Dr. Len's Cancer Blog

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Dr. Len's Cancer Blog

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Melanoma (12 posts)  RSS

Genomics May Be The New Frontier, But Knowing Your Family Medical History Is Still Very Important

by Dr. Len July 29, 2015

It's no secret that genomics is cutting edge science. It is exciting, it is changing the way we think about ourselves and the medical care we receive. But with all the "gee whiz" aspects of what we are discovering every day about our genetic code, it may be surprising to learn that one of the most important parts of our new tool kit may be sitting right there in front of us gathering more dust than attention.

This revelation came while attending a conference this past week sponsored by a group called HL7. HL7 develops standards for the exchange, integration, sharing, and retrieval of electronic health information in the healthcare setting. They convened this particular meeting to better understand how we can more effectively integrate genomic data into health care delivery and research so we can full advantage of the information from genomic-derived science that is coming at us like a tsunami. 

What stood out amidst all of the topics discussed-and what achieved the greatest consensus among the conferees-was the role that the tried-and-true basic family history can play in helping us understand how the information provided by genomics fits together with real life. That's correct: the old fashioned family history that you occasionally fill out in the doctor's office that neither you nor your health professional usually pay much attention to.

Perhaps that needs to change.More...

Some Of The Answers To Cancer Care May Be Found With Our Companion Dogs Walking Right Beside Us

by Dr. Len June 10, 2015

Fate can work in mysterious ways.

A couple of months ago I was invited to participate in a symposium conducted by the National Cancer Policy Board at the Institute of Medicine in Washington DC. The topic was cancer in dogs, and how we might find ways to benefit dogs, their owners and science to better inform the treatment of cancer in humans through what is called "comparative oncology".  It was an unusual topic in my experience and that of my colleagues, so I eagerly anticipated learning about something I hadn't given much consideration to in the past.

Little did I know at the time how personal this journey was going to be for me and my family.

Shortly after I accepted the invitation, we received sad news: our Golden Retriever Lily-who has been a member of our family for 11 years-developed swelling in her face. Our vet saw her the next day and told us she had lymphoma. The outlook without treatment wasn't good, and with treatment wasn't much better.  

Tears flowed in our home that evening.

A week later we found a mass on Lily's back leg. Another trip to the vet, another needle biopsy, and another cancer, this time a sarcoma. The prognosis was even worse. Lily likely had weeks to live.

Lily fortunately didn't suffer, and died peacefully last week.  Our local vet and my newly acquainted veterinary oncologists from Purdue (who were part of the conference faculty) became our trusted guides through a journey about which we knew precious little.

And now I found myself offering a presentation as the last speaker at the symposium, discussing our journey and what I have learned from the conference. Getting past the tears of our loss wasn't easy. More...

The Survivors And Advocates Highlight That Personalized Medicine Is About All Of Us

by Dr. Len June 02, 2015

When it comes to personalized/precision medicine we should never forget it's all about the people, particularly the cancer survivors whose very lives depend on us getting it done quickly and getting it right.

That was the message from a discussion I had the privilege to moderate  on Monday evening with cancer survivors and representatives of advocacy organizations, professional associations, government agencies, and industry at a session held in conjunction with the annual meeting of the American Society of Clinical Oncology (ASCO),  now wrapping up in Chicago.

There has been an incredible amount of big science presented at this meeting that relates very directly to the care we provide cancer patients. Some of that science has immediate application to cancer care. On several occasions, acknowledged experts opined in front of thousands of physicians, other scientists, and health professionals that new treatments-particularly immunotherapy-were new standards of care in the management of patients with certain cancers.

Running in parallel to the development of new approaches to the treatment of cancer is the science that is helping to define and personalize which patients would benefit most from which treatments. As an example, for the new immunotherapy drugs there are biomarkers that may eventually predict who is going to respond better to which medicine. And frequently during the research presentations there was evidence that the more a cancer cell had mutated the more likely it was to respond to these new drugs.

But it was the survivors who touched my heart, my thoughts and my hopes.More...

Father Knows Best As Immunotherapy Takes Its Place As A Pillar Of Cancer Care

by Dr. Len May 30, 2015

Question: What do all these cancers have in common: Melanoma, lung, kidney, bladder, ovarian, head and neck, Hodgkin lymphoma, stomach, breast (and others)?

Answer: They have all shown evidence of meaningful, durable responses when treated with one or more of the new immunotherapy drugs. And that is truly amazing-not to mention very unexpected, even by the experts who know this stuff.

That's the message that is coming out of the 2015 annual scientific meeting of the American Society of Clinical Oncology, where thousands of doctors, researchers and others from around the world make the annual trek to Chicago to share and learn the latest advances in cancer treatment.

The journey to this point has been fascinating. More...

Don't Fry Day Reminds Us To Stay Safe In The Sun

by Dr. Len May 20, 2015

It's that time of year again, those months we all look forward to when life (sometimes) gets a little bit slower, the days a bit longer, and many of us take (yes!!!!!) a vacation. It's also time for Don't Fry Day, which is the Friday before Memorial Day. That's the day when organizations including the American Cancer Society and led by the National Council on Skin Cancer Prevention remind you to be sun safe, and know what to do to protect the skin you are in.

From an American Cancer Society perspective, the rules are pretty straight forward and easy to remember:

  • Slip! (on a shirt)
  • Slop! (on the sunscreen)
  • Slap! (on a wide brimmed hat), and
  • Wrap! (on a pair of UV protective sunglasses)

I could go through a long list of what you should do and how you should do it to protect your skin, but it's easier to go to our website or to the National Council on Skin Cancer Prevention website for that information. You should take the information to heart. Skin damage isn't a walk in the park (or on the beach, for that matter)-either now while you may be on vacation, or years later when you deal with the delayed effects such as skin aging, wrinkles, and-yes-skin cancer.

You can't be expected not to enjoy the outdoors. That's part of a healthy lifestyle. Staying inside day in and day out just isn't fun. Unless there is a reason you can't go out of doors, you should spend time outside. It's how you spend that time that can make all the difference. More...

Is It Time For Precision/Personalized Medicine?

by Dr. Len January 30, 2015

This blog was originally published on the Medpage Today website on January 22, 2015. It is reposted here with permission.

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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...

Number Of Skin Cancers And Costs Of Treatment Have Increased Dramatically Reinforcing Need For Prevention

by Dr. Len November 13, 2014

The numbers about skin cancer incidence and costs in the United States are worse than anyone expected.

That's the message that comes from a report published recently in the American Journal of Preventive Medicine on research from the Centers For Disease Control and Prevention, the Agency for Healthcare Research and Quality and the National Cancer Institute.

The researchers took a look at the number of skin cancers--both melanoma and non-melanoma--that were diagnosed in the United States for two different periods of time, from 2002-2006 and 2007-2011. They also examined the total cost of care for the treatment of those patients.

The staggering reality is that the average number of skin cancers diagnosed in this country in people 18 and older went from 3.4 million per year during the first time frame to 4.9 million in the second period. That means through 2011 that close to 5,000,000 (yes, 5 million) adults have a skin cancer diagnosed every year-and today that number may even be higher. More...

CanceRX 2014: We Need Innovative Approaches To Support Cancer Drug Development

by Dr. Len 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...

Ultraviolet Bad: Surgeon General Issues A Call To Action To Prevent Skin Cancer

by Dr. Len July 31, 2014

(Note: This blog was originally published on another American Cancer Society website on July 29 because of technical problems on this site. Those have now been resolved and it is now reposted here. We appreciate your understanding.)

 

"Ultraviolet bad."

That was the core message that came out of the introduction Tuesday morning of the Surgeon General's Call to Action to Prevent Skin Cancer at a meeting held at the National Press Club in Washington DC.

There were some other messages that now raise skin cancer awareness and prevention high on the public health awareness list, such as the fact that over 5 million people every year have a diagnosis of skin cancer (and many have more than one skin cancer), and that we are spending over $8 billion dollars treating the disease. But most important is the fact that this is one of the most preventable cancers, and if current trends are any indication we are not getting the job done when it comes to decreasing the number of skin cancers and saving 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...

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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