Monthly Archives: March 2010

Will Colorado Limit Access to Mammograms?

As I write this, I am on a flight to Denver, Colorado in anticipation of testifying tomorrow before a Colorado Senate committee on a bill that aims to restrict access to screening mammograms for women between the ages of 40 and 49.  And I promise you I wouldn’t be making this trek if I didn’t take this issue very seriously and very personally.

This particular hearing takes on added importance for a number of reasons, not the least of which in my personal opinion is the laying down of the gauntlet to restrict breast cancer screening as a result of the recently released guidelines from the United States Preventive Services Task Force this past November.

As predicted, legislators, state governments and insurance companies are using the Task Force report as a reason to restrict access to what the American Cancer Society believes screening mammography an important test that has proven value in saving many, many years of life for women in this country.  Our goal and our commitment is to do everything we can to make certain that doesn’t happen.


You probably recall the furor that greeted these federal government guidelines last November, during the heat … Continue reading →

So What Did We Learn Yesterday About Tanning Beds?

So what did we learn after all was said and done at yesterday’s Food and Drug Administration advisory committee hearing to help advise the FDA whether or not there will be future regulations that may restrict the use of tanning beds?

The answer—after having slept on it for a night and talking with colleagues who also attended the meeting—is we aren’t sure.  There was no obvious drama, no votes, just discussion by the panel members trying to come to consensus and provide FDA staff with some thoughts and guidance as to how to deal with the issues.

It’s when the rhetoric doesn’t match the data, and no one challenges the speakers on the issue, that I begin to become concerned whether the real message is sinking in, namely that these products are dangerous when used as intended, and research shows they not only damage the skin, but they have no real benefits—and that the current laws are not being effectively enforced.


One message did come through loud and clear yesterday, through staff research, testimony presented to the committee, and comments by members of the committee themselves.  That message is that tanning is dangerous, no matter whether it … Continue reading →

Should We Ban Tanning Beds? The FDA Is Listening

I am spending today attending a hearing of an advisory committee for the Food and Drug Administration to review current regulatory oversight regarding indoor tanning devices, namely tanning beds.

The charge to the panel is to determine what—if anything—should be done by the FDA to increase the scrutiny of these devices and the industry.

Why is this important?  After all, you might ask, doesn’t the government already assure that tanning beds are safe?  Don’t some states and local governments already regulate the industry?  Why do we need more?

Well, if you understand that tanning beds fall into the same regulatory category as devices such as tongue depressors, and that the International Agency for Research on Cancer recently declared that tanning beds are Class I carcinogens (like tobacco and asbestos), then you can begin to understand why this discussion is so important.


The data appear to be reasonably clear that tanning beds when used as intended have a real risk of causing harm to the user.  When you also consider that many of the users of these devices are younger than 18, and many of them are young women, the long term risk of that use is … Continue reading →

Groundhog Day Diet: Overcoming Everyday Challenges

It’s been about six weeks since I wrote about my “Groundhog Day Diet” so I thought it might be time for an update.

For those of you who are unaware, this is my annual diet ritual that—like many of you—I start every January to lose the same 20 or 30 pounds I have gained over the prior year, only to try to lose it again. 

(The inspiration for the name as you may have already guessed was Bill Murray’s movie of many years ago where he was consigned to live the same 24 hours again and again as he reported on the annual Groundhog Day “celebration” in Pennsylvania.)

For those of you who have no interest in my successes and failures of the past 10 weeks, you can move on.  But for some of you who share my frustration over trying to heed the call to eat healthier, you may find some inspiration in the struggles, solutions and outcome of my most recent dieting adventure.


First, the good news: I am down about 25 pounds.  I have cut back on the doses of my blood pressure medications, and my efforts to exercise regularly have remained intact … Continue reading →

Guiding Cancer Treatment: The Role of NCCN

I am currently in Ft. Lauderdale attending the annual meeting of the National Comprehensive Cancer Network (NCCN), an organization representing 21 of the nation’s most recognized and respected comprehensive cancer centers.

I suspect that many of you are not familiar with NCCN, yet it may be the single most influential organization when it comes to how we treat cancer in this country, and also how we pay for it.  That’s because of its widely recognized clinical cancer treatment guidelines, which have been recognized by insurers, government and others as representing the best available recommendations for cancer treatment. 


I will freely admit that I use NCCN guidelines routinely in advising patients and families on their care, and oncology practices are increasingly letting people know that they follow these guidelines as they make treatment decisions, even going so far as to put that information on their websites and letterheads as a means of letting people know they are committed to quality cancer care.

There is a lot of complaint and concern these days about how we practice medicine in this country, particularly as part of the health reform debate.  Doctors are mortified by the concept of “cookbook medicine,” … Continue reading →

Georgia And The Tobacco Tax: Time To Get It Done

One of the reasons I enjoy what I do is that from time to time I get to do some interesting things. 

Participating in today’s “tobacco tax rally” at the Georgia state capitol was one of those “things.”  Several hundred people from all over the state attended the rally, and are out visiting their legislators as I write this to tell them they support an increase in the tax, which is pretty remarkable for a state that until recently had a significant economic reliance on growing and selling tobacco.

And then there are the interesting facts you learn when you prepare and participate in these presentations.  Today’s rally was no exception.


The increase in the tobacco tax has taken on more urgency this year than in the past, in Georgia and elsewhere.

Like other states, Georgia is facing significant state budget woes as a result of the economy.  Tax revenues are down, programs are being cut, and vulnerable citizens are at risk of losing some of their state benefits.

In Georgia, the Medicaid program is facing substantial cuts.  Hospitals and health professionals are potentially at risk of paying money back to the state for … Continue reading →

New Prostate Cancer Screening Guidelines

In the words of that great philosopher, Yogi Berra, “This is like déjà vu all over again.”

Maybe yes, maybe no.   

If you assume that the new guidelines for the early detection of prostate cancer released today by the American Cancer Society don’t offer anything different compared to the last major revision of the guidelines in 2001, then you may be missing some important messages about prostate cancer screening.

And you may miss what I consider the most important message of all: prostate cancer is so common in men age 50 and over that finding it by prostate cancer screening may be nothing more for most men than a fortuitous “random walk.”  As I learned myself, even with a perfectly normal PSA there is a real possibility that you have prostate cancer.  Whether you need to find it or not is the heart of the issue.


Prostate cancer is clearly a major health issue in the United States.  The American Cancer Society estimated that in 2009 (the latest year for which statistics are available) there were 192,280 men diagnosed with prostate cancer, making it the most common form of cancer in men.  Deaths … Continue reading →