Dr. Len's Cancer Blog

Two articles published this afternoon in the Lancet and the Canadian Medical Association Journal once again remind us that just because something looks good in cancer treatment doesn’t mean it is good, and may actually cause harm.

You may remember the controversy that surfaced a couple of years ago about medications called ESAs which were (and continue to be) used to boost the red blood cell counts of patients with cancer.

What did today’s studies report that has me so concerned?  Basically that there was no situation—whether or not patients were on active chemotherapy or whether they were simply being treated for anemia associated with their cancer—where these drugs did not increase the risk of death. 

The results are as predicted: the prostate cancer vaccine Provenge (sipuleucel-T) prolonged survival in men with hormone –resistant prostate cancer, but didn’t do anything to delay progression of the disease.

The results of a clinical trial studying this controversial vaccine were released this afternoon at the annual meeting of the American Urological Association in Chicago, and the news wires are already humming with the news.

The article in today’s New York Times by reporter Gina Kolata has a lot of truth, and perhaps a bit of misdirection.

It seems that we are hearing more and more about the lack of progress in treating cancer, or the failures of prevention and early detection.  I’m not certain what is driving this sudden spate of articles in several highly regarded media venues, but it must be acknowledged as an obvious topic of interest.  Otherwise, reporters wouldn’t be reporting it. At the same time, I also believe that we must put these discussions into balance and context. 

It is undeniable that we have made progress in the prevention, diagnosis, and treatment of cancer.  At the same time, we need to acknowledge the harms of our treatments and the limitations of our capabilities.

Praise the volunteers!!! 

That certainly is a thought that is very important to the American Cancer Society during this annual celebration of National Volunteer Week.  After all, we have millions of volunteers in thousands of communities nationwide, and even some throughout the world.

Without our volunteers, the Society—as well as thousands of other schools, churches and other organizations—could not support our core mission, let alone survive.  We are fortunate to have many wonderful people throughout this nation who are devoted to our cause.  They are what makes the American Cancer Society such a special place for so many of us, volunteers and employees alike.

“Happy birthday to you, happy birthday to you…”

How many times a year do you sing the birthday song or wish a loved-one, a friend, a colleague or anyone you know happy birthday?   Although sometimes done casually and without much thought (except for those of us over the mystical age of 39), there actually is a lot of meaning in that greeting, more than we frequently acknowledge.

For many of us, especially cancer survivors, that greeting is more than a casual gesture to wish us well.  It marks survival, progress and the hope of birthdays to come. 

To acknowledge and celebrate those birthdays, the American Cancer Society announced today the launch of a nationwide campaign as “The Official Sponsor of Birthdays”. (You can get more information at www.morebirthdays.com).

There are two new buzz words that could have significant implications for our health care going forward.  Those words are “comparative effectiveness.”

Why is comparative effectiveness so important?  Because depending on your interpretation and definition of the concept, this could be anything from a very much needed way to address some nagging questions about how we treat different diseases or the forerunner of a more aggressive effort to control medical costs.

Another day, another announcement of a potentially promising new cancer treatment, and another day of caution. Dendreon is the name of the company that issued the press release and has worked for years to develop the vaccine to treat advanced, hormone-refractory prostate cancer. 

In today’s announcement, the company said that the vaccine—called Provenge--“met its primary endpoint of improving overall survival compared to a placebo control.  The magnitude of the survival difference observed in the intent to treat population resulted in the study successfully achieving the pre-specified level of statistical significance defined in the study’s design.”

But not everyone is ready—just yet—to say the battle is won.  And the advocacy community is poised and ready to fight back if anyone suggests we not accept today’s announcement as the final word as to whether or not this vaccine is effective.

We are voracious consumers of technology in this country when it comes to our health care.  A recent discussion with a physician I know well about breast cancer screening using MRI highlights how sometimes our love-affair with technology can lead to personal dilemmas that are not easy to resolve.