OK. So Groundhog Day was on Saturday this year, and unlike the furry little beast what I have to say each year around this time is just as good today as him looking for his shadow on Saturday.

What is all this about, you are probably asking yourself?

It is about an annual update that I started a couple of years ago on my blog to remind myself and those who are interested that losing weight and staying healthy is a tough slog and a major commitment which too often is not successful. Like many of you out there I am not immune to all the problems surrounding diet and trying to get weight under control. Try, try, try again and again, and hopefully one day we can all get it "right." That's why I dubbed this the Groundhog Day Diet, after the Bill Murray movie of a similar name where he strikes out to relive the same day again and again until he gets it "right."

And, let's face it: I am not alone in this dilemma. Many of us are in the same boat: we keep trying, but nothing seems to work. There are temptations and messages all around us that are leading us to eat ourselves into oblivion. We as a nation are becoming larger and larger, and now there are concerns that overweight and obesity-if left unchecked, and on their current trajectory-will result in reversal of the gains we have made in extending and improving life. But maybe--just maybe--with the new techologies offered by apps and smarphones we will be able to actually take control of our lives and our eating habits and make some real progress through more awareness and information in realtime at the moment we are making our choices about our diets. More...

I find myself sitting here to write a blog in recognition of Breast Cancer Awareness month, and frankly it's not as easy as I anticipated. And I am asking myself why that is.

We have made considerable progress in the early detection of breast cancer. I have commented frequently about the differences in breast cancer detection, treatment and survival today and when I started my medical training and career in the 1970's.

Early detection is clearly a success story if the measure of success is whether or not we can find breast cancer when it is "small" in most women. Our technology lets us do that with mammography techniques that are far more accurate and sophisticated than they were a few decades ago. Much of our discussion today centers around what role newer approaches, such as MRI, ultrasound, and most recently 3-D mammography have in early detection of breast cancer.

Our treatments are much more refined than they were in 1970, as well. We now have lumpectomy and radiation as a valid replacement for many mastectomies. We have sentinel node biopsy instead of axillary node dissection, which for some women adds nothing but long term misery caused by swelling of the arm. We have hormone-related treatments, chemotherapies, and biologic therapies that can prevent cancer from recurring; and we have an increasing number of promising approaches to treat the disease if it does come back.

We have genetic tests that can help pinpoint women at higher risk of developing breast cancer, and others that can help some women and their doctors decide whether or not they need to receive chemotherapy as part of their adjuvant (preventive) treatment after primary treatment with surgery.

We certainly have increased awareness of breast cancer beyond anything imagined in 1970. It's hard to imagine, but back then, cancer was not discussed in polite company (really). Some women did everything they could to hide their disfigurement and even what they thought was their "shame." Today, breast cancer is discussed openly and frankly (most of the time), and the voice of advocates is being heard at levels never dreamed of decades ago.

So with all this progress, why shouldn't I be celebrating our successes? More...

Every once in a while a medical journal takes a bit of a leap by publishing an article or opinion piece that may just be a bit out of their usual norm or comfort zone. Today's issue of the Journal of the American Medical Association (JAMA) may have done just that with a discussion of physician eating habits, and exhorting doctors to get to the heart-or should I say "meat"-of the matter and set an example for their patients.

Although I may sound like I am being a bit "tongue in cheek" about the article, it is actually a topic that I have thought about frequently in the past.

Go to a medical meeting, or for that matter to any meeting which is medically oriented or there are medical implications-and take a look at the food service and you will understand what I mean. Or perhaps your local hospital cafeteria would be a good start. Our local hospital is well-known for their fried chicken, and when it is served I understand the line goes out the door. And then look at the puny salad bar, stuck in the corner... Well, I suspect you get the picture. We medical folks just don't do a great job of setting a good example when it comes to what and how much we eat. More...

I have a confession to make:

As soon as I finished reading the Annual Report to the Nation yesterday as I was preparing to write my blog, I got up from my desk and took a walk for 20 minutes.

What, might you ask, compelled me to do this?

The answer is what made me take a walk is the same reason I am writing this follow-up commentary to yesterday's blog: Sitting at my desk all day may kill me. It may be doing the same for you. 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...

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...

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...

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...

There are few times in life when one gets to watch history being made. Today is one of those times.

I am in New York with a number of colleagues from the American Cancer Society and other committed organizations to observe a UN High Level Meeting which will--at long last--put non-communicable diseases on the international agenda. The impact of the decisions made here over the next two days can indeed change the face of global health forever. More...

(A letter to my newborn granddaughter)

Good morning, Rayna Analiese. Welcome to the world!

You are a teeny 8 pound 8 ounce bundle of beauty and joy who arrived yesterday afternoon at 1:32 PM CDT--100 years (almost to the very day) after one of your great grandmothers was born. 

Grandpa--who is normally not a big lover of babies--went gaga over you. "So cute! So cute!" is about all he could say as he snuggled you in his tall arms--afraid all the while that he might drop this football-size bundle of love.

You have lots of people who love you, and lots more who are going to love you--not to mention all the people who love you who haven't had a chance to meet you in person yet. You have aunts and uncles and great aunts and uncles and grandmothers and grandfathers and great grandmothers to boot--and don't forget your great-great grandmother who will squeeze you tight. You are going to have to get used to the large family feasts filled with all sorts of nasty food when you come home from time to time to parade your cute little bonnets around the many houses you will have to visit. Mom and Dad are certainly going to have fun on those trips.

But I wouldn't be me if I didn't think for a moment about what your new life means, so forgive me for a moment while I ponder the meaning you bring into our lives, especially for Grandma Sandra and Grandpa Len. More...