Dr. Len's Cancer Blog

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Dr. Len's Cancer Blog

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Progress In Colorectal Cancer Not Shared By Everyone

by Dr. Len March 19, 2014

An article published this week in the American Cancer Society journal CA: A Journal for Clinicians received a lot of media attention. The report showed dramatic declines in the rate of people being diagnosed with colorectal cancer, as well as decreases in the rates of colorectal cancer deaths over the past number of years.

But the press didn't say much about the fact that not everyone has benefitted from the progress we have made in the prevention, early detection, and improved treatment for colorectal cancer. It is a sad but very real commentary on how we approach health care in this country that African Americans have not benefitted equally from this progress in treating a cancer that for many people can be prevented or effectively treated when found before it spreads to other parts of the body.

As a nation, I believe it is incumbent that we address this glaring health disparity. To do less is unacceptable. More...

One Doctor's Confession: Basal And Squamous Cell Skin Cancers Are NOT Benign

by Dr. Len January 07, 2014

I have made a resolution for 2014: I will never, never, never again call basal and squamous skin cancers "benign" cancers.

Why would I make such a strange commitment? The explanation is simple:  I spent 4 hours on New Year's Eve sitting in the surgeon's chair getting a skin cancer taken off my nose. Nothing about the experience fits the "benign" label so many professionals, including yours truly, have used:  routine; easy to treat; nothing to worry about.  Friends, after this experience, which left me looking like a tall, white-haired Rudolph the Reindeer, I am here to tell you these cancers are not to be trifled with, and are worth every effort you can make at preventing them by reducing exposure to UV radiation. More...

The Flu Is One Gift That We Don't Have To Keep On Giving For People With Cancer

by Dr. Len December 17, 2013

 

It's the holiday season, a time of reflection, celebration and for many, giving gifts. But there is at least one gift that no one wants to get, and certainly no one wants to give: the flu. And for people with cancer, and those they come in contact with, the flu can be a very serious event. For that reason and many more, people more than 6 months old-and especially those in contact with people who have serious illnesses like cancer-should get vaccinated against the flu.

Too many of us think the flu is a minor inconvenience. But that is almost certainly because we confuse the typical cold or upper respiratory infection, which usually means discomfort and maybe a day or two off work.  Influenza is a much different and much more dangerous animal, especially to people with chronic diseases.

Over time we have become somewhat immune to the messages about the dangers of the flu, now that we have vaccinations and medicines which can treat the illness. Few are alive who remember anything about the great influenza pandemic of 1918:

"The influenza of that season, however was far more than a cold...The flu was most deadly for people ages 20-40...It infected 28% of all Americans (Tice). An estimated 675,000 Americans died of influence during the pandemic, ten times as many as in the world war. Of the US soldiers who died in Europe, half of them fell to the influenza virus and not the enemy (Deseret News) An estimated 43,000 servicemen mobilized for WWI died of influenza (Crosby)."

We have been fortunate not to have a repeat of that pandemic. But for some of us, the flu remains a deadly possibility, one that we might be able to prevent if we take the precaution of getting a flu shot.

People with cancer are among the groups at especially high risk of getting the complications of flu. And also let's not ignore the "risk pool" of people who live with patients with cancer and those who care for people with cancer. We tend to forget that those healthier folks who help people with serious illnesses can be the transmitters of this potentially serious and life-threatening infection.

Because of those risks, people with cancer and those they come in contact with really need to understand their options about getting vaccinated against the flu, and-assuming they don't have specific contraindications to the vaccine-if at all possible get it done. It is still not too late to get this year's flu vaccination. No one can predict when the vaccine "season" will peak or how serious it will be in any given year. But waiting until the last minute, when the story is all over the news, is not a good idea and it's not good medicine. And worse, it doesn't work. More...

Dr. Len Says: When It Comes To Skin Cancer, Do As I Say, Not As I Do

by Dr. Len May 14, 2013

So May is skin cancer awareness month. No time like the present to come out with the news: I have been diagnosed with skin cancer.

There really isn't much special about that, since it is a distinction I share with over 2 million Americans who have a skin cancer removed every year. Fortunately, for most, it is a cancer that is not of particular concern since most can be removed. But even those "simple" surgeries--as I have learned from my own experience--can be a bit problematic.

Occasionally it helps to find some humor in difficult situations, and this is one of those times. And since I am generally pretty open about what goes on in my aging body--in an effort to help others understand that they are not alone on some of these issues--I have to hold myself out as an example of what NOT to do when it comes to taking care of yourself.

You see, I am supposed to know this stuff about skin cancer. I know the risks, I know how to prevent it, I know what it looks like, and I know what we are supposed to do when we see a suspicious lesion. Not only do I know these things, I talk and write about them frequently. I am supposed to have a certain level of expertise about skin cancer. In fact, this very month if you happen to be in a doctor's office and they have a closed circuit program from CNN's Accent Health, you will see my smiling face telling you what you need to know about skin cancer.

And if you look closely at my chin in that segment, you will see the little nodule on the left hand side that I chose to ignore--until some friends of mine would not let me ignore it any longer. More...

National Minority Health Month Is A Call To Action

by Dr. Len April 18, 2013

April is National Minority Health Month.

That's the "dry" statement. The impact statement is that-unfortunately-for many in this country, this is more than a phrase. It's a reality that their health and their health care are in crisis. And the sooner more of us understand this, the sooner we can make a genuine effort to implement effective strategies that will address the sad state of affairs many people find themselves in when it comes to their health, and preventing and appropriately treating their diseases.

This is about more than high blood pressure and diabetes. It's about heart disease and stroke and cancer and the list goes on. This is about neighborhoods were residents don't have a place to walk or may even have fear of walking outside their homes. This is about people living in communities where they can't find affordable, fresh vegetables and healthier foods. This is about not having access to a regular source of medical care, or getting timely treatment for conditions such as breast cancer which many of us take for granted. It is about assuring equitable and quality treatment once diagnosed. This is about the lack of trained health professionals from these communities who have roots and understanding of their cities, towns and neighborhoods where they might be able to make a real difference in the lives of so many people. More...

Will My Smartphone Help Me End The Purgatory Of My Groundhog Day Diet?

by Dr. Len February 04, 2013

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...

Filed Under:

Diet | Environment | Prevention | Vitamins

A Moment Of Reflection As The Pink Of Breast Cancer In October Gives Way To The Reality of Lung Cancer In November

by Dr. Len November 05, 2012

Now that we are saying goodbye to the pink of October as we move onward from breast cancer awareness month, let us welcome the month of November, when we will shift our attention to lung cancer.

An article I read this past week posted on "Fair Warning" highlighted these issues, using breast cancer and lung cancer as a frame of reference. It carefully and in my personal opinion very professionally looked at the differences. Not casting blame, not failing to report both sides of the story, the author concisely pointed out how the way we relate to these two cancers is so fundamentally different.

In October we are awash in pink. Sometimes it seems the whole world is "pinked."  Breast cancer is a passionate and compassionate topic, one that touches so many aspects of our sensitivities and sensibilities. It is a disease which frightens many women. It is a disease worthy of our efforts to find a preventive strategy that is acceptable and a treatment that will provide a cure. It is a disease which in our minds is almost always curable, if only we find it early. And-please keep this in mind-it is a disease where the perception is common that women (and the rare man) didn't do something specific to cause in the first place, other than occasionally to have the unfortunate fate of having been born to parents who carried a genetic trait that increased their risk.

Although lung cancer is a disease that merits our concern and our focused and committed efforts to reduce its incidence and impact on our lives, our families and our society, the reality is that how we talk and act about lung cancer is eons away from how we approach the topic of breast cancer. After all, lung cancer is in the minds of many a disease that people bring on themselves. If only they didn't give in to tobacco. If only they had stopped when they knew the real risks. If only, if only, if only...

Lung cancer is almost always a fatal disease. It is a disease that frequently strikes in the later years of life, when other diseases are also prevalent, and those other diseases (think heart disease, diabetes, and lung disease) can substantially impact the ability to treat lung cancer. It is a disease where screening has proven to be successful, but we forget that the vast majority of people screened for lung cancer still died and a significant number of folks who were screened but didn't have lung cancer died from the investigations needed to prove they didn't have lung cancer in the first place.

Breast cancer touches almost everyone, and the survivors (fortunately) are legion. They carry the flag to promote early detection, research into treatment, political attention to issues of interest (think mammography and more recently breast density), and fundraising for the cause.

Lung cancer is, in comparison, much more hidden, even perhaps shunned and shamed, since it is perceived as a disease of blame. There is no army of survivors. Much less is spent on lung cancer research compared to breast cancer. Lung cancer does not get a lot of political attention unless we are talking about laws to decrease smoking (which are not bad in and of themselves). But when you think about it, many of those laws are backed not by the smokers-who still want the right to expose themselves to second hand smoke in the last refuges available, such as bars frequented only by adults-but rather by the legions of people who understandably will no longer tolerate the true evils of second hand smoke where they work, where they play and even where they live (smoking in communal buildings such as apartments and condominiums is becoming a hot topic). More...

During Breast Cancer Awareness Month We Must Not Only Celebrate Our Success But Also Understand Our Limitations

by Dr. Len October 03, 2012

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...

During Breast Cancer Awareness Month We Must Not Only Celebrate Success, But Reflect On Our Limitations As Well

by Dr. Len October 03, 2012

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...

Doctors And Their Eating Habits: Maybe It Is Time For A Change

by Dr. Len September 12, 2012

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...

Filed Under:

Diet | Environment | Prevention

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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