Liz (The Liz Army) posted the link below and made me reflect a lot about the challenges facing the world's health care system and the lack of strategic thinking from politicians. The disconnect between what politicians do and the defense and implementation of rules that benefit the people they represent is quite shocking. While the headline paints a much worse picture of what the politician meant, I do believe that this issue needs to be debated. Rep. David Dreier said "I don't think someone who is diagnosed with a brain tumor should have health care provided".
http://thinkprogress.org/health/2012/07/10/513735/republican-rep-i-dont-think-someone-who-is-diagnosed-with-a-brain-tumor-should-have-health-care-provided/
In a well-functioning democracy the Government is supposed to be composed of people elected by the people and should work for the people. The American Constitution is one of the most incredible timeless documents ever assembled and it created the foundation for the most incredible society ever devised: a free society that self-regulates itself based on free markets and the rule of law, a machine that constantly adapts to the needs of its time and that every once in a while requires a set of new regulations to control certain aspirations of its society. A few examples:
- The Pure Food and Drug Act - created in 1906 to address food and drug safety, giving birth to the FDA
- The Federal Reserve Act - created to address financial instability in 1907, giving birth to the Federal Reserve Bannk
- The Affordable Care Act - created in 2012 to address the increase in health care costs in the US
I am using the US in my example because I am more familiar with it and because this Congressman's statement affects me personally. I will soon talk about Brazil, a relatively new social experiment that seems to be thriving for the first time in its history by emulating what the US once did well.
In this specific case this politician argues that insurance companies should be able to discriminate against people with brain tumors while as a safety net people with pre-existing conditions enroll in a high-risk insurance pool paid by the Government. This is just another classic example of socializing losses and privatizing gains. The complete lack of strategic thinking from a U.S. Congressman is concerning and somewhat puzzling, putting the issue of "capture" at the forefront of this debate. Is this elected Government Official thinking about his country or about his campaign contributors?
His tagline might appeal to the tax-cutting Republican voter who does not like to see that there is a cost to live in a civilized society, but as my uncle used to say the only difference between Republicans and Democrats is on how they pay for Government costs. The first one pushes the burden to future generations by issuing debt while the second one places the burden on current citizens through taxes.
Health care is not something where you can regulate in a "half-pregnant" way, I believe regulation should be explicitly driven by what we want to socialize and what we want to privatize, and who is keeping the profits and losses in each case. There is no argument that an unhealthy society places a huge burden on the heatlhy, but there is also no question that most people understand the need to spread the risks and costs of health care, hence the development of a large health insurance industry.
The biggest risk I see in this proposal is the lack of transparency on who is going to pay for the expensive treatments provided by the Government and what will be the benefits of having an insurance plan if catastrophic events are covered by the Government.
If the Government does not get a pool of money from healthy individuals I do not see this as a viable proposal, unless the costs are simply going to be paid by higher tax costs, which reduces visibility to how much money is entering the healhcare piggy bank and how much goes out, although the out-going flow is easy to track.
My suggestion would be to absolutely not accept discrimination in the insurance industry. This is the exact same issue that led to the collapse of the Blue Cross Blue Shield system. When insurance companies were allowed to discrimate, new health insurance firms popped-up and captured all the profitable, healthy patients that subsidized the costly, older, sick patients. This lead to the collapse of the BCBS system and to the big increase in health insurance costs due to a pervasive competition for the healthy individuals and an unacceptable discrimination against the sick ones, defeatting the purpose of the Health Insurance industry.
On the opposite side we have Brazil. I pay high taxes and public health care is deducted straight from my payroll, but in exchange I get my expensive chemo medication through the public health case system. I also have private insurance and a law was just passed saying that insurance companies need to provide coverage for this drug, and therefore I should have it covered privately.
Until this law was passed I would have needed to go to court to receive the chemo drug that I have always paid for through my health insurance, but since I am covered by the public system I did not have to go through this hassle. Health insurance is always there when you are healthy, but once you are sick you need to fight hard to claim your benefits, in some instances even having to go to court, like a friend of mine that won her case against a widely known problematic health insurance company in Brazil to have her glioma treatment covered.
However talk to any doctor in Brazil and they will argue that I should not get this expensive treatment through the public system as it places a massive burden on the system costs. Given the fact that I do have private insurance I do agree that I pay too much to have the Government fund my treatment, but in any case I pay for both systems, a somewhat inneficient model but one that provides a good safety net.
To summarize this long rumbling, I have the following suggestions:
- Not allow for health care discriminatory practices - if discrimination is not acceptable based on race, gender or sexual preferences, why should they be accepted for health care purposes?
- Create a publicly based high risk insurance pool but also create an income stream to pay for it that is highly transparent and congruent with the investment needs;
- Never end the debate for a better, more efficient health care system. There will never be a right or wrong answer to this, we need to keep trying until we are all satisfied with what we get relative to how much we contribute, as individuals and as a society;
- Always be aware that for every cost we need an income stream, in the short-term and in the long-term. This is particularly critical for countries with increasingly older people such as the European countries.
In this whole debate I have not mentioned NGOs. I have been blessed to count with the indirect support of several Brain Tumor NGOs that helped me clarify treatment options, research avenues and survival stories. Without the efforts of tireless volunteers from the UK based Astrofund, the American Brain Tumor Association and the German Brain Tumor Association I am sure several people afflicted with brain tumor would have had a much worse prognostic. However we should always strive for more and as I get closer to all these issues I see many opportunities for the future, such as:
- Organized collaboration between patients, research, medical, business and regulatory communities. We all have the same interest and should work together to accomplish our goals, a better and long life for brain tumor patients;
- Increased collaboration and competition between NGO's and drug companies - by threatening to lower drug costs by funding cancer-drugs research, NGO's might help re-direct drug companies investments from erectile-disfuntion drug marketing to cancer drug research;
- Global collaboration between NGO's to increase research collaboration, reduce adminstrative costs (websites maintenance, content development etc.), reduce fund-raising costs (the money is going towards the same purpose) and give more hope to all of us living with glioma.
To come back to this post's title the Affordable Health Care Act is good news because it finally changes something that most people were not happy about, let's just hope it doen't take people from one bad place to another bad place, and the only way to make that happen is by actively understanding what it means to you.
This is it for today, I missed my bike ride but I had to get this off my chest (and brain).
Sunday, July 22, 2012
Monday, July 16, 2012
New Correlations Between Glioma and...
I shared in my first post the leading correlations to brain and nervous system cancers to be the following:
- Average Height: 70%
- Life Expectancy: 62%
- Recorded Alcohol Consumption: 60%
I have now investigated new hypothesis and came up with new, also high correlations that could lead to glioma (or not):
- Protein Consumption (kg/yr): 63%
- Carbs % of Diet: -68%
That's right, the higher the contribution of carbs to one's diet the lower chance to develop brain tumor. Of course I might be stretching my conclusion here. As I learned in statistics correlations do not mean causality. In fact the high % of carbs in a diet might just mean lower protein consumption, the potential cause (these do not look like independent variables).
This leads me into a new hypothesis: could protein consumption lead to cancer? When I combined all the variables into one multi-variate correlation, carbs and protein consumption had negative correlations to brain tumor while the other variables remained with positive correlations.
One of the leading theories about why we thrived as humans is the size of our brains. Large brains were only developed because we were able to support it with higher protein consumption as we evolved, enabling us to sustain the high energy levels required by the brain to function properly. Another theory, available in the book "Born to Run", is that by being able to run for very long distances we were able to hunt large, protein filled animals, feeding our growing brain.
What if one thing led to the next? As we ate more proteins new genetic mutations helped us develop our brains, but potentially our high level of activity enabled us to control the increase in brain size without it turning into a deadly tumor. One of my hypothesis is that heat-shock proteins (HSPs) might help us as a tumor suppressor gene helps us fight cancer cells. In fact new experimental brain tumor vaccines are based on HSPs, which levels are increased after physical exhertion. In fact after half-marathons HSPs levels increase and remain high, and given its function, which is to restore damaged DNA after our body is exposed to high temperatures, I started believing in my crazy theory.
According to my neuro-surgeon I probably developed my brain tumor about 10 years ago, coinciding with a period of extreme physical inactivity from my part (I would play pick-up soccer or basketball once in a while).
I am not a professional scientist (not even an amateur one), but if a real scientist is looking for hypothesis I hope this one is worth investigating and leads into something, even if just into more research grants for scientists to investigate and help us living with glioma.
What exactly am I speculating again?
That a combination of being tall, high alcohol and protein consumption, and little physical activity (meaning not running at least say 20k/week) might be a potential cause for what I have, which would put all my tall friends in a risk group. I will keep running crazy correlations until I find more stuff. I tried to correlate polution with it all and could not get to a high correlation, so I will keep digging. If you know something that might help this amateur investigation please share it with me. Thanks!
- Average Height: 70%
- Life Expectancy: 62%
- Recorded Alcohol Consumption: 60%
I have now investigated new hypothesis and came up with new, also high correlations that could lead to glioma (or not):
- Protein Consumption (kg/yr): 63%
- Carbs % of Diet: -68%
That's right, the higher the contribution of carbs to one's diet the lower chance to develop brain tumor. Of course I might be stretching my conclusion here. As I learned in statistics correlations do not mean causality. In fact the high % of carbs in a diet might just mean lower protein consumption, the potential cause (these do not look like independent variables).
This leads me into a new hypothesis: could protein consumption lead to cancer? When I combined all the variables into one multi-variate correlation, carbs and protein consumption had negative correlations to brain tumor while the other variables remained with positive correlations.
One of the leading theories about why we thrived as humans is the size of our brains. Large brains were only developed because we were able to support it with higher protein consumption as we evolved, enabling us to sustain the high energy levels required by the brain to function properly. Another theory, available in the book "Born to Run", is that by being able to run for very long distances we were able to hunt large, protein filled animals, feeding our growing brain.
What if one thing led to the next? As we ate more proteins new genetic mutations helped us develop our brains, but potentially our high level of activity enabled us to control the increase in brain size without it turning into a deadly tumor. One of my hypothesis is that heat-shock proteins (HSPs) might help us as a tumor suppressor gene helps us fight cancer cells. In fact new experimental brain tumor vaccines are based on HSPs, which levels are increased after physical exhertion. In fact after half-marathons HSPs levels increase and remain high, and given its function, which is to restore damaged DNA after our body is exposed to high temperatures, I started believing in my crazy theory.
According to my neuro-surgeon I probably developed my brain tumor about 10 years ago, coinciding with a period of extreme physical inactivity from my part (I would play pick-up soccer or basketball once in a while).
I am not a professional scientist (not even an amateur one), but if a real scientist is looking for hypothesis I hope this one is worth investigating and leads into something, even if just into more research grants for scientists to investigate and help us living with glioma.
What exactly am I speculating again?
That a combination of being tall, high alcohol and protein consumption, and little physical activity (meaning not running at least say 20k/week) might be a potential cause for what I have, which would put all my tall friends in a risk group. I will keep running crazy correlations until I find more stuff. I tried to correlate polution with it all and could not get to a high correlation, so I will keep digging. If you know something that might help this amateur investigation please share it with me. Thanks!
Sunday, July 1, 2012
What Causes Glioma? First Hypothesis
Why would a Mechanical Engineer with an MBA that currently works in Marketing think that he might substitute thousands of researchers and doctors trying to answer the same question? I don't know, I just like to solve problems, and this is my biggest one!
To be clear this is not a profound scientific research, it is just a compilation of hypothesis from someone that spends an awful amount of time thinking about gliomas. I hope that a real scientist feels compelled to dig deeper into these ideas and maybe provide a real answer to this century-old question.
As you probably know there are no obvious reasons why Brain Tumors occur. I've read a lot about this with no conclusive answer, so I started doing my own research.
Most doctors will say that head and neck cancers or tumors are highly correlated with alcohol and cigarette consumption. In addition genetic factors play a big role, and I just found out that I hit the jack-pot on this one. I am a breed of Portuguese, German and Dutch immigrants and these rank in the 14th, 16th amd 29th positions in my brain tumor per 1000 people incidence rank out of 167 countries.
I targeted alcohol consumption after finding out that Germany had a 3 times higher Brain Tumor incidence than the world average, and we all know what Germans are famous for, aside from being very industrious.
In addition I found out that brain tumors for some reason are correlated to height. In fact my wife's grandfather died from a gliobastoma, and he was 1.92m, my exact same height. Oscar Schmidt, a legendary basketball player in Brazil, also suffered from an oligoastrocytoma, the exact same brain tumor I carry.
I ran some correlations between alcohol per capita consumption, average height and life expectancy vs. brain/nervous system tumors and found stunning correlations. The sources of my data were:
Brain and Nervous System Cancer Incidence by Country: Globocan 2008 WHO Research
- http://globocan.iarc.fr/
Per capita alcohol consumption: World Health Organization, found in Wikipedia through the link below:
- http://en.wikipedia.org/wiki/List_of_countries_by_alcohol_consumption
Average Height - Males 20+ years old:
http://www.interbasket.net/news/4385/2009/09/average-height-by-country-males-20-years/
Now let's go to the correlations between the factors analyzed and brain tumor/nervous system cancer incidence:
1. Average Height: 70%
2. Recorded per capita alcohol consumption: 62%
3. Life Expectancy: 60%
These are all simple single-variable correlations that simply reinforce factors that are available in several scientific papers but the numbers stunned me. In addition there are some flaws in the numbers I analyzed such as I only looked at Male Average Hieght and Brain Tumors occur in males with a higher incidence. In addition GLOBOCAN statistics have several approximations in cases where data was not available, such as using neighboring countries as proxies for countries that did not have data available.
Nonetheless I have to mention another big surprise: 4 out of the top 5 countries in Brain Tumor incidence are Nordic countries:
1. Denmark
2. Norway
3. Finland
4. Serbia
5. Sweden
I looked at life expectancy to adjust for people that simply by living longer have a higher chance of having anything, but height and alcohol consumption surpassed life expectancy in my correlations, to my surprise.
But one unanswered question remains: why do brain tumors also occur in kids? Seizures are usually the smoking gun that announce a brain tumor. One common reason that leads kids to have seizures is hyponatremia, or water intoxication. This led me down a hypothesis that combines alcohol consumption in adults and a potential cause that can be common to kids: dehydration.
The Hypothalamus is the brain region responsible for regulating water absorption through antidiuretic hormone (ADH). It also produces oxitocin, which is now being researched as potentially being responsible for ethical behavior. When alcohol is ingested it affects ADH, increasing urination and leading to dehydration. I can't comment on oxitocin. If somehow we are dehydrated the hypothalamus might go nuts and the excessive electrical stimulus might lead glial cells to be more active. This might be a completely silly hypothesis but I am not implying that I have the answer, this is just a question.
Another crazy hypothesis I created based on a sample of one is Folic Acid consumption. Folic Acid is present primarily in leaffed vegetables, which have been nearly neglected from my diet throughout my life. I found out that when kids with leukemia had folic acid injected into their blood stream the rate of reproduction of their blood cells got even worse. When I had my first daughter I adopted a product called Instant Breakfast, a chocolate milk my wife's doctor recommended her to get the necessary folic acid needed during pregnancy. I figured that if it was good for her it would be good for me as I never used multi-vitamins. I drank one a day for 7 years nearly every day.
I have capped my current knowledge but I will continue to study and provide new ideas, I hope these are real ideas and not just rumblings from an ignorant undoctor.
To be clear this is not a profound scientific research, it is just a compilation of hypothesis from someone that spends an awful amount of time thinking about gliomas. I hope that a real scientist feels compelled to dig deeper into these ideas and maybe provide a real answer to this century-old question.
As you probably know there are no obvious reasons why Brain Tumors occur. I've read a lot about this with no conclusive answer, so I started doing my own research.
Most doctors will say that head and neck cancers or tumors are highly correlated with alcohol and cigarette consumption. In addition genetic factors play a big role, and I just found out that I hit the jack-pot on this one. I am a breed of Portuguese, German and Dutch immigrants and these rank in the 14th, 16th amd 29th positions in my brain tumor per 1000 people incidence rank out of 167 countries.
I targeted alcohol consumption after finding out that Germany had a 3 times higher Brain Tumor incidence than the world average, and we all know what Germans are famous for, aside from being very industrious.
In addition I found out that brain tumors for some reason are correlated to height. In fact my wife's grandfather died from a gliobastoma, and he was 1.92m, my exact same height. Oscar Schmidt, a legendary basketball player in Brazil, also suffered from an oligoastrocytoma, the exact same brain tumor I carry.
I ran some correlations between alcohol per capita consumption, average height and life expectancy vs. brain/nervous system tumors and found stunning correlations. The sources of my data were:
Brain and Nervous System Cancer Incidence by Country: Globocan 2008 WHO Research
- http://globocan.iarc.fr/
Per capita alcohol consumption: World Health Organization, found in Wikipedia through the link below:
- http://en.wikipedia.org/wiki/List_of_countries_by_alcohol_consumption
Average Height - Males 20+ years old:
http://www.interbasket.net/news/4385/2009/09/average-height-by-country-males-20-years/
Now let's go to the correlations between the factors analyzed and brain tumor/nervous system cancer incidence:
1. Average Height: 70%
2. Recorded per capita alcohol consumption: 62%
3. Life Expectancy: 60%
These are all simple single-variable correlations that simply reinforce factors that are available in several scientific papers but the numbers stunned me. In addition there are some flaws in the numbers I analyzed such as I only looked at Male Average Hieght and Brain Tumors occur in males with a higher incidence. In addition GLOBOCAN statistics have several approximations in cases where data was not available, such as using neighboring countries as proxies for countries that did not have data available.
Nonetheless I have to mention another big surprise: 4 out of the top 5 countries in Brain Tumor incidence are Nordic countries:
1. Denmark
2. Norway
3. Finland
4. Serbia
5. Sweden
I looked at life expectancy to adjust for people that simply by living longer have a higher chance of having anything, but height and alcohol consumption surpassed life expectancy in my correlations, to my surprise.
But one unanswered question remains: why do brain tumors also occur in kids? Seizures are usually the smoking gun that announce a brain tumor. One common reason that leads kids to have seizures is hyponatremia, or water intoxication. This led me down a hypothesis that combines alcohol consumption in adults and a potential cause that can be common to kids: dehydration.
The Hypothalamus is the brain region responsible for regulating water absorption through antidiuretic hormone (ADH). It also produces oxitocin, which is now being researched as potentially being responsible for ethical behavior. When alcohol is ingested it affects ADH, increasing urination and leading to dehydration. I can't comment on oxitocin. If somehow we are dehydrated the hypothalamus might go nuts and the excessive electrical stimulus might lead glial cells to be more active. This might be a completely silly hypothesis but I am not implying that I have the answer, this is just a question.
Another crazy hypothesis I created based on a sample of one is Folic Acid consumption. Folic Acid is present primarily in leaffed vegetables, which have been nearly neglected from my diet throughout my life. I found out that when kids with leukemia had folic acid injected into their blood stream the rate of reproduction of their blood cells got even worse. When I had my first daughter I adopted a product called Instant Breakfast, a chocolate milk my wife's doctor recommended her to get the necessary folic acid needed during pregnancy. I figured that if it was good for her it would be good for me as I never used multi-vitamins. I drank one a day for 7 years nearly every day.
I have capped my current knowledge but I will continue to study and provide new ideas, I hope these are real ideas and not just rumblings from an ignorant undoctor.
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