Tag Archives for National Institutes of Health

Prominent Oncologist’s Death Wish at Age 75

Published in Pawtucket Times, December 12, 2014

Dr. Ezekiel Emanuel, MD, Ph.D., a nationally-recognized oncologist and bioethicist, definitely marches to a different drummer.  While millions of older Americans pop Vitamins and supplements like M&M Candy, regularly exercise at their local gym, religiously jog and carefully watch what they eat to increase their life span, the chair of medical bioethics and health policy at the University of Pennsylvania, says living past the ripe old age of 75 is not on his bucket list.  We would be doing both society and our loved ones a favor by agreeing with this belief, he says.

When I am 75…

Why not age 80 or even 85?  Emanuel admits that his 75th birthday day was just a randomly chosen number, but the year was selected because scientific studies indicate that increases in physical and mental disability occur around this age, as well as a decline in both creativity and productivity.

The renowned 57-year old breast oncologist is at the top of his professional game.  Emanuel has received dozens of awards from organizations such as the National Institutes of Health and the American Cancer Society, including being elected to the Institute of Medicine (IOM) of the National Academy of Science, the Association of American Physicians, and the Royal College of Medicine (UK). Hippocrates Magazine even selected him as Doctor of the Year in Ethics.

Emanuel is a prolific writer, editing 9 books and penning over 200 scientific articles. He is currently a columnist for the New York Times and appears regularly on television shows including Morning Joe and Hardball with Chris Matthews.  .

The prominent physician, is also considered a key designer of the Affordable Care Act (commonly called Obamacare).  At a personal level, he has two well-known brothers, Chicago mayor Rahm Emanuel, former White House chief of staff, and Hollywood agent Ari Emanuel.

With this prominence, Emanuel’s death wish to die at 75, (the year 2032) before the onset of Alzheimer’s disease and other dementias, and decreased physical stamina (it’s harder to walk a quarter of a mile, even to climb 10 stairs) is drawing the ire of critics who charge that he advocates for health care rationing and legalized euthanasia.

But Emanuel claims that these charges are not true.  Setting his death at 75 is just his personal preference, he says, leaving his mortal coil. In his writings and media interviews he notes that setting the age when he hopes to die just drives his daughters and brothers crazy.

Last October, at the BBC Future’s World-Changing Ideas Summit in Manhattan, Emanuel’s prop, a full-page AARP ad from a newspaper, featuring an older couple hiking above a line of text that read, “When the view goes on forever, I feel like I can, too. Go long.”  Reinforcing his point, Emanuel is not buying AARP’s message pushing the positives of living an extended life.  For him, he doesn’t buy it and most definitely, seventy is not the new 50.

Sharing a Death Wish on the Air Ways

On Dec. 7, on CBC Radio Canada’s Sunday Edition, Emanuel, discussed his controversial October 21, 2014 article published in the The Atlantic, “Why I Hope to Die at 75.”  His Sunday interview detailed his unconventional and controversial stance, especially to AARP, the nation’s largest aging advocacy group, and aging organizations who strongly oppose this type of thinking.

Throughout the 28.12 minute interview with Michael Enright, Emanuel, he warns listeners, “Don’t focus on years, and focus on quality.”

“A good life is not just about stacking up the years and living as long as possible. People need to focus on quality of life,” says Emanuel, noting that “Setting an actual date for a good time to die helps you focus on what is important in your life.”

“It is really about what you are doing to contributing and enriching the world.  I want people to stop focusing on just more years, focusing on quality,” he says.

Emanuel says that you need to be realistic on living forever, your body and mind doesn’t  go on forever.  You should just be satisfied with living a complete life, he says.

By age 75, people will have gone through all stages of life, says Emanuel.  As a child you begin to develop skills and figuring out your place in the world. You go to college, raise a family, work to hone your skills and talents. At the later stages of your life you give advice and mentor people, he says, noting that in your mid-seventies, physical deterioration and mental slowing along with loss of creativity, begin to be felt.

During his radio interview, Emanuel claimed he is very active, recently climbing Mount Kilimanjaro with is two nephews, stressing that he is in relatively good health and doesn’t have a terminal illness and has no plans to commit suicide.   As a matter of fact, the physician even condemned physician-assisted suicide and euthanasia, in a 1997 article published in The Atlantic, a policy allowed in the states of Oregon, Vermont and Washington.  His philosophical view of ending one’s life is to allow the body to age naturally, he stresses.

In eighteen years, Emanuel pledges to refuse all medical procedures and treatments, including taking medications such as statins, cholesterol lowing drugs, and antibiotics that could prevent life-threatening illnesses or extend his life.  He notes that his last colonoscopy will be at 65, to screen for cancer.  No more colonoscopies after 75.  And, he’ll only accept palliative care after that milestone age, too.

“I’m not suggesting people kill themselves at 75 but, rather, let nature take its course,” Emanuel says.

How Others See it

Emanuel’s personal preference not to seek medical procedures or to use medications at age 75 that might lead to his death is not the same as physician assisted suicide, says Rev. Christopher M. Mahar, S.T.L., of the Providence Catholic Diocese, noting that this choice has always been respected by the Catholic Church.

“He is not actively choosing to take his life, and as long as he is not rejecting any of the ordinary means necessary for the preservation of life, such as nutrition and hydration, and is not intentionally destroying his body, he is free to decide for himself, says Mahar.

As Emanuel says, there is a downside to aging.  My 88-year-old mother died after a 14 year battle with Alzheimer’s disease.  At age 89, my father, whose quality of life declined over his later years, died suddenly, by having a pulmonary embolism.

For me, 89 is the year I choose to meet my maker, hanging up my spurs.  Yes, I will let nature take its course, but I will most continue to take Vitamins and antibiotics, even my Lisinopril, for high blood pressure.  I will not turn my back on medical procedures or technology that might enhance the quality of my life, even lengthen it.

I agree with the statement of late Actress Betty Davis stated, “Old age ain’t no place for sissies.”   There is no alternatives, you can only hope for nature to ultimately take its course, and it will.  And so, we all are inclined to pick our own magic number.

Herb Weiss, LRI ’12, is a Pawtucket writer who covers aging, health care and medical issues.

TV Celeb Valerie Harper Calls for More Funding for Cancer Research

Published in Pawtucket Times, May 12, 2014

With a growing population of aging baby-boomers, the U.S. Special Committee on Aging held a hearing on Wednesday to put the spotlight on how decreased federal funding to support cancer research is derailing the nation’s successful efforts on its fight against cancer and to detail treatment advances. .

In Dirksen Building 562, Chairman Bill Nelson (D-Florida) addressed the packed room on how innovative cancer research has tripled the number of survivors during the last 40 years, while continued federal cuts to balance the nation’s budget are having a severe impact on biomedical research.

But, despite significant advances in medical treatments over the years, cancer still is a major medical condition for the national to confront. About 1.6 million Americans—the majority of them over age 55—will receive a cancer diagnosis this year, and more than 585,000 will die from the disease.

Putting Cancer Research on the Public Agenda

In his opening statement, Nelson stated that “As a result of the sequestered cuts, Francis Collins, director of the National Institutes of Health (NIH), had to stop 700 research grants from going out the door.” Federal funding support has “accelerated the pace of new discoveries and the development of better ways to prevent, detect, diagnose, and treat cancer in all age groups,” he says.

Cancer research has been put on the radar screen of the Senate Aging panel because “little is known about the impact of cancer treatments on the body as it ages,” added Nelson.

Nelson notes that although many cancer survivors are in remission because of ground breaking advances in research, there still remains a large percentage of people with cancer across the nation who are still dependent on their next clinical trial, or even the next NIH research grant to keep them alive just a little bit longer. This is why Congress must be committed in its war against cancer, he adds, noting that the best place to start is to renew the federal government’s role and commitment to innovative research that is taking place at universities, oncology centers and hospitals, where much of the federal funds are being directed by NIH.

Dr. Harold Varmus, director of the National Cancer Institute, said more research is needed to fully understand how cancer is linked to aging. “Because most types of cancer-but not all-are commonly diagnosed in older age groups, the number of people with cancer is rising [with the world’s population rapidly aging], and continue to rise, here and globally.”.

“For people of any age, the first line of defense against cancers and their damaging consequences is prevention,” states Varmus.

Dr. Thomas Sellers, director of the H. Lee Moffitt Cancer Center and Research Institute, made his views quite clear about the federal government’s “irreplaceable role” in funding medical research. “No other public, corporate, or charitable entity is willing or able to provide the broad and sustained funding for the cutting edge research necessary to yield new innovations and technologies for cancer care of the future,” he says.

Sellers warns, “Without increased funding now, the spectacular advancements we have witnessed in the past will not be there in the future.”

Star Power to Make a Point

One of the nation’s most prominent lung cancer survivors, Valerie Harper, who rose to fame on the “The Mary Tyler Moore Show” and “Rhoda,” “Valerie,” and more recently on “Dancing with the Starts, advocated at the May 7 Senate panel for increased funding for cancer research. Harper, detailed her own battle with cancer, reminiscing about her initial diagnosed with lung cancer in 2009, later finding out last year that her cancer had spread to the lining of her brain.

Through the eyes of an entertainer Harper explained her fight with cancer. “Cancer reminds me of a very bad but tenacious performer, who although no one wants to see, insists on doing an encore, having a return engagement, making a comeback and worst of all, going on tour,” she said.

According to Harper, more than two-thirds of all lung cancers occur among former smokers or those who never smoked, the majority being former smokers.  Second hand smoke, air pollution and radon, a colorless, tasteless and odorless gas, can cause lung cancer. But, one’s genes can play a role in developing lung cancer, too, she says.

Seventy four-year old, Harper, a cancer survivor of four years, admitted she never smoked, but was exposed to secondhand smoke for decades. As to family, her mother developed lung cancer and later died from it. The actress believes that her lung cancer might be traced to two risk factors, second-hand smoke and genetics.

In her opening testimony, Harper claimed that 75 percent of all lung cancers are often times discovered too late, in the later stages when the disease has already spread. The vocal cancer advocate called for Congress to put more funding into finding better ways for early detection of the disease.

Harper notes that research can also identify new treatment options for lung cancer when it is detected in stages 3 and 4 and finding promising ways to personalize chemotherapy, by testing genetic markers, making the treatment less toxic and more effective against specific tumors.

Others on the Witness List

In 2012, Chip Kennett, 32, a former Senate staffer, remembers passing his annual physical “with flying colors.” Weeks later, a nagging, blurry spot in his right eye would lead to a PET scan that showed he had cancer “everywhere.”

Looking back, he expressed to the Senate panel the shock of being diagnosed with having cancer. “There are really no words to describe what it feels like to be told you have an incurable disease that will kill you,” he said.

Now 18 months post-diagnosis, Kenett, who is now living with an as-yet incurable form of State IV lung cancer, is now in his fourth targeted treatment, the clinical trials have allowed the young man to lead a relatively normal and productive life. “Research saves lives and I am a living example of that. The drugs that have kept me alive for the past 18 months were not available just seven years ago,” he says.

Other witnesses at the hearing included Mary Dempsey, assistant director and cofounder of the Patrick Dempsey Center for Cancer Hope and Healing in Lewiston, Maine, who shared her experience of taking care of her mother, Amanda with her Brother, nationally renowned actor Patrick Dempsey seen on “Grey’s Anatomy.” Over 17 years since the mother’s initial diagnoses in 1997, she had a total of twelve recurrences and just recently died in March.

“My mom lived this experience, and I shared it with her as her primary caregiver,” notes Dempsey said. “In this role, I experienced first-hand the impact cancer had on every part of my life. For me, it really became a full-time job, navigating resources, understanding the medical world, and coping with the profound changes in our lives.”

A Call for Increased Cancer Funding

Hopefully the Senate Aging Panel’s efforts to put medical research on the short list of the nation’s policy agenda will get the attention of GOP lawmakers who over the years have attempted to balance the nation’s budget by slashing NIH funding.

Cancer touches every family. Everyone knows of a family member, colleague or friend who has died from cancer or is a cancer survivor. Americans must send a strong message to their Congressional lawmakers, “no more cuts to medical research.” If the nation is truly at war with cancer, it is shameful to not give the nation’s medical researchers the adequate funding necessary to defeat it once and for all.

Herb Weiss, LRI ’12, is a Pawtucket based writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com

Aging Programs Get Slashed in Bush’s War Budget

Published in Pawtucket Times on February 18, 2002

In the shadow of the horrific terrorist attacks on Sept. 11th, domestic programs take the backseat in President Bush’s $ 2.13 trillion fiscal year 2003 budget, released in early February, with significant funding increases being targeted for both military and  homeland defense.

As 77 million baby boomers approach their 65th birthdays within the next decade, aging groups say the President’s wartime budget does not go far enough in many areas to meet the aging baby boomer’s needs in the coming years.

One of the most hotly debated Congressional issues is affordable prescription drugs. With the Congressional election looming next year, this is certain to be a key issue in every state. Don’t look for this issue to lose importance to seniors or to the aging groups who call for meaningful Medicare drug benefits.

According to the Congressional Budget Office, over the next 10 years, Medicare beneficiaries will spend about $1.6 trillion out-of-pocket on prescription drugs. But the recently released Bush budget proposal only contains $ 190 billion over 10 years for Medicare reform, including $ 77 billion to assist seniors with prescription drugs.

The National Council on Aging (NCOA), a Washington, D.C.-based advocacy group, estimates that on average, the Bush administration’s proposal would cover less than one out of 10 dollars spend on drugs by seniors.

Martha A. McSteen, president of the National Committee to Preserve Social Security and Medicare, agreed that Bush’s budget proposal shortchanges seniors and the disabled in providing needed health care and services.

In his State of the Union address, the president restated his campaign promise to provide prescription drug coverage for every senior, noted McSteen, who added, “That is an empty promise if the budget does not contain these needed resources.

“At least $ 450 billion is needed over the next 10 years to provide a comprehensive and affordable prescription drug benefit as part of the Medicare program,” McSteen says.

John Rother, AARP’s Policy and Strategy Director, said, “Although federal budget constraints are greater than last year, so too is the need for affordable prescription drugs for Americans age 65 and over. Unfortunately, disease and pain did not disappear with the budget surplus.”

However, U.S. Sen. Lincoln Chafee, R-Rhode Island, said he believes the President’s budget request recognizes the precarious state of the Medicare system, as well as other challenges faced by the nation’s seniors.

“The president has acknowledged the need for a Medicare prescription drug benefit as well as [the need] for a significant increase in funding for disease research conducted by the National Institutes of Health,” he said.

While Chafee said he will push for legislation that will create more comprehensive Medicare prescription drug benefits than the legislation proposed by the president, he warned the deficit created by the combination of the economic slowdown, the war on terrorism and last year’s tax cut will make enactment of any new spending programs more difficult to accomplish.

Meanwhile, programs under the Older Americans Act, are provided with less funding in Bush’s budget proposal than they were last year.

“Around the country, people are on waiting lists for meals-on-wheels programs and congregate meals programs,” said McSteen.

“There are state and local programs that need additional federal funds to counter the increasing problems of elder abuse. The administration’s funding request for these programs is woefully inadequate.”

Other federal programs get sliced and diced under the Bush administration’s FY 2003 budget, according to U.S. Rep. Patrick Kennedy, D-Rhode Island, who pointed to an 8 percent cut for the Centers for Disease Control and Prevention’s budget for chronic care.

The four-term Congressman and member of the House Aging Caucus said he finds this cut troubling due to the significant gains that have been made in efforts to prevent and treat diseases that effect an aging population.

With a growing number of families caring or loved ones with Alzheimer’s Disease, Kennedy said he strongly opposes the Bush administration’s axing of the Missing Alzheimer’s Disease Patient Alert Program, which helps protect and locate missing patients with the devastating disease.

The program has assisted in the return of more that 5,700 wanderers and increased its data base to 67,000 persons with Alzheimer’s,” said Kennedy. “It has succeeded in its many efforts on a budget of $ 898,000 in fiscal year 2002.”

While prescription drugs comes up a loser in the Bush budget, some aging initiatives are clearly on the White House’s radar screen.

Bush’s budget proposal provides about $ 3 billion in additional funds toward research and is the final installment in a five-year effort to double the size of the National Institute of Health budget, says McSteen. She said she believes increased federal funding would assist in “producing breakthroughs in the prevention, treatment, management of conditions associated with aging.”

The Administration’s budget also provides a personal exemption to home caretakers of family members and the funding of respite and direct care worker demonstration projects.

Now Bush’s Budget proposal moves to Congress, where a Republican-controlled House and Democratic Senate will make major revisions, ultimately hammering out a final road map to federal spending.

The funding of federal programs to meet the needs of older Americans is crucial as our nation’s population ages.

Furthermore, with an increasing federal budget deficit, Republican and Democratic lawmakers must not get tied down to partisan wrangling as they attempt to iron out differences in creating a Medicare benefit to make prescription rugs more affordable to seniors.

As the Congressional elections get closer, seniors will call for concrete legislative action, not political rhetoric or fancy words.