Monthly Archives: October 2007

Maybe Vitamin D Isn’t The Answer After All

We have been bombarded over the past couple of years with scientific articles suggesting that vitamin D is the key to improving many aspects of our health, including reducing the risks of dying from cancer.


An article in this week’s Journal of the National Cancer Institute reminds us that perhaps we should be a bit cautious in embracing vitamin D as “the answer” before we do more research.


The report, from the National Cancer Institute and the Centers for Disease Control and Prevention, concluded that vitamin D levels in the blood were not related to overall cancer mortality. 


However, the study did find that higher levels of vitamin D were associated with a substantial decrease in the risk of dying from colorectal cancer, and possibly with a reduction in the risk of dying from breast cancer.


The study was performed between 1988 and 1994 and was designed to examine the health and nutritional status of the noninstutionalized United States population.


As part of the study, the researchers took baseline blood samples, which included a measurement of serum vitamin D levels.


16,818 people were part of the study which continued with follow-up through the … Continue reading →

SCHIP, Children’s Health, And The Tobacco Tax

As I write this, our legislators in Washington are trying to figure out how to compromise and move a bill forward that would continue a valuable and laudable program which provides health care to at-risk children in our country. 


The bill is entitled State Children’s Health Insurance Program, more commonly known as SCHIP.


You have probably heard something about this on the news or in a newspaper report.  It was recently passed by Congress, but vetoed by the President because of concerns that eligibility standards were too liberal.


Most of the politicians and people polled in this country recognize in principle that this program is valuable and needs to be continued. However, not everyone agrees on how much funding should be provided for the program and how many kids should be eligible for this benefit.


The arguments are political and philosophical.  This being Washington, DC, that is understandable.


But what is not quite as understandable are the arguments some of our political leaders have been using to question one significant way to fund the program, namely increasing the federal tobacco tax by 61 cents, from 39 cents to a dollar … Continue reading →

Report To The Nation: The Progress Continues

Every year, the American Cancer Society along with other collaborators (including the Centers for Disease Control and Prevention, the North American Association of Central Cancer Registries, the National Cancer Institute and others) provides an annual report to the nation on the status of our progress in addressing the burden of cancer in our country.


Consider it an accountability report.  It provides a considerable amount of information on whether we are—or are not—reducing the incidence and mortality from cancer.


For the past several years, the news has been good.  We have seen declines in incidence and deaths from several of the major cancer types in men and women. 


Fortunately, this year’s report released today—which covers statistics through 2004—is no exception, and some of the declines in incidence and mortality for cancer overall and certain cancers in particular are striking.


This is probably the key statistic: from 1993 to 2002, the annual decrease in cancer deaths was about 1.1%.  From 2002 through 2004, that rate of decline almost doubled to 2.1%.


For men and women, for most of the common cancers, there was a continued decline in death rates. 


Among … Continue reading →

Can Microsoft Fix The Medical Record?

Last week Microsoft announced a new personal health record product called Health Vault, which is designed to provide a patient-centered medical document that will contain personally relevant medical information, and perhaps copies of tests such as EKG’s and records of blood pressure and glucose measurements.


Simultaneously with that announcement, Bill Gates wrote an op-ed piece in the Wall Street Journal where he praised the promise of health information technology (HIT), while bemoaning the slow progress we have made in this arena.


Well, Mr. Gates, not to be impolite, but welcome to the table. Maybe your influence will help us address the obstacles.


HIT is one area in medical practice that has been consistently difficult and stubborn to address broadly and successfully.  No matter how much progress we have made in medicine over the past three decades, the barriers to success in HIT remain daunting and the goals elusive.


HIT is not a new concept. 


Years ago, I used to regularly interview billing system vendors for my own practice.  Finally, after many, many years, companies were able to develop products that were useful in handling the business side of a medical office.  Continue reading →

CT Scans: A Better Way To Screen for Colon Cancer?

There is little question in the minds of many experts that we could do a much better job of diagnosing certain cancers earlier, resulting in more effective treatments and better survivals.


When it comes to colorectal cancer, we simply don’t do a great job of screening for the disease.  Colorectal cancer is a topic that people don’t normally want to talk about, yet the potential for reducing deaths from this cancer has been estimated in the tens of thousands each year—if we only did what we already know.


If we started effectively screening the people age 50 and over in this country tomorrow, we would cut deaths from this disease substantially and reasonably quickly.


And, in the case of colorectal cancer, we are not just talking about effectively treating the disease. We are talking about possibly preventing it in the first place.


That’s why an article in today’s New England Journal of Medicine is so interesting, and potentially so important.


The “traditional” methods for colorectal cancer screening include a test called fecal occult blood test, sigmoidoscopy, barium enema and colonoscopy either used as a stand-alone test, or in specific combinations (such as sigmoidoscopy every … Continue reading →