National Cancer Institute director John Neiderhuber worries the NCI 2007 budget could be slashed by five to 10 percent. And he worries that key cancer research will inevitably come to a halt as a result.

Worries stem from budget cuts proposed by President Bush. Cuts would cost the NCI between $36 million and $4.7 billion -- but Bush reports that NCI funding has doubled in the past 10 years and would still remain relatively high. And due to the recent American Cancer Society announcement that cancer deaths dropped for the second straight year, White House spokesman Tony Fratto says, "We're proud of the significant investment that we have made in cancer research. We're also proud of the results showing that researchers are delivering on that investment."

But researchers still worry. They worry cuts will undermine their successes. They feel like the rug is being pulled out from under them, just as they are making significant progress. They suspect 95 clinical trials could be postponed or cancelled, 3,000 patients could miss the opportunity of joining a trial, and some cancers will be completely eliminated from studies.

"There is a real cost in human life," says Allen Lichter, executive vice president of the American Society of Clinical Oncology, of the more-than-monetary toll budget cuts will take on NCI research efforts.

One study already on hold, pending funding decisions, is the next phase of a study evaluating whether a class of drugs called aromatase inhibitors, can prevent breast cancer. Another research group has opted to stop studying brain tumors. This is a huge loss to patients with this type of cancer, says Lichter.

It's a huge loss to all of us really -- because cancer will affect each of us in some way, some day. And so with cut budgets come cut hopes, cut dreams, and sadly -- cut survival.

The cost of drugs to treat cancer can be very expensive. If you do not have good medical insurance it could prove disastrous for you and your family.

I read an article in Cure Magazine last night called Help for Patients. In this article it provided information on assistance programs. It also mentioned that many patient assistance programs will require proof of income, social security income, interest and retirement to prove financial burden and to meet income requirements of the programs.

Patients interested in enrolling in an assistance program can start by doing some research on the organizations listed below:

• Amgen Reimbursement Connection: 800-272-9376 www.amgen.com/patients/assistance.html
• Bristol-Myers Squibb Patient Assistance Foundation: 800-736-0003 www.bmspaf.org
• CancerCare: 800-813-4673 www.cancercare.org
• GlaxoSmithKline's Commitment to Access: 866-865-6491 www.commitmenttoaccess.gsk.com
• Genentech's Single Point of Contact: 888-249-4918 www.spoconline.com
• Lilly Cares: 800-545-9662 www.lillycares.com
• Partnership in Prescription Assistance: 888-477-2669 www.pparx.org
• Patient Advocate Foundation: 866-512-3861 www.copays.org
• Pfizer's FirstRESOURCE: 877-744-5675 www.pfizerhelpfulanswers.com
• RxAssist and Rx Outreach Patient Assistance Programs: www.rxassist.org
• RxHope: 877-979-4673 www.rxhope.com
• Sanofi-Aventis's PACT plus: 800-996-6626
• Schering-Plough's Commitment to Care Program: 800-51-7157 www.schering-plough.com
• Together Rx Access: 800-444-4106 www.togetherrxaccess.com

I once waited to see my oncologist -- in a room with nothing more than outdated magazines and my own wandering mind -- for four hours. I offered up 20 hours of my time for chemotherapy treatments and then spent five days -- two times, for a total of ten days -- waiting in the hospital for doctors to determine how to raise my blood counts and decrease my fever after the completion of a dose-dense chemotherapy attack. I traveled to and from radiation appointments for 35 days, spending an average of 90 minutes on each of these round-trip excursions. I reclined in an infusion chair every three weeks for 12 months so that a new breast cancer wonder drug could sail through my veins. I spent 52 hours in that chair. And I spent countless hours pouring out my emotions to a counselor, in an attempt to clear my mind of all that cancer took from me -- including my time.

These are just seven memories I have of time lost to cancer. There are others -- countless others -- but this should suffice as proof that among all the potential side effects that accompany cancer, loss of time is a guarantee.

According to the first study to put a price tag on the time patients spend battling cancer, it seems the disease steals at least $2.3 billion worth of time for patients in the first year of treatment alone.

Eleven of the most common cancers were included in the study. And it was determined that 368 hours are lost during the first year of treatment for ovarian cancer. For lung cancer, 272 hours are lost. For kidney cancer, 193 hours go down the drain. These hours don't take into account time spent in bed recovering from surgery or chemotherapy treatments. It accounts only for time engaged in actively receiving care -- it counts chemotherapy, radiation, blood tests, scans, surgery, check-ups, waiting to see doctors, and driving to and from appointments.

The study, published in the Journal of the National Cancer Institute, sheds new light on the burden of commitment -- the human cost of cancer.

"Cancer is more than the just the dollars and cents for the medicines and the treatments and the doctors. It's also the lost opportunities for the patients," said the American Cancer Society's Dr. Len Lichtenfeld, of this overlooked reality.

Lichtenfeld says this study demonstrates the need for early detection. The earlier cancer is caught, the less time patients spend in the system. It also shows the need for more targeted therapies that spare patients physical side effects and allow them opportunities for taking pills at home instead of receiving treatment in clinics.

I would love to have back the time I spent treating and recovering from cancer. But I'm not heartbroken over my lost time. Because it bought me something in the end -- more time.

Mammograms are offered at the M.D. Anderson Cancer Center in the Texas Medical Center. They are also offered on M.D. Anderson's self-contained 38-foot van containing a LoRad MIV mammography unit. The van travels to various workplace sites where employees and clients can jump on board the van for a mobile mammogram.

Hartford Hospital's Take the Time mammogram van travels to clinics, churches, senior centers, and other Connecticut locations where women can easily access life-saving screenings. The University Breast Health Center in Augusta, Georgia is home to a mobile mammography program that reaches underserved women unable to report for on-site visits. Lexington Medical Center in South Carolina offers mobile mammograms. Y-ME National Breast Cancer Organization affiliates offer their own traveling screening services. And a mobile mammogram service was offered on Kent State University's campus during this October's Breast Cancer Awareness Month.

Mammograms on the go are no different than mammograms at fixed locations. They are high quality, safe, confidential -- and typically speedier than the traditional screening procedure. Often, a woman knows before she departs that her image is technically accurate. She can ask questions and receive information, and she can expect a prompt call from the radiologist or her physician who will discuss results. Sometimes, mobile mammograms take as little as 20 minutes to complete.

Mammograms are recommended for women age 40 and older and for women with a personal or family history of breast cancer. As with all medical services, there are barriers -- such as awareness, cost, transportation, convenience -- that prevent access for some people. Mobile mammograms help drive away barriers. They allow more women more access to the best tool for identifying breast cancer in its earliest form.

Roll on, mammogram vans!

On Sunday, for the very first time, I read a magazine article about the hospital where I received treatment for breast cancer. I had never before seen mention of my hospital, my doctors, my city in anything other than local and regional newspapers and on area television stations. I figured news about Shands Hospital at The University of Florida was out there -- in more areas than my own -- because it's a well-known facility. People travel from all over to receive treatment here. So I know it's a good place. But to see in the October 2006 issue of Good Housekeeping an actual blurb about a new kind of lumpectomy -- pioneered right here in Gainesville, Florida -- is exciting.

I am the happy recipient of this new kind of lumpectomy -- which really is not new at all. It was developed 20 years ago by the surgeon who performed my own lumpectomy, and it allows women who undergo lumpectomy the chance to avoid return trips to the operating room.

The method is called frozen section analysis, and it was first used by Dr. Edward Copland III, first director of the UF Shands Cancer Center, who was tired of waiting for pathology reports and tired of operating on patients two and three times to ensure clear tumor margins.

It all happens like this -- a surgeon removes the breast cancer tumor, takes tissue samples, freezes them in an embedding compound, and sends them to a pathologist for immediate analysis. In a typical case, this frozen section process adds just 15 minutes to the operating time. If pathology reveals more tissue must be removed, the surgeon returns to the patient, still under anesthesia, and continues surgery. The patient does not need to return for more surgery.

Surgeons at most institutions rely on a method called permanent section analysis to determine whether or not cancerous cells remain along the margins of a tumor. The technique is labor-intensive, takes days to complete, and requires patients to return for additional surgery if margins are not clear. Surgeons using the frozen section method still consult permanent sections to confirm margins are clear -- but they are mostly certain of their findings during frozen section.

Studies show frozen section analysis to be safe and effective -- and it adds just $851 to the cost of surgery, a savings considering the cost of returning for surgery as a result of permanent analysis.

There are many advantages -- but the procedure is tricky and on occasion can fail to detect some cancerous margins, indicating frozen section should continue to be used in conjunction with permanent section. Opponents of the practice say false positives could result in unnecessary mastectomy. But Copeland says this has never happened at UF -- and he would never remove a woman's breasts until permanent section confirmed it was necessary.

Despite the promise of this method, only a handful of institutions make practice of this surgery-sparing technique. Shands at UF is the only hospital in North Florida where breast surgeons perform frozen section analysis on a regular basis.

The procedure -- which is not risky, is not harmful, and clearly saves patients from returning for surgery -- is the exact procedure I received almost two years ago. Dr. Copeland removed my tumor, froze tissue samples, sent them to pathology, and 15 minutes later knew my tumor had clear margins and had not spread to my lymph nodes. He visited my family in the hospital waiting room just after surgery and told them the good news -- clear margins, no spread, a 1.1 cm. tumor, stage I. And while other tumor criteria, such as ER/PR status and HER2 status, did not come my way immediately, I at least knew the basics when I woke from surgery. No waiting. No worrying. No complaints.

It's a question that could face any one of us at any time -- the question over whether to pay the high cost of cancer treatment, when it could send us into debt, or to discontinue treatment in order to save money for the family members who will survive us. Dying of lung cancer, Carolyn Hobbs was confronted with this exact question when considering a new biotechnology drug -- Erbitux -- that she learned cost $1,800. The drug may have extended her life but she determined it wasn't worth it -- and she refused the treatment.

During the last decade, expensive new treatments -- some upwards of $50,000 -- have given some patients their first real fighting chance against disease. The problem with these treatments, however, is that most patients will only survive an extra few months. A lucky few may survive for years. For some, maybe the small fortune these few months or years cost is worth it. For others, squandering their life savings on an extended death sentence is not worth it.

For me -- right now -- I believe I would do anything possible to ensure a longer life. And according to one poll, nearly one-third of Americans faced with death would also do anything possible to survive just a bit longer. This percentage is up from one-fifth in 1990. So I have some company in my corner. But I have not walked in the shoes that require this type of decision. I can only speculate about how I might approach this life-and-death decision. And hopefully, I will never have to make it.

Health care coverage for working Americans is like a brittle tree in a hard wind -- and the larger limbs are beginning to snap. Between the years 2000 to 2005, 6.8 million more people became uninsured according to the latest report from the U.S. Census Bureau's Housing and Household Economic Statistics Division. Current data estimates 46.6 million people are without health insurance coverage. As employer-based health insurance continues to fade, government programs are taking up the slack -- up to a point. But given the lack of funding, there is only so much that can be offered.

In a statement issued by the Center for American Progress, "These problems did not just happen: they resulted from flawed economic and health policies which force Americans to work more for less. When it returns after Labor Day, this Congress should act to mitigate these problems by passing a straightforward minimum wage increase and extend health funding for programs like the State Children's Health Insurance Program. Moreover, policy makers should recognize the need for major change, such as providing affordable health care to all Americans and taking action to address growing income inequality."

Some are calling for a government-based universal health care system that guarantees health care coverage for all Americans. Others are suggesting a mix of private and public health care coverage. What ever the solution, there certainly needs to be one.

We can start with a shift in perspective and change in expectation. If you are working full-time for a company, presumably your efforts are helping that company make a profit. Health insurance coverage should not be viewed as a luxury benefit, nor should the largest burden of health insurance premiums be shouldered by the employee whose earnings just meet living expenses. Yet, this is happening every day in this country. The hard wind continues to batter the brittle tree.

Personally, I am not sold on a government-run, government-backed universal health plan simply because I have covered too many horror stories about rationed care in other industrialized countries. It seems a combination of programs might be the solution but the government and our elected officials certainly need to be held accountable for implementing programs that insure all Americans.

American Public Health Association Georges Benjamin is quoted by United Press International as saying, ""This is the worst news we've had all year. Our nation is not secure if we're not healthy."

I feel fortunate to have received every cancer drug I needed to fight my breast cancer -- Adriamycin, Cytoxan, Herceptin, and every nausea pill, pain capsule, and anti-anxiety formula on the market. I got exactly what doctors thought I needed -- without worry about availability or funding or politics. I am lucky. Some in the UK are not so lucky.

Two targeted therapies for bowel cancer will not be used in Britain's state-run health system, according to NICE -- the National Institute for Health and Clinical Excellence. NICE, the country's financial watchdog, determined the high cost of the medicines meant their use was not compatible with the best use of resources. Patients are angry because these same two drugs -- Avastin and Erbitux -- are used widely in the United States and in much of Europe. And while neither drug offers a cure for bowel cancer, both treatments have been shown in clinical trials to extend life expectancy by four or five months in some patients.

Based on doses given during the trials, it is estimated that the average cost of treating one patient with Avastin would be around 16,800 pounds and with Erbitux -- about 11,700 pounds. Apparently, this is too much. But according to Hilary Whittaker of the charity Beating Bowel Cancer, the decision to deprive patients of this medication is a scandal. I agree. And for these patients, I am sad.

Metastatic brain tumors -- tumors that spread from a cancer in another area of the body -- are among the worst tumors and will plague about 200,000 people in the United States every year. But once considered a death sentence, these brain tumors -- primarily those one centimeter in size or less -- can now be treated with a breakthrough radiation technique launched at the University of Florida College of Medicine. This new state-of-the-art radiosurgery device for noninvasive, outpatient treatment is more precise and more powerful than previous methods of treatment. Approved by the FDA in June, this Trilogy Tx system makes traditional surgery unnecessary for many patients. Dr. William Friedman, chairman for the department of neurosurgery at UF and one of two professors who developed and patented seven components of this system over the past 20 years, says, "I'm a surgeon, but if you can provide an outpatient, noninvasive treatment that requires no anesthesia, has extremely high cure rates, and very low complication rates, the question is: Why do surgery?"

Patients of this treatment are fitted with a head ring that prevents the their heads from moving while the Trilogy machine rotates to deliver radiation beams from many angles. While traditional radiation is given every day, Monday through Friday, for six weeks, the Trilogy Tx requires one single treatment that lasts for 15 minutes. It's comparable in cost to standard radition, is cheaper than surgery, and is typically covered by insurance. And it works -- which is the best selling feature, I think.

Diane Lane, award-winning actress, appeared on NBC's Today Show this morning and had her hair cut off on live television in the official launch of the Pantene Beautiful Lengths campaign. At the same time, 50 women volunteers across the country are having eight inches of their hair cut in a hair donation that will go to making no-cost wigs for women who have lost their hair during chemotherapy cancer treatment.

The campaign is hoping to inspire women and men to make a gift of their healthy hair, cutting it to create wigs for women in need. In addition, Pantene will launch the program with a $1 million donation to the Women's Cancer Research Fund for cancer research.

"This simple act of cutting my hair is going to make a profound difference to a woman who is fighting to regain both her health and sense of self," Lane said. "My dream is that every woman who hears about Pantene Beautiful Lengths will become inspired to grow her hair and donate a natural resource that only she can give." You can watch pre-show outtakes of the broadcast, as well as the Hope Pass it On video at Pantene Beautiful Lengths website. For those that missed the early morning show, NBC has not posted any video coverage of Lane's appearance. Not yet anyway, I checked.

In USA Today, Prices soar for cancer drugs, are some disturbingly stunning and eye-opening facts regarding the current cost of cancer drugs and an examination of where the costs might be headed. For example, Avastin, a newer drug used to treat colorectal cancer, costs about $50,000 dollars a year in treatment. That price is expected to go to $100,000 dollars a year if Avastin is approved to treat breast and lung cancers. It would be an understatement to say cancer patients and insurance companies are concerned. It's an uneasy feeling.

Some cancer drugs can cost $10,000 dollars a month for a single drug. The average monthly cost for a prescription cancer drug is estimated at $1,600 dollars. Without insurance, few could afford to buy life saving drugs and the consumer has to be sitting precariously perched at the mercy of insurance companies to keep funding the medicine. I think it would be safe to say that any cancer patient among the 45 million uninsured Americans is going without much-needed  medications if they have to come up with the money to buy the drugs. At these prices it is not possible.

"These costs are out of control," says Fran Visco, president of the National Breast Cancer Coalition, which is planning a conference focused on drug costs in the fall. "We can't allow it to continue." Who is going to stop the drug companies from charging what they want?

"It's really exploiting the desperation of people with a life-threatening illness," says Marcia Angell, former editor of The New England Journal of Medicine.

I just posted about quacks who exploit the desperation of cancer patients. While I do not equate drug companies with that jailed quack specifically, there seem to be more bad guys than the obvious scoundrels who prey on vulnerability. I don't have the answers but I am pessimistic about how this turns out for the cancer patient. I have yet to see anything in our society fall in price. I don't begrudge a business of profit -- but this is starting to look like a free-for-all and forget who might be hurt along the way.  What do you think?

Quick autopsies -- or rapid organ donation -- may steer scientists in the direction of better diagnosing and treating the most lethal of cancers. Some 33,700 Americans will be diagnosed with pancreatic cancer this year -- and 32,300 will die. There is no early detection test for this disease and early symptoms are vague and may be mistaken for health concerns like indigestion. By the time the classic symptoms -- jaundice and itching -- surface, the cancer has typically spread and patients have only months to live. Rapid autopsies have been used before -- for Alzheimer's and prostate cancer -- but this a first in the study of pancreatic cancer and it just may lead to the discovery of what makes this cancer so aggressive and so deadly.

Nevada is home to the loneliest road in America, legalized brothels and Las Vegas. Now -- according to a spokesman for Gov. Kenny Guinn -- the state government will help Nevadans with the ability to purchase low-cost prescription drugs from Canada via the internet by providing direct web links to pharmacies in Canada. Nevada is not listening to the staunch objections from the U.S. Food and Drug Administration to the fact that it is illegal. The legislators state that the import option is needed because many people pay twice as much for similar prescriptions in this country and often cannot afford the drugs they need to live. Lawmakers contend that the federal policies regarding the ability to obtain low-cost prescription drugs are simply a disgrace.

Nevada lawmakers passed the measure allowing Nevadans access to less expensive prescription drugs from Canada, and Nevada regulators have given approval to move ahead with implementing links to pharmacies in Canada. There will be a warning on the state website saying that the federal government views getting prescriptions filled in Canada with non-FDA-approved drugs an illegal act. The state website and links to Canadian pharmacies is scheduled to go live today.