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 →
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 →
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 →
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 →
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 →
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 →
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 →
A recent research report on melanoma from the Centers for Disease Control and Prevention received virtually no notice, yet one of the statistics in that report was—at least for me—stunning, and marked a rare public health win.
People in public health know all too well the gap between educating people about cancer risks and seeing actual results. Skin cancer is no different: We have known for many years that the risk of skin cancer is related to exposure to UV radiation, either from the sun of for indoor tanning.
Yet despite widespread efforts to educate people about this very real cancer risk, we haven’t made much progress reducing its frequency—at least until now.… Continue reading →
Sometimes it all depends on your point of view when it comes to areas of divergent opinion about the value of certain medical tests and procedures.
So it should be no surprise that the release earlier this week of the United States Preventive Services Task Force draft statement of their new updated recommendations on the use of the PSA test to screen men for prostate cancer has generated some controversy of its own.
However, this time around it’s not just the advocates or the detractors aiming their fire at the Task Force—it’s journalists and bloggers battling over how media reports and headlines portrayed the impact and ultimate meaning of that draft report (I emphasize “draft” with more on that later). The report basically took the PSA test out of Task Force purgatory by changing the prior recommendation from “don’t do it at all” to a more permissive “have a discussion and make a decision if it’s right for you.”… Continue reading →
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 →