First Edition: June 4, 2018

Kaiser Health News: Outsiders Swoop In Vowing To Rescue Rural Hospitals Short On Hope — And Money
Beau Gertz faced a crowd of worried locals at this town’s senior center, hoping to sell them on his vision for their long-beloved — but now bankrupt — hospital. In worn blue jeans and an untucked shirt, the bearded entrepreneur from Denver pledged at this town hall meeting in March to revive the Surprise Valley Community Hospital — a place many in the audience counted on to set their broken bones, stitch up cattle-tagging cuts and tend to aging loved ones. (Feder Ostrov, 6/4)

Kaiser Health News: Bubble Pop? Brownie Batter? Vapes’ Added Flavors Fuel E-Cig Debate 
A heated debate is redrawing alliances in the tobacco control movement as federal officials wrestle with how to regulate the growing e-cigarette market. The players include researchers, smoking-cessation advocates and “vaping” connoisseurs.“ It’s become very divisive in a community that was largely united against Big Tobacco,” said Samir Soneji, an associate professor at the Dartmouth Institute for Health Policy and Clinical Practice, who researches tobacco control policy. (Luthra, 6/4)

The Hill: States Defy Trump On ObamaCare
Blue states are defying the Trump administration in a bid to protect ObamaCare and keep their insurance markets stable. Several states, including California and Maryland, are looking to put limits on short-term insurance plans, even as the Trump administration is poised to expand access to them nationwide. The states are doing so because they fear the availability of the short-term plans will drive up premium costs for ObamaCare. (Weixel, 6/2)

The Hill: Health Advocates Sense Momentum On Medicaid Expansion 
Opponents argue Medicaid expansion will lead to runaway spending. Virginia's Republican state Senate majority leader, Tommy Norment, denounced the state's move on Wednesday, saying it “abandons Virginia’s long-standing reputation for fiscal responsibility." But backers sense that the politics have shifted on the issue. With former President Obama out of office and ObamaCare repeal efforts seemingly dead in Congress, there could be less resistance to accepting changes as part of the health-care law. (Sullivan, 6/2)

The New York Times: Trump Plan To Lower Drug Prices Could Increase Costs For Some Patients
When President Trump unveiled his plan to lower prescription drug prices in a Rose Garden speech last month, he said he would inject more competition into the market by bolstering negotiating powers under Medicare. But experts analyzing the plan warn of a possible side effect: The proposal could significantly increase out-of-pocket costs for some of the sickest people on Medicare. At the heart of the president’s plan is a proposal to switch some expensive drugs from one part of Medicare to another part — moving them from Part B, the medical benefit created in the original 1965 Medicare law, to Part D, the outpatient drug benefit added by Congress in 2003. (Pear, 6/2)

The Wall Street Journal: FDA Chief Expects Agency To Play Role In Overseeing Requests For Unproven Drugs
U.S. Food and Drug Administration Commissioner Scott Gottlieb said he expects the agency will still decide in some cases whether terminally ill patients can receive unproven drugs, despite a new law intended to weaken the FDA’s power over such cases. The new “Right to Try” law, signed by President Donald Trump last week, allows terminally ill patients to try experimental drugs outside of standard clinical trials, without needing FDA approval and as long as drug companies are willing to provide them. (Loftus, 6/3)

Reuters: Novartis Readies Anti-Sexism Message For Migraine Drug
With women hardest hit by migraine headaches, Swiss drugmaker Novartis is gearing up its marketing message to counteract sexism that it worries might become a barrier to adoption of its new medicine Aimovig. The injectable monoclonal antibody that Novartis has developed with Amgen won approval in the United States this month and on Friday bagged a recommendation from a key European panel, clearing the way for likely approval on the continent. (Miller and Varghese, 6/1)

The Associated Press: Many Breast Cancer Patients Can Skip Chemo, Big Study Finds
The study is the largest ever done of breast cancer treatment, and the results are expected to spare up to 70,000 patients a year in the United States and many more elsewhere the ordeal and expense of these drugs. "The impact is tremendous," said the study leader, Dr. Joseph Sparano of Montefiore Medical Center in New York. Most women in this situation don't need treatment beyond surgery and hormone therapy, he said. The study was funded by the National Cancer Institute, some foundations and proceeds from the U.S. breast cancer postage stamp. Results were discussed Sunday at an American Society of Clinical Oncology conference in Chicago and published by the New England Journal of Medicine. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test. (Marchione, 6/3)

The New York Times: Good News For Women With Breast Cancer: Many Don’t Need Chemo
Many women with early-stage breast cancer who would receive chemotherapy under current standards do not actually need it, according to a major international study that is expected to quickly change medical treatment. ... The study found that gene tests on tumor samples were able to identify women who could safely skip chemotherapy and take only a drug that blocks the hormone estrogen or stops the body from making it. The hormone-blocking drug tamoxifen and related medicines, called endocrine therapy, have become an essential part of treatment for most women because they lower the risks of recurrence, new breast tumors and death from the disease. (Grady, 6/3)

The Washington Post: Most Women With A Common Type Of Early-Stage Breast Cancer Can Skip Chemo, A New Report Finds
The cancer in question is driven by hormones, has not spread to the lymph nodes and does not contain a protein called HER2. Generally, after surgery, such patients receive endocrine therapy, such as tamoxifen, which is designed to block the cancer-spurring effects of hormones. Otis Brawley, chief medical and scientific officer of the American Cancer Society, called the trial a good example of “precision medicine” and said it would save many women from unneeded chemotherapy. (McGinley, 6/3)

NPR: Breast Cancer Genomic Test Can Rule Out Need For Chemo
In the U.S., the most recent data shows around 135,000 new cases yearly of the specific breast cancer studied, says Dr. Joseph Sparano, an oncologist at Montefiore Medical Center, a professor of medicine at the Albert Einstein College of Medicine and the lead author of the study. Twenty-five percent of those patients won't qualify for chemotherapy because of age or medical problems. Out of the 100,000 or so patients who could take the gene test to help make a decision about chemotherapy, he says at least two-thirds fall into the middle range that can benefit from the study findings. (Watson, 6/3)

The Wall Street Journal: Doctors Suggest Less Chemo, Surgery For Some Cancer Treatments
The studies are part of a growing movement among cancer doctors and researchers to de-escalate treatments for certain tumor types, as drugs become increasingly expensive. The average U.S. monthly price of oncology drugs more than doubled to $15,535 in 2015 from $7,103 in 2006, according to a May report in the Journal of Oncology Practice. Overall U.S. spending on cancer drugs doubled from 2012 to 2017, to nearly $50 billion, according to IQVIA Institute for Human Data Science. (Loftus, 6/3)

Stat: Cancer Patients Want Immunotherapy Even When Evidence Is Lacking
Immunotherapy is a source of great hope in cancer care. It has rescued some patients from the brink, while giving others a reason to believe that they, too, could beat the long odds. But these therapies are also creating a vexing dilemma for doctors: Their patients, citing television ads and media accounts of miraculous recoveries, are pushing hard to try them, even when there is little to no evidence the drugs will work for their particular cancer. (Ross, 6/4)

Stat: Grail Cancer Liquid Biopsy Shows 'Proof Of Principle,' But Challenges Remain
Along way to go, but getting there — that’s the verdict on the highly anticipated data Grail released Saturday about its liquid biopsy for cancer. The Illumina spinoff is almost as well known for its executive departures and ability to raise buckets of money as for its out-of-the-park goal: detecting tumors super-early, when even cancers with a horrible prognosis might be treatable, by analyzing DNA that has escaped its cells and is floating in the blood. (Begley, 6/2)

The Associated Press: Blacks Fare Surprisingly Well In Prostate Cancer Research
Black men with advanced prostate cancer fared surprisingly well in two new studies that challenge current thinking about racial disparities in the disease. Blacks are more likely to get prostate cancer and to die from it than whites, but the new research suggests getting access to the same treatment may help balance the odds — even if it doesn't greatly extend life after cancer has spread. Given the same standard treatments, blacks with advanced disease may do even better than whites, the studies suggest. (Tanner, 6/1)

Politico: ‘The Police Aren’t Just Getting You In Trouble. They Actually Care.’
She watched her sister dying, slumped over her kitchen table, unconscious and gasping. When the police and paramedics came, they turned her sister onto the floor and sprayed naloxone up her nose—once, then a second dose. The anti-opiate did its work in minutes: Her sister woke up. Three days later, she opened the door to the police again. Derek Back, a police officer in plainclothes, and Tiffany Duggan, an addiction recovery coach, hadn’t come with an arrest warrant but a potential lifeline: a bed in a drug treatment facility. (Trickey, 6/2)

The New York Times: The Fight To Get A Vaccine To Center Of Ebola Outbreak
Aiming to squelch an Ebola outbreak that has infected 54 people, killing almost half of them, aid workers in the Democratic Republic of the Congo have begun giving an experimental vaccine to people in the rural region at the epicenter of the outbreak. Epidemiologists working in the remote forests have not yet identified the first case, nor many of the villagers who may have been exposed. Investigators will need to overcome extreme logistical hurdles to reconstruct how the virus was transmitted, vaccinate contacts and halt the spread. (Baumgaertner, 6/1)

The Washington Post: Even If A Medical Test Shows An Abnormality, You May Not Need To Worry About It
I have an extra vein into my heart that, in most people, disappears during embryonic development. My eyeballs are shaped more like lemons than like baseballs. And I once woke up after a foot surgery to hear the doctor say, “I’ve never seen anything like that before. ”I’m not the only one who is loaded with physiological quirks. A survey of friends revealed tonsils that kept growing back after tonsillectomies; a missing kidney that was discovered missing only after age 40; and blood that tests positive for syphilis, even though there is no syphilis. I heard about extra toes, fingers and nipples. One friend never grew wisdom teeth. Another grew seven of them. (Sohn, 6/3)

The Washington Post: Group Doctor Appointments Can Mean Better Health
Walter Gardner knew his life was at risk: Nearly 100 pounds overweight, he had developed Type 2 diabetes and needed several prescriptions. Traditional medical appointments had little effect on the 55-year-old’s health. Then he was offered a way to spend more time with his doctor. Gardner seized the opportunity. “I needed to do something or I probably wasn’t going to make it to 60,” he said. (Levingston, 6/2)

The Associated Press: Organ-Donor Advocate Dies Waiting For Kidney
A Delaware man who for years advocated for increased organ donations has died while lingering on the list for a kidney transplant. Fifty-six-year-old Bill Murray of Wilmington had spent the last five years receiving dialysis for chronic kidney disease. During those years, he advocated for kidney-disease awareness and the need for organ donation to help the tens of thousands of Americans waiting for a transplant. (6/2)

NPR: From Chaos To Calm: A Life Changed By Ketamine
For six years now, life has been really good for James. He's got a great job as the creative director of an advertising firm in New York City. He enjoys spending time with his wife and kids. And it's all been possible, he says, because for the past six years he's been taking a drug called ketamine. Before ketamine, James was unable to work or focus his thoughts. His mind was filled with violent images. And his mood could go from ebullient to dark in a matter of minutes. (Hamilton, 6/4)

The New York Times: Cinnamon May Be Safe In Foods, But Is It Safe In E-Cigarettes?
A common cinnamon food additive that is widely used to flavor e-cigarettes had harmful effects on human lung cells in a laboratory culture, disrupting the cells’ innate host defense system, scientists report. The compound, called cinnamaldehyde, gives cinnamon its characteristic flavor and smell and is generally considered safe when added to food. But like many chemicals in e-cigarette emissions, it has not been thoroughly evaluated for safety when inhaled rather than ingested, said Phillip Clapp, who recently completed his doctorate in the lab of Dr. Ilona Jaspers, deputy director of the University of North Carolina at Chapel Hill’s Center for Environmental Medicine, Asthma and Lung Biology. (Rabin, 6/1)

The New York Times: Antibiotics Weren’t Used To Cure These Patients. Fecal Bacteria Were.
The bacteria can take over a person’s intestines and be difficult to eradicate. The infection causes fever, vomiting, cramps and diarrhea so severe that it kills 14,000 people a year in the United States alone. The first line of treatment for the attacking microbes, called Clostridium difficile, is antibiotics. But a group of Norwegian researchers asked if something more unusual — an enema containing a stew of bacteria from feces of healthy people — might work just as well. (Kolata, 6/2)

The Associated Press: Health Care, Immigration Dominate California Governor Race
No topic has dominated California's governor race like President Donald Trump. The Republicans want to be like him; the Democrats want to oppose him. But whoever wins will face a long list of challenges from housing and homelessness to health care. Here's a look at some of the debates that have emerged during the race, which includes Democrats Gavin Newsom, Antonio Villaraigosa, John Chiang and Delaine Eastin and Republicans John Cox and Travis Allen. (Cooper, 6/2)

The Associated Press: Puerto Rico Agency Sues Government To Obtain Death Data
Puerto Rico's Institute of Statistics announced Friday that it has sued the U.S. territory's health department and demographic registry seeking to obtain data on the number of deaths following Hurricane Maria as a growing number of critics accuse the government of lacking transparency. The lawsuit was filed Thursday, the same day Puerto Rico Gov. Ricardo Rossello told CNN there would be "hell to pay" if officials don't release mortality data. Puerto Rico's Health Department released some information Friday, saying an additional 1,397 overall deaths were reported from September to December in 2017, compared with the same period the previous year. However, officials did not provide causes of death for any of the 11,459 total people deceased during the period. (Coto, 6/1)

The Associated Press: Renowned Texas Heart Transplant Program Suspends Operations
"Although extensive reviews are conducted on each unsuccessful transplant, the recent patient outcomes deserve an in-depth review before we move forward with the program," Doug Lawson, CEO of Catholic Health Initiatives Texas Division, which owns St. Luke's, said in a statement. "Our prayers are with the families, as well as all those on the waiting list." (6/2)

The Associated Press: Agency: Most Florida Nursing Homes Are Without Backup Power
A government agency reports that most Florida nursing homes and assisted-living facilities do not have backup power despite new requirements enacted after a dozen people died in a sweltering center following Hurricane Irma. The state Agency for Health Care Administration says only 48 nursing homes and 91 assisted-living facilities have installed equipment and had state inspections as of May 25. The new rules that went into effect Friday require all facilities to have backup power for cooling for at least 96 hours. (6/2)

Reuters: His Twin Shot Dead, A Washington Teen Shines Spotlight On Gun Crime
Every school day, Zion Kelly passes by the locker once used by his slain twin brother, Zaire, who was shot in the head during an attempted robbery in their Washington, D.C. neighborhood last September. Zaire is one of more than 170,000 youths between the ages of 5 and 24 that have been killed by gun violence in the United States since the Centers for Disease Control and Prevention (CDC) began collecting data in 1981. (6/1)

Politico: San Francisco To Vote On Flavored Tobacco Ban
A major tobacco company is pouring millions of dollars into a ballot initiative that would repeal the country’s strongest effort yet to ban the sale of flavored tobaccos, which are attracting a whole new generation of users including children and teens. A $12 million campaign primarily funded by R.J. Reynolds is urging San Francisco voters next Tuesday to reject the city’s ban on selling flavored vaping products, hookah tobacco and menthol cigarettes. The flavored tobacco comes in brightly colored packages and tastes like bubblegum, mango or chicken-and-waffles, which public health advocates say are designed to entice young people. (Colliver, 6/2)

The Associated Press: Proposal Would Add ‘X’ Category To NYC Birth Certificates
People born in New York City who do not identify their gender as either male or female would have the option of choosing a third category for their birth certificates under a new proposal. Mayor Bill de Blasio and City Council Speaker Corey Johnson said the new category of “X’’ would be available through the proposal, which is expected to be introduced by Johnson on Thursday with public hearings to be held later this month. Currently, if parents of a newborn do not want to identify a sex, they can say the sex of the child is undetermined or unknown. The “X’’ category would be something adults could choose for their own birth certificate. (Hajela, 6/3)

The Associated Press: Clinic Owner Accused Of Medical Marijuana Fraud
A clinic owner in Delaware has been arrested and charged with submitting fraudulent applications for medical marijuana. Delaware State police said Saturday that Carolan Krajewski has been charged with forgery and tampering with public records. Krajewski is owner of Delaware Holistic Medicine in Lewes. The clinic was formerly known as Disjointed. (6/2)