Monthly Archives: September 2008

Lance Armstrong: A Soul For The World

Lance Armstrong is a truly amazing person.


He is a world class athlete. He is a cancer survivor under perhaps the most difficult of circumstances.  He is someone who didn’t sit back on his successes and memories but instead reached out and created a focus on cancer and survivorship that has touched millions.


Today, the Lance Armstrong Foundation announced that they were taking the cancer fight globally, as an integral part of Mr. Armstrong’s decision to reenter competitive cycling.


Wearing his suit and his sports gear, he has committed to working throughout the world to bring attention to cancer, and the plight of those who suffer from cancer—frequently silently and in pain—in Africa, Australia, or wherever his journeys may take him.


We tend to forget that fighting cancer is a worldwide effort. Not just in the developed world, but throughout the emerging economies as well.  The cancer world is becoming increasingly flat.


After we get done patting ourselves on the back about the significant advances we have made in cancer research and treatment, we should take a moment to remember that it wasn’t so long ago that our relationship with cancer was … Continue reading →

Screening For Lung Cancer: No Quick Answer

Lung cancer remains the leading cause of cancer deaths in the United States, and will remain so for the foreseeable future. That makes answering the question whether or not the early detection of lung cancer with CT scans can in fact reduce the risk of dying from this killer disease all the more important.


Over the past two days, the American Cancer Society has hosted a meeting of experts in Washington DC to answer the question of whether there is anything we can do to accelerate our knowledge as to whether or not lung CT scans really reduce deaths from lung cancer.


The conclusions of these experts were important.  But the meeting was not without some controversy when it came to assessing the value of another large United States clinical trial that has been used by many to promote lung cancer screening with CT scans in current or former smokers.


During the course of the meeting, the panel of experts was asked to answer several questions. 


Basically, what the American Cancer Society wanted to know was whether there was value in combining the results of all the trials, in an effort to … Continue reading →

Survivor Care Plans: What You Need To Know For You

If you or a loved one has had cancer, how much do you really know about your disease after you have completed your treatment?


If the experts are right, not much.  Certainly not enough to tell another doctor the stage of your disease, the type and dose of chemotherapy you received, the plan for follow-up and the potential long term side effects.  And that doesn’t even begin to address the questions of the impact of the disease and its treatment on your psyche and your pocketbook.


Now, fast forward with me.  It is twenty years after your diagnosis and treatment.  You are doing well, and you are now under the care of a primary care clinician.  A researcher writes a report about a new finding that would put you at high risk of having a heart attack as a result of a drug you received during your cancer treatment. But you and your primary care clinician don’t read or hear about the report, so you can’t take preventive steps to protect yourself.




This scenario is not far fetched.  The sad truth is that most patients treated for cancer are … Continue reading →

Quality Cancer Care: Know It When You See It

How do you know if you or someone you love is getting the best quality care for their cancer?


The sad truth is that you don’t. It is difficult to impossible for most people to understand what really constitutes quality medical care.  In fact, I suspect it is also difficult for many medical professionals to measure quality cancer care.


The good news is that most health care professionals and the hospitals where they work want to do the best they can for their patients.  We are fortunate in that regard.


But despite good intentions, those of us who have seen the research which measures quality medical care know that many of those intentions fall short of the mark.


To address these concerns, the Cancer Quality Alliance (CQA) has written an article in the current issue of the American Cancer Society’s journal CA: A Cancer Journal for Clinicians which tries to give medical professionals and patients an understanding of what in fact constitutes high-quality cancer care.  (The Alliance is a collaboration of many different types of organizations which is committed to improving the quality of cancer care.)


By comparing five scenarios … Continue reading →

Stand Up To Cancer: The Show

As I sit here tonight watching the “Stand Up To Cancer” television show, I find myself admiring the quality of the effort that went into this program.


The producers and the entertainers have certainly tugged at my heartstrings, and I suspect they have done so for many, many people throughout the country as well.  This is, in a simple phrase, a smashing success.


The combination of real life stories with the promise of research progress is always compelling.  We have all suffered losses through the impact of cancer in our families and our lives, and we all hold out the hope that one day the words “you have cancer” will no longer be heard by anyone anywhere.


There is no doubt that we have much to learn about cancer and how to treat it.  There is also no doubt that we have made considerable progress in cancer research and cancer treatment over the past number of years.  We have treatments today that were dreams only a couple of years ago.


All of this does take money, and that money is becoming harder to come by.  If this show helps raise awareness and … Continue reading →

Tribute To Those Who Stand Up To Cancer Every Day


It is no secret that when the stars come out, they get the attention of the masses.  That is a good thing when it comes to cancer research.


Yesterday, USA Today ran a lead story in their “Life” section about tonight’s “Stand Up To Cancer” television event, and today the American Cancer Society ran a full page advertisement in the same newspaper with the headline “A question so important it will take an entire nation to answer it.” (A copy of this ad appears on our website


But there is more to the story, and we must embrace the concept with the understanding that there is much to be done in the fight against cancer.  It will take more than any organization’s single moment if we are going to succeed in our efforts to reduce the burden and suffering from these dreaded diseases we call cancer.


Our progress in cancer research and cancer treatment has been the result of a few large steps and many, many smaller ones.  It has been a difficult, long haul.


I have watched us come from the dreams ignited by a war on cancer declared in Continue reading →

Does A Prostate Screening Exam Belong On TV?

There has been a buzz lately in cancer research circles about an event that is going to air tomorrow evening on the three major television networks from 8 to 9PM EDT.


It is always a powerful moment when the media and Hollywood come together to promote something as important as cancer research.  The organizers of this event are to be commended for their commitment to raising awareness of the need for more funding for cancer research and putting the topic front and center in the public eye.


But sometimes strange things happen on the way to the chapel.  One of those is noted in an email I received late yesterday announcing that Brad Garrett is going to have a prostate cancer screening examination shown on national TV as part of this program.


That certainly will be interesting on several counts.


First is the obvious: having a rectal exam on national television takes us to a new level.  Whether or not that is appropriate in the eye of the public remains to be seen.  I guess it all depends on how it is filmed.  Let’s just say as a doctor it isn’t … Continue reading →

Vytorin And The Increased Risk Of Cancer

Recently, there have been some question as to whether or not Vytorin is effective in reducing the risk of cholesterol-related heart disease.  Now, another concern has been raised that Vytorin can increase the risk of getting cancer.


This week the New England Journal of Medicine has published two research papers and an editorial that provide the first detailed glimpse into the controversy.  Unfortunately, the evidence isn’t sufficient in my opinion to provide a clear yes or no answer as to whether the increased risk of cancer is real.


Vytorin is a drug that has been widely advertised to reduce cholesterol.  If you are like me, you have seen hundreds of these advertisements.  The drug itself is actually a combination of two medicines.  One, simvistatin, is a widely used typical cholesterol lowering medicine that has been around for years.  The other drug in the combo is ezetimibe which works through a different mechanism to lower cholesterol.  Its use has not been as long or as widespread.  Through the rest of this blog I will simply refer to the drugs by their trade name Vytorin.


We have substantial experience with simvistatin … Continue reading →

Michael Jordan And His Cigar

Sometimes you just can’t get it right for trying.


I must admit that I am not a big “media fan” or stargazer, and I know nothing about an online website called TMZ.  What I have learned is that TMZ’s claim to fame is showing movie stars behaving badly.


Why am I even writing about this?


Because earlier this week, our division office in California was contacted by TMZ for a news comment.  The topic was a photo of Michael Jordan smoking a cigar at a softball game.  Nothing really unusual about that part of the story.


One of our respected volunteers responded, and was straight and to the point: celebrities set examples that other people—especially young people—follow.  Cigar smoking is one example of an unhealthy behaviorSmoking is harmful for your health and causes one out of three cancer deaths.


That’s it. End of statement.


The next thing you know, the headline on the website proclaims that the American Cancer Society is “burning” over Mr. Jordan’s “cigar shots.”


Well, sorry to say, but we are not.  It is not even a lingering topic of discussion … Continue reading →

Skin Cancer And The Risk Of Other Cancers

Last week I wrote about an article in the Journal of the National Cancer Institute that suggested a drug commonly used to treat high blood pressure might prevent some of the more common forms of skin cancer.


Another article in the same issue of the Journal was also thought provoking.  That research suggested that the diagnosis of common skin cancers—especially in young people—may be a signal of increased risk of other more serious forms of cancer elsewhere in the body.


As I mentioned last week, 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.  Fortunately, these cancers are usually easily treated by removing them with few of them leading to more serious disease.


In the currently reported research, the investigators’ theory was that skin cancer could be a “marker” for other problems in our bodies that would increase our risk for other common cancers.  They based their theory on other research which has suggested such a relationship may exist.


The researchers collected information from about 19,000 … Continue reading →