Monthly Archives: May 2008

Invest In Research, But Don’t Forget The Miracles

It’s time to talk cancer science and discovery.


 


I am currently in Chicago, attending the annual meeting of the American Society of Clinical Oncology (ASCO).  This is what most of us consider the premier international cancer meeting, and is attended by over 30,000 physicians and cancer scientists, hearing information on over 5000 studies, some of which inevitably will set the standards of care in cancer treatment for years to come.


 


As I write this, I am listening to a series of talks from leaders in cancer medicine.


 


One presentation that has just concluded was given by Dr. John Niederhuber, the director of the National Cancer Institute.


 


What he reminded us that despite our advances in cancer treatment, and while we are struggling to get sufficient funds for cancer research, we can never forget that miracles do occur.


  


Dr. Niederhuber reviewed many of the issues facing cancer research today, including the lack of new funding sources, and our need to extend our capabilities to provide state-of-the-art care for patients in every part of this country, no matter their economic circumstances, the color of their skin, or the language they speak.


 


He … Continue reading →

Sunwise and Sunsafe

As I write this, my mind is on my exit for the weekend, and thoughts of being with my family, friends, and the dogs (two very active golden retrievers, but more about them another day) in the north Georgia mountains.  (Yes, there are mountains in north Georgia. Not too high, but they are mountains.)  


 


I am thinking of taking walks, doing some cooking, maybe fishing, and basically taking 72 hours to relax a bit (If  that is possible with the dogs.  They don’t get much attention normally, so this is their time for vacation, too.).


 


But it is also that time of year when we need to be thinking about not only the good things associated with being out of doors, but how we have to take care of ourselves and our health when we are out in the sun.


 


May is Skin Cancer Prevention Month.  


 


The timing is obviously not coincidental. Many of you—like me—dramatically increase our time outside during the summer months.  For those of you who live in sunnier climates, it’s a time of the year when the intensity of the sun becomes greater as do the … Continue reading →

Chantix: What To Do Now?

News reports this morning that the smoking cessation drug Chantix (varenicline) has been linked to an increasing number and variety of side-effects was disturbing.    


The announcement that the Federal Aviation Administration has decided to ban the use of Chantix by pilots and air-traffic controllers certainly doesn’t give one a sense of comfort.


 


The report was released by The Institute for Safe Medication Practices.


 


For those of you, like me, who have never heard of this institute, you may be interested to know the following, as listed on Healthfinder.gov, a website of the Department of Health and Human Services:


 “The purpose of the Institute for Safe Medication Practices (ISMP) is to educate healthcare practitioners and institutions, regulatory agencies, professional organizations and the pharmaceutical industry about adverse drug events and their prevention. The Institute provides an independent review of medication errors submitted by practitioners to a national Medication Errors Reporting Program (MERP) operated by the United States Pharmacopeia. ISMP is an FDA MEDWATCH partner and regularly communicates with the FDA to help to prevent medication errors.”


Their credentials look good to me.


The report released today is pretty blunt in its comments:


 


“A strong signal … Continue reading →

Vitamin D And Breast Cancer: What Does It Mean?

We are getting into the “season” when there is a plethora of cancer news, primarily due to forthcoming annual meeting of the American Society of Clinical Oncology meeting, which is scheduled to begin in two weeks in Chicago.


 


Unlike years past, when the abstracts were embargoed until the scientific studies had been presented at the meeting, this year ASCO released almost all of the abstracts last evening.  Only a handful of the most significant abstracts have been withheld from the public release.


 


One of the abstracts highlighted by ASCO had to do with vitamin D levels of women diagnosed with breast cancer.  The results of that study are certainly thought provoking, and will undoubtedly add to the discussion on the role of vitamin D in health and its influence on cancer incidence and prognosis.


 


We need to bear in mind that all we have so far is an abstract of the research, which essentially represents the most preliminary form of reporting scientific results.  The actual public presentation of the data won’t happen until the ASCO meeting.  That’s when other researchers have a chance to listen to the information, get clarification of the … Continue reading →

Carepartners: Special People For A Special Need

Caregivers for cancer patients are very special people.  They are the ones who stay by the side of their family member, friend, or perhaps even co-worker who is diagnosed with cancer.  They frequently are the ones who listen most carefully to what the doctors have to say, and they frequently provide the support that patients need to get through their arduous journey once a cancer is diagnosed.


 


I don’t need to tell you that some of the most difficult and feared words that a doctor can say to a patient are, “You have cancer.”  We know that once those words are uttered for the first time, a person can go emotionally and even physically numb. 


 


That’s where the caregivers step in.  But I think it is more than “giving care.”  It is one of the most special partnerships that any of us can imagine.  So I am going to suggest that we consider changing this phrase to one that perhaps more accurately describes this relationship, namely “carepartners.”


 


Patients don’t hear much after those words are spoken regarding their diagnosis, much less the treatment or the prognosis.  All too frequently, … Continue reading →

Smoking In New York: A Success Story

Those of you who read this blog regularly know that I frequently make the comment that if New York City can go smoke-free, anyone can.


 


During yesterday’s meeting celebrating the release of the new guidelines for smoking cessation, I was particularly struck by some information mentioned by one of the speakers outlining the incredible success and impact of New York’s smoking ban that went into effect in 2002.


 


Now I have the actual data, and I believe it is proof positive that when you have the political and public will to do something, there are real benefits to be gained.  And those benefits are not just economic in terms of dollars, but also include a reduction in illness and the saving of lives.


 


Bottom line, these numbers make it hard to argue against the fact that effective public policy has a real impact on our health and the quality of our lives.


 


Here is some of the data, released in 2007:


 



  • In 2006, there were 20% fewer smokers in New York compared to 2002.  That represents 240,000 people.

 




  •  Declines in smoking were seen in most age groups, with the exception
Continue reading →

Today’s Hero: C. Everett Koop, MD

It is clearly evident in this room today, where the Public Health Service is unveiling its updated guidelines for treating tobacco use and dependence, that Dr. C. Everett Koop is one of the heroes of this moment and this movement.


 


As he just mentioned during his remarks at this meeting, Dr. Koop is in his tenth decade of life.  He has seen a lot, and done a lot.


 


There are many of you out there who probably don’t know anything about Dr. Koop aside from those ads that run frequently on TV. 


 


He was a world-class pediatric surgeon at Children’s Hospital in Philadelphia when I first met him as a senior medical student in 1970.


 


Dr. Koop was—and remains—a formidable man, with a tall stature and a presence that cannot be denied.  He is a man of deep religious beliefs and moral behavior. 


 


He went from Children’s to become Surgeon General of the United States.  It was a nomination that was not without controversy, given Dr. Koop’s beliefs and conservatism.


 


Dr. Koop became one of the outstanding Surgeons General of my lifetime.  He attacked AIDS and vigorously … Continue reading →

New Guidelines For Treating Tobacco Dependence

Today I am in Chicago, attending a meeting where the United States Public Health Service is releasing their updated guidelines titled “Treating Tobacco Use and Dependence: Clinical Practice Guideline 2008 Update.” 


 


The PHS was part of consortium of eight Federal Government and non-profit organizations that produced this guideline.  The American Cancer Society and many other respected organizations have endorsed these guidelines.


 


These guidelines are an update of recommendations that were first published in 1996, and revised in 2000.  The current report represents evidence from over 8700 published articles in the medical literature, which have been published beginning in 1975.


 


What has surprised me is that some of my colleagues believe that there may not be much interest in this guideline, that it may be “more of the same.”  Yes, they say, we have had successes, but given those gains people and health care professionals are no longer focused on the importance of smoking cessation.  Simply put, we have moved on to other “big new ideas.”


 


I don’t agree.


 


According to the Partnership for Prevention in 2007 in a pamphlet handed out at the conference, “Providing smokers with advice … Continue reading →

The National Comprehensive Cancer Network

I am going to let you in on a little secret.


 


My confessional is prompted by the realization this past weekend, when I was on a call with someone referred by a friend, that I haven’t shared something with you that I rely on regularly when I talk with patients, families or friends who have questions about cancer treatment.


 


That “secret” is a website which provides what I consider the most up-to-date information used by doctors to guide their treatment of cancer.  That website is hosted by the National Comprehensive Cancer Network, or NCCN.


 


NCCN is a coalition of 21 leading cancer centers across the United States.  One of their major efforts is to continuously update recommendations for a large number of cancers and supportive care issues at least annually, if not more frequently.


 


NCCN makes that information available to anyone who wants to read it on the web at www.nccn.org.


 


Why is this so important? 


 


There are really two fundamental reasons that come to mind:


 


1) Cancer care is becoming increasingly complex, as our knowledge about the types and subtypes of cancers continues to rapidly increase.  Continue reading →