The news that Alex Trebek has advanced stage IV pancreatic cancer has been met with an outpouring of support and good wishes, as would be expected for someone who has been a part of our lives for so many years.
The fact is, pancreatic cancer is a difficult disease to treat effectively. That is due in no small part to the fact that—as the case with Mr. Trebek–pancreatic cancer is usually diagnosed at a later stage, remaining undetected until it causes difficulties and symptoms by its spread. The reality is that for most people pancreatic cancer is too advanced to be treated with surgery and is not very responsive to currently available chemotherapy and targeted therapy medications. And newer forms of treatment such as immunotherapy and CAR-T haven’t shown particular success at this point.… Continue reading →
Good news is always welcome, especially when talking about something as serious as cancer. And there is plenty of welcome information in the American Cancer Society’s release today of our annual report on “Cancer Statistics, 2019” and its accompanying consumer-oriented version of “Cancer Facts & Figures 2019.”
Among the good news in this report: A significant decline in death rates from cancer—especially among some of the most common cancers, significant improvements in early detection and treatment of cancer, and a decrease in the disparities in death rates between African-Americans and whites.
Despite the good news, unfortunately, there are also pieces of the puzzle that have not been solved. And to ignore that information is a disservice to those who struggle with cancer and those who have passed because of this dread disease. The reality is we can—indeed, we must—do better. And that fact is an equally important part of the information contained in this report.… Continue reading →
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 research report on melanoma from the Centers for Disease Control and Prevention received virtually no notice, yet one of the statistics in that report was—at least for me—stunning, and marked a rare public health win.
People in public health know all too well the gap between educating people about cancer risks and seeing actual results. Skin cancer is no different: We have known for many years that the risk of skin cancer is related to exposure to UV radiation, either from the sun of for indoor tanning.
Yet despite widespread efforts to educate people about this very real cancer risk, we haven’t made much progress reducing its frequency—at least until now.… Continue reading →
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 →
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 →
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 →
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 →
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 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?
- 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) Women should continue screening mammography as long as their overall health is good and they have a life … Continue reading →