Dr. Len's Cancer Blog

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Dr. Len's Cancer Blog

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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...

What We Can All Learn As New Orleans Shows The Way To A Healthier, Smoke-Free City

by Dr. Len 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...

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...

In New Orleans’ Efforts To Make Bars and Casinos Smoke Free, It’s The Musicians’ Songs That Are the Sweetest.

by Dr. Len 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...

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...

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...

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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