthols, which is the nation’s \u003ca href=\"https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/brand_preference/index.htm\" target=\"_blank\" rel=\"noopener\">best-selling\u003c/a> mint-flavored cigarette. The ads, featuring vintage film of people smashing kegs during Prohibition, claim that it didn’t work for alcohol and drugs, so it won’t work for flavored tobacco.\u003c/p>\n\u003cp>Billionaire Michael Bloomberg \u003ca href=\"https://www.kqed.org/futureofyou/441395/sf-voters-may-ban-vape-flavors-menthol-cigarettes\" target=\"_blank\" rel=\"noopener\">contributed $1.8 million\u003c/a> to the Yes campaign.\u003c/p>\n\u003cp>San Francisco resident Donna Anderson protested on behalf of the No campaign during a recent rally at Civic Center.\u003c/p>\n\u003cp>\u003cem>‘No on Proposition E’ ads, funded by the tobacco industry, liken the proposed ban to 1920s-era Prohibition …\u003c/em>\u003c/p>\n\u003cp>\u003ciframe loading=\"lazy\" title=\"Bans Don’t Work, No on Prop E (30 sec.)\" width=\"500\" height=\"281\" src=\"https://www.youtube.com/embed/HHKy5eum8l4?start=3&feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>“You’re just driving sales underground,” says Anderson. “It will not stop people from accessing what they want or using what they want.”\u003c/p>\n\u003cp>She uses the example of marijuana laws to illustrate how a black market usually hurts people of color the most.\u003c/p>\n\u003cp>“Black people, Latino people; people have been locked up — and are still locked up — having to do with little more than an ounce of marijuana,” said Anderson.\u003c/p>\n\u003cp>\u003cstrong>Local Businesses On Edge\u003c/strong>\u003c/p>\n\u003cp>At the Mission Smoke Shop, owner Sam Azar has plastered his walls with “No-on-E” signs.\u003c/p>\n\u003cp>“It’s going to hurt me as a small business here in the city by, like 30 percent or more,” he predicts.\u003c/p>\n\u003cfigure id=\"attachment_441406\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-441406 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-800x531.jpg\" alt=\"\" width=\"800\" height=\"531\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-800x531.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-768x510.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-1020x677.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-1200x797.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-1180x784.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-960x638.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-240x159.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-375x249.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-520x345.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164.jpg 1843w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sam Azar worries about how a ban on flavored tobacco products will hurt the bottom line at his Mission Smoke Shop. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He would no longer profit from flavored pipe tobacco, flavored hookah, infused cigars, or numerous racks of syrupy vape liquids. There are more than 7,000 sweet and savory e-cigarette flavors on the market — everything from gummi bear and Unicorn Milk to Red Bull and nacho cheese.\u003c/p>\n\u003cp>But medical experts worry about the role aromas play in enticing young people to try nicotine and get hooked on cigarettes.\u003c/p>\n\u003cp>Derek Smith, director of the \u003ca href=\"http://sanfranciscotobaccofreeproject.org/\" target=\"_blank\" rel=\"noopener\">Tobacco Free Project\u003c/a> at the San Francisco Department of Public Health, says flavors and menthol deceptively mask the taste of tobacco and make it easier to inhale nicotine.\u003c/p>\n\u003cp>“Someone who has tried a cigarette for the first time will often turn green and cough,” said Smith, in an email. “Imagine instead a cereal, milk-flavored inhalation that is considerably less harsh to start with.”\u003c/p>\n\u003cp>\u003cstrong>Physicians Take to the Streets\u003c/strong>\u003c/p>\n\u003cp>Smith \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/CDPH%20Document%20Library/Policy/FlavoredTobaccoAndMenthol/FinalFlavoredTobaccoInfographic.pdf\" target=\"_blank\" rel=\"noopener\">says\u003c/a> nearly all youth in the state start their tobacco habit with a flavored product, which worries doctors who gathered at a recent “Yes-on-E” rally on the steps of the Civic Center.\u003c/p>\n\u003cp>“The tobacco industry has targeted menthol cigarettes to the black community, to poor people, to mothers,” said Amanda Wright, a resident physician at UCSF. “And if you look at these products, they literally look like candy and that is clearly targeting our children.”\u003c/p>\n\u003cp>Wright was standing next to a table laden with row after row of juice boxes and candy wrappers. They look like sugary snack foods, but they’re actually packages of vaping products. The New York Times recently \u003ca href=\"https://www.nytimes.com/2018/05/01/health/fda-crackdown-vaping-children.html\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on a federal crackdown of these look-alikes.\u003c/p>\n\u003cfigure id=\"attachment_441402\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-441402 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-1020x498.jpg\" alt=\"\" width=\"640\" height=\"312\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-1020x498.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-160x78.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-800x391.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-768x375.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-1200x586.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-1180x576.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-960x469.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-240x117.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-375x183.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-520x254.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863.jpg 1896w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">The candylike packaging for vaping products on display at a Yes-on-E rally. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nicotine is particularly addictive for the teenage brain, according to Pam Ling, a physician and smoking researcher at UCSF.\u003c/p>\n\u003cp>“This population is the future of the tobacco industry,” says Ling. “The industry recognized decades ago that if they don’t get kids to start, they [the industry] will die out.”\u003c/p>\n\u003cp>The California Department of Public Health \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/CDPH%20Document%20Library/Policy/FlavoredTobaccoAndMenthol/FinalFlavoredTobaccoInfographic.pdf\" target=\"_blank\" rel=\"noopener\">says\u003c/a> the number of kids in California who vape is currently double the number who smoke, but some \u003ca href=\"http://pediatrics.aappublications.org/content/early/2017/11/30/peds.2017-1832\" target=\"_blank\" rel=\"noopener\">research\u003c/a> suggests that a lot of those kids will be smoking cigarettes before long.\u003c/p>\n\u003cp>“Once these kids start with the e-cigarettes, the likelihood that they’ll be smoking cigarettes a year or so later is increased by a factor of three or four,” says Stanton Glantz, who heads the \u003ca href=\"https://tobacco.ucsf.edu/\">Center for Tobacco Control Research and Education\u003c/a> at UCSF.\u003c/p>\n\u003cp>Glantz says that in his \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28115540\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, about a third of the kids who start using nicotine via e-cigarettes are not the kind of kids whose race, gender, home life and school performance would make them a high risk to pick up smoking on their own.\u003c/p>\n\u003cp>In other words, vaping is increasing the pool of teen smokers. A 2016 \u003ca href=\"https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the U.S. Surgeon General cited a 900 percent increase in the use of e-cigarettes by high school students from 2011 to 2015. Right now there is very little regulation of e-products at the federal level.\u003c/p>\n\u003cfigure id=\"attachment_441466\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/RS30897_PROPE_076-e1525979992131.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-441466 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/RS30897_PROPE_076-800x1200.jpg\" alt=\"\" width=\"800\" height=\"1200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An array of flavors displayed at Vapor Den, including banana cream, mango and fruit mix. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Glantz also contends that a flavor ban will help adults who \u003ca href=\"https://www.npr.org/sections/health-shots/2017/05/25/530026958/many-adults-dont-think-exposure-to-vaping-is-bad-for-kids\" target=\"_blank\" rel=\"noopener\">think they’re inhaling\u003c/a> a significantly safer alternative.\u003c/p>\n\u003cp>“When e-cigarettes first became available, there was a lot of hope that they would be better than cigarettes,” he says, “but the more we learn the worse they look.”\u003c/p>\n\u003cp>Though the long-term health effects of smoking e-cigarettes is still unknown, Glantz believes the safety of the devices has been \u003ca href=\"https://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-040617-013757\" target=\"_blank\" rel=\"noopener\">oversold\u003c/a>.\u003c/p>\n\u003cp>“Electronic smoking products emit particles of chemicals, not clean air, and technically an aerosol, not a vapor,” Smith says. “Think smog or hairspray — not the pure water vapor that steams when your teapot whistles.”\u003c/p>\n\u003cp>These \u003ca href=\"https://pubs.acs.org/doi/full/10.1021/acs.chemrestox.6b00188?src=recsys&=\" target=\"_blank\" rel=\"noopener\">ultrafine particles and toxins\u003c/a> can damage the lungs and may lead to heart attacks. Levels of the particles in the vapor produced by some devices may be lower than in tobacco smoke, but aren’t zero.\u003c/p>\n\u003cp>\u003ciframe loading=\"lazy\" title=\"Why Is Vaping So Popular?\" width=\"500\" height=\"281\" src=\"https://www.youtube.com/embed/P9zps5LsVXs?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>If San Francisco voters pass the flavor ban, it will be among the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2017/10/24/559833483/new-york-bans-vaping-indoors-in-public-state-law-classes-e-cigs-with-cigarettes\" target=\"_blank\" rel=\"noopener\">toughest restrictions\u003c/a> on e-cigarettes in the country; opponents of the measure fear it will set a precedent.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Jon Brooks contributed to this post. This post has been edited since it was originally published.\u003c/em>\u003c/p>\n\n",
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"excerpt": "The referendum, which bans flavored tobacco products like menthol cigarettes and gummi bear e-cigarettes, is passing with 68 percent of the vote.",
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"title": "San Francisco Passes First-in-the-Nation Flavored Tobacco, Vaping Ban",
"description": "The referendum, which bans flavored tobacco products like menthol cigarettes and gummi bear e-cigarettes, is passing with 68 percent of the vote.",
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"headline": "San Francisco Passes First-in-the-Nation Flavored Tobacco, Vaping Ban",
"datePublished": "2018-06-06T00:01:13-07:00",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Update June 6, 2018: \u003c/em>\u003c/p>\n\u003cp>San Francisco is on its way to becoming the first city in the nation to ban all flavored tobacco products from store shelves.\u003c/p>\n\u003cp>With all precincts now having reported their results, Measure E is passing with a whopping 68 percent of the vote. The final results won’t be tallied until all vote-by-mail ballots are counted.\u003c/p>\n\u003cp>The R.J. Reynolds Tobacco Company spent nearly $13 million on a campaign to stop the ban. The company sells the nation’s best-selling menthol cigarette. All that money was appalling to Patrick Reynolds, his grandfather founded the company, but he’s now an anti-tobacco advocate because he lost his father to emphysema.\u003c/p>\n\u003cp>“The only memory I have of him is a man lying down dying gasping of breath,” Reynolds said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Reynolds stridently opposes adding flavors to e-cigarettes like berry, nacho cheese or gummy bear.\u003c/p>\n\u003cp>“It is an obscene, outrageous brazen ploy by the tobacco industry and by the vaping industry to ensnare another generation to be addicted,” Reynolds said. “And it’s just got to stop.”\u003c/p>\n\u003cp>The citywide ban will go into effect 10 days after the election is certified.\u003c/p>\n\u003cp>\u003cem>Original post\u003c/em>\u003c/p>\n\u003cp>San Francisco could became the first city in the nation to ban flavored tobacco products from all store shelves. This includes everything from candy flavored e-cigarettes to conventional menthol smokes.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘The industry recognized decades ago that if they don’t get kids to start, they [the industry] will die out.’ \u003ccite>Dr. Pam Ling, UCSF \u003c/cite>\u003c/aside>\n\u003cp>City supervisors last year unanimously approved a \u003ca href=\"http://sfgov.org/elections/sites/default/files/Documents/candidates/Legal_Text_Repeal_of_Flavored_Tobacco_Products_Ban.pdf\" target=\"_blank\" rel=\"noopener\">ban\u003c/a> on the products, but the tobacco industry funded a referendum, \u003ca href=\"https://ballotpedia.org/San_Francisco,_California,_Proposition_E,_Ban_on_the_Sale_of_Flavored_Tobacco_(June_2018)\" target=\"_blank\" rel=\"noopener\">Proposition E\u003c/a>, to put the issue before voters. Residents will decide in the June 5 election whether the ordinance goes into effect. Voting by mail has already begun.\u003c/p>\n\u003cp>\u003cstrong>Nearly $10 Million And Counting\u003c/strong>\u003c/p>\n\u003cp>The R.J. Reynolds Tobacco Company is \u003ca href=\"https://sfethics.org/ethics/2018/03/campaign-finance-dashboards-june-5-2018-and-november-6-2018-elections.html\" target=\"_blank\" rel=\"noopener\">blanketing\u003c/a> the city in radio, television and direct mail advertisements urging a “no” vote on Proposition E. The tobacco giant has shelled out nearly $10 million to save Newport menthols, which is the nation’s \u003ca href=\"https://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/brand_preference/index.htm\" target=\"_blank\" rel=\"noopener\">best-selling\u003c/a> mint-flavored cigarette. The ads, featuring vintage film of people smashing kegs during Prohibition, claim that it didn’t work for alcohol and drugs, so it won’t work for flavored tobacco.\u003c/p>\n\u003cp>Billionaire Michael Bloomberg \u003ca href=\"https://www.kqed.org/futureofyou/441395/sf-voters-may-ban-vape-flavors-menthol-cigarettes\" target=\"_blank\" rel=\"noopener\">contributed $1.8 million\u003c/a> to the Yes campaign.\u003c/p>\n\u003cp>San Francisco resident Donna Anderson protested on behalf of the No campaign during a recent rally at Civic Center.\u003c/p>\n\u003cp>\u003cem>‘No on Proposition E’ ads, funded by the tobacco industry, liken the proposed ban to 1920s-era Prohibition …\u003c/em>\u003c/p>\n\u003cp>\u003ciframe loading=\"lazy\" title=\"Bans Don’t Work, No on Prop E (30 sec.)\" width=\"500\" height=\"281\" src=\"https://www.youtube.com/embed/HHKy5eum8l4?start=3&feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>“You’re just driving sales underground,” says Anderson. “It will not stop people from accessing what they want or using what they want.”\u003c/p>\n\u003cp>She uses the example of marijuana laws to illustrate how a black market usually hurts people of color the most.\u003c/p>\n\u003cp>“Black people, Latino people; people have been locked up — and are still locked up — having to do with little more than an ounce of marijuana,” said Anderson.\u003c/p>\n\u003cp>\u003cstrong>Local Businesses On Edge\u003c/strong>\u003c/p>\n\u003cp>At the Mission Smoke Shop, owner Sam Azar has plastered his walls with “No-on-E” signs.\u003c/p>\n\u003cp>“It’s going to hurt me as a small business here in the city by, like 30 percent or more,” he predicts.\u003c/p>\n\u003cfigure id=\"attachment_441406\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-441406 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-800x531.jpg\" alt=\"\" width=\"800\" height=\"531\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-800x531.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-768x510.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-1020x677.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-1200x797.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-1180x784.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-960x638.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-240x159.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-375x249.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164-520x345.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5146-e1525820098164.jpg 1843w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Sam Azar worries about how a ban on flavored tobacco products will hurt the bottom line at his Mission Smoke Shop. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He would no longer profit from flavored pipe tobacco, flavored hookah, infused cigars, or numerous racks of syrupy vape liquids. There are more than 7,000 sweet and savory e-cigarette flavors on the market — everything from gummi bear and Unicorn Milk to Red Bull and nacho cheese.\u003c/p>\n\u003cp>But medical experts worry about the role aromas play in enticing young people to try nicotine and get hooked on cigarettes.\u003c/p>\n\u003cp>Derek Smith, director of the \u003ca href=\"http://sanfranciscotobaccofreeproject.org/\" target=\"_blank\" rel=\"noopener\">Tobacco Free Project\u003c/a> at the San Francisco Department of Public Health, says flavors and menthol deceptively mask the taste of tobacco and make it easier to inhale nicotine.\u003c/p>\n\u003cp>“Someone who has tried a cigarette for the first time will often turn green and cough,” said Smith, in an email. “Imagine instead a cereal, milk-flavored inhalation that is considerably less harsh to start with.”\u003c/p>\n\u003cp>\u003cstrong>Physicians Take to the Streets\u003c/strong>\u003c/p>\n\u003cp>Smith \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/CDPH%20Document%20Library/Policy/FlavoredTobaccoAndMenthol/FinalFlavoredTobaccoInfographic.pdf\" target=\"_blank\" rel=\"noopener\">says\u003c/a> nearly all youth in the state start their tobacco habit with a flavored product, which worries doctors who gathered at a recent “Yes-on-E” rally on the steps of the Civic Center.\u003c/p>\n\u003cp>“The tobacco industry has targeted menthol cigarettes to the black community, to poor people, to mothers,” said Amanda Wright, a resident physician at UCSF. “And if you look at these products, they literally look like candy and that is clearly targeting our children.”\u003c/p>\n\u003cp>Wright was standing next to a table laden with row after row of juice boxes and candy wrappers. They look like sugary snack foods, but they’re actually packages of vaping products. The New York Times recently \u003ca href=\"https://www.nytimes.com/2018/05/01/health/fda-crackdown-vaping-children.html\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on a federal crackdown of these look-alikes.\u003c/p>\n\u003cfigure id=\"attachment_441402\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-441402 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-1020x498.jpg\" alt=\"\" width=\"640\" height=\"312\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-1020x498.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-160x78.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-800x391.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-768x375.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-1200x586.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-1180x576.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-960x469.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-240x117.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-375x183.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863-520x254.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/13/2018/05/IMG_5101-e1525822179863.jpg 1896w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">The candylike packaging for vaping products on display at a Yes-on-E rally. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nicotine is particularly addictive for the teenage brain, according to Pam Ling, a physician and smoking researcher at UCSF.\u003c/p>\n\u003cp>“This population is the future of the tobacco industry,” says Ling. “The industry recognized decades ago that if they don’t get kids to start, they [the industry] will die out.”\u003c/p>\n\u003cp>The California Department of Public Health \u003ca href=\"https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CTCB/CDPH%20Document%20Library/Policy/FlavoredTobaccoAndMenthol/FinalFlavoredTobaccoInfographic.pdf\" target=\"_blank\" rel=\"noopener\">says\u003c/a> the number of kids in California who vape is currently double the number who smoke, but some \u003ca href=\"http://pediatrics.aappublications.org/content/early/2017/11/30/peds.2017-1832\" target=\"_blank\" rel=\"noopener\">research\u003c/a> suggests that a lot of those kids will be smoking cigarettes before long.\u003c/p>\n\u003cp>“Once these kids start with the e-cigarettes, the likelihood that they’ll be smoking cigarettes a year or so later is increased by a factor of three or four,” says Stanton Glantz, who heads the \u003ca href=\"https://tobacco.ucsf.edu/\">Center for Tobacco Control Research and Education\u003c/a> at UCSF.\u003c/p>\n\u003cp>Glantz says that in his \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28115540\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, about a third of the kids who start using nicotine via e-cigarettes are not the kind of kids whose race, gender, home life and school performance would make them a high risk to pick up smoking on their own.\u003c/p>\n\u003cp>In other words, vaping is increasing the pool of teen smokers. A 2016 \u003ca href=\"https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the U.S. Surgeon General cited a 900 percent increase in the use of e-cigarettes by high school students from 2011 to 2015. Right now there is very little regulation of e-products at the federal level.\u003c/p>\n\u003cfigure id=\"attachment_441466\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/RS30897_PROPE_076-e1525979992131.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-441466 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/RS30897_PROPE_076-800x1200.jpg\" alt=\"\" width=\"800\" height=\"1200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An array of flavors displayed at Vapor Den, including banana cream, mango and fruit mix. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Glantz also contends that a flavor ban will help adults who \u003ca href=\"https://www.npr.org/sections/health-shots/2017/05/25/530026958/many-adults-dont-think-exposure-to-vaping-is-bad-for-kids\" target=\"_blank\" rel=\"noopener\">think they’re inhaling\u003c/a> a significantly safer alternative.\u003c/p>\n\u003cp>“When e-cigarettes first became available, there was a lot of hope that they would be better than cigarettes,” he says, “but the more we learn the worse they look.”\u003c/p>\n\u003cp>Though the long-term health effects of smoking e-cigarettes is still unknown, Glantz believes the safety of the devices has been \u003ca href=\"https://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-040617-013757\" target=\"_blank\" rel=\"noopener\">oversold\u003c/a>.\u003c/p>\n\u003cp>“Electronic smoking products emit particles of chemicals, not clean air, and technically an aerosol, not a vapor,” Smith says. “Think smog or hairspray — not the pure water vapor that steams when your teapot whistles.”\u003c/p>\n\u003cp>These \u003ca href=\"https://pubs.acs.org/doi/full/10.1021/acs.chemrestox.6b00188?src=recsys&=\" target=\"_blank\" rel=\"noopener\">ultrafine particles and toxins\u003c/a> can damage the lungs and may lead to heart attacks. Levels of the particles in the vapor produced by some devices may be lower than in tobacco smoke, but aren’t zero.\u003c/p>\n\u003cp>\u003ciframe loading=\"lazy\" title=\"Why Is Vaping So Popular?\" width=\"500\" height=\"281\" src=\"https://www.youtube.com/embed/P9zps5LsVXs?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>If San Francisco voters pass the flavor ban, it will be among the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2017/10/24/559833483/new-york-bans-vaping-indoors-in-public-state-law-classes-e-cigs-with-cigarettes\" target=\"_blank\" rel=\"noopener\">toughest restrictions\u003c/a> on e-cigarettes in the country; opponents of the measure fear it will set a precedent.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Jon Brooks contributed to this post. This post has been edited since it was originally published.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Millions May Have Been Prescribed the Wrong Heart Meds, Study Says",
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"content": "\u003cp>More than 11 million Americans may have received incorrect prescriptions for aspirin, statins and blood pressure medications to prevent a heart attack or stroke, according to a study by the \u003ca href=\"http://med.stanford.edu/\">Stanford University School of Medicine\u003c/a>.[contextly_sidebar id=\"umDTpLmik9hK8eNRjnsW7rpmcRPF19ZX\"]\u003c/p>\n\u003cp>That's because the tool used to estimate a patient's risk of heart attack or stroke is based on outdated data, apparently off by as much as 20 percent, according to the \u003ca href=\"http://annals.org/aim/article-abstract/2683613/clinical-implications-revised-pooled-cohort-equations-estimating-atherosclerotic-cardiovascular-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a>, published Monday in \u003cem>Annals of Internal Medicine.\u003c/em>\u003c/p>\n\u003cp>\"A lot has changed in terms of diets, environments and medical treatment since the 1940s,” senior author Dr. Sanjay Basu said in the \u003ca href=\"http://med.stanford.edu/news/all-news/2018/06/millions-could-have-incorrect-statin-aspirin-blood-pressure-prescriptions.html\" target=\"_blank\" rel=\"noopener\">press release \u003c/a>that accompanied the study. “So, relying on our grandparents’ data to make our treatment choices is probably not the best idea.”\u003c/p>\n\u003cp>The problem was discovered when some doctors, including Basu, kept noticing that the current tool was failing to accurately predict risk in their patients, particularly if they were African American.\u003c/p>\n\u003cp>Because the calculator was built on older studies that lacked a sufficient sample of African-Americans, doctors may have in fact been underestimating the risks of heart attacks or strokes in those patients.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“So while many Americans were being recommended aggressive treatments that they may not have needed according to current guidelines, some Americans — particularly African-Americans — may have been given false reassurance and probably need to start treatment given our findings,” Basu said in the press release.[contextly_sidebar id=\"IVz9AhjwqJ3N1XCCqSO9xlwYfN9Xm5GQ\"]\u003c/p>\n\u003cp>The study says that in many cases medications were over prescribed.\u003c/p>\n\u003cp>A CBS \u003ca href=\"https://www.cbsnews.com/news/millions-of-americans-could-be-getting-wrong-heart-meds-study-finds/\" target=\"_blank\" rel=\"noopener\">report\u003c/a> describes the calculator's importance in developing preventive treatments:\u003c/p>\n\u003cblockquote>\u003cp>Risk estimate tools predict the likelihood of a future heart attack or stroke in the next 10 years. Doctors use these tools to help them decide what treatment a patient needs, if any at all.\u003c/p>\u003c/blockquote>\n\u003cp>In response to the troubling findings, the team of researchers developed a new calculator, incorporating an updated list of risk factors. From a \u003ca href=\"https://www.statnews.com/2018/06/04/new-risk-calculator-could-change-the-aspirin-statins-and-blood-pressure-medications-some-people-take/\" target=\"_blank\" rel=\"noopener\">STAT \u003c/a>news story:\u003c/p>\n\u003cblockquote>\u003cp>To test their methods, the researchers created two models. In the first one, they updated the cohorts they used. The populations were more diverse racially and ethnically, and they also reflected factors that can’t necessarily be captured by blood tests. Nutrition, physical activity, or even secondhand smoke — which wasn’t recognized in the 1940s — can affect a person’s baseline risk for disease. That’s why risk calculators don’t stay accurate forever.\u003c/p>\u003c/blockquote>\n\u003cp>Some doctors, however, still question whether the updated calculator can accurately assess risks in communities of color.\u003c/p>\n\u003cp>Dr. Andrew DeFilippis and Patrick Trainor of the University of Louisville, Kentucky say the new calculator falls short in accounting for racial differences in risk factors.\u003c/p>\n\u003cp>“This question is timely because a growing Hispanic population and 40 percent increase in Asian-Americans account for more than half of the U. S. population growth between 2000 and 2019,” they said in an \u003ca href=\"http://annals.org/aim/article/doi/10.7326/M18-1175\" target=\"_blank\" rel=\"noopener\">editorial\u003c/a> published with the Stanford study. “We clearly need an accurate risk assessment tool for these growing American populations.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Stanford researchers say the newer tool will need to be updated with changing times.\u003c/p>\n\n",
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"excerpt": "A Stanford study finds that a traditional tool used by doctors to assess patients' risk of heart attack or stroke is based on decades old data, causing many doctors to incorrectly prescribe drugs.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>More than 11 million Americans may have received incorrect prescriptions for aspirin, statins and blood pressure medications to prevent a heart attack or stroke, according to a study by the \u003ca href=\"http://med.stanford.edu/\">Stanford University School of Medicine\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That's because the tool used to estimate a patient's risk of heart attack or stroke is based on outdated data, apparently off by as much as 20 percent, according to the \u003ca href=\"http://annals.org/aim/article-abstract/2683613/clinical-implications-revised-pooled-cohort-equations-estimating-atherosclerotic-cardiovascular-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a>, published Monday in \u003cem>Annals of Internal Medicine.\u003c/em>\u003c/p>\n\u003cp>\"A lot has changed in terms of diets, environments and medical treatment since the 1940s,” senior author Dr. Sanjay Basu said in the \u003ca href=\"http://med.stanford.edu/news/all-news/2018/06/millions-could-have-incorrect-statin-aspirin-blood-pressure-prescriptions.html\" target=\"_blank\" rel=\"noopener\">press release \u003c/a>that accompanied the study. “So, relying on our grandparents’ data to make our treatment choices is probably not the best idea.”\u003c/p>\n\u003cp>The problem was discovered when some doctors, including Basu, kept noticing that the current tool was failing to accurately predict risk in their patients, particularly if they were African American.\u003c/p>\n\u003cp>Because the calculator was built on older studies that lacked a sufficient sample of African-Americans, doctors may have in fact been underestimating the risks of heart attacks or strokes in those patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“So while many Americans were being recommended aggressive treatments that they may not have needed according to current guidelines, some Americans — particularly African-Americans — may have been given false reassurance and probably need to start treatment given our findings,” Basu said in the press release.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The study says that in many cases medications were over prescribed.\u003c/p>\n\u003cp>A CBS \u003ca href=\"https://www.cbsnews.com/news/millions-of-americans-could-be-getting-wrong-heart-meds-study-finds/\" target=\"_blank\" rel=\"noopener\">report\u003c/a> describes the calculator's importance in developing preventive treatments:\u003c/p>\n\u003cblockquote>\u003cp>Risk estimate tools predict the likelihood of a future heart attack or stroke in the next 10 years. Doctors use these tools to help them decide what treatment a patient needs, if any at all.\u003c/p>\u003c/blockquote>\n\u003cp>In response to the troubling findings, the team of researchers developed a new calculator, incorporating an updated list of risk factors. From a \u003ca href=\"https://www.statnews.com/2018/06/04/new-risk-calculator-could-change-the-aspirin-statins-and-blood-pressure-medications-some-people-take/\" target=\"_blank\" rel=\"noopener\">STAT \u003c/a>news story:\u003c/p>\n\u003cblockquote>\u003cp>To test their methods, the researchers created two models. In the first one, they updated the cohorts they used. The populations were more diverse racially and ethnically, and they also reflected factors that can’t necessarily be captured by blood tests. Nutrition, physical activity, or even secondhand smoke — which wasn’t recognized in the 1940s — can affect a person’s baseline risk for disease. That’s why risk calculators don’t stay accurate forever.\u003c/p>\u003c/blockquote>\n\u003cp>Some doctors, however, still question whether the updated calculator can accurately assess risks in communities of color.\u003c/p>\n\u003cp>Dr. Andrew DeFilippis and Patrick Trainor of the University of Louisville, Kentucky say the new calculator falls short in accounting for racial differences in risk factors.\u003c/p>\n\u003cp>“This question is timely because a growing Hispanic population and 40 percent increase in Asian-Americans account for more than half of the U. S. population growth between 2000 and 2019,” they said in an \u003ca href=\"http://annals.org/aim/article/doi/10.7326/M18-1175\" target=\"_blank\" rel=\"noopener\">editorial\u003c/a> published with the Stanford study. “We clearly need an accurate risk assessment tool for these growing American populations.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Stanford researchers say the newer tool will need to be updated with changing times.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Cancer Care Dilemma: Patients Want Immunotherapy Even When Evidence Is Lacking",
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"content": "\u003cp class=\"danger-zone\">Immunotherapy is a source of great hope in cancer care. It has \u003ca href=\"https://www.statnews.com/2017/09/12/cancer-immunotherapy-improvement/\">rescued\u003c/a>some patients from the brink, while giving others a reason to believe that they, too, could beat the long odds.[contextly_sidebar id=\"0iktmFOQroWtY1hQ3e3h8lY9q5AbDMyB\"]\u003c/p>\n\u003cp class=\"danger-zone\">But these therapies are also creating a vexing dilemma for doctors: Their patients, citing \u003ca href=\"https://www.ispot.tv/ad/w_y8/keytruda-its-tru-donnas-story-living-longer-is-possible\" target=\"_blank\" rel=\"noopener\">television ads\u003c/a> and media accounts of miraculous recoveries, are pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer.\u003c/p>\n\u003cp class=\"danger-zone\">Doctors want to give their patients every shot at survival, but can they justify prescribing a drug when it hasn’t been tested for that patient’s type of cancer? Many of these treatments bring risks of painful — even life-threatening— side effects and carry total price tags pushing $1 million. In some cases, insurers won’t pay.\u003c/p>\n\u003cp class=\"\">“Whether it works or not, the burden both financially and emotionally on families and patients is massive,” said Dr. Vicki Jackson, chief of Massachusetts General Hospital’s palliative care unit, which helps patients with their decision-making process. “If you try it and it doesn’t work, then you’ve used up all your life savings.”\u003c/p>\n\u003cp class=\"\">There are few objective guideposts to determine which patients should get which treatments, or even undergo genetic testing to determine whether they are among the minority of patients who might benefit substantially from immuno-oncology medicines. The dividing line is often drawn by variations in age, tumor stage, and underlying health status — and the weight given to those measures still relies on physician discretion.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Is it ethically and morally appropriate to not offer these potentially curative options on the basis of a very slight difference in kidney or liver function?” asked Dr. Ephraim Hochberg, a Mass. General oncologist who specializes in lymphoma.\u003c/p>\n\u003cp>Precision medicine, and the use of genetic markers to predict the success of treatments, promises to help answer these questions. Scientists at Stanford, for example, \u003ca href=\"https://www.statnews.com/2018/05/14/cancer-immunotherapy-pet-predictor/\">engineered\u003c/a> a radioactive molecule, detectable by PET imaging, to track whether a patient’s T cells are activated and thus capable of fighting cancer if the patient is given immunotherapy.[contextly_sidebar id=\"FOtikbkxZiNfNj2OB2DLb5zd76Z6QV0k\"]\u003c/p>\n\u003cp>The technique worked in lab mice but has not yet been tried in human patients, and other such approaches are further off. Meanwhile, patients and doctors are left to make life and death treatment decisions on uncertain terrain.\u003c/p>\n\u003cp>This struggle plays out on a near-daily basis at Mass. General, a Harvard-affiliated academic medical center with a deep well of resources and expertise. STAT interviews with specialists at the hospital reveal both the complexity of the variables at play, and the difficulty of establishing clear treatment protocols when data on real-world outcomes is still lacking.\u003c/p>\n\u003cp>The extent of these difficulties is only magnified for oncologists working with fewer resources in smaller community hospitals, where the vast majority of the nation’s cancer patients receive their care.\u003c/p>\n\u003cp>The uncertainty over treatment eligibility primarily pertains to a new class of treatments that harness the power of a patient’s immune system to attack cancer cells. These drugs have reached the market fairly recently, and have been tested in patients with a limited number of cancer types. And even in those types, the \u003ca href=\"https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/\">drugs work only some of the time\u003c/a>.\u003c/p>\n\u003cp>These treatments include the checkpoint inhibitors Keytruda and Opdivo, CAR-T drugs such as Yescarta and \u003ca href=\"https://www.statnews.com/2017/08/30/novartis-car-t-cancer-approved/\">Kymriah\u003c/a>, and neo-antigen vaccines.\u003c/p>\n\u003cp>Hochberg often deals with patients who want to try \u003ca href=\"https://www.statnews.com/2017/10/27/car-t-kite-cell-journey/\">CAR-T therapy\u003c/a>, which re-engineers a patient’s T cells to recognize molecules on cancer cells and attack them. CAR-T drugs cost between $375,000 and $475,000, and the administration of treatment and follow-up care adds hundreds of thousands of thousands of dollars to the total bill.\u003c/p>\n\u003cp>In theory, CAR-T therapies can be tried on older patients whose bodies cannot withstand chemotherapy and radiation, but the National Comprehensive Cancer Network, which publishes treatment guidelines, has not established detailed eligibility criteria.\u003c/p>\n\u003cp>A similar struggle is playing out over the use of checkpoint inhibitors. It is not always clear which patients should get tested for a rare genetic condition, known as mismatch repair syndrome, that indicates receptivity to these drugs. While the testing is routinely conducted in treatment for patients with uterine and colon cancers, it is not always done for patients with other types of cancer.\u003c/p>\n\u003cp>“The fundamental problem is that it’s a costly test, so people are reluctant to make it automatic,” said Dr. David Ryan, clinical director of Mass. General’s Cancer Center. “Right now we’re relying on the oncologist to pick up those patients where there’s a reasonable chance of having mismatch repair deficiency, and ordering that test from pathology. Everybody’s having a hard time figuring out how to do this.”[contextly_sidebar id=\"blUI6ansejyqkxbdlWCDpHI5OeCoOQ3E\"]\u003c/p>\n\u003cp>Insurers play a key role in making sure that sky-high spending for these drugs is based on evidence of efficacy. But their involvement cuts both ways. In some cases, they deny coverage for treatments even when they are recommended by oncologists who believe there is a strong scientific basis to back up their decisions.\u003c/p>\n\u003cp>That scenario arose recently for Dr. Zosia Piotrowska, a medical oncologist at Mass. General who specializes in treating lung cancer. She recommended a combination of targeted therapies for a 50-year-old mother of four who has struggled with metastatic lung cancer for five years.\u003c/p>\n\u003cp>The patient’s cancer is exceedingly rare and marked by a gene mutation that indicates greater receptivity to targeted therapies. Piotrowska said various combinations of treatments had allowed the patient to live a normal life for several years, but her insurer recently denied coverage for the new round of treatment, which comes with a price of $16,000 a month.\u003c/p>\n\u003cp>Piotrowska appealed the decision, but the insurer still denied coverage, citing a lack of support for the treatment option in National Comprehensive Cancer Network guidelines. Though such guidelines set forth detailed protocols, they do not address the myriad nuances of each type of cancer and rapid changes in treatment options.\u003c/p>\n\u003cp>“The guidelines can’t keep up with the pace of research,” Piotrowska said. “As we learn more and more and develop better treatments, certain patients fall into these loopholes where we understand the biology of what’s going on, we have a treatment, but you can’t explain it to the insurer.”\u003c/p>\n\u003cp>That denial of coverage means the patient must decide whether to pay out of pocket and drain family savings for an uncertain benefit. Piotrowska said this patient has enough resources to continue with treatment, but for the vast majority of patients, the price would mean certain financial ruin.\u003c/p>\n\u003cp>The advent of immune-based therapies is only making the decisions harder. For a \u003ca href=\"https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/\">small percentage\u003c/a> of patients, the treatments can be a savior, but without comprehensive insurance coverage, they are guaranteed to lead to financial distress. And because there is not yet much data on how the patients who initially benefit are faring in the long run, it is nearly impossible for new patients and their families to assess costs and benefits.\u003c/p>\n\u003cp>Doctors said the confusion over who should get immune-based treatments is bound to be exacerbated by the passage last month of the controversial \u003ca href=\"https://www.statnews.com/2018/05/30/trump-signs-right-to-try/\">“right-to-try” legislation\u003c/a>, which aims to give patients with terminal illness a different pathway to try experimental medicines that haven’t yet been approved by the Food and Drug Administration. It will not be clear how the law will affect patients until regulations are clarified in the coming months.[contextly_sidebar id=\"uFgg9fWxQTxW5cFzzQ7kroOuopy28usR\"]\u003c/p>\n\u003caside class=\"read-more standard\">\n\u003cdiv class=\"read-more-text\">\u003c/div>\n\u003c/aside>\n\u003cp>In some ways, the pressures and uncertainties posed by new cancer treatments are good problems to have. Julie Guillot said she wishes she’d had the luxury of such challenges when her son was sick.\u003c/p>\n\u003cp>Zach was diagnosed with acute myeloid leukemia when he was 5. For a boy of that age, concerns about unclear clinical benefits of treatments and sky high costs do not apply in the same way they might for an older patient. All the calculations point to the same answer: Try everything you can.\u003c/p>\n\u003cp>Zach received heavy doses of chemotherapy and three bone marrow transplants during years of expensive treatment that left him suffering from uncontrollable fevers, nausea, and infections. He died in 2014.\u003c/p>\n\u003cp>Guillot now works as an \u003ca href=\"https://www.statnews.com/2017/02/20/car-t-therapy-critics-just-dont-get/\">advocate\u003c/a> to help other patients get access to the best treatments and to ensure that experimentation in cancer care can continue to proceed on its inevitably hard and messy course toward cures.\u003c/p>\n\u003cp>“If we are avoidant of new therapies because of the risk, the lack of data, or the cost, breakthrough therapies like CAR-T and bone marrow transplant would never be developed,” she said. “When you are faced with this, people are willing to take risks for a chance to live.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/06/04/cancer-care-dilemma-immunotherapy/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">Immunotherapy is a source of great hope in cancer care. It has \u003ca href=\"https://www.statnews.com/2017/09/12/cancer-immunotherapy-improvement/\">rescued\u003c/a>some patients from the brink, while giving others a reason to believe that they, too, could beat the long odds.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">But these therapies are also creating a vexing dilemma for doctors: Their patients, citing \u003ca href=\"https://www.ispot.tv/ad/w_y8/keytruda-its-tru-donnas-story-living-longer-is-possible\" target=\"_blank\" rel=\"noopener\">television ads\u003c/a> and media accounts of miraculous recoveries, are pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer.\u003c/p>\n\u003cp class=\"danger-zone\">Doctors want to give their patients every shot at survival, but can they justify prescribing a drug when it hasn’t been tested for that patient’s type of cancer? Many of these treatments bring risks of painful — even life-threatening— side effects and carry total price tags pushing $1 million. In some cases, insurers won’t pay.\u003c/p>\n\u003cp class=\"\">“Whether it works or not, the burden both financially and emotionally on families and patients is massive,” said Dr. Vicki Jackson, chief of Massachusetts General Hospital’s palliative care unit, which helps patients with their decision-making process. “If you try it and it doesn’t work, then you’ve used up all your life savings.”\u003c/p>\n\u003cp class=\"\">There are few objective guideposts to determine which patients should get which treatments, or even undergo genetic testing to determine whether they are among the minority of patients who might benefit substantially from immuno-oncology medicines. The dividing line is often drawn by variations in age, tumor stage, and underlying health status — and the weight given to those measures still relies on physician discretion.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Is it ethically and morally appropriate to not offer these potentially curative options on the basis of a very slight difference in kidney or liver function?” asked Dr. Ephraim Hochberg, a Mass. General oncologist who specializes in lymphoma.\u003c/p>\n\u003cp>Precision medicine, and the use of genetic markers to predict the success of treatments, promises to help answer these questions. Scientists at Stanford, for example, \u003ca href=\"https://www.statnews.com/2018/05/14/cancer-immunotherapy-pet-predictor/\">engineered\u003c/a> a radioactive molecule, detectable by PET imaging, to track whether a patient’s T cells are activated and thus capable of fighting cancer if the patient is given immunotherapy.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The technique worked in lab mice but has not yet been tried in human patients, and other such approaches are further off. Meanwhile, patients and doctors are left to make life and death treatment decisions on uncertain terrain.\u003c/p>\n\u003cp>This struggle plays out on a near-daily basis at Mass. General, a Harvard-affiliated academic medical center with a deep well of resources and expertise. STAT interviews with specialists at the hospital reveal both the complexity of the variables at play, and the difficulty of establishing clear treatment protocols when data on real-world outcomes is still lacking.\u003c/p>\n\u003cp>The extent of these difficulties is only magnified for oncologists working with fewer resources in smaller community hospitals, where the vast majority of the nation’s cancer patients receive their care.\u003c/p>\n\u003cp>The uncertainty over treatment eligibility primarily pertains to a new class of treatments that harness the power of a patient’s immune system to attack cancer cells. These drugs have reached the market fairly recently, and have been tested in patients with a limited number of cancer types. And even in those types, the \u003ca href=\"https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/\">drugs work only some of the time\u003c/a>.\u003c/p>\n\u003cp>These treatments include the checkpoint inhibitors Keytruda and Opdivo, CAR-T drugs such as Yescarta and \u003ca href=\"https://www.statnews.com/2017/08/30/novartis-car-t-cancer-approved/\">Kymriah\u003c/a>, and neo-antigen vaccines.\u003c/p>\n\u003cp>Hochberg often deals with patients who want to try \u003ca href=\"https://www.statnews.com/2017/10/27/car-t-kite-cell-journey/\">CAR-T therapy\u003c/a>, which re-engineers a patient’s T cells to recognize molecules on cancer cells and attack them. CAR-T drugs cost between $375,000 and $475,000, and the administration of treatment and follow-up care adds hundreds of thousands of thousands of dollars to the total bill.\u003c/p>\n\u003cp>In theory, CAR-T therapies can be tried on older patients whose bodies cannot withstand chemotherapy and radiation, but the National Comprehensive Cancer Network, which publishes treatment guidelines, has not established detailed eligibility criteria.\u003c/p>\n\u003cp>A similar struggle is playing out over the use of checkpoint inhibitors. It is not always clear which patients should get tested for a rare genetic condition, known as mismatch repair syndrome, that indicates receptivity to these drugs. While the testing is routinely conducted in treatment for patients with uterine and colon cancers, it is not always done for patients with other types of cancer.\u003c/p>\n\u003cp>“The fundamental problem is that it’s a costly test, so people are reluctant to make it automatic,” said Dr. David Ryan, clinical director of Mass. General’s Cancer Center. “Right now we’re relying on the oncologist to pick up those patients where there’s a reasonable chance of having mismatch repair deficiency, and ordering that test from pathology. Everybody’s having a hard time figuring out how to do this.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Insurers play a key role in making sure that sky-high spending for these drugs is based on evidence of efficacy. But their involvement cuts both ways. In some cases, they deny coverage for treatments even when they are recommended by oncologists who believe there is a strong scientific basis to back up their decisions.\u003c/p>\n\u003cp>That scenario arose recently for Dr. Zosia Piotrowska, a medical oncologist at Mass. General who specializes in treating lung cancer. She recommended a combination of targeted therapies for a 50-year-old mother of four who has struggled with metastatic lung cancer for five years.\u003c/p>\n\u003cp>The patient’s cancer is exceedingly rare and marked by a gene mutation that indicates greater receptivity to targeted therapies. Piotrowska said various combinations of treatments had allowed the patient to live a normal life for several years, but her insurer recently denied coverage for the new round of treatment, which comes with a price of $16,000 a month.\u003c/p>\n\u003cp>Piotrowska appealed the decision, but the insurer still denied coverage, citing a lack of support for the treatment option in National Comprehensive Cancer Network guidelines. Though such guidelines set forth detailed protocols, they do not address the myriad nuances of each type of cancer and rapid changes in treatment options.\u003c/p>\n\u003cp>“The guidelines can’t keep up with the pace of research,” Piotrowska said. “As we learn more and more and develop better treatments, certain patients fall into these loopholes where we understand the biology of what’s going on, we have a treatment, but you can’t explain it to the insurer.”\u003c/p>\n\u003cp>That denial of coverage means the patient must decide whether to pay out of pocket and drain family savings for an uncertain benefit. Piotrowska said this patient has enough resources to continue with treatment, but for the vast majority of patients, the price would mean certain financial ruin.\u003c/p>\n\u003cp>The advent of immune-based therapies is only making the decisions harder. For a \u003ca href=\"https://www.statnews.com/2017/03/08/immunotherapy-cancer-breakthrough/\">small percentage\u003c/a> of patients, the treatments can be a savior, but without comprehensive insurance coverage, they are guaranteed to lead to financial distress. And because there is not yet much data on how the patients who initially benefit are faring in the long run, it is nearly impossible for new patients and their families to assess costs and benefits.\u003c/p>\n\u003cp>Doctors said the confusion over who should get immune-based treatments is bound to be exacerbated by the passage last month of the controversial \u003ca href=\"https://www.statnews.com/2018/05/30/trump-signs-right-to-try/\">“right-to-try” legislation\u003c/a>, which aims to give patients with terminal illness a different pathway to try experimental medicines that haven’t yet been approved by the Food and Drug Administration. It will not be clear how the law will affect patients until regulations are clarified in the coming months.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003caside class=\"read-more standard\">\n\u003cdiv class=\"read-more-text\">\u003c/div>\n\u003c/aside>\n\u003cp>In some ways, the pressures and uncertainties posed by new cancer treatments are good problems to have. Julie Guillot said she wishes she’d had the luxury of such challenges when her son was sick.\u003c/p>\n\u003cp>Zach was diagnosed with acute myeloid leukemia when he was 5. For a boy of that age, concerns about unclear clinical benefits of treatments and sky high costs do not apply in the same way they might for an older patient. All the calculations point to the same answer: Try everything you can.\u003c/p>\n\u003cp>Zach received heavy doses of chemotherapy and three bone marrow transplants during years of expensive treatment that left him suffering from uncontrollable fevers, nausea, and infections. He died in 2014.\u003c/p>\n\u003cp>Guillot now works as an \u003ca href=\"https://www.statnews.com/2017/02/20/car-t-therapy-critics-just-dont-get/\">advocate\u003c/a> to help other patients get access to the best treatments and to ensure that experimentation in cancer care can continue to proceed on its inevitably hard and messy course toward cures.\u003c/p>\n\u003cp>“If we are avoidant of new therapies because of the risk, the lack of data, or the cost, breakthrough therapies like CAR-T and bone marrow transplant would never be developed,” she said. “When you are faced with this, people are willing to take risks for a chance to live.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/06/04/cancer-care-dilemma-immunotherapy/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Therapy Made From Patient's Immune System Shows Promise For Advanced Breast Cancer",
"title": "Therapy Made From Patient's Immune System Shows Promise For Advanced Breast Cancer",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Doctors at the National Institutes of Health say they've apparently completely eradicated cancer from a patient who had untreatable, advanced breast cancer.[contextly_sidebar id=\"XBqZwaw0YLkXChOC5E9p7x7LlwjI87h0\"]\u003c/p>\n\u003cp>The case is raising hopes about a new way to harness the immune system to fight some of the most common cancers. The methods and the patient's experience are described Monday in a \u003ca href=\"https://www.nature.com/articles/s41591-018-0040-8\">paper\u003c/a> published in the journal \u003cem>Nature Medicine\u003c/em>.\u003c/p>\n\u003cp>\"We're looking for a treatment — an immunotherapy — that can be broadly used in patients with common cancers,\" says \u003ca href=\"https://ccr.cancer.gov/Surgery-Branch/steven-a-rosenberg\">Dr. Steven Rosenberg\u003c/a>, an oncologist and immunologist at the National Cancer Institute, who has been developing the approach.\u003c/p>\n\u003cp>Rosenberg's team painstakingly analyzes the DNA in a sample of each patient's cancer for mutations specific to their malignancies. Next, scientists sift through tumor tissue for immune system cells known as \u003ca href=\"https://www.cancer.gov/publications/dictionaries/cancer-terms/def/t-cell\">T cells\u003c/a> that appear programmed to home in on those mutations.\u003c/p>\n\u003cp>But Rosenberg and others caution that the approach doesn't work for everyone. In fact, it failed for two other breast cancer patients. Many more patients will have to be treated — and followed for much longer — to fully evaluate the treatment's effectiveness, the scientists say.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Still, the treatment has helped seven of 45 patients with a variety of cancers, Rosenberg says. That's a response rate of about 15 percent, and included patients with advanced cases of colon cancer, liver cancer and cervical cancer.\u003c/p>\n\u003cp>\"Is it ready for prime time today? No,\" Rosenberg says.\"Can we do it in most patients today? No.\"\u003c/p>\n\u003cp>But the treatment continues to be improved. \"I think it's the most promising treatment now being explored for solving the problem of the treatment of metastatic, common cancers,\" he says.\u003c/p>\n\u003cp>The breast cancer patient helped by the treatment says it transformed her life.\u003c/p>\n\u003cp>\"It's amazing,\" says Judy Perkins, 52, a retired engineer who lives in Port St. Lucie, Fla.[contextly_sidebar id=\"LBQmSDLCPJe4N0too3CcLvpq1h2WnS7o\"]\u003c/p>\n\u003cp>When Perkins was first diagnosed and treated for breast cancer in 2003, she thought she'd beaten the disease. \"I thought I was done with it,\" she says.\u003c/p>\n\u003cp>But about a decade later, she felt a new lump. Doctors discovered the cancer had already spread throughout her chest. Her prognosis was grim.\u003c/p>\n\u003cp>\"I became a metastatic cancer patient,\" says Perkins. \"That was hard.\"\u003c/p>\n\u003cp>Perkins went through round after round of chemotherapy. She tried every experimental treatment she could find. But the cancer kept spreading. Some of her tumors grew to the size of tennis balls.\u003c/p>\n\u003cp>\"I had sort of essentially run out of arrows in my quiver,\" she says. \"While I would say I had some hope, I was also kind of like ready to quit, too.\"\u003c/p>\n\u003cp>Then she heard about the experimental treatment at the NIH. It was designed to fight some of the most common cancers, including breast cancer.\u003c/p>\n\u003cp>\"The excitement here is that we're attacking the very mutations that are unique to that cancer — in that patient's cancer and not in anybody else's cancer. So it's about as personalized a treatment as you can imagine,\" Rosenberg says.\u003c/p>\n\u003cp>His team identified and then grew billions of T cells for Perkins in the lab and then infused them back into her body. They also gave her two drugs to help the cells do their job.[contextly_sidebar id=\"7hRhhF6kMzZu5JjMty7K1k5yrQUh2pfA\"]\u003c/p>\n\u003cp>The treatment was grueling. Perkins says the hardest part was the side effects of a drug known as interleukin, which she received to help boost the effectiveness of the immune system cells. Interleukin causes severe flu-like symptoms, such as a high fever, intense malaise and uncontrollable shivering.\u003c/p>\n\u003cp>But the treatment apparently worked, Rosenberg reports. Perkins' tumors soon disappeared. And, more than two years later, she remains cancer-free.\u003c/p>\n\u003cp>\"All of her detectable disease has disappeared. It's remarkable,\" Rosenberg says.\u003c/p>\n\u003cp>Perkins is thrilled.\u003c/p>\n\u003cp>\"I'm one of the lucky ones,\" Perkins says. \"We got the right T cells in the right place at the right time. And they went in and ate up all my cancer. And I'm cured. It's freaking unreal.\"\u003c/p>\n\u003cp>In an \u003ca href=\"https://doi.org/10.1038/s41591-018-0065-z\">article\u003c/a> accompanying the new paper, \u003ca href=\"https://news.oicr.on.ca/2018/03/oicr-names-dr-laszlo-radvanyi-as-new-president-and-scientific-director/\">Laszlo Radvanyi\u003c/a>, president and scientific director of the Ontario Institute for Cancer Research, calls the results \"remarkable.\"\u003c/p>\n\u003cp>The approach and other recent advances suggest scientists may be \"at the cusp of a major revolution in finally realizing the elusive goal of being able to target the plethora of mutations in cancer through immunotherapy,\" Radvanyi writes.\u003c/p>\n\u003cp>Other cancer researchers agree.\u003c/p>\n\u003cp>\"When I saw this paper I thought: \"Whoa! I mean, it's very impressive,\" says \u003ca href=\"https://www.systemsbiology.org/bio/james-r-heath/\">James Heath\u003c/a>, president of the Institute for Systems Biology in Seattle.\u003c/p>\n\u003cp>\"One of the most exciting breakthroughs in biomedicine over the past decade has been activating the immune system against various cancers. But they have not been successful in breast cancer. Metastatic breast cancer is basically a death sentence,\" Heath says. \"And this shows that you can reverse it. It's a big deal.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>One key challenge will be to make the treatment easier, faster, and affordable, Rosenberg says. \"We're working literally around the clock to try to improve the treatment.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Therapy+Made+From+Patient%27s+Immune+System+Shows+Promise+For+Advanced+Breast+Cancer&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "An experimental therapy seems to have eradicated cancer in a patient with metastatic breast cancer who had failed every other treatment. The goal is to reliably repeat that success in more people.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors at the National Institutes of Health say they've apparently completely eradicated cancer from a patient who had untreatable, advanced breast cancer.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The case is raising hopes about a new way to harness the immune system to fight some of the most common cancers. The methods and the patient's experience are described Monday in a \u003ca href=\"https://www.nature.com/articles/s41591-018-0040-8\">paper\u003c/a> published in the journal \u003cem>Nature Medicine\u003c/em>.\u003c/p>\n\u003cp>\"We're looking for a treatment — an immunotherapy — that can be broadly used in patients with common cancers,\" says \u003ca href=\"https://ccr.cancer.gov/Surgery-Branch/steven-a-rosenberg\">Dr. Steven Rosenberg\u003c/a>, an oncologist and immunologist at the National Cancer Institute, who has been developing the approach.\u003c/p>\n\u003cp>Rosenberg's team painstakingly analyzes the DNA in a sample of each patient's cancer for mutations specific to their malignancies. Next, scientists sift through tumor tissue for immune system cells known as \u003ca href=\"https://www.cancer.gov/publications/dictionaries/cancer-terms/def/t-cell\">T cells\u003c/a> that appear programmed to home in on those mutations.\u003c/p>\n\u003cp>But Rosenberg and others caution that the approach doesn't work for everyone. In fact, it failed for two other breast cancer patients. Many more patients will have to be treated — and followed for much longer — to fully evaluate the treatment's effectiveness, the scientists say.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Still, the treatment has helped seven of 45 patients with a variety of cancers, Rosenberg says. That's a response rate of about 15 percent, and included patients with advanced cases of colon cancer, liver cancer and cervical cancer.\u003c/p>\n\u003cp>\"Is it ready for prime time today? No,\" Rosenberg says.\"Can we do it in most patients today? No.\"\u003c/p>\n\u003cp>But the treatment continues to be improved. \"I think it's the most promising treatment now being explored for solving the problem of the treatment of metastatic, common cancers,\" he says.\u003c/p>\n\u003cp>The breast cancer patient helped by the treatment says it transformed her life.\u003c/p>\n\u003cp>\"It's amazing,\" says Judy Perkins, 52, a retired engineer who lives in Port St. Lucie, Fla.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>When Perkins was first diagnosed and treated for breast cancer in 2003, she thought she'd beaten the disease. \"I thought I was done with it,\" she says.\u003c/p>\n\u003cp>But about a decade later, she felt a new lump. Doctors discovered the cancer had already spread throughout her chest. Her prognosis was grim.\u003c/p>\n\u003cp>\"I became a metastatic cancer patient,\" says Perkins. \"That was hard.\"\u003c/p>\n\u003cp>Perkins went through round after round of chemotherapy. She tried every experimental treatment she could find. But the cancer kept spreading. Some of her tumors grew to the size of tennis balls.\u003c/p>\n\u003cp>\"I had sort of essentially run out of arrows in my quiver,\" she says. \"While I would say I had some hope, I was also kind of like ready to quit, too.\"\u003c/p>\n\u003cp>Then she heard about the experimental treatment at the NIH. It was designed to fight some of the most common cancers, including breast cancer.\u003c/p>\n\u003cp>\"The excitement here is that we're attacking the very mutations that are unique to that cancer — in that patient's cancer and not in anybody else's cancer. So it's about as personalized a treatment as you can imagine,\" Rosenberg says.\u003c/p>\n\u003cp>His team identified and then grew billions of T cells for Perkins in the lab and then infused them back into her body. They also gave her two drugs to help the cells do their job.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The treatment was grueling. Perkins says the hardest part was the side effects of a drug known as interleukin, which she received to help boost the effectiveness of the immune system cells. Interleukin causes severe flu-like symptoms, such as a high fever, intense malaise and uncontrollable shivering.\u003c/p>\n\u003cp>But the treatment apparently worked, Rosenberg reports. Perkins' tumors soon disappeared. And, more than two years later, she remains cancer-free.\u003c/p>\n\u003cp>\"All of her detectable disease has disappeared. It's remarkable,\" Rosenberg says.\u003c/p>\n\u003cp>Perkins is thrilled.\u003c/p>\n\u003cp>\"I'm one of the lucky ones,\" Perkins says. \"We got the right T cells in the right place at the right time. And they went in and ate up all my cancer. And I'm cured. It's freaking unreal.\"\u003c/p>\n\u003cp>In an \u003ca href=\"https://doi.org/10.1038/s41591-018-0065-z\">article\u003c/a> accompanying the new paper, \u003ca href=\"https://news.oicr.on.ca/2018/03/oicr-names-dr-laszlo-radvanyi-as-new-president-and-scientific-director/\">Laszlo Radvanyi\u003c/a>, president and scientific director of the Ontario Institute for Cancer Research, calls the results \"remarkable.\"\u003c/p>\n\u003cp>The approach and other recent advances suggest scientists may be \"at the cusp of a major revolution in finally realizing the elusive goal of being able to target the plethora of mutations in cancer through immunotherapy,\" Radvanyi writes.\u003c/p>\n\u003cp>Other cancer researchers agree.\u003c/p>\n\u003cp>\"When I saw this paper I thought: \"Whoa! I mean, it's very impressive,\" says \u003ca href=\"https://www.systemsbiology.org/bio/james-r-heath/\">James Heath\u003c/a>, president of the Institute for Systems Biology in Seattle.\u003c/p>\n\u003cp>\"One of the most exciting breakthroughs in biomedicine over the past decade has been activating the immune system against various cancers. But they have not been successful in breast cancer. Metastatic breast cancer is basically a death sentence,\" Heath says. \"And this shows that you can reverse it. It's a big deal.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>One key challenge will be to make the treatment easier, faster, and affordable, Rosenberg says. \"We're working literally around the clock to try to improve the treatment.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Therapy+Made+From+Patient%27s+Immune+System+Shows+Promise+For+Advanced+Breast+Cancer&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study Aims To Show Transplants Between HIV-Positive Patients Are Safe, Save Lives",
"title": "Study Aims To Show Transplants Between HIV-Positive Patients Are Safe, Save Lives",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>A large-scale clinical trial launched by the National Institutes of Health in May could pave the way for more HIV-positive patients with kidney disease to receive life-saving transplants.[contextly_sidebar id=\"a0scXdDhVUfyg2KqOZ0K4mbuthRZryBP\"]\u003c/p>\n\u003cp>The trial, called the \u003ca href=\"https://www.nih.gov/news-events/news-releases/nih-clinical-trial-track-outcomes-kidney-transplantation-hiv-positive-donors-hiv-positive-recipients\" target=\"_blank\" rel=\"noopener\">HOPE in Action Multicenter Kidney Study,\u003c/a> will assess the risks of transplanting kidneys from HIV-positive donors into patients living with the virus, says Dr. Christine Durand, assistant professor of medicine at Johns Hopkins University and a principal investigator of the study.\u003c/p>\n\u003cp>\"We have an organ shortage crisis in this country and individuals living with HIV are disproportionately affected,\" she says. The research will help determine whether the pool of HIV-infected organs is \"safe and effective.\" If so, she says, it would benefit everyone awaiting kidneys.\u003c/p>\n\u003cp>\"Everytime someone with HIV gets an organ transplant they move everybody else up on the waitlist,\" says Durand.\u003c/p>\n\u003cp>There are \u003ca href=\"https://www.kidney.org/news/newsroom/factsheets/End-Stage-Renal-Disease-in-the-US\" target=\"_blank\" rel=\"noopener\">468,000 Americans\u003c/a> receiving dialysis for end-stage renal disease. According to Durand's research, an estimated 1.5 percent of those live with HIV. About 1 percent of liver transplant candidates have HIV.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This means that more than 10,000 HIV positive individuals could benefit from a kidney or liver transplant,\" says Durand.\u003c/p>\n\u003cp>The HOPE in Action study will track 160 kidney transplants, half receiving HIV-positive kidneys and half receiving virus-free organs. Recipients will be monitored after surgery for signs of organ rejection, organ failure, and other complications, such as the risk of infecting the patient with more than one strain of HIV.\u003c/p>\n\u003cp>This will allow doctors to more accurately predict risk after these transplants, and offer the procedure to more HIV-positive people on the transplant waiting list. The researchers also hope to make a case for allowing such transplants to become standard care.\u003c/p>\n\u003cp>Currently, HIV-positive transplants are only permitted if they are part of a clinical trial, such as this one. In 2013, President Obama signed a law, \u003ca href=\"https://obamawhitehouse.archives.gov/blog/2013/11/21/hiv-organ-policy-equity-hope-act-now-law\" target=\"_blank\" rel=\"noopener\">the HIV Organ Policy Equity (HOPE) Act\u003c/a>, allowing HIV-positive individuals to donate certain organs (currently only kidneys and livers), but only as part of a research study conducted with oversight by an academic institution.\u003c/p>\n\u003cp>That law partly rolled back a 1988 law which outlawed harvesting HIV-infected organs.[contextly_sidebar id=\"xbpxyu6mzzv9z7TaZRMEIp5klSJ3h0RD\"]\u003c/p>\n\u003cp>\"At the time it was at the height of the AIDS scare,\" Durand says. \"HIV was a death sentence, so there were a lot of laws put into place to protect the blood supply, to protect organ donation.\"\u003c/p>\n\u003cp>HIV-positive transplant candidates are already eligible to receive virus-free organs, but generally \"they face longer wait times than those who don't have the virus,\" says Durand. This is the case, she adds, even though they have similar survival and organ function after transplant.\u003c/p>\n\u003cp>As HIV testing and treatment improved, donation has become feasible, she says. And \u003ca href=\"http://jasn.asnjournals.org/content/26/9/2222.abstract\" target=\"_blank\" rel=\"noopener\">early research started to show\u003c/a> transplant survival rates could be similar to those of transplant recipients without HIV.\u003c/p>\n\u003cp>But \"many transplant centers say they don't have the expertise or experience to perform these transplants,\" says Durand. The HOPE study may provide data to change this and set clinicians' fears to rest.\u003c/p>\n\u003cp>One center participating in the trial is Indiana University Health in Indianapolis. They've yet to perform a transplant but in April, the Indiana Donor Network, Indiana's organ procurement organization recovered organs from an HIV-positive donor for the first time, and successfully matched a kidney and a liver to two people who needed them out of state. Dr. Tim Taber, chief medical officer for the Indiana Donor Network and a transplant nephrologist at Indiana University Health says he thinks the HOPE in Action study can change clinicians' attitudes about HIV-positive transplantation.\u003c/p>\n\u003cp>\"I think people will be more comfortable with it after a while and after they see that it's been successful so I think it will become more and more common to see HIV-positive donors procured and put in, obviously, HIV-positive recipients,\" he says.\u003c/p>\n\u003cp>It took a few years after Obama signed the HOPE Act for transplants to actually happen between HIV-positive people. In 2015, the National Institutes of Health and Health and Human Services \u003ca href=\"https://www.niaid.nih.gov/sites/default/files/hopeactcriteria.pdf\" target=\"_blank\" rel=\"noopener\">published safeguards and research criteria\u003c/a> for medical centers willing to perform these transplants as clinical research. And a team at Johns Hopkins performed \u003ca href=\"https://www.npr.org/sections/health-shots/2016/03/31/472389956/new-source-of-transplant-organs-for-patients-with-hiv-others-with-hiv\" target=\"_blank\" rel=\"noopener\">the first HIV-positive organ transplant\u003c/a> in 2016.[contextly_sidebar id=\"hUwHooQjUeRk2Iaphb8SlbZQA0om8DpO\"]\u003c/p>\n\u003cp>Any organ procurement organization that follows the NIH research criteria can send HIV-infected donor organs to transplant centers.\u003c/p>\n\u003cp>So far only 16 out of 58 organ procurement organizations around the country have worked on HIV-positive cases since the HOPE Act made it legal, according to Brianna Doby, donation community consultant for a team at Johns Hopkins University that supports organ recovery organizations dealing with their first HIV-positive donor.\u003c/p>\n\u003cp>So far, there have been approximately 50 HIV-positive kidney and liver transplants performed in the U.S. This is far fewer than researchers at Johns Hopkins predicted in a 2011 study, published in the American Journal of Transplantation. They estimated between 500 and 600 new HIV-positive organs would become available after the HOPE Act.\u003c/p>\n\u003cp>Doby says for the past several decades the transplant system has focused on doing everything possible to exclude disease from the donor pool, including HIV and Hepatitis C. And some organ procurement organizations still fear their staff will be at risk when working with an HIV-positive donor. But that needs to change, she says.\u003c/p>\n\u003cp>\"We need to be able to work with organs that increase the risk of those disease, or if you have one of those diseases, find a donor that has those,\" she says. \"Because it's the best shot you have at life, right?\"\u003c/p>\n\u003cp>For the HOPE Act to fulfill its potential Doby says more donors are needed. \"The HOPE Act is not widely known about and many people might just assume they can't be donors if they are also HIV-positive, so they don't register,\" she says.\u003c/p>\n\u003cp>Donation centers are gradually starting to recover more HIV-infected organs, according to Dorry Segev, a transplant surgeon at Johns Hopkins and another principal investigator on the new NIH study. Some local organ procurement centers are \"interested in being pioneers in this area and have been really responsive and good at recovering organs from donors with HIV,\" Segev wrote in an e-mail, while others are \"waiting in the wings to see what happens.\"\u003c/p>\n\u003cp>Any fear they have about the safety of harvesting HIV-positive organs are unfounded he says. He hopes more centers will realize that \"recovering HIV+ organs is not just something interesting, but is actually a responsibility to our patients.\"[contextly_sidebar id=\"XejfKo4ekdt9y93X9my8fqXKEZLcgJLe\"]\u003c/p>\n\u003cp>At hospital transplant centers, clinicians biggest fear is that patients could contract a second strain of HIV from the donor, Segev explains. \"In fact,\" he wrote, \"we have such good [antiretroviral therapy] regimens that basically any strain of HIV can be suppressed with \u003cem>some\u003c/em> ART regimen, so no matter what strain of HIV comes from the donor, we can basically treat it in the recipient.\"\u003c/p>\n\u003cp>If a hospital performing transplants wants to receive HIV-positive organs they have to receive institutional review board approval and prove that they can meet transplantation criteria outlined by the Department of Health and Human Services. The process might deter some transplant centers from participating.\u003c/p>\n\u003cp>Indiana Donor Network's Taber says it's not hard to meet the requirements to procure HIV-positive organs because the safety precautions are the same whether or not there's an infection. His protocol is to \"treat everybody like they have some infection from the moon that you don't want to get.\"\u003c/p>\n\u003cp>And if it can help more patients get transplants, he says, it's a good thing.\u003c/p>\n\u003cp>\"It provides just another opportunity for patients to get transplanted,\" he says.\"It's not a home run but it's one more way to get these people off the list.\"\u003c/p>\n\u003cp>Durand says there's a lot of untapped potential to work with HIV-positive organs. So far 24 centers meet the criteria to perform transplants between people with HIV. Among these centers, Durand said there are more than 300 patients with HIV who have agreed to accept an HIV-positive organ. \"We expect this number to grow significantly,\" she says.\u003c/p>\n\u003cp>And if the trial goes well, it might open the door to other organs. She hopes future research trials will include hundreds of HIV-positive people waiting for hearts and lungs.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was produced in collaboration with WFYI and \u003c/em>\u003ca href=\"http://sideeffectspublicmedia.org\" target=\"_blank\" rel=\"noopener\">\u003cem>Side Effects Public Media\u003c/em>\u003c/a>\u003cem>, a news collaborative covering public health.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Side Effects Public Media. To see more, visit \u003ca>Side Effects Public Media\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Study+Aims+To+Show+Transplants+Between+HIV-Positive+Patients+Are+Safe%2C+Save+Lives&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Hundreds of otherwise viable organs that are HIV-positive are wasted each year, while HIV-positive patients in need of transplants languish on waiting lists. Researchers want to change that.",
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"description": "Hundreds of otherwise viable organs that are HIV-positive are wasted each year, while HIV-positive patients in need of transplants languish on waiting lists. Researchers want to change that.",
"title": "Study Aims To Show Transplants Between HIV-Positive Patients Are Safe, Save Lives | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A large-scale clinical trial launched by the National Institutes of Health in May could pave the way for more HIV-positive patients with kidney disease to receive life-saving transplants.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The trial, called the \u003ca href=\"https://www.nih.gov/news-events/news-releases/nih-clinical-trial-track-outcomes-kidney-transplantation-hiv-positive-donors-hiv-positive-recipients\" target=\"_blank\" rel=\"noopener\">HOPE in Action Multicenter Kidney Study,\u003c/a> will assess the risks of transplanting kidneys from HIV-positive donors into patients living with the virus, says Dr. Christine Durand, assistant professor of medicine at Johns Hopkins University and a principal investigator of the study.\u003c/p>\n\u003cp>\"We have an organ shortage crisis in this country and individuals living with HIV are disproportionately affected,\" she says. The research will help determine whether the pool of HIV-infected organs is \"safe and effective.\" If so, she says, it would benefit everyone awaiting kidneys.\u003c/p>\n\u003cp>\"Everytime someone with HIV gets an organ transplant they move everybody else up on the waitlist,\" says Durand.\u003c/p>\n\u003cp>There are \u003ca href=\"https://www.kidney.org/news/newsroom/factsheets/End-Stage-Renal-Disease-in-the-US\" target=\"_blank\" rel=\"noopener\">468,000 Americans\u003c/a> receiving dialysis for end-stage renal disease. According to Durand's research, an estimated 1.5 percent of those live with HIV. About 1 percent of liver transplant candidates have HIV.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"This means that more than 10,000 HIV positive individuals could benefit from a kidney or liver transplant,\" says Durand.\u003c/p>\n\u003cp>The HOPE in Action study will track 160 kidney transplants, half receiving HIV-positive kidneys and half receiving virus-free organs. Recipients will be monitored after surgery for signs of organ rejection, organ failure, and other complications, such as the risk of infecting the patient with more than one strain of HIV.\u003c/p>\n\u003cp>This will allow doctors to more accurately predict risk after these transplants, and offer the procedure to more HIV-positive people on the transplant waiting list. The researchers also hope to make a case for allowing such transplants to become standard care.\u003c/p>\n\u003cp>Currently, HIV-positive transplants are only permitted if they are part of a clinical trial, such as this one. In 2013, President Obama signed a law, \u003ca href=\"https://obamawhitehouse.archives.gov/blog/2013/11/21/hiv-organ-policy-equity-hope-act-now-law\" target=\"_blank\" rel=\"noopener\">the HIV Organ Policy Equity (HOPE) Act\u003c/a>, allowing HIV-positive individuals to donate certain organs (currently only kidneys and livers), but only as part of a research study conducted with oversight by an academic institution.\u003c/p>\n\u003cp>That law partly rolled back a 1988 law which outlawed harvesting HIV-infected organs.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"At the time it was at the height of the AIDS scare,\" Durand says. \"HIV was a death sentence, so there were a lot of laws put into place to protect the blood supply, to protect organ donation.\"\u003c/p>\n\u003cp>HIV-positive transplant candidates are already eligible to receive virus-free organs, but generally \"they face longer wait times than those who don't have the virus,\" says Durand. This is the case, she adds, even though they have similar survival and organ function after transplant.\u003c/p>\n\u003cp>As HIV testing and treatment improved, donation has become feasible, she says. And \u003ca href=\"http://jasn.asnjournals.org/content/26/9/2222.abstract\" target=\"_blank\" rel=\"noopener\">early research started to show\u003c/a> transplant survival rates could be similar to those of transplant recipients without HIV.\u003c/p>\n\u003cp>But \"many transplant centers say they don't have the expertise or experience to perform these transplants,\" says Durand. The HOPE study may provide data to change this and set clinicians' fears to rest.\u003c/p>\n\u003cp>One center participating in the trial is Indiana University Health in Indianapolis. They've yet to perform a transplant but in April, the Indiana Donor Network, Indiana's organ procurement organization recovered organs from an HIV-positive donor for the first time, and successfully matched a kidney and a liver to two people who needed them out of state. Dr. Tim Taber, chief medical officer for the Indiana Donor Network and a transplant nephrologist at Indiana University Health says he thinks the HOPE in Action study can change clinicians' attitudes about HIV-positive transplantation.\u003c/p>\n\u003cp>\"I think people will be more comfortable with it after a while and after they see that it's been successful so I think it will become more and more common to see HIV-positive donors procured and put in, obviously, HIV-positive recipients,\" he says.\u003c/p>\n\u003cp>It took a few years after Obama signed the HOPE Act for transplants to actually happen between HIV-positive people. In 2015, the National Institutes of Health and Health and Human Services \u003ca href=\"https://www.niaid.nih.gov/sites/default/files/hopeactcriteria.pdf\" target=\"_blank\" rel=\"noopener\">published safeguards and research criteria\u003c/a> for medical centers willing to perform these transplants as clinical research. And a team at Johns Hopkins performed \u003ca href=\"https://www.npr.org/sections/health-shots/2016/03/31/472389956/new-source-of-transplant-organs-for-patients-with-hiv-others-with-hiv\" target=\"_blank\" rel=\"noopener\">the first HIV-positive organ transplant\u003c/a> in 2016.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Any organ procurement organization that follows the NIH research criteria can send HIV-infected donor organs to transplant centers.\u003c/p>\n\u003cp>So far only 16 out of 58 organ procurement organizations around the country have worked on HIV-positive cases since the HOPE Act made it legal, according to Brianna Doby, donation community consultant for a team at Johns Hopkins University that supports organ recovery organizations dealing with their first HIV-positive donor.\u003c/p>\n\u003cp>So far, there have been approximately 50 HIV-positive kidney and liver transplants performed in the U.S. This is far fewer than researchers at Johns Hopkins predicted in a 2011 study, published in the American Journal of Transplantation. They estimated between 500 and 600 new HIV-positive organs would become available after the HOPE Act.\u003c/p>\n\u003cp>Doby says for the past several decades the transplant system has focused on doing everything possible to exclude disease from the donor pool, including HIV and Hepatitis C. And some organ procurement organizations still fear their staff will be at risk when working with an HIV-positive donor. But that needs to change, she says.\u003c/p>\n\u003cp>\"We need to be able to work with organs that increase the risk of those disease, or if you have one of those diseases, find a donor that has those,\" she says. \"Because it's the best shot you have at life, right?\"\u003c/p>\n\u003cp>For the HOPE Act to fulfill its potential Doby says more donors are needed. \"The HOPE Act is not widely known about and many people might just assume they can't be donors if they are also HIV-positive, so they don't register,\" she says.\u003c/p>\n\u003cp>Donation centers are gradually starting to recover more HIV-infected organs, according to Dorry Segev, a transplant surgeon at Johns Hopkins and another principal investigator on the new NIH study. Some local organ procurement centers are \"interested in being pioneers in this area and have been really responsive and good at recovering organs from donors with HIV,\" Segev wrote in an e-mail, while others are \"waiting in the wings to see what happens.\"\u003c/p>\n\u003cp>Any fear they have about the safety of harvesting HIV-positive organs are unfounded he says. He hopes more centers will realize that \"recovering HIV+ organs is not just something interesting, but is actually a responsibility to our patients.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At hospital transplant centers, clinicians biggest fear is that patients could contract a second strain of HIV from the donor, Segev explains. \"In fact,\" he wrote, \"we have such good [antiretroviral therapy] regimens that basically any strain of HIV can be suppressed with \u003cem>some\u003c/em> ART regimen, so no matter what strain of HIV comes from the donor, we can basically treat it in the recipient.\"\u003c/p>\n\u003cp>If a hospital performing transplants wants to receive HIV-positive organs they have to receive institutional review board approval and prove that they can meet transplantation criteria outlined by the Department of Health and Human Services. The process might deter some transplant centers from participating.\u003c/p>\n\u003cp>Indiana Donor Network's Taber says it's not hard to meet the requirements to procure HIV-positive organs because the safety precautions are the same whether or not there's an infection. His protocol is to \"treat everybody like they have some infection from the moon that you don't want to get.\"\u003c/p>\n\u003cp>And if it can help more patients get transplants, he says, it's a good thing.\u003c/p>\n\u003cp>\"It provides just another opportunity for patients to get transplanted,\" he says.\"It's not a home run but it's one more way to get these people off the list.\"\u003c/p>\n\u003cp>Durand says there's a lot of untapped potential to work with HIV-positive organs. So far 24 centers meet the criteria to perform transplants between people with HIV. Among these centers, Durand said there are more than 300 patients with HIV who have agreed to accept an HIV-positive organ. \"We expect this number to grow significantly,\" she says.\u003c/p>\n\u003cp>And if the trial goes well, it might open the door to other organs. She hopes future research trials will include hundreds of HIV-positive people waiting for hearts and lungs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced in collaboration with WFYI and \u003c/em>\u003ca href=\"http://sideeffectspublicmedia.org\" target=\"_blank\" rel=\"noopener\">\u003cem>Side Effects Public Media\u003c/em>\u003c/a>\u003cem>, a news collaborative covering public health.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Side Effects Public Media. To see more, visit \u003ca>Side Effects Public Media\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Study+Aims+To+Show+Transplants+Between+HIV-Positive+Patients+Are+Safe%2C+Save+Lives&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "When Scientists Develop Products From Personal Medical Data, Who Should Profit?",
"title": "When Scientists Develop Products From Personal Medical Data, Who Should Profit?",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>If you go to the hospital for medical treatment and scientists there decide to use your medical information to create a commercial product, are you owed anything as part of the bargain?[contextly_sidebar id=\"xg39QV5nwjkzRaw7H5UkEXIAZgbQaNjg\"]\u003c/p>\n\u003cp>That's one of the questions that is emerging as researchers and product developers eagerly delve into digital data such as CT scans and electronic medical records, making artificial-intelligence products that are helping doctors to manage information and even to help them diagnose disease.\u003c/p>\n\u003cp>This issue cropped up in 2016, when Google DeepMind decided to test an app that measures kidney health by gathering 1.6 million records from patients at the Royal Free Hospital in London. The British authorities found \u003ca href=\"http://www.bbc.com/news/technology-40483202\" target=\"_blank\" rel=\"noopener\">this broke patient privacy laws\u003c/a> in the United Kingdom. (\u003cem>Update on June 1 at 9:30 a.m. ET:\u003c/em> DeepMind \u003ca href=\"https://deepmind.com/blog/ico-royal-free/\" target=\"_blank\" rel=\"noopener\">says\u003c/a> it was able to deploy its app despite the violation.)\u003c/p>\n\u003cp>But the rules are different in the United States. The most notable cases have involved living tissue, but the legal arguments apply to medical data as well. One of the best examples dates back to 1976, when John Moore went to UCLA to be treated for hairy cell leukemia.\u003c/p>\n\u003cp>\u003ca href=\"http://law.gsu.edu/profile/leslie-e-wolf/\" target=\"_blank\" rel=\"noopener\">Prof. Leslie Wolf\u003c/a>, director of the Center for Health, Law and Society at the Georgia State University College of Law, says Moore's doctors gave him good medical care, \"but they also discovered there was something interesting about his cells and created a cell line from his cells without his knowledge,\" she says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"And what complicated things even more is they asked Mr. Moore to travel down from his home in Seattle to L.A. multiple times, for seven years, to get additional cells without telling him they had this commercial interest in his cells.\"[contextly_sidebar id=\"DoYi5dXWSx7RCJVBTZf1P61atenUYp3T\"]\u003c/p>\n\u003cp>Moore sued. In 1990, The California Supreme Court \u003ca href=\"http://online.ceb.com/CalCases/C3/51C3d120.htm\" target=\"_blank\" rel=\"noopener\">decided that he did not own his cells\u003c/a>, but found his doctors had an obligation to inform him that his tissue was being used for commercial purposes and to give him a chance to object. Moore reached a settlement following his court battle, \"but Mr. Moore certainly felt betrayed through the process,\" Wolf says.\u003c/p>\n\u003cp>The most famous case of this nature involves a Maryland woman, Henrietta Lacks. Back in 1951, doctors at the Johns Hopkins hospital in Baltimore collected cells from her cervical cancer and turned them into the world's first immortal cell line, which grows perpetually in the lab and is used widely in research. As documented in Rebecca Skloot's \u003ca href=\"https://en.wikipedia.org/wiki/The_Immortal_Life_of_Henrietta_Lacks\">book\u003c/a> and an HBO biopic starring Oprah Winfrey, the family learned only much later what had transpired and received no compensation. In 2013, the National Institutes of Health \u003ca href=\"https://www.npr.org/sections/health-shots/2013/08/07/209807857/decades-after-lacks-death-family-gets-a-say-on-her-cells\" target=\"_blank\" rel=\"noopener\">came to an agreement with her family\u003c/a> guiding the use of her genetic information, but the family \u003ca href=\"https://www.washingtonpost.com/local/henrietta-lackss-family-wants-compensation-for-her-cells/2017/02/14/816481ba-f302-11e6-b9c9-e83fce42fb61_story.html?utm_term=.448bab1431d9\" target=\"_blank\" rel=\"noopener\">has continued to raise the issue\u003c/a>.\u003c/p>\n\u003cp>While those fights were about living tissue, \"in a certain sense whether it's cells or [digital] bits and bytes, it's all information about an individual, at some level,\" says \u003ca href=\"http://www.radiology.emory.edu/faculty/safdar-nabile.html\">Dr. Nabile Safdar,\u003c/a> a radiologist at Emory University and author \u003ca href=\"https://www.jacr.org/article/S1546-1440(17)31599-5/fulltext\">of a recent paper discussing the issue\u003c/a> of patients' rights as it pertains to their medical scans.\u003c/p>\n\u003cp>This information is increasingly being used in research, and that in turn can easily end up being used to develop a commercial product that's worth millions. Are the patients entitled to a cut?\u003c/p>\n\u003cp>\"That's a question that I think we need to figure out,\" Safdar says. \"And if were a patient and my data were used to develop something that was being shared outside as a product, I'd want to know.\"\u003c/p>\n\u003cp>That's not how it's usually done. At many research hospitals, patients routinely sign a paper, in that huge stack of admission paperwork, giving permission for the institution to use their personal data for research.\u003c/p>\n\u003cp>\"For someone to sign away the rights in perpetuity for their data to be used for all possible research applications in the future, that's something I think would deserve a lot of scrutiny, and that's not something I would agree with,\" Safdar says.\u003c/p>\n\u003cp>Here's a current example. Researchers at Johns Hopkins Medicine \u003ca href=\"https://www.npr.org/sections/health-shots/2018/05/30/615466696/for-some-hard-to-find-tumors-doctors-see-promise-in-artificial-intelligence\">are mining years of CT scans\u003c/a> that were performed initially to care for patients. Those patients signed a form saying it was okay to use that data for research. And the research has been approved by the university's institutional review board, which is charged with weighing the ethics of research projects, says \u003ca href=\"https://www.hopkinsmedicine.org/news/media/releases/karen_horton_named_director_of_department_of_radiology_and_radiological_science\">Dr. Karen Horton\u003c/a>, director of radiology.[contextly_sidebar id=\"njADn3noIN9V0ZYkwAdgQ0CYTEXexAJi\"]\u003c/p>\n\u003cp>Horton is now using some of this data to teach computers how to recognize pancreatic cancer. She says part of their agreement is that the data are stripped of all information that could identify an individual patient, \"so there's no [privacy] risk to a patient to have their images used to train the computer.\"\u003c/p>\n\u003cp>And Horton says technically, the data don't belong to the patients. \"Right now as the law defines it, your medical images are property of the health system,\" she says. \"You don't own the image.\"\u003c/p>\n\u003cp>But Wolf, the law professor and ethicist at Georgia State, says she's not sure that's a strong argument. \"Yes, they [the doctors] created the scans,\" she says, \"but certainly the patient has rights related to the scans,\" such as the right to view them and of course to decide at the outset whether they can be used in research.\u003c/p>\n\u003cp>It generally takes thousands of scans from many individuals to develop a commercial product, so no single person's data is especially valuable on its own. Overall, Wolf says, patients don't have much of a legal argument here, but there is an ethical issue.\u003c/p>\n\u003cp>\"My own concern is not that it is problematic \u003cem>per se\u003c/em>,\" she says. But, \"I don't think we've done a really good job of letting people know that this is in fact what we do with their data.\"\u003c/p>\n\u003cp>She \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356669/\">cites lawsuits\u003c/a> where blood samples that had been taken at birth ended up being used for research.\u003c/p>\n\u003cp>\"One of the moms in the case said if 'I had been asked I think I would have said yes,' but it was the sense of not even being asked, and having the data used,\" Wolf says. \"People generally will agree, but they want to be asked, at least at some level.\"\u003c/p>\n\u003cp>And Safdar says there are times when people might, indeed, want to object to how their data are being used.\u003c/p>\n\u003cp>\"There's a wealth of information in a CT scan or an MRI,\" Safdar says. Looking at features such as liver fat, artery clogs and brain atrophy, researchers might calculate a probability for how long that person is likely to live.\u003c/p>\n\u003cp>These algorithms are generally called \"black boxes,\" because there's no way to know how they reach their conclusions. And if the computer algorithm \"spits out that you have two months to live, there are implications for employment, for insurability, for all kinds of things that impacts that person's daily life,\" Safdar says. \"That worries me a little bit, especially when it's not clear how that black box is making those decisions.\"\u003c/p>\n\u003cp>And what if the algorithm has actually baked in an unconscious prejudice of some sort, he asks, such as about race, age or sex?\u003c/p>\n\u003cp>\"When that same model, when trained [to work] on a specific group of people, is now applied to a totally different group of people, it could make totally erroneous decisions.\"\u003c/p>\n\u003cp>These issues are becoming more pressing as these AI-based products start coming to market.\u003c/p>\n\u003cp>\u003cem>You can contact Richard Harris at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\">\u003cem>rharris@npr.org\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=When+Scientists+Develop+Products+From+Personal+Medical+Data%2C+Who+Gets+To+Profit%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>SaveSaveSaveSaveSaveSave\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>SaveSave\u003c/p>\n\n",
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"excerpt": "Data from patient medical records are being used to develop commercial products. What rights do we have over the use of our personal health information?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you go to the hospital for medical treatment and scientists there decide to use your medical information to create a commercial product, are you owed anything as part of the bargain?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That's one of the questions that is emerging as researchers and product developers eagerly delve into digital data such as CT scans and electronic medical records, making artificial-intelligence products that are helping doctors to manage information and even to help them diagnose disease.\u003c/p>\n\u003cp>This issue cropped up in 2016, when Google DeepMind decided to test an app that measures kidney health by gathering 1.6 million records from patients at the Royal Free Hospital in London. The British authorities found \u003ca href=\"http://www.bbc.com/news/technology-40483202\" target=\"_blank\" rel=\"noopener\">this broke patient privacy laws\u003c/a> in the United Kingdom. (\u003cem>Update on June 1 at 9:30 a.m. ET:\u003c/em> DeepMind \u003ca href=\"https://deepmind.com/blog/ico-royal-free/\" target=\"_blank\" rel=\"noopener\">says\u003c/a> it was able to deploy its app despite the violation.)\u003c/p>\n\u003cp>But the rules are different in the United States. The most notable cases have involved living tissue, but the legal arguments apply to medical data as well. One of the best examples dates back to 1976, when John Moore went to UCLA to be treated for hairy cell leukemia.\u003c/p>\n\u003cp>\u003ca href=\"http://law.gsu.edu/profile/leslie-e-wolf/\" target=\"_blank\" rel=\"noopener\">Prof. Leslie Wolf\u003c/a>, director of the Center for Health, Law and Society at the Georgia State University College of Law, says Moore's doctors gave him good medical care, \"but they also discovered there was something interesting about his cells and created a cell line from his cells without his knowledge,\" she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"And what complicated things even more is they asked Mr. Moore to travel down from his home in Seattle to L.A. multiple times, for seven years, to get additional cells without telling him they had this commercial interest in his cells.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Moore sued. In 1990, The California Supreme Court \u003ca href=\"http://online.ceb.com/CalCases/C3/51C3d120.htm\" target=\"_blank\" rel=\"noopener\">decided that he did not own his cells\u003c/a>, but found his doctors had an obligation to inform him that his tissue was being used for commercial purposes and to give him a chance to object. Moore reached a settlement following his court battle, \"but Mr. Moore certainly felt betrayed through the process,\" Wolf says.\u003c/p>\n\u003cp>The most famous case of this nature involves a Maryland woman, Henrietta Lacks. Back in 1951, doctors at the Johns Hopkins hospital in Baltimore collected cells from her cervical cancer and turned them into the world's first immortal cell line, which grows perpetually in the lab and is used widely in research. As documented in Rebecca Skloot's \u003ca href=\"https://en.wikipedia.org/wiki/The_Immortal_Life_of_Henrietta_Lacks\">book\u003c/a> and an HBO biopic starring Oprah Winfrey, the family learned only much later what had transpired and received no compensation. In 2013, the National Institutes of Health \u003ca href=\"https://www.npr.org/sections/health-shots/2013/08/07/209807857/decades-after-lacks-death-family-gets-a-say-on-her-cells\" target=\"_blank\" rel=\"noopener\">came to an agreement with her family\u003c/a> guiding the use of her genetic information, but the family \u003ca href=\"https://www.washingtonpost.com/local/henrietta-lackss-family-wants-compensation-for-her-cells/2017/02/14/816481ba-f302-11e6-b9c9-e83fce42fb61_story.html?utm_term=.448bab1431d9\" target=\"_blank\" rel=\"noopener\">has continued to raise the issue\u003c/a>.\u003c/p>\n\u003cp>While those fights were about living tissue, \"in a certain sense whether it's cells or [digital] bits and bytes, it's all information about an individual, at some level,\" says \u003ca href=\"http://www.radiology.emory.edu/faculty/safdar-nabile.html\">Dr. Nabile Safdar,\u003c/a> a radiologist at Emory University and author \u003ca href=\"https://www.jacr.org/article/S1546-1440(17)31599-5/fulltext\">of a recent paper discussing the issue\u003c/a> of patients' rights as it pertains to their medical scans.\u003c/p>\n\u003cp>This information is increasingly being used in research, and that in turn can easily end up being used to develop a commercial product that's worth millions. Are the patients entitled to a cut?\u003c/p>\n\u003cp>\"That's a question that I think we need to figure out,\" Safdar says. \"And if were a patient and my data were used to develop something that was being shared outside as a product, I'd want to know.\"\u003c/p>\n\u003cp>That's not how it's usually done. At many research hospitals, patients routinely sign a paper, in that huge stack of admission paperwork, giving permission for the institution to use their personal data for research.\u003c/p>\n\u003cp>\"For someone to sign away the rights in perpetuity for their data to be used for all possible research applications in the future, that's something I think would deserve a lot of scrutiny, and that's not something I would agree with,\" Safdar says.\u003c/p>\n\u003cp>Here's a current example. Researchers at Johns Hopkins Medicine \u003ca href=\"https://www.npr.org/sections/health-shots/2018/05/30/615466696/for-some-hard-to-find-tumors-doctors-see-promise-in-artificial-intelligence\">are mining years of CT scans\u003c/a> that were performed initially to care for patients. Those patients signed a form saying it was okay to use that data for research. And the research has been approved by the university's institutional review board, which is charged with weighing the ethics of research projects, says \u003ca href=\"https://www.hopkinsmedicine.org/news/media/releases/karen_horton_named_director_of_department_of_radiology_and_radiological_science\">Dr. Karen Horton\u003c/a>, director of radiology.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Horton is now using some of this data to teach computers how to recognize pancreatic cancer. She says part of their agreement is that the data are stripped of all information that could identify an individual patient, \"so there's no [privacy] risk to a patient to have their images used to train the computer.\"\u003c/p>\n\u003cp>And Horton says technically, the data don't belong to the patients. \"Right now as the law defines it, your medical images are property of the health system,\" she says. \"You don't own the image.\"\u003c/p>\n\u003cp>But Wolf, the law professor and ethicist at Georgia State, says she's not sure that's a strong argument. \"Yes, they [the doctors] created the scans,\" she says, \"but certainly the patient has rights related to the scans,\" such as the right to view them and of course to decide at the outset whether they can be used in research.\u003c/p>\n\u003cp>It generally takes thousands of scans from many individuals to develop a commercial product, so no single person's data is especially valuable on its own. Overall, Wolf says, patients don't have much of a legal argument here, but there is an ethical issue.\u003c/p>\n\u003cp>\"My own concern is not that it is problematic \u003cem>per se\u003c/em>,\" she says. But, \"I don't think we've done a really good job of letting people know that this is in fact what we do with their data.\"\u003c/p>\n\u003cp>She \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356669/\">cites lawsuits\u003c/a> where blood samples that had been taken at birth ended up being used for research.\u003c/p>\n\u003cp>\"One of the moms in the case said if 'I had been asked I think I would have said yes,' but it was the sense of not even being asked, and having the data used,\" Wolf says. \"People generally will agree, but they want to be asked, at least at some level.\"\u003c/p>\n\u003cp>And Safdar says there are times when people might, indeed, want to object to how their data are being used.\u003c/p>\n\u003cp>\"There's a wealth of information in a CT scan or an MRI,\" Safdar says. Looking at features such as liver fat, artery clogs and brain atrophy, researchers might calculate a probability for how long that person is likely to live.\u003c/p>\n\u003cp>These algorithms are generally called \"black boxes,\" because there's no way to know how they reach their conclusions. And if the computer algorithm \"spits out that you have two months to live, there are implications for employment, for insurability, for all kinds of things that impacts that person's daily life,\" Safdar says. \"That worries me a little bit, especially when it's not clear how that black box is making those decisions.\"\u003c/p>\n\u003cp>And what if the algorithm has actually baked in an unconscious prejudice of some sort, he asks, such as about race, age or sex?\u003c/p>\n\u003cp>\"When that same model, when trained [to work] on a specific group of people, is now applied to a totally different group of people, it could make totally erroneous decisions.\"\u003c/p>\n\u003cp>These issues are becoming more pressing as these AI-based products start coming to market.\u003c/p>\n\u003cp>\u003cem>You can contact Richard Harris at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\">\u003cem>rharris@npr.org\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. 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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
"site": "radio",
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},
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"rss": "https://feeds.npr.org/510312/podcast.xml"
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.commonwealthclub.org/podcasts",
"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
"tuneIn": "https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"
}
},
"forum": {
"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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},
"freakonomics-radio": {
"id": "freakonomics-radio",
"title": "Freakonomics Radio",
"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
}
},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
"airtime": "MON-FRI 7pm-8pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Fresh-Air-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/fresh-air/",
"meta": {
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"here-and-now": {
"id": "here-and-now",
"title": "Here & Now",
"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
"airtime": "MON-THU 11am-12pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Here-And-Now-Podcast-Tile-360x360-1.jpg",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
}
},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/hiddenbrain.jpg",
"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"airtime": "SUN 7pm-8pm",
"meta": {
"site": "news",
"source": "NPR"
},
"link": "/radio/program/hidden-brain",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/hidden-brain/id1028908750?mt=2",
"tuneIn": "https://tunein.com/podcasts/Science-Podcasts/Hidden-Brain-p787503/",
"rss": "https://feeds.npr.org/510308/podcast.xml"
}
},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"rss": "https://feeds.npr.org/510313/podcast.xml"
}
},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
"imageAlt": "KQED Hyphenación",
"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
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"source": "kqed",
"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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"amazon": "https://music.amazon.com/podcasts/6c3dd23c-93fb-4aab-97ba-1725fa6315f1/hyphenaci%C3%B3n",
"rss": "https://feeds.megaphone.fm/KQINC2275451163"
}
},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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"apple": "https://itunes.apple.com/us/podcast/id1492194549",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/xtTd",
"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
"meta": {
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},
"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"spotify": "https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x",
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"stitcher": "https://www.stitcher.com/show/on-our-watch",
"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
"site": "news",
"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
"site": "radio",
"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
"apple": "https://podcasts.apple.com/us/podcast/id73801135",
"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
}
},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
"officialWebsiteLink": "https://www.npr.org/sections/money/",
"meta": {
"site": "news",
"source": "npr"
},
"link": "/radio/program/planet-money",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/M4f5",
"apple": "https://itunes.apple.com/us/podcast/planet-money/id290783428?mt=2",
"tuneIn": "https://tunein.com/podcasts/Business--Economics-Podcasts/Planet-Money-p164680/",
"rss": "https://feeds.npr.org/510289/podcast.xml"
}
},
"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Political Breakdown",
"officialWebsiteLink": "/podcasts/politicalbreakdown",
"meta": {
"site": "radio",
"source": "kqed",
"order": 5
},
"link": "/podcasts/politicalbreakdown",
"subscribe": {
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"amazon": "https://music.amazon.com/podcasts/e0c2d153-ad36-4c8d-901d-f1da6a724824/political-breakdown",
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