May 14, 2015
Dealing with a diagnosis of cancer remains a very scary, emotionally charged experience. That experience is not helped by the addition of conflicting advice, especially advice based on opinion and not evidence. And once in a while, that's what happens when a celebrity is the source of the information, as has now occurred with Sandra Lee. But this time reporters are stepping up to address the issue on the record.
Many of you are familiar with the now widely available interview Ms. Lee gave with ABC's Good Morning America anchor Robin Roberts, herself a cancer survivor who has openly shared her journey with the public. Ms. Lee told the nation that she has breast cancer, that a lumpectomy had positive margins, and that her doctors recommended a double mastectomy since she was a "ticking time bomb" in her words.
What the nation also knows is that Ms. Lee at the age of 48 was critical of guidelines that-in her words-tell women to wait until they are 50 to get a screening mammogram. She also recommended that women of all ages, even in their 20s and 30s, call their health professional now and get a mammogram. In short, all women "need to know" whether or not they have breast cancer.
A diagnosis of breast cancer is traumatic. A positive mammogram that turns out not to be cancer--what doctors call a "false positive"--is also traumatic, especially if a women has to endure the uncertainty of follow-up tests including additional x-rays and biopsies, which are certainly uncomfortable at the least and disfiguring at the worst. Younger women have a greater number of false positive mammograms, in part because their breast tissue is more dense making the reading of a mammogram more difficult.
People are entitled to their opinions. But when personal thoughts turn into public pronouncements it can create a sense of fear and a sense of panic that may not be warranted. Often, listening to what the science tells us can help us confront some of that fear. In this case what the science tells us is that screening women in their 20s and 30s who are at average risk of breast cancer would cause a great deal of harm and not much benefit. More...
April 21, 2015
Years ago when I first started this blog I wrote about the democratization of information, and how people would come to an era where they had ready access to information yet reserved the right to determine whether that information was valid or not.
Fast forward to today, and a company called Color Genomics announced a new genomic based profile to measure breast cancer risk. They are clearly headed into the democratization of health care, since they are pricing the test at $249 and have tried to reduce the barriers for women and men to get the test.
Inevitably, this announcement is going to fan the flames of how far we should be going to allow people to get whatever laboratory tests they would like, whenever they want them. Although a health professional must order the test, in reality doctors will be available to meet your need if you decide to bypass your personal physician. And although most professional organizations active in this field recommend genetic counseling from a qualified professional be done before such tests are done, the company says they will provide such counseling-after the test results are known. 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...
October 02, 2014
It's October and that means we are about to see a lot of pink for the next 31 days. And virtually all of the work comes down to one simple -some might say overly simple-message: get a mammogram.
But as National Breast Cancer Awareness Month (NBCAM), begins, I find myself one again asking some difficult questions: Are we really looking at the right side of the equation? Is it all about mammograms? Is there more to the story? The answer is absolutely unequivocal and without a moments hesitation: YES! More...
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.)
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...
July 24, 2014
I had the privilege this week to serve as the keynote speaker for the 4th Summit sponsored by Latinas Contra Cancer-an organization founded and led by Ysabel Duron, a formidable cancer survivor and news media presence in San Francisco.
Bringing together members of the Latino community, researchers, community health workers, promotores (more on that later) and advocates, the summit focused on the issues facing the Latino community in increasing awareness, access to care, improved treatment and research opportunities among other topics. But what was most impressive was the spirit, engagement and commitment that permeated the room for the two days of the meeting.
I would like to share with you some of what I learned during the preparation for that lecture, as well as some observations that tie together the impact and calls to action that are relevant to the Latino community and many other ethnic and socioeconomic groups in the United States. (You may wish to refer to the American Cancer Society's "Cancer Facts and Figures for Hispanics/Latinos 2012-2014" which contains a wealth of information relative to cancer for this community.) More...
June 17, 2014
This past week I had the privilege of participating in a meeting hosted by the President's Cancer Panel on the role of social media in improving cancer control and treatment. The goal was to give advice to the Panel on a planned series of meetings they will be convening to discuss the topic. It was the range and quality of the discussion that day that left me thinking about the broader topic of social media and how it could help improve cancer control going forward. More...
May 31, 2014
At the annual meeting of the American Society of Clinical Oncology (ASCO) here in Chicago, something vitally important is happening: there is an increasing recognition of something no one really wanted to talk about in polite company until now. It is the fact that the costs of many of the new treatments being developed are extraordinary.
The headlines about cost and value of cancer care greeted me when I walked into the McCormick Center in Chicago for the opening sessions of the meeting. This is the leading cancer meeting in the world, and what happens here makes news worldwide, significantly impacting the lives of patients with cancer wherever they may be.
Now there is an increasing recognition of the elephant in the room: the costs of these new treatments are extraordinary. No matter how one chooses to slice and dice the arguments, these drugs are expensive with costs per month of $8000 and upwards getting a lot of attention and increasing concerns, especially at this meeting. More...
May 16, 2014
This was the dream: we would use technology to create a seamless healthcare system, one where people, computers and machines would work together to improve patient care in many different ways. Health care would be more efficient, it would be safer, it would be less expensive, we would be able to transfer health-related information quickly and accurately.
After spending three days at a meeting this past week with some of the top experts in the field, I am not so certain that the dream is going to come true anytime soon. Perhaps more concerning, the problems--including patient safety issues--that are cropping up in so many areas are very troubling. More...
May 11, 2014
My wife and I did something special this past Friday evening. We attended a Relay for Life in our hometown of Thomasville GA. And the memories of the event will not be soon forgotten, for so many reasons. More...