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 →
In Praise of Hope
Reading the headlines in the morning newspaper lately can downright depressing. After all, this is supposed to be a holiday season, a time of celebration—not one of a continuing cacophony of conflict at every level.
It was with that feeling that I recalled three conversations I had recently with people who have various cancers. And I realized that despite all the chaos around us, maybe it’s time to say something in praise of hope.
Hope is very real, especially when you or a loved one or someone you know is diagnosed and treated for cancer. Hope is that to which we cling to get us through the difficult days and weeks. Hope is what keeps us looking forward, hope is what we pray for.
We know hope itself cannot change the physical world. It can’t create success. If it could, no patient would ever succumb to this dread disease. However, for the three folks I spoke to, there are very real reasons to be hopeful.… Continue reading →
Lung cancer treatment is clearly the story of the week coming out of the annual meeting of the American Association for Cancer Research in Chicago. And although media coverage of this emerging information about the role of immunotherapy in lung cancer has been extensive, there is—as always—more to the story, especially if you look closely at the numbers and in particular if you are a non-smoker with lung cancer.
One study stands out among the others in which immunotherapy along with chemotherapy significantly improved survival for patients with certain forms of lung cancer when compared to chemotherapy alone. Not only was that study reported at the Chicago meeting, it was also published simultaneously in the prestigious New England Journal of Medicine, offering us considerable detail into how the study was performed and the results.… 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 →
Are you a baby boomer? Have you been tested for hepatitis C virus (HCV)? Do you know why you should be tested for hepatitis C? Do you even know what hepatitis C is?
According to research published today by my colleagues from the American Cancer Society in the American Journal of Preventive Medicine, the odds are overwhelming that if you are in the boomer generation you have not been tested for the virus, and that has me wondering why that is the case. Could it be that we don’t know about hepatitis C? Could it be that our health professionals aren’t recommending testing? Could it be that the costs of treatment may be seen as a barrier to care?
Why is this important? Because if you do have hepatitis C you are at risk of dying from liver cancer and other diseases. The kicker: the deadly results of hepatitis C can be prevented with an effective, albeit expensive treatment. Deaths from liver cancer in the United States are increasing more rapidly than any other type of cancer, according to a recent report. And even when localized at diagnosis, liver cancer is most often fatal.
It doesn’t necessarily have … Continue reading →
It’s not often you are asked publicly to comment on a particular investment by an entrepreneur as well-known as Mark Cuban. And although I don’t usually offer such advice, this one piqued my interest—more so because of a larger story than the particular company itself.
Mr. Cuban wrote that he is “really excited about changing the economics and results of healthcare with this one.” I don’t doubt his sincerity, however may I suggest there are some much bigger problems that need to be addressed to meet that noble transformative and audacious goal?
The company in question is called LungDirect. They offer a program that gathers information on CT scans performed for the early detection of lung cancer, analyzes the data and facilitates reports required by the Centers for Medicare and Medicaid Services (CMS) for payment under the Medicare program (more about that below). In short, it’s a sophisticated approach to what we call a “medical registry.”
I can’t comment here nor do I know whether their tool is any better or any worse than other similar programs. What I do know is that although registry reporting can be complex, creating technology that assists in tracking patients, collating, … Continue reading →
4.9 million—yes, million— people are diagnosed with skin cancer every year in the United States. It costs an estimated $8.1 billion—with a “B— to treat those skin cancers, according to the Centers for Disease Control (CDC).
Do I have your attention? I hope so. The problem is we don’t have enough attention. There is no other way to explain why too many states still allow those under 18 to access tanning beds across this country.
Have we made progress? Yes, but not nearly enough according to a research paper and editorial published today in JAMA Dermatology.
The study, from the CDC, looked at surveys of high school students done every two years between 2009 and 2015. The researchers found that overall the frequency of tanning bed use in the previous year declined from 15.6% of all high school students in 2009 to 7.3% of all students in 2015.
That’s progress. However, when they took a closer look at different groups of students they found that among non-Hispanic white female students the numbers using a tanning bed the previous year dropped from 37.4% to 15.2%.
Sound good? Maybe—until you look at the percentages for those 17 and older: in … Continue reading →
In 2011 with much fanfare the National Cancer Institute announced that lung cancer screening decreased deaths from lung cancer by 20%. In 2013, the American Cancer Society (among other organizations) published well-thought-out guidelines recommending high quality screening along with shared decision making so eligible patients could understand the risks and benefits of screening. In 2015 the Medicare program announced that lung cancer screening would be covered, along with the shared decision component.
With all of that evidence and support, one would think that lung cancer screening would see rapid uptake in the United States in an effort to reduce deaths from this all-too-frequent cause of cancer death.
If you thought that, you would be wrong. So the logical question is why? In the face of all this evidence, why are high risk current and smokers not being screened, and how do we make it right?
That question is the result of a spate of recent articles (links 1,2,3) in journals from the American Medical Association, along with a somewhat “direct” editorial that highlights the need to better understand how lung cancer screening works and the need to inform health professionals and their … Continue reading →
Is the future of cancer screening at your local shopping mall?
That’s the question sticking in my mind after reading a recent report about a local radiology practice opening a large mammography center in an upscale shopping mall in Long Island, New York.
Let’s face it: Medical care is changing. And with changes come new ideas. Some will work, some won’t. The thought of getting a mammogram while on a shopping trip may just be what the doctor ordered and the consumer needs, or it may not. I don’t know the answer, and only time will tell.
I grew up in a world—which is now fading away—where patients and doctors had relationships. You had your doctor, and your doctor knew the other doctors who would be best for your care, and that primary doctor followed you and cared for you for years. As you aged, someone knew you well—maybe even became a family friend or someone you interacted with in your community.
Today we have mega hospitals, mega practices, and failing long term primary care relationships in many parts of the country. Having those relationships was once thought to be a key to successful health strategies. Now we are handing … Continue reading →