Sunday, April 29, 2012

STOPSTOPSTOPSTOP

STOP.  I made a horrible mistake.  I thought I had put a notice on this blog telling the faithful few that I'm not going to use it anymore.  I know I wrote something; I guess I must have forgotten to post it.  That must be why my computer kept spewing up incomprehensible warnings yesterday.  Anyway, I won't ;post to this blog anymore, everything on it has been transferred to Myrl'sBlog, and I apologize  for the confusion.

Parkfriend.  The reason I didn't put in a link is that I don't know how.  Remember, I grew up in an era where communication took place by what now is called snail mail, or by means of a dial-up machine attached to the kitchen wall!

Friday, April 27, 2012

BRIBERY (& nothing about OC)


               In the dead of an Illinois winter: sabbatical at Northwestern U.  Yes, I was missing a tooth.
               She loved me anyway.                                       

Did you know that I can “track” the number of pages read on my blog? That is, I can tell how many times each entry has been looked at, although I can’t tell who did the looking.  These statistics tell me one very important fact – you are looking at my blog mainly to see pictures of my beautiful wife.  Oh, sure, you might read the accompanying text, but it’s mainly Linda you want to see.  I forgive you.  I feel the same myself.

The reason I know this is that the entry LINDA ON HER WEDDING DAY has three times as many “hits” as the next highest entries.  Also, the ones with no pictures - only text - are at the bottom of the list.  I will try to salve my wounded pride and push on.

So, I am going to try to bribe you.  It seems that you want to see pictures of Linda on her wedding day.  I have three more.  (Incidentally, I’m in them, too.)  I plan to use them on anniversaries.  However, to drum up enthusiasm I promise to post the best picture of all – just as soon as I have a dozen or so “Followers” for the new version of the blog, “FIGHT BACK against OVARIAN CANCER” (you remember, WWW.QUILTCUTIE.BLOGSPOT.COM).  So far I have no followers at all (three with the old blog.)  Maybe Carolyn will add a “Comment” to this posting explaining how it is done.  To get the picture you really only need nine, ‘cause I plan to “Follow”, too.  That way I can be alerted whenever anybody posts a “Comment”.

My faithful editor and research assistant Dick Ingwall has pointed me to an interesting article in the New Yorker which I will be writing about in a few days.  I am headed back to Bellingham next week.

Wednesday, April 25, 2012

MEDICAL ECONOMICS


Linda and Viv Hailwood on a tough hike on Howgill Fell, Yorkshire Dales National Park.  About 1999.
                                  (She had a stream named after her on that hike:  Linda Beck.)


The review article I mentioned in my last post has a multitude of interesting things to say.  I just re-read the “box” on medical economics and was, as usual,  perplexed. 
I believe it was Senator Everett Dirksen who, in talking about a Federal budget of many years ago, said “a billion here, a billion there, and pretty soon you’re talking about real money.”  If he were alive today he’d probably say “trillion.”

Still Dirksen might have been impressed at the monetary cost that cancer inflicts on American society.  The estimate for 2002 was $171.6 billion, of which $60.9 billion were directs cost of medical care and the remainder the value of lost productivity.   I would bet the figure for 2012 would be close to twice that. 

I guess I shouldn’t have been surprised to learn that they actually do cost-effectiveness (CE) analysis on cancer screening strategies.  In comparing Strategy A to Strategy B (Strategy B could be no screening at all) one calculates CE = (Ca – Cb)/(LYa – LYb), where Ca is the cost of strategy A, LYa is the number of years of life saved using strategy A, etc.  A is judged to be superior to B if CE is less than $50,000.  I read this as a tacit estimate of the maximum value of a year of human life at $50K!  Note that nothing is said in this analysis about quality of life (QOL).

So why am I perplexed?  I guess it just rubs against the lay of my fur to put a monetary value on human life.  How much would I have paid to obtain another year of good life for Linda?  Everything I own.  But, how much would a year of life her life been worth if she had to live it as she was during her last two weeks?  Not much.  They need to factor QOL into their equations; don’t ask me how.

So, yes, I know that medical costs are out of control and we have to do something about it.  Maybe Cost-Benefit analysis has its uses.  That’s fine in the abstract – but when the life of someone you love is the subject, cost becomes irrelevant.

I’d be interested in some serious discussion of this issue.  Sorry this posting is so gloomy.

Tuesday, April 24, 2012

A BOOK (well, small article) REPORT


1983, on Thera (Santorini)

The group I work with at the Hutch has as one of its principal interests the development of tests to permit early detection of ovarian cancer.  I have just run on a review article on the need for such tests for cancer in general.  In case you want to read it yourself, the citation (done like a geologist would do) is Etzione, R., et al, The case for early detection: Nature Reviews, v. 3, pp. (well, they don’t give the page numbers) April 2003.  It is well written, comprehensible for the most part, and blessedly short.  My only real complaint (more of a peevish quibble, really) is that it is hard to read on a computer.  For you Kindle experts it should be duck soup.
I have several things from this article to pass on.  By this time it should not be necessary for me to remind you that I am a geologist, not a biochemist, and may occasionally (or more often ?) get things wrong.  This is your last warning; don’t believe anything I say without serious thought, and don’t act on anything I say without consulting an expert.
The first thing, I can’t get wrong.  The authors present us with a graph showing the 5- and 10-year survival frequencies of victims of breast, colorectal, lung and prostate chance, contrasting these frequencies in people whose cancers were discovered when they were localized with frequencies after the cancer had spread.  As you might expect, the former had a much better result than the latter.  Consider breast cancer for example.  For women diagnosed in the period 1993-97, the five-year survival frequency was about 20% if the cancer had spread (was “distant”) but 95% if it hadn’t (was “local”).  For prostate cancer the benefit of early detection was even more pronounced.  Even lung cancer showed this trend, but the actual numbers were pretty dismal.  My take-home from this is that what we (my group, at the Hutch) are doing is worth the time, effort and money – and then some.
Those same graphs showed how survival numbers increased in the interval  1972 to about 1997.  This must reflect improvements in treatment – drugs, radiation, surgery, voodoo, whatever.  There was noticeable, consistent improvement shown – but in terms of  years of life saved it couldn’t compare to the benefit of early detection. 
I have a few more things to say, but I am getting impatient with my typing problems and a gin and tonic is waiting.  I may post more on this article in a day or two.





Monday, April 23, 2012

NOT OC. NEW BLOG, SAME THEME


                                                 Linda with Whiskers and Murphy, 1985

Okay, this may mess everything up, but it's worth a try.  I have opened this new blog with a name including the term "ovarian cancer", in the hope that when people Google that term my blog will show up.  The Web address is nearly the same, just lacking the "LJB" part.  I will put all my new "posts" here, but older ones still will be available at the original "address".  If this falls flat I will delete this blog and continue on my merry way.

For any of you who have stumbled on this blog by accident, so to speak, and have no idea what I'm talking about, please bookmark this site and then go to www.ljb-quiltcutie.blogspot.com. (Or Google "Myrl'sBlog".)   My early entries there will explain all.  And, welcome. Let's fight ovarian cancer together.

Myrl Beck