Dr. Len's Cancer Blog

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Dr. Len's Cancer Blog

The American Cancer Society

They Are YOUR Medical Records. Will The Blue Button Help You Get Them?

by Dr. Len June 07, 2013

 

It is a disarmingly simple idea: create a blue button logo with a download moniker on it and let it loose so people can actually download, review, and keep their own medical records. But simple on the surface masks complexity below a revolutionary concept: that patients are not only the subject of the records, but that they own those records, and through that ownership can actually be partners in their care or even improve their own health.

That was the topic of a meeting I attended yesterday at the White House, where representatives of government, health technology vendors, consumer groups, and others interested in advancing the role and usefulness of health information technology came together to give updates on the progress of the "Blue Button" program, review the current state of affairs, and pledge to advance the concept going forward. And I was honored to be invited to join this knowledgeable and committed group on behalf of the American Cancer Society.

When you think about it, patients with cancer and other serious illnesses should be clamoring for this to become the routine and not the exception. As I have written before, it is difficult enough to hear that you have cancer and are going to need complicated treatment. But that is just the beginning of what can be a very tortuous journey for patients and their caregivers through the cancer treatment maze. Complex diagnoses, loads of records, and no way to have the health information communicated easily from one place to another is just one more way that the quality of life of cancer patients is impacted by their illness.

Why do we tolerate this? I don't know, that's for sure. As patients we should be our own advocates. We should be expecting--no, demanding--a more transparent and efficient system of care. And getting our information in our hands is just one way to make that happen. The people in that room yesterday are committed to the concept that you own your medical information and should have access to it,, and that we are obligated to make to find a simple and straight forward way to get your medical information to you and to anyone you choose to share it with, whether that be a doctor, a family member, or a company or organization you want to help you organize and understand that information. More...

It's Guns vs. Butter (Again): How Do We Reconcile Expensive Cancer Treatments With The Need To Improve The Basics Of Cancer Care?

by Dr. Len June 03, 2013

As we walk the halls and sit in the lectures at the annual meeting of the American Society of Clinical Oncology, there's an elephant in the room. It is right there in front of us, but not many of us seem willing to talk about it. Fewer still are making any commitments to do something about it.

So what is this ubiquitous juxtaposition that is right in front of us but we can't seem to see?

It is the contrast between incredibly sophisticated science and computer data that will help us understand cancer and its treatment vs. the reality that we can't have medical records that really work. It is the fact that we have million dollar machines to treat cancer but we have tens of thousands of lives lost to cervical cancer in underdeveloped and underserved countries that could be saved with saved using vinegar. It is cancer care's version of the "guns vs. butter" debate of the 1960s. More...

Maybe It Really Is Different This Time For Patients With Advanced Melanoma

by Dr. Len June 03, 2013

Every convention and large meeting has a theme, and at the annual meeting of the American Society of Clinical Oncology in Chicago the theme is "Building Bridges To Conquer Cancer." But for me, the theme as articulated in my blog the other day is "Is it really different this time?" Some agree with me and some don't, but that's OK. I am wearing a badge that says I am a "35 year member of ASCO" (I actually have been attending these meetings longer than that) so I perhaps have a bit of a different perspective than those younger than me. And there is plenty of commentary to back up my well-meaning and hopefully thought provoking conservatism.

In one of the major "award" lectures yesterday, Dr. Charles Sawyers from Memorial Sloan Kettering Cancer Center in New York pointed out the disappointment we have had with many of our newer targeted therapies that once held the promise of truly making cancer a chronic disease. They are exciting in the beginning, but for many patients the responses are not long enough. As Dr. Sawyers noted, cancer cells eventually win the battle, and become resistant to the treatmentIn this context I was having another one of those ubiquitous hallway discussions with one of my friends and former colleagues who now runs a major advocacy/research organization focused on melanoma when she touted the new research and drugs available to treat advanced melanoma. And I said the words, "Is it really different this time?" to which she responded, "Yes, it is." And I said I wasn't so certain. So at her persistent urging, I went to the melanoma session yesterday to see for myself. And I sent my friend an email where I wrote, "You win" and to which she responded, "Told you so."

What changed? What made me eat the proverbial crow? Why is it different this time? More...

Genomics And Personalized Medicine: Is It Really Different This Time?

by Dr. Len June 01, 2013

Another year and another annual meeting for the American Society of Clinical Oncology in Chicago. This is a meeting that regularly attracts many thousands of doctors, researchers, pharmaceutical folks and others interested in the science and business of cancer from around the globe to learn, to discuss, to persuade, to educate on the progress being made in clinical cancer research and treatment.

And like every year, there are themes that emerge, that tend to dominate the discussions. And there are other themes that aren't so visible, that don't get as much attention yet in my mind are equally important as they reflect not only on the item of the moment but on how we deliver on the promises we have made in the past and the hopes we all have for the future.

Clearly, the dominant and visible theme at this year's gathering is personalized medicine.

What strikes me about this topic is that over the past year it has gone from a "niche" discussion to a dominant theme not only here at ASCO but everywhere I turn. I am even seeing routine television news shows and commentators talking about the promise of personalized medicine. A talk that I planned six months ago to deliver in a couple of weeks from now in Boston where I was going to discuss (once again) the promise of personalized medicine in cancer care is now passé. Everyone knows about it, thanks to the incredible coverage it has been receiving literally everywhere. Now anyone who has been paying attention to the evening news could give that talk. The topic is ubiquitous.

So what is personalized medicine? At heart, what this is all about is harnessing our exploding knowledge of the human genome and applying it to the treatment of severe disease for individuals based on genetic analysis. Our focus today is on cancer, but other diseases such as degenerative brain diseases also will be impacted by our knowledge of the human genome.

As I sat in a lecture yesterday afternoon on the topics of genomics and personalized medicine, I was amazed about how much knowledge we have garnered in what appears to be such a short period of time. We now are hearing about new approaches to analyze how cancer cells work to discover master regulatory cells. The promise, of course, now that we have insight into the pathways of how cancer cells work internally is that we can target our efforts to those master regulators and conquer them, thus converting the cancer cell back to normality. Sounds simple, but it's not. And it has taken a lot of research to get us to that point.

So one comes away from those discussions imbued with a new enthusiasm that the cure is around the corner. We are almost there. We will succeed--hopefully in the very near term.

But then I pinch myself and say, "Really?" More...

About Dr. Len

Dr. Len

J. Leonard Lichtenfeld, MD, MACP - Dr. Lichtenfeld is Deputy Chief Medical Officer for the national office of the American Cancer Society.

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