The Food and Drug Administration this week approved a device to reduce hair loss in women receiving chemotherapy for the treatment of breast cancer. The media attention has been extensive and highly favorable. But taking a closer look at this, there are a couple things, as yet unreported, that have me more than a little concerned.
The machine is a form of a cold cap, and is designed to reduce the blood circulation to the scalp while a woman receives treatment to either reduce the risk of breast cancer returning, or to treat recurrent disease. The theory—which has been around for decades—is that if one reduces the circulation of blood to the scalp you also reduce the circulation of the drugs that can cause hair loss to the hair follicles. The result is that the hair doesn’t fall out, a common and very sad side effect of some chemotherapy drugs.
It is that same phenomenon, reducing chemo’s attack on the hair follicles that has always been the concern, as well: by preventing the chemotherapy from reaching the scalp, are we creating a “safe haven” for tumor cells that may cause a problem years or even decades later?
I just noticed this blog celebrated its 10th anniversary this September. So I hope you won’t mind me taking this opportunity to share some observations and reminiscences of what it’s been like to document by blog a decade of the changing landscape of cancer.
The first blog was published on September 9, 2005 when I introduced the blog and my vision for what i hoped it would represent.
The blog originated with a concept developed by our media relations team. Social media was just coming into prominence, and the Society was looking at ways to get into this space. Bob Lutz, a senior executive at General Motors at the time, was the model: he wrote a regular blog himself, and was pretty open in sharing his thoughts. It was clearly not one of those ghost written, pre-packaged types of things. How he found the time to do a blog was an interesting question, but the concept was intriguing: if we could have one of our senior folks write something similar, perhaps it would get some recognition in this rapidly expanding means of communicating.
So we ventured into the space and I started writing “Dr. Len’s Blog”. One of … Continue reading →
A couple of months ago I was invited to participate in a symposium conducted by the National Cancer Policy Board at the Institute of Medicine in Washington DC. The topic was cancer in dogs, and how we might find ways to benefit dogs, their owners and science to better inform the treatment of cancer in humans through what is called “comparative oncology”. It was an unusual topic in my experience and that of my colleagues, so I eagerly anticipated learning about something I hadn’t given much consideration to in the past.
Little did I know at the time how personal this journey was going to be for me and my family.
Shortly after I accepted the invitation, we received sad news: our Golden Retriever Lily-who has been a member of our family for 11 years-developed swelling in her face. Our vet saw her the next day and told us she had lymphoma. The outlook without treatment wasn’t good, and with treatment wasn’t much better.
Tears flowed in our home that evening.
A week later we found a mass on Lily’s back leg. Another trip to the vet, another needle biopsy, and another … Continue reading →
When it comes to personalized/precision medicine we should never forget it’s all about the people, particularly the cancer survivors whose very lives depend on us getting it done quickly and getting it right.
That was the message from a discussion I had the privilege to moderate on Monday evening with cancer survivors and representatives of advocacy organizations, professional associations, government agencies, and industry at a session held in conjunction with the annual meeting of the American Society of Clinical Oncology (ASCO), now wrapping up in Chicago.
There has been an incredible amount of big science presented at this meeting that relates very directly to the care we provide cancer patients. Some of that science has immediate application to cancer care. On several occasions, acknowledged experts opined in front of thousands of physicians, other scientists, and health professionals that new treatments-particularly immunotherapy-were new standards of care in the management of patients with certain cancers.
Running in parallel to the development of new approaches to the treatment of cancer is the science that is helping to define and personalize which patients would benefit most from which treatments. As an example, for the new immunotherapy drugs there are biomarkers that may eventually … Continue reading →
As the American Society of Clinical Oncology (ASCO) convenes its annual scientific meeting in Chicago–where thousands of participants from around the world gather to learn about the latest advances in cancer research and treatment–we should not lose sight of the fact that the quality of life for patients during cancer treatment and survival is a critical part of what we must address as part of a holistic approach to the cancer care paradigm.
For decades cancer prevention and treatment has focused on the war metaphor: fight cancer, beat cancer, fight hard, whatever. The reality is that not infrequently people do everything right and they still die from this dread disease. Does that mean they didn’t fight hard enough? I don’t think so, and I suspect many of you agree.
But there is a yawning gap, and that is that we don’t pay as much attention to the … Continue reading →
I’m not talking about the incredible information that has already been produced by researchers examining the human genome. Nor am I referring to the work that is going on in major cancer centers and elsewhere exploring how to better match patients with genomic analyses of their cancers, for example.
And I am not talking about the advances in targeted therapies associated with diagnostic tests that can help guide the treatment of patients with a variety of cancers including but not limited to lung and breast cancers as examples.
No, I am asking whether we are prepared to usher in the new era of medical practice where genomic analyses in one form or another will be a part of our everyday medical practice. It’s not just about cancer, my friends. It will be coming to a primary care practice near … Continue reading →
What if you were sitting in the room with some of the best financial and scientific minds in the country and someone asked how many of you would be willing to contribute a modest sum of money to create a company with the potential of speeding up the evaluation of drugs that could revolutionize cancer treatment?
That was the opening question of a fascinating meeting I attended recently at the Massachusetts Institute of Technology, one where I didn’t want to leave my seat for a moment for fear I would miss another thought-provoking comment or idea.
The meeting was called CanceRX 2014, and for two solid days about 300 participants listened, debated, and engaged in discussion on how to make that scenario happen. No small task, to be certain. But in this era of ever increasing research discoveries of new treatment targets, it is clear that we need some innovative thinking to take what we learn in the laboratory to the bedsides of the patients we care for. And to make that happen we need as much “out of the box” thinking as we can muster. [more]
It’s October and that means we are about to see a lot of pink for the next 31 days. And virtually all of the work comes down to one simple -some might say overly simple-message: get a mammogram.
But as National Breast Cancer Awareness Month (NBCAM), begins, I find myself one again asking some difficult questions: Are we really looking at the right side of the equation? Is it all about mammograms? Is there more to the story? The answer is absolutely unequivocal and without a moments hesitation: YES! [more]
There’s no doubt NBCAM is a big deal. In fact it’s probably the biggest cancer care effort for the entire year. It has been enormously successful in bringing attention to breast cancer and creating public focus on a very important issue for women and the men who love them, even as it does crowd out attention to other cancers that also deserve our attention, like lung, childhood cancer, ovarian cancer, and on and on.
And why shouldn’t we highlight mammography’s role? In the bad old days, as a much younger oncologist, I used to dream of a day when we could have not only better treatments for cancer, … Continue reading →
Today marks a major step forward in cancer clinical trials and drug development with the launch of the Lung-MAP protocol to evaluate new treatments for squamous cell lung cancer, a common cancer which has proven resistant to the standard drugs currently available. In response to this genuine unmet need, Lung-MAP has been designed to move new therapies more quickly from the laboratory to the bedside of patients afflicted with this serious disease and few options available.
Many–including present company–have written about the need to improve this process. We are in a new era of cancer drug development, spearheaded by our ever increasing knowledge of cancer genes and the targets within those genes that can be used to disrupt the cancer cell on its inexorable road to proliferation and destruction. Getting those drugs speedily through development and clinical testing has been a real challenge. And, going forward, finding the patients with the “right” genomic signature who are candidates to receive these therapies is going to be difficult. In simple terms, we need to find the patients where they live and match them to these new drugs as quickly as possible. And that hopefully will translate into more and … Continue reading →