As I write this, I am returning from a trip to Los Angeles where I participated yesterday in a panel discussion on the topic of cancer prevention and early detection. The occasion was the 2012 Global Conference sponsored by the Milken Institute. (If you are not familiar with this conference, it is probably one of the premier finance and investing conferences in the country, if not the world. And the luminaries in attendance--both as attendees and speakers--were a testament to the influence of the Institute and its founder, Michael Milken.)

I was on this panel through an invitation from the Melanoma Research Alliance and its chief executive, Wendy Selig, a former colleague of mine when she was at the American Cancer Society Cancer Action Network.  Other participants included Dr. Stephen Gruber, who is the recently appointed director for the USC Norris Comprehensive Cancer Center in Los Angeles, Dr. Sancy Leachman who is the director of melanoma and cutaneous oncology at the Huntsman Cancer Institute in Salt Lake City, and Sherry Lansing who is the CEO of a foundation of the same name and a well-known cancer research advocate (she is very well known in the entertainment industry as the former head of Paramount Pictures and one of the people who conceived of Stand Up To Cancer which has done much to transform the landscape of cancer research in this country).

What made this event more interesting was that the audience was made up of those same financial and investing folks I mentioned above. As you might imagine, almost all the sessions were devoted to topics very relevant to their professional interests. The topic of the session I participated in was a bit off the usual target of the meeting. This session was not about investing--it was about health. I must admit that I was surprised at the number of attendees who joined us for our discussion, and even more pleasantly surprised that they remained engaged throughout our 90 minutes.

In what would have otherwise been a fairly typical recitation of facts about how cancer prevention and early detection can reduce the burden and suffering from cancer, a theme emerged: we as professionals are not doing our best in clarifying our advice about the prevention and early detection of cancer through cancer screening.

When you are sitting in a room with some very intelligent people realizing that our lack of clarity and conflicting recommendations on advising people what they need to do about their health, you begin to understand that we are facing a dilemma that could have a significant impact on how successful we are going to be in getting people to take action to reduce the risk of cancer or finding it early. 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...

To screen or not to screen for prostate cancer, that is the question. Or is it?

A report from the venerable United States Preventive Services Task Force (USPSTF) made it to the media yesterday--a bit ahead of schedule--and it not only says we aren't certain whether a man should get a PSA test to find prostate cancer early, it came flat out and said, effectively, "Don't do it!"

Now that is a recommendation that is going to create a good deal of discussion, I would think. 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...

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...

I bet there was a huge collective sigh of relief about the land among men with prostate cancer, their families, their physicians and especially the company involved when the Centers for Medicare and Medicaid Services (CMS)-which runs the Medicare program-announced their decision this afternoon to cover the new cancer immunotherapy treatment for advanced prostate cancer, called Provenge®, under Medicare.

The stakes are huge: I suspect the market (and cost to Medicare) will run into potentially billions of dollars, yet the benefits for all of that money at first glance seem to be modest.

Ordinarily, the outcome in favor of approval would have been as close to certain as possible. 

After all, this new treatment for prostate cancer did increase the survival of men with asymptomatic advanced prostate cancer that no longer responds to hormone treatment.  But the treatment doesn't prevent progression of the disease, there isn't much data to show that men live a better quality of life after receiving Provenge®, and then there is the key statistic: it will cost $93,000 for each treatment-without including the associated costs for doctor visits and everything else that comes along with cancer treatments.

So the specter of the government saying "No more!" to expensive drugs with "limited" benefits has passed for the moment, but I promise the debate is just getting started.  Consider this the preliminary round in a heavyweight match-up between Uncle Sam and the pharmaceutical companies that charge lots of money for their new treatments. More...

Oh, vitamin D, where have ye gone?  We miss ya!!

That might be the refrain of many who have labored so long to promote awareness of vitamin D as a possible cancer prevention agent for the past number of years. 

Not that the advocates have lost their faith-a recent article from Dr. Cedric Garland, who is an expert on vitamin D as a case in point-but a report from the Institute of Medicine (IOM) has thrown a bit of a damper on the unbridled enthusiasm that vitamin D was the answer to cancer prevention that many have been seeking for some time.

No, the IOM did not endorse vitamin D as a cancer prevention agent.  And based on what they could say from the literature, the panel did endorse the concept that vitamin D is important for bone health, while blood tests that reportedly showed substantial deficiencies throughout the United States were in fact not being appropriately interpreted.

Now, in a "Perspective" piece in this week's New England Journal of Medicine, three of the IOM panel members share their thoughts with the public as to why the panel did not reach the conclusion that vitamin D decreases cancer risk.  And, while they support that conclusion, they also don't lose sight of the possibility that there may just be some truth behind the claims-bit it hasn't been proven just yet. More...

An article just released by the Centers for Disease Control and Prevention in their weekly publication "Morbidity and Mortality Weekly Report" provides an assessment of the progress we have made in the diagnosis and treatment of cancer.

Clearly, since 1971, we have made substantial advances in the cancer treatment.  We have become a larger and older nation.  We have pushed the threshold for the diagnosis of cancer, with breast and prostate cancers as leading examples.

The result is that we have many millions more people alive with cancer today than was ever the case in our history.

But with the progress also comes cautions about what the data means, and where our journey must go if we are to address some of the key issues reflected in these statistics. More...

An article published this week in the medical journal Cancer Epidemiology, Biomarkers and Prevention and written by my colleagues at the American Cancer Society sends me a message that we can run but we can't hide. 

The topic of the research is the relationship between whether or not a man has adequate (or any) health insurance and how far advanced and aggressive his prostate cancer is at the time of diagnosis. 

The message we seem to be running from is that we continue to bury our heads in the sand at the sad truth that people without adequate health insurance are somehow less worthy of having some decent level of medical care that might save their lives, especially when viewed through the cancer lense.

More...