Category Archives: Ted Gansler

Are lung cancer breath tests more than hot air?

By Ted Gansler, MD, MBA, MPH

Can breath tests (like those used to check whether drivers have been drinking alcohol) be used for lung cancer screening? Or, is this (pardon the pun) just a lot of “hot air?” Although breath tests for lung cancer are “not ready for prime time,” there has been some encouraging research.

There are 3 main ways to fight cancer – prevention, screening, and treatment. Although lung cancer remains the leading cause of death from cancer worldwide and in the United States, researchers are making progress against this disease on all 3 fronts. 

Over nearly a half century, researchers tried several tests for lung cancer screening, none of which were accurate enough for widespread use. Because of research results released in 2010, the American Cancer Society and several other organizations now recommend that people at high risk for lung cancer (certain groups of current and former smokers) ask their doctor about CT scans for lung cancer screening.

On average, people in these high risk groups who have this test every year according to the ACS guidelines can reduce their risk of dying from lung cancer by about 20%. This can save a lot of lives and prevent a lot of suffering, so if you are a current or former smoker, you should read more about our lung cancer screening recommendations.… Continue reading →

Cell Phones, Bras, and Breast Cancer Risk

By Ted Gansler, MD, MPH

 

Like other contributors to the Expert Voices blogs, I am occasionally asked to reply to questions from journalists about various cancer-related topics. The most recent question I received is whether it is true that women who carry a cell phone in their bras are at increased risk for developing breast cancer.

This kind of question is surprisingly difficult to answer. It’s relatively easy to write about things that are known to cause cancer. It’s more difficult to be confident that something does not cause cancer, but one can still provide some guidance if there have been at least a few carefully-conducted epidemiologic studies with negative results. The most challenging requests we receive are often about questions that researchers have not addressed by scientific studies of humans populations. This is one such question.

Cause or Coincidence?


There are a few known instances of breast cancer in young women who have kept cell phones in their bras. (Even when cell phones are not being used for conversation or texting, if they are on then they still periodically emit low energy electromagnetic signals to stay in touch with nearby cell towers.) Because breast cancer is an uncommon and tragic occurrence among young women, these cases have received significant attention on television and on the Internet.… Continue reading →

Can eating chocolate prevent cancer?

By Ted Gansler, MD, MPH

 

In the course of my routine medical journal reading last year, I came across a short article in The Lancet Oncology about chocolate and cancer prevention. I saved that file on my computer (without reading it), thinking that it might serve as the point of departure for a lighthearted and slightly romantic Valentine’s Day essay on this blog.

With that deadline only a few days away, I opened the file and read the article, as well as a few others. The good news is that chocolate does not cause cancer and that moderate consumption of dark chocolate may have a positive impact on heart disease risk. The rest is more complicated.

If you try an Internet search for words like “chocolate prevents cancer,” you will find several thoughtful summaries of the available evidence. You will also find some cute but misleading articles implying that eating a lot of chocolate candy prevents cancer. And, you will find a lot of articles with cute headlines and introductions that save their unsweetened facts for the conclusion.

My favorite scientific reviews of cancer and chocolate evaluate information from pre-clinical studies, observational epidemiological studies, and clinical trials separately, and I will follow this approach to get the most thorough view of the topic.… Continue reading →

Can you trust that medical journal?

By Ted Gansler, MD, MBA, MPH

 

Ed. note (10/10/13): Dr. Gansler has an update to this blog, originally published 4/18/13.
In an interesting update on this topic, Science magazine recently published results of a “sting operation” intended to identify bogus journals. A journalist from Science fabricated an intentionally bogus article about a fictitious anti-cancer drug, with errors so obvious that, “Any reviewer with more than a high-school knowledge of chemistry and the ability to understand a basic data plot should have spotted the paper’s short-comings immediately.” Shockingly, the vast majority of journals that received this article failed to notice these obvious flaws and agreed to publish it… for a fee. For more details, see http://www.sciencemag.org/content/342/6154/60.full.

An article in the April 8 New York Times titled “Scientific Articles Accepted (Personal Checks, Too)” caught my attention. It describes the growing availability of free online medical journals that use questionable tactics to gather and publish research of questionable quality.

The article piqued my interest because the experiences of some researchers described in it are similar to my own. I am also an editor of CA: A Cancer Journal for Clinicians, one of the American Cancer Society’s medical journals, so I have an interest in the world of journal publishing.… Continue reading →

What do you really learn from a path report?

By Ted Gansler, MD, MBA, MPH

Most people’s impression of pathology is based on the forensic pathologists in TV shows such as “CSI” (or, if you’re my age, “Quincy, ME”). But for people facing cancer, there is another aspect of pathology to learn about – the testing that is done to find out whether an area of diseased tissue is benign (not cancer) or malignant (cancer).

Doctors often suspect that a person has cancer based on their physical exam findings and on the results of x-rays and scans. In the vast majority of cases, however, samples of cells (called cytology) or tissue samples (biopsies) must be tested to know for sure. And, if the tumor is cancerous, pathology testing will also determine what kind of cancer is present. This information is very important in guiding the treatment you receive, and in estimating your outlook for recovery and survival.

People receiving treatments for cancer usually get to know the teams of professionals who perform surgery and who prescribe and give their chemotherapy and radiation. On the other hand, you rarely meet the pathologists, technologists, and other laboratory professionals who test the biopsies, blood, and other specimens removed from your body. Learning about what they do with your samples can help you make informed decisions about your care.… Continue reading →

Breast Cancer Myths: Separating Fact from Fiction

By Ted Gansler, MD, MBA, MPH

You have probably seen and heard a lot about breast cancer during the past few weeks, but as we approach the end of this year’s breast cancer awareness month this is a good time to ask how much of the information you encountered is actually true. See if you know which of the following statements are true and which are false… [more]

TRUE OR FALSE: Most breast cancer is hereditary. You don’t need to worry if you don’t have a family history of breast cancer.


FALSE.
Only about 5% to 10% of breast cancer cases are thought to be the result of gene defects (called mutations) inherited from a parent. The lifetime risk for breast cancer can be as high as 80% for members of some families who inherit certain mutations of BRCA genes. The risk is not nearly as high for most women with a family history of breast cancer. On average, having 1 first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman’s risk, and having 2 first-degree relatives triples her risk. About 20% to 30% of women with breast cancer have a family member with this disease (although most of these families do not have abnormal BRCA genes).… Continue reading →

Is your car killing you with benzene?

By Ted Gansler, MD, MBA

An e-mail message that may have come into your inbox recently claims that dangerous levels of a cancer-causing chemical (benzene) are released from the plastic surfaces of automobile interiors. The e-mail recommends opening the vehicle’s windows to remove the benzene before using the air conditioner.

 

Although benzene is linked to leukemia, very little research has looked at whether the interior surfaces of cars release dangerous amounts of benzene, and the information that is available does not support the e-mail’s claims. [more]

Let’s break the message down and compare the claims with the facts.

 

Here is the e-mail message (this links to snopes.com, which is not affiliated with cancer.org or ACS)

 

 

And here’s a point-by-point comparison of the claims and the facts:

 

Claim: My car’s manual says to roll down the windows to let out all the hot air before turning on the A/C. WHY?

Fact: On a sunny day, the temperature in a parked car can be more than 40 degrees (Fahrenheit) higher than the outside air. Opening the windows is the fastest way to exchange the hot interior air with the cooler outside air. Once that is done, the air conditioner can make the interior cooler than the outside air.… Continue reading →

Is Cancer Screening Going to the Dogs?

By Ted Gansler, MD, MBA

There’s been a lot of news lately about cancer-sniffing dogs after a new study by Japanese researcher Hideto Sonoda and his colleagues was published in the medical journal Gut. So we couldn’t help but wonder, is that possible?

 

If you haven’t heard about it, the recent study suggests that specially-trained dogs can identify the scent of volatile chemicals (those that evaporate into the air at room temperature) present in colon cancer. [more]

 

In the study, a Labrador sniffed breath samples and stool samples from patients who were known to have colon cancer, which had been identified by colonoscopy and biopsy. The dog correctly recognized cancer-related scents in 91% of the breath samples and 97% of the stool samples. And amazingly, when the dog was allowed to sniff breath and stool samples from patients who didn’t have colon cancer, the dog incorrectly “diagnosed” only 1% as malignant. This study adds to a small number of other published articles showing similar results for bladder, lung, and breast cancers, and to a recent conference presentation regarding prostate cancer.

 

In addition to these experimental studies, there have been several anecdotal reports of patients whose pet dogs seemed attracted to or upset by skin and breast cancers.… Continue reading →