Monthly Archives: November 2008

Success In The Past And Hope For The Future

Since 1998, the American Cancer Society along with the National Cancer Institute, the Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries have provided an “Annual Report to the Nation on the Status of Cancer.”  This year’s report has just been released in the current issue of the Journal of the National Cancer Institute.


For the first time in the history of these reports, the researchers have found that both the incidence rates and deaths from cancer in both men and women are declining.


But before you become too excited, you need to remember that we still have a long way to go in our efforts to reduce the burden and suffering from the diseases we commonly call “cancer.”


First, some good news:


From 1999 through 2005, the rate of cancers diagnosed in the United States has declined 0.8% each year for men and women combined.  From 2002 to 2005, the rate of death from cancer has also declined 1.8% a year.  In 2005, 106,000 deaths from cancer were averted as a result of our progress.


For men, lung cancer incidence and deaths have … Continue reading →

The Numbers Tell The Sad Tale Of Tobacco Tragedies

No sooner had I completed posting my blog this morning about the Great American Smokeout than two new tobacco-related reports appeared in my email from the Centers for Disease Control and Prevention.  The articles detailed the latest information from the CDC on cigarette smoking in the United States, including the economic impact as well as years-of-life-lost in this country due to tobacco use and exposure to second-hand smoke.


Some success, to be certain,  but also sad and substantial failures.  The price that tobacco makes us pay–both in lives and money–defies our ability to comprehend much less accept.


The information describing the number of current smokers was interesting.  For several years, the percentage of adult smokers who fit the definition of “current smokers” in the United States has remained fairly steady at around 21%. In 2007, fortunately, the most recent survey data from CDC show that number has declined about 1% to 19.8%.  That is a significant year-over-year improvement.


As one might expect, more adult men (22.3%) than women (17.4%) are current smokers.  Somewhat surprisingly—given the past high rates of smoking in the African American community and as discussed in a recent … Continue reading →

Great American Smokeout: A Time To Quit

It’s never too late to stop smoking.  And it isn’t too early—if you or a loved one or good friend is a smoker—to start thinking about next week’s Great American Smokeout.


The Great American Smokeout—or GASO, for short—is a signature American Cancer Society event that occurs every year on the Thursday before Thanksgiving.  This year’s GASO celebrates the 32nd anniversary of this successful program which began in 1976. 


Since GASO started, millions of men and women in this country have stopped smoking, and millions more haven’t started.  In fact, today there are more former smokers in the United States than current smokers.  But we still have about 20% of adults in this country still smoking cigarettes.  Unfortunately, that number is not falling as much as it did when GASO was first introduced over 30 years ago.


Did you know that the American Cancer Society estimates that since the early 1990’s hundreds of thousands of lives—especially among men–have been saved as a result of tobacco cessation and decreased uptake of the smoking habit?  But we still lose over 435,000 people every year because of tobacco, which is the leading preventable … Continue reading →

Vitamin D Fails To Decrease Breast Cancer Risk

Finally, we have the results of a large scale randomized, placebo-controlled clinical trial to tell us whether or not vitamin D can reduce the risk of breast cancer.


The study, reported in today’s issue of the Journal of the National Cancer Institute, concludes that there is no evidence that vitamin D decreases breast cancer incidence in post-menopausal women.


But I will bet you dollars-to-doughnuts (well, maybe not doughnuts—they are fattening) that this study isn’t going to provide closure to the hotly-debated question of whether or not vitamin D reduces breast cancer risk.


The study was part of the larger Women’s Health Initiative which was designed to look at the impact of hormone therapy on the health of post-menopausal women.  As part of that study, close to 18000 post-menopausal women were randomly assigned to take 1000 mg of calcium and 400 IU (international units—the recommended daily allowance for vitamin D) daily.  The other 18,000 women took placebos.


The problem is that both groups of women were allowed to take extra vitamin D and calcium, and a good number of them did just that—although the number of women who did so was basically the … Continue reading →

Finally, Some Good News On Disparities And Cancer

Sometimes I don’t think we acknowledge and celebrate our successes.  An example would be the decrease in the number of smokers in New York City, especially among young people.  Too few of us are aware of this remarkable success.


Another example would be something that I have noted previously: there has been a significant decline in smoking related cancer deaths among African American men in the United States.


A paper in the current issue of Cancer, Epidemiology and Biomarkers now sets the record straight with respect to that second observation.


Unfortunately, the news is not all good.  In cancers where screening for early detection is available, the impact of disparate care has led to an increase in the mortality gap between whites and blacks in this country for these cancers.


The researchers—who are from the epidemiology department at the American Cancer Society–examined the trends in cancer deaths in the United States from 1975 through 2004.  They looked at cancer death rates and the differences between white American men and women, and African American men and women.  They further divided the analysis into the rates for all cancers combined, for … Continue reading →

Ronald Davis, MD

Ronald Davis, MD, a friend and trusted colleague, passed away yesterday from pancreatic cancer.  Ron was 52 years old.


The House of Medicine, the tobacco control community, his family and his many friends have lost someone who was not only committed to his profession but also served as an exemplar of what it meant to be a physician, a husband, a father, and a friend.


This past June, I shared my thoughts about Ron and his battle with cancer on this blog.  Being part of the audience the day he gave his speech as the outgoing president of the American Medical Association was very special. I know that his words, his optimism, his faith and his reality impacted many of you as well.


As I write this, I am on my way to Orlando to participate in another meeting of the AMA’s House of Delegates.  Ron’s passing is certain to hang heavy over our gathering, but his spirit and his soul will never be far from our thoughts.


To his wife, his sons, and his family, our sympathy, thoughts and prayers are with you.


To those who knew Ron and worked … Continue reading →

Migraines Reduce Breast Cancer Risk

Have you ever wondered what gives a researcher the idea for a particular project? 


If so, then try this one on for size:  Is breast cancer less frequent in women who have migraine headaches?


At first glance, that seems to me to be an odd question.  But someone did ask the question, and the answer was a bit surprising: Yes, migraines are associated with a lower risk of breast cancer. And, yes, there actually is a scientific rationale for having asked the question in the first place.


Women with migraines are probably very aware that there is a relationship between when they get their migraines and their menstrual cycles.  Women on birth control pills who have a history of migraines have an increase in their migraines if they take one of the pills where they take a week off their medicine.  And, women who are pregnant have fewer migraines.


So what is the clue in all of this that would lead to asking the migraine/breast cancer question?


All of the above are associated with a significant change in circulating estrogen levels. High estrogen, fewer migraines.  In the circumstances noted … Continue reading →

Vitamins And Cancer: Looking In The Wrong Places

Are we looking for cancer prevention clues in all the wrong places?  That is the question I am asking myself as another vitamin theory bites the dust.


A report in this week’s Journal of the American Medical Association (and supported in part by research funding from the American Cancer Society) examined the relationship between folic acid, vitamin B6 and vitamin B12 and breast cancer.


The bad news? A combination vitamin pill did not reduce the risk of breast cancer. 


The good news? A combination vitamin pill did not increase the risk of breast cancer, or any other cancer.


In the study, the researchers examined the effect of giving a daily dose of the three vitamins in a single pill to a group of women who were at high risk of heart disease.  Half the participants received the vitamins, and the other half took a placebo (or dummy pill) that did not contain the vitamins.


After a little over 7 years of treatment, there was no difference between the two groups of women with respect to the incidence of breast cancer or any other cancer.  There was also no difference in … Continue reading →