Dr. Len's Cancer Blog

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Dr. Len's Cancer Blog

The American Cancer Society

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...

Are We Ready For Inexpensive, Patient Directed Genetic Testing For Breast Cancer?

by Dr. Len 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...

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...

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...

Defining Value in Cancer Care Depends On Your Perspective

by Dr. Len November 12, 2014

(This blog was originally posted on Medpage Today and is reprinted here with permission)

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Value.

A simple word with lots of meanings, all of which depend on the context of the moment. Value in healthcare -- especially in cancer care -- is certainly no exception. What is undeniable is that we are seeing an increasing clamor about value in cancer treatment. And one person's value is clearly another person's concern.

At the crux of the debate is the question of whether we will continue to see improvements in cancer care that are meaningful, and whether we will be able to support the very innovation that, in no small part, holds such great promise for the future of making cancer a chronic disease for many and even finding a cure for some.

A recent Washington conference sponsored by the Turning The Tide Against Cancercoalition is an excellent case in point.

Conference organizers brought together experts from around the country who are vitally concerned about the progress we are making, and must continue to make, in elevating personalized (or precision) medicine as a key part of advancing cancer research and cancer care. The agenda included a number of presentations about not only how to make personalized medicine more relevant to all of us, but also how to address the question of "value." 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...

An Impassioned Woman, A Young Man, And A Message About Tobacco That Can Teach All Of Us A Lesson

by Dr. Len October 13, 2014

With a dedication and thanks to Carolyn for her passion about the impact of smoking, especially on our youth.

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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...

Filed Under:

Lung Cancer | Prevention | Tobacco

Breast Cancer Awareness Is About More Than Mammograms: What You Need To Know

by Dr. Len 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...

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...

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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