Durham VA Duke University

‘All’ Veteran Cancer Survivors To Be Enrolled In New Genetic Testing Program

The Department of Veterans Affairs is rolling out a genetic testing program for all cancer survivors starting with Durham VA Medical Center linked to Duke University.

According to VA, “The test can help providers determine which medications will be most effective for patients, improving access to appropriate treatments and reducing adverse drug reactions, which research shows costs up to $30 billion per year.”

The program called VA Pharmacogenics Action for Cancer SuRvivorship (PHASeR) is a pilot program at Durham VA. The program “will enroll all cancer survivors who receive treatment at the facility.”

The plan is to enroll 250,000 US veterans at 125 sites nationwide. For now, the pilot program is being rolled up using a $25 million donation from Denny Sanford and the Sanford Health medical system named for him.

The tests will be processed at the Sanford Health Imagenetics facility located in South Dakota.

There was no mention of opting in for the research program that will share veteran genomic data with the private entity. Instead, the agency’s announcements say “all” survivors will be enrolled at Durham VA and likely nationwide based on the projections provided in the agency’s own press release.

But what about informed consent? Doesn’t this sound like research on humans?

“We have seen firsthand how this testing can positively influence patient care,” said Kelby Krabbenhoft, president and CEO of Sanford Health. “Through the generosity of Mr. Sanford, we are proud to join VA to make the test available to our nation’s Veterans.”

It may come as no surprise that this initiative comes six months after Dr. David Shulkin joined Sanford Health as its chief innovation officer.

“Secretary Shulkin is one of the most talented health care leaders in the country, and he brings a wealth of knowledge and experience to Sanford Health,” said Kelby Krabbenhoft, president and CEO of Sanford Health. “His unique perspective, clinical expertise and powerful voice will further Sanford Health’s continued development and diversification, which is so critical to our ability to bring new treatments and cures to the patients we serve.”

“After completing my work in the public sector, Sanford Health was an obvious choice to continue my health care career,” Dr. Shulkin said.  “Sanford’s unique brand of innovation and clinical integration is bringing precision medicine to the bedside which is rapidly improving patient care in unprecedented ways. I look forward to joining the Sanford team and bringing my background and skills to help drive these advancements in medical practice.”

Shulkin is now a director on the Sanford International Board. He also serves as an “ambassador” for the organization “on many of the system’s domestic and international products” likely including the rollout of PHASeR.

But is this type of arrangement in conflict with ethics laws concerning former Cabinet members and engagement in private sector arrangements?

How about the auto-enrolling of “all” cancer survivors into the testing program? Doesn’t this seem like mandatory involvement in medical research without informed consent?

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  1. Ben,

    The concern about informed consent for the treatment can potentially be avoided as the research will not present a risk to the veteran. However, volunteer donors, which is now on the table, obviously presents a different perspective where the individual would have to be fully informed of the risks.

    ¨Risks¨ being the operative term brings to mind how else could the research outcomes be utilized. For example, the VA has depended on the IOH to conduct research since 1995 on medical conditions that are considered presumptive if the veteran served in Vietnam and was exposed to Agent Orange. However, the genetic research on current veteran cancer survivors could determine a cellular predisposition to cancer, which would challenge the existing presumption as interrupting the nexus between Vietnam service, AO exposure, and current as well as future determined conditions, as injury, warranting disability.

    I, for one, plan to watch this ongoing research closely.

  2. I’m not getting Ben’s blog either. This cancer thing with VA just doesn’t sound right.. Is this after the 5 years? Or can they say we’re cured and force us to be a lab rat? Whatever their reasons, I am betting there’s money in it for our crooked leader’s in the VHA..

    1. You missed it Elf: “https://mail.google.com/mail/u/0/?shva=1#label/VA+articles/FMfcgxwBVzxzStgBsHDBmhWkFXzwsLCR”

      1. It opens my gmail notification link receipt when I click on it. I was going to forward it to you but can’t remember if I ever exchanged email and what the first 4 characters of that email are if I did.

      2. Try this link instead and then put it in your favorites to open every day: “https://www.disabledveterans.org/”

    2. Nope. Hope he is okay. FB been giving a lot of people fits too. Amazon deleting my wish list of books and other usual forms of today’s fascism and tyranny. Really great living in a free country and in the information age. (sarcasm)

  3. I cured my skin cancer with ‘alternative’ medicine. They wanted to cut it out so I told them no that I wanted to try to do it myself. It took 22 months but it is completely cured. The lesion, the size of a quarter, was on my back. My daughter saw it and asked if I had fallen or bruised my back. I told my provider and it took over 3 effing years for them to do something about it. It got larger and was painful and bleeding and they still did not give a shit!

    My provider at the time they wanted to do something about it wanted to burn it off with nitrogen but I told her no. She flipped out accusing me of being a difficult patient.

    The surgeon said that if she would had her way she would have really screwed up my back and probably would not have stopped the cancer. In other words ‘the bitch’ was WRONG!!!!

    There is no FUCKING way they are going to get me to ‘manditorily volunteer’ for this FUCKED UP program!!!!!!!!!!!!!!!!!!!!!!!!!!

    I have had about enough of the screwed up bullshit they dish out!

    Make me president and it (the whole v.a scam) will be fixed within a week!!! GUARANTEED!!!!!

    Is it legal, moral, or ethical, for VA doctors to make decisions of, for, about, or pertaining to, my medical or psychiatric care, with out ever speaking to me, evaluating me, or informing me of said decisions??????
    Problem I’ve encountered learned about yesterday and today, in phone cons w VA non va care dept. Previously the chief of staff was signing off on some care decisions for me, allowing me care needed. She just “retired” out of the blue. Was informed certain care decisions have been, continue to be made for me, with out my input or knowledge. I am not incompetent, but found old record said differently. I addressed that w chief of psychiatry 2 yrs ago, told it was corrected, and all red flags for disruptive behavior (was never informed I’d been flagged, nor given rights of due process. Chief shrink disclosed the director had removed chief of VA Psychiatry from making care decisions or interviewing in them so he could not help me further.
    I’ve been in Non VA care since Choice began due to serious greivances w VA PCPs, Psych providers, patient advocacy that utterly failed me, left me in severe pain emotional distress, ongoing now 8 year long ordeal.
    I need help, please advise, considering the 50 plus attorneys I’ve contacted in this time refuse to help me.
    No have not consulted politicians, due to numerous vets statements in person and in blogs, that politicians began to help, but failed to follow up or resolve their problems.
    For balance Here, I have heard from some vets that did have politicians help them resolve their problems w VA care issues. I no longer trust VA to manage my non va care or espec to give me medical care, but can’t afford Medicare coverage beyond parts a&b to exit VA care, due to horrible medical and psych services delivered at VA.
    There is much m leaving out here for obvious reasons… Please advise, you have my contact email address…
    Thank you

  5. This genetic bank will be used the disapprove claims. VA will state that you were/are prone to cancer anyway “NOT OUR FAULT YOU GOT CANCER”.$$$$$$$$$$$$$$$$$$$$ caching!

  6. I believe Stanford is the leader on the West Coast. He probably had enough of the NorEasters. We are even getting a taste of one here in Wyoming today.

      1. I’m in Torrington. Recent visits to Cheyenne VAMC have been good. Took a second director after the criis to see any improvement.

        I don’t believe the problem is as much with Cheyenne as with the Regional Office in Denver. I’ve come to realize the Regional Director has a lot of sway over the Medical Directors. It appears reducing “entitlements” in the regional director’s area is bonus territory. I’d like to get my hands on the bonus system for the Regional Office and how they are calculated.

  7. My blood was collected (was threatened with court-martial if I didn’t comply) back in late 1997 or early 1998, while on active duty, for then stated purpose of identification, was to be uploaded into the national law enforcement data base.
    How do I know if it was not also or instead, used to test me for genetic purposes, for good or bad reasons regards my personal health care?
    I’m posting sev links to info VA Drs will never tell you about or use in your medical care, until the VA decides to use it. These are modern known info. That’s my point: VA is so out of date on modern medical knowledge it’s plum loco.

    Groundbreaking test for PTSD developed.

    Threat-Related Attention Bias Variability and Posttraumatic Stress.

    Attention control training reduces attention bias variability, improves PTSD symptoms.

    Using targeted brain stimulation to change attention patterns for anxious individuals.

    Brain stimulation improves depression symptoms, restores brain waves in clinical study.

    Could The Cure For A Rare Chronic Pain Disorder Be … More Pain?

    This New Way to Treat Medical Problems Gets to the Root Cause of What’s Bothering You.

    Not enough veterans complete psychotherapy for PTSD

    Alzheimer’s Biomarker Tied to Sleep Apnea.

    Not all sleep is equal when it comes to cleaning the brain.

    Want to know if someone is manipulating research data?

    1. ptsd is a physical problem caused by immunoexcitotoxicity. dr russell blaylock is the primary researcher on excitotoxicity. all this behavior modification is bullshit. it’s a physical problem and it’s called “mental” so they don’t have to fix it. there’s alot of money to be made by keeping vets in ptsd.

      1. Ben, if you are listening, get your crew to contact NIH and do an article on this. (immunoexcitotoxicity)

        The primary source or beginning is a concussion, even mild ones. Could be from a fall as a toddler or at any time in your life. So, PTSD is simply a symptom of a Post Concussion Syndrome. Started harping on the organicity of PTSD in 1987 along with the writing off of simple PCS as adjustment disorders. Did a fast on the Mall in DC in 1995. Was visited by a group of neurologist led by an NIU neurologist, during the American Neurology Convention, who said NIH would look into it.

        If the military didn’t pick up anything in those induction scores or if they accepted you for duty and subsequently, because of military exposure your condition is aggravated to the point of interfering with daily life including employability, the VA owes you compensation. That is the reason Yale has won the Discharge Review Case and is on the verge of winning a class action case on claims more than a year old.

        Between 1995 and 1998 the number of PCS studies in the NIH Library more than quadrupled. She, (the NIH neurologist) was good to her word. Must have said something at the convention to get it started.

        But look at the inertia of getting something done. 2008 an article in a newspaper caused Congress to finally recognize and compensate PCS calling it TBI. But PCS also happens in just exposure to a blast. Repeated outgoing heavy artillery brought a lot of vets into the PTSD groups I attended between 1984 and 1995. PTSD was the only peg they could hang their hat on. Even mild, moderate and severe TBI had found themselves in the “Adjustment Disorder” diagnosis and couldn’t find any peg to hang a compensation claim on other than PTSD between 1980 and 2008. Before that they just had to accept adjustment disorder. There is no difference between being close to an improvised explosive and an incoming RPG (simply rockets in Vietnam) But the VA appears to be on the bend of recognizing only improvised explosives, not incoming heavy artillery or continuous exposure to outgoing from your enclosed turret on a ship or camouflaged field howitzer.

        Well, yes, PCS causes an adjustment disorder. But as long as you are treating it as a behavioral problem instead of an adjustment to an organic problem (immunoexcitotoxicity) the necessary adjustments won’t be made to even have a semblance of a normal life. And an organic treatment has no chance of being appropriately directed.

        It is easy for physicians to see that diabetes is an organic problem that will never cure. It can only be maintained and controlled through continuing care. But they cannot recognize that with PCS or even that it is PCS they are dealing with.

        Cerebral malaria also brings on immunoexcitotoxicity with the exact same problems of PCS. But those victims from WWII, Korea, Vietnam, Somalia and the current wars are still “adjustment disorders” or hanging their hats on PTSD.

        The present pressure of having therapists put an “end date” on therapy simply doesn’t recognize the problem. Some epileptic drugs help. But you won’t be given them unless you get an EEG that shows something. For me the 2015 Rx for Keppra was life changing. At 74 I became more employable than I was at 34. All of my friends and family noticed a huge difference.

        And the VA doesn’t want to confirm temporal lobe seizures (the center for immunoexcitotoxicity) because it is a situation like diabetes, requiring continuing care and often ultimately compensation because of progression.

  8. Sanford???

    Why not one of the leading cancer and genetic research orgs such as Mayo, Cleveland Clinic, Johns Hopkins?

    Something strange there.

  9. I was successfully treated for AO caused cancer. non- Hotckins Lymphoma, in 2015, here in MX when I edpresently live – due to lack of funds to live in my native CA., as in no pension – did receive comp, which did not cover total cost of my treatment here. Had 5+hrs operation, to include two blood transfusions, since I was 4 units short of blood. I also suffer from Microcytic Anemia for over 20 yrs. as originally diagnosed my San Francisco VA. Since I was treated in MX, distrust of Fresno VA Med. Hospital facility, this doesn’t apply to me. Informed by comp/pen doctor that I would get more $$$ if my cancer returns – was extremely adamant about that when I questioned his decision. I’m alive and that’s good…

  10. I just received this. Google the title to read the full article!

    “When a Veteran is Injured by the VA: The Federal Torts Claims Act
    You can sue the VA for medical malpractice through the Federal Torts Claims Act.”

    By Margaret Wadsworth

    When you are injured by a VA doctor or other employee of the Department of Veterans Affairs (VA), you have two legal remedies available to you. You can file a claim with the VA for disability compensation (commonly referred to as a Section 1151 claim), and/or you can seek money damages under the Federal Torts Claims Act (FTCA). The purpose of this article is to explain your rights under the FTCA.

    1. Is that the Federal Administrative Courts, or the US Civil Courts.
      Makes a HUGE difference.

  11. Don’t you just love the spin on turning all cancer survivors who are veterans into lifetime test subjects? Now the VHA will have open season to do run tests on anyone who survived cancer. If someone has survived cancer…ahem, beat it, why are they being subjected to more medical procedures? Anyone who has survived cancer knows those days of running to the doctor should be behind them. But the good old VA is just going to sign up everyone.

    This just seems like another feeble attempt to access everyone’s DNA.

  12. At some point, there is logic in the analyses of large sets of data that can better predict outcomes. On the other hand, someone severely distrusting of the pseudo-socialist or free market econo-nazi regimes could easily postulate that this is DoD get a sneak peek at how men and women were poisoned in the last batch of anthrax/burn-pit/depleted uranium diseases now being adroitly denied by the VA. All the better to polish future lies.

  13. And this is illegal as they CANNOT force you into this program. I would love to see how the idiots who came up with this idea can justify it via the right to privacy (federal law) says its illegal.

    1. The way they’re pissing away funding blows my mind. Totally disabled veterans paid at the rate of 100 percent bring home less than a new street hire housekeeping aide at the VA if you consider location pay and any meager bonus.

      How is the VA even able to coordinate such a mass project when they can’t even fill out medical records professionally for a large number of veterans? All I see is it’s a pile of smoke to freely waste millions of dollars that should be going to us. We can’t even afford a home anymore and they’re blowing our funding into the wind on a mass research project.

    2. It looks like “Shithead Shulkin”, the former Secretary who ripped off taxpayers, had something to do with it!
      Since his name is named in such a glorious manor, let him get cancer and let the vha fix his sorry ass.

      1. And you are supposed to be able to file in both avenues simultaneously. But LOL getting a 1151 Tort Case through District Court. The 10th Circuit denied my appeal and now I have to go to the Supreme Court. But the 10th seemed to suggest my challenge to the Feres Doctrine should be taken to the Supreme Court for its adjustment to its prior ruling. At least they didn’t use the road block “its settled law” in their decision and seemed to hint without saying so directly, that they were in agreement with my arguments.

        Wish they had sent it to SCOTUS under their authority. I’m going to have to set up a “GoFundMe” account in order to just afford the copying. 40 copies of everything plus binding. Wow! 3 sets to the 10th cost me over $500.00. That means I’ll be paying over $6,666.00 just for that one set not counting the rest which will likely cost over $20,000.00.

        But it will be worth going into hock in a big way if it helps others get their due also. Have some very helpful contra-decisions by other Circuit Courts of Appeals including the CAFC (appeals court for CAVC decisions) decisions. Wish me luck and some help getting the go fund me account funded.

        So much on my plate. Have to get that up first or will fail in just affording to start. The petition for certiorari has to be filed by 1 June. 45 days later all those copies I can’t afford which would mean lost already if I don’t find funding.

  14. I do not trust the VA to put a bandaid on a papercut…………and I certainly would NOT trust the VA with something as serious and life altering as cancer, no matter the reason or effort…..

  15. I’m of the opinion there’s many veterans which could have been saved, from cancer, IF THE VA WOULD HAVE HIRED COMPETENT HEALTHCARE PROFESSIONALS: ie; Doctors and Nurses.
    Instead, they’ve been caught hiring individuals who shouldn’t be collecting garbage! Remember that one in Ohio who was a “Serial Killer”?! Or, how about that dentist who never washed and never wore surgical gloves – where thousands of patients had to be screened for aids/hiv.
    Or, how about the “ALLEGED technicians” who didn’t clean the colonoscopy machines correctly. (I’ll leave that discription lingering in your mind for awhile!) Or, then there’s that asswipe called “The Candyman” at the “Candyland” the VA upper crust “covered for” all while he was murdering a Former United States Marine!
    I could go on and on and on and on for days telling y’all how many incompetent ASSHOLES work at vha/VA/VBA’s across this nation.
    Only I do believe you get the idea!

    My “brother” Lee, a former Marine, would still be alive IF the VA hired COMPETENT HEALTHCARE PROFESSIONALS!

  16. Hey, don’t knock socialized medicine. The countries that are doing it right have a life expectancy of +2 years longer than the US. And they are all above us on the WHO standings based upon outcomes. Stands to reason. You are more likely to get unnecessary surgery or care that will make you worse if the person giving the care gets paid if does it and doesn’t get paid if he doesn’t do anything. You can have your fee based medicine all the way to your last breath. I’ll take the better and longer life any day.

    1. The trick with socialized medicine is to pay for outcomes. Contracts for health as in “Accountable Care Organizations” of which the VAMC is supposed to be one but instead of focusing on outcomes the bonus focus is on cost cutting like the HMO organizations. Their profit comes from denying care. So the present VAMC is not a socialized medicine model. It is an HMO model. The worst of the worse.

      1. You want socialized anything then you are more then willing to move to a country you admire so you can get it right? We ARE NOT AND NEVER WILL BE a socialized anything. All you have to do is look south to the Socialized Country of Venezuela and see how well its working for them. Or look at Finland where the Universal socialized health care has sunk that country as it is costing more then the entire GDP of that country for their “socialized” medicine. And you want the US to do that? Dream on chuckles.

      2. Dan, Venezuela is not a socialized country. It is an autocratic country of the ilk we seem to be headed into. Extremes of Capitalism end up with Kings or “Gods” like Kim Jung Un. Extremes of excuses of socialism end up with dictators similar to the Kings of the old religious orders such as Christianity and Islam with “Lords” and “Mullahs” granted “sovereign rights” such as is claimed now for our government including the VA “against being sued.”

        I’ve looked hard in the Constitution for that claimed “Sovereignty”. The Constitution reads to me like a “Sovereign Document” to which all are accountable including government entities, even the Administration, Congress and the Courts as well as the people. As Veterans we’ve all sworn to uphold and protect the Constitution rather than the King or Shah or Prince or what ever individual claiming absolute power such as the present ruler of Venezuela.

        We started as a “tiered democracy” similar to the Greek Poleis. The ideal has crashed into rank partisanship and gross gluttony. I use “gluttony” in stead of greed because even a poor many can have miserly greed. It takes a glutton to go way beyond even ordinary wealthy power.

  17. Hey, amazing.
    Diet based on genetic markers instead of fads. Medical help based on genes… finally. No two people are the same. You cant make a “catch-all” drug to heal everyone.
    I say, good start. Now dont fuck it up.

    1. Problem is LP this is nothing really new. Then to how will the socialist VA and now civvy care, med boards, AMA, get past that ‘catch-all’ mind-set or like with pain meds and other stuff their ‘across the board’ mentality is we are all the same, not individuals. What would be the costs of such a thing? Would it be like organ transplants that the elite and DC crowd gets put to the top before the peasants? Does or would those special Cancer treatment hospitals and clinics still deny Choice, Medicare and Medicaid? Supposedly they do all the advancements and test treatments others do not. Then with diets we’d be back on the same old debates like eggs good no bad. Cholesterol is needed for our system, no it’s bad bad bad. Vegan vs. meat eaters, raw milk good no raw milk bad bad bad. On it goes. Same crap different day. Same claims, same rhetoric, same narcissistic boasting, etc. Not to forget the elite that travel outside of the US for med care and treatments not allowed here or have to go to special secret hospitals for the elite and trendy.

  18. I’m sorry VA, you only want to figure-out WHY they survived cancer *in-spite-of* the VA, so you can figure-out how to botch it 100% next time around and collect that performance bonus when you pass ‘go’ again or are relocated due to killing a Vet with last in class world ass medicine.

    Cash grab and further withering away any remaining privacy a Veteran has for future profits like futures on hogs on stock market, but nonhuman test subjects.

    1. I left a splatter suggestion about this just now in VA’s porcelain network, seems half the intended message became part of the porcelain transmitter so now I have to send another….transmitting….transmitting….~~~splat~~~

  19. We’ve been “rats” for the super rich since they discovered they could get us after the civil war by claiming they were taking our interest at heart. Well, actually, when it comes to prosthetics, it has put a lot of vets standing that otherwise would have been bed ridden for the rest of their lives keeping those super executives from having to learn Russian, Chinese, Arabic or some other language and work the floor of their factories in stead of the upper floor office suite.

  20. Sorry VA, I don’t have fur or a tail. I guess this means we’re subhuman. Oh, and I don’t like bananas either, so go suck it! Remember when “Hawkeye” walked naked through the camp and no one noticed? That’s how the VA doesn’t see us. WAKE UP LEM! THEIR TURNING US INTO RATS!

    1. WTF! I just noticed that my new virus program found facebook tracking my ass here. (Not anymore).

    1. G-morning. Nothing new. Different day same crap.

      Precision meds? Suffer in pain until your last moments then a 50/50 chance if that of getting life ending comfort meds. Yeah, everything over the years is from “the experts.” Oh wow innovations, advancements, integration? Love those musical chairs being played too.

      Adverse reactions but we are “forced” or ordered to take no help head meds for pain even with severe side effects? And other dope that doesn’t work.

      Innovations, positivity, “Secretary Shulkin is one of the most talented health care leaders in the country, and he brings a wealth of knowledge and experience to Sanford Health,” let me laugh. Phaser? What ethics? The elites are even brain-washed, intentionally ignorant, but hip to Star Trek? How much did the establishment and college crowd, class projects, pay their PR firms for this piece of info and BS? No-one knows what goes on behind the scenes or what our SES and secret agents do with our info. While some want DNA and info from the peeps world-wide? Can’t forget how they want to use all that info while nothing much is secure and private today. Truth, ethics, transparency, full-disclosure, etc., in colleges or gubberment today? Laws that can’t be enforced? Ha. They do as they damn well please full circle.

    2. Good morning Lem. So what’s new you ask. Nothing really, just another scheme to hack the private data of vets.

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