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It typically depends on where patients live, and sometimes on their health insurance.\u003c/p>\n\u003cp>Cancer patients with lower incomes — and especially those in rural places — \u003ca href=\"https://www.cancer.gov/news-events/cancer-currents-blog/2020/persistent-poverty-increased-cancer-death-risk#:~:text=A%20new%20study%20by%20NCI,than%20people%20in%20other%20counties.\">tend to fare worse\u003c/a>. \u003ca href=\"https://escholarship.org/content/qt8xc078vj/qt8xc078vj_noSplash_451b26b4f066a1cfb27ba71f52096a73.pdf?t=nxk0lm\">Studies have shown (PDF)\u003c/a> that patients with Medi-Cal, the health insurance program for residents with lower incomes, are less likely to get the recommended treatment and have lower cancer survival rates compared to people with private insurance.\u003c/p>\n\u003cp>This disparity is at the crux of a California bill recently signed into law by Gov. Gavin Newsom that supporters say will make it at least a little easier for Medi-Cal patients to access cancer subspecialists, treatments and clinical trials.[pullquote size=\"medium\" align=\"right\" citation=\"Linda Nguy, policy advocate, Western Center on Law and Poverty\"]'Actually requiring plans [to contract with cancer centers] — that would have brought some meat to the table. From our understanding, plans already make efforts to contract with as many providers as possible, but it comes down to a reimbursement issue.'[/pullquote]\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB987\">The new law\u003c/a>, which goes into effect in January, requires Medi-Cal insurance plans to “make a good faith effort” to contract with \u003ca href=\"https://www.cancer.gov/research/infrastructure/cancer-centers\">cancer centers recognized by the National Cancer Institute\u003c/a> — which often have access to the latest treatments — or other qualifying cancer centers.\u003c/p>\n\u003cp>Authored by Democratic \u003ca href=\"https://calmatters.org/legislator-tracker/anthony-portantino-1961/\">Sen. Anthony Portantino\u003c/a> of Glendale, it was originally drafted to mandate that Medi-Cal plans add at least one of these cancer centers to their provider networks, but negotiations resulted in a scaled-back version, only requiring health plans to \u003cem>try\u003c/em> to add a cancer center.\u003c/p>\n\u003cp>The law also requires Medi-Cal plans to notify enrollees with complex cancers about their right to request a referral to any of these centers, even if it’s out of their plan’s network. Whether a patient can be treated at one of these centers, however, depends on whether the plan and the out-of-network provider can hash out a payment deal. This referral notification, supporters say, is critical: Patients can’t ask for something they don’t know is an option.\u003c/p>\n\u003cp>Supporters say that even if limited, this law will be an important step toward helping cancer patients with lower incomes get specialized care.\u003c/p>\n\u003cp>“I think making incremental change has the ability to save lives and that’s what we’re trying to do here,” Portantino said.\u003c/p>\n\u003cp>Too often patients from underserved communities arrive at these specialized cancer centers very late after their diagnoses, said Dr. Joseph Alvarnas, hematologist-oncologist and vice president of government affairs at \u003ca href=\"https://www.cityofhope.org/\">City of Hope\u003c/a>, one of eight California cancer centers with a National Cancer Institute designation, and a sponsor of the law.\u003c/p>\n\u003cp>“The conversation begins with, ‘If I could only have gotten here sooner,’ or ‘My family and I fought tooth-and-nail to get here,’” he said.\u003c/p>\n\u003cp>Alvarnas said that, historically, City of Hope used to see more Medi-Cal patients, but that changed as the state has largely moved its Medi-Cal program from a fee-for-service model (in which patients could see any provider who accepted Medi-Cal and the state paid providers for each service rendered) to managed care (considered a more cost-effective model, in which the state pays health insurance companies a fixed amount per enrollee).\u003c/p>\n\u003cp>“In managed care, part of the way that model works is it includes narrower clinician networks and more limited hospital choices,” Alvarnas said. “If you have high blood pressure or you’ve got a condition that can be cared for by many types of doctors, that’s an OK model.\u003c/p>\n\u003cp>“But when it comes to cancer care, your network of clinicians may not have an expert in leukemia or relapsed myeloma.”\u003c/p>\n\u003cp>Hospitals sometimes must send some of their sickest patients to cancer centers like City of Hope — as was the case for Patrick Nandy of Whittier. In 2008, during his senior year of college, he was diagnosed with acute lymphoblastic leukemia, a cancer of the blood and bone marrow that can progress very quickly. Nandy said that when oncologists at St. Jude Medical Center could no longer treat him, he was transferred to City of Hope, where he participated in a chemotherapy clinical trial and a cord blood stem cell transplant.\u003c/p>\n\u003cp>“I think about how lucky I am,” Nandy said. “Doctors said two more weeks and I probably would have been gone.”\u003c/p>\n\u003cp>These are the types of therapies that should be available to all patients with complex or aggressive cancers, but that’s not always the case, Alvarnas said.\u003c/p>\n\u003cp>A \u003ca href=\"https://escholarship.org/content/qt8xc078vj/qt8xc078vj_noSplash_451b26b4f066a1cfb27ba71f52096a73.pdf?t=nxk0lm\">2015 analysis by the University of California, Davis (PDF)\u003c/a> found worse outcomes for cancer patients with Medi-Cal compared to people with other types of insurance. Among some of the findings: Thirty-nine percent of breast cancer patients on Medi-Cal were diagnosed at an early stage compared to 61% of those who were privately insured.\u003c/p>\n\u003cp>The study also found Medi-Cal patients diagnosed with early stage lung cancer had a 48% five-year survival rate, lower than the 65% five-year survival rate for those with private insurance. Medi-Cal patients also were less likely to receive the necessary therapies or treatments for several cancer types.\u003c/p>\n\u003cp>The law will apply to people with rare or complex cancers, including advanced stage brain cancer, lung cancer, colorectal cancer, leukemia and lymphoma, among others, Alvarnas said. The sought- after treatment and research centers include City of Hope, University of California comprehensive cancer centers, the Stanford Cancer Institute, as well as a number of Kaiser Permanente sites and the Cedars-Sinai Cancer Institute.\u003c/p>\n\u003cp>While the law as passed had no registered opposition, it was watered down during negotiations involving providers, health plans and the California Department of Health Care Services, which oversees the Medi-Cal program.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/wp-content/uploads/2022/06/SB-987-Portantino-Author-OPPOSE-4.12.22.pdf\">Health insurance plans initially opposed Portantino’s bill (PDF)\u003c/a> because requiring plans to contract with centers, they warned, comes with new administrative hurdles that could disrupt or delay patient care.[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Joseph Alvarnas, vice president of government affairs, City of Hope\"]'The state has worked very hard over the last decade to improve health care coverage. The issue, though, is there's a gulf between coverage and real access, because there is also a focus by the state to make sure that health care costs are somewhat controlled.'[/pullquote]\u003c/p>\n\u003cp>Linda Nguy, an advocate with the Western Center on Law and Poverty, said her organization withdrew its support after the bill was narrowed. “Actually requiring plans [to contract with cancer centers] — that would have brought some meat to the table,” Nguy said. “From our understanding, plans already make efforts to contract with as many providers as possible, but it comes down to a reimbursement issue.”\u003c/p>\n\u003cp>Medi-Cal, which covers about a third of Californians, pays providers \u003ca href=\"https://www.urban.org/sites/default/files/publication/88836/2001180-medicaid-physician-fees-after-the-aca-primary-care-fee-bump_0.pdf\">a lower rate than other insurance types (PDF)\u003c/a>. While lower reimbursement rates make the program \u003ca href=\"https://www.cbpp.org/research/health/frequently-asked-questions-about-medicaid\">more cost-efficient\u003c/a>, \u003ca href=\"https://www.healthaffairs.org/do/10.1377/forefront.20190401.678690/full/\">low payments can deter providers\u003c/a> from participating in Medi-Cal.\u003c/p>\n\u003cp>The debate over cancer care equity shows the complexities of achieving true access even in a state that has expanded insurance coverage to more people. California is scheduled to become the first state in the country to offer Medi-Cal coverage to all income-eligible people regardless of immigration status. Last week, Gov. Gavin Newsom’s office announced that \u003ca href=\"https://www.gov.ca.gov/2022/10/19/medi-cal-expansion-provided-286000-undocumented-californians-with-comprehensive-health-care/#:~:text=SACRAMENTO%20%E2%80%93%20Today%2C%20Governor%20Gavin%20Newsom,years%20of%20age%20and%20older%2C\">286,000 undocumented people age 50 and older started to receive comprehensive coverage in May\u003c/a>. In 2024, California will open the Medi-Cal program to approximately 700,000 more people ages 26 to 49.\u003c/p>\n\u003cp>“The state has worked very hard over the last decade to improve health care coverage,” Alvarnas said. “The issue, though, is there’s a gulf between coverage and real access, because there is also a focus by the state to make sure that health care costs are somewhat controlled.”\u003c/p>\n\u003cp>While the bill fell short of what supporters initially aimed for, the work to make cancer care more easily accessible will continue, said Autumn Ogden-Smith, director of state legislation for the American Cancer Society Cancer Action Network, another sponsor of the bill. For instance, how to more easily get a patient into one of these cancer centers if they don’t live nearby is a priority, she said.\u003c/p>\n\u003cp>“If you pull up a map, you’ll see these centers tend to cover certain areas — San Diego, Los Angeles, San Francisco, Davis-Sacramento,” Ogden-Smith said. “We’re going to have to focus on how we get the people in Northern California and in the middle of the state” to cancer centers, she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Patients with lower incomes who need specialized cancer treatment often struggle to get it. Advocates say a new law is a small step toward improving services for them.",
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"title": "New California Law Targets Inequity in Cancer Care. Some Say It Doesn't Go Far Enough | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Cancer is the second-leading cause of death in California, behind only heart disease. This year alone, the state will tally an estimated \u003ca href=\"https://cancerstatisticscenter.cancer.org/#!/state/California\">189,000 new cancer cases\u003c/a> and close to 61,000 deaths.\u003c/p>\n\u003cp>Yet while patients often need specialists, treatments and the chance to participate in clinical trials, that access is not equitable throughout the state. It typically depends on where patients live, and sometimes on their health insurance.\u003c/p>\n\u003cp>Cancer patients with lower incomes — and especially those in rural places — \u003ca href=\"https://www.cancer.gov/news-events/cancer-currents-blog/2020/persistent-poverty-increased-cancer-death-risk#:~:text=A%20new%20study%20by%20NCI,than%20people%20in%20other%20counties.\">tend to fare worse\u003c/a>. \u003ca href=\"https://escholarship.org/content/qt8xc078vj/qt8xc078vj_noSplash_451b26b4f066a1cfb27ba71f52096a73.pdf?t=nxk0lm\">Studies have shown (PDF)\u003c/a> that patients with Medi-Cal, the health insurance program for residents with lower incomes, are less likely to get the recommended treatment and have lower cancer survival rates compared to people with private insurance.\u003c/p>\n\u003cp>This disparity is at the crux of a California bill recently signed into law by Gov. Gavin Newsom that supporters say will make it at least a little easier for Medi-Cal patients to access cancer subspecialists, treatments and clinical trials.\u003c/p>\u003c/div>",
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"content": "'Actually requiring plans [to contract with cancer centers] — that would have brought some meat to the table. From our understanding, plans already make efforts to contract with as many providers as possible, but it comes down to a reimbursement issue.'",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB987\">The new law\u003c/a>, which goes into effect in January, requires Medi-Cal insurance plans to “make a good faith effort” to contract with \u003ca href=\"https://www.cancer.gov/research/infrastructure/cancer-centers\">cancer centers recognized by the National Cancer Institute\u003c/a> — which often have access to the latest treatments — or other qualifying cancer centers.\u003c/p>\n\u003cp>Authored by Democratic \u003ca href=\"https://calmatters.org/legislator-tracker/anthony-portantino-1961/\">Sen. Anthony Portantino\u003c/a> of Glendale, it was originally drafted to mandate that Medi-Cal plans add at least one of these cancer centers to their provider networks, but negotiations resulted in a scaled-back version, only requiring health plans to \u003cem>try\u003c/em> to add a cancer center.\u003c/p>\n\u003cp>The law also requires Medi-Cal plans to notify enrollees with complex cancers about their right to request a referral to any of these centers, even if it’s out of their plan’s network. Whether a patient can be treated at one of these centers, however, depends on whether the plan and the out-of-network provider can hash out a payment deal. This referral notification, supporters say, is critical: Patients can’t ask for something they don’t know is an option.\u003c/p>\n\u003cp>Supporters say that even if limited, this law will be an important step toward helping cancer patients with lower incomes get specialized care.\u003c/p>\n\u003cp>“I think making incremental change has the ability to save lives and that’s what we’re trying to do here,” Portantino said.\u003c/p>\n\u003cp>Too often patients from underserved communities arrive at these specialized cancer centers very late after their diagnoses, said Dr. Joseph Alvarnas, hematologist-oncologist and vice president of government affairs at \u003ca href=\"https://www.cityofhope.org/\">City of Hope\u003c/a>, one of eight California cancer centers with a National Cancer Institute designation, and a sponsor of the law.\u003c/p>\n\u003cp>“The conversation begins with, ‘If I could only have gotten here sooner,’ or ‘My family and I fought tooth-and-nail to get here,’” he said.\u003c/p>\n\u003cp>Alvarnas said that, historically, City of Hope used to see more Medi-Cal patients, but that changed as the state has largely moved its Medi-Cal program from a fee-for-service model (in which patients could see any provider who accepted Medi-Cal and the state paid providers for each service rendered) to managed care (considered a more cost-effective model, in which the state pays health insurance companies a fixed amount per enrollee).\u003c/p>\n\u003cp>“In managed care, part of the way that model works is it includes narrower clinician networks and more limited hospital choices,” Alvarnas said. “If you have high blood pressure or you’ve got a condition that can be cared for by many types of doctors, that’s an OK model.\u003c/p>\n\u003cp>“But when it comes to cancer care, your network of clinicians may not have an expert in leukemia or relapsed myeloma.”\u003c/p>\n\u003cp>Hospitals sometimes must send some of their sickest patients to cancer centers like City of Hope — as was the case for Patrick Nandy of Whittier. In 2008, during his senior year of college, he was diagnosed with acute lymphoblastic leukemia, a cancer of the blood and bone marrow that can progress very quickly. Nandy said that when oncologists at St. Jude Medical Center could no longer treat him, he was transferred to City of Hope, where he participated in a chemotherapy clinical trial and a cord blood stem cell transplant.\u003c/p>\n\u003cp>“I think about how lucky I am,” Nandy said. “Doctors said two more weeks and I probably would have been gone.”\u003c/p>\n\u003cp>These are the types of therapies that should be available to all patients with complex or aggressive cancers, but that’s not always the case, Alvarnas said.\u003c/p>\n\u003cp>A \u003ca href=\"https://escholarship.org/content/qt8xc078vj/qt8xc078vj_noSplash_451b26b4f066a1cfb27ba71f52096a73.pdf?t=nxk0lm\">2015 analysis by the University of California, Davis (PDF)\u003c/a> found worse outcomes for cancer patients with Medi-Cal compared to people with other types of insurance. Among some of the findings: Thirty-nine percent of breast cancer patients on Medi-Cal were diagnosed at an early stage compared to 61% of those who were privately insured.\u003c/p>\n\u003cp>The study also found Medi-Cal patients diagnosed with early stage lung cancer had a 48% five-year survival rate, lower than the 65% five-year survival rate for those with private insurance. Medi-Cal patients also were less likely to receive the necessary therapies or treatments for several cancer types.\u003c/p>\n\u003cp>The law will apply to people with rare or complex cancers, including advanced stage brain cancer, lung cancer, colorectal cancer, leukemia and lymphoma, among others, Alvarnas said. The sought- after treatment and research centers include City of Hope, University of California comprehensive cancer centers, the Stanford Cancer Institute, as well as a number of Kaiser Permanente sites and the Cedars-Sinai Cancer Institute.\u003c/p>\n\u003cp>While the law as passed had no registered opposition, it was watered down during negotiations involving providers, health plans and the California Department of Health Care Services, which oversees the Medi-Cal program.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/wp-content/uploads/2022/06/SB-987-Portantino-Author-OPPOSE-4.12.22.pdf\">Health insurance plans initially opposed Portantino’s bill (PDF)\u003c/a> because requiring plans to contract with centers, they warned, comes with new administrative hurdles that could disrupt or delay patient care.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Linda Nguy, an advocate with the Western Center on Law and Poverty, said her organization withdrew its support after the bill was narrowed. “Actually requiring plans [to contract with cancer centers] — that would have brought some meat to the table,” Nguy said. “From our understanding, plans already make efforts to contract with as many providers as possible, but it comes down to a reimbursement issue.”\u003c/p>\n\u003cp>Medi-Cal, which covers about a third of Californians, pays providers \u003ca href=\"https://www.urban.org/sites/default/files/publication/88836/2001180-medicaid-physician-fees-after-the-aca-primary-care-fee-bump_0.pdf\">a lower rate than other insurance types (PDF)\u003c/a>. While lower reimbursement rates make the program \u003ca href=\"https://www.cbpp.org/research/health/frequently-asked-questions-about-medicaid\">more cost-efficient\u003c/a>, \u003ca href=\"https://www.healthaffairs.org/do/10.1377/forefront.20190401.678690/full/\">low payments can deter providers\u003c/a> from participating in Medi-Cal.\u003c/p>\n\u003cp>The debate over cancer care equity shows the complexities of achieving true access even in a state that has expanded insurance coverage to more people. California is scheduled to become the first state in the country to offer Medi-Cal coverage to all income-eligible people regardless of immigration status. Last week, Gov. Gavin Newsom’s office announced that \u003ca href=\"https://www.gov.ca.gov/2022/10/19/medi-cal-expansion-provided-286000-undocumented-californians-with-comprehensive-health-care/#:~:text=SACRAMENTO%20%E2%80%93%20Today%2C%20Governor%20Gavin%20Newsom,years%20of%20age%20and%20older%2C\">286,000 undocumented people age 50 and older started to receive comprehensive coverage in May\u003c/a>. In 2024, California will open the Medi-Cal program to approximately 700,000 more people ages 26 to 49.\u003c/p>\n\u003cp>“The state has worked very hard over the last decade to improve health care coverage,” Alvarnas said. “The issue, though, is there’s a gulf between coverage and real access, because there is also a focus by the state to make sure that health care costs are somewhat controlled.”\u003c/p>\n\u003cp>While the bill fell short of what supporters initially aimed for, the work to make cancer care more easily accessible will continue, said Autumn Ogden-Smith, director of state legislation for the American Cancer Society Cancer Action Network, another sponsor of the bill. For instance, how to more easily get a patient into one of these cancer centers if they don’t live nearby is a priority, she said.\u003c/p>\n\u003cp>“If you pull up a map, you’ll see these centers tend to cover certain areas — San Diego, Los Angeles, San Francisco, Davis-Sacramento,” Ogden-Smith said. “We’re going to have to focus on how we get the people in Northern California and in the middle of the state” to cancer centers, she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "California Stoves Are Leaking Cancerous Gases, Study Finds",
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"headTitle": "California Stoves Are Leaking Cancerous Gases, Study Finds | KQED",
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"content": "\u003cp>Gas stoves in California homes are leaking cancer-causing benzene, researchers found in a new study published Thursday, though they say more research is needed to understand how many homes have leaks.\u003c/p>\n\u003cp>In the study, published in \u003ca href=\"https://doi.org/10.1021/acs.est.2c02581\">Environmental Science and Technology\u003c/a>, researchers also estimated that over 4 tons of benzene per year are being leaked into the atmosphere from outdoor pipes that deliver the gas to buildings around California. And those emissions are unaccounted for by the state.\u003c/p>\n\u003cp>Eric Lebel is a co-author of the study and a senior scientist at PSE Healthy Energy, the nonprofit energy research and policy institute that conducted the research. He says that even low-level gas leaks can generate concentrations of benzene seven times California’s recommended exposure limits, and that these leaks can also affect outdoor air quality.[aside label='Related Articles' tag='benzene']“We estimate that leaks from gas appliances and the pipes that feed them in cities can emit the same amount of benzene each year in the state of California as 60,000 passenger cars,” said Lebel.\u003c/p>\n\u003cp>The researchers collected samples of gas from 159 homes in different regions of California and measured to see which types of gases were being emitted into homes when stoves were off. They found at least 12 hazardous air pollutants in all the samples they tested, including benzene, toluene, ethylbenzene and xylene (together known as BTEX), all of which can have adverse health effects in humans with chronic exposure or acute exposure in larger amounts.\u003c/p>\n\u003cp>Of most concern to the researchers was \u003ca href=\"https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/benzene\">benzene\u003c/a>, a known carcinogen that can lead to leukemia and other cancers and blood disorders, according to the National Cancer Institute.\u003c/p>\n\u003cp>The finding could have major implications for indoor and outdoor air quality in California, which has the second highest level of residential natural gas use in the United States.\u003c/p>\n\u003cp>“What our science shows is that people in California are exposed to potentially hazardous levels of benzene from the gas that is piped into their homes,” said Drew Michanowicz, study co-author and senior scientist at PSE Healthy Energy. “We hope that policymakers will consider this data when they are making policy to ensure current and future policies are health-protective in light of this new research.”\u003c/p>\n\u003cp>Homes in the greater Los Angeles, North San Fernando Valley and Santa Clarita Valley areas had the highest benzene in gas levels. Leaks from stoves in these regions could emit enough benzene to significantly exceed the limit determined to be safe by the California Office of Environmental Health Hazards Assessment.[pullquote size=\"medium\" align=\"right\" citation=\"Drew Michanowicz, co-author and senior scientist, PSE Healthy Energy\"]‘We hope that policymakers will consider this data when they are making policy to ensure current and future policies are health-protective in light of this new research.’[/pullquote]This finding in particular didn’t surprise residents and health care workers in the region who spoke to The Associated Press about the study. That’s because many of them experienced the \u003ca href=\"https://apnews.com/article/business-california-los-angeles-southern-california-gas-co-sempra-energy-a043c5dbe2bd14776a8f38e24b2ce055\">largest-known natural gas leak\u003c/a> in the nation in Aliso Canyon in 2015.\u003c/p>\n\u003cp>Back then, 100,000 tons of methane and other gases, \u003ca href=\"https://www.noaa.gov/media-release/study-2015-california-blowout-led-to-largest-us-methane-release-ever#:~:text=The%20Aliso%20Canyon%20natural%20gas,methane%20leak%20in%20U.S.%20history.\">including benzene\u003c/a>, leaked from a failed well operated by Southern California Gas Co. It took nearly four months to get the leak under control and resulted in headaches, nausea and nosebleeds.\u003c/p>\n\u003cp>Dr. Jeffrey Nordella was a physician at an urgent care in the region during this time and remembers being puzzled by the variety of symptoms patients were experiencing. “I didn’t have much to offer them,” except to help them try to detox from the exposures, he said.\u003c/p>\n\u003cp>That was an acute exposure of a large amount of benzene, which is different from chronic exposure to smaller amounts, but “remember \u003ca href=\"https://www.who.int/publications/i/item/WHO-CED-PHE-EPE-19.4.2\">what the World Health Organization said\u003c/a>: There’s no safe level of benzene,” he said.\u003c/p>\n\u003cp>Kyoko Hibino was one of the residents exposed to toxic air pollution as a result of the Aliso Canyon gas leak. After the leak, she started having a persistent cough and nosebleeds and eventually was diagnosed with breast cancer, which also has been \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/10450771/\">linked to benzene exposure\u003c/a>. Her cats also started having nosebleeds and one recently passed away from leukemia.\u003c/p>\n\u003cp>“I’d say let’s take this study really seriously and understand how bad (benzene exposure) is,” she said.\u003c/p>\n\u003cp>State regulators have committed to phasing out the sale of gas furnaces and water heaters by 2030.\u003c/p>\n\u003cp>\u003cem>KQED’s Keith Mizuguchi contributed to this story.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gas stoves in California homes are leaking cancer-causing benzene, researchers found in a new study published Thursday, though they say more research is needed to understand how many homes have leaks.\u003c/p>\n\u003cp>In the study, published in \u003ca href=\"https://doi.org/10.1021/acs.est.2c02581\">Environmental Science and Technology\u003c/a>, researchers also estimated that over 4 tons of benzene per year are being leaked into the atmosphere from outdoor pipes that deliver the gas to buildings around California. And those emissions are unaccounted for by the state.\u003c/p>\n\u003cp>Eric Lebel is a co-author of the study and a senior scientist at PSE Healthy Energy, the nonprofit energy research and policy institute that conducted the research. He says that even low-level gas leaks can generate concentrations of benzene seven times California’s recommended exposure limits, and that these leaks can also affect outdoor air quality.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We estimate that leaks from gas appliances and the pipes that feed them in cities can emit the same amount of benzene each year in the state of California as 60,000 passenger cars,” said Lebel.\u003c/p>\n\u003cp>The researchers collected samples of gas from 159 homes in different regions of California and measured to see which types of gases were being emitted into homes when stoves were off. They found at least 12 hazardous air pollutants in all the samples they tested, including benzene, toluene, ethylbenzene and xylene (together known as BTEX), all of which can have adverse health effects in humans with chronic exposure or acute exposure in larger amounts.\u003c/p>\n\u003cp>Of most concern to the researchers was \u003ca href=\"https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/benzene\">benzene\u003c/a>, a known carcinogen that can lead to leukemia and other cancers and blood disorders, according to the National Cancer Institute.\u003c/p>\n\u003cp>The finding could have major implications for indoor and outdoor air quality in California, which has the second highest level of residential natural gas use in the United States.\u003c/p>\n\u003cp>“What our science shows is that people in California are exposed to potentially hazardous levels of benzene from the gas that is piped into their homes,” said Drew Michanowicz, study co-author and senior scientist at PSE Healthy Energy. “We hope that policymakers will consider this data when they are making policy to ensure current and future policies are health-protective in light of this new research.”\u003c/p>\n\u003cp>Homes in the greater Los Angeles, North San Fernando Valley and Santa Clarita Valley areas had the highest benzene in gas levels. Leaks from stoves in these regions could emit enough benzene to significantly exceed the limit determined to be safe by the California Office of Environmental Health Hazards Assessment.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>This finding in particular didn’t surprise residents and health care workers in the region who spoke to The Associated Press about the study. That’s because many of them experienced the \u003ca href=\"https://apnews.com/article/business-california-los-angeles-southern-california-gas-co-sempra-energy-a043c5dbe2bd14776a8f38e24b2ce055\">largest-known natural gas leak\u003c/a> in the nation in Aliso Canyon in 2015.\u003c/p>\n\u003cp>Back then, 100,000 tons of methane and other gases, \u003ca href=\"https://www.noaa.gov/media-release/study-2015-california-blowout-led-to-largest-us-methane-release-ever#:~:text=The%20Aliso%20Canyon%20natural%20gas,methane%20leak%20in%20U.S.%20history.\">including benzene\u003c/a>, leaked from a failed well operated by Southern California Gas Co. It took nearly four months to get the leak under control and resulted in headaches, nausea and nosebleeds.\u003c/p>\n\u003cp>Dr. Jeffrey Nordella was a physician at an urgent care in the region during this time and remembers being puzzled by the variety of symptoms patients were experiencing. “I didn’t have much to offer them,” except to help them try to detox from the exposures, he said.\u003c/p>\n\u003cp>That was an acute exposure of a large amount of benzene, which is different from chronic exposure to smaller amounts, but “remember \u003ca href=\"https://www.who.int/publications/i/item/WHO-CED-PHE-EPE-19.4.2\">what the World Health Organization said\u003c/a>: There’s no safe level of benzene,” he said.\u003c/p>\n\u003cp>Kyoko Hibino was one of the residents exposed to toxic air pollution as a result of the Aliso Canyon gas leak. After the leak, she started having a persistent cough and nosebleeds and eventually was diagnosed with breast cancer, which also has been \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/10450771/\">linked to benzene exposure\u003c/a>. Her cats also started having nosebleeds and one recently passed away from leukemia.\u003c/p>\n\u003cp>“I’d say let’s take this study really seriously and understand how bad (benzene exposure) is,” she said.\u003c/p>\n\u003cp>State regulators have committed to phasing out the sale of gas furnaces and water heaters by 2030.\u003c/p>\n\u003cp>\u003cem>KQED’s Keith Mizuguchi contributed to this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Agricultural chemical giant Monsanto is on trial yet again in the Bay Area.\u003c/p>\n\u003cp>Just one day after a federal jury decided that Monsanto must pay $80 million in damages to a Santa Rosa man, and less than a year after a state jury awarded $300 million in damages to a Vallejo groundskeeper in a similar case, opening statements were delivered Thursday in a new trial involving Monsanto in Alameda County Superior Court.\u003c/p>\n\u003cp>This time, it’s the case of Alva and Alberta Pilliod, a Livermore couple in their 70s who used Monsanto’s herbicide Roundup on their three Northern California properties for more than 30 years.\u003c/p>\n\u003cp>Both were diagnosed with non-Hodgkin’s lymphoma, a relatively common form of cancer. Their diagnoses came four years apart, in 2011 and 2015 respectively. After aggressive chemotherapy treatments, both are currently in remission.\u003c/p>\n\u003cp>Like the plaintiffs in the previous two trials against Monsanto, the Pilliods used Roundup for weed control. It wasn’t until they saw a television commercial in 2017 that the Pilliods learned Roundup may be a carcinogen, their attorney said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Monsanto denies that its product causes cancer.\u003c/p>\n\u003cp>The new case is the first to go to trial in a grouping of 150 similar cases, and there are more than 760 lawsuits pending in U.S. District Court in San Francisco. According to the advocacy group U.S. Right to Know, there are more than 11,000 cases against Monsanto in the broader United States, alleging that Roundup exposure causes non-Hodgkin’s lymphoma.\u003c/p>\n\u003cp>Roundup first came on the market in 1974 and is still sold today.\u003c/p>\n\u003cp>In his opening statement Thursday, the couple's lead attorney Brent Wisner told a 12-person jury that the likelihood of both of his clients being diagnosed with the same type of lymphoma, in this case a diffuse large B-cell lymphoma, is 1 in 20,500.\u003c/p>\n\u003cp>Wisner estimated that the Pilliods sprayed 1,500 gallons of Roundup over the course of 35 years.\u003c/p>\n\u003cp>“Monsanto keeps telling the world that this is stuff is safe, that it doesn't cause cancer,” Wisner said. “When you look at the evidence objectively, no one agrees with them.”\u003c/p>\n\u003cp>Monsanto’s counsel, Tarek Ismail, argued in his opening statement that both of the Pilliods had serious prior health risks: A history of prior cancer, autoimmune diseases and years of smoking. He said these risk factors make it impossible to determine the cause of the couple's cancers.\u003c/p>\n\u003cp>A debate has continued for years about whether or not the active ingredient in Roundup, glyphosate, is carcinogenic. Regulatory bodies worldwide, including the federal Environmental Protection Agency, Health Canada and the European Food Safety Authority have said that glyphosate does not cause cancer. However, in 2015 the International Agency for Research on Cancer, part of the World Health Organization, categorized the substance as a “probable carcinogen.”\u003c/p>\n\u003cp>The burden will rest on Wisner and his team to prove that Roundup can cause cancer and that the weed killer was a contributing factor in the development of the Pilliods’ cancer. In opening statements that lasted more than two and a half hours, Wisner outlined how the plaintiffs would maneuver the science-heavy trial. His approach was similar to the approach of plaintiffs in the other two cases.\u003c/p>\n\u003cp>To prove that Roundup is carcinogenic, Wisner said he would highlight studies done on rodents, cell studies and epidemiological evidence. Monsanto’s attorneys said that the company and independent researchers have done many studies to verify that glyphosate and the Roundup formulation are safe.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The trial is expected to last about a month. Witness testimony begins April 2.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Agricultural chemical giant Monsanto is on trial yet again in the Bay Area.\u003c/p>\n\u003cp>Just one day after a federal jury decided that Monsanto must pay $80 million in damages to a Santa Rosa man, and less than a year after a state jury awarded $300 million in damages to a Vallejo groundskeeper in a similar case, opening statements were delivered Thursday in a new trial involving Monsanto in Alameda County Superior Court.\u003c/p>\n\u003cp>This time, it’s the case of Alva and Alberta Pilliod, a Livermore couple in their 70s who used Monsanto’s herbicide Roundup on their three Northern California properties for more than 30 years.\u003c/p>\n\u003cp>Both were diagnosed with non-Hodgkin’s lymphoma, a relatively common form of cancer. Their diagnoses came four years apart, in 2011 and 2015 respectively. After aggressive chemotherapy treatments, both are currently in remission.\u003c/p>\n\u003cp>Like the plaintiffs in the previous two trials against Monsanto, the Pilliods used Roundup for weed control. It wasn’t until they saw a television commercial in 2017 that the Pilliods learned Roundup may be a carcinogen, their attorney said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Monsanto denies that its product causes cancer.\u003c/p>\n\u003cp>The new case is the first to go to trial in a grouping of 150 similar cases, and there are more than 760 lawsuits pending in U.S. District Court in San Francisco. According to the advocacy group U.S. Right to Know, there are more than 11,000 cases against Monsanto in the broader United States, alleging that Roundup exposure causes non-Hodgkin’s lymphoma.\u003c/p>\n\u003cp>Roundup first came on the market in 1974 and is still sold today.\u003c/p>\n\u003cp>In his opening statement Thursday, the couple's lead attorney Brent Wisner told a 12-person jury that the likelihood of both of his clients being diagnosed with the same type of lymphoma, in this case a diffuse large B-cell lymphoma, is 1 in 20,500.\u003c/p>\n\u003cp>Wisner estimated that the Pilliods sprayed 1,500 gallons of Roundup over the course of 35 years.\u003c/p>\n\u003cp>“Monsanto keeps telling the world that this is stuff is safe, that it doesn't cause cancer,” Wisner said. “When you look at the evidence objectively, no one agrees with them.”\u003c/p>\n\u003cp>Monsanto’s counsel, Tarek Ismail, argued in his opening statement that both of the Pilliods had serious prior health risks: A history of prior cancer, autoimmune diseases and years of smoking. He said these risk factors make it impossible to determine the cause of the couple's cancers.\u003c/p>\n\u003cp>A debate has continued for years about whether or not the active ingredient in Roundup, glyphosate, is carcinogenic. Regulatory bodies worldwide, including the federal Environmental Protection Agency, Health Canada and the European Food Safety Authority have said that glyphosate does not cause cancer. However, in 2015 the International Agency for Research on Cancer, part of the World Health Organization, categorized the substance as a “probable carcinogen.”\u003c/p>\n\u003cp>The burden will rest on Wisner and his team to prove that Roundup can cause cancer and that the weed killer was a contributing factor in the development of the Pilliods’ cancer. In opening statements that lasted more than two and a half hours, Wisner outlined how the plaintiffs would maneuver the science-heavy trial. His approach was similar to the approach of plaintiffs in the other two cases.\u003c/p>\n\u003cp>To prove that Roundup is carcinogenic, Wisner said he would highlight studies done on rodents, cell studies and epidemiological evidence. Monsanto’s attorneys said that the company and independent researchers have done many studies to verify that glyphosate and the Roundup formulation are safe.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The trial is expected to last about a month. Witness testimony begins April 2.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Sonoma County Man Awarded $80 Million in Lawsuit Claiming Roundup Weed Killer Caused His Cancer",
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"content": "\u003cp>A U.S. jury on Wednesday awarded $80 million in damages to a North Bay resident who blamed Roundup weed killer for his cancer, in a case that his attorneys say could help determine the fate of hundreds of similar lawsuits.\u003c/p>\n\u003cp>The six-person jury in a San Francisco federal court returned its verdict in favor of Edwin Hardeman, 70, who said he used Roundup products to treat poison oak, overgrowth and weeds on his Sonoma County property for years, and was never adequately warned of its potential dangers. The same jury previously found, in a unanimous verdict, that Roundup was a substantial factor in Hardeman's non-Hodgkin's lymphoma.\u003c/p>\n\u003cp>Monsanto said it would appeal the jury award.\u003c/p>\n\u003cp>Agribusiness giant Monsanto, which was purchased last year by Bayer AG for $63 billion, says studies have established that the active ingredient in its widely used weed killer, glyphosate, is safe. The company said it will appeal.\u003c/p>\n\u003cp>[aside label=\"Monsanto in Court\" tag=\"monsanto\"]\u003c/p>\n\u003cp>\"We are disappointed with the jury's decision, but this verdict does not change the weight of over four decades of extensive science and the conclusions of regulators worldwide that support the safety of our glyphosate-based herbicides and that they are not carcinogenic,\" according to a statement from Bayer, which acquired Monsanto last year.\u003c/p>\n\u003cp>A different jury in August awarded another man $289 million, but a judge later reduced it to $78 million. Monsanto has appealed that award as well.\u003c/p>\n\u003cp>Hardeman's trial may be more significant than that case. U.S. Judge Vince Chhabria is overseeing hundreds of Roundup lawsuits and deemed Hardeman's case and two others \"bellwether trials.\"\u003c/p>\n\u003cp>The outcome of such cases can help attorneys decide whether to keep fighting similar lawsuits or settle them. Legal experts said verdicts in favor of Hardeman and the other test plaintiffs would give their attorneys a strong bargaining position in any settlement talks for the remaining cases before Chhabria.\u003c/p>\n\u003cp>Many government regulators have rejected a link between cancer and glyphosate. Monsanto has vehemently denied such a connection, saying hundreds of studies have established that the chemical is safe.\u003c/p>\n\u003cp>Monsanto developed glyphosate in the 1970s, and the weed killer is now sold in more than 160 countries and widely used in the United States.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The herbicide came under increasing scrutiny after the France-based International Agency for Research on Cancer, which is part of the World Health Organization, classified it as a \"probable human carcinogen\" in 2015.\u003c/p>\n\u003cp>Lawsuits against Monsanto followed, and thousands are now pending nationwide. Another trial, beginning Thursday in Oakland, involves a Livermore couple in their mid-70s who were both diagnosed with non-Hodgkin’s lymphoma after using Roundup for about 40 years.\u003c/p>\n\u003cp>Monsanto has attacked the international research agency's opinion as an outlier. The U.S. Environmental Protection Agency says glyphosate is safe for people when used in accordance with label directions.\u003c/p>\n\u003cp>Jennifer Moore, one of Hardeman's attorneys, called the verdict history making.\u003c/p>\n\u003cp>\"Today the jury sent a message loud and clear that companies should no longer put products on the market for anyone to buy without being truthful, without testing, and without warning if it causes cancer,\" she said. \"They chose not to tell the American public and they chose not to tell the world that their product was dangerous and today the jury held unanimously that that was wrong, it was deceitful and it was malicious.\"\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The herbicide came under increasing scrutiny after the France-based International Agency for Research on Cancer, which is part of the World Health Organization, classified it as a \"probable human carcinogen\" in 2015.\u003c/p>\n\u003cp>Lawsuits against Monsanto followed, and thousands are now pending nationwide. Another trial, beginning Thursday in Oakland, involves a Livermore couple in their mid-70s who were both diagnosed with non-Hodgkin’s lymphoma after using Roundup for about 40 years.\u003c/p>\n\u003cp>Monsanto has attacked the international research agency's opinion as an outlier. The U.S. Environmental Protection Agency says glyphosate is safe for people when used in accordance with label directions.\u003c/p>\n\u003cp>Jennifer Moore, one of Hardeman's attorneys, called the verdict history making.\u003c/p>\n\u003cp>\"Today the jury sent a message loud and clear that companies should no longer put products on the market for anyone to buy without being truthful, without testing, and without warning if it causes cancer,\" she said. \"They chose not to tell the American public and they chose not to tell the world that their product was dangerous and today the jury held unanimously that that was wrong, it was deceitful and it was malicious.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A California woman who says Johnson & Johnson baby powder caused her to develop mesothelioma was awarded $29 million by a jury Wednesday. J&J says it will appeal the judgment.\u003c/p>\n\u003cp>The plaintiff, Terry Leavitt, said she regularly used two J&J products in the 1960s and ’70s containing talc. In 2017, she was diagnosed with mesothelioma, a kind of cancer linked to asbestos exposure.\u003c/p>\n\u003cp>After two days of deliberation, the jury found that J&J talc-based products were defective and caused Leavitt’s mesothelioma, and that the company had failed to warn consumers about the risks. The jury, in the California Superior Court in Oakland, awarded Leavitt and her husband $29.4 million in damages.\u003c/p>\n\u003cp>J&J faces thousands of lawsuits alleging its talc-based products harmed consumers. This suit is the first to go to trial since articles by Reuters and The New York Times alleged the company feared for years that its baby powder might contain asbestos. J&J denies that its talc powder contains asbestos or is responsible for health problems.\u003c/p>\n\u003cp>J&J said it would appeal, pointing to “serious procedural and evidentiary errors,” Reuters reported. “The jury verdicts are not medical, scientific or regulatory conclusions about a product,” it said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In December, documents came to light showing J&J \u003ca href=\"https://www.reuters.com/investigates/special-report/johnsonandjohnson-cancer/\">worried for decades\u003c/a> that its baby powder might be laced with small amounts of asbestos, which can occur naturally underground near talc. A company executive in the 1970s warned that J&J’s talc mines might not be free of asbestos. Some of its talc products sometimes contained materials that “might be classified as asbestos powder,” The \u003ca href=\"https://www.nytimes.com/2018/12/14/business/baby-powder-asbestos-johnson-johnson.html\">New York Times\u003c/a> reported, quoting an internal company memo.\u003c/p>\n\u003cp>Recent cases have focused on talc’s link to mesothelioma, but many additional cases allege the powder has caused ovarian cancer. All told, the pharmaceutical company faces more than 13,000 talc-related lawsuits nationwide, Reuters reports.\u003c/p>\n\u003cp>Last year, 22 women \u003ca href=\"https://www.npr.org/2018/07/13/628684038/jury-awards-4-7-billion-to-women-in-johnson-johnson-talcum-powder-suit\">were awarded\u003c/a> $4.7 billion after they sued J&J, alleging they developed ovarian cancer because of the company’s products. More than $4 billion of the jury award consisted of punitive damages, which are meant to punish a defendant for wrongdoing. J&J \u003ca href=\"https://www.nytimes.com/2018/12/19/business/johnson-johnson-baby-powder-verdict.html\">failed \u003c/a>in December to convince a judge to throw out that verdict but told The Times it would appeal that decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Research, clinical evidence and nearly 40 years of studies by independent medical experts around the world continue to support the safety of talc,” the company \u003ca href=\"https://www.jnj.com/our-products/5-important-facts-about-the-safety-of-talc\">says\u003c/a>. “Talc does not cause cancer.”\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Johnson+%26+Johnson+Hit+With+%2429+Million+Verdict+In+Mesothelioma+Case&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A California woman who says Johnson & Johnson baby powder caused her to develop mesothelioma was awarded $29 million by a jury Wednesday. J&J says it will appeal the judgment.\u003c/p>\n\u003cp>The plaintiff, Terry Leavitt, said she regularly used two J&J products in the 1960s and ’70s containing talc. In 2017, she was diagnosed with mesothelioma, a kind of cancer linked to asbestos exposure.\u003c/p>\n\u003cp>After two days of deliberation, the jury found that J&J talc-based products were defective and caused Leavitt’s mesothelioma, and that the company had failed to warn consumers about the risks. The jury, in the California Superior Court in Oakland, awarded Leavitt and her husband $29.4 million in damages.\u003c/p>\n\u003cp>J&J faces thousands of lawsuits alleging its talc-based products harmed consumers. This suit is the first to go to trial since articles by Reuters and The New York Times alleged the company feared for years that its baby powder might contain asbestos. J&J denies that its talc powder contains asbestos or is responsible for health problems.\u003c/p>\n\u003cp>J&J said it would appeal, pointing to “serious procedural and evidentiary errors,” Reuters reported. “The jury verdicts are not medical, scientific or regulatory conclusions about a product,” it said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In December, documents came to light showing J&J \u003ca href=\"https://www.reuters.com/investigates/special-report/johnsonandjohnson-cancer/\">worried for decades\u003c/a> that its baby powder might be laced with small amounts of asbestos, which can occur naturally underground near talc. A company executive in the 1970s warned that J&J’s talc mines might not be free of asbestos. Some of its talc products sometimes contained materials that “might be classified as asbestos powder,” The \u003ca href=\"https://www.nytimes.com/2018/12/14/business/baby-powder-asbestos-johnson-johnson.html\">New York Times\u003c/a> reported, quoting an internal company memo.\u003c/p>\n\u003cp>Recent cases have focused on talc’s link to mesothelioma, but many additional cases allege the powder has caused ovarian cancer. All told, the pharmaceutical company faces more than 13,000 talc-related lawsuits nationwide, Reuters reports.\u003c/p>\n\u003cp>Last year, 22 women \u003ca href=\"https://www.npr.org/2018/07/13/628684038/jury-awards-4-7-billion-to-women-in-johnson-johnson-talcum-powder-suit\">were awarded\u003c/a> $4.7 billion after they sued J&J, alleging they developed ovarian cancer because of the company’s products. More than $4 billion of the jury award consisted of punitive damages, which are meant to punish a defendant for wrongdoing. J&J \u003ca href=\"https://www.nytimes.com/2018/12/19/business/johnson-johnson-baby-powder-verdict.html\">failed \u003c/a>in December to convince a judge to throw out that verdict but told The Times it would appeal that decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Research, clinical evidence and nearly 40 years of studies by independent medical experts around the world continue to support the safety of talc,” the company \u003ca href=\"https://www.jnj.com/our-products/5-important-facts-about-the-safety-of-talc\">says\u003c/a>. “Talc does not cause cancer.”\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Johnson+%26+Johnson+Hit+With+%2429+Million+Verdict+In+Mesothelioma+Case&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "High-Stakes Monsanto Trial Begins in S.F. Over Weed Killer Cancer Claims",
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"content": "\u003cp>A jury in federal court in San Francisco will decide whether Roundup weed killer caused a California man's cancer in a trial starting Monday. Plaintiffs' attorneys say the trial could help determine the fate of hundreds of similar lawsuits.\u003c/p>\n\u003cp>Edwin Hardeman, 70, is the second plaintiff to go to trial of thousands around the United States who claim agribusiness giant Monsanto's weed killer causes cancer.\u003c/p>\n\u003cp>Monsanto says studies have established that the active ingredient in Roundup, glyphosate, is safe.\u003c/p>\n\u003cp>\"There is a mountain of evidence,\" Hardeman's attorney, Brent Wisner, said outside court. \"This company needs to get straight and be honest with its customers and say, listen, there is evidence it's associated with cancer and let people make a choice about whether or not they use the product.\"\u003c/p>\n\u003cp>A San Francisco jury in August \u003ca href=\"https://www.kqed.org/science/1927142/san-francisco-jury-to-rule-whether-monsanto-caused-bay-area-mans-cancer\" rel=\"noopener\" target=\"_blank\">awarded another man $289 million \u003c/a>after determining Roundup caused his non-Hodgkin's lymphoma. A judge later slashed the award to $78 million, and Monsanto has appealed.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/science/1927142/san-francisco-jury-to-rule-whether-monsanto-caused-bay-area-mans-cancer\">Monsanto Found Guilty in Landmark Cancer Case Trial\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/science/1927142/san-francisco-jury-to-rule-whether-monsanto-caused-bay-area-mans-cancer\">\u003cimg src=\"https://ww2.kqed.org/wp-content/uploads/sites/35/2018/07/GettyImages-994931004-1180x824.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>Hardeman's trial is before a different judge and may be more significant. U.S. Judge Vince Chhabria is overseeing hundreds of Roundup lawsuits, and has deemed Hardeman's case and two others \"bellwether trials.\"\u003c/p>\n\u003cp>\"If we are able to succeed here then it really sends a signal to Monsanto and specifically to Bayer that they have a real problem,\" Wisner said.\u003c/p>\n\u003cp>The outcome of bellwether cases can help attorneys decide whether to continue fighting similar suits in court or settle them. A jury verdict in favor of Hardeman and the other test plaintiffs would give their attorneys a strong bargaining position in any settlement talks for the remaining cases before Chhabria, said David Levine, a professor at the University of California, Hastings College of the Law who has followed the Roundup litigation.\u003c/p>\n\u003cp>Thousands of \u003ca href=\"https://www.kqed.org/stateofhealth/361923/california-cracks-down-on-weed-killer-as-lawsuits-abound\">other Roundup lawsuits\u003c/a> are pending in state courts around the country.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many government regulators have rejected a link between cancer and glyphosate. Monsanto has vehemently denied such a connection, saying hundreds of studies have established that the chemical is safe.\u003c/p>\n\u003cp>Monsanto developed glyphosate in the 1970s, and the weed killer is now sold in more than 160 countries and widely used in the U.S.\u003c/p>\n\u003cp>The herbicide came under increasing scrutiny after the France-based International Agency for Research on Cancer, which is part of the World Health Organization, classified it as a \"probable human carcinogen\" in 2015.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/science/1920399/us-judge-blocks-weed-killer-warning-label-in-california\">U.S. Judge Blocks Weed-Killer Warning Label in California\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/science/1920399/us-judge-blocks-weed-killer-warning-label-in-california\">\u003cimg src=\"https://ww2.kqed.org/wp-content/uploads/sites/35/2018/02/GettyImages-899547980-1180x785.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>Lawsuits against Monsanto followed. Monsanto has attacked the international research agency's opinion as an outlier. The U.S. Environmental Protection Agency says glyphosate is safe for people when used in accordance with label directions.\u003c/p>\n\u003cp>Hardeman started using Roundup products to treat poison oak, overgrowth and weeds on his 56-acre Sonoma County property in the 1980s and continued using them through 2012, according to his attorneys. He was diagnosed with non-Hodgkin's lymphoma in 2015.\u003c/p>\n\u003cp>In a setback for Hardeman, Chhabria issued a ruling last month breaking his trial up into two phases. Hardeman's attorneys will first have to convince jurors that his use of Roundup caused his non-Hodgkin's lymphoma before they can make arguments for punitive damages.\u003c/p>\n\u003cp>The trial is expected to last about a month.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Edwin Hardeman, 70, is the second plaintiff to go to trial of thousands around the U.S. who claim agribusiness giant Monsanto's weed killer Roundup causes cancer. The judge has called it a ‘bellwether trial.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A jury in federal court in San Francisco will decide whether Roundup weed killer caused a California man's cancer in a trial starting Monday. Plaintiffs' attorneys say the trial could help determine the fate of hundreds of similar lawsuits.\u003c/p>\n\u003cp>Edwin Hardeman, 70, is the second plaintiff to go to trial of thousands around the United States who claim agribusiness giant Monsanto's weed killer causes cancer.\u003c/p>\n\u003cp>Monsanto says studies have established that the active ingredient in Roundup, glyphosate, is safe.\u003c/p>\n\u003cp>\"There is a mountain of evidence,\" Hardeman's attorney, Brent Wisner, said outside court. \"This company needs to get straight and be honest with its customers and say, listen, there is evidence it's associated with cancer and let people make a choice about whether or not they use the product.\"\u003c/p>\n\u003cp>A San Francisco jury in August \u003ca href=\"https://www.kqed.org/science/1927142/san-francisco-jury-to-rule-whether-monsanto-caused-bay-area-mans-cancer\" rel=\"noopener\" target=\"_blank\">awarded another man $289 million \u003c/a>after determining Roundup caused his non-Hodgkin's lymphoma. A judge later slashed the award to $78 million, and Monsanto has appealed.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/science/1927142/san-francisco-jury-to-rule-whether-monsanto-caused-bay-area-mans-cancer\">Monsanto Found Guilty in Landmark Cancer Case Trial\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/science/1927142/san-francisco-jury-to-rule-whether-monsanto-caused-bay-area-mans-cancer\">\u003cimg src=\"https://ww2.kqed.org/wp-content/uploads/sites/35/2018/07/GettyImages-994931004-1180x824.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>Hardeman's trial is before a different judge and may be more significant. U.S. Judge Vince Chhabria is overseeing hundreds of Roundup lawsuits, and has deemed Hardeman's case and two others \"bellwether trials.\"\u003c/p>\n\u003cp>\"If we are able to succeed here then it really sends a signal to Monsanto and specifically to Bayer that they have a real problem,\" Wisner said.\u003c/p>\n\u003cp>The outcome of bellwether cases can help attorneys decide whether to continue fighting similar suits in court or settle them. A jury verdict in favor of Hardeman and the other test plaintiffs would give their attorneys a strong bargaining position in any settlement talks for the remaining cases before Chhabria, said David Levine, a professor at the University of California, Hastings College of the Law who has followed the Roundup litigation.\u003c/p>\n\u003cp>Thousands of \u003ca href=\"https://www.kqed.org/stateofhealth/361923/california-cracks-down-on-weed-killer-as-lawsuits-abound\">other Roundup lawsuits\u003c/a> are pending in state courts around the country.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many government regulators have rejected a link between cancer and glyphosate. Monsanto has vehemently denied such a connection, saying hundreds of studies have established that the chemical is safe.\u003c/p>\n\u003cp>Monsanto developed glyphosate in the 1970s, and the weed killer is now sold in more than 160 countries and widely used in the U.S.\u003c/p>\n\u003cp>The herbicide came under increasing scrutiny after the France-based International Agency for Research on Cancer, which is part of the World Health Organization, classified it as a \"probable human carcinogen\" in 2015.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>\u003ca href=\"https://www.kqed.org/science/1920399/us-judge-blocks-weed-killer-warning-label-in-california\">U.S. Judge Blocks Weed-Killer Warning Label in California\u003c/a>\u003c/h3>\n\u003cfigure>\u003ca href=\"https://www.kqed.org/science/1920399/us-judge-blocks-weed-killer-warning-label-in-california\">\u003cimg src=\"https://ww2.kqed.org/wp-content/uploads/sites/35/2018/02/GettyImages-899547980-1180x785.jpg\" alt=\"\">\u003c/a>\u003c/figure>\n\u003c/aside>\n\u003cp>Lawsuits against Monsanto followed. Monsanto has attacked the international research agency's opinion as an outlier. The U.S. Environmental Protection Agency says glyphosate is safe for people when used in accordance with label directions.\u003c/p>\n\u003cp>Hardeman started using Roundup products to treat poison oak, overgrowth and weeds on his 56-acre Sonoma County property in the 1980s and continued using them through 2012, according to his attorneys. He was diagnosed with non-Hodgkin's lymphoma in 2015.\u003c/p>\n\u003cp>In a setback for Hardeman, Chhabria issued a ruling last month breaking his trial up into two phases. Hardeman's attorneys will first have to convince jurors that his use of Roundup caused his non-Hodgkin's lymphoma before they can make arguments for punitive damages.\u003c/p>\n\u003cp>The trial is expected to last about a month.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"disqusTitle": "Nobel Prize for 'Landmark' Cancer Research Conducted at UC Berkeley",
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"content": "\u003cp>https://www.youtube.com/watch?time_continue=899&v=ScuTG1bzSHY\u003c/p>\n\u003cp>The Nobel Prize in medicine was awarded Monday to two researchers from the United States and Japan for advances in discovering how the body’s immune system can fight off the scourge of cancer.[contextly_sidebar id=\"CWuF65jUQjKNMEH73SFwE7Eh0o965day\"]\u003c/p>\n\u003cp>The $1.01 million prize will be shared by James Allison and Tasuku Honjo.\u003c/p>\n\u003cp>Allison conducted his research at the University of California-Berkeley and is now at the M.D. Anderson cancer center in Houston. Honju works at Japan’s Kyoto University.\u003c/p>\n\u003cp>Their parallel work concerned proteins that act as brakes on the body’s immune system and it constitutes “a landmark in our fight against cancer,” said a statement from the Nobel Assembly of Sweden’s Karolinska Institute, which selects winners of the annual prestigious award.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Allison studied a known protein and developed the concept into a new treatment approach, while Honjo discovered a new protein that also operated as a brake on immune cells.\u003c/p>\n\u003cp>“I’m honored and humbled to receive this prestigious recognition,” Allison said in a statement released by the university’s MD Anderson Cancer Center in Houston, where he is a professor.\u003c/p>\n\u003cp>“A driving motivation for scientists is simply to push the frontiers of knowledge. I didn’t set out to study cancer, but to understand the biology of T cells, these incredible cells that travel our bodies and work to protect us,” he said.[contextly_sidebar id=\"TrEVYlEaRWGIwxl3wZCxQN7b50EP4tx2\"]\u003c/p>\n\u003cp>Allison takes care in his statement to give credit to “a succession of graduate students, postdoctoral fellows and colleagues at MD Anderson, the University of California, Berkeley, and Memorial Sloan Kettering Cancer Center” who joined in the research.\u003c/p>\n\u003cp>Allison’s and Honjo’s prize-winning work started in the 1990s and was part of significant advances in cancer immunotherapy.\u003c/p>\n\u003cp>“In some patients, this therapy is remarkably effective,” Jeremy Berg, editor-in-chief of the \u003cem>Science\u003c/em> family of journals, told The Associated Press. “The number of different types of cancers for which this approach to immunotherapy is being found to be effective in at least some patients continues to grow.”\u003c/p>\n\u003cp>Therapy developed from Honjo’s work led to long-term remission in patients with metastatic cancer that had been considered essentially untreatable, the Nobel Assembly said.[contextly_sidebar id=\"JxHmQ4y9gmGqrPe0YiiMCtrrGiOV1Oid\"]\u003c/p>\n\u003cp>Berg said that former President Jimmy Carter’s cancer, which had spread to his brain, was treated with one of the drugs developed from Honjo’s work.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The physics prize is to be announced Tuesday, followed by chemistry. The winner of the Nobel Peace Prize will be named Friday and the economics laureate will be announced next Monday. No literature prize is being given this year.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/ScuTG1bzSHY'\n title='//www.youtube.com/embed/ScuTG1bzSHY'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>The Nobel Prize in medicine was awarded Monday to two researchers from the United States and Japan for advances in discovering how the body’s immune system can fight off the scourge of cancer.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The $1.01 million prize will be shared by James Allison and Tasuku Honjo.\u003c/p>\n\u003cp>Allison conducted his research at the University of California-Berkeley and is now at the M.D. Anderson cancer center in Houston. Honju works at Japan’s Kyoto University.\u003c/p>\n\u003cp>Their parallel work concerned proteins that act as brakes on the body’s immune system and it constitutes “a landmark in our fight against cancer,” said a statement from the Nobel Assembly of Sweden’s Karolinska Institute, which selects winners of the annual prestigious award.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Allison studied a known protein and developed the concept into a new treatment approach, while Honjo discovered a new protein that also operated as a brake on immune cells.\u003c/p>\n\u003cp>“I’m honored and humbled to receive this prestigious recognition,” Allison said in a statement released by the university’s MD Anderson Cancer Center in Houston, where he is a professor.\u003c/p>\n\u003cp>“A driving motivation for scientists is simply to push the frontiers of knowledge. I didn’t set out to study cancer, but to understand the biology of T cells, these incredible cells that travel our bodies and work to protect us,” he said.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Allison takes care in his statement to give credit to “a succession of graduate students, postdoctoral fellows and colleagues at MD Anderson, the University of California, Berkeley, and Memorial Sloan Kettering Cancer Center” who joined in the research.\u003c/p>\n\u003cp>Allison’s and Honjo’s prize-winning work started in the 1990s and was part of significant advances in cancer immunotherapy.\u003c/p>\n\u003cp>“In some patients, this therapy is remarkably effective,” Jeremy Berg, editor-in-chief of the \u003cem>Science\u003c/em> family of journals, told The Associated Press. “The number of different types of cancers for which this approach to immunotherapy is being found to be effective in at least some patients continues to grow.”\u003c/p>\n\u003cp>Therapy developed from Honjo’s work led to long-term remission in patients with metastatic cancer that had been considered essentially untreatable, the Nobel Assembly said.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Berg said that former President Jimmy Carter’s cancer, which had spread to his brain, was treated with one of the drugs developed from Honjo’s work.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The physics prize is to be announced Tuesday, followed by chemistry. The winner of the Nobel Peace Prize will be named Friday and the economics laureate will be announced next Monday. No literature prize is being given this year.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>As he grew older, Dale Kunitomi paid closer attention to his health — and to his doctor’s advice. When he noticed rectal bleeding in 2010, he went to see his physician, who ordered a colonoscopy.[contextly_sidebar id=\"vc7B3eLIIv6aV3Hq5qcJq85a0z0PMqRC\"]\u003c/p>\n\u003cp>The diagnosis: colon cancer.\u003c/p>\n\u003cp>Kunitomi, now 74, underwent surgery, radiation and chemotherapy — and now he has been cancer-free for seven years. “The things that are said about early detection and living a healthy lifestyle are important,” said Kunitomi, a resident of Ventura County, Calif. “You are foolish if you don’t pay attention.”\u003c/p>\n\u003cp>Californians are living longer with most types of cancer, due to earlier detection and more effective treatments, according to\u003ca href=\"http://www.ucdmc.ucdavis.edu/publish/news/newsroom/13098\" target=\"_blank\" rel=\"noopener\"> new research\u003c/a> from the University of California-Davis. But racial, ethnic and socioeconomic disparities persist, the report found.\u003c/p>\n\u003cp>The study, published this month, shows that 65 percent of people diagnosed with cancer between 2006 and 2010 survived five years or more from the time their disease was discovered, up from 58 percent for those diagnosed between 1990 and 1994. The researchers drew from data on 1.4 million California adults diagnosed with 27 different kinds of cancer. They found improved survival rates for patients with all but five types of cancer.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Non-Latino whites had the highest five-year survival rate for all cancers combined, followed by Latinos — though Pacific Islanders and Asians, like Kunitomi, had the highest rates for 13 of the cancers studied, including breast, colon, liver and lung. African-Americans had the worst overall prognosis.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444171\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_over-time1-1020x747.png\" alt=\"\" width=\"640\" height=\"469\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-1020x747.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-160x117.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-800x586.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-768x563.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-960x703.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-240x176.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-375x275.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-520x381.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>The California numbers echo a national trend of significant improvement in cancer survival, one also tempered by racial and ethnic disparities. A recent analysis in the journal Cancer, which relied on death rather than survival rates, found a \u003ca href=\"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21460\" target=\"_blank\" rel=\"noopener\">26 percent decline in cancer mortality\u003c/a> in the United States between 1991 and 2015 — translating to nearly 2.4 million cancer deaths avoided. The study showed mortality rates declined for all the major cancers, including breast, colorectal and prostate.\u003c/p>\n\u003cp>Dr. Otis Brawley, one of the authors of that report and chief medical and scientific officer of the American Cancer Society, attributed the improvement to better screening, detection and treatment — and a decline in smoking. He said cancer deaths likely would drop even further if there were more equal access to prevention, diagnosis and treatment.[contextly_sidebar id=\"fmc02MyXuNyOxUDOEz7MyAsTaZY5UAeN\"]\u003c/p>\n\u003cp>Perhaps unsurprisingly, the UC-Davis data show that poor Californians don’t live as long with cancer as those of greater means. About three-quarters of the patients at the highest socioeconomic level, with all cancers combined, survived five years or more. Just over half the patients at the lowest levels lived that long. Age was also a major factor: The younger patients were at the time of the diagnosis, the better their chance of survival.\u003c/p>\n\u003cp>Separate research from UC-Davis, published in 2015, showed the impact of health insurance status: Uninsured patients and those on Medi-Cal — California’s version of the federal Medicaid program for low-income people — had worse cancer care and outcomes than people with private insurance.\u003c/p>\n\u003cp>The research published this month showed the most critical factor in survival was finding the cancer early, which the report said underscores the importance of screening. One hundred percent of breast cancer patients survived at least five years if their disease was detected at stage 1. Only 28 percent of patients lived that long if their cancer was found when it was at stage 4, the most advanced stage. Most types of cancer show similarly stark disparities.\u003c/p>\n\u003cp>Stages, which depend in part on the size of the tumor and whether the cancer has spread, are a gauge of how serious the disease is.\u003c/p>\n\u003cp>“The earlier things are picked up, the more likely it is that treatment is successful,” said Dr. Kenneth Kizer, senior author of the study and director of the UC-Davis Institute for Population Health Improvement.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444172\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-1020x708.png\" alt=\"\" width=\"640\" height=\"444\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-1020x708.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-160x111.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-800x555.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-768x533.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-960x667.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-240x167.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-375x260.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-520x361.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>Cancer screening and treatment for African-Americans lag behind other racial and ethnic groups, said Dr. Nancy Lee, who is on the board of Black Women’s Health Imperative, a national organization that seeks to improve the health of black women. Long-standing and sometimes unrecognized bias in the health care system disadvantages black patients in a way that can compromise their medical outcomes, said Lee, who previously led the cancer division of the U.S. Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>White women in California are more likely to get breast cancer, the most common cancer among women, but black women are more likely to die from it, the UC-Davis report found.[contextly_sidebar id=\"VH6Y1JhelA7uLcj4KfqvO237ZI6LRYmK\"]\u003c/p>\n\u003cp>Bobby Smith’s wife, an African-American, died 13 years ago after her breast cancer moved into her lymph nodes and eventually metastasized to her brain. Smith said he doesn’t believe doctors gave her all the information she needed to make the best decisions about her treatment. “Health care professionals treat and serve people of color differently,” said Smith, who lives in Los Angeles.\u003c/p>\n\u003cp>The UC-Davis report used data from the \u003ca href=\"http://www.ccrcal.org/\" target=\"_blank\" rel=\"noopener\">California Cancer Registry,\u003c/a> a repository of data on cancer patients dating to 1988 that contains information on patient demographics, diagnosis, initial treatment and outcomes.\u003c/p>\n\u003cp>The rates reported in the study measure “relative” survival, which represents survival in the absence of other causes of death. The study showed patients with prostate, breast, melanoma and uterine cancers had among the highest survival rates: More than 80 percent of them lived at least five years after their diagnosis.\u003c/p>\n\u003cp>Survival did not improve for patients with some cancers, including bladder, cervical and testicular. And fewer than 20 percent of patients with cancers of the lung, liver, pancreas and esophagus lived past five years.\u003c/p>\n\u003cp>For breast cancer patients, five-year survival improved from 85 percent among those diagnosed between 1990 and 1994 to 90 percent among those diagnosed between 2006 and 2010.\u003c/p>\n\u003cp>The patterns were similar for lung cancer, the second most commonly diagnosed cancer in California and the leading cause of cancer deaths nationwide. The disease tends to be diagnosed late, and patients with stage 4 cancer had just a 4 percent survival rate after five years.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444173\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-1020x708.png\" alt=\"\" width=\"640\" height=\"444\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-1020x708.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-160x111.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-800x555.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-768x533.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-960x667.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-240x167.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-375x260.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-520x361.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>Kizer of UC-Davis said new treatments offer great promise for cancer patients, but how much money they have and who their insurers are may well determine whether or not they reap the benefits.\u003c/p>\n\u003cp>Cancer is hard enough for people with means and education, said Susan Lasker Hertz, 61, a Colorado nurse who was diagnosed with stage 2 breast cancer in 2009 and then developed leukemia three years later. Hertz, who is now in remission from both cancers, said her knowledge and experience helped her navigate the health care system and get treated quickly after her diagnosis. But it wasn’t easy.\u003c/p>\n\u003cp>“I am an educated, white, highly knowledgeable health care professional,” she said, “and it is still overwhelming.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>KHN's coverage in California is supported in part by \u003ca href=\"http://www.blueshieldcafoundation.org/\" target=\"_blank\" rel=\"noopener\">Blue Shield of California Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As he grew older, Dale Kunitomi paid closer attention to his health — and to his doctor’s advice. When he noticed rectal bleeding in 2010, he went to see his physician, who ordered a colonoscopy.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The diagnosis: colon cancer.\u003c/p>\n\u003cp>Kunitomi, now 74, underwent surgery, radiation and chemotherapy — and now he has been cancer-free for seven years. “The things that are said about early detection and living a healthy lifestyle are important,” said Kunitomi, a resident of Ventura County, Calif. “You are foolish if you don’t pay attention.”\u003c/p>\n\u003cp>Californians are living longer with most types of cancer, due to earlier detection and more effective treatments, according to\u003ca href=\"http://www.ucdmc.ucdavis.edu/publish/news/newsroom/13098\" target=\"_blank\" rel=\"noopener\"> new research\u003c/a> from the University of California-Davis. But racial, ethnic and socioeconomic disparities persist, the report found.\u003c/p>\n\u003cp>The study, published this month, shows that 65 percent of people diagnosed with cancer between 2006 and 2010 survived five years or more from the time their disease was discovered, up from 58 percent for those diagnosed between 1990 and 1994. The researchers drew from data on 1.4 million California adults diagnosed with 27 different kinds of cancer. They found improved survival rates for patients with all but five types of cancer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Non-Latino whites had the highest five-year survival rate for all cancers combined, followed by Latinos — though Pacific Islanders and Asians, like Kunitomi, had the highest rates for 13 of the cancers studied, including breast, colon, liver and lung. African-Americans had the worst overall prognosis.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444171\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_over-time1-1020x747.png\" alt=\"\" width=\"640\" height=\"469\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-1020x747.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-160x117.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-800x586.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-768x563.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-960x703.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-240x176.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-375x275.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1-520x381.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_over-time1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>The California numbers echo a national trend of significant improvement in cancer survival, one also tempered by racial and ethnic disparities. A recent analysis in the journal Cancer, which relied on death rather than survival rates, found a \u003ca href=\"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21460\" target=\"_blank\" rel=\"noopener\">26 percent decline in cancer mortality\u003c/a> in the United States between 1991 and 2015 — translating to nearly 2.4 million cancer deaths avoided. The study showed mortality rates declined for all the major cancers, including breast, colorectal and prostate.\u003c/p>\n\u003cp>Dr. Otis Brawley, one of the authors of that report and chief medical and scientific officer of the American Cancer Society, attributed the improvement to better screening, detection and treatment — and a decline in smoking. He said cancer deaths likely would drop even further if there were more equal access to prevention, diagnosis and treatment.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Perhaps unsurprisingly, the UC-Davis data show that poor Californians don’t live as long with cancer as those of greater means. About three-quarters of the patients at the highest socioeconomic level, with all cancers combined, survived five years or more. Just over half the patients at the lowest levels lived that long. Age was also a major factor: The younger patients were at the time of the diagnosis, the better their chance of survival.\u003c/p>\n\u003cp>Separate research from UC-Davis, published in 2015, showed the impact of health insurance status: Uninsured patients and those on Medi-Cal — California’s version of the federal Medicaid program for low-income people — had worse cancer care and outcomes than people with private insurance.\u003c/p>\n\u003cp>The research published this month showed the most critical factor in survival was finding the cancer early, which the report said underscores the importance of screening. One hundred percent of breast cancer patients survived at least five years if their disease was detected at stage 1. Only 28 percent of patients lived that long if their cancer was found when it was at stage 4, the most advanced stage. Most types of cancer show similarly stark disparities.\u003c/p>\n\u003cp>Stages, which depend in part on the size of the tumor and whether the cancer has spread, are a gauge of how serious the disease is.\u003c/p>\n\u003cp>“The earlier things are picked up, the more likely it is that treatment is successful,” said Dr. Kenneth Kizer, senior author of the study and director of the UC-Davis Institute for Population Health Improvement.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444172\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-1020x708.png\" alt=\"\" width=\"640\" height=\"444\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-1020x708.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-160x111.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-800x555.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-768x533.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-960x667.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-240x167.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-375x260.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1-520x361.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_breast-cancer1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>Cancer screening and treatment for African-Americans lag behind other racial and ethnic groups, said Dr. Nancy Lee, who is on the board of Black Women’s Health Imperative, a national organization that seeks to improve the health of black women. Long-standing and sometimes unrecognized bias in the health care system disadvantages black patients in a way that can compromise their medical outcomes, said Lee, who previously led the cancer division of the U.S. Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>White women in California are more likely to get breast cancer, the most common cancer among women, but black women are more likely to die from it, the UC-Davis report found.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Bobby Smith’s wife, an African-American, died 13 years ago after her breast cancer moved into her lymph nodes and eventually metastasized to her brain. Smith said he doesn’t believe doctors gave her all the information she needed to make the best decisions about her treatment. “Health care professionals treat and serve people of color differently,” said Smith, who lives in Los Angeles.\u003c/p>\n\u003cp>The UC-Davis report used data from the \u003ca href=\"http://www.ccrcal.org/\" target=\"_blank\" rel=\"noopener\">California Cancer Registry,\u003c/a> a repository of data on cancer patients dating to 1988 that contains information on patient demographics, diagnosis, initial treatment and outcomes.\u003c/p>\n\u003cp>The rates reported in the study measure “relative” survival, which represents survival in the absence of other causes of death. The study showed patients with prostate, breast, melanoma and uterine cancers had among the highest survival rates: More than 80 percent of them lived at least five years after their diagnosis.\u003c/p>\n\u003cp>Survival did not improve for patients with some cancers, including bladder, cervical and testicular. And fewer than 20 percent of patients with cancers of the lung, liver, pancreas and esophagus lived past five years.\u003c/p>\n\u003cp>For breast cancer patients, five-year survival improved from 85 percent among those diagnosed between 1990 and 1994 to 90 percent among those diagnosed between 2006 and 2010.\u003c/p>\n\u003cp>The patterns were similar for lung cancer, the second most commonly diagnosed cancer in California and the leading cause of cancer deaths nationwide. The disease tends to be diagnosed late, and patients with stage 4 cancer had just a 4 percent survival rate after five years.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-large wp-image-444173\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-1020x708.png\" alt=\"\" width=\"640\" height=\"444\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-1020x708.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-160x111.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-800x555.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-768x533.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-960x667.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-240x167.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-375x260.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1-520x361.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/08/cancer-survival_lung-cancer1.png 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/p>\n\u003cp>Kizer of UC-Davis said new treatments offer great promise for cancer patients, but how much money they have and who their insurers are may well determine whether or not they reap the benefits.\u003c/p>\n\u003cp>Cancer is hard enough for people with means and education, said Susan Lasker Hertz, 61, a Colorado nurse who was diagnosed with stage 2 breast cancer in 2009 and then developed leukemia three years later. Hertz, who is now in remission from both cancers, said her knowledge and experience helped her navigate the health care system and get treated quickly after her diagnosis. But it wasn’t easy.\u003c/p>\n\u003cp>“I am an educated, white, highly knowledgeable health care professional,” she said, “and it is still overwhelming.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>KHN's coverage in California is supported in part by \u003ca href=\"http://www.blueshieldcafoundation.org/\" target=\"_blank\" rel=\"noopener\">Blue Shield of California Foundation.\u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>State officials, having concluded coffee drinking is not a risky pastime, are proposing a regulation that will essentially tell consumers of America’s favorite beverage they can drink up without fear.\u003c/p>\n\u003cp>The unprecedented action Friday by the Office of Environmental Health Hazard Assessment to propose a regulation to clear coffee of the stigma that it could pose a toxic risk followed a review of more than 1,000 studies published this week by the World Health Organization that found inadequate evidence that coffee causes cancer.\u003c/p>\n\u003cp>The state agency implements a law passed by voters in 1986 that requires warnings of chemicals known to cause cancer and birth defects. One of those chemicals is acrylamide, which is found in many things and is a byproduct of coffee roasting and brewing present in every cup of joe.\u003c/p>\n\u003cp>If the regulation is adopted, it would be a huge win for the coffee industry which faces potentially massive civil penalties after recently losing an \u003ca href=\"https://www.kqed.org/bayareabites/126358/fact-check-calif-judge-rules-coffee-must-come-with-a-cancer-warning-but-should-it\" rel=\"noopener\" target=\"_blank\">8-year-old lawsuit\u003c/a> in Los Angeles Superior Court that \u003ca href=\"https://www.kqed.org/science/1921850/california-judge-coffee-needs-cancer-warnings\" rel=\"noopener\" target=\"_blank\">could require scary warnings on all coffee packaging sold in California\u003c/a>.\u003c/p>\n\u003cp>Judge Elihu Berle found that Starbucks and other coffee roasters and retailers had failed to show that benefits from drinking coffee outweighed any cancer risks. He had previously ruled the companies hadn’t shown the threat from the chemical was insignificant.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The state’s action rejects that ruling.\u003c/p>\n\u003cp>“The proposed regulation would state that drinking coffee does not pose a significant cancer risk, despite the presence of chemicals created during the roasting and brewing process that are listed under Proposition 65 as known carcinogens,” the agency said in a statement. “The proposed regulation is based on extensive scientific evidence that drinking coffee has not been shown to increase the risk of cancer and may reduce the risk of some types of cancer.”\u003c/p>\n\u003cp>Attorney Raphael Metzger, who won the court case on behalf of The Council for Education and Research on Toxics, said he was shocked the agency would move to nullify the court decision and undermine its own report more than a decade ago that drinking even small amounts of coffee resulted in a significant cancer risk.\u003c/p>\n\u003cp>“The takeaway is that the state is proposing a rule contrary to its own scientific conclusion. That’s unprecedented and bad,” Metzger said. “The whole thing stinks to high hell.”\u003c/p>\n\u003cp>The National Coffee Association had no comment on the proposed change. In the past, the organization has said coffee has health benefits and that the lawsuit made a mockery of the state law intended to protect people from toxics.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/science/1921948/science-says-what-we-know-about-cancer-risk-and-coffee\" rel=\"noopener\" target=\"_blank\">Scientific evidence on coffee has gone back and forth over many years\u003c/a>, but concerns have eased recently about possible dangers, with some studies finding health benefits.\u003c/p>\n\u003cp>Big Coffee didn’t deny that acrylamide was found in the coffee, but argued it was only found at low levels and was outweighed by other benefits such as antioxidants that reduce cancer risk.\u003c/p>\n\u003cp>The state agency’s action comes about a week after bipartisan bills were introduced in both houses of Congress to require science-based criteria for labels on food and other products. One of the sponsors, Rep. Kurt Schrader, D-Oregon, alluded to the California coffee lawsuit as an example of misleading warnings.\u003c/p>\n\u003cp>“When we have mandatory cancer warnings on a cup of coffee, something has gone seriously wrong with the process,” Schrader said in a news release. “We now have so many warnings unrelated to the actual health risk posed to consumers, that most people just ignore them.”\u003c/p>\n\u003cp>The lawsuit against Starbucks and 90 companies was brought by the tiny nonprofit under a law that allows private citizens, advocacy groups and attorneys to sue on behalf of the state and collect a portion of civil penalties for failure to provide warnings.\u003c/p>\n\u003cp>The Safe Drinking Water and Toxic Enforcement Act, better known as Proposition 65, requires warning labels for about 900 chemicals known to cause cancer or birth defects.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The law has been credited with reducing cancer-causing chemicals, but it has been criticized for leading to quick settlement shakedowns and vague warnings that are often ignored.\u003c/p>\n\n",
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"excerpt": "State health officials proposed a regulation change that would declare coffee doesn't present a significant cancer risk, countering a recent state court ruling that had shaken up some coffee drinkers. ",
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"title": "State Moves to Clear Coffee of Cancer-Risk Stigma | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>State officials, having concluded coffee drinking is not a risky pastime, are proposing a regulation that will essentially tell consumers of America’s favorite beverage they can drink up without fear.\u003c/p>\n\u003cp>The unprecedented action Friday by the Office of Environmental Health Hazard Assessment to propose a regulation to clear coffee of the stigma that it could pose a toxic risk followed a review of more than 1,000 studies published this week by the World Health Organization that found inadequate evidence that coffee causes cancer.\u003c/p>\n\u003cp>The state agency implements a law passed by voters in 1986 that requires warnings of chemicals known to cause cancer and birth defects. One of those chemicals is acrylamide, which is found in many things and is a byproduct of coffee roasting and brewing present in every cup of joe.\u003c/p>\n\u003cp>If the regulation is adopted, it would be a huge win for the coffee industry which faces potentially massive civil penalties after recently losing an \u003ca href=\"https://www.kqed.org/bayareabites/126358/fact-check-calif-judge-rules-coffee-must-come-with-a-cancer-warning-but-should-it\" rel=\"noopener\" target=\"_blank\">8-year-old lawsuit\u003c/a> in Los Angeles Superior Court that \u003ca href=\"https://www.kqed.org/science/1921850/california-judge-coffee-needs-cancer-warnings\" rel=\"noopener\" target=\"_blank\">could require scary warnings on all coffee packaging sold in California\u003c/a>.\u003c/p>\n\u003cp>Judge Elihu Berle found that Starbucks and other coffee roasters and retailers had failed to show that benefits from drinking coffee outweighed any cancer risks. He had previously ruled the companies hadn’t shown the threat from the chemical was insignificant.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The state’s action rejects that ruling.\u003c/p>\n\u003cp>“The proposed regulation would state that drinking coffee does not pose a significant cancer risk, despite the presence of chemicals created during the roasting and brewing process that are listed under Proposition 65 as known carcinogens,” the agency said in a statement. “The proposed regulation is based on extensive scientific evidence that drinking coffee has not been shown to increase the risk of cancer and may reduce the risk of some types of cancer.”\u003c/p>\n\u003cp>Attorney Raphael Metzger, who won the court case on behalf of The Council for Education and Research on Toxics, said he was shocked the agency would move to nullify the court decision and undermine its own report more than a decade ago that drinking even small amounts of coffee resulted in a significant cancer risk.\u003c/p>\n\u003cp>“The takeaway is that the state is proposing a rule contrary to its own scientific conclusion. That’s unprecedented and bad,” Metzger said. “The whole thing stinks to high hell.”\u003c/p>\n\u003cp>The National Coffee Association had no comment on the proposed change. In the past, the organization has said coffee has health benefits and that the lawsuit made a mockery of the state law intended to protect people from toxics.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/science/1921948/science-says-what-we-know-about-cancer-risk-and-coffee\" rel=\"noopener\" target=\"_blank\">Scientific evidence on coffee has gone back and forth over many years\u003c/a>, but concerns have eased recently about possible dangers, with some studies finding health benefits.\u003c/p>\n\u003cp>Big Coffee didn’t deny that acrylamide was found in the coffee, but argued it was only found at low levels and was outweighed by other benefits such as antioxidants that reduce cancer risk.\u003c/p>\n\u003cp>The state agency’s action comes about a week after bipartisan bills were introduced in both houses of Congress to require science-based criteria for labels on food and other products. One of the sponsors, Rep. Kurt Schrader, D-Oregon, alluded to the California coffee lawsuit as an example of misleading warnings.\u003c/p>\n\u003cp>“When we have mandatory cancer warnings on a cup of coffee, something has gone seriously wrong with the process,” Schrader said in a news release. “We now have so many warnings unrelated to the actual health risk posed to consumers, that most people just ignore them.”\u003c/p>\n\u003cp>The lawsuit against Starbucks and 90 companies was brought by the tiny nonprofit under a law that allows private citizens, advocacy groups and attorneys to sue on behalf of the state and collect a portion of civil penalties for failure to provide warnings.\u003c/p>\n\u003cp>The Safe Drinking Water and Toxic Enforcement Act, better known as Proposition 65, requires warning labels for about 900 chemicals known to cause cancer or birth defects.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The law has been credited with reducing cancer-causing chemicals, but it has been criticized for leading to quick settlement shakedowns and vague warnings that are often ignored.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Should Insurance Companies Have to Cover Fertility Treatments for Cancer Patients?",
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"content": "\u003cp>When Alice Crisci was only 31 years old and working as a management consultant in Los Angeles, she was diagnosed with breast cancer.\u003c/p>\n\u003cp>Then, just as that was sinking in, her doctor gave her more bad news: It was highly likely that chemotherapy would leave her infertile.\u003c/p>\n\u003cp>Crisci had always wanted to have children. But the \u003ca href=\"https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/fertility-and-women-with-cancer/how-cancer-treatments-affect-fertility.html\" target=\"_blank\" rel=\"noopener\">chemotherapy, radiation and surgery\u003c/a> could destroy her eggs and compromise her reproductive system.\u003c/p>\n\u003cp>Plus, she was about to spend years on powerful anti-tumor medications — taking away from her prime years for getting pregnant. Her doctors were eager to schedule surgery and start chemotherapy, and she needed to plan quickly.\u003c/p>\n\u003cp>Her 2008 diagnosis kicked off a flurry of research and high-stakes decisions.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003cspan style=\"font-size: x-large\">‘\u003cstrong>I had to decide on surgery, \u003c/strong>decide on the type of reconstruction, decide on the type of treatment in terms of chemo and the follow-up, and decide on fertility preservation, decide on a sperm donor.’\u003c/span>\u003ccite>Alice Crisci\u003c/cite>\u003c/aside>\n\u003cp>“I had to decide on surgery, decide on the type of reconstruction, decide on the type of treatment in terms of chemo and the follow-up, and decide on fertility preservation, decide on a sperm donor,” said Crisci, who is 41.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“It’s not just so simple as to do a lumpectomy or a mastectomy. Do I do a single or a double? Do I do fertility preservation or not? Do I do eggs alone or eggs and embryos? Do I split my cycle?”\u003c/p>\n\u003ch2>A lifetime of big decisions\u003c/h2>\n\u003cp>It’s like this for a lot of cancer patients in their childbearing years — a lifetime of big decisions crammed into a couple of weeks, while oncologists urge them to hurry up, schedule surgery and begin chemo.\u003c/p>\n\u003cp>It used to be that cancer patients gave up on having children of their own, but with technological advances in reproductive medicine, there are options now. Many younger patients go through treatments to preserve their fertility; they extract eggs, bank sperm and freeze embryos.\u003c/p>\n\u003cp>But when cancer patients want a chance at parenthood, who pays for the expensive treatments?\u003c/p>\n\u003ch2>Who pays?\u003c/h2>\n\u003cp>Many states are \u003ca href=\"http://www.allianceforfertilitypreservation.org/advocacy/state-legislation\" target=\"_blank\" rel=\"noopener\">considering legislation\u003c/a> to require insurance companies to cover fertility preservation for cancer patients. California has so far left these decisions up to health insurance companies and state regulators. Patient advocates and doctors say that’s not fair to vulnerable cancer patients who want a chance at parenthood.\u003c/p>\n\u003cp>Crisci was determined to get through her cancer treatment and become a mom someday, but there was more bad news — the cost. Her insurance would pay for the surgery and chemo, but not for the hormone injections, egg extraction and the yearly fees for storing materials until she was healthy enough to try for a baby.\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/futureofyou/442280/new-cancer-care-dilemma-patients-want-immunotherapy-even-when-evidence-is-lacking\" target=\"_blank\" rel=\"noopener\">New Cancer Care Dilemma: Patients Want Immunotherapy Even When Evidence Is Lacking\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>For men who get cancer, preserving sperm is just a couple of thousand dollars. But when it comes to reproduction, human anatomy isn’t fair.\u003c/p>\n\u003cp>“It was a $20,000 expense I put on a credit card,” Crisci said, adding that it was never even a question to her whether or not to take the financial risk.\u003c/p>\n\u003cp>When Crisci told her live-in boyfriend they had to work fast to freeze embryos, he balked, and they broke up. Now, she also had to choose a sperm donor too.\u003c/p>\n\u003cp>Crisci was lucky. She had health insurance and a good salary to pay back the debt she took on for fertility treatment. But she and other cancer patient advocates worry about how other young women just starting out in life without savings or credit will come up with the money needed for these treatments.\u003c/p>\n\u003ch2>Expensive treatments\u003c/h2>\n\u003cp>“Those costs are high for anyone — IVF, fertility treatments. It’s a challenging time, even more challenging financially,” said Joyce Reinecke, executive director of the Alliance for Fertility Preservation, a national organization based in the East Bay. “For a young person who maybe hasn’t been working that long or is in college, it’s not feasible. They don’t have that choice to make if they don’t have that money.”\u003c/p>\n\u003cp>Reinecke was just married when she found out she had cancer. Now she has twin teenage daughters who are graduating from high school, but she remembers how daunting it felt to be fighting a deadly disease and trying to plan for a future she might not have.\u003c/p>\n\u003cp>For a long time, insurance companies didn’t cover infertility, or even consider it a disease. Now, the same treatments that preserve a cancer patient’s fertility are often still lumped together with elective treatments paid for out of pocket.\u003c/p>\n\u003ch2>Luxury vs. quality of life\u003c/h2>\n\u003cp>“People saw this, I think, in part as more of a luxury thing whereas we see it as kind of part of one of the core values in medicine. We’re trying to help people’s quality of life — their ability to have a family,” said Dr. Joseph Letourneau, a reproductive medicine specialist at UCSF’s Center for Reproductive Medicine.\u003c/p>\n\u003cp>Patient advocates and doctors say insurance coverage and regulations need to catch up with medical technology and cover fertility preservation for cancer patients.\u003c/p>\n\u003cp>“This is medically necessary, and these services now, such as sperm banking and egg freezing, are really standard medical procedures and they are part of the standard of cancer care,” Reinecke said.\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/stateofhealth/323065/hype-offers-hope-and-risks-to-cancer-patients\" target=\"_blank\" rel=\"noopener\">Hype Offers Hope — and Risks — to Cancer Patients\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>She has worked to pass laws that require insurance companies to cover fertility preservation. She has \u003ca href=\"http://www.allianceforfertilitypreservation.org/advocacy/state-legislation\" target=\"_blank\" rel=\"noopener\">succeeded in three states\u003c/a> (Maryland, Connecticut and Rhode Island), but not California.\u003c/p>\n\u003cp>Reinecke said signing fertility preservation coverage into law would give all cancer patients, not just the rich ones, an equal chance at fertility treatments.\u003c/p>\n\u003cp>In Sacramento, three fertility preservation bills were introduced in the state Legislature. One made it as far as Gov. Jerry Brown’s desk \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201320140AB912\" target=\"_blank\" rel=\"noopener\">in 2013\u003c/a>, but he \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2017/09/2013_AB_912_Veto_Message.pdf\" target=\"_blank\" rel=\"noopener\">vetoed it\u003c/a>, saying he was reluctant to mandate any new insurance benefits just as Obamacare was coming into effect.\u003c/p>\n\u003ch2>Appeal and hope\u003c/h2>\n\u003cp>After the most recent attempt \u003ca href=\"https://californiahealthline.org/news/preserving-fertility-when-it-is-threatened-by-life-saving-medicine/\" target=\"_blank\" rel=\"noopener\">last year\u003c/a>, patient advocates decided to give up on new legislation and instead try to use existing regulations to get fertility preservation covered.\u003c/p>\n\u003cp>“This is a basic health care service that is medically necessary and therefore is covered. Then, whether an individual patient or not is entitled to that coverage, based on the medical facts of their case, is what’s at hand,” Reinecke said.\u003c/p>\n\u003cp>State regulators say when insurance companies deny coverage, patients can file an appeal with the California Department of Managed Health Care in Sacramento, which regulates HMOs to make sure medically necessary basic health care services are covered. This appeals process, called an \u003ca href=\"https://www.dmhc.ca.gov/fileacomplaint/independentmedicalreviewandcomplaintreports.aspx\" target=\"_blank\" rel=\"noopener\">Independent Medical Review,\u003c/a> requires patients to just fill out an \u003ca href=\"https://www.dmhc.ca.gov/fileacomplaint/submitanindependentmedicalreviewcomplaintform.aspx\" target=\"_blank\" rel=\"noopener\">online form\u003c/a>.\u003c/p>\n\u003cp>Filing an appeal is free, but it still requires patients to pay thousands of dollars out of pocket for fertility preservation treatments, and hope they get reimbursed later by their insurance companies.\u003c/p>\n\u003cp>Time-sensitive appeals are supposed to be expedited and completed within a week, but doctors like Letourneau say it usually takes a couple of months to get a decision. Letourneau said when he walks patients through this process, he spends a lot of time on the phone with them trying to ease their worries about cancer treatment, fertility choices and financial risks.\u003c/p>\n\u003cp>So far, the handful of Californians who have filed these appeals have won. But they still have to wait even longer for their insurance company to reimburse them.\u003c/p>\n\u003cp>Letourneau said the appeals process if flawed because it serves only patients who have the time, money and savvy to try to overturn their insurance company’s decision. He worries about the many cancer patients who can’t afford to try or may not even know that an appeal is an option.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003cspan style=\"font-size: x-large\">‘\u003cstrong>For people who don’t have those resources, you might not be able to count on hope\u003c/strong>, and you might then just not be able to have children, and that’s just wrong.’\u003c/span>\u003ccite>Dr. Adams Dudley\u003c/cite>\u003c/aside>\n\u003cp>“Their cancer provider might look at them and say, ‘Gosh, I don’t want to provide them the false hope that they could go freeze their eggs when it’s going to be an out-of-pocket expense of $8,000 and I know they don’t have that.’ So why bring it up?” he said.\u003c/p>\n\u003cp>Oncologists and reproductive specialists are working together to serve patients, Letourneau said, and he’s hopeful that better coverage would mean \u003ca href=\"https://academic.oup.com/jnci/article/107/10/djv202/986599\" target=\"_blank\" rel=\"noopener\">more patients choose to treat their cancer more aggressively \u003c/a>— that they’ll feel better about taking anti-tumor medication longer, knowing there’s hope they can still get pregnant later on.\u003c/p>\n\u003cp>The Department of Managed Health Care stands by the appeals process, declining to answer questions about the many cancer patients who don’t have the time or money to file an appeal.\u003c/p>\n\u003ch2>‘Cancer Patients Often Don’t Have Time’\u003c/h2>\n\u003cp>A couple of months is an eternity when you’re treating cancer, according to Dr. Adams Dudley, a health policy expert with UCSF.\u003c/p>\n\u003cp>“For people who don’t have those resources, you might not be able to count on hope, and you might then just not be able to have children, and that’s just wrong,” Dudley said.\u003c/p>\n\u003cp>Patients shouldn’t be forced to choose between fighting cancer aggressively, the chance to have children and going into debt to preserve their fertility, he said.\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/futureofyou/442273/therapy-made-from-patients-immune-system-shows-promise-for-advanced-breast-cancer\" target=\"_blank\" rel=\"noopener\">Therapy Made From Patient’s Immune System Shows Promise For Advanced Breast Cancer\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>Dudley argues that leaving these decisions up to state regulators and a slow-moving bureaucracy isn’t fair to the vast majority of patients who don’t have thousands of dollars to risk on the chance of bearing their own children someday. And it means that everyone who’d benefit from extracting eggs isn’t getting the chance to do so, he said.\u003c/p>\n\u003cp>“The problem with this appeals process is that it takes time, and cancer patients often don’t have time. Particularly the kinds of cancers that people of childbearing age get can be really aggressive, really terrible things that you need to get into and treat right away,” Dudley said.\u003c/p>\n\u003cp>The delay in covering an effective but expensive treatment is common in the field of reproductive health, Dudley added.\u003c/p>\n\u003cp>“If there were a new treatment that allowed you to have some really good outcome in almost any other disease, there wouldn’t be an issue of whether or not it would be covered. We’d just cover it. We wouldn’t say, ‘Oh, there are new chemotherapies that really improve your survival from cancer, but you can’t have them because they’re too expensive.’ We don’t do that generally. But we tend to treat reproductive health and mental health differently,” he said.\u003c/p>\n\u003cp>Dudley said state regulators and politicians should realize that the way insurers — governed by state regulators — treat reproductive health and fertility preservation has a huge impact on the lives of cancer patients.\u003c/p>\n\u003ch2>A happy ending for Alice\u003c/h2>\n\u003cp>For Alice Crisci, going into debt to pay for fertility treatment helped her get through the dark, lonely moments soon after her diagnosis. With each expensive injection of hormones, she was banking on the fact that her body still worked and that she would beat cancer, resume a normal life and eventually have a baby.\u003c/p>\n\u003cp>“The injections were a little bit painful, but I was in control. I was the one who got to do it. Nobody was doing it to me. And I felt like I was stimulating life force,” she said.\u003c/p>\n\u003cp>Crisci’s story has a happy ending. She’s an \u003ca href=\"http://www.fertileaction.org/about/alices-story/\" target=\"_blank\" rel=\"noopener\">entrepreneur\u003c/a> living in San Carlos, and single mom to a curly-headed 4-year-old named Dante.\u003c/p>\n\u003cp>“I named him Dante because it means enduring. We certainly endured a lot to get to be together,” she said.\u003c/p>\n\u003cp>Crisci and other advocates want other cancer patients to have a chance at parenthood, too.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Since January, they’ve been pressing state regulators to issue a formal letter telling insurers that California considers fertility preservation to be medically necessary and therefore should be covered.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Alice Crisci was only 31 years old and working as a management consultant in Los Angeles, she was diagnosed with breast cancer.\u003c/p>\n\u003cp>Then, just as that was sinking in, her doctor gave her more bad news: It was highly likely that chemotherapy would leave her infertile.\u003c/p>\n\u003cp>Crisci had always wanted to have children. But the \u003ca href=\"https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/fertility-and-women-with-cancer/how-cancer-treatments-affect-fertility.html\" target=\"_blank\" rel=\"noopener\">chemotherapy, radiation and surgery\u003c/a> could destroy her eggs and compromise her reproductive system.\u003c/p>\n\u003cp>Plus, she was about to spend years on powerful anti-tumor medications — taking away from her prime years for getting pregnant. Her doctors were eager to schedule surgery and start chemotherapy, and she needed to plan quickly.\u003c/p>\n\u003cp>Her 2008 diagnosis kicked off a flurry of research and high-stakes decisions.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003cspan style=\"font-size: x-large\">‘\u003cstrong>I had to decide on surgery, \u003c/strong>decide on the type of reconstruction, decide on the type of treatment in terms of chemo and the follow-up, and decide on fertility preservation, decide on a sperm donor.’\u003c/span>\u003ccite>Alice Crisci\u003c/cite>\u003c/aside>\n\u003cp>“I had to decide on surgery, decide on the type of reconstruction, decide on the type of treatment in terms of chemo and the follow-up, and decide on fertility preservation, decide on a sperm donor,” said Crisci, who is 41.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“It’s not just so simple as to do a lumpectomy or a mastectomy. Do I do a single or a double? Do I do fertility preservation or not? Do I do eggs alone or eggs and embryos? Do I split my cycle?”\u003c/p>\n\u003ch2>A lifetime of big decisions\u003c/h2>\n\u003cp>It’s like this for a lot of cancer patients in their childbearing years — a lifetime of big decisions crammed into a couple of weeks, while oncologists urge them to hurry up, schedule surgery and begin chemo.\u003c/p>\n\u003cp>It used to be that cancer patients gave up on having children of their own, but with technological advances in reproductive medicine, there are options now. Many younger patients go through treatments to preserve their fertility; they extract eggs, bank sperm and freeze embryos.\u003c/p>\n\u003cp>But when cancer patients want a chance at parenthood, who pays for the expensive treatments?\u003c/p>\n\u003ch2>Who pays?\u003c/h2>\n\u003cp>Many states are \u003ca href=\"http://www.allianceforfertilitypreservation.org/advocacy/state-legislation\" target=\"_blank\" rel=\"noopener\">considering legislation\u003c/a> to require insurance companies to cover fertility preservation for cancer patients. California has so far left these decisions up to health insurance companies and state regulators. Patient advocates and doctors say that’s not fair to vulnerable cancer patients who want a chance at parenthood.\u003c/p>\n\u003cp>Crisci was determined to get through her cancer treatment and become a mom someday, but there was more bad news — the cost. Her insurance would pay for the surgery and chemo, but not for the hormone injections, egg extraction and the yearly fees for storing materials until she was healthy enough to try for a baby.\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/futureofyou/442280/new-cancer-care-dilemma-patients-want-immunotherapy-even-when-evidence-is-lacking\" target=\"_blank\" rel=\"noopener\">New Cancer Care Dilemma: Patients Want Immunotherapy Even When Evidence Is Lacking\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>For men who get cancer, preserving sperm is just a couple of thousand dollars. But when it comes to reproduction, human anatomy isn’t fair.\u003c/p>\n\u003cp>“It was a $20,000 expense I put on a credit card,” Crisci said, adding that it was never even a question to her whether or not to take the financial risk.\u003c/p>\n\u003cp>When Crisci told her live-in boyfriend they had to work fast to freeze embryos, he balked, and they broke up. Now, she also had to choose a sperm donor too.\u003c/p>\n\u003cp>Crisci was lucky. She had health insurance and a good salary to pay back the debt she took on for fertility treatment. But she and other cancer patient advocates worry about how other young women just starting out in life without savings or credit will come up with the money needed for these treatments.\u003c/p>\n\u003ch2>Expensive treatments\u003c/h2>\n\u003cp>“Those costs are high for anyone — IVF, fertility treatments. It’s a challenging time, even more challenging financially,” said Joyce Reinecke, executive director of the Alliance for Fertility Preservation, a national organization based in the East Bay. “For a young person who maybe hasn’t been working that long or is in college, it’s not feasible. They don’t have that choice to make if they don’t have that money.”\u003c/p>\n\u003cp>Reinecke was just married when she found out she had cancer. Now she has twin teenage daughters who are graduating from high school, but she remembers how daunting it felt to be fighting a deadly disease and trying to plan for a future she might not have.\u003c/p>\n\u003cp>For a long time, insurance companies didn’t cover infertility, or even consider it a disease. Now, the same treatments that preserve a cancer patient’s fertility are often still lumped together with elective treatments paid for out of pocket.\u003c/p>\n\u003ch2>Luxury vs. quality of life\u003c/h2>\n\u003cp>“People saw this, I think, in part as more of a luxury thing whereas we see it as kind of part of one of the core values in medicine. We’re trying to help people’s quality of life — their ability to have a family,” said Dr. Joseph Letourneau, a reproductive medicine specialist at UCSF’s Center for Reproductive Medicine.\u003c/p>\n\u003cp>Patient advocates and doctors say insurance coverage and regulations need to catch up with medical technology and cover fertility preservation for cancer patients.\u003c/p>\n\u003cp>“This is medically necessary, and these services now, such as sperm banking and egg freezing, are really standard medical procedures and they are part of the standard of cancer care,” Reinecke said.\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/stateofhealth/323065/hype-offers-hope-and-risks-to-cancer-patients\" target=\"_blank\" rel=\"noopener\">Hype Offers Hope — and Risks — to Cancer Patients\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>She has worked to pass laws that require insurance companies to cover fertility preservation. She has \u003ca href=\"http://www.allianceforfertilitypreservation.org/advocacy/state-legislation\" target=\"_blank\" rel=\"noopener\">succeeded in three states\u003c/a> (Maryland, Connecticut and Rhode Island), but not California.\u003c/p>\n\u003cp>Reinecke said signing fertility preservation coverage into law would give all cancer patients, not just the rich ones, an equal chance at fertility treatments.\u003c/p>\n\u003cp>In Sacramento, three fertility preservation bills were introduced in the state Legislature. One made it as far as Gov. Jerry Brown’s desk \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201320140AB912\" target=\"_blank\" rel=\"noopener\">in 2013\u003c/a>, but he \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2017/09/2013_AB_912_Veto_Message.pdf\" target=\"_blank\" rel=\"noopener\">vetoed it\u003c/a>, saying he was reluctant to mandate any new insurance benefits just as Obamacare was coming into effect.\u003c/p>\n\u003ch2>Appeal and hope\u003c/h2>\n\u003cp>After the most recent attempt \u003ca href=\"https://californiahealthline.org/news/preserving-fertility-when-it-is-threatened-by-life-saving-medicine/\" target=\"_blank\" rel=\"noopener\">last year\u003c/a>, patient advocates decided to give up on new legislation and instead try to use existing regulations to get fertility preservation covered.\u003c/p>\n\u003cp>“This is a basic health care service that is medically necessary and therefore is covered. Then, whether an individual patient or not is entitled to that coverage, based on the medical facts of their case, is what’s at hand,” Reinecke said.\u003c/p>\n\u003cp>State regulators say when insurance companies deny coverage, patients can file an appeal with the California Department of Managed Health Care in Sacramento, which regulates HMOs to make sure medically necessary basic health care services are covered. This appeals process, called an \u003ca href=\"https://www.dmhc.ca.gov/fileacomplaint/independentmedicalreviewandcomplaintreports.aspx\" target=\"_blank\" rel=\"noopener\">Independent Medical Review,\u003c/a> requires patients to just fill out an \u003ca href=\"https://www.dmhc.ca.gov/fileacomplaint/submitanindependentmedicalreviewcomplaintform.aspx\" target=\"_blank\" rel=\"noopener\">online form\u003c/a>.\u003c/p>\n\u003cp>Filing an appeal is free, but it still requires patients to pay thousands of dollars out of pocket for fertility preservation treatments, and hope they get reimbursed later by their insurance companies.\u003c/p>\n\u003cp>Time-sensitive appeals are supposed to be expedited and completed within a week, but doctors like Letourneau say it usually takes a couple of months to get a decision. Letourneau said when he walks patients through this process, he spends a lot of time on the phone with them trying to ease their worries about cancer treatment, fertility choices and financial risks.\u003c/p>\n\u003cp>So far, the handful of Californians who have filed these appeals have won. But they still have to wait even longer for their insurance company to reimburse them.\u003c/p>\n\u003cp>Letourneau said the appeals process if flawed because it serves only patients who have the time, money and savvy to try to overturn their insurance company’s decision. He worries about the many cancer patients who can’t afford to try or may not even know that an appeal is an option.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003cspan style=\"font-size: x-large\">‘\u003cstrong>For people who don’t have those resources, you might not be able to count on hope\u003c/strong>, and you might then just not be able to have children, and that’s just wrong.’\u003c/span>\u003ccite>Dr. Adams Dudley\u003c/cite>\u003c/aside>\n\u003cp>“Their cancer provider might look at them and say, ‘Gosh, I don’t want to provide them the false hope that they could go freeze their eggs when it’s going to be an out-of-pocket expense of $8,000 and I know they don’t have that.’ So why bring it up?” he said.\u003c/p>\n\u003cp>Oncologists and reproductive specialists are working together to serve patients, Letourneau said, and he’s hopeful that better coverage would mean \u003ca href=\"https://academic.oup.com/jnci/article/107/10/djv202/986599\" target=\"_blank\" rel=\"noopener\">more patients choose to treat their cancer more aggressively \u003c/a>— that they’ll feel better about taking anti-tumor medication longer, knowing there’s hope they can still get pregnant later on.\u003c/p>\n\u003cp>The Department of Managed Health Care stands by the appeals process, declining to answer questions about the many cancer patients who don’t have the time or money to file an appeal.\u003c/p>\n\u003ch2>‘Cancer Patients Often Don’t Have Time’\u003c/h2>\n\u003cp>A couple of months is an eternity when you’re treating cancer, according to Dr. Adams Dudley, a health policy expert with UCSF.\u003c/p>\n\u003cp>“For people who don’t have those resources, you might not be able to count on hope, and you might then just not be able to have children, and that’s just wrong,” Dudley said.\u003c/p>\n\u003cp>Patients shouldn’t be forced to choose between fighting cancer aggressively, the chance to have children and going into debt to preserve their fertility, he said.\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>\n\u003cli>\u003ca href=\"https://www.kqed.org/futureofyou/442273/therapy-made-from-patients-immune-system-shows-promise-for-advanced-breast-cancer\" target=\"_blank\" rel=\"noopener\">Therapy Made From Patient’s Immune System Shows Promise For Advanced Breast Cancer\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>Dudley argues that leaving these decisions up to state regulators and a slow-moving bureaucracy isn’t fair to the vast majority of patients who don’t have thousands of dollars to risk on the chance of bearing their own children someday. And it means that everyone who’d benefit from extracting eggs isn’t getting the chance to do so, he said.\u003c/p>\n\u003cp>“The problem with this appeals process is that it takes time, and cancer patients often don’t have time. Particularly the kinds of cancers that people of childbearing age get can be really aggressive, really terrible things that you need to get into and treat right away,” Dudley said.\u003c/p>\n\u003cp>The delay in covering an effective but expensive treatment is common in the field of reproductive health, Dudley added.\u003c/p>\n\u003cp>“If there were a new treatment that allowed you to have some really good outcome in almost any other disease, there wouldn’t be an issue of whether or not it would be covered. We’d just cover it. We wouldn’t say, ‘Oh, there are new chemotherapies that really improve your survival from cancer, but you can’t have them because they’re too expensive.’ We don’t do that generally. But we tend to treat reproductive health and mental health differently,” he said.\u003c/p>\n\u003cp>Dudley said state regulators and politicians should realize that the way insurers — governed by state regulators — treat reproductive health and fertility preservation has a huge impact on the lives of cancer patients.\u003c/p>\n\u003ch2>A happy ending for Alice\u003c/h2>\n\u003cp>For Alice Crisci, going into debt to pay for fertility treatment helped her get through the dark, lonely moments soon after her diagnosis. With each expensive injection of hormones, she was banking on the fact that her body still worked and that she would beat cancer, resume a normal life and eventually have a baby.\u003c/p>\n\u003cp>“The injections were a little bit painful, but I was in control. I was the one who got to do it. Nobody was doing it to me. And I felt like I was stimulating life force,” she said.\u003c/p>\n\u003cp>Crisci’s story has a happy ending. She’s an \u003ca href=\"http://www.fertileaction.org/about/alices-story/\" target=\"_blank\" rel=\"noopener\">entrepreneur\u003c/a> living in San Carlos, and single mom to a curly-headed 4-year-old named Dante.\u003c/p>\n\u003cp>“I named him Dante because it means enduring. We certainly endured a lot to get to be together,” she said.\u003c/p>\n\u003cp>Crisci and other advocates want other cancer patients to have a chance at parenthood, too.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Many Breast Cancer Patients Can Skip Chemo, Study Finds",
"title": "Many Breast Cancer Patients Can Skip Chemo, Study Finds",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Most women with the most common form of early-stage breast cancer can safely skip chemotherapy without hurting their chances of beating the disease, doctors are reporting from a landmark study that used genetic testing to gauge each patient’s risk.[contextly_sidebar id=\"BFMet48xKrp1h6NyWt3K8Xsz7gIOPSeq\"]\u003c/p>\n\u003cp>The study is the largest ever done of breast cancer treatment, and the results are expected to spare up to 70,000 patients a year in the United States and many more elsewhere the ordeal and expense of these drugs.\u003c/p>\n\u003cp>“The impact is tremendous,” said the study leader, Dr. Joseph Sparano of Montefiore Medical Center in New York. Most women in this situation don’t need treatment beyond surgery and hormone therapy, he said.\u003c/p>\n\u003cp>The study was funded by the National Cancer Institute, some foundations and proceeds from the U.S. breast cancer postage stamp. Results were discussed Sunday at an American Society of Clinical Oncology conference in Chicago and published by the New England Journal of Medicine. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test.\u003c/p>\n\u003cp>\u003cstrong>Moving Away From Chemo\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Cancer care has been evolving away from chemotherapy — older drugs with harsh side effects — in favor of gene-targeting therapies, hormone blockers and immune system treatments. When chemo is used now, it’s sometimes for shorter periods or lower doses than it once was.\u003c/p>\n\u003cp>For example, another study at the conference found that Merck’s immunotherapy drug Keytruda worked better than chemo as initial treatment for most people with the most common type of lung cancer, and with far fewer side effects.[contextly_sidebar id=\"sLig6uVQeZQDplnvMdLRkmGUnVlPvI7v\"]\u003c/p>\n\u003cp>The breast cancer study focused on cases where chemo’s value increasingly is in doubt: women with early-stage disease that has not spread to lymph nodes, is hormone-positive (meaning its growth is fueled by estrogen or progesterone) and is not the type that the drug Herceptin targets.\u003c/p>\n\u003cp>The usual treatment is surgery followed by years of a hormone-blocking drug. But many women also are urged to have chemo to help kill any stray cancer cells. Doctors know that most don’t need it, but evidence is thin on who can forgo it.\u003c/p>\n\u003cp>The study gave 10,273 patients a test called Oncotype DX, which uses a biopsy sample to measure the activity of genes involved in cell growth and response to hormone therapy, to estimate the risk that a cancer will recur.\u003c/p>\n\u003cp>\u003cstrong>What the Study Found\u003c/strong>\u003c/p>\n\u003cp>About 17 percent of women had high-risk scores and were advised to have chemo. The 16 percent with low-risk scores now know they can skip chemo, based on earlier results from this study.\u003c/p>\n\u003cp>The new results are on the 67 percent of women at intermediate risk. All had surgery and hormone therapy, and half also got chemo.[contextly_sidebar id=\"TPjTNdjmhxB5MX6ZoUQCtfkvBdzmJm43\"]\u003c/p>\n\u003cp>After nine years, 94 percent of both groups were still alive, and about 84 percent were alive without signs of cancer, so adding chemo made no difference.\u003c/p>\n\u003cp>Certain women 50 or younger did benefit from chemo; slightly fewer cases of cancer spreading far beyond the breast occurred among some of them given chemo, depending on their risk scores on the gene test.\u003c/p>\n\u003cp>\u003cstrong>Will People Trust the Results?\u003c/strong>\u003c/p>\n\u003cp>All women like those in the study should get gene testing to guide their care, said Dr. Richard Schilsky, chief medical officer of the oncology society. Oncotype DX costs around $4,000, which Medicare and many insurers cover. Similar tests including one called MammaPrint also are widely used.\u003c/p>\n\u003cp>Testing solved a big problem of figuring out who needs chemo, said Dr. Harold Burstein of the Dana-Farber Cancer Institute in Boston. Many women think “if I don’t get chemotherapy I’m going to die, and if I get chemo I’m going to be cured,” but the results show there’s a sliding scale of benefit and sometimes none, he said.\u003c/p>\n\u003cp>Dr. Lisa Carey, a breast specialist at the University of North Carolina’s Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it.[contextly_sidebar id=\"2pkXhBlSu04mLyMby8g8IUTSIxIwtjpB\"]\u003c/p>\n\u003cp>Dr. Jennifer Litton at MD Anderson Cancer Center in Houston, agreed, but said: “Risk to one person is not the same thing as risk to another. There are some people who say, ’I don’t care what you say, I’m never going to do chemo,’” and won’t even have the gene test, she said. Others want chemo for even the smallest chance of benefit.\u003c/p>\n\u003cp>Adine Usher, 78, who lives in Hartsdale, New York, joined the study 10 years ago at Montefiore and was randomly assigned to the group given chemo.\u003c/p>\n\u003cp>“I was a little relieved. I sort of viewed chemo as extra insurance,” she said. The treatments “weren’t pleasant,” she concedes. Her hair fell out, she developed an infection and was hospitalized for a low white blood count, “but it was over fairly quickly and I’m really glad I had it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If doctors had recommended she skip chemo based on the gene test, “I would have accepted that,” she said. “I’m a firm believer in medical research.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Cancer care has been evolving away from chemotherapy — older drugs with harsh side effects — in favor of gene-targeting therapies, hormone blockers and immune system treatments. When chemo is used now, it’s sometimes for shorter periods or lower doses than it once was.\u003c/p>\n\u003cp>For example, another study at the conference found that Merck’s immunotherapy drug Keytruda worked better than chemo as initial treatment for most people with the most common type of lung cancer, and with far fewer side effects.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The breast cancer study focused on cases where chemo’s value increasingly is in doubt: women with early-stage disease that has not spread to lymph nodes, is hormone-positive (meaning its growth is fueled by estrogen or progesterone) and is not the type that the drug Herceptin targets.\u003c/p>\n\u003cp>The usual treatment is surgery followed by years of a hormone-blocking drug. But many women also are urged to have chemo to help kill any stray cancer cells. Doctors know that most don’t need it, but evidence is thin on who can forgo it.\u003c/p>\n\u003cp>The study gave 10,273 patients a test called Oncotype DX, which uses a biopsy sample to measure the activity of genes involved in cell growth and response to hormone therapy, to estimate the risk that a cancer will recur.\u003c/p>\n\u003cp>\u003cstrong>What the Study Found\u003c/strong>\u003c/p>\n\u003cp>About 17 percent of women had high-risk scores and were advised to have chemo. The 16 percent with low-risk scores now know they can skip chemo, based on earlier results from this study.\u003c/p>\n\u003cp>The new results are on the 67 percent of women at intermediate risk. All had surgery and hormone therapy, and half also got chemo.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After nine years, 94 percent of both groups were still alive, and about 84 percent were alive without signs of cancer, so adding chemo made no difference.\u003c/p>\n\u003cp>Certain women 50 or younger did benefit from chemo; slightly fewer cases of cancer spreading far beyond the breast occurred among some of them given chemo, depending on their risk scores on the gene test.\u003c/p>\n\u003cp>\u003cstrong>Will People Trust the Results?\u003c/strong>\u003c/p>\n\u003cp>All women like those in the study should get gene testing to guide their care, said Dr. Richard Schilsky, chief medical officer of the oncology society. Oncotype DX costs around $4,000, which Medicare and many insurers cover. Similar tests including one called MammaPrint also are widely used.\u003c/p>\n\u003cp>Testing solved a big problem of figuring out who needs chemo, said Dr. Harold Burstein of the Dana-Farber Cancer Institute in Boston. Many women think “if I don’t get chemotherapy I’m going to die, and if I get chemo I’m going to be cured,” but the results show there’s a sliding scale of benefit and sometimes none, he said.\u003c/p>\n\u003cp>Dr. Lisa Carey, a breast specialist at the University of North Carolina’s Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Dr. Jennifer Litton at MD Anderson Cancer Center in Houston, agreed, but said: “Risk to one person is not the same thing as risk to another. There are some people who say, ’I don’t care what you say, I’m never going to do chemo,’” and won’t even have the gene test, she said. Others want chemo for even the smallest chance of benefit.\u003c/p>\n\u003cp>Adine Usher, 78, who lives in Hartsdale, New York, joined the study 10 years ago at Montefiore and was randomly assigned to the group given chemo.\u003c/p>\n\u003cp>“I was a little relieved. I sort of viewed chemo as extra insurance,” she said. The treatments “weren’t pleasant,” she concedes. Her hair fell out, she developed an infection and was hospitalized for a low white blood count, “but it was over fairly quickly and I’m really glad I had it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If doctors had recommended she skip chemo based on the gene test, “I would have accepted that,” she said. “I’m a firm believer in medical research.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"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. ",
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"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. ",
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"marketplace": {
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"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.",
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"masters-of-scale": {
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},
"mindshift": {
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"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>",
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"order": 12
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"onourwatch": {
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"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?",
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"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",
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},
"pbs-newshour": {
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},
"perspectives": {
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"order": 14
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"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.",
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"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",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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