Something happened the other day that I am ashamed to tell you about. I snapped. Here's what happened. I went over to the Punta Gorda office of State Representative Paige Kreegle to pick up the proclamation made by Governor Crist declaring November as Lung Cancer Awareness month. I was talking with his administrative aid, Zac, who had kindly done the work necessary to get the Governor to make the proclamation and I found myself yelling at him for a passing comment he innocently made as I was leaving the office. The comment was something to the effect of "Yeah, Paige can really get behind this (Free to Breathe 5K lung cancer awareness) event. He hates smoking." It was the last three words that set me off. "This is not about smoking," I said, "it's about LUNG CANCER!"
I tried to straighten out the young man, by explaining something to him. I should have been calmer, but it raised the hair on the back of my head and I let go. (Sorry Zac. It is not you. It is the stigma surrounding lung cancer that makes me angry!)
I have found that the first words I am typically greeted with when someone learns I have lung cancer is, "oh, were you a smoker?" It is no wonder. To get people to quit smoking, we are constantly reminding them that smoking increases the risk of the developing the disease. It is natural to want to verify the relationship between lung cancer and smoking. But to those of us on the receiving end of such comments, there is an implication that we are to be blamed for bring the disease on ourselves. There is most definitely an attitude of "you did this to yourself, so live with the consequences." The starkest evidence is the lack of funding for lung cancer research and early detection.
Here are some facts that nobody wants to say outloud. Yes, we all want to see people quit smoking. Smoking is not good for you an is ONE OF the direct causes of not only lung cancer, but of other cancers and lung disease as well as heart disease. (Radon is also KNOWN to be a direct cause of lung cancer.) We need to make sure that young people never start smoking and avoid the addiction. Once you start smoking is a very difficult drug habit to break.
But the fact is that, even had I quit 10 or 20 years ago, I would STILL have had an elevated risk for developing lung cancer. Quiting does NOT eliminate the risk. That, of course, is not advertised because if long time smokers believed that they are going to contract lung cancer anyway, why quit? I understand the logic. The problem is that, because of the stigma of lung cancer, we are not investing in research for early detection and treatment. Lung cancer is the number one cancer killer, with one of the lowest survival rates, and gets the least amount of funding. Explain that to me.
This year there will be over 200,000 new cases of lung cancer diagnosed. Something like 10% - 15% of the new cases will be people who NEVER smoked. That is 20,000 - 30,000 cases a year. Over 100,000 of the new cases will be former smokers (people who quit prior to their diagnosis). So if you take these two groups together, about 60% of current lung cancer patients either never smoked or quit years ago. Who is really to blame here? The addicts and former addicts or a society that allows tobacco companies to sell their product without much regulation?
Lung cancer advocates like me have gotten together and are trying to do something about fighting the stigma of lung cancer. We feel that supportive care and sympathy (not blame) is particularly important to patients living with lung cancer. Lung cancer patients have feelings of guilt and are isolated by an unspoken stigma associated with their diagnosis.
The stigma does more than just blame smokers. It pushes the responsibility of the disease away from society where it belongs and onto the patients and their families, where it shames them into silence. This silence leads to fear, isolation and marked underfunding for the early detection and treatment of lung cancer. Twice as many women will die from lung cancer than breast cancer, but federal funding for breast cancer research this year is a record $1.1 billion; lung cancer, by comparison, will receive only $199 million, down from $240 million last year.
I am not ashamed to have lung cancer. I am a victim, like many of the 70 million former smokers, who were addicted to tobacco and finally quit. And I am fighting for all of the people who will eventually develop lung cancer. There needs to be an accepted screening protocol to detect lung cancer before it develops. That effort has the potential to save millions of lives. Help me by joining our Free to Breathe 5K Run Walk on October 31st! Go to www.freetobreathe.org to register now.
Sunday, September 27, 2009
Sunday, September 13, 2009
Moe Excercise
For the past year I have been trying to get Yoko to get up early with me to exercise. We purchased a treadmill while I was receiving chemo treatments as diet and exercise were to be an integral part of my road to recovery. There was only one thing wrong with the plan. It required that I find the time to do it on regular basis...and I have a pretty full schedule during my waking hours. The only time for exercise that would makes sense for me is early morning.
Unfortunately, I have never been an early riser. A few years ago I purchased bicycles for Yoko and I in the hope we would become regular early morning riders. Predictably, neither of us could get out of bed early enough to get dressed and fit in a vigorous rided before I had to be at work. So the bikes gathered dust in the garage. When I was diagnosed with cancer, I pledged that I would begin some sort of exercise routine. I bought the treadmill with the thought that I would roll out of bed and jog. Yeah, right. What was I thinking?
My latest plan to do regular exercise is working. In my desperation to find an exercise solution I decided to adopt a dog from the animal shelter. Besides saving a dog and making room in the local shelter, the need to walk a dog is a good incentive to get up in the morning.
Yoko and I went down to the animal shelter and looked at every dog they had. To say the least, Yoko was not in favor of getting a dog, but relented when I promised I would take care of her. The dog we selected is a 60 pound boxer mix. We named her Moe, based on the selection process we used -- inny, meany, miney....
When we got her a few months ago Moe was 10 months old and 60 lbs of licking and loving affection. And I was right. You can't ignore a 60 poung animal that wants to go out. Every morning Moe comes into the bedroom and licks my feet letting me know it is 6:30 AM and time to go for our daily walk. At first I kind of dreaded getting up at this hour, but it only took one time of ignoring her pleas to go to convince me I can't ignore her any more. I have gotten into the habit of getting up every morning, throwing on some clothes, hooking up my i-pod and taking Moe on a three mile walk. I take her on a shorter walk in the evening when I get home.
I am using the 3 mile walk as training to participate in the Free to Breathe 5 K Run/Walk planned for Punta Gorda on October 31st. Right now it takes me about 40 minutes to walk this distance. I am hoping to develop my regular walk into a run over time. Won't you join me?
Unfortunately, I have never been an early riser. A few years ago I purchased bicycles for Yoko and I in the hope we would become regular early morning riders. Predictably, neither of us could get out of bed early enough to get dressed and fit in a vigorous rided before I had to be at work. So the bikes gathered dust in the garage. When I was diagnosed with cancer, I pledged that I would begin some sort of exercise routine. I bought the treadmill with the thought that I would roll out of bed and jog. Yeah, right. What was I thinking?
My latest plan to do regular exercise is working. In my desperation to find an exercise solution I decided to adopt a dog from the animal shelter. Besides saving a dog and making room in the local shelter, the need to walk a dog is a good incentive to get up in the morning.
Yoko and I went down to the animal shelter and looked at every dog they had. To say the least, Yoko was not in favor of getting a dog, but relented when I promised I would take care of her. The dog we selected is a 60 pound boxer mix. We named her Moe, based on the selection process we used -- inny, meany, miney....
When we got her a few months ago Moe was 10 months old and 60 lbs of licking and loving affection. And I was right. You can't ignore a 60 poung animal that wants to go out. Every morning Moe comes into the bedroom and licks my feet letting me know it is 6:30 AM and time to go for our daily walk. At first I kind of dreaded getting up at this hour, but it only took one time of ignoring her pleas to go to convince me I can't ignore her any more. I have gotten into the habit of getting up every morning, throwing on some clothes, hooking up my i-pod and taking Moe on a three mile walk. I take her on a shorter walk in the evening when I get home.
I am using the 3 mile walk as training to participate in the Free to Breathe 5 K Run/Walk planned for Punta Gorda on October 31st. Right now it takes me about 40 minutes to walk this distance. I am hoping to develop my regular walk into a run over time. Won't you join me?
Saturday, September 12, 2009
Free to Breathe 5K Event Set for October 31st
In October of 2007 at the age of 52 I was diagnosed with Stage IIIA Non-Large Cell Lung. After my diagnosis I was shocked to learn about the grim prospects facing lung cancer patients and the lack of progress in treating lung cancer over the last 4 decades. More than 160,000 people will die from lung cancer this year and over 200,000 will be newly diagnosed. Only five percent of people with my diagnosis will survive five years or longer from the date of diagnosis. The overall five year survival rate for lung cancer is 15%. There are 70 million people who, like me, finally quit smoking -- many quit decades ago -- and think they are out of the woods. Maybe you are one of them?
Unfortunately, many former smokers and many people who NEVER smoked will be stricken by lung cancer in the years to come. Lung cancer use to be primarily a male disease. Now half of all lung cancer patients are women and twice as many women will die from lung cancer as breast cancer. Many never smoked. Last year breast cancer received over $23,000 per death in federal research dollars -- close to $1 billion in total, while lung cancer's allocation was about $240 million, less than $1500 per death. I promised myself that, if I got well enough, I would dedicate myself to raising awareness and research funding for lung cancer. Thankfully, I am in remission now and I am able to follow thru. But I need your help.
I formed a lung cancer committee here in Charlotte County earlier this year. We've decided to partner with the National Lung Cancer Partnership to bring the first Free to Breathe 5K Walk/Run and Memorial 1 mile walk to Punta Gorda this fall. The event is designed to raise lung cancer awareness in our community and raise funding for desparately needed lung cancer research. Through State Representative Paige Kreegle's office, we have asked Governor Crist to proclaim November lung cancer awareness month. Our event on October 31st at the Charlotte Sports Park will be the kick-off event for Lung Cancer Awareness month in Florida. Our hope is to have 300 - 500 people running or walking at this first event. To succeed, it critical to obtain the support of the local community,including the medical community, the media, the business community and like-minded people who have been devastated by a lung cancer diagnosis in their family.
As part of the event, there will be a one mile Memorial Walk honoring the lives of lung cancer patients that have lost their battle with the disease. If you would like to honor someone you know or a loved one who has died from the disease, contact me at tecappiello@gmail.com. I'll be sure their name is posted on the Memorial Mile Walk.
You can find details about the event and register as an individual or team representing your organization to run or walk, volunteer, donate, or create a fundraising page at www.freetobreathe.org. Anything you can do to help would be greatly appreciated!
Unfortunately, many former smokers and many people who NEVER smoked will be stricken by lung cancer in the years to come. Lung cancer use to be primarily a male disease. Now half of all lung cancer patients are women and twice as many women will die from lung cancer as breast cancer. Many never smoked. Last year breast cancer received over $23,000 per death in federal research dollars -- close to $1 billion in total, while lung cancer's allocation was about $240 million, less than $1500 per death. I promised myself that, if I got well enough, I would dedicate myself to raising awareness and research funding for lung cancer. Thankfully, I am in remission now and I am able to follow thru. But I need your help.
I formed a lung cancer committee here in Charlotte County earlier this year. We've decided to partner with the National Lung Cancer Partnership to bring the first Free to Breathe 5K Walk/Run and Memorial 1 mile walk to Punta Gorda this fall. The event is designed to raise lung cancer awareness in our community and raise funding for desparately needed lung cancer research. Through State Representative Paige Kreegle's office, we have asked Governor Crist to proclaim November lung cancer awareness month. Our event on October 31st at the Charlotte Sports Park will be the kick-off event for Lung Cancer Awareness month in Florida. Our hope is to have 300 - 500 people running or walking at this first event. To succeed, it critical to obtain the support of the local community,including the medical community, the media, the business community and like-minded people who have been devastated by a lung cancer diagnosis in their family.
As part of the event, there will be a one mile Memorial Walk honoring the lives of lung cancer patients that have lost their battle with the disease. If you would like to honor someone you know or a loved one who has died from the disease, contact me at tecappiello@gmail.com. I'll be sure their name is posted on the Memorial Mile Walk.
You can find details about the event and register as an individual or team representing your organization to run or walk, volunteer, donate, or create a fundraising page at www.freetobreathe.org. Anything you can do to help would be greatly appreciated!
Friday, September 4, 2009
Lung Cancer and Healthcare Reform -- Adding My 2 Cents
The debate about heathcare reform is raging on and it has a lot of people concerned about the future direction of the country. I feel I am (or should be) on the frontlines of the debate. First of all, I am a lung cancer patient receiving excellent care from our privately run health system. I wouldn't change that for the world. On the other hand if I lost my job I would be one of the people who would be uninsurable. Secondly, I am Chairman of the Board of St Vincent de Paul Community Healthcare, a not-for-profit clinic and pharmacy here in Charlotte County, which is taking care of the needs of thousand of people in our community who have no healthcare coverage, including patients with cancer. I have a pretty good idea about who the uninsured are. Third, I've lived in a country that has universal healthcare (Japan), so I know what is possible. And lastly, being a stockbroker, I understand how markets work. I feel I understand the issues in the debate-- both pro and con. Would you like to know what I think?
Having the central government command a crucial part of our economy can be likened to my experience in China in the mid-1980's. At the time I was working with the accounting firm Arthur Andersen. We were engaged to help one of the world's largest producers of duck decide whether it was the right time to invest in China. The Chinese did not produce enough duck and wanted my client's technology so they could produce more. After a 10 day trip to understand the environment we did not go forward with the project because the Chinese had a political need to control poultry prices and would not allow us to charge what it cost to produce ducks and receive a premium for the risk we would be taking. The government ran the show in China and could not politically do what was needed to increase pricing to attract producers and create a clearing market. The result was price controls and a continuing shortage of duck. Its the same reason there were bread lines in Russia.
Today we have the equivalent of breadlines in the healthcare industry. We have a dwindling supply of primary care physicians because they are not sufficiently reimbursed from Medicare (i.e. price controls). We have a developing cadre of "consierge" doctors who "don't take" medicare or certain insurance coverages and charge a country-club like entry fee when accepting new patients (i.e. a sort of black market for heathcare.) The supply of heathcare providers is shrinking because of cost controls imposed by government and private insurers. Once everyone has "universal healthcare insurance" and cost becomes irrelevant there will be lines for every kind of healthcare service. That's just the nature of markets. What we need to make our healthcare system work are clearing markets -- and equilibrium between supply and demand.
I am not sure insurance is the answer. When an insurer is paying virtually the entire cost, what incentive is there to keep costs down? We'll spend whatever it takes to keep Mom and Dad alive, even if it is for a few more weeks. That doesn't make much sense really.
I think the answer is staring us straight in the face but no one has proposed it. We should have public facilities, just like we have public schools. We have made education a human right and mandated that every community have public schools. Why couldn't we do the same thing for healthcare? Why couldn't we create public health clinics and dental clinics, out-patient surgery centers, imaging centers and hospitals where you can be treated for free. There is no insurance intermediary. Undoubtedly, since it is free, there would be lines. We would need an army of doctors to do their residency and hone their skills at these public facilities. We could have a system where, after a certain period of low-paying public service, medical student's school loans are forgiven. Doctors could then enter into private practice debt free. Any healthcare worker working at a public facility would be entitled to sovereign immunity and indemnified by the state.
If you don't like the quality of services a public healthcare facility provides, nothing would stop you from purchasing health insurance and going to private facilities and paying a premium for superior service. Under my proposal private hospitals would not be required, as they are today, to care for the uninsured, saving the hosptials millions, resulting in lower insurance costs.
How would all this be paid for? What about using the $900 billion President Obama is saying we can save from the waste in the current system to build healthcare facilities all over the country? (This would be a stimulus on par with building the building of the national interstate road system and a gigantic stimulus to the economy.) We should be able to divert medicare insurance proceeds to building a public healthcare system. We're still going to end up with a shortage of healthcare workers, but I am sure we could create incentives to create the added workforce we will need.
What do you think?
Having the central government command a crucial part of our economy can be likened to my experience in China in the mid-1980's. At the time I was working with the accounting firm Arthur Andersen. We were engaged to help one of the world's largest producers of duck decide whether it was the right time to invest in China. The Chinese did not produce enough duck and wanted my client's technology so they could produce more. After a 10 day trip to understand the environment we did not go forward with the project because the Chinese had a political need to control poultry prices and would not allow us to charge what it cost to produce ducks and receive a premium for the risk we would be taking. The government ran the show in China and could not politically do what was needed to increase pricing to attract producers and create a clearing market. The result was price controls and a continuing shortage of duck. Its the same reason there were bread lines in Russia.
Today we have the equivalent of breadlines in the healthcare industry. We have a dwindling supply of primary care physicians because they are not sufficiently reimbursed from Medicare (i.e. price controls). We have a developing cadre of "consierge" doctors who "don't take" medicare or certain insurance coverages and charge a country-club like entry fee when accepting new patients (i.e. a sort of black market for heathcare.) The supply of heathcare providers is shrinking because of cost controls imposed by government and private insurers. Once everyone has "universal healthcare insurance" and cost becomes irrelevant there will be lines for every kind of healthcare service. That's just the nature of markets. What we need to make our healthcare system work are clearing markets -- and equilibrium between supply and demand.
I am not sure insurance is the answer. When an insurer is paying virtually the entire cost, what incentive is there to keep costs down? We'll spend whatever it takes to keep Mom and Dad alive, even if it is for a few more weeks. That doesn't make much sense really.
I think the answer is staring us straight in the face but no one has proposed it. We should have public facilities, just like we have public schools. We have made education a human right and mandated that every community have public schools. Why couldn't we do the same thing for healthcare? Why couldn't we create public health clinics and dental clinics, out-patient surgery centers, imaging centers and hospitals where you can be treated for free. There is no insurance intermediary. Undoubtedly, since it is free, there would be lines. We would need an army of doctors to do their residency and hone their skills at these public facilities. We could have a system where, after a certain period of low-paying public service, medical student's school loans are forgiven. Doctors could then enter into private practice debt free. Any healthcare worker working at a public facility would be entitled to sovereign immunity and indemnified by the state.
If you don't like the quality of services a public healthcare facility provides, nothing would stop you from purchasing health insurance and going to private facilities and paying a premium for superior service. Under my proposal private hospitals would not be required, as they are today, to care for the uninsured, saving the hosptials millions, resulting in lower insurance costs.
How would all this be paid for? What about using the $900 billion President Obama is saying we can save from the waste in the current system to build healthcare facilities all over the country? (This would be a stimulus on par with building the building of the national interstate road system and a gigantic stimulus to the economy.) We should be able to divert medicare insurance proceeds to building a public healthcare system. We're still going to end up with a shortage of healthcare workers, but I am sure we could create incentives to create the added workforce we will need.
What do you think?
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