Early detection

What Can We Do To Lessen Financial Hardship As A Side Effect Of Cancer Care?

A cancer diagnosis can create almost unfathomable change to a person’s life. It can literally threaten our very being. And somehow, we live in a world in which we let this random, tragic occurrence exact profound cost in financial stability, only adding to the distress.

That is the message of a research report published by my colleagues at the American Cancer Society on the topic of financial hardship and sacrifice associated with cancer care in the United States.… Continue reading →

The American Cancer Society’s 2020 Cancer Statistics Report: Remarkable Progress And Opportunities To Do Even Better

The American Cancer Society’s annual report on cancer statistics has been published, and it brings with it more “good news” about the progress against cancer. However, there are also some notable areas of concern that should lead us to reinforce our focus on what we need to do to continue to reduce the burden and suffering from cancer in the United States—and make even more progress.

The good news is that the decline in the rate of deaths from cancer continues to improve: from 1991 (when the cancer death rate in this country was at its peak) until 2017 (the most recent year for which data is available) there was a decline of 29% in the cancer death rate. That translates into 2.9 million fewer deaths from cancer than would have been expected had the rate of cancer deaths not changed from 1991.

And while all most other non-cancer related causes of deaths were increasing or remaining stable, the rate of deaths from cancer declined by a remarkable 2.2% from 2016 to 2017, continuing a long string of declines over many years. This was in fact the largest single-year drop in cancer mortality since rates began falling in the early … Continue reading →

`No progress in cancer care? Really?

`No progress in cancer care? Really?

That’s the question I am struggling with following an interview I did with a radio network last week, and which will likely be released a couple of weeks from now. I was asked to respond to the premise offered by a book author who is a well-known professor at a major academic medical center, exclaiming that our treatment for cancer is based on “Slash, burn and poison” and that our cancer research efforts are currently substantially misdirected.

Instead, the professor says, we should admit that we have not made meaningful progress in treating cancer, and that our research is too directed to the end of the cancer cycle (namely a couple of months improvement in life expectancy for those with cancer) and in fact should be focused on the “first cell.”

It’s a refrain I have heard before, as early as my beginning engagement in treating patients with cancer in the 1970s. “Slash, burn and poison”—or similar words—were legion at that time. Surgery, radiation and chemotherapy were toxic, had substantial side effects, often ineffective and not offering much hope beyond a small number of cancers such as Hodgkin Disease which was showing excellent responses … Continue reading →

Cancer And The “Cure”

Words have meaning. And when it comes to cancer, especially advanced cancer, there aren’t many words that have more meaning than the word “cure.” Yet it is that very word and concept that is top of mind for some of us these days.

We clinicians are guilty as charged when it comes to reluctance declaring those who have had a remarkable response to treatments for advanced cancer “cured.” Experience has taught us over decades that we have misused the word and overpromised those we cared for. Our patients and loved ones have paid a price for our over optimism. Consequently, our culture has taught us to avoid the word, lest we be shown to have been less-than-truthful when a cancer returns with a vengeance.

And yet our world is changing: we are now seeing long term responses to treatments in diseases where until recently we had little hope of such success.

Recent reports of rapidly declining mortality in melanoma, normal life spans for many people treated for previously fatal diseases like chronic myelogenous leukemia, and the potential for impressive gains in outcomes for people with lung cancer are but a few examples that suggest we are indeed in … Continue reading →

What Will It Take To Shake The Tree And Save More Lives From Lung Cancer: A Report From ASCO 2019

Every year, the annual meeting of the American Society of Clinical Oncology is unmatched in bringing forward the latest advances in cancer care. It is a time to learn about important—and usually– incremental advances in cancer research and cancer care, and every year has some of us, especially those of us with some years under our belts, thinking about big picture themes in cancer: where we’ve been, where we are, and where we’re going.

For me, today’s theme is lung cancer and the sad fact that our care for those at high risk and those  diagnosed with the disease is far from what it should be. But more than I ever, I am convinced the future holds hope.… Continue reading →

The Remarkable Story No One Is Talking About: The Substantial Decline In Deaths From Advanced Melanoma

Here is some news about cancer that isn’t widely known and is hiding in plain sight: Deaths from melanoma—a skin cancer that has lethal potential—have declined dramatically over the past several years. And while that fact alone is surprising, so is the reason behind the drop.

Let’s make something clear at the outset: too many people die from melanoma. It is not the most common skin cancer (the American Cancer Society estimates 96,480 people in the United States will be diagnosed with melanoma in 2019, and 7,230 will die from it), but it is much more likely to spread and lead to death than most other much more common forms of skin cancer. And it has too frequently been a fatal disease.

That is now beginning to change, thanks in part to public awareness and earlier diagnosis. However, we can’t ignore what may be the most important factor: much better treatments. In fact, improvement in treatments with targeted drugs and immunotherapies have now begun to have a considerable impact saving lives for those with advanced melanoma.… Continue reading →

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 →

Alex Trebek Is Diagnosed With Advanced Pancreatic Cancer–And We Are Reminded Of The Strength And Dignity Those With Cancer Offer To Others, Every Day

The news that Alex Trebek has advanced stage IV pancreatic cancer has been met with an outpouring of support and good wishes, as would be expected for someone who has been a part of our lives for so many years.

The fact is, pancreatic cancer is a difficult disease to treat effectively. That is due in no small part to the fact that—as the case with Mr. Trebek–pancreatic cancer is usually diagnosed at a later stage, remaining undetected until it causes difficulties and symptoms by its spread. The reality is that for most people pancreatic cancer is too advanced to be treated with surgery and is not very responsive to currently available chemotherapy and targeted therapy medications. And newer forms of treatment such as immunotherapy and CAR-T haven’t shown particular success at this point.… 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 →