It's Groundhog Day, and that means millions of people will focus their attention on a furry little creature in Punxsutawney PA to see whether or not the animal sees its shadow. Breaking news bulletins say that he did, so we have six more weeks of winter to look forward to.

I--on the other hand--think there is a greater significance to Groundhog Day. It is the day when I check on my own shadow, and determine whether or not I have kept my commitment to keeping my weight steady during the past year, which has proven to be a difficult accomplishment. The answer this year is mostly yes, partly no.

A brief history:

A couple of years ago I took a look at my weight charts for the past decade (yes, Virginia, there are some of us who do that). What I saw disturbed me: for the three previous years, my weight would go down in January and February when I would rigorously diet, only to rise over the remaining months of the year. And, on top of that, when I looked back I saw that both the peaks and valleys were becoming higher and higher, so that each year my weight at the bottom of the trough was higher, and so was the peak in December. And that, my friends, would not suggest a healthy outcome.

So I dubbed this observation my "Groundhog Day Diet," based on the Bill Murray film of the same name. You may remember the picture: Murray relives Groundhog Day every day until he gets it right. Much like Mr. Murray, I decided that I would get it right by not going through the same cycle year after year.

Finally, this year I met with some success: I did gain some weight, but the peak was lower. And the numbers on the scale were steadier over the course of the year. I partly accomplished my goal. Where I missed was that I still weigh too much, just like lots of you. And, as any good doctor would tell you, over time weight takes its toll on things like our joints, our blood pressure, our cholesterol, you name it. 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...

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...

This week I decided to read a section in the newspaper I don't ordinarily have time for and came across an article that described all the wonderful technology and social media that is being applied to the science of getting people to, into, and out of the shopping mall parking lot-especially during this season of holiday joy.

There appear to be several premises driving parking lot technology. Among them: 1) get them to the parking lot. If the lot is too full, maybe having them come later might be customer-friendly. You know, build mall parking lot loyalty and all that stuff through serving the customer (remember that thought). 2) Once they get to the lot, get them to the closest parking spot which is what everyone wants. (Except me. I like to park far away and tote up the steps on my pedometer. My wife is not a fan of that strategy.) 3) Provide them valet services that work, including having the car ready and waiting for you when you set back to the front door laden with packages by using beepers that can signal the valet you are on your way.

There are other aspects of this wondrous technology, including special lights that show you where there was an available place just for you, social media apps that transmit this information to your smart phone, big signs that tell you the same thing so you don't have to be distracted from driving looking at your smart phone while you are trying to find a parking spot.

As I said, fascinating stuff. But what could this possibly have to do with health care? More...

It isn't much of a road, really. A single lane gravel covered path through the National Forest near our home in North Georgia. It isn't a grand road, like an interstate where cars go about their business at 70 MPH or more, or large trucks haul their goods from coast to coast. It isn't a grand boulevard, like Park Avenue in New York or Michigan Avenue in Chicago.

No, it's just a country road. But for me, it's a beautiful road. It's a place to take a long walk pretty much undisturbed, especially on a Thanksgiving Day like today. It's a road through hardwoods that have lost most of their leaves, which make a beautiful reddish brown canopy on the forest floor, awaiting the inevitable decay that comes with winter. The pine trees and the holly bushes stand their green guard, awaiting the spring when the oaks, mountain laurel and rhododendron will make their reappearance to joys of many.

This morning was an especially pretty time to take a walk along the road. It was cold (32 degrees), the sky was covered in mist, with puffs of smoke rising from the river that runs along much of my path. As the sun rose, the mist gave way to cloudless blue skies, with the sound of the overnight frost dripping water onto the leaves of the trees below. And the river made its gurgling sound, occasionally punctuated by the report of a hunter's rifle.

What is so special about this road on this particular day? More...

The announcement today from Canada that women should severely curtail their use of screening mammograms for the early detection of breast cancer and discontinue regular clinical examinations and self-breast examinations was interesting in and of its own. But the editorial that accompanied that announcement-from a long-time avowed skeptic of the benefits of screening mammograms-took the debate to a new level. Whether that level was higher or lower is a matter of personal interpretation, but in the editorial was the statement that abandoning breast cancer screening is the most effective way we have to reduce the risks of breast cancer. The statement, highlighted in an accompanying press release (http://www.eurekalert.org/pub_releases/2011-11/cmaj-nbc111611.php) was, in short a stunner.

What is even more amazing is that there hasn't been much reaction to that statement. And keep in mind that just two days earlier, the medical journal The Lancet published a letter from an international  group of experts in breast cancer screening who raised the issue of an organized anti-mammography campaign orchestrated in part by the head of the Nordic Cochrane Centre, headed by none other than the physician who wrote the editorial. But from where I sit-a place that is usually the epicenter of these discussions-there has in fact been very little reaction. No media, no frantic calls, no running to man the barricades. Essentially, nothing.

I find that hard to understand for a story with this degree of impact. Maybe we are all just worn out from the screening debates, after several years of indecision about the benefits of mammograms, the frequency of pap tests, and the big debate recently about whether or not prostate cancer screening really saves lives.

For me and others I know, there is increasing concern that the value of screening for the prevention and early detection of cancer will get lost in the morass of conflicting comments, and that we might be at risk of turning off the public to the benefits of screening for cancer, and perhaps lives will be lost in the process. And that would be shameful. 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...

As you know, my posts to the blog have been missing in action for the past several weeks. Nothing bad or wrong, mind you. Just lots of travel, lots of meetings, lectures and getting to know some very wonderful people across the country.

So I am sitting here on a Sunday afternoon, trying to catch up on emails while attending yet another meeting (yes, on a Sunday. Maybe it's time to get a life). And I came across the message below about our Hope Lodge in Manhattan which celebrated its fourth anniversary this past week. And when you think about it, it is a very special story: 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...