Colon Cancer

The American Cancer Society Sets A Goal To Reduce The Burden Of Cancer: Are We Up To The Challenge?

Ever wonder what would happen to cancer in this country if we all did better at what we do every day?

The American Cancer Society has an answer in a recently published paper in our journal CA: A Cancer Journal for Clinicians, and it may surprise you what we could accomplish if we set our minds to the task.

We recently reported that between 1990 and 2015, the cancer death rate declined by 27%. That’s a remarkable accomplishment. However, we still have a long way to go. Too many of us experience the burdens and losses from cancer. All of us want to see this disease in its many forms vanquished.

Our researchers looked at what would happen if all of us had the same cancer risk as college graduates in the United States, then came up with an estimate of how that would impact deaths from cancer from 2015 and 2035.

The answer: we could reduce deaths from cancer by close to another 40% beyond what we have already accomplished. That would be a total of over 54% from 1990. And it would mean 1.3 million fewer premature deaths from cancer between 2020 and 2035. Remarkably, it would mean … Continue reading →

A Cure For Cancer? Not So Fast

The news report in the Jerusalem Post regarding researchers’ claim that they have found a cure for cancer is certain to get our attention. And, it goes without saying, we all share the aspirational hope that they are correct. Unfortunately, we must be aware that this is far from proven as an effective treatment for people with cancer, let alone a cure.… Continue reading →

Cancer Statistics 2019: Cancer Death Rates Have Declined 27% In 25 Years, And We Still Have A Long Way To Go

Good news is always welcome, especially when talking about something as serious as cancer. And there is plenty of welcome information in the American Cancer Society’s release today of our annual report on “Cancer Statistics, 2019” and its accompanying consumer-oriented version of “Cancer Facts & Figures 2019.”

Among the good news in this report: A significant decline in death rates from cancer—especially among some of the most common cancers, significant improvements in early detection and treatment of cancer, and a decrease in the disparities in death rates between African-Americans and whites.

Despite the good news, unfortunately, there are also pieces of the puzzle that have not been solved. And to ignore that information is a disservice to those who struggle with cancer and those who have passed because of this dread disease. The reality is we can—indeed, we must—do better. And that fact is an equally important part of the information contained in this report.… Continue reading →

Justice Ginsburg Diagnosed With Cancer In the Lung: What We Know–And What We Don’t Know

The announcement today that Justice Ruth Bader Ginsburg has undergone surgery for cancer in her lung reminds us all that in situations like this we need to be cautious in speculating as to exactly what has happened to the Justice. Notwithstanding information that has been made available to the public in several reports, we need to be aware that there is likely additional information that is not yet available to the media and others.

As in similar situations where those who are in the public arena—be they judges, politicians, actors/actresses or other celebrities—the information they choose to share is usually carefully vetted before being released. Sometimes the information is freely provided. Other times, it is kept very private. Either way, we need to respect those decisions which can be very personal.… Continue reading →

Times Change, Our Bodies Change, And Now The Body Mass Index (BMI) Guidelines May Change Too

A recent news story in the Journal of the American Medical Association (JAMA) reminds me that lots of things in our lives are changing these days, not the least of which is the shape of our bodies.

Oh, my. This aging thing isn’t so easy, and that is really the message behind Rita Rubin’s timely piece about shifting body mass and muscle as we age and its implications. Although focused on women, I can attest personally that men fall into the same trap as well. That 250 pounds when you are older simply is not the same 250 pounds when you were in college. Now 250 pounds looks more like 280—even though the scale still says 250. Go figure…

Although I may be trying to provide a little humor to the subject, the reality is it’s not humorous when it comes to our health. As we age, muscle turns to fat. In a process called “sarcopenia,” muscle begins an inexorable march to become fat, and for most of us it doesn’t make too much difference how much we try to forestall the shift. It is programmed into our bodies, and although exercise might help, Mother Nature simply doesn’t … Continue reading →

Chewing Gum To Detect Cancer: Reporting The Hype, Diminishing The Facts

Sometimes It’s important to know the news behind the news: the comments and the cautions that don’t get into the article that the public gets to read. It’s the sort of thing that keeps me up at night: trying to convey the reality, while realizing what most people want to hear is the hope.

That’s the problem I have with a story posted on a major news network website yesterday, where I have a brief quotation that failed to capture the thoughts I tried to express at the time of the interview. The reporter had very limited time, and the information I wanted to provide was complicated. Instead of the caution I tried to convey to counter the potential “hype” about chewing gum to find cancer early, the report suggests that this is a test that will be available soon—while failing to inform how complicated it would be to achieve that goal.… Continue reading →

What Do We Do Now That Colorectal Cancer Rates Are Increasing For Younger People?

After years of declining rates of colorectal cancer (CRC), a new study from the American Cancer Society raises the specter that not all is going as well as we would have hoped, especially among younger folks born since 1990. And that raises the question of what the future holds for this frequently preventable form of cancer, including a possible reexamination of when it is appropriate to start CRC screening for people at average risk of developing the disease.

The research, published today in the Journal of the National Cancer Institute looked at the rates of colon and rectal cancer diagnoses from 1974 through 2013 in several parts of the country. The researchers were particularly interested in changing patterns of CRC in people 20 years of age and older who were diagnosed with invasive CRC from 1974 through 2013.

There is a lot of complexity in the published results, so let’s focus on the main messages of the study:

  • After decreasing since 1974, colon cancer incidence rates increased by 1% to 2% per year from the mid-1980s through 2013 in adults ages 20 to 39. In adults 40 to 54, rates increased by 0.5% to 1% per year from the
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Do Fitness Trackers Help Us Lose Weight? The New York Times Says “No”; I Say “Not So Fast”

I am devoted to my fitness tracker, having used it for several years to remind me to be active, monitor my diet and improve my sleep. Now the New York Times tells me it doesn’t make a difference, at least when it comes to the weight loss part of the program. And I might agree, if only the evidence they relied on told the whole story. In my opinion, it did not.

Unfortunately, some of the science on which the Times’ reporter based his comments had a possible flaw that may influence the conclusion that fitness trackers not only don’t encourage weight loss, but improbably may lead to less weight loss when using the device.

That, my friends, would be a real bummer. However, if you had evaluated that research closely you may have been aware of the problem. From where I sit, I don’t think many folks have made that effort. And I remain unconvinced that the research supports the conclusion that fitness trackers–when used in typical real-life situations–don’t make a difference in keeping us engaged in our health including as an adjunct in weight loss programs.… Continue reading →

Twenty Years Later, And We Still Don’t Routinely Offer BRCA Test To Women At High Risk For Breast Cancer

A report in this week’s Journal of the American Medical Association (JAMA) shows that too few women with recently diagnosed breast cancer and at high risk of a BRCA genetic mutation received appropriate genetic counseling and testing for the mutation—a missed opportunity not only to improve treatment for these patients, but also to prevent some breast, ovarian and other cancers in the first place.

This study makes the difficult point that when it comes to routine screening for genetic abnormalities in women (and men, for that matter) who may be at increased risk, we simply aren’t doing the job. The situation may well be worse than this report suggests, especially considering that in some areas of the country Medicare doesn’t even cover preventive testing for the BRCA mutation. And this is more than 20 years after the test was first discovered and placed into clinical practice.

I guess sometimes it takes a long time for the way we care for our patients to catch up with the science that we know works. But twenty years??? Uh, that seems like a long, long time.… Continue reading →

We Are Beginning To Realize The Promise Of Cell Free DNA In Cancer Care

Right now, when we want to know everything we can about a tumor, we do surgery: a biopsy to take a sample of it and look at it under a microscope and determine as best we can how to treat it. But what if instead you could get a blood test, and learn even more. That’s the promise of the relatively new science of what is called cell free DNA (cfDNA). It holds the hope of helping us better understand cancer, its behavior in our bodies over time, and even offering clues on how to better treat cancer in ways we would never have imagined even a few short years ago.

It was an important area of discussion at the American Society of Clinical Oncology meeting this week. It’s a meeting where, every year, we get a sense of the future of cancer treatment before it becomes a reality. From genomics, to immunotherapy, to targeted therapies–you name it—promising areas appear on the scene, then either become part of our reality or lose luster as the process unfolds over the course of several ASCO annual meetings. This year, several studies presented on the topic of the so-called “liquid biopsy” illustrate how … Continue reading →