On the shoulders of giants

by George on 24 January 2012

“What Descartes did was a good step. You have added much several ways, and especially in taking the colours of thin plates into philosophical consideration. If I have seen further it is by standing on ye sholders of Giants“

While science was the subject of Isaac Newton’s above quote in a 1676 letter to his rival Robert Hooke [shown exactly as he wrote it] it could quite easily be applied to medicine in general and certainly to cancer. Cancer claimed a giant recently when Terry Hamblin passed away, a pioneer of stem cell research now considered by some to be the best long-term cure for cancer and certainly an alternative to the toxic drugs used in chemotherapy.

The three types of treatment for cancer have the nicknames: cut (surgery) burn (radio therapy) and poison (chemo therapy).

Hamblin’s stem cell treatment for lymphoma using the patient’s blood rather than drilling into bone marrow for example, is now a standard treatment and far less invasive.

Professor Terry Hamblin who has died age 68 was a haematologist who delivered the “world’s first cancer vaccine”

Hamblin injected Catherine Nosrati, a lymphoma patient who was then 42, with the so-called DNA “vaccine” at the Royal Bournemouth Hospital in 1999. In theory, the “vaccine” works by combining genetic material from a cancer cell with a harmless part of a toxin, thus stimulating the body’s immune system to destroy the toxin – and the cancer cell along with it. More than a decade after the first “vaccination”, trial programmes are still under way. According to an article in the International Journal of Medical Microbiology, “genetic immunisation with {DNA vaccines} has proven to be a promising tool in conferring protective immunity against tumours in various animal experiments”. Its effectiveness for humans, however, remains to be established.

Hamblin, known as “Prof” to his friends, dedicated most of his working life to leukaemia research, in particular chronic lymphocytic leukaemia (CLL), the most common form of the disease. It had long been known that for about half of people with CLL, the disease grows and progresses slowly, and it may take years for symptoms to appear or for treatment to be needed. The other half have a more aggressive form of the disease and need treatment sooner. Hamblin and colleagues carried out DNA analysis and discovered that the disease indeed had two molecular forms, one giving patients an average of 25 years’ survival and the other, only eight years. As a result it became possible for clinicians to reassure many patients, especially older ones with the more slowly progressing form of the disease, that they would probably not need any treatment in their lifetimes.

In the early 1980s, Hamblin carried out the first successful “autologous” stem cell transplant into a lymphoma sufferer using stem cells from the patient’s blood. Previously, the procedure had involved taking stem cells from the patient’s bone marrow, an unpleasant and invasive procedure. The use of blood for stem cell transplants is now a standard procedure.

Terence John Hamblin was born in Worcester on March 12 1943 and studied Medicine at Bristol University. After a series of jobs in Bristol and Poole, Dorset, he was appointed Consultant Haematologist at the Royal Bournemouth Hospital in 1974 at the young age of 31.

At Bournemouth Hamblin and his colleagues developed a first class haematology service, and for about 30 years he travelled regularly to the Southampton Medical School, attending seminars, talking to academic scientists, and integrating scientific data. A professor at Southampton University from 1987, Hamblin became an expert in plasma exchange; myelodysplastic syndrome; monoclonal antibody therapy; stem cell transplantation; and chronic lymphocytic leukaemia.

                  

He was also an honorary consultant haematologist at Kings College Hospital, London, editor-in-chief of the medical journal Leukaemia Research, and a regular columnist for the magazine World Medicine. His publications include Plasmapheresis and Plasma Exchange (1979); Immunological Investigation of Lymphoid Neoplasms (1983); Haematological Problems in the Elderly (1987); and Immunotherapy of Disease (1990) .

Perhaps unusually for a scientist, Hamblin was a devout Christian of fundamentalist views (among other things he was vice-president of the Biblical Creation Society and served as deacon of his local Baptist church). He kept a blog, in which commentary on the latest discoveries in cancer research alternated with thoughts on biblical texts. Yet he was sensitive to his audience and if the subject of the Bible came up in conversation with non-believer colleagues, he would address issues in a secular manner. [unusual for a fundamentalist]

He raised large sums for cancer research and in 2002 he was awarded the Binet-Rai medal for outstanding research in chronic lymphocytic leukaemia.

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What on Earth is a Rab C Nesbitt Annuity?

by George on 21 January 2012

Or what is an Annuity?

This is a question that comes up at every The Pensions Advisory Service  TPAS presentation I give although the audience often doesn’t need to worry, as they are typically in public sector pension schemes where pension income is protected from the daily changes of annuity rates. An annuity is where you swap a lump of money for a guaranteed income – usually for life. For most people the lump of money comes from their pension which is usually the largest lump of money most of us will ever have. I use the word guaranteed here as the income is usually provided by a very large insurance company. These monsters are heavily regulated, can provide risk cover cheaply for ordinary people. Competition is ferocious, many rates have come down (not just on car insurance) and clever chaps called actuaries crunch numbers to assure everyone that there is enough money in the kitty to meet claims.

Got a young child with a penchant for maths? Have a look at becoming an actuary - they tend to be very well paid, but then the exams are tough. Forget also the old joke “What sort of guy becomes an actuary?” Someone who finds accountancy too interesting!

But back to annuities – an income for life in return for a capital sum. The government used to sell them until 1837, without any underwriting or medical checks. You may remember from the end of the 1994 film The Madness of King George the baddie played by Ian Holm is paid off after “curing” the King, and a major part of his settlement is an annuity.

Proving that you learn something every day, there is even an Annuity Museum a visit to which, would be interesting for any financial adviser. But there is a problem with annuities. Returns are based on two main factors: life expectancy and medium-term interest rates. Feeling brave? Check your own life expectancy with the Government Actuary Department GAD. Better healthcare means we are living longer meaning lower annuity rates while interest rates have also been low for a while which has the same effect. Annuity rates are less than half of those available ten years ago. Even worse, the difference between what you get swapping your capital for an income for life and what you could get giving it to an IFA who would select an income fund(s) that would allow you to keep your capital, is often only 1 or 2 per cent. As one of my fellow IFAs put it once, Annuities are Theft!

But life expectancy rates vary hugely throughout the UK, so let  in today’s The Daily Telegraph Your Money explain:

 Never mind Scottish devolution, a Rab C Nesbitt annuity could boost your pension income

Scottish independence is getting the politicians excited again but most people north of the border could gain more from evolution than devolution. Before my mother and father disown me, I had better explain that I have just been looking at life expectancy statistics – and they make dismal reading for folk who will celebrate Burns Night next Wednesday.

For example, the average man living in Glasgow City will die 13 years and six months younger than his counterparts in Kensington & Chelsea, according to the Office for National Statistics. While medical advances, improved diet and less smoking mean more people across Britain are living longer, the gap between lifespans for different groups of the population is growing, according to new analysis by the Longevity Science Advisory Panel released this week.

The main factor, of course, is money; the rich tend to live longer than the poor. Steven Baxter of Club Vita actuaries – the professional mathematicians who advise pension funds – pointed out that these facts had important implications for people entering retirement.

He said: “People living in different parts of the United Kingdom should take different steps to get best value for their pension savings when they retire. The reason is because of the way insurers allow for differences in life expectancy between different socioeconomic groups by regions in their annuity prices.”

An annuity is a guaranteed income for life, which most members of defined contribution or money purchase pensions buy when they retire. Those who live longest do best but those who die sooner never get their capital back.

So, for example, Mr Baxter said: “People living in the South West, the West Midlands and Yorkshire & Humber, which all have above-average life expectancy, may find buying an annuity attractive but people living in Wales and Scotland, with below-average life expectancy, may find income drawdown more attractive than buying an annuity.”

Life companies have recognised these facts by adjusting most of the annuity yields they offer to reflect the purchaser’s postcode, among other factors. Smokers, for example, are paid higher yields because they are likely to die sooner and collect fewer annuity payments. Non-smokers and residents of well-to-do areas are offered less because they tend to live longer and collect more.

So might it be worth buying or renting a bedsit in Glasgow and taking up smoking before buying an income for life? Professional advisers were divided about what might be called the Rab C Nesbitt annuity. Bob Bullivant of Annuity Direct said: “This would probably work for someone owning two properties as they will need to provide identification for money laundering purposes.

“Such people should get a quote for each postcode. Renting a bedsit is more difficult in terms of identification.”

Life insurers have only themselves to blame if people begin to make the most of different incomes being paid to pensioners in different parts of the country, according to Steve Bee of Paradigm Pensions. He said: “The trend to so-called postcode annuities is worrying.

“If postcode annuity pricing is used as a blunt instrument and people can as a result gain an advantage by moving home in order to purchase one at a better rate, then the maths underlying the pricing of the annuities simply wouldn’t stand up.”

Billy Mackay of self-invested personal pension (SIPPS) specialists A J Bell said: “I have had a look at a selection of annuity application forms and I am not convinced there is a robust argument to be made for renting a place in the hope it will enhance the annuity figure.

“Any pension saver providing a rental address with the aim of inflating their income would run a significant risk of a subsequent reduction in the annuity amount.”

Alan Steel, an independent financial adviser of Linlithgow, said: “Annuity providers always ask if you smoke, but not when you started smoking, and there could be a similar opportunity for people with second properties.

“If you take up smoking and move to Glasgow before buying an annuity, you could be laughing all the way to the bank. But turning up in a string vest with a tin of Irn-Bru would be going too far.”

Pensioners planning to make the most of postcode annuities should always seek independent financial advice. If you think life is unfair, just look at the facts and figures about death.

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Silicon Valley? Just another ghetto

January 19, 2012

Opposites Attract  – but Likes cluster First meeting of 2012 of George’s favourite networking group 3Cs Community  is another humdinger hosted again by Simmons & Simmons at their City Point Office. Few minutes of listening to first speaker Andrew Humphries of Tech City and you wonder where the recession went. Styling itself as The Digital Capital of Europe, [...]

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Fire Down Below

January 14, 2012

We Shall Not Remember Them First full week of the new year and nearly everyone is back at work. Only three weeks after the festivities and several weeks since Remembrance Sunday, the official time of year to be sad and think back. But not everyone is remembered and certainly not all with gratitude, reminding us [...]

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Nomoreirishjokes please

January 5, 2012

No More Irish jokes please! Giving my age away here, but comedian Charlie Chester (1914-1997) said humour is “really about cruelty!” Might even have seen him say it on B&W TV but the point is, we usually laugh at somebody. All very well but it depends which end of it you are. Let me restrain myself [...]

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Before Starbucks

January 3, 2012

Starbucks nearly ended up being called Pequod.. Taking its name from the first mate in the story of Moby Dick written by Herman Melville , the world’s largest coffee chain now has over 16,000 stores worldwide. Prior to this, coffee bars were typically individual or family businesses where the most famous included Café Hawelka in Vienna and Les Deux [...]

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Let Us Now Praise Famous Men

January 1, 2012

Frank Wild – A Forgotten hero Just when you think you have written the perfect blog to wrap up the year you stumble across another article that is too good to pass over but thinking about the subject, it makes a good one to kick off 2012 with. And if Grytviken sounds familiar, think of it [...]

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Misery we would not inflict on a terrorist

December 30, 2011

Physician heal thyself – or maybe not? It is easy to forget that doctors get ill too, as mentioned in this thought provoking review from Slashdot Will this start another debate about funding the NHS, I wonder? The review mentions “futile care” which in the USA, tends to be paid for by insurance companies. Being privately [...]

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I didn’t do it My Way

December 29, 2011

Regrets? I’ve had a few..la..la..la Frank Sinatra fans may recognise the mangled headings from his hit My Way where the words were written by Paul Anka and the tune based on the French song Comme d’habitude (As usual). But the first words of My Way  “And now the end is near….” seem appropriate with the birth of a [...]

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The Cancer Season

December 17, 2011

Merry Christmas It’s that time of year again when you tend to look back and plan forward. Not for nothing is the first month of the year named after the two-faced Roman god Janus who is the god of beginnings and transitions as well as being the god of gates and doors. Best news professionally? [...]

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