N.C. cancer patients’ lives are at stake if Senate doesn’t act this week

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Cancer patients increasingly take pills for their treatment rather than injections. But insurance rules make them far more expensive. Diedra Laird 2015 file photo

A cancer diagnosis is one of the most disrupting and frightening experiences a person can go through. I know because it happened to me just last year.

I live with two forms of blood cancer – myelodysplastic syndrome and myelofibrosis. I am also one of the fortunate ones. Ongoing treatment has so far been successful in keeping the cancer in check, but I live with the reality that my body will stop responding so positively and I will need a new treatment game plan.

And unless the North Carolina Senate acts this week on legislation bringing fairness to cancer health coverage, I will also continue living with the reality that I might not be able to afford the next treatment I need, even though I have health insurance.

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For many years, intravenous (IV) delivery was the primary method for administering the medicines used to treat cancer, but these days, many of the frontline cancer treatments are in pill form – used in conjunction with injectable or IV therapies, or even in place of them.

In fact, well over one-third of the anti-cancer medications approved by the Food & Drug Administration over the last two years are in pill form. For many cancers, the most effective and appropriate form of treatment comes in a pill, and for some cancers, such as chronic myeloid leukemia, an oral therapy is the only available treatment option.

Despite the need for oral anti-cancer medications, some health plans in North Carolina require patients to pay a large sum for them, often in the thousands of dollars, as opposed to the more reasonable fixed copay charge for IV treatments. The high costs make it difficult and often impossible for cancer patients to get the therapies their doctors prescribe. Without those prescribed therapies the prospects for continued life are extremely limited.

The sobering reality is that cancer is the leading cause of death in our state, with nearly 57,000 North Carolinians diagnosed each year. And yet, North Carolina is one of only seven states that hasn’t enacted legislation requiring health insurers to cover oral anti-cancer medications in the same way they cover injectable or IV chemotherapy.

The state House passed such legislation – known as the Cancer Treatment Fairness Act (HB 206) – this year and during the past two legislative sessions, yet it has never gotten a hearing in the Senate.

With the clock ticking down on this year’s session, time is of the essence for the Cancer Treatment Fairness Act and for the many North Carolinians that it would help. I hope senators will finally listen to our voices and allow the legislation to move forward.

Health insurance is a pool we all pay into so that we can afford care if or when we need it. No North Carolinian should have to forego the necessary treatment prescribed by their doctor because insurers do not cover oral anti-cancer medications in a fair way. It’s time to bring insurance policies in line with modern medicine – and in line with the rest of the country – and make cancer care fair in North Carolina.

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Silencing of gene affects people’s social lives

Scientists examined how a process known as methylation, which can reduce the expression of specific genes, affects a gene called OXT. This gene is responsible for the production of a hormone called oxytocin, which is linked to a wide range of social behaviors in humans and other mammals.
Credit: © Zerbor / Fotolia

A team of researchers led by psychologists at the University of Georgia have found that the silencing of a specific gene may affect human social behavior, including a person’s ability to form healthy relationships or to recognize the emotional states of others.

In a paper published June 20 in the Proceedings of the National Academy of Sciences, scientists examined how a process known as methylation, which can reduce the expression of specific genes, affects a gene called OXT. This gene is responsible for the production of a hormone called oxytocin, which is linked to a wide range of social behaviors in humans and other mammals.

“Methylation restricts how much a gene is expressed,” said Brian W. Haas, the study’s lead author and assistant professor of psychology in UGA’s Franklin College of Arts and Sciences. “An increase in methylation typically corresponds to a decrease in the expression of a gene, so it affects how much a particular gene is functioning.

“When methylation increases on the OXT gene, this may correspond to a reduction in this gene’s activity. Our study shows that this can have a profound impact on social behaviors.”

Haas and his collaborators collected saliva samples from more than 120 study participants to perform genetic tests that show the levels of methylation on the OXT gene. The participants went through a battery of tests to evaluate their social skills as well as their brain structure and function.

What they found is that participants with greater methylation of the OXT gene–likely corresponding to lower levels of OXT expression–had more difficulty recognizing emotional facial expressions, and they tended to have more anxiety about their relationships with loved ones.

In one part of the study, participants were presented with brief video clips of people’s faces that begin with a neutral expression and gradually morph into an emotional face. The participant’s job is to press a button as soon as they feel confident that they know which type of emotion that face is showing.

“Participants with greater methylation of the OXT gene were less accurate in describing the emotional states of the people they saw in pictures,” he said. “That’s a typical characteristic associated with autism, for example.”

The researchers also used functional magnetic resonance imaging–a technology that measures brain activity by detecting changes in oxygenated blood flow–to examine the regions of people’s brains that were activated during various tasks, and they found that those with increased methylation of the OXT gene had reduced neural activity in brain regions associated with social-cognitive processing.

These participants also displayed reduced gray matter within an area of the brain called the fusiform gyrus, which is important for face processing and social cognition.

“All of our tests indicate that the OXT gene plays an important role in social behavior and brain function,” Haas said.

While Haas and his co-authors caution that these results are preliminary and that much work must be done to more clearly define the role of oxytocin and the genes that control it, he is hopeful this research may one day lead to new and improved treatments for a variety of social disorders.

“Methylation is a dynamic process, and level of methylation can change over the course of a person’s lifetime,” he said. “But it may be possible to alter the level of methylation with some type of medication that could help people who have abnormalities in social cognition.”


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