The Scan by 2 Minute Medicine®: Over the Counter Birth Control, The Promise of the Pancreatic Cancer Vaccine, and Montana Bans TikTok!

The Scan by 2 Minute Medicine® is a pop-culture medical newsletter and exclusive benefit for 2 Minute Medicine Plus subscribers.

Over-the-Counter Birth Control?

The Story: This past month, an advisory panel at the Food and Drug Administration (FDA) has recommended making a hormonal contraceptive pill, Opill, available over the counter (OTC). This news comes in the context of a highly charged political environment around access to abortion, which has diminished significantly since the overturning of Roe v. Wade last year. If approved this summer, it could mean significantly greater access to contraception for women across the country.

How do birth control pills work?

Hormonal birth control pills are a widely used method of contraception for women. Opill is a contraceptive pill that only contains progestin, a synthetic form of the hormone progesterone. These progestin-only pills work by thickening the cervical mucus, making it difficult for sperm to reach and fertilize the egg. They also thin the lining of the uterus, reducing the chances of a fertilized egg implanting and growing. When taken at the same time every day, these pills have a failure rate of about 1%, making them highly reliable for preventing unwanted pregnancies. While Opill has fewer side effects than a combination birth control pill (one that includes both estrogen and progestin), patients are still at risk of unscheduled bleeding, breast tenderness, and mood changes. Moreover, not everyone can take hormonal birth control – research suggests that taking a progestin-only pill like Opill can worsen pre-existing liver disease or breast cancer. Up until now, individuals have required a prescription from their primary care provider to access birth control. At these health visits, they typically have discussed potential side effects and pre-existing medical conditions to ensure safe usage.

I’m listening…

If approved this summer, making Opill available over the counter could increase contraception availability for women across the country and lead to benefits such as more favorable pregnancy outcomes, improved child well-being, and decreased abortion rates. However, some FDA researchers have raised concerns about patient education when the pills are available over the counter and if women with certain medical conditions, such as breast cancer, would properly follow the warnings and avoid using the product. Others have questioned the ability of consumers to follow instructions to take the pill consistently and use other forms of contraception or abstain from sex in the case of a missed dose. The final decision by the FDA is expected this upcoming August.

The Promise of a Pancreatic Cancer Vaccine

This past month, a trial for a cancer vaccine targeting a notorious pancreatic cancer has yielded positive results. Pancreatic cancer is the leading cause of cancer death in the United States. With an increasing incidence and a survival rate of 12% that has remained relatively stagnant for nearly 60 years, being diagnosed with cancer is far from favorable. After developing a novel cancer vaccine, the study researchers decided to test its efficacy on this particular life-threatening disease. The researchers chose to target the most common type of pancreatic cancer, pancreatic ductal adenocarcinoma (PDAC), which is lethal in 88% of patients. In the trial, over half of the patients who received the cancer vaccine remained free from relapse.

The pancreatic cancer vaccine operates on the same principles as a normal vaccine – a weakened version of the disease is injected into the patient, in the hopes that the patient’s immune system will learn about what the cancer “looks like” so it can recognize and eliminate when the cancer comes in full force. Like the COVID-19 vaccine, the pancreatic cancer vaccine in question is an mRNA vaccine. Unlike regular vaccines, the attenuated vaccine is taken from a sample of the patient’s own tumor. In this way, the vaccines are tailored to each patient’s individual tumor. In the results of the study, the vaccine was able to reduce relapse in half of those who received it. This is an example of cancer immunotherapy – harnessing the power of the immune system to defend the body against cancer. Of course, it is important to note that cancer vaccines have their weaknesses; they do not prevent cancer from developing in the first place, genetic testing is expensive, and personalized treatment isn’t available for all types of cancer. However, the success of this small trial is a testament to the power and potential of personalized medicine, which will continue to be a great opportunity for future cancer research.

Montana Bans TikTok

Recently, Montana has become the first state to fully ban TikTok. Although this decision comes in the context of cybersecurity and political tensions between the U.S. and China, school officials in other countries have also followed suit, deeming TikTok to be a significant public health risk to young students.

According to a recent report, TikTok has a particular tendency to expose teenagers to harmful content related to suicide, self-harm, eating disorders, and cyberbullying, often within minutes of them creating an account. This is particularly concerning since evidence suggests that exposure to maladaptive behavior may promote similar behavior among vulnerable youth. Moreover, online social reinforcement of these behaviors may be related to increased risk for serious psychological symptoms, such as anxiety and depression. In line with the current climate, the American Psychological Association (APA) has recommended that teenagers should receive proper training before entering the realm of social media. In doing so, youth would learn how to question the accuracy of social media content, refrain from excessive social comparisons online, and identify problematic social media use. These recommendations align with the increasing efforts to combat harmful online content that can negatively impact adolescent mental health. With that said, Montana’s decision has been met with criticism from certain groups – critics say that it overlooks the potential advantages of the app, such as promoting online connections, creativity, and providing learning opportunities. Regardless, it seems that striking a balance and equipping youth with the necessary skills to navigate the digital landscape wisely is key.

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