• The Houston Chronicle reports that “A national survey of about 1,100 adults that Harris Interactive conducted in July found that 7 percent of U.S. adults use online personal health records. The poll also found that 35 percent of those surveyed were unaware that the technology exists. The survey’s margin of error was plus or minus 3 percentage points.”
• The New York Times reports on a new twist to the myspace.com and Facebook fads — web pages such as thestatus.com where hospital patients and chronically ill people can update their friends and family on their condition and receive notes of support. Because the trick with these ventures is to figure out how to monetize the site, the Times notes that carepages.com which was created by the Mayo Clinics, the Cleveland Clinic, and Massachusetts General Hospital, among other care providers, “offers newsletters; educational materials specific to the patient’s illness; links to the hospital florist, gift shop or medical foundation.”

Here are The Wall Street Journal’s 2006 Technology Award winners for Biotech-Medicine and Medical Devices:

Biotech-Medicine
Pfizer/Nektar Therapeutics, U.S.
Nominees: Both companies say too many individuals were involved to single out individuals.
Innovation; Exubera, a powdered inhalable insulin for the treatment of diabetes.

Medical Devices
Incisive Surgical, U.S.
Nominee: John L. Shannon, Jr., President and CEO
Innovation: Insorb, a mechanical skin stapler that places absorbable staples underneath the skin.

Very cool.

More encouraging news was released today in the public health campaign against cancer, the second deadliest disease in America after heart disease. According to a report in the most recent issue of the journal Science, researchers from Howard Hughes Medical Institute (HHMI), Johns Hopkins University, Case Western Reserve University School of Medicine, and a team of researchers from The Kimmel Cancer Center at Johns Hopkins have identified 189 genetic mutations that play a major role in the development of breast cancer and colorectal cancer.

Foodconsumer.org reports that

“Only by understanding this blueprint of cancer will we be fully able to understand the mechanism of what makes a cancer a cancer and to think about strategies for diagnosis, prevention and therapy,” said Dr. Victor Velculescu, senior researcher on the project and an assistant professor of oncology at [the] Kimmel Cancer Center.

The [research] team found far more mutated genes in tumor cells than they had expected. They found 189 genetic mutations in the tumors, which are suspected to be involved in causing cancer. The main point was that these genes were never implicated in cancer previously.

“Scientists who have seen these data have told us that it keeps them up all night thinking,” said Bert Vogelstein, a co-researcher in the study. “It will hopefully open up a large number of opportunities in many areas of cancer research.”

The researchers had theorized that they would find a maximum of 90 mutations that alter protein structure. Through crosschecking, the researchers identified an average of 11 genes in each cancer that were most likely involved in how the cancer presented itself. Approximating this to the human genome, the researchers say an average of about 17 genes are expected to have critical involvement in the development of each cancer.

The researchers found another startling fact. No two cancers were similar even if the genes were the same, meaning that different genes presented in different ways for the same type of cancer in different individuals. The genes contributing to breast cancer were different from those mutated in colorectal cancers.

This is just the beginning of a federally financed effort, called the Cancer Genome Atlas, to map the genetic mututations that cause the various forms of cancer. It is hoped that the effort will lead to the development of new drug treatments for this terrible disease.

Nexium is the purple pill that you’ve seen on TV, a proton pump inhibitor to treat acid reflux disease. AstraZeneca sold $4.6 billion dollars worth of this medication in 2005. In July 2005, TRICARE, the Defense Department’s health care program for military retirees and active duty dependents, reclassified Nexium as a non-formulary drug on the ground that cost effective alternatives like now over the counter Prilosec were readily available.

Today UnitedHealthcare, the Nation’s second largest health insurance company, announced that it will stop covering Nexium on the same ground. According to the Associated Press report, UnitedHealthcare took the action because it “had expected costs in the category to slow after generic and over-the-counter versions of Prilosec, the predecessor drug to Nexium, became available in 2003. But that didn’t happen” — possibly because of aggressive advertising of the drug particularly at the time when Prilosec, another AstraZeneca product, lost its patent protection. UnitedHealthcare expects to cut its proton pump inhibitor expenses in half as a result of this and related actions.

Following up on Sen. George Voinovich’s (R – Ohio) August 22 announcement, Senator Tom Carper (D Del.) and Sen. Voinovich yesterday introduced the Federal Employees’ Electronic Personal Health Records Act of 2006, S. 3846. According to Senator Carper’s press release, “The legislation would require all insurance carriers that contract with the Federal Employees Health Benefits Program to make an electronic health record available for every FEHBP enrollee.”

The National Cancer Institute has released its annual cancer status report with these significant findings:

The long-term decline in overall cancer death rates continued through 2003 for all races and both sexes combined. The declines were greater among men (1.6 percent per year from 1993 through 2003) than women (0.8 percent per year from 1992 through 2003), although rates for men remain 46 percent higher than for women. Death rates decreased for 11 of the 15 most common cancers in men and for 10 of the 15 most common cancers in women. The authors attribute the decrease in death rates, in part, to successful efforts to reduce exposure to tobacco, earlier detection through screening, and more effective treatment, saying that continued success will depend on maintaining and enhancing these efforts. “The greater decline in cancer death rates among men is due in large part to their substantial decrease in tobacco use. We need to enhance efforts to reduce tobacco use in women so that the rate of decline in cancer death rates becomes comparable to that of men,” said Betsy A. Kohler, President of the North American Association of Central Cancer Registries, Inc (NAACCR).

Other noteworthly findings were a leveling off of the breast cancer incidence rate over the period 2001 – 2003, ending a string of increases that began in the 1980s and an increase female thyroid cancer incidence rates.

Dr. Mark McClellan, the Adminstrator of the federal government’s Centers of Medicare and Medicaid Services, announced that he is resigning his position in October. No successor has yet been announced.

The Federal Workforce and Agency Organization Subcommittee has posted complete information about Friday’s health information technology hearing on its website. This is the Subcommittee’s fourth hearing on this topic since July 2005. Steve Barr reports in his Federal Diary column of today’s Washington Post that Subcommittee Chair Jon “Porter [R Nev.] also hopes to mark up a bill [H.R. 4859] that would create electronic health records for the 8 million Americans covered by the federal employee health insurance program.”

The House Federal Workforce and Agency Organization subcommittee held a special hearing in St. Louis, Missouri, yesterday. At the hearing, OPM Deputy Associate Director Daniel A. Green informed the attendees that “OPM’s chief priority in the health care arena was to work to implement the President’s recent executive order to expand the information and options available to federal employees.” OPM has posted its executive order implementation steps on its website, which recently received a facelift.

I watched Dr. Stephen Rosenberg of the National Cancer Institute on Good Morning America today. As I noted in the blog yesterday, Dr. Rosenberg’s miraculous gene therapy cured two out of seventeen potentially fatal melanoma cases. In his interview this morning, Dr. Rosenberg explained that the treatment was administered two years ago, and since then his team has strengthened the treatment and moreover has adapted the therapy to fight other potentially fatal cancers. He is waiting for Food and Drug Administration approval to test the therapy on other types of cancer.