Avastin approved

Here's another example of the strange decisions we collectively make, and applaud, when it comes to health care. Avastin is a therapy designed to inhibit angiogenesis, the accelerated formation of new blood vessels that nourish tumors. Breast cancer patients using Avastin had, due to reduction in the severity of new tumors (because their growth was inhibited), on average 5 1/2 months longer quality of life during the final stages of their disease. They didn't live any longer, they were just more comfortable 5 1/2 months longer than they would have been without Avastin. I don't know the details of how "comfortable" and "uncomfortable" are defined, and I wouldn't be surprised if the definitions themselves are controversial (and I wouldn't be surprised, either, if the definitions are widely accepted). The point is this: the drug isn't curative, it's palliative. Palliative care is important. Despite the all the pink ribbon campaigns, and the 40-something starlet "survivors" going on Larry King to coyly reveal their lumpectomy scars, the fact of the matter is breast cancer is a very deadly disease. It's not the number one killer of women (that's heart disease) and it's not even the number one cancer for women (that's lung cancer) but it's a big one, and the vast majority of women who get it eventually die of it. Fewer are dying quickly, although increasingly early detection distorts that statistic (eg, a woman detects her cancer at age 37, and dies at age 44, while another detects her cancer at 40, and dies at 44....they both are dead at 44, both only one is a "5-year-survivor." It's often a meaningless characterization). And, very very slowly, more women with breast cancer are living long enough to properly die of heart disease in their 70's (and thereby "improve" cancer statistics, even though they still have cancer at the time of death), but most women diagnosed with breast cance are eventually going to die of breast cancer; some in a just a few years, most within a decade. It's not a curable disease, it's usually a fatal disease, and palliative care is therefore critical. And, the same can be said for many other incurable diseases. So it's all good, then, right? Yes, except that Avastin is going to cost $10,000 a month. IOW, the vast majority of well-insured women diagnosed with breast cancer are going to spend $55,000 to be more comfortable for some 5.5 month period during their likely inevitable demise. That's a lot of money, and that's a lot of people. And yeah, sure, the price of Avastin will come down, but eventually it will be replaced with a drug-to-be-name-later that will probably cost even more than $10,000/month, and maybe be effective for even more than 5.5 months (but still not extend life, or be curative). Being more comfortable as you are dying is incredibly important, but there's no escaping the cost spiral this represents. It's just nuts. We rightly worry about exporting our wealth to hostile nations by sending them money for oil, and we fret over real estate values declining and net worth therefore evaporating, but we do not seem to have a way to put health care costs in perspective. The day may already be here when it's not your house that's your biggest single investment, rather, it's your death. We need to re-think this. What we're doing now is just not adding up.

Almost all cancer drugs don't prolong life. Most actually quickens death.