February 25, 2011
Sometimes we have moments which may help us focus our thinking on an issue, or perhaps clarify our understanding of a problem. We can ponder large problems, but it is those experiences on a more "micro" basis that brings clarity to our thoughts.
A discussion I had this past week with a couple facing an insurance denial for cancer-related surgery was just such an experience.
I can't go into all the details, but the bottom line for me is that if we don't find some way to bring clarity and rationality to our health care non-system soon, many people are going to find themselves wondering what happened when they needed help the most. More...
February 10, 2011
I wasn't going to write this blog. But after listening to some of the reports on the news yesterday (while I was trying to stay healthy on my elliptical) I realized I had to say something, if for no other reason that to provide some context on an interesting and important piece of clinical research.
This week's Journal of the American Medical Association has a report indicating that many women no longer need to have the lymph nodes under their arm removed during breast cancer surgery-even if cancer is found in the single "sentinel lymph node" frequently removed as part of the surgical procedure.
This is one more piece of the puzzle that has been answered by clinical researchers and patients over decades, namely whether or not women diagnosed with breast cancer had to undergo radical disfiguring surgery to control their disease.
Now, this research shows that even less surgery is "more" when it comes to benefitting the patient.
The real question (which is the practical and important question) is whether doctors are going to listen to what the research tells them. My concern-unfortunately-is that there are those docs who are simply going to ignore this report, and continue to go on doing what they have already done. We want to believe that evidence guides medical practice, and in some places it does. But in far too many institutions in this country "What I think" outweighs "what they know." More...
February 04, 2011
As I write this, I am en route to New York to participate in the lighting of the Empire State Building tonight in honor and recognition of World Cancer Day.
Spearheaded by the Union for International Cancer Control (better known as UICC)--an international organization devoted to reducing the burden of cancer worldwide--and vigorously supported by the American Cancer Society and many other notable organizations, people, and governments worldwide, World Cancer Day is intended to highlight the growing number of cancer cases and deaths around the world and the need for us to pay serious attention to the problem and institute measures to reduce that burden.
As part of World Cancer Day, the American Cancer Society is releasing the second edition of Global Cancer Facts and Figures, a monograph that assembles in one place what we currently know about the worldwide burden of cancer. A special section in the booklet highlights the growing cancer burden in Africa, and what needs to be done to address what could well become an epidemic of cancer on that continent.
When you look at cancer globally, you begin to realize there are several parts to understanding and addressing the problem. And although the increasing number of cancer cases and deaths is universal, the solutions are local. More...
February 02, 2011
Today is February 2nd, and it's Groundhog Day.
For me, it is the first anniversary of my Groundhog Day diet, so it's a good time to reflect on whether or not I met my personal goal set last Groundhog Day not to repeat the diet mistakes of the past, and try to maintain my weight for a whole year.
Was I successful? Partly yes, and partly no. But the good news is I did better this year than I did in the past, so that's a start-as long as one has a long term view of life. More...
February 01, 2011
An article in today's edition of the Journal of the American Medical Association is bound to raise a vigorous discussion-both pro and con-regarding the side effects and usefulness of one of the first targeted therapies approved to treat cancer. Moreover, it is bound to add fuel to the firestorm that is developing over whether or not the drug bevacizumab-more commonly known as Avastin®--should or should not continue to be available in the United States for the treatment of advanced breast cancer.
Of particular interest to me are the comments of the expert who wrote the editorial which accompanied the report who directly calls out the question of whether bevacizumab adds value in cancer treatment while "exposing all treated patients, and society, to enormous costs and occasional life-threatening toxic effects. These unfortunate circumstances are sad for those who pay the bills-and sadder for patients with solid tumors."
The lines in the sand are drawn, the arguments will commence, and the outcome is uncertain.
What is undoubtedly clear is that 10 years ago, as we peered into the crystal ball of targeted therapies, enormous toxicities and questionable outcomes were not what we expected.More...