Survivors

Millions Of Skin Cancers Occur Every Year, So Why Do Many Teens Still Use Tanning Beds?

4.9 million—yes, million— people are diagnosed with skin cancer every year in the United States. It costs an estimated $8.1 billion—with a “B— to treat those skin cancers, according to the Centers for Disease Control (CDC).

Do I have your attention? I hope so. The problem is we don’t have enough attention. There is no other way to explain why too many states still allow those under 18 to access tanning beds across this country.

Have we made progress? Yes, but not nearly enough according to a research paper and editorial published today in JAMA Dermatology.

The study, from the CDC, looked at surveys of high school students done every two years between 2009 and 2015. The researchers found that overall the frequency of tanning bed use in the previous year declined from 15.6% of all high school students in 2009 to 7.3% of all students in 2015.

That’s progress. However, when they took a closer look at different groups of students they found that among non-Hispanic white female students the numbers using a tanning bed the previous year dropped from 37.4% to 15.2%.

Sound good? Maybe—until you look at the percentages for those 17 and older: in … Continue reading →

We Order Anything From Anywhere In A Flash But Still Fill Out Paper Forms At The Doctor’s Office. Why?

In a world where in a moment I can order from thousands of items and have them delivered to my doorstep the same or next day at the press of a button without having to re-enter my name, address, and billing information each time, it would seem that filling out paper forms at the doctor’s office by hand to have someone else re-enter the information into a computer that doesn’t communicate with other computers in the same clinic system is craziness. And if someone doesn’t do it right, it can follow you everywhere forever–and you may never know.

After some recent personal medical visits, I can’t imagine what it is like for cancer patients and families dealing with serious illness trying to navigate the complex system we call healthcare. It’s time we get the technology working for the patients, not making their lives even more difficult.

In each of my encounters the setting was fairly typical for a large health system in a large metropolitan city. I needed to get care regarding two straightforward problems with two different clinics in the same system a couple of weeks apart. So far so good: the care was excellent, the support staff friendly … Continue reading →

Twenty Years Later, And We Still Don’t Routinely Offer BRCA Test To Women At High Risk For Breast Cancer

A report in this week’s Journal of the American Medical Association (JAMA) shows that too few women with recently diagnosed breast cancer and at high risk of a BRCA genetic mutation received appropriate genetic counseling and testing for the mutation—a missed opportunity not only to improve treatment for these patients, but also to prevent some breast, ovarian and other cancers in the first place.

This study makes the difficult point that when it comes to routine screening for genetic abnormalities in women (and men, for that matter) who may be at increased risk, we simply aren’t doing the job. The situation may well be worse than this report suggests, especially considering that in some areas of the country Medicare doesn’t even cover preventive testing for the BRCA mutation. And this is more than 20 years after the test was first discovered and placed into clinical practice.

I guess sometimes it takes a long time for the way we care for our patients to catch up with the science that we know works. But twenty years??? Uh, that seems like a long, long time.… Continue reading →

Need To Balance Innovation, Benefits and Restraint When It Comes To The Rising The Costs Of Cancer Drugs

Cancer drugs—especially the new targeted and immunotherapies—are very, very expensive.

No doubt about that, and there is also no lack of effort trying to cast blame on who bears responsibility for those costs. There is even a recent article in the British Medical Journal that analyzes the size of the vials those drugs come in and suggests for some companies at least that may be a strategy to increase costs even further. What most experts can agree on is that this is a complicated problem for which there are no easy solutions.

I recently wrote a short commentary on the issue which appeared in Healio’s “HemOnc Today.” Although not exhaustive in terms of analyzing the issue, it does point out that we need to find a balance that continues to provide the incentive to innovate and bring new treatments to the care of cancer patients, while maintaining some degree of restraint given the reality that these costs simply cannot continue to increase without limit.… Continue reading →

Making A Difference: The Melanoma Research Alliance

A full waiting room. To most of us, it’s a bad sign, as we anticipate the excruciatingly dull minutes ahead. But at a meeting I attended this past week, it was a sign of hope, of progress; of making a difference.

I was in Washington DC to attend the annual scientific session of the Melanoma Research Alliance (MRA) in Washington DC, an organization that is only eight years old. When this group first met, it was made up of a relative handful of melanoma researchers and clinicians who came together to figure out what they could do to discover and promote more research and better treatment options for patients with melanoma.

The people behind the effort were Michael Milken and Debra and Leon Black. For them the mission was personal: Mr. Milken was a prostate cancer survivor who wanted to devote his energies to accelerating discoveries in cancer care. The Blacks are also well known in financial circles, and Ms. Black was (and remains) a melanoma survivor. 

At the time, the landscape for patients with advanced melanoma was bleak. There were a couple of available treatments, but they really didn’t have much of an impact on improving or extending Continue reading →

The Updated Breast Cancer Screening Guideline From The American Cancer Society

The American Cancer Society has now released its newly updated Breast Cancer Screening guideline in the Journal of the American Medical Association

This guideline—which was last updated in 2003—reflects the American Cancer Society’s best thinking on breast cancer screening for women at average risk of breast cancer. They are not intended for women at high risk, such as those with genetic abnormalities (BRCA as an example), a personal history of breast cancer or a history of radiation therapy prior to age 30.  That guideline is available on our website at www.cancer.org.

So let’s get right to the heart of the matter: what are the new recommendations?

  1. Women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 (Strong recommendation*)

          1a) Women aged 45 to 54 years should be screened annually (Qualified       recommendation*)

          1b) Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually. (*Qualified recommendation)

          1c) Women should have the opportunity to begin annual screening between the ages of 40 and 44 years (Qualified recommendation*)

2) Continue reading →

10 Years And Half A Million Words…

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 →

Granny’s Gone: On Saving Lives And Honoring Life

Granny and her five generations
Granny and the five generations

Granny’s gone.

She left us this past week, 93 years young. Sadly, five generations are now four.

Yes, cancer was part of her journey. For the rest of us, that journey serves as a poignant lesson on the balance between saving lives and honoring life.… Continue reading →

Is It Appropriate To Offer The Public “Liquid Biopsies” For the Early Detection Of Cancer?

The recent announcement by a California company offering DNA blood tests (also known as “liquid biopsies”) for the early detection of cancer takes us to a place most of us expected we would get to, but much earlier than we are prepared for. Simply stated, our technology and rush to get new tests to market-even before we have a basic understanding of how to use those tests to improve the health of consumers–has outstripped our scientific understanding, and we ignore the implications at our own peril. [more]

First, some history:

The concept of having a blood test to diagnose cancer early is not new. In fact, I recall an international meeting about a decade ago where a lecturer predicted the diagnosis of cancer through a simple finger stick that would be sent to a lab for analysis.

Fast forward to June of 2009 when I was a guest on the Today Show and was asked to offer a closing thought telling viewers something they didn’t know about cancer. My comment was to the effect that one day in the not too distant future we would be able to find cancer cells circulating in the blood in people who didn’t … Continue reading →

New Research On Ductal Carcinoma In Situ (DCIS) Brings Knowledge–Now We Need Understanding

It has been said that with knowledge comes understanding.

A research paper and editorial published in this week’s issue of JAMA Oncology may have brought knowledge, but if you read various media reports I am not so certain it has clarified understanding. And the distinction is important, because when a woman is confronted with the diagnosis of a “Stage O” breast cancer (aka ductal carcinoma in situ or DCIS), the decisions she makes about treatment can have far-reaching and long lasting impact for her and those who care about her. [more]

First, some brief background: DCIS was rarely diagnosed before the advent of mammographic screening for breast cancer. Perhaps it was found incidentally when a breast biopsy was done for another reason, or perhaps a woman or her physician felt a mass that turned out to be DCIS. Once mammography became more widespread in the 1970’s, we began to see a marked increase in the number of women diagnosed with DCIS. Today, the American Cancer Society estimates that in 2015 slightly more than 60,000 women in the United States will be diagnosed with this lesion (compared to 234,190 women who will have a more typical invasive breast cancer).

The situation … Continue reading →