Lessons in life rarely come at us with lights flashing and horns blaring. Such was the situation recently when I was attending a luncheon in Portland OR for some of our Strides Against Breast Cancer volunteers.

He was not a flashy gentleman. Most of the attendees were young women, and the conversation was very animated. He was more reserved. Older, gray hair with a worn baseball cap, jeans and a work shirt. A bit taciturn but  pleasant, and he had made a special effort to be there. Clearly he was in some personal discomfort and I realized that he needed to talk.

Without going into all of the details, his wife had died from breast cancer. Obviously, they had been partners for life and her loss was painful. In a sense, he appeared to have dealt with that as well as one can "deal" after the loss of someone sorely loved. As I have said for many years, the sad reality is that when we love we always know that sometime in that love there will be intense loss, and that the loss is never the end of the journey.

We talked a bit and the messages arrived. There were lessons he wanted me to hear, and they weren't entirely positive. More...

One of the things I enjoy about what I get to do every day--besides working for a wonderful organization, committed volunteers and very special colleagues--is that I am able to get a broad overview of the world of cancer research, diagnosis and treatment, among other topics. Over time, one gets to incorporate that input into a larger vision of where we have been, where we are and where we are headed.

Sometimes that "larger vision" is challenged with new information that makes you think a bit about whether you need to readjust your thinking about the state of cancer research and treatment. Recently I attended a meeting where just such a challenge occurred.

The meeting was convened by the Institute of Medicine, and brought together stakeholders to be informed and discuss the current status of genomics and drug discovery in cancer. To a more specific point, it provided insights from a variety of viewpoints on the current status of genomics as a science and how that science and knowledge will be translated to the care of patients, with the obvious goal of reducing the burden and suffering from cancer.

What I heard--while reinforcing some of my usually optimistic thoughts--actually was troubling. As we look to the future of that translation, it was clear (at least to some of the presenters) we are headed for some speed bumps. How we handle those speed bumps could define the progress we make in cancer treatment over the next decade or even longer. More...

Sometimes you have the opportunity to be educated, or to learn a bit more about a topic of importance. Yesterday was one of those opportunities.

Attending a meeting (as an observer) of the National Cancer Institute Director's Consumer Liaison Group on the issue of cancer drug shortages, there were some messages delivered that provided a bit more clarity surrounding a very complex problem. And there were messages delivered that had even me sit up and take notice, and frame the seriousness and depth of the problems that confront patients, their families and those who treat them. The observations were--to say the least--very unsettling. More...

Does it get much worse than this?

A story in the New York Times last week highlights the dwindling supply of the drug methotrexate, which is vital in the treatment of a form of childhood acute leukemia. The closure in November of a key manufacturing plant-without other readily available sources of the drug-means that children with a very treatable form of leukemia may go without a drug that can make a difference in their lives. And there are no immediately obvious solutions to the problem.

This is-unfortunately-only the latest chapter in a saga that has been unfolding over the past year. For a variety of reasons, the supplies of vital drugs necessary to treat cancer and other diseases have been in various periods of short supply, and we as a nation have been unable to find answers that make sense.

Maybe, just maybe, it's time to take the actions necessary to deal with the problem. Too many lives are at stake to expect otherwise. More...

Sometimes science is not as convenient as we would like it to be. We want answers, we want clarity, we want direction--especially when it comes to the treatment of patients with cancer.

So when I read two articles and an editorial released Wednesday in the New England Journal of Medicine, I was struck as to how studies seeking to answer similar questions could come to different conclusions. And, as I struggled to explain the research findings to reporters prior to their release to the general public, I found myself searching for words that would adequately explain the message of the research. Quite frankly, determining that message proved to be difficult. More...

Today the Commissioner of the Food and Drug Administration, Dr. Margaret Hamburg, announced that the FDA is withdrawing approval of Avastin® (bevacizumab) for the treatment of metastatic breast cancer.

This announcement culminates a highly watched process where the FDA determined that although it had granted accelerated approval for the use of this drug in treating breast cancer, subsequent studies did not demonstrate in any group of women that Avastin® actually helped patients in any meaningful way, while causing significant harms-including death.

In the accelerated approval process, the FDA permits a company to market a drug for a specific indication, usually in a life threatening disease, while allowing the company to perform additional trials to confirm the value of the drug. After those trials are done, under this form of approval, the FDA reserves the right to revoke that approval if the original promise of the drug is not confirmed. That is what has happened with Avastin® in breast cancer.

As difficult as this decision has been for the FDA, it is even more difficult for women (and their loved ones and their doctors) who believe that Avastin® has saved their lives. The Commissioner emphasized that she was acutely aware of that concern in making her determination, but she underlined the fact that when the science was carefully reviewed, there was no evidence of meaningful benefit of Avastin® in breast cancer treatment.

The full impact of this decision is difficult to determine at this time. More...

It's that time of year again.

Thanksgiving is just a week away (go turkey!!!), which means today is the American Cancer Society's annual Great American Smokeout (or GASO for short). In fact, 2011 is the 36th year for the Smokeout, which makes it a longstanding (and successful) tradition in our world.

What, you may ask, is GASO?

Well, GASO is a day to focus on the opportunity--if you are a smoker or know someone who is--to make a commitment to quit, or perhaps a day to choose as your "quit day" if you were alert enough to plan ahead. It is a day when you can take a step that could be one of the most important ones you can make, a pledge to do something which could be the single greatest thing you can do for your health, a day to reduce your risk of death from cancer and many other diseases related to smoking.

Quitting isn't easy. We all know that. Cigarettes and other forms of tobacco are among the most addicting substances we can take into our bodies. And the sad reality is that if you decide to smoke, the chances are about 1 in 2 that smoking will have a role in causing your death. And to make matters even worse, that death is likely to be premature.

In fact, every year in this country, 443,000 people die from tobacco related illnesses. More...

Today I would like to share with you some thoughts on the topic of the costs of cancer treatments. It is the result of a moment on Saturday morning while, in the midst of listening to hurricane coverage on television, I was scanning the pages of my morning paper. There in the headlines was the comment that the Food and Drug Administration on Friday-presumably a bit later in the day, since the article was posted online at 8PM-approved a new drug called crizotinib (Xalkori®) for the treatment of lung cancer.

The news didn't get much attention, likely because it was overwhelmed by the hurricane. But at any other time, I suspect it would have been all over the media since this drug in fact represents a breakthrough treatment for some patients with lung cancer (more on that later).

But as I read the rest of the story, I almost choked on my coffee when I saw the cost of the new treatment: $9600 a month for a medicine that consists of two pills a day. Now, to me in my world, that was news. Just off the top of my head, that seemed a pretty steep price for success. More...

(A letter to my newborn granddaughter)

Good morning, Rayna Analiese. Welcome to the world!

You are a teeny 8 pound 8 ounce bundle of beauty and joy who arrived yesterday afternoon at 1:32 PM CDT--100 years (almost to the very day) after one of your great grandmothers was born. 

Grandpa--who is normally not a big lover of babies--went gaga over you. "So cute! So cute!" is about all he could say as he snuggled you in his tall arms--afraid all the while that he might drop this football-size bundle of love.

You have lots of people who love you, and lots more who are going to love you--not to mention all the people who love you who haven't had a chance to meet you in person yet. You have aunts and uncles and great aunts and uncles and grandmothers and grandfathers and great grandmothers to boot--and don't forget your great-great grandmother who will squeeze you tight. You are going to have to get used to the large family feasts filled with all sorts of nasty food when you come home from time to time to parade your cute little bonnets around the many houses you will have to visit. Mom and Dad are certainly going to have fun on those trips.

But I wouldn't be me if I didn't think for a moment about what your new life means, so forgive me for a moment while I ponder the meaning you bring into our lives, especially for Grandma Sandra and Grandpa Len. More...

The votes are in, and the Food and Drug Administration's Advisory Committee said unanimously that the approval of Avastin (bevacizumab) for the treatment of metastatic breast cancer should be withdrawn.

The decision did not go down quietly, with women loudly voicing their disagreement, and one saying that this shouldn't be happening in the United States of America. I could not sit there and hear the cries without feeling their pain and anguish. More...