I have a confession to make:

As soon as I finished reading the Annual Report to the Nation yesterday as I was preparing to write my blog, I got up from my desk and took a walk for 20 minutes.

What, might you ask, compelled me to do this?

The answer is what made me take a walk is the same reason I am writing this follow-up commentary to yesterday's blog: Sitting at my desk all day may kill me. It may be doing the same for you. More...

The "Annual Report to the Nation on the Status of Cancer" was released this afternoon as has been the case every year since the first report was issued in 1998. And, like many of the reports previously, we are fortunate to continue to see declines in the rates of deaths for many cancers along with a decrease in the frequency of some cancers.

However, the news is not all good.

Unfortunately, the incidence of some cancers continues to increase. And, as explained very clearly in this excellent report, this nation continues to suffer from an epidemic of overweight, obesity and physical activity that the authors suggest-but don't actually say-has the potential to overcome the favorable impact of declining smoking and tobacco use on cancer incidence and deaths. The implication is clear that if we don't do something-and do something quickly-to reverse the trend we will see incidence and deaths from certain cancers continue to increase in the future.

And I would stress the point that it is no longer just being oversized that increases your risk of cancer, but also sitting all day on the job (like I am doing right now) as another factor that plays into your cancer risk, independent of how large or small you may be. More...

Welcome to the New Year!

And as has been the case for many years in the past, the American Cancer Society takes the New Year opportunity of providing the nation with the latest estimates of cancer incidence and deaths, along with a measure of how well we are doing in reducing the burden of cancer in the United States.

The data is contained in two reports released today by the Society: the consumer oriented Cancer Facts and Figures 2012 and the more scientifically directed Cancer Statistics 2012. Both are available online. 

It is never "good news" to realize that the burden of cancer in this country is immense. And with the country gaining in population and age, the extent of that burden is inevitably going to increase. But this year's report does contain some welcome information, namely that cancer death rates have declined in men and women of every racial/ethnic group over the past 10 years, with the sole (and unfortunate) exception of American Indians/Alaska Natives. In addition, the Society now estimates that a bit more than one million cancer deaths (1,024,400 to be exact) have been avoided since 1991-1992.

That one million number is actually more significant than it seems. Many of the people in that 1 million never heard the words "you have cancer." Maybe they had a colon polyp removed before it became cancerous, maybe they stopped-or never started-smoking. Maybe they had a pap smear that found a pre-cancerous lesion. And then there are the patients who have benefitted from the advances in cancer treatment that have occurred over the past number of decades.

But the 1 million number also means that these are people who have hopefully remained active and engaged in life, loved by their families, productive in their communities. In economic terms, the return on investment on avoiding those one million deaths may likely be incalculable. In human terms, it is an amazing accomplishment. 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...

"Poverty is a carcinogen."

Those were the words of Dr. Samuel Broder when he was director of the National Cancer Institute in 1989.  

As amply documented in the annual "Cancer Facts and Figures 2011" released today by the American Cancer Society, cancer shows that poverty remains one of the most potent a carcinogen-rivaling tobacco and obesity-as we have ever seen.

We have heard lots and lots about how cell phones and Styrofoam cause cancer.  But do you hear anyone talking about the huge impact of poverty and limited education on cancer?

If you don't hear anything about a true carcinogen that statistics show causes 37% of the deaths from cancer in people between the ages of 27 and 64, then maybe you have the answer to a very important question: If we are serious about reducing the burden and suffering from cancer, why aren't we paying attention to those most in need? More...

$10.28

That is a number I want you to think about.  And as you think about it, consider the implications for your health, your wallet and your state budget.

$10.28 is the amount of money it costs for the health and economic consequences of smoking a pack of cigarettes.  Yes, that's right: our economy and our health care gets dinged $10.28 for each pack that someone smokes, every day, 365 days a year, for however many years.  That's a lot of money.

Who pays that cost?

We all pay those costs in salaries and wages (the money that is lost in productivity, health insurance premiums, etc) that we would otherwise have for investment in business or improved wages for workers.  We all pay those costs in higher taxes it costs our state and federal governments to provide health care and other benefits for caring for those unfortunate folks who suffer from the debilitating effects of smoking.

More important than the money, however, is how much we "pay" in personal "costs" when someone we love or someone we know dies as a result of tobacco, a product that when used as intended will kill half of its users.

All of this and more is contained in a report issued this afternoon by the American Cancer Society's advocacy affiliate American Cancer Society Cancer Action Network (ACS CAN).More...

Good things-hopefully-come to those who wait.

That time-worn phrase may well apply to today's announcement by the Food and Drug Administration (FDA) that they have (finally) updated the regulations as to how sunscreens must be tested and labeled to provide consumers with accurate information as to what is actually inside the sunscreen package.

Why the patience piece?  Because we have been operating for decades in the United States without effective, modern oversight of claims made by some sunscreen manufacturers.  Hopefully today's announcement by the FDA is the beginning of the process to correct that problem.

Too many people believe that what the claims they read on the sunscreen label-with words such as "sun block", water resistant, SPFs approaching 100-are in some way regulated by someone when in fact they actually are not. Today's announcement should help clear some of that confusion.

And, lost in all the babble is the fact that sunscreen is just one part of an effective approach to engage in sunsafe behavior. More...

I am on the plane home from the 2011 American Society of Clinical Oncology annual meeting trying to figure out the best way to write a "wrap up" blog about my sense of what I learned and saw in Chicago over the past 4 days.

I wish I could tell you all the highlights of all the new studies and all of the exciting breakthroughs, but I can't.  Realistically is it impossible to attend all the sessions, read all of the thousands of abstracts and view the additional thousands of posters that are presented at this meeting.  There is so much information that trying to get one's arms around even a fraction of what is available is a monstrous effort.

I will leave it to others to write the headlines and the stories about what they think the latest and greatest research and/or treatment may be, and how it will impact the future of cancer care (they are frequently wrong).

For me, what is more important is the general sense of where we are today and where we are headed when it comes to reducing the burden and suffering from cancer.  Are we really making progress, or basically stalled at the status quo?

And then there where the lighter sides of the meeting, including redemption, blisterwalks, and whether I can ever become part of the social media scene if I keep forgetting my hashtags. More...

Each year, I come to the annual meeting of the American Society of Clinical Oncology (ASCO) not entirely certain what will be the blockbuster story.  Once I arrive, I start to hear the buzz about certain presentations that someone or other thinks will be really important.  But at the end of the meeting, I usually have the sense that--for better or worse--much of the buzz doesn't translate into really meaningful advances in the treatment of cancer.

But this year--for me at least--there is one presentation that has and will continue to have far reaching impact.  And that is the presentation this afternoon of two studies that confirm--at last--significant advances in the treatment of melanoma.

The two studies, which involve the use of a new drug called vemurafenib and another drug called ipilimumab (which was recently approved by the Food and Drug Administration for treating advanced melanoma and was the topic of one of my ASCO blogs last year), clearly show that we are at long last making progress in the treatment of advanced melanoma, which is a cancer that one of the experts here at the meeting said earlier today, was "the cancer that gives cancer a bad name."

For me, the results are stunning.  They are all the more so when you realize that the standard chemotherapy drug used today to treat advanced melanoma is the exact same one I used literally 40 years ago when I first began my training in medical oncology.

These new results, as the saying goes, are an overnight success that took 40 years to get here.  In all of that time--until this past year--there has been no chemotherapy drug which has meaningfully improved the survival of patients facing this tragic situation.  Until now. More...