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 →
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 →
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 →
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 →
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 →
After years of declining rates of colorectal cancer (CRC), a new study from the American Cancer Society raises the specter that not all is going as well as we would have hoped, especially among younger folks born since 1990. And that raises the question of what the future holds for this frequently preventable form of cancer, including a possible reexamination of when it is appropriate to start CRC screening for people at average risk of developing the disease.
The research, published today in the Journal of the National Cancer Institute looked at the rates of colon and rectal cancer diagnoses from 1974 through 2013 in several parts of the country. The researchers were particularly interested in changing patterns of CRC in people 20 years of age and older who were diagnosed with invasive CRC from 1974 through 2013.
There is a lot of complexity in the published results, so let’s focus on the main messages of the study:
- After decreasing since 1974, colon cancer incidence rates increased by 1% to 2% per year from the mid-1980s through 2013 in adults ages 20 to 39. In adults 40 to 54, rates increased by 0.5% to 1% per year from the
… Continue reading →
I am devoted to my fitness tracker, having used it for several years to remind me to be active, monitor my diet and improve my sleep. Now the New York Times tells me it doesn’t make a difference, at least when it comes to the weight loss part of the program. And I might agree, if only the evidence they relied on told the whole story. In my opinion, it did not.
Unfortunately, some of the science on which the Times’ reporter based his comments had a possible flaw that may influence the conclusion that fitness trackers not only don’t encourage weight loss, but improbably may lead to less weight loss when using the device.
That, my friends, would be a real bummer. However, if you had evaluated that research closely you may have been aware of the problem. From where I sit, I don’t think many folks have made that effort. And I remain unconvinced that the research supports the conclusion that fitness trackers–when used in typical real-life situations–don’t make a difference in keeping us engaged in our health including as an adjunct in weight loss programs.… Continue reading →
In 2011 with much fanfare the National Cancer Institute announced that lung cancer screening decreased deaths from lung cancer by 20%. In 2013, the American Cancer Society (among other organizations) published well-thought-out guidelines recommending high quality screening along with shared decision making so eligible patients could understand the risks and benefits of screening. In 2015 the Medicare program announced that lung cancer screening would be covered, along with the shared decision component.
With all of that evidence and support, one would think that lung cancer screening would see rapid uptake in the United States in an effort to reduce deaths from this all-too-frequent cause of cancer death.
If you thought that, you would be wrong. So the logical question is why? In the face of all this evidence, why are high risk current and smokers not being screened, and how do we make it right?
That question is the result of a spate of recent articles (links 1,2,3) in journals from the American Medical Association, along with a somewhat “direct” editorial that highlights the need to better understand how lung cancer screening works and the need to inform health professionals and their … Continue reading →
Some information just released is creating a lot of enthusiasm about the use of cold caps to prevent hair loss from chemotherapy in women with breast cancer. But a deeper look into the data shows that this welcome news is not nearly as clear-cut as it might seem. And I’m afraid doctors explaining the potential limitations of these devices to patients hearing enthusiastic reports are going to be left holding the bag if this new treatment doesn’t work as intended.
Let’s face it: losing one’s hair is traumatic, to say the least. For some folks, the risk of hair loss may affect their decisions about which chemotherapy treatment they should receive for their cancer, or whether they should receive it at all. No question: this is important to many women (and men) when faced not only with the trauma of treatment but with the very diagnosis of cancer itself.
Two articles and commentaries in this week’s issues of the Journal of the American Medical Association (JAMA) and its companion JAMA Oncology present new information about an old approach to preventing hair loss, along with some new thoughts and suggestions as to what this may mean longer term. And along … Continue reading →
Perhaps more than most, doctors struggle with memories that mark sad moments in their careers. For me, one of the most indelible was about a wonderful young man with chronic myeloid leukemia (CML).
When I started my oncology career in the early 1970’s, CML was almost always fatal. It would start with a chronic phase which was treated with pretty simple medications. But those medications didn’t cure the disease.
The “almost always” scenario with CML was that several years on, it would morph into an acute phase, or “blast crisis,” that almost always ended in an untimely and frequently very premature death.
I came into contact with this young man just as he was diagnosed with CML. A couple of years later, he entered that acute phase. Rather than face the rigors of intensive chemotherapy, a regimen that was almost always futile, he took his own life. Moments like that live with us forever.
Decades later, (2003 to be exact) a prominent oncologist—who at the time was the director of the National Cancer Institute—made an audacious promise. Andrew von Eschenbach said that by 2015 we would end the suffering and death from cancer and convert it to a chronic … Continue reading →