Monthly Archives: June 2007

Symptoms In Ovarian Cancer: The Key To Survival?

A consensus statement issued today on the topic of ovarian cancer symptoms has garnered a good deal of media attention.


The statement, developed by the American Cancer Society, the Gynecologic Cancer Foundation and the Society of Gynecologic Oncologists makes the point that women who have bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly, or urinary symptoms including urgency or frequency should see their doctor (preferably a gynecologist) if the symptoms are new and persistent. (I regret that I can’t find a link to this statement at this time.)


This is a step in the right direction, but we have much further to go if we are to make a significant impact in reducing suffering and death from this disease.


Ovarian cancer is not an uncommon cancer in women. 


The American Cancer Society estimates there will be 22,430 new cases diagnosed in the United States in 2007. It is the 8th most common cancer in women.  The Society estimates there will be 15,280 deaths from ovarian cancer this year, making it the 5th most common cause of cancer death in women.


Unfortunately, ovarian cancer is usually diagnosed after it … Continue reading →

When It Comes To Cancer, Health Insurance Matters

If you had any doubts that health insurance makes a difference when it comes to survival from cancer, then articles released today in the medical journal Cancer should erase the question from your mind.


In two research papers and an editorial, investigators from the American Cancer Society and the Society’s President make it very clear that if you don’t have adequate insurance, the odds are considerable that as far as breast and head and neck cancer are concerned, you are more likely to be diagnosed with your cancer at a later stage when treatment options are either more limited or more toxic, and the odds for survival are substantially less.


With more than 46 million Americans uninsured, these reports are certain to add fuel to the growing debate over the state of our health care system in the United States now and in the future.


In the first report, the researchers looked at information regarding health insurance and other demographic factors in over 553,000 women diagnosed with breast cancer from 1998 to 2003.


The source of their information was from over 1400 hospitals that participate in a program called the National Cancer Database, sponsored jointly by … Continue reading →

Vitamin D And The Risk Of Cancer

A report in the current issue of the American Journal of Clinical Nutrition is certain to raise once again the role of vitamin D in preventing cancer.


The researchers, from the Osteoporosis Research Center at Creighton University in Omaha, Nebraska did a study primarily designed to study the effects of calcium and vitamin D on osteoporosis.


However, when they decided to look at the same study group to determine whether calcium with or without additional vitamin D supplementation had an impact on the incidence of cancer, they found a stunning 78% decrease in the risk of developing cancer in those women who took both calcium and 1000 units of vitamin D3 daily for four years.


This is essentially the first study that has provided any evidence from a forward looking, randomized controlled trial which randomly assigned study participants into various treatment groups. 


One third of the 1179 post-menopausal women—who lived in Nebraska—received a placebo (or dummy pill), one third received 1400-1500 mg of calcium supplements daily, and one third received the calcium with the addition of 1000 IU of vitamin D3 (on further chemical analysis, the researchers found that the actual amount of vitamin … Continue reading →

When Fear Intimidates Science

I did something the other day that has bothered me for the past 72 hours: I decided not to publish a comment in my blog because of fear of retribution or possibly retaliation.


Today, I decided to correct that decision and discuss my concerns.


Although it may not be a momentous piece of information, it nonetheless made me think long and hard about why I made the decision I did at that time, and what the implications were for providing information to the public about current controversies in oncology.


The topic of my blog this past Saturday was about the changing face of oncology, as reflected in the annual American Society of Clinical Oncology meeting.


What has concerned me were the comments in my draft about an investigational cancer vaccine called Provenge.


As I noted in that blog draft, we live in a different world today than we did years ago when it comes to public knowledge and influence on the drug approval process.


We have more information readily available, with many more people having access to that information.  I call this phenomenon the “democratization of information.”


Along with that democratization (if … Continue reading →

Sorafenib:A New Treatment For Primary Liver Cancer

A presentation this afternoon at ASCO’s annual meeting this afternoon in Chicago  is going to discuss the effectiveness of an oral targeted therapeutic drug called sorafenib (Nexavar) in the treatment of primary liver cancer.


(We need to distinguish primary liver cancer—which originates in the liver and is known by its medical name hepatocellular carcinoma—from cancers that spread to the liver from other organs, such as breast, lung and colon cancer.)


The report is important because up until now there have been no really effective chemotherapeutic agents to treat this form of cancer.  In addition, this treatment is given by mouth, and the side effects were relatively modest.  In fact, the same level of side effects occurred both in the patients who took the drug, and those who took a placebo.


The researchers are going to report that the patients who took sorafenib lived a median of 10.7 months, while those who took the placebo (or dummy pill) lived a median of 7.9 months.  (Median is a statistical measure that means half of the patients lived longer than a particular time, while half the patients died before that time).


Looked at … Continue reading →

Something New, Something Old: More From ASCO

We are now into the third day of the annual meeting of the American Society of Clinical Oncology here in Chicago.


Trying to determine what research and which issues are going to become most relevant to cancer treatment are becoming a bit clearer.  There is even a little bit of controversy to go along with the scientific presentations.


For example, at a presentation earlier today, a researcher from Germany made a comment that received a considerable amount of interest from those in attendance, including members of the media.


The study, which examined the value of MRI compared to standard screening mammography in the detection of non-invasive breast cancer (called ductal carcinoma in situ, or more commonly known as DCIS), concluded that MRI was more likely than mammography to identify high grade DCIS lesions.  This is important, since high grade DCIS is more likely than its low grade counterpart to progress to true invasive breast cancer.


The modest controversy occurred because the researcher was quoted as saying something to the effect that MRI was a better screening tool than mammography, and that the reasons we don’t recommend MRI for routine breast cancer screening are … Continue reading →

How Our Oncology World Has Changed

The annual meeting of the American Society of Clinical Oncology has always been one of my favorite medical meetings.


I have been attending this yearly gathering since the early 1970s.  The current meeting underway in Chicago shows how much the practice of oncology has changed, and reflects many of the broader social and demographic changes in our medical universe over the past 35 years.


Many of those changes are laudable and important.  But, some reflect underlying societal influences that have the potential to alter our view of how we conduct our science, and how we apply our knowledge to new treatments.


When I first started attending ASCO in the early 1970s, it was a relatively small meeting with a couple of hundred attendees.  The meeting could be held in small convention centers attached to hotels in various locations around the country.


Getting your arms around the agenda and attending many of the sessions wasn’t difficult to do.  You knew which presentations were important, and there were no exhibits to distract your attention.


I can still recall the debate at ASCO as to whether we would allow exhibitors to have displays at … Continue reading →

In Praise Of Our Volunteers

It has been a very hectic number of weeks of travel, meetings and lectures. .  Cramped spaces on airplane flights haven’t helped matters either. All contribute to the fact that I have not been able to update my blog for a while.


As I write this I am en route to the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago.  I look forward to this meeting every year, especially since it provides the opportunity to hear the latest in cancer research and listen to lectures on the current state-of-the-art in cancer treatment.  I expect this year’s meeting will be no exception, and I hope to provide some insights on this blog over the next couple of days.


Right now, however, I am reflecting on something unusual that has happened during these past weeks as I traveled around the country.  And that is the number of volunteers who have stopped me to say hello and let me know about their personal relationships with the American Cancer Society.


I guess this probably wouldn’t be so unusual if this had been occurring routinely in the past.


After all, when I … Continue reading →