Monthly Archives: March 2006

More Sad News for Smokers

Several years ago I read an article in a medical journal that estimated the survival probabilities of people who smoked.


 


What struck me about the data in that article was the percentage of smokers who lived into their 80’s and 90’s.  It approached zero.


 


The graph from that article still hangs on a board next to my desk (As I write this, I am traveling, so I can’t provide the reference.  I will try to update that information at a later date.)


 


In this week’s issue of the Annals of Internal Medicine there is another article that again demonstrates how lethal smoking can be.  It also shows that it is never too late to quit smoking.


 


The authors were able to take advantage of the excellent health records and data typical of Scandinavian countries to monitor the smoking histories and causes of death of about 50,000 people in 3 counties in Norway.  In addition, they were fortunate to have folks who for the most part stayed in the communities where they lived, and were willing to get the check-ups required for the study over many years.


 


The study reports the … Continue reading →

Genetic Tests and Breast Cancer Risk: Not Perfect

We have known there are families with increased risks of developing certain cancers due to genetic abnormalities.  This has been particularly true in the case of women with breast cancer.


 


For years, we struggled with the knowledge that women in some families were highly susceptible to developing breast cancer.  Counseling these women was difficult, because we had no clear roadmap to provide us evidence-based recommendations as to what was best for a particular patient.


 


We did the best we could, and when the family history was very strong we would occasionally recommend that the woman consulting us have prophylactic mastectomies.  This was a difficult decision for many of our patients to make, in no small part because they were usually young, and responding to a case of breast cancer in a sister or mother.


 


As time went on, and we learned more about various genetic syndromes, we became more confident that we were honing in on better tests which would provide us the evidence and information about genetic abnormalities that we had previously lacked. 


 


We began to understand and then map the human genome.  Increasingly sophisticated and complex tests were developed which … Continue reading →

For Smokers, Help Is Just A Phone Call Away

An article in the current issue of the Archives of Internal Medicine reports that telephone counseling services do better than routine medical approaches in helping people stop smoking.


 


Basically, what the authors did was invite a large number of veterans treated at 5 Veterans’ Administration Medical Centers in the Midwest to participate in a smoking cessation program.


 


Almost 69,000 mostly male VAMC patients were invited.  Of that group, 1831 responded and 838 people decided to participate.


 


The groups were divided in two, with the “study” group receiving telephone counseling to support their efforts at quitting smoking, while the other half formed the “control” group that received some information on smoking cessation by mail, routine medical care and other medications and services as offered by the VA system.


 


The study is important because it demonstrates that an intervention such as telephone counseling for smoking cessation can significantly improve quit rates at one year.


 


Based on follow-up phone calls at one year after starting their participation in the study, 13% of the folks who were offered telephone counseling had not smoked for the previous six months.  For the control group, the comparable number was about … Continue reading →

Governor Richards

Our thoughts and prayers go out to Governor Richards as she begins her course of treatment for her cancer of the esophagus.


 


We do not have specific information on her condition, and respect her privacy as she faces this difficult challenge in her life.


 


We can provide some general background information that may be useful in answering questions about the disease, although this does not apply necessarily to her specific situation. 


 


The facts about the disease, the statistics and the treatment are dry and objective.


 


We must always remember that behind these facts there are many personal stories of those who have had this disease.  They too have had to struggle with the same news that the Governor has just received.


 


Cancer of the esophagus is an uncommon cancer in women.  The American Cancer Society estimates that there will be 3,290 cases of the disease diagnosed in women in the United States in 2006.


 


Symptoms of this cancer can be very subtle, and usually involve difficulty swallowing, heartburn, a change in dietary habits (more liquids, less solids) and unexplained weight loss.  Patients can also have chest discomfort.  Occasionally, the … Continue reading →

More Thoughts About Dana Reeve

This has been a difficult day.


The American Cancer Society lost a friend who was recently honored by our Eastern Division as Mother of the Year, in recognition of her devotion to her son and step-children. (You can read the American Cancer Society tribute to Dana Reeve on our website.)


As I traveled from Atlanta to Toronto, I could not escape the frequent media pieces showing a beautiful, vibrant, optimistic women who would be taken from this earth long before her time.


Ms. Reeve’s death was a reminder for me personally about the loss of a parent when I was young.  My heart goes out to her son and step-children, and I hope they will find strengh in the memories of their parents, who were loved, admired and respected by so many.


Today was also a reminder of what it was like to be a doctor, unable to provide a cure for a young person afflicted with cancer. Each loss was a personal one, and served as a reminder of how much we needed to accomplish to prevent those tragic deaths.


It was also a reminder of my young, beatiful and talented cousin who was taken from this earth at the … Continue reading →

In Memoriam: Dana Reeve

My colleagues and I at the American Cancer Society were saddened to learn this morning of the tragic death of Dana Reeve from lung cancer.


 


Our heartfelt sympathies go out to Ms. Reeve’s family and friends in their moment of loss and sorrow.


 


Ms. Reeve was a noble woman, who through her example and support for her husband during his time of need gave light to the problems and hopes of people with spinal cord injuries.  She set an example to all of us of what can be accomplished through love, devotion and perseverance. 


 


She will always be remembered for showing so many what can be done in times of the greatest need.  She was a vital and brave woman.


 


Her death highlights the fact that not every case of lung cancer is caused by cigarette smoke.  We will never know what actually caused this disease to occur in this woman, and her death highlights the need for us to better understand the causes of lung cancer in people who have no known exposures to toxic agents like cigarettes.


 


We also need to reflect at a moment such as this on … Continue reading →

Honey, What Happened to the Haze?

Today’s story is a short one, but nonetheless instructive to me and I hope to you.


 


Like other states considering smoke-free restaurant laws, Georgia went through a considerable amount of debate, angst and anguish last year as the legislature debated whether or not to pass a smoke-free ordinance.


 


You can only imagine how politically charged the issue was, not only because the restaurant and bar owners were concerned about their potential loss of business, but also because of the long heritage of tobacco as a staple product and income producer for this state for many years (in fact, my wife—who is a physician—talks frequently of what it was like to help her family pick tobacco when she was a child).


 


But the bill was passed, in no small part as a result of the intense efforts of American Cancer Society Georgia volunteers and staff.


 


That didn’t end the suspense, for it took the Governor until the very last minute to decide to sign the bill.


 


Now Georgia has no smoking in restaurants that permit people 18 and under on their premises.  If you are an establishment that doesn’t let young folks in, then you … Continue reading →