Dr. Len's Cancer Blog

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Dr. Len's Cancer Blog

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Lung Cancer (67 posts)  RSS

Is It Too Much To Expect More Balance When Discussing Proton Beam Therapy For Cancer Patients?

by Dr. Len 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...

Lung-MAP--A Bold Initiative To Find New Treatments For Squamous Cell Lung Cancer--Launches Today

by Dr. Len 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...

ASCO 2014 Is A Wrap: If Immunotherapy Is The Queen Of The Ball, Then Panomics Holds The Keys To The Kingdom

by Dr. Len 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...

The Haunting Memories When Screening Doesn't Work

by Dr. Len 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...

Palliative Care Is About Quality Of Life Throughout The Cancer Journey

by Dr. Len 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...

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...

American Cancer Society Celebrates Its 100 Year Anniversary Today With A Vision Of Making This Century Cancer's Last

by Dr. Len May 22, 2013

One hundred years.

That is a long time. And although thriving, remaining relevant and engaged for 100 years is a remarkable accomplishment for any organization, the American Cancer Society today takes pride not only in reflecting on the accomplishments of the last 100 years but also in our commitment to continue the fight, and make this century cancer's last.

A lot will be written about the remarkable accomplishments of the Society over the past century. The American Cancer Society takes pride in the fact that it has been able to serve millions of people during that time. It has put its mark on numerous improvements in the science and treatment of cancer. We have made incredible strides in understanding cancer, what causes it and what influences it, including the role of tobacco and overweight/obesity. We have funded 46 Nobel Prize winners at some time during their careers, frequently when they needed a start to develop their theory which led to great discoveries. And we have funded numerous investigators who have made other important and lifesaving contributions to understanding cancer and reducing its burden.

But the list is not complete. There is still too much we don't understand about cancer, its causes, and its impacts on patients, their families, their communities. We have come to a "tipping point" in the cycle where we have unlocked the genetic code of cancer and are just beginning to transform that information into lifesaving treatments. We wrestle with the early detection and prevention of some cancers, at a time when we thought--incorrectly, as it turns out--that simply finding cancer early was enough. We struggle with finding a way to get access to lifesaving or life comforting treatments to those who are diagnosed with cancer but don't have the resources to follow their journey in the best way possible. We have millions of survivors, yet understand too little about the problems they face long term, let alone being able to provide them with a system of care to respond to their needs. We have made remarkable progress in keeping children with cancer alive, free of disease into adulthood, but we haven't acknowledged the terrible price some of them have to pay from the side effects of their treatments. More...

Is Cancer Research and Treatment Moving From Evolution To Revolution?

by Dr. Len April 09, 2013

Is our evolution becoming a revolution? Am I in danger of becoming a victim of the same "hope and hype" that I derided as a young oncologist in the 1970's and 80's and is currently the focus of some vocal critics of recent glowing media reports on the successes of cancer research and treatment?

Those are the questions I am asking myself as I reflect on the experiences I have had over the past two weeks. And although I may be proven wrong, I am becoming even more convinced that we are truly at the tipping point, the place where the sweat and tears of failure and slow progress give way to truly significant change in how we view, diagnose and treat cancer. More...

New Report On Smoking In Women Confirms That "Women Who Smoke Like Men Die Like Men"

by Dr. Len January 23, 2013

"You've come a long way baby!"

That slogan from decades ago now returns with a new meaning and a new vengeance, according to a study released today in the New England Journal of Medicine.

The report, co-authored by Michael Thun, the recently retired vice president emeritus of the American Cancer Society along with colleagues from several outstanding institutions in the United States, shows clearly and unfortunately that women who are smokers are now neck and neck with men smokers when it comes to the relative risk of dying compared to non-smokers, whether it is from all causes, lung cancer, chronic obstructive lung disease (emphysema), and cardiovascular diseases including heart disease and stroke. (See below for an explanation of relative risk)

In a somewhat unvarnished tone, the authors write, "This finding is new and confirms the prediction that, in relative terms, 'women who smoke like men die like men.'" More...

Filed Under:

Lung Cancer | Prevention | Tobacco

New Lung Cancer Screening Guidelines From The American Cancer Society: What You Should Know

by Dr. Len January 10, 2013

Lung cancer is the leading cause of cancer deaths in this country. In 2012, the American Cancer Society estimates that there were about 226,000 people newly diganosed with lung cancer, and 160,000 deaths. If there is good news here-and unfortunately there isn't much good news when it comes to lung cancer-it is that deaths from this dreaded disease have been declining in men and women, since fewer people are smoking. But there is much we have to do to improve this picture.

That's one of the reasons the American Cancer Society is releasing new guidelines on screening for lung cancer. After carefully reviewing the available research, the Society has concluded that there is good evidence that lung cancer screening saves lives by reducing deaths from lung cancer (20% in largest carefully controlled study) in people at high risk when the screening is done by experienced, high-volume lung cancer screening programs.

So who should be screened? Who is at high risk?

According to the guidelines, those for whom lung cancer screening with low-dose chest CT scans are appropriate are people who are between the ages of 55 and 74 and who have smoked 30 pack years (a pack year is one pack of cigarettes a day for one year) or more or who have smoked 30 pack years in the past and quit within the last 15 years and are now within that age range. Those individuals who meet those criteria-should they choose to be screened-should have a low dose chest CT scan every year until age 74.

However, this isn't a blanket recommendation. There are other cautions in the guidelines that you should know about. 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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