Angelina Jolie’s Voluntary Double Mastectomy

Actress Angelina Jolie revealed recently that she chose to have a double mastectomy followed by reconstructive surgery with breast implants, to reduce her chances of dying of breast cancer.  Ms. Jolie, 37, says that she chose a double mastectomy because she tested positive for the mutated BRCA1 gene, which gave her nearly a 65% chance of developing breast cancer.   She explains her choice in an op-ed piece in the New York Times on May 14.  In the piece, Ms. Jolie says she wants other women to know they have choices.

Some readers hailed Ms. Jolie for her bravery and her willingness to speak so openly about such a personal decision.  A few readers, however, questioned the notion of choices.  For the average woman with a fear of cancer, a voluntary double mastectomy is probably not an option because of the cost.  Testing for the BRCA1 gene, genetic counseling, surgery, and breast reconstruction can cost tens of thousands of dollars.  Most insurance companies won’t pay for it if it’s done voluntarily, before the patient first develops any breast cancer.

Angelina Jolie says that for her it was a good choice, even though she had never been diagnosed with cancer.   On the positive side, her very public announcement may help other women make informed choices.   But practically speaking, it’s a choice that will remain out of reach of many women because of cost.   Even under Obamacare, testing for the BRCA gene (about $3,000) and genetic counseling will only be covered only “if appropriate”.  How that will be interpreted is anybody’s guess.

For more on this subject, see a previous blog post titled "Double Mastectomies Are On the Rise."

Scientists Clone Human Cells

Using essentially the same techniques that resulted in the first cloned adult animal (Dolly the sheep), scientists at Oregon Health Sciences University have cloned human cells and coaxed them into developing into human embryos. Their intent was to be able to produce cloned cell lines from the embryos strictly for therapeutic purposes. The research is published online in the journal Cell. The researchers started with eight human eggs from a single human donor, and after enucleating the eggs, joined them with human skin cells. From these they obtained five blastocysts (early-stage embryos) and ultimately produced four cloned cell lines.

So far, human embryos produced by these techniques (known as somatic cell nuclear transfer) have not been allowed to develop into full-term human babies. The cloning of humans, of course, raises some serious ethical issues. Society will have to grapple with the issue soon, because it’s now clearly within the realm of possibility.

The basic idea behind reproductive cloning research is to be able to produce human tissues that are an exact match for the human patient from which the cloned cell was taken. Tissues produced these techniques could be used to produce skin for treating burns, or perhaps heart, or liver cells to repair a damaged organ, without fear of tissue rejection.

Do the potential medical benefits outweigh the ethical concerns associated with the creation and ultimately the sacrifice of human embryos? You decide.

The NTSB Recommends Lower Blood Alcohol Limits

The National Traffic Safety Board (NTSB) is urging all states to lower the blood alcohol concentration that constitutes drunk driving, to 0.05%. Currently, the limit is 0.08% in all 50 states. The NTSB estimates that lowering the limit to 0.05% would save nearly 1,000 lives per year.

The NTSB estimates that even at 0.05% blood alcohol there is some impairment of depth perception and other visual abilities, resulting in a 39% increase in the chances of an accident while driving. At the current level of 0.08%, the chance of an accident is increased by 100%. Most countries in Europe and also Australia already have a 0.05% limit.

However the NTSB can only recommend the change; it has no legal authority to force states to adopt new laws. The last time a reduction in blood alcohol was recommended (from 0.10 to 0.08%), it took 21 years before the last state made the change. Nevertheless, most states do pay attention to the NTSB’s recommendation and to public opinion. We can expect many states to set new limits at 0.05% by their next legislative session.

Do you know how many drinks you would probably have to consume to surpass the current 0.08% limit? It’s worth knowing if you ever drink and then drive.

Products Containing DMAA are Still Available

General Nutrition Centers (GNC) is still selling dietary supplement products containing dimethylamylamine (DMAA), a full month after the FDA issued a health warning about the drug. DMAA is an amphetamine-like stimulant found in the workout-boosting product Jack3d.

The FDA says there have been over 80 reports of adverse health effects associated with DMAA, and urges consumers to stop using it. In addition, the FDA argues that DMAA does not qualify as a dietary supplement according to the accepted definition of a dietary supplement. The FDA has already convinced the product’s manufacturers to stop making these products. But the retailer GNC says it does not believe that DMAA is unsafe, and so it continues to sell its stock of workout products containing DMAA.

Whether DMAA qualifies as a dietary supplement may have to be decided in court, if GNC continues to push the issue. Even so, it’s unusual for a company to refuse to take a product off its shelves when it’s labeled unsafe by the FDA. Most companies would err on the side of caution by removing of the product from store shelves immediately. A company that continues to sell a product considered dangerous by the FDA would be risking future lawsuits. Indeed, there’s already one lawsuit against GNC for a death allegedly related to Jack3D.

What is GMC’s logic in continuing to sell Jack3d?!

Atmospheric CO2 Levels Reach a Milestone

According to the National Oceanographic and Atmospheric Administration (NOAA), atmospheric CO2 levels rose to a weekly average concentration (rounded to whole numbers) of 400 parts per million (ppm) last week. The actual weekly average for May 5th was 399.52 ppm.

Atmospheric CO2 measurements have been taken every hour of every day at the top of Mauna Loa in Hawaii since the 1950s. The accumulated data show quite convincingly that CO2 levels have risen rapidly over the past 60 years and are now higher (compared to historical averages estimated by other, indirect methods) than the levels at any time over the past three million years.

It is widely believed that the rising CO2 levels of modern times are a direct result of human activities, including especially the burning of fossil fuels (coal, oil, and gas). 400 ppm is just a number, of course; it does not necessarily signify an important level in and of itself. It’s just another signpost on the road of continuously rising CO2 concentrations. Despite all the talk over the past decade or so about the need to stop it to prevent global warming, little action has been taken so far.

So CO2 levels will probably continue to rise for awhile, until we actually get serious about doing something about it.

Morning-After Pill Ruling is Appealed

As expected, the Justice Department has appealed the ruling last month by a U.S. District Court judge that the morning-after pill should be made available to girls under the age of 17. Predictably, social conservatives and anti-abortionists are supporting the appeal.

President Obama himself is “comfortable” (now) with the pill being made available to girls as young as 15, according to an NBC news article. But he seemed to be against it back in 2011 (see this blog, Dec. 11, 2011). Perhaps his apparent change of heart was influenced by the fact that he is no longer facing an election?

The available scientific evidence supports making the morning-after pill available to all ages. The pill has proven to be safe enough that were it not a contraceptive pill, it would have been approved for younger girls long ago.

Like it or not, availability of the morning-after pill remains a political issue, not a scientific one.