Thursday, June 12, 2014
Doctor's Perspective

Disease and the human genome
The human genome project is changing the way we think about disease. We will be able to predict some diseases in the future which will allow us to take action to prevent them. For example, we have known for years that there is a gene, the BRCA gene, that increases a woman's risk for breast cancer. Women with breast cancer in their family can find out if they have this gene. It might lead to more frequent screening. Some women who do elect to undergo bilateral prophylactic breast removal. Recently, some researchers have been looking at what gene might be associated with lung cancer. To their surprise, they found that the BRCA gene is also associated with developing lung cancer. Smokers without the gene run just under a 15% risk of developing lung cancer. Smokers with the gene run just over a 25% risk of developing lung cancer. Thus, the risk for this group of patients is about double what it is for the group of smokers who do not have it. This leads us to whether or not it makes sense to test cigarette smokers for the presence of this gene. If so, they could be told that their risk of developing lung cancer is about 1 in 4. It is about 1 in 8 for the general population without the gene. The problem is that it is unlikely to make a difference to the male cigarette smoker. If the 1 in 8 chance is not enough to get him to stop, it is not likely that the 1 in 4 chance will make a difference. This then falls into the category of whether we should spend insurance dollars on a test. The cost would be shared by all individuals insured through their premiums. The people who would benefit from knowing the information are not likely to stop. A more interesting question has to do with women who test positive for BRCA. They are at increased risk of breast cancer and lung cancer. They would have to make a decision about what to do about each risk. Would they choose to stop smoking? Would they choose to have increased breast evaluations? Would they choose to have their breasts removed as a preventive measure? These are all complicated decisions. However, they represent the tip of the iceberg. As we learn more about the genes responsible for causing medical problems, more individuals are going to be faced with decisions like this which will lead to even bigger questions. Who should get genetic testing? What should happen with the results? Who will pay for the testing? (Currently individuals can have the testing done at their own expense). What will health insurers do for individuals that choose to take risks once they know the results? There will be a lot more to come on this front in the future. People need to understand more about it now so they will be able to make informed decisions about their health care. If you have comments about this column or suggestions for other topics, send an email to Dr. Anthony Policastro at

Hospice 5K Run & Family Fun walk Join the fun with hundreds of runners and walkers as Delaware Hospice holds the 6th annual Delaware Hospice 5K on Wednesday, July 9, at the Delaware Hospice Center in Milford. Registration opens at 5:30 p.m., the race begins at 6:30, and the post-event cookout and party will go on until evening. Individual entries are $20, and the team rate for a group of four or family rate for a group of four or more from the same household is $50. Pre-registered participants receive a t-shirt. T-shirts will be available for same day registration while supplies last. Medals will be presented to category winners, and door prizes will be available for everyone. Register online at or contact Peggy Dolby, assistant director of development, at or 746-4666.

Stroke Support Group Nanticoke Memorial Hospital's next Stroke Support Group meeting is at 1:30 p.m. on Tuesday, June 17, at the Seaford Library. The group is designed for individuals who have survived a stroke as well as their families and caregivers. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support and allow for networking. Refreshments will be provided. Pre-registration is not required for this free support group. For more information, contact Nanticoke Memorial Hospital at 629-6611, ext. 8626.

Free hospice workshop Delaware Hospice will a hold a free workshop, "Remembering our Fathers and Grandfathers," at the Hospice Center in Milford from 10 a.m. to noon on Saturday, June 14. This workshop is especially for adults who have lost their fathers or grandfathers. Near the occasion of Father's Day, this session will include activities to facilitate remembering and honoring your father as well as provide education in healthy coping skills  in a confidential, non-judgmental, casual environment with others who have experienced a similar loss. A continental breakfast will be offered. Bring a photo of your loved one for the Remembrance Table.

Registration is required by Thursday, June 12. Register by contacting Michelle August at 800-838-9800 or

Autism Delaware receives award Autism Delaware has received The President's Volunteer Service Award for 2013. Presented by the Corporation for National and Community Service, the award recognizes the autism agency's adult services program for its "commitment to strengthening our nation and for making a difference through volunteer service." For more information about Autism Delaware, visit

State to receive settlement Delaware Attorney General Beau Biden and 44 of his colleagues announced a $105 million settlement today with GlaxoSmithKline to resolve claims that the pharmaceutical giant unlawfully marketed asthma and anti-depressant medications. The Attorneys General allege that GlaxoSmithKline unlawfully promoted its asthma drug, Advair, and antidepressant drugs, Paxil and Wellbutrin by misrepresenting the uses and qualities of these drugs. In Delaware, such conduct falls under the Consumer Fraud Act, which is enforced by Biden's Consumer Protection Unit. Delaware's share of the settlement will be $1.015 million. On top of the $105 million, the settlement also requires the company to make significant changes in its marketing efforts that will ultimately benefit consumer. The settlement also requires GlaxoSmithKline to continue its Patient First Program at least through March 2019. The Patient First Program reduces financial incentives for sales representatives to engage in deceptive marketing. In addition, the company will be required to scientifically train personnel to be ultimately responsible for developing and approving responses to health care provider questions and for these responses to be unbiased and non-promotional.

Two more heroin deaths confirmed The Office of the Chief Medical Examiner has confirmed two more overdose deaths related to fentanyl-laced heroin during April, bringing the total to eight deaths in Delaware this year. Fentanyl is a synthetic painkiller that is 50 to 100 times more potent than heroin, according to the Centers for Disease Control and Prevention. The Medical Examiner's Office said toxicology reports confirmed two additional deaths on April 2 in Millsboro and April 5 in Claymont. "The warning needs to get out that fentanyl-laced heroin is here in Delaware and that people are dying from it," Department of Health and Social Services Secretary Rita Landgraf said. "For those who suffer from addiction, the state and private providers are prepared to support individuals who are ready to seek treatment." If you or a loved one needs treatment in Sussex County, call 800-345-6785.

Look-In Glass Shoppe Jewelry sale Shop for jewelry, gifts and more in the Medical Staff Conference Room at Nanticoke Memorial Hospital on Monday, June 23 from 7 a.m. to 4 p.m. and Tuesday, June 24 from 7 a.m. to 3 p.m. The Look-In Glass Shoppe at Nanticoke Memorial Hospital will host an "In Design" sale featuring the latest trends in fashion jewelry at great savings. All jewelry items are $6 each, designer inspired handbags and other select merchandise will be available at greatly reduced prices. All proceeds from sales at the Look-In Glass Shoppe are used toward the purchase of a new fetal monitoring system for Nanticoke Memorial Hospital's Mother and Baby Care Unit. For more information, call 629-6611, ext. 2475.

SAFE KIDS conference Seats are available for the annual SAFE KIDS Childhood Injury Prevention Conference which will be held Wednesday, June 25 from 8 a.m. to 3:30 p.m. at the Modern Maturity Center in Dover. The annual conference is geared toward education, healthcare, child care and other professionals with an interest in childhood injury prevention. To register, visit, fill out the registration form and email it to If you have any questions about the conference or registration process, contact Angela Quackenbush at 302-223-1350.

Input sought on SHIP The Delaware Division of Public Health (DPH) wants your input on Delaware's first State Health Improvement Plan (SHIP). DPH recently worked with a broad spectrum of non-profit and medical provider partners to create a draft statewide health assessment. The assessment was then used to develop an improvement plan - goals for our most important health needs. Efforts now will be devoted to building a work plan to address these two goals. We invite comments on the SHIP through June 30. Visit and scroll down to the "How Do I" Section. For questions, call 302-744-4703.