Dr. Len's Cancer Blog

A comment in today’s Wall Street Journal (accompanied by a large picture of a very angry Congresswoman) should not go unnoticed and cannot be left unchallenged, especially given the confusion caused by the mammography guidelines released earlier this week.

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I hosted a chat Thursday, November 19th about the new mammography guidelines issued this week by the USPSTF. You can see an archived version of the chat here...
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The United States Preventive Services Task Force (USPSTF) today released a series of reports updating their guideline recommendations for screening mammography for the early detection of breast cancer.  Their conclusions are bound to raise another round of intense discussion about the benefits, risks and harms of screening for breast cancer.

 

There is certainly nothing wrong with that, with the exception that if we make the wrong decisions or offer women the wrong guidance about the early detection of breast cancer, we could reverse the considerable progress that has been make in reducing deaths from this disease over the past twenty years.

 

Unlike the Task Force, the American Cancer Society is not changing its current recommendations that women at average risk of getting breast cancer should get a mammogram every year starting at age 40.

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I find myself early on Sunday morning after the House of Representatives passed landmark health care reform legislation last night asking how I really feel about this momentous event.

 

The answer is that I actually feel pretty good. And I must admit that surprised me. 

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I think it is time for one of my irregular updates on a favorite subject, and one of my personal failings: being overweight or obese.

 

The information yesterday from the American Institute for Cancer Research (AICR) that excess body fat (who doesn’t have excess body fat???) causes an extra 100,500 cases of cancer every year in this country didn’t help matters.

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An article in today’s New England Journal of Medicine reports some interesting and intriguing research that may help some women with a not uncommon pre-cancerous lesion of the vulva called vulvar intraepithelial neoplasia, or VIN.

 

By using proteins found in the cancer-causing human papilloma virus type 16 (HPV-16), the researchers were able to make a vaccine that actually led to an effective treatment for a small group of women with VIN, resulting in complete disappearance of the lesion in almost half of the women they treated.

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An article in this week’s issue of the Journal of the American Medical Association and a companion news story on the front page of the New York Times has created a firestorm of media interest.

 

The problem I have with both of the articles is: where’s the news?

 

Let me cut to the chase, in no small part because I am travelling today and have limited time to write this before and between flights: The American Cancer Society is not working on any stealth project to change commentary on our website to emphasize the shortcomings and risks of screening. 

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I have a confession to make: I am not a big fan of “gee whiz” medical technology.  At least not until it is proven to really make a difference in the care we provide our patients, or the outcomes of their treatments. 

 

A study in yesterday’s Journal of the American Medical Association comparing the side effects and outcomes of prostate cancer surgery using the robot to more traditional surgery reinforces that notion. 

 

Using the robot to treat prostate cancer surgically may be better in some respects, but not better in others.  And maybe not better enough for you to listen to all of the advertising hype about the robot, and forego treatment from a urologic surgeon who in fact may be more skilled at the operation and not use the robot.

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And then there were 44…

 

No sooner had I completed and posted my blog on Tuesday about the Nobel Prize awarded to a scientist whose research had been supported by the American Cancer Society than the Nobel Prize committee made an additional award in the field of Chemistry to another Society grantee.

 

The scientist who received the award was Dr. Thomas Steitz from Yale University.  The American Cancer Society has been a supporter of Dr. Steitz’ work for many years, having provided two multi-year grants between 1983 and 1997 totaling more than $1 million.

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Yesterday’s announcement that three American scientists won the Nobel Prize in Physiology or Medicine serves as a reminder of how important research is in moving forward our progress in diagnosing and treating cancer. 

 

In addition, one of the awardees, Dr. Jack Szostak, was supported in the past with a research grant from the American Cancer Society.  That brings to 43 the number of researchers that the American Cancer Society has supported at some time in their careers who have gone on to win the Nobel Prize, a truly stunning accomplishment that has not been matched by any other voluntary health organization. 

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