Monthly Archives: February 2007

Does Surgery Worsen Outomes For Breast Cancer?

A recent article in the International Journal of Surgery has rekindled interest in the myth that surgery itself may have an adverse effect on cancer survival by removing the cancer.  In this report, the “target” population is pre-menopausal African American women with breast cancer.


 


The authors write that they have a theory that might provide a scientific basis for the myth.


 


It’s not bad to have a theory.  But when the theory regarding a myth becomes interpreted as a fact, the risk of harm to people at risk is substantially increased.


 


That could happen in this particular circumstance.


 


Let’s take a look at the history of this myth, and see how it has played into the current discussion.


 


This myth was present back when I started my oncology practice over 30 years ago.  It had probably been around for a long time, and if I had to take a guess, it existed and was supported because of the observations and experiences of many patients.


 


Back then, we didn’t find cancer early.  We didn’t have mammograms.  We didn’t have CT scans, and we didn’t have MRI machines.  We didn’t … Continue reading →

New Breast Cancer Genetic Test: What Does It Mean?

An announcement earlier today from the US Food and Drug Administration has garnered an amazing amount of media attention in a very short period of time.


 


The announcement discussed FDA approval for what the FDA said was “the first cleared molecular test that profiles genetic activity” in breast cancer. 


 


The test, called MammaPrint and developed by a company called Agendia which is based in the Netherlands, analyzes 70 genes in a sample of breast cancer tissue and provides a prognostic index estimating the likelihood of breast cancer recurrence after primary treatment.


 


According to a statement by the Commissioner of the FDA, Dr. Andrew von Eschenbach, “MammaPrint results will provide patients and physicians with more information about the prospects for the outcome of the disease.  This information will support treatment decisions.”


 


If you read this blog regularly, you may recall that we discussed this and similar tests in some detail in early August, following a research report and an editorial in the New England Journal of Medicine.


 


Unfortunately, the results of that study and the comments in the editorial weren’t exactly overwhelmingly enthusiastic regarding the practical implications of these particular genetic predictive tests.


 Continue reading →

DCA: Cancer Breakthrough Or Urban Legend?

There is the medical equivalent of a tsunami wave building out there, only we don’t know where this one is going to land.


 


It is called DCA, and we are suddenly receiving requests for information about something few if any of us had heard about as a cancer treatment until this past week.


 


I suspect some of this rapid explosion is fueled in part by the internet and the rapid exchange of information, and some by advocates who believe in the long-held conspiracy theory that someone is holding back the single simple answer to curing all cancer.


 


We even received an urgent plea from one media outlet on Thursday asking us to help them out with understanding DCA, since their website was being inundated with internet traffic that was overwhelming their servers.


 


Before we replace rational discourse with irrational exuberance, it is my personal opinion that a bit of caution is in order.  The basic reason for my conservative view is “been there, done that.”


 


I don’t know the details of how this phenomenon got started, but I can take a stab at an answer.


 


Do a general internet search on dichloroacetate … Continue reading →

Cigarettes Mean Big Bucks

The financial markets are going gaga over Altria.


 


Who is Altria and why all the excitement?


 


Just one of the most profitable companies which happens to make cigarettes and markets them around the world.  You may know it better from one of its leading brands: Marlboro.


 


But the reason for the excitement isn’t just about the cigarette business.  It’s about the business that Altria is getting out of.


 


You see, Kraft Foods is also part of Altria.  You know Kraft Foods because you likely use many of their products, especially macaroni and cheese.


 


That’s quite a contrast: cigarettes vs. mac and cheese.


 


And because Altria will no longer make macaroni and cheese, investors are excited.


 


They call this an “unwinding” that will “unlock the value” of the company and remove an albatross from around their corporate neck.  The cheese company will no longer drag down the profits of the cigarette makers.


 


Instead of making your kids happy at dinner, they will now be able to devote all of their resources to killing many of them by age 80.


 


And that means big bucks and big profits.


 Continue reading →