Monthly Archives: August 2008

Did Christina Applegate Send The Right Message?

When Christina Applegate recently revealed that she had an inherited form of breast cancer and had bilateral mastectomies, there was an outpouring of media interest and genuine concern.  When she said she was cured, a lot of breast cancer survivors and doctors scratched their heads wondering what message she was sending.


There is something in our national psyche that makes the diagnosis of cancer in a celebrity something more important.  They rise above the rest of us when sadness impacts their lives, and for many of us their disease becomes our disease.


One of the things I have learned over the years is that when it comes to someone else’s illness, there is little we know and much we don’t.  Celebrities and politicians in particular—since they are constantly in the public spotlight—have to make decisions as to how much to say and what not to say.


What we know about Ms. Applegate is that she has an inherited genetic mutation that is known to be associated with a high risk of breast and ovarian cancer.  She was screened regularly, which was the right thing to do.  Apparently a screening MRIContinue reading →

Can Skin Cancer Be Prevented If You Are At Risk?

An article in the current issue of the Journal of the National Cancer Institute provides a clue as to how many skin cancers could be prevented in those at high risk by using drugs that are common and readily available.


Skin cancer is the most common cancer diagnosed in the United States today.  In 2008, over 1 million people will be diagnosed with either basal cell (BCC) or squamous cell skin cancers (SCC) or malignant melanoma. 


Basal and squamous cell cancers are very common, usually easily treated, and infrequently lead to death.  Melanoma, on the other hand, is less common but more malignant and unfortunately if not caught early can spread throughout the body. 


All of these cancers have been tied to sun exposure, which is one of the reasons the American Cancer Society and many other health-related organizations urge people to practice sun-safe behaviors.


Despite being so common, little is known about the frequency and outcomes of patients with squamous and basal cell skin cancers.  That is because unless the cancer spreads, we don’t routinely track those diagnoses in cancer registries like we do for many other types … Continue reading →

Could PET Scans Be Key To A New Cancer Treatment?

You learn as a doctor to never say never. 


This past Wednesday I was a member of a panel that was brought together by the Centers for Medicare and Medicaid Services (CMS) to review the clinical indications for using PET scans in cancer.


While trying to make decisions regarding the effectiveness and benefits of PET scans in various cancers, I made a discovery that was a surprise to me: something that I previously thought was a far out theory for cancer treatment may in fact be plausible after all.


For those not familiar with PET scans, they are an imaging procedure which utilizes radioactive glucose to point out where cancer is located in the body. 


The technique has been around for a while, and more recently PET scan information has been merged with CT scans to produce images that are very helpful to doctors determine whether a cancer has spread, and if so where it is in the body.


For some cancers, there is also some evidence that PET scans may highlight how aggressive a cancer may be, or whether or not the cancer has actually responded to chemotherapy.


The issue … Continue reading →

The Eat Right Challenge And The Belly Index

Today marks the American Cancer Society’s 2008 Great American Eat Right Challenge. 


It is a time to remind all of us of the importance of healthy eating, healthy weight, and healthy exercise in reducing our risk of cancer.  It is also a day to “call to action” the American people to take what they know and finally do something about their ever increasing waistlines.


I guess I get a bit cynical from time to time about this subject.  The results of a survey recently completed by the Society don’t do much to improve my frame of mind on this topic. 


It appears that tackling our diets and getting off our duffs just isn’t at the top-of-mind for many of us.


I spend a good deal of time travelling on business and have done so for many years.  One of the things I do when sitting idly in an airport waiting to board a flight is take a “belly index.”  The belly index reflects the number of people—both men and women—who have an enlarged girth which is clearly visible as they exit a plane or walk down the hallways.

 Continue reading →

Vitamin D: More Words Of Caution

A study in the current issue of the Archives of Internal Medicine addresses a question that has interested me for some time: does vitamin D really reduce the risk of death for the general population?


The study, from Johns Hopkins in Baltimore and the Albert Einstein College of Medicine in New York, examined data from a national health survey performed in the United States from 1988 through 1994.


The studies did back up the claim that vitamin D deficiency is associated with an increased risk of death in the general population, but did not show that it reduced deaths from all types of cancer. 


Perhaps even more important to me was an observation in the report that suggested there may indeed be an increase in death rates for women who have higher levels of vitamin D in their blood.


The authors noted that approximately 41% of men and 53% of women in the United States are deficient in vitamin D based on prior studies.


The researchers examined data from a nationwide health survey that was performed in the United States from 1988 through 1994.  They evaluated health-related surveys, physical examinations and blood … Continue reading →

Breast Cancer: The Risks of Recurrence

A study just released in the Journal of the National Cancer Institute is getting a lot of media attention.


The research, from the M.D. Anderson Cancer Center in Houston, Texas took a look at what happened to about 2800 women with breast cancer who were treated at the center from 1985 through 2001.  All of the women had primary breast cancer of various stages, and all of them had some form of adjuvant therapy.


The goal of the study was to find out how many women had their breast cancer recur 5 years or more after they completed their adjuvant therapy.  What it also pointed out, to me at least, was that some commonly held beliefs about the outlook for women with breast cancer aren’t always correct.


The women in the study represented the universe of women with primary breast cancer.  There were younger and older women, women whose breast cancers were hormone sensitive or not, pre and post menopausal women, and women with various stages of primary breast cancer, among other factors.


Many of the women had received tamoxifen as their adjuvant therapy.  Some of the women also received … Continue reading →

Prostate Cancer Screening: Is 75 The Age To Stop?

This week’s article in the Annals of Internal Medicine about the benefits and risks of screening for prostate cancer is certainly going to fuel the debate about whether or not men younger that the age of 75 should be routinely screened for this disease. 


However, for men 75 and over, according to the government experts, the question has been answered: don’t bother.


But is that the best answer for you?


For those of you approaching the age of 75, those may be viewed as “fighting words.”  You may be getting older, but probably believe you are getting better at enjoying your life.  So why not do everything you can to make certain that the years you have on this earth will be time spent free of prostate cancer and its consequences?


The experts have reviewed the scientific evidence, and the jury has returned the verdict. They say the conclusion is clear that for men age 75 and over, screening for prostate cancer with the PSA test doesn’t offer much benefit, and it certainly can cause harm.  So, don’t do it.


Back when I was a medical student, we were taught that … Continue reading →