May 4, 2017
Jen Marie Robustelli

35 Years of American Death Data | Oncology Download May 2, 2017

35 Years of American death data | How to have a better death | The survivors: How an experimental treatment saved patients and changed medicine | Budget deal defies Trump, includes $2B increase for medical research

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Every Tuesday morning, we send the Oncology Download out to thousands of oncology professionals. The newsletter is designed to be skimmable for the busy professional—our team curates 3-5 top stories from policy, research, industry, and mainstream media sources, and summarize these stories with takeaways geared toward cancer professionals dedicated to using data and technology to improve the lives of cancer patients. 

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35 Years of American death data

FiveThirtyEight visualizes mortality rates for leading causes of death in every US county from 1980 to 2014 in an impressive and interactive data visualization.

FiveThirtyEight covers research on "garbage codes" from the Institute for Health Metrics and Evaluation. Some notable trends for oncology folks from 30+ years of data:

  • While cardiovascular disease (at #1) and cancer (#2) are by far the largest causes of death in the US, both are trending down. 
  • In 1980, cancer accounted for about 240/100,00 deaths. In 2014, it accounted for 192/100,000 deaths.
  • Regional insights show rising cancer rates and increased deaths from substance abuse in Appalachia, even while overall rates deaths from cancer have dropped.
  • Get the full data set for all cancers here. Above, I've linked the visualization to show all cancers automatically.

See FiveThirtyEight's Guide to 35 Years of American Death video for tips on how to navigate the interactive data visualization.

How to have a better death

Cancer patients who die in hospital typically experience more pain, stress and depression than similar patients who die in a hospice or at home.

There is a disconnect between patients dying of a chronic condition, like cancer, and physicians. This article from the Economist calls for a better understanding and conversation around palliative care and is a particularly relevant read for physicians. Though there are many threads to untangle in this issue, here are some of the most important themes for this audience:

  • Only a third of American patients with terminal cancer are asked about their goals at end of life. Most oncologists, a key group who see a lot of dying patients, say that they have never been taught how to talk to them. Doctors are trained to do “everything possible”, often without talking through people’s preferences or ensuring that the prognosis is clearly understood.
  • Medicalized deaths are not what patients seem to want. Combined polling data shows that most people in good health hope that they will die at home. Few say that their priority is to live as long as possible, rather, they want to die free from pain, at peace, and surrounded by loved ones for whom they are not a burden.

The survivors: How an experimental treatment saved patients and changed medicine

Travel back in time to the beginning of precision medicine with this heartwarming success story of the drug Gleevec—which the New England Journal of Medicine recently said “changed everything".

If the previous two articles were a bit heavy for you, consider this article the happy movie epilogue as you leave the theater. The story follows Dr. Brian Druker and his 31 chronic myeloid leukemia patients in the 1999 round of trials of the compound that would eventually become Gleevec.

"I’m looking at this and thinking, 'This is amazing. We’ve never seen anything like this before.' These are people who’d been told to get their affairs in order. And now their blood counts are normal. But here’s the problem: When can you celebrate? I felt a little bit like walking on eggshells, because it’s like, 'OK, is this going to be a flash in the pan, or is this going to last?' And there’s only one way to find out: wait and see."—Dr. Druker

Budget deal defies Trump, includes $2B increase for medical research

The budget agreement Congress reached on Sunday would give the National Institutes of Health a $2 billion increase for the second year in a row.

As we've covered in several stories in this roundup, President Trump's initial proposal to cut $5.8 billion (later reduced to a $1.2 billion cut) from the NIH would halt or significantly delay some of the progress researchers have made for cancer and other diseases. Per Axios health reporter David Nather (someone worth following), it seems Congress will actually be doing the opposite—giving the NIH a budget increase of $2 billion.

Next Article:
What Netflix Can Teach Us About Cancer | Oncology Download April 25, 2017
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