April 24, 2015
It's a headline that I suspect many thought would never be written, but it was-in the New Orleans Advocate on April 22:
"Harrah's Casino in New Orleans gives patrons lollipops as it introduces smoking ban"
Six months ago, there weren't many who thought this could happen, that the City Council of New Orleans would pass and the Mayor would sign a smoke-free bar and casino ordinance in New Orleans. But pass it they did, and now it's the law.
The lesson from this incredible feat is that when we are committed to making our lives healthier and safer we can make it happen. It may be through smoke-free legislation or it may be through increasing tobacco taxes. But these laws and regulations make a difference for so many, from workers who work in these establishments, to those who patronize them and to those entertain us there such as the musicians in New Orleans, who were so much a part of making this happen.
However, we can't forget that while successes are wonderful to celebrate much remains to be done. And that is why I continue to work closely with the Society's advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN) to advocate for proven tobacco control measures that will help people quit and discourage kids from ever picking up the deadly habit. More...
January 30, 2015
This blog was originally published on the Medpage Today website on January 22, 2015. It is reposted here with permission.
Are we prepared for the genomics revolution?
The President's proposed Precision Medicine Initiative as mentioned in his recent State of the Union address suggests it's probably time to get ready for some changes in our daily routines as health professionals.
I'm not talking about the incredible information that has already been produced by researchers examining the human genome. Nor am I referring to the work that is going on in major cancer centers and elsewhere exploring how to better match patients with genomic analyses of their cancers, for example.
And I am not talking about the advances in targeted therapies associated with diagnostic tests that can help guide the treatment of patients with a variety of cancers including but not limited to lung and breast cancers as examples.
No, I am asking whether we are prepared to usher in the new era of medical practice where genomic analyses in one form or another will be a part of our everyday medical practice. It's not just about cancer, my friends. It will be coming to a primary care practice near you probably sooner than you realize -- but it is coming. More...
January 15, 2015
Let's call it the Battle of New Orleans, 2015.
As I write this, I am traveling from a meeting of the New Orleans City Council where testimony was heard regarding a new ordinance which would prohibit smoking in the city's famed bars and the local casino.
As noted by Councilwoman LaToya Cantrell-who is the lead sponsor of the bill and who chaired the meeting--at the end of the hearing, it is a topic which has certainly engendered a lot of discussion among the residents of this iconic American city. Even when sitting in the airport the morning after the meeting I happened to overhear a gentleman near me intensely discussing the merits of the recommendations on the phone with a friend.
But loudest among the many voices were the sweet sounds that came from the musicians who provided testimony to the Council. There was no opposition from the music world: these artists earn their living inhaling the smoke of others, and they came out loud and clear about the need and benefit of being able to provide us entertainment in a healthier, smoke-free environment. As one of them noted a performer doesn't have to consume a bit of every alcoholic beverage served all night long. But when you smoke in my face, I have no option but to take it in.More...
November 06, 2014
What if you were sitting in the room with some of the best financial and scientific minds in the country and someone asked how many of you would be willing to contribute a modest sum of money to create a company with the potential of speeding up the evaluation of drugs that could revolutionize cancer treatment?
That was the opening question of a fascinating meeting I attended recently at the Massachusetts Institute of Technology, one where I didn't want to leave my seat for a moment for fear I would miss another thought-provoking comment or idea.
The meeting was called CanceRX 2014, and for two solid days about 300 participants listened, debated, and engaged in discussion on how to make that scenario happen. No small task, to be certain. But in this era of ever increasing research discoveries of new treatment targets, it is clear that we need some innovative thinking to take what we learn in the laboratory to the bedsides of the patients we care for. And to make that happen we need as much "out of the box" thinking as we can muster. More...
October 13, 2014
With a dedication and thanks to Carolyn for her passion about the impact of smoking, especially on our youth.
You never know when something special is going to happen, as in one of those times when you just wish you had a camera rolling to capture a moment, a comment, a statement about the way the world is--and the way the world could be.
This past weekend my wife and I were attending a meeting in Baltimore when we had one of those moments. Nothing complicated, just very interesting--and very informative in so many ways.
It was at a convenience store near our hotel. We had gone out to get some things for the room, and when we got to the store there were a number of young men sitting on the stoop at the entrance to the store. Maybe 5 or 6 total, about 12 or 13 years old, dressed for school, sitting and enjoying the day.
They were just chatting, and when we asked to be able to open the door to the store they immediately moved aside. But what I wanted to say and didn't say to one of them who was puffing away on one of those thin cigars trying to look very cool was that maybe they just shouldn't be smoking. Maybe I could send a soft message of concern, maybe it would register, probably wouldn't. But I am an older man, and I thought to myself that they probably wouldn't care what I thought. So into the store we went.
No sooner did we get inside than this whirling dervish of a woman, about (maybe) 5 feet three inches in height rushed past us. The best way to explain what we saw and heard was that store clerk giving those young men what ended up as a bit of a tongue lashing. It started as a request they remove themselves from the stoop and not block the entrance, but then she saw the cigar and it was action time. More...
September 30, 2014
I had an interesting day this past week. Sadly, it left me wondering why the same "hope and hype" directed at cancer patients and their families decades ago when I started my oncology career was still alive and well today. But then, maybe I am the naïve one to think that anything should have really changed.
In the morning I found out that a story I had been interviewed for a story which appeared on the Kaiser Health News website. A discussion about proton beam therapy for cancer (PBT), it basically pointed out that insurers aren't necessarily paying for the treatment and that the information supporting its use is not as definitive as some would hope or claim.
Not long after, I was informed of an online discussion on Twitter (called a "tweet chat" at #protonbeam) being hosted by a major medical institution and a well-known weekly newsmagazine on the very topic of proton beam therapy, or PBT. What I watched unfold over the hour-long discussion was what I call a "scrum" of doctors and public relations people promoting proton beam therapy as the answer to many cancer treatment dilemmas with nary a word about the limitations of our knowledge or potential problems with the treatment. It was all about "we can do it, call us and we will tell you how good we are, and insurers won't pay us." Simply stated, the "conversation" seemed to be glancing by some of the inconvenient facts surrounding what has become another poster story for how we develop and promote new treatments in medicine, let alone cancer care. More...
June 15, 2014
Today marks a major step forward in cancer clinical trials and drug development with the launch of the Lung-MAP protocol to evaluate new treatments for squamous cell lung cancer, a common cancer which has proven resistant to the standard drugs currently available. In response to this genuine unmet need, Lung-MAP has been designed to move new therapies more quickly from the laboratory to the bedside of patients afflicted with this serious disease and few options available.
Many--including present company--have written about the need to improve this process. We are in a new era of cancer drug development, spearheaded by our ever increasing knowledge of cancer genes and the targets within those genes that can be used to disrupt the cancer cell on its inexorable road to proliferation and destruction. Getting those drugs speedily through development and clinical testing has been a real challenge. And, going forward, finding the patients with the "right" genomic signature who are candidates to receive these therapies is going to be difficult. In simple terms, we need to find the patients where they live and match them to these new drugs as quickly as possible. And that hopefully will translate into more and better treatments for patients, and save lives. More...
June 04, 2014
As in years past, the trip home from the Annual Meeting of the American Society of Clinical Oncology in Chicago gives me a moment to reflect on what I have heard and hopefully learned over the past five days.
This meeting is a whirlwind of activity and information, far too much for any one person to absorb and process. You can be focused on one topic, you can be general, and you can hear new cutting edge research or be educated on topics of general interest in cancer. You can go to the exhibit hall and be overwhelmed by the booths and displays (I tend not to go there, but obviously many others do). I suspect you get the idea.
Ultimately for me it is the take away messages about trends in cancer research and cancer care that matter the most personally. And this year the trends appear to be somewhat similar to past years, with perhaps some new wrinkles. What is undeniable is that if immunotherapy is the queen at the ball, then "panomics" (I really like that word) holds the keys to the kingdom. More...
March 27, 2014
I had the opportunity earlier this week to participate in a Twitter chat on the topic of colorectal cancer awareness. The chat was intended to bring attention to a nationwide campaign called "80 by 2018" designed to increase colorectal cancer screening rates to 80% of the population over the next 4 years. If it is successful, we should see a decline in both incidence and deaths from this disease.
But I am haunted by two of the comments I tweeted during the session chat that won't leave my conscience:
"As a doc, you don't forget the patients you couldn't help. And you celebrate those you did. #CRCawareness is key #80by2018"
"Let's remember that screening doesn't help everyone, so don't forget the need for more research in understanding #CRC #80by2018"
While we celebrate the opportunity to save more lives with screening, we cannot ignore or forget those for whom screening for colorectal cancer (or other cancers, for that matter) couldn't or didn't make a difference. More...
August 09, 2013
A newspaper story last week caught my eye when it headlined: "Senators Revive Push for End-of-Life-Care Planning." It reported on new legislation making the rounds in Washington to address care planning for those with advanced illnesses.
You remember "end of life care planning," don't you? It was part of the Affordable Care Act debate several years ago, and quickly became translated into "death panels" where opponents made the argument that the government wanted to help people decide not to receive needed treatment. That was a moment that will live in my memory forever, and it's not a pleasant memory.
So here we are with this new bill, and a headline that suggests we may be headed down the same path once again. This time, however, I hope we can have a more rational and appropriate discussion about an issue that is rapidly evolving in cancer care, supported by medical evidence and medical professionals, not to mention organizations like the American Cancer Society who believe the time has come to engage our patients, their families and caregivers, and the nation at large in understanding the need for compassion as we care for patients with serious illness, including cancer. More...