Dr. Len's Cancer Blog

It’s time to talk cancer science and discovery.

I am currently in Chicago, attending the annual meeting of the American Society of Clinical Oncology (ASCO).  This is what most of us consider the premier international cancer meeting, and is attended by over 30,000 physicians and cancer scientists, hearing information on over 5000 studies, some of which inevitably will set the standards of care in cancer treatment for years to come.

As I write this, I am listening to a series of talks from leaders in cancer medicine.

One presentation that has just concluded was given by Dr. John Niederhuber, the director of the National Cancer Institute.

What he reminded us that despite our advances in cancer treatment, and while we are struggling to get sufficient funds for cancer research, we can never forget that miracles do occur.

As I write this, my mind is on my exit for the weekend, and thoughts of being with my family, friends, and the dogs (two very active golden retrievers, but more about them another day) in the north Georgia mountains.  (Yes, there are mountains in north Georgia. Not too high, but they are mountains.)  

I am thinking of taking walks, doing some cooking, maybe fishing, and basically taking 72 hours to relax a bit (If  that is possible with the dogs.  They don’t get much attention normally, so this is their time for vacation, too.).

But it is also that time of year when we need to be thinking about not only the good things associated with being out of doors, but how we have to take care of ourselves and our health when we are out in the sun.

News reports this morning that the smoking cessation drug Chantix (varenicline) has been linked to an increasing number and variety of side-effects was disturbing.    

The announcement that the Federal Aviation Administration has decided to ban the use of Chantix by pilots and air-traffic controllers certainly doesn't give one a sense of comfort.

It should come as no surprise that when you study a drug on relatively healthy people, and that drug impacts the central nervous system directly as its mode of action, that you might expect to find some additional side effects when it gets out into the real world.

But read the list below and you may be surprised what the researchers found.

The news that Senator Edward Kennedy has been diagnosed with a malignant brain tumor is certainly sad and difficult to read.

No matter your political persuasion, there is no denying the fact that this man and his family have had a singular impact on this country and its politics for several generations.  It goes without saying that he has been a major force in cancer research and treatment.  Even recently, he led hearings into expanding federal funding for cancer research.

Our thoughts and prayers go out to the Senator and his family at this difficult time.

There is certain to follow a rash of speculation on the specific circumstances of the Senator’s diagnosis.

We are getting into the “season” when there is a plethora of cancer news, primarily due to forthcoming annual meeting of the American Society of Clinical Oncology meeting, which is scheduled to begin in two weeks in Chicago.

Unlike years past, when the abstracts were embargoed until the scientific studies had been presented at the meeting, this year ASCO released almost all of the abstracts last evening.  Only a handful of the most significant abstracts have been withheld from the public release.

One of the abstracts highlighted by ASCO had to do with vitamin D levels of women diagnosed with breast cancer.  The results of that study are certainly thought provoking, and will undoubtedly add to the discussion on the role of vitamin D in health and its influence on cancer incidence and prognosis.

Caregivers for cancer patients are very special people.  They frequently are the ones who listen most carefully to what the doctors have to say, and they frequently provide the support that patients need to get through their arduous journey once a cancer is diagnosed.

I don’t need to tell you that some of the most difficult and feared words that a doctor can say to a patient are, “You have cancer.”  We know that once those words are uttered for the first time, a person can go emotionally and even physically numb. 

That’s where the caregivers step in.  But I think it is more than “giving care.”  It is one of the most special partnerships that any of us can imagine.  So I am going to suggest that we consider changing this phrase to one that perhaps more accurately describes this relationship, namely “carepartners.”

Those of you who read this blog regularly know that I frequently make the comment that if New York City can go smoke-free, anyone can.

During yesterday’s meeting celebrating the release of the new guidelines for smoking cessation, I was particularly struck by some information mentioned by one of the speakers outlining the incredible success and impact of New York’s smoking ban that went into effect in 2002.

Now I have the actual data, and I believe it is proof positive that when you have the political and public will to do something, there are real benefits to be gained.  And those benefits are not just economic in terms of dollars, but also include a reduction in illness and the saving of lives.

Bottom line, these numbers make it hard to argue against the fact that effective public policy has a real impact on our health and the quality of our lives.

It is clearly evident in this room today, where the Public Health Service is unveiling its updated guidelines for treating tobacco use and dependence, that Dr. C. Everett Koop is one of the heroes of this moment and this movement.

As he just mentioned during his remarks at this meeting, Dr. Koop is in his tenth decade of life.  He has seen a lot, and done a lot.

Dr. Koop became one of the outstanding Surgeons General of my lifetime.  He attacked AIDS and vigorously fought the tobacco companies.  Whatever his personal beliefs, he became an articulate spokesperson and advocate for what was right in medical science, medical care and the public health.

Today I am in Chicago, attending a meeting where the United States Public Health Service is releasing their updated guidelines titled “Treating Tobacco Use and Dependence: Clinical Practice Guideline 2008 Update.” 

These guidelines are an update of recommendations that were first published in 1996, and revised in 2000.  The current report represents evidence from over 8700 published articles in the medical literature, which have been published beginning in 1975.

What has surprised me is that some of my colleagues believe that there may not be much interest in this guideline, that it may be “more of the same.”  Yes, they say, we have had successes, but given those gains people and health care professionals are no longer focused on the importance of smoking cessation.  Simply put, we have moved on to other “big new ideas.”

I don’t agree.

I am going to let you in on a little secret.

My confessional is prompted by the realization this past weekend, when I was on a call with someone referred by a friend, that I haven’t shared something with you that I rely on regularly when I talk with patients, families or friends who have questions about cancer treatment.

That “secret” is a website which provides what I consider the most up-to-date information used by doctors to guide their treatment of cancer.  That website is hosted by the National Comprehensive Cancer Network, or NCCN.