A Blood Test For Early Detection Of Melanoma? Not Yet

The headline scrolling across the bottom of an evening news show certainly grabbed my attention: a new blood test had the possibility of detecting early melanoma and saving thousands of lives. And then there were more reports elevating this early research report to a point that I became quite interested—and frankly concerned.

News flash: The research is far from being shown to have proven value in the early diagnosis of melanoma, a less common but certainly potentially deadly form of skin cancer. I am not certain the various media headlines and articles appropriately reflected that fact, once again offering hype over inconvenient reality.… Continue reading →

A New Treatment With Immunotherapy Brings A Moment Of Hope For Patients With Lung Cancer

Lung cancer treatment is clearly the story of the week coming out of the annual meeting of the American Association for Cancer Research in Chicago. And although media coverage of this emerging information about the role of immunotherapy in lung cancer has been extensive, there is—as always—more to the story, especially if you look closely at the numbers and in particular if you are a non-smoker with lung cancer.

One study stands out among the others in which immunotherapy along with chemotherapy significantly improved survival for patients with certain forms of lung cancer when compared to chemotherapy alone. Not only was that study reported at the Chicago meeting, it was also published simultaneously in the prestigious New England Journal of Medicine, offering us considerable detail into how the study was performed and the results.… Continue reading →

Times Change, Our Bodies Change, And Now The Body Mass Index (BMI) Guidelines May Change Too

A recent news story in the Journal of the American Medical Association (JAMA) reminds me that lots of things in our lives are changing these days, not the least of which is the shape of our bodies.

Oh, my. This aging thing isn’t so easy, and that is really the message behind Rita Rubin’s timely piece about shifting body mass and muscle as we age and its implications. Although focused on women, I can attest personally that men fall into the same trap as well. That 250 pounds when you are older simply is not the same 250 pounds when you were in college. Now 250 pounds looks more like 280—even though the scale still says 250. Go figure…

Although I may be trying to provide a little humor to the subject, the reality is it’s not humorous when it comes to our health. As we age, muscle turns to fat. In a process called “sarcopenia,” muscle begins an inexorable march to become fat, and for most of us it doesn’t make too much difference how much we try to forestall the shift. It is programmed into our bodies, and although exercise might help, Mother Nature simply doesn’t … Continue reading →

A Real News Story Of Hope: Impressive Decline in Melanoma Incidence In Young Women Will Result In A World With Less Cancer

A recent research report on melanoma from the Centers for Disease Control and Prevention received virtually no notice, yet one of the statistics in that report was—at least for me—stunning, and marked a rare public health win.

People in public health know all too well the gap between educating people about cancer risks and seeing actual results. Skin cancer is no different: We have known for many years that the risk of skin cancer is related to exposure to UV radiation, either from the sun of for indoor tanning.

Yet despite widespread efforts to educate people about this very real cancer risk, we haven’t made much progress reducing its frequency—at least until now.… Continue reading →

FDA Approves Consumer BRCA Test, And We Take Another Step Into The Brave New World Of Genomics

The approval by the Food and Drug Administration of 23andMe’s BRCA test is bound to create a discussion about the merits and pitfalls of direct to consumer genetic testing for cancer risk.

It is also going to add fuel to a growing fire about how we as a nation assess genetic risks for cancer, and whether society is prepared for what is inevitably going to become a genomic-influenced and informed culture of health.

From my perspective, as someone who has given considerable thought to these questions over the past several years, there are no easy answers.… Continue reading →

An Ad About Risk Misses The One In Plain Sight

Sometimes you just can’t make this stuff up.

At least, that’s the thought I was left with this morning when I happened to see a television advertisement touting a particular company’s abilities to apply predictive analytics to ordinary situations and avoid a potential catastrophic loss.

However, in telling the story about the company’s capabilities to reduce risk and harm, they inadvertently sent the wrong message about protecting one’s life by practicing a reasonable degree of sun safety. And that’s the message that has resonated for me throughout the day.… Continue reading →

The Task Force Shift on PSA: It Really IS A Big Deal

Sometimes it all depends on your point of view when it comes to areas of divergent opinion about the value of certain medical tests and procedures.

So it should be no surprise that the release earlier this week of the United States Preventive Services Task Force draft statement of their new updated recommendations on the use of the PSA test to screen men for prostate cancer has generated some controversy of its own.

However, this time around it’s not just the advocates or the detractors aiming their fire at the Task Force—it’s journalists and bloggers battling over how media reports and headlines portrayed the impact and ultimate meaning of that draft report (I emphasize “draft” with more on that later). The report basically took the PSA test out of Task Force purgatory by changing the prior recommendation from “don’t do it at all” to a more permissive “have a discussion and make a decision if it’s right for you.”… Continue reading →

Chewing Gum To Detect Cancer: Reporting The Hype, Diminishing The Facts

Sometimes It’s important to know the news behind the news: the comments and the cautions that don’t get into the article that the public gets to read. It’s the sort of thing that keeps me up at night: trying to convey the reality, while realizing what most people want to hear is the hope.

That’s the problem I have with a story posted on a major news network website yesterday, where I have a brief quotation that failed to capture the thoughts I tried to express at the time of the interview. The reporter had very limited time, and the information I wanted to provide was complicated. Instead of the caution I tried to convey to counter the potential “hype” about chewing gum to find cancer early, the report suggests that this is a test that will be available soon—while failing to inform how complicated it would be to achieve that goal.… Continue reading →

Few Boomers Get Hepatitis C Test Even Though It Can Save Lives

Are you a baby boomer? Have you been tested for hepatitis C virus (HCV)? Do you know why you should be tested for hepatitis C? Do you even know what hepatitis C is?

According to research published today by my colleagues from the American Cancer Society in the American Journal of Preventive Medicine, the odds are overwhelming that if you are in the boomer generation you have not been tested for the virus, and that has me wondering why that is the case. Could it be that we don’t know about hepatitis C? Could it be that our health professionals aren’t recommending testing? Could it be that the costs of treatment may be seen as a barrier to care?

Why is this important? Because if you do have hepatitis C you are at risk of dying from liver cancer and other diseases. The kicker: the deadly results of hepatitis C can be prevented with an effective, albeit expensive treatment. Deaths from liver cancer in the United States are increasing more rapidly than any other type of cancer, according to a recent report. And even when localized at diagnosis, liver cancer is most often fatal.

It doesn’t necessarily have … Continue reading →

Mark Cuban Asked And I Respond: Will This Company Transform The Economics and Results of Healthcare?

It’s not often you are asked publicly to comment on a particular investment by an entrepreneur as well-known as Mark Cuban. And although I don’t usually offer such advice, this one piqued my interest—more so because of a larger story than the particular company itself.

Mr. Cuban wrote that he is “really excited about changing the economics and results of healthcare with this one.” I don’t doubt his sincerity, however may I suggest there are some much bigger problems that need to be addressed to meet that noble transformative and audacious goal?

The company in question is called LungDirect. They offer a program that gathers information on CT scans performed for the early detection of lung cancer, analyzes the data and facilitates reports required by the Centers for Medicare and Medicaid Services (CMS) for payment under the Medicare program (more about that below). In short, it’s a sophisticated approach to what we call a “medical registry.”

I can’t comment here nor do I know whether their tool is any better or any worse than other similar programs. What I do know is that although registry reporting can be complex, creating technology that assists in tracking patients, collating, … Continue reading →