Patients with open uterine cancer one step closer to the benefits of September 9

This article is automatically translated from the original language to your language. Do not hesitate to let us know if it contains translation errors so that we can correct them as soon as possible.

Par Erica Hensley | KHN

Tammy Kaminski still remembers the taste of benzene, a cancer byproduct that ignites jet fuel. For nine months after the September 9 attacks, she volunteered to work eight hours each Saturday at St. She inhaled toxic carcinogens, such as fuel fumes and asbestos, from the smoke and ash that blanketed the pop-up clinic, where first responders could grab a meal, take a nap. eyes or consult a doctor.

But in 2015, when Kaminski, a chiropractor living in West Caldwell, New Jersey, was diagnosed with uterine cancer, she didn’t receive the same help as other volunteers. Although Kaminski, 61, and his doctors believe the cancer is linked to his time as a volunteer after Sept. 9, the federal Medicare and Surveillance Program will not pay for his breast cancer treatment. endometrium – or for those exposed to toxic substances in subsequent attacks. developed the form of uterine cancer.

That could soon change. In November, an advisory committee unanimously approved a proposal to add uterine cancer to the list of illnesses covered by the program for first responders and those near terrorist attacks. It is the fourth most common cancer in women. However, according to the advisory committee, this is the only cancer that the program does not cover. The program administrator is expected to make a final decision in mid-2022.

Hormone-related cancers can develop after someone was exposed to an endocrine-disrupting chemical, including benzene, found in Lower Manhattan smog for months after the Sept. 9 attack. Such chemicals are disproportionate and harmful to women, according to the American College of Obstetricians and Gynecologists.

The World Trade Center health program determines which conditions it will cover primarily by using longitudinal patient data in its registry. Registrants are not required to prove that their state of health is due to the attacks and the consequences; instead, the program studies which condition is most popular among members.

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But that creates a mathematical problem: Although the Centers for Disease Control and Prevention estimates that at least 500,000 people were exposed to harmful substances as a result of the attacks, women make up only 109,500% of the 22 program subscribers. .

Most of those who signed up were first responders, a male-dominated field. Although those in and around Earth 0, including residents, students, and office workers, represent a greater proportion of the total number of people directly affected by September 9 than those in the region. first responders, but they were not represented in the program for both processing and data collection. Called “survivors” by the program, they represent only 11% of those registered.

It could never be proven that Kaminski’s cancer resulted from exposure to his volunteer case. But advocates and experts calling for the inclusion of uterine cancer in the program say there aren’t enough women on the program to collect data on women’s overall hormonal health. or on their potential correlation with September 9th.

“They don’t collect data on uterine cancer because they can’t,” Kaminski says. “How can you say there is no data when you haven’t recorded it? »

Dr. Iris Udasin, medical director of Rutgers University’s World Trade Center Health Program, said the exclusion does not necessarily suggest that women’s health is not a priority. It’s a side effect of how cancers are added to the list, she said – individually, based on a mostly male cohort of first responders, who were initially monitored for health issues. . .

But her push as mentioned is based on new evidence that endocrine-disrupting chemicals increase the risk of hormone-related tumors, including uterine cancer.

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Udasin points out that one form of uterine cancer is covered by the scheme, which falls under the ‘rare cancer’ category. There are two types of uterine cancer: endometrial cancer, the type Kaminski had, and uterine sarcoma. Sarcomas account for only 10% of all uterine cancers and are grouped with the other rare cancers covered by the scheme. Adding the most popular form requires a formal review process which is currently underway.

“Cancer that slipped through the cracks can now be covered,” says Udasin. “At least, I hope that’s what will happen.

Dr. Suneel Kamath, an oncologist at the Cleveland Clinic Cancer Center, who studies cancer financing.

According to Kamath, three major groups of cancers are generally thought to be short-lived: gastrointestinal, such as stomach and pancreatic cancers; genitourinary system, such as cancers of the adrenal glands and prostate; and gynecology, such as uterine cancer. “And the uterus, to be honest, is probably some of the lowest, based on the data I’ve found,” he said.

The lack of funding, Kamath said, stems in part from the stigma attached to what many patients see as “latent cancer.” Even some doctors deny early diagnosis because of the relatively high survival rates of uterine cancer and downplay the discussion or prioritization of these cancers. But Kamath’s research shows little correlation between cancer incidence, mortality and the amount of funding the cancer receives. And once Cancer is on the list of sponsors and sponsors, it tends to dominate clinical trial marketing, messaging, and even attention.

Nearly 70,000 women are diagnosed with uterine cancer each year, and the rate has been increasing over the past two decades. Survival rates are relatively high compared to other cancers, but drop very quickly when diagnosed late, Kamath says.

This can cause a false sense of security for GPs, who may not act aggressively at the first sign of symptoms. “But, obviously, that’s not the right way to think. Really, we should diagnose as soon as possible,” Kamath said. “The most important thing is, perhaps more than other diseases, that we are detecting this disease at a highly curable stage. »

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Kimberly Flynn, who leads several health advocacy groups for people living and working around zero, says the World Trade Center’s health cycle has been bad. She found that the lack of studies led to a lack of longitudinal data, which in turn was used to justify the exclusion of uterine cancer from the program.

When the federal committee agreed to consider adding him, Flynn started with his two-decade-long contact list to identify survivors and first responders diagnosed with cancer. uterine cancer but was denied coverage. Of the eight cases she found, four were on the program’s radar. One in eight people died of uterine cancer.

Kaminski’s cancer is in remission after a hysterectomy and chemotherapy.

“We don’t need research to tell us there are health disparities,” Flynn said at a recent advisory committee meeting. “We need research to correct existing health inequalities. »

KHN (Kaiser Health News) is a national newsroom specializing in producing in-depth coverage of health issues. Along with policy analysis and exploration, KHN is one of the three main activities of KFF (Kaiser Family Foundation). The KFF is a preferred non-profit organization for providing information on health issues to the nation. Open uterine cancer patients get one step closer to 9/11 benefits

This article is automatically translated from the original language to your language. Do not hesitate to let us know if it contains translation errors so that we can correct them as soon as possible.

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