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FDA Sets Standard for Communicating Risks About Dense Breasts After Mammogram

The Food and Drug Administration (FDA) announced a requirement that mammogram providers will need to inform women with dense breasts that their results may be difficult to interpret and advise them to speak with their doctor about whether additional testing is appropriate, the Washington Post reported. Dense breasts have more glandular and fibrous connective tissue that can be hard to discern from cancer on mammography results, and women with dense breasts have a higher risk of developing breast cancer. Thirty-eight states already have some requirement that women be informed if a mammogram reveals dense breasts, but the language varies widely and, in some cases, doesn’t include direction to speak with a doctor about additional testing options. JoAnn Pushkin, executive director of the New York-based website DenseBreast-info, told the Post that some states merely inform women if they have dense breasts. “That’s really not enough to raise a red flag in a woman’s brain that they need to circle back around with a health provider and have a conversation about additional screening,” Pushkin said. The FDA’s decision will set a minimum standard for facilities across the U.S., and states could still require sharing more in-depth information. Providers are required to put the new rule into effect within the next 18 months.

How Immunotherapy Saved Jimmy Carter and Gained National Attention

Immunotherapies, which work by harnessing the immune system to fight cancer, got unexpected attention when former president Jimmy Carter was diagnosed with metastatic melanoma in August 2015. Prior to Carter’s metastatic melanoma diagnosis, congressional leaders’ “eyes would immediately roll around to the back of their heads,” whenever immunotherapy was brought up, noted Norman “Ned” Sharpless, a former director of the National Cancer Institute, in a March 6 Washington Post article. That changed, when Carter, at age 91, was diagnosed with metastatic melanoma, a diagnosis that Carter took to mean he had only weeks to live. He started immunotherapy treatment with an immune checkpoint inhibitor called Keytruda (pembrolizumab), and all signs of the cancer were gone by the end of the year. Policymakers, doctors and patients across the country started paying attention to this burgeoning field of oncology research. “For the public, Carter put immunotherapy on the map, period,” Drew M. Pardoll, the director of the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins in Baltimore, told the Post. He said patients started asking for immunotherapy, a phenomenon that became known as “the Jimmy Carter effect.” Immunotherapies have been approved by the Food and Drug Administration for over 20 types of cancer, including cancers of the kidney, head and neck, and lung, and are recognized as the fourth pillar of cancer treatment, along with chemotherapy, surgery and radiation, the Post reported. Carter’s recovery held in the subsequent years. He has recently entered hospice care at age 98, though his family has declined to say for what condition.

People Who Have Cancer While in Prison or Soon After Release Have Higher Cancer Mortality

People who are diagnosed with cancer while incarcerated or shortly after they are released face numerous barriers to adequate health care and have a higher cancer mortality, PBS NewsHour reported March 7. The story explored findings, published in September in in PLOS ONE that found people diagnosed with cancer while incarcerated or in the first year after their release have a higher risk of dying from the cancer than people who had never been incarcerated. The challenges facing this population start in jails and prisons, where health records may not follow them between facilities, and extend to the time after their incarceration when they can find obstacles accessing public insurance, such as Medicaid, and when many local and state laws block people who were formally incarcerated from getting secure housing or work. “You can see how this intricate web of laws and policies and practices really constrain your ability to meet your basic health needs following release,” said Emily Wang, an author of the study and founding director of the SEICHE Center for Health and Justice at the Yale University School of Medicine in New Haven, Connecticut. The delays and challenges can be agonizing for people trying to establish a new life while seeking cancer treatment, noted Dwayne Watterman, who directs facilities for New Jersey Reentry Corporation. These people often don’t find sympathy from the public or from health care providers, he adds. “It’s about punishment,” Watterman told PBS NewsHour, adding that health care and social services systems can have an uncaring attitude toward people who have served time in jail that conveys, “It’s OK for them to be in this situation, and this is a part of their suffering. This is a part of what they’ve done.”