Dr. Len's Cancer Blog

My travels over the past several days have taken me to a number of cities to participate in various meetings and speak before several groups on the topic of cancer care and cancer prevention.

Although the schedule has been a bit hectic, it has provided a number of opportunities to reflect on a variety of issues that are important to me personally and may be of interest to you as well.

An article in the current issue of Urology illustrates some of the hopes and barriers related to advancing our abilities to diagnose prostate cancer accurately through screening tests, at the earliest possible time.

This particular article reports information about a prostate cancer protein found in the blood called EPCA-2.

The research, performed at Johns Hopkins in Baltimore—which is recognized as one of the leading prostate cancer treatment and research centers in the world—demonstrates that this new marker appears to be more sensitive and specific in detecting prostate cancer compared to the widely used PSA test.

The question is whether or not this new test really is a major advance in the screening and diagnosis of prostate cancer.

In December 2006 I discussed a paper presented at a national breast cancer meeting in San Diego which reported that there had been a dramatic decrease in the incidence of breast cancer between 2002 and 2003.

At the time, the authors indicated they thought the decrease was due to the fact that women had stopped taking their hormone replacement therapy medications in 2002 in response to a warning from the Women’s Health Initiative (WHI). 

My response was that I wasn’t so certain that stopping HRT was the complete explanation for the observed decrease in breast cancer cases. 

Now, with the publication of a more detailed paper in the current issue of the New England Journal of Medicine, I must admit that I am still confused as to all the factors that contributed to the decline.

News today that Presidential candidate and former United States Senator has been treated for indolent lymphoma adds to the visibility and impact of cancer diagnoses and treatment in the current Presidential campaign.

First, we wish Senator Thompson well in his journey with his illness.  He is another example of how people with cancer continue to live their lives with vigor and expectations. 

As with the recent announcements from Elizabeth Edwards and Tony Snow, we once again see someone who is determined to move forward with life despite their illness, just as millions of people surviving cancer do every day in this country.

I returned from vacation this past Monday to a slew of headlines and media commentary about newly released guidelines from the American College of Physicians suggesting that women in their 40’s should reconsider the routine recommendation for screening mammograms in that age group.

The headlines were very specific, such as “Benefits of Mammography For Women In 40s Challenged” (Washington Post) and “Mammograms Under 50 Optional for Many Women: Group” (Reuters).

A press release from the College noted that the guidelines were evidence-based and advised women to become part of the decision making  process.  

I have waded through the three articles and an editorial that comprised the report in the current issue of the Annals of Internal Medicine, and I am wondering if the media—and some of the experts who have been quoted—have actually read the articles.