Cancer And The “Cure”

Words have meaning. And when it comes to cancer, especially advanced cancer, there aren’t many words that have more meaning than the word “cure.” Yet it is that very word and concept that is top of mind for some of us these days.

We clinicians are guilty as charged when it comes to reluctance declaring those who have had a remarkable response to treatments for advanced cancer “cured.” Experience has taught us over decades that we have misused the word and overpromised those we cared for. Our patients and loved ones have paid a price for our over optimism. Consequently, our culture has taught us to avoid the word, lest we be shown to have been less-than-truthful when a cancer returns with a vengeance.

And yet our world is changing: we are now seeing long term responses to treatments in diseases where until recently we had little hope of such success.

Recent reports of rapidly declining mortality in melanoma, normal life spans for many people treated for previously fatal diseases like chronic myelogenous leukemia, and the potential for impressive gains in outcomes for people with lung cancer are but a few examples that suggest we are indeed in … Continue reading →

A Plea For A Focus On The Humanity Of Cancer Care: Are We Missing An Opportunity When It Comes To Artificial Intelligence?

Yesterday I wrote about emerging themes at the ongoing annual meeting of the American Society of Clinical Oncology here in Chicago. That blog was about lung cancer, and the reality that the time has come to aggressively address our failures to improve outcomes for those at risk of lung cancer and those diagnosed with the disease.

Today I want to share some thoughts about another theme: artificial intelligence, or as I prefer to call it “data analytics.” Fundamentally: how can we capture the capability of analytics to improve the care and outcomes of cancer patients? And more importantly: how can we harness this technology to help bring back the human touch in cancer care?

Admittedly that’s a large focus covering lots of opportunities. Speak to one expert and you will get one idea of how analytics could improve care. Speak to another and you will get another entirely different view of what that means and how we should be using our rapidly advancing capabilities to harness machines and their capacity to learn and engage health care, specifically cancer care.

My real concern is that there are so many sophisticated opportunities to choose from that we may be missing some … Continue reading →

What Will It Take To Shake The Tree And Save More Lives From Lung Cancer: A Report From ASCO 2019

Every year, the annual meeting of the American Society of Clinical Oncology is unmatched in bringing forward the latest advances in cancer care. It is a time to learn about important—and usually– incremental advances in cancer research and cancer care, and every year has some of us, especially those of us with some years under our belts, thinking about big picture themes in cancer: where we’ve been, where we are, and where we’re going.

For me, today’s theme is lung cancer and the sad fact that our care for those at high risk and those  diagnosed with the disease is far from what it should be. But more than I ever, I am convinced the future holds hope.… Continue reading →

The Remarkable Story No One Is Talking About: The Substantial Decline In Deaths From Advanced Melanoma

Here is some news about cancer that isn’t widely known and is hiding in plain sight: Deaths from melanoma—a skin cancer that has lethal potential—have declined dramatically over the past several years. And while that fact alone is surprising, so is the reason behind the drop.

Let’s make something clear at the outset: too many people die from melanoma. It is not the most common skin cancer (the American Cancer Society estimates 96,480 people in the United States will be diagnosed with melanoma in 2019, and 7,230 will die from it), but it is much more likely to spread and lead to death than most other much more common forms of skin cancer. And it has too frequently been a fatal disease.

That is now beginning to change, thanks in part to public awareness and earlier diagnosis. However, we can’t ignore what may be the most important factor: much better treatments. In fact, improvement in treatments with targeted drugs and immunotherapies have now begun to have a considerable impact saving lives for those with advanced melanoma.… Continue reading →

The American Cancer Society Sets A Goal To Reduce The Burden Of Cancer: Are We Up To The Challenge?

Ever wonder what would happen to cancer in this country if we all did better at what we do every day?

The American Cancer Society has an answer in a recently published paper in our journal CA: A Cancer Journal for Clinicians, and it may surprise you what we could accomplish if we set our minds to the task.

We recently reported that between 1990 and 2015, the cancer death rate declined by 27%. That’s a remarkable accomplishment. However, we still have a long way to go. Too many of us experience the burdens and losses from cancer. All of us want to see this disease in its many forms vanquished.

Our researchers looked at what would happen if all of us had the same cancer risk as college graduates in the United States, then came up with an estimate of how that would impact deaths from cancer from 2015 and 2035.

The answer: we could reduce deaths from cancer by close to another 40% beyond what we have already accomplished. That would be a total of over 54% from 1990. And it would mean 1.3 million fewer premature deaths from cancer between 2020 and 2035. Remarkably, it would mean … Continue reading →

Alex Trebek Is Diagnosed With Advanced Pancreatic Cancer–And We Are Reminded Of The Strength And Dignity Those With Cancer Offer To Others, Every Day

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 →

A Bellwether Study On Excess Body Weights Sends A Warning: Young Adults Have Increased Rates of Cancer

What if I told you our children were being exposed to a known carcinogen, and it was increasing with successively younger kids? If that carcinogen were a preservative in packaging or chemicals from industrial waste, there would be widespread outcry. But it’s neither of those things. It’s something far more dangerous, but that we’ve somehow accepted as no big deal. But the risk is very real. The carcinogen is excess weight.

Now a new report from my colleagues at the American Cancer Society shares evidence the problem is worse than most of us realized.… Continue reading →

A Cure For Cancer? Not So Fast

The news report in the Jerusalem Post regarding researchers’ claim that they have found a cure for cancer is certain to get our attention. And, it goes without saying, we all share the aspirational hope that they are correct. Unfortunately, we must be aware that this is far from proven as an effective treatment for people with cancer, let alone a cure.… Continue reading →

Cancer Statistics 2019: Cancer Death Rates Have Declined 27% In 25 Years, And We Still Have A Long Way To Go

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 →

Justice Ginsburg Diagnosed With Cancer In the Lung: What We Know–And What We Don’t Know

The announcement today that Justice Ruth Bader Ginsburg has undergone surgery for cancer in her lung reminds us all that in situations like this we need to be cautious in speculating as to exactly what has happened to the Justice. Notwithstanding information that has been made available to the public in several reports, we need to be aware that there is likely additional information that is not yet available to the media and others.

As in similar situations where those who are in the public arena—be they judges, politicians, actors/actresses or other celebrities—the information they choose to share is usually carefully vetted before being released. Sometimes the information is freely provided. Other times, it is kept very private. Either way, we need to respect those decisions which can be very personal.… Continue reading →