1)The son in law came in at 1:35, #11 in his class.

2) The wife came in at around 2:35, but she did finish after walking a portion of the 5k run at the end.  And just finishing was a terrific accomplishment in our eyes.

3) The 19 yo daughter finished around 2:25, running strong at the end. She won 3rd place in her group.  There were only 3 entrants.

4) The real hero was in the 15 yo son. He is in good shape and was doing well until the final run when he developed terrible leg cramps. He had to walk the entire 5k, part of it "straight legged" and the last 1/2 mile limping severely. He made it across the finish line--unassisted--at 2:56, which was 4 minutes before he would have been disqualified. He got a second place award, since there were only two entrants in his age class. He showed incredbile determination.  We are very proud of him.

A lot of experts write and talk about getting more exercise and making the commitment to a healthier lifestyle.  I am one of those folks who think staying active is important, especially as we get older.

But there are many out there who just can't seem to get it done.  One excuse or another, whether it is time, work, travel or other obligations-whatever, we just can't seem to get where we need to be when it comes to our health.

So forgive me while I take a personal moment to share with you my pride and admiration of someone very close to me who has made that commitment for the sake of her health and well-being to do something special, something they never dreamed they would be able to do.

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It's off to the North Georgia mountains to spend some time celebrating family, friends and birthdays (July was a prolific month in our family).  Will be back August 2.

In the meantime, be well and be safe. 

Dr. Len

 Yes, this is me doing what I love to do: barbecuing (my friends picked this picture as one of their favorites).  Maybe we'll throw in a little fishing also.

In early June I appeared on a nationwide news show and in a very brief comment indicated that I thought a new approach to radiation therapy in the treatment of primary breast cancer was "not ready for prime time."  Subsequently, later in the month, I wrote a blog on the treatment-called TARGIT-where I further outlined my concerns.  My primary issue-among some other more technical matters--were that the results of the trial were being promoted to suggest that the treatment was "ready" for moving into clinical use.  I wasn't so certain.

During this period of time, I was contacted by someone affiliated with the company that manufacturers the machine used to deliver the radiation, and offered an opportunity to have a discussion with some of the researchers involved in the clinical trials of TARGIT.  We accepted their offer.

Last week we had our follow-up call, and I think now is a good time to offer some information regarding that discussion.

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Sometimes you just can't get a break...

That's the way I feel after reading an article my colleagues from the American Cancer Society and other experts wrote in today's edition of the American Journal of Epidemiology.  The topic? The relationship between the time you spend sitting during the day and your chances of premature death.

The bottom line? If you sit all day, you are in real trouble even if you exercise regularly.  For those of us who try to exercise regularly, it's possibly one of the most discouraging reports I have read in a long time.

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The news this afternoon that an FDA advisory panel recommended removing approval for bevacizumab (Avastin®) as a treatment for advanced breast cancer is certainly going to be difficult for patients, their families, supporters and doctors alike.

The unfortunate reality is that despite earlier reports that this targeted therapy (which has been successful in treating a number of other cancers and works by inhibiting the growth of new blood vessels that feed cancer tumors) was successful in treating advanced breast cancer didn't hold up when studied in further clinical trials.

Bevacizumab in the treatment of breast cancer has followed a long, somewhat tortuous course beginning as early as 2005 with an announcement by the National Cancer Institute that the drug was successful in a clinical trial where women with advanced breast cancer were treated with the drug.

Following that announcement, it took an additional almost 3 years until the FDA approved bevacizumab as a treatment for breast cancer.  However, that approval was not a "slam dunk", after another FDA advisory panel had recommended against approval on a close vote.  The FDA overrode the panel's recommendation, and gave the drug a conditional approval while further clinical trials were underway.

It was the results of those clinical trials that were presented to the FDA's cancer drug advisory panel today, resulting in an overwhelming (12-1) vote to remove approval of bevacizumab as an effective treatment for advanced breast cancer.

The trials in question used standard chemotherapy with or without bevacizumab, and looked to see how long the treatment(s) delayed the progression of breast cancer (what we call "progression free survival", or PFS) as well as how long the women lived after they received their treatment ("overall survival" or OS).

The reports from a couple of years ago showed the addition of bevacizumab almost doubled progression free survival from 5.8 months to 11.3 months.  However, the data at that time did not show that bevacizumab increased survival, which up to this point in time has been the "gold standard" for approving almost all cancer treatment drugs.  That is one of the reasons the FDA asked for more information.

For some of us, the core question at that time was whether or not women had a better quality of life during that period of extended progression free survival, even if the drug did not increase the length of their days.  The thinking was that even if total survival wasn't improved, at least if they had better function and less pain, it would still be worthy to consider the drug effective.  Unfortunately, the studies were not designed to give an answer to that question.

Now come the two new studies, and the news wasn't particularly impressive that bevacizumab made a real difference in the treatment of the women in the trials.

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How do you know if you or a loved one are getting quality cancer care? 

That's an interesting question, although it isn't a new one.  I have been asked that question on a number of occasions and in several media interviews, and quite frankly it's difficult to answer.  In no small part because like many other things we do in medicine, true quality is difficult to measure with any certainty.

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I am on one of those journeys today that no one wants to take, but in your heart you know you have to take.  It is a journey of remembrance for someone who is no longer with us, who succumbed at a too young age from cancer.  It is journey for someone who touched me and many others through is smile, his friendship and his commitments.

I can't say that I knew Joe and his beautiful wife for many years.  In fact, our relationship was too short, a couple of years in duration.  It began as many of mine do, during a luncheon meeting in a southwest Florida city where I had the opportunity to meet with a number of like-minded people to share with them news about the American Cancer Society and the research we support to reduce the burden and suffering from cancer.

What came through so clearly during my brief introduction to Joe and his wife was that here were two very special people, a couple committed to each other, a couple committed to life, and a couple committed to doing good, to doing for others as a way of saying thanks for the blessings of their lives.

There were a couple of more similar meetings, much along the same line.  And then one day the phone call, "Joe has cancer."  Without going into details, the cancer was a rare one and localized at the time of diagnosis.  Joe was fortunate to be treated at a highly regarded medical center, with excellent surgeons and oncologists.  Always the optimist, Joe looked forward to many years of life and health.

Our discussions were brief, and his doctors outlined a course of treatment.  Joe and his wife went on living and helping, and I suspect praying as well.

Unfortunately, it wasn't to be long afterwards when another call came: the cancer had spread.  More discussions, more decisions.

As you have probably determined, Joe's journey was not a successful one.  Surrounded by his family, he passed away several weeks ago.  His memorial service is scheduled today at a location in south Florida that was near and dear to him.  The invitation says it is a celebration of his life, but I know that while there will be happiness in his memories, there will be sadness in many hearts.

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"You have cancer" are words that no one wants to hear. Yet, in the United States

in 2010, the American Cancer Society estimates that about 1.5 million people will hear those words, and the impact on their lives and their families will be immense.

If there is good news, it's that there is a probability that 2 out of 3 people diagnosed with cancer in this country will survive their ordeal. The sad news, based on an article published online this week in the Journal of Clinical Oncology, is that too many of these folks will start their journey hearing those fateful words in a less than appropriate manner in a less than appropriate setting.

To me, that is not only dismaying, it's appalling. And if we physicians can't understand, empathize and even sympathize with our patients when we tell them their life is at risk, then we are in serious trouble as a profession.

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Every year the American Cancer Society provides a report that is one of the most widely quoted scientific articles in this country.  This year's "Cancer Statistics, 2010" report was released this morning, and provides a considerable amount of information regarding the burden of cancer in the United States, such as the expected number of new cancer cases and number of cancer deaths in the United States in 2010.

As part of the same report, my colleagues at the American Cancer Society also dissect the numbers and provide insight into the trends in cancer incidence and deaths, what is happening and perhaps why it is happening.  Statistics--no matter how good you are at writing reports--are always somewhat droll and boring.  But there are the occasional pearls that leap out at you from time to time, especially if you are interested in this particular subject (which obviously, I am).

Some good news is that--as we have seen in recent years--the death rates from cancer in this country continue their steady decline since the early 1990's.  For men of all races, death rates from cancer have fallen 21% between 1990 and 2006, the latest year for which accurate information is available.  Most of that decline can be explained by decreases in deaths from lung, prostate and colorectal cancer which account for 80% of the observed fall in cancer deaths in men.  For women, the data show a 12.3% decrease in cancer death rates over the similar period of time with most of the decrease coming from falling breast and colorectal cancer death rates.  For women, unfortunately--as has been the case for the past several years--lung cancer deaths have remained steady.

These changes from the early 1990's through 2006 have occurred slowly, year over year over year.  But when looked at in total, you begin to understand the impact of this accumulated progress. My colleagues estimate that over this period of time, 767,000 deaths from cancer have been avoided.

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