Monthly Archives: January 2007

The Harm Of Second-hand Smoke At Work Is Real

There are some things that are hard to believe, like a prediction that Martians will land in Atlanta tomorrow.


Even harder to accept is the fact that some folks, including people in positions of substantial responsibility–such as mayors, governors and other politicians—don’t believe that exposure to second-hand smoke is harmful.


It is, and the evidence is very clear that exposure to second-hand smoke causes illness and death. 


Despite all of that evidence, we still seem to have barriers put into place which prevent us from enacting laws which would protect those of us who are non-smokers (and I would also include former smokers) from the harmful effects of environmental tobacco smoke.


One of the remaining issues regarding the harms of second-hand smoke has been the question of how much lung cancer risk exists for non-smokers who are exposed to second-hand smoke in the workplace.


A study reported today in the American Journal of Public Health answers that question, and takes us one step closer to understanding how dangerous second-hand smoke can be.


As the authors point out, most research on the topic of second-hand smoke and the risk of developing lung cancer have … Continue reading →

Fewer Mammograms Means More Breast Cancer Deaths

It was a small statistic in a straightforward report.  But its impact and implications are potentially huge:


From 2000 to 2005, the percentage of women age 40 and over who received a mammogram within the previous two years fell from 76.4% to 74.6%, or 1.8%.


1.8% doesn’t seem like much, so why all the fuss?


Because in real terms, this means that thousands of women may have undetected breast cancer and will potentially miss the opportunity to save their lives.


This really wasn’t unexpected by those of us who try to keep up with current mammography practices.


My colleagues at the American Cancer Society noted a year ago that there had been a decline in mammography screening compliance.  We were also aware that there appeared to be a decline in mammography in women on Medicare, a group that is at particularly high risk of developing breast cancer.


During the course of the past year, we have had discussions with several different groups, including insurers and quality assurance organizations, who were concerned about their own observations that mammography screening rates were dropping.


Then, at the San Antonio breast cancer conference in … Continue reading →

More Progress: Cancer Deaths Decline

Last February I wrote a blog about the decrease in the number of people dying from cancer in the United States from 2002 to 2003.


This was the first time since records have been kept that such a decline was ever seen, despite the fact that we have a population in this country that is growing and becoming older.


One of my conclusions from that posting was the following:


 Probably the most important ‘next question’ is whether we believe this decline in the number of cancer deaths will continue.  The obvious answer is that we hope so.  The honest answer is we don’t know.”


Now we do know the answer to that question, and we can say with certainty that, for the second consecutive year, the absolute number of people dying from cancer in this country has continued to decrease.


And, my friends, that is wonderful news.


Every year the American Cancer Society publishes an article titled “Cancer Statistics.”  


In that publication, we do two things:


First, we estimate what the number of new cancer cases and cancer deaths will be in the United States for the … Continue reading →

Making Trial Results Public: We Need To Do Better

I want to follow-up on the blog I posted earlier today about the Erbitux announcement.


No, I haven’t heard from the company, so there is no further information to report as to the effectiveness of Erbitux in the “first line” treatment of patients with advanced colorectal cancer.


What is interesting is that I am not the only one having some difficulty today about how companies report the information from their clinical trials.


This afternoon the New England Journal of Medicine published two studies on new drugs for the treatment of advanced renal cell carcinoma (kidney cancer). 


These reports reviewed two clinical trials for two different targeted therapies, sorafenib and sunitinib.


In both cases, these drugs delayed the time it took for the kidney cancer to progress.


The sorafenib studies had been completed in early 2005, and in December 2005 the drug was approved by the FDA for the treatment of advanced kidney cancer.


The sunitinib data was presented at the ASCO annual meeting in June 2006.


One of these papers almost did not get published in the New England Journal, which is considered one of the premier—if not the premier—medical … Continue reading →

A New Colon Cancer Treatment? Who Knows?

How pharmaceutical companies and the media handle stories of importance to cancer patients can have great impact, particularly on the emotions and decisions that patients and their families face when trying to make a decision on what is the best treatment is for their particular illness.


Imagine my surprise today when I heard a headline on a national TV show this morning that one of the newer targeted therapy drugs had proven effective in the treatment of metastatic colorectal cancer, and I couldn’t get the facts behind the news.


Colorectal cancer is one the common forms of cancer in the United States.


In 2006, the American Cancer Society estimated that 148,610 people will be diagnosed with colorectal cancer in the United States, and 55170 people would die from this disease (updated estimates for 2007 will be released on January 19).


Of those diagnosed between 1995 and 2002, according to the SEER database, 39% will have disease confined to the colon, 37% will have regional disease (meaning the cancer will have spread to the lymph nodes), and 19% will have distant (or metastatic) disease that has spread beyond the lymph nodes (the remaining 5% … Continue reading →

The Personal Costs of Cancer Care

How many times have you or someone you know complained about the time you spend in the doctor’s office waiting for an appointment or a test of some sort?


There are even folks who let it be known that their time is valuable, too—and if the doctor can’t keep the appointment on time, maybe they (the patient) should send the doctor a bill for their wasted time in the office.


An article in this week’s Journal of the National Cancer Institute takes that concept one step further, and shows that for cancer patients, at least, the time spent in the doctor’s office, the hospital, and getting to and from various appointments has real value. 


In fact, the article suggests that if we invested more effort in finding cancers early and developing better treatments for cancers, more people would be able to spend more of their time doing what they would rather be doing that having to sit in an office or lying in a hospital bed getting medical care.


With an expanding array of drugs and other treatments for cancer, there is no question that the cost of cancer care is becoming incredibly expensive.  Continue reading →