Do you know what it’s like to sit in a meeting and learn that something you hold close as a fundamental principle is probably not as fundamentally true as you thought?
That’s the way I felt earlier this week while attending a meeting on the quality of pharmaceuticals, sponsored by the Food and Drug Administration and Duke University’s Margolis Center for Health Policy.… Continue reading →
Are sunscreens safe?
That’s the question that will be on the minds of many as the Food and Drug Administration releases a second study on the absorption of sunscreens. The reality is that answering the “safe” question is becoming more complicated—and more important as well, given the fact that so many of us use sunscreens as part of our own sun safety efforts, while others (me included) use sunscreen as part of our daily routine.
Despite the questions raised in this study, the FDA concludes:
“These findings do not indicate that individuals should refrain from the use of sunscreen.” (Emphasis mine)
It is a difficult balancing act pitting product safety up against the prevention of some very nasty cancers. It leaves many consumers and experts in the midst of a quandary of what to do and what to recommend.… Continue reading →
A cancer diagnosis can create almost unfathomable change to a person’s life. It can literally threaten our very being. And somehow, we live in a world in which we let this random, tragic occurrence exact profound cost in financial stability, only adding to the distress.
That is the message of a research report published by my colleagues at the American Cancer Society on the topic of financial hardship and sacrifice associated with cancer care in the United States.… Continue reading →
Remember this from a year ago in the Jerusalem Post?
“We believe we will offer in a year’s time a complete cure for cancer…Our cancer cure will be effective from day one, will last a duration of a few weeks and will have no or minimal side-effects at a much lower cost than most other treatments on the market…Our solution will be both generic and personal.”
Well it’s been a year. Haven’t heard anything? Well, you are not alone. Maybe it will come tomorrow (everything is possible, however not likely). Unfortunately–especially for cancer patients, their loved ones, and in fact all of us who cling to the hope every day that such a cure would be discovered–there isn’t anything I could find to suggest the investigators were able to deliver.… Continue reading →
The American Cancer Society’s annual report on cancer statistics has been published, and it brings with it more “good news” about the progress against cancer. However, there are also some notable areas of concern that should lead us to reinforce our focus on what we need to do to continue to reduce the burden and suffering from cancer in the United States—and make even more progress.
The good news is that the decline in the rate of deaths from cancer continues to improve: from 1991 (when the cancer death rate in this country was at its peak) until 2017 (the most recent year for which data is available) there was a decline of 29% in the cancer death rate. That translates into 2.9 million fewer deaths from cancer than would have been expected had the rate of cancer deaths not changed from 1991.
And while all most other non-cancer related causes of deaths were increasing or remaining stable, the rate of deaths from cancer declined by a remarkable 2.2% from 2016 to 2017, continuing a long string of declines over many years. This was in fact the largest single-year drop in cancer mortality since rates began falling in the early … Continue reading →
`No progress in cancer care? Really?
That’s the question I am struggling with following an interview I did with a radio network last week, and which will likely be released a couple of weeks from now. I was asked to respond to the premise offered by a book author who is a well-known professor at a major academic medical center, exclaiming that our treatment for cancer is based on “Slash, burn and poison” and that our cancer research efforts are currently substantially misdirected.
Instead, the professor says, we should admit that we have not made meaningful progress in treating cancer, and that our research is too directed to the end of the cancer cycle (namely a couple of months improvement in life expectancy for those with cancer) and in fact should be focused on the “first cell.”
It’s a refrain I have heard before, as early as my beginning engagement in treating patients with cancer in the 1970s. “Slash, burn and poison”—or similar words—were legion at that time. Surgery, radiation and chemotherapy were toxic, had substantial side effects, often ineffective and not offering much hope beyond a small number of cancers such as Hodgkin Disease which was showing excellent responses … Continue reading →
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 →
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 →
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 →
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 →