Monthly Archives: December 2007

Happy Holidays–And Don’t Forget Your Health

I hope you are having a wonderful holiday season, enjoying shopping for gifts, visiting with friends and family, and making great resolutions and promises for the New Year.


What have I been doing?


My vacation started about a week ago.  But I don’t know that many people would envy what I did during the first week of my long awaited and much needed respite from my daily routine: I had a screening colonoscopy.


Yup, that’s right: a screening colonoscopy.


I write and lecture a lot about the importance of preventive medicine. 


I previously wrote a blog about my holiday experience two years ago, when I found out I had some fairly serious but common medical problems as a result of not following my own good medical advice.  My bottom line: I was stuck in “do as I say and not as I do.”


Two years later, fortunately all is much better and under control.  I made a commitment at that time to myself and my family to take care of myself, and I have done reasonably well—although like everyone else, I am certainly not perfect.


But my wife reminded … Continue reading →

Health Insurance And Cancer: The Sad Reality

An article published online yesterday in the American Cancer Society’s CA: A Journal for Clinicians  which reviews in detail the relationship between health insurance (or lack thereof) and cancer outcomes has received a good deal of press attention over the past 24 hours.


The article, written by my colleagues from our Department of Epidemiology and Surveillance Research here at the Society, is an in-depth review of published research which correlates the presence or absence of adequate health insurance with access to cancer care, cancer screening, and cancer outcomes.


On a logical basis, the conclusions are not surprising. 


As noted by the authors, “There is substantial evidence that lack of adequate health insurance coverage is associated with less access to care and poorer outcomes for cancer patients.  As our nation’s investments in cancer research provide greater understanding of how to prevent cancer, detect it early, and treat it effectively, access to health care becomes even more important to the American Cancer Society’s goal of eliminating cancer as a major public health problem.”


The statistics in the article are mind numbing in their detail.  They outline a system that is in fact a broken … Continue reading →

Avastin And Breast Cancer: It’s Not Over Yet

The decision yesterday by the FDA’s Oncology Drug Advisory Committee to recommend that Avastin (bevacizumab) not be approved for the treatment of metastatic breast cancer is one more step in a discussion that has significant implications not only for the use of Avastin in breast cancer, but also how this type of decision-making is going to influence cancer treatment in the future.


Avastin is a type of drug that we call “targeted therapy.”  These newer drugs generally target a specific process in a cancer cell that can then influence the function of the cell and lead to its death.  In the case of Avastin, the targets are the blood vessels that cancers need to grow.  Avastin interferes with that process, and has been demonstrated to be effective in a number of cancers, including colon and lung cancers.


In April, 2005, the National Cancer Institute announced that a clinical trial of Avastin with chemotherapy used in the treatment of women with recurrent breast cancer (compared to a “control” group that received only the chemotherapy) resulted in such positive results that the oversight committee monitoring the study ordered it to be stopped and the results released … Continue reading →