Dr. Len's Cancer Blog

Sometime patience pays off.  And sometimes patience means you think you have come to the end of the road, only to find that someone has built an extension for the highway.

That’s the outcome from the next study, which reported that the use of a tumor vaccine in patients with a non-Hodgkin lymphoma called follicular lymphoma were found to have longer remissions after chemotherapy if they received the vaccine when compared to patients who received the same treatment but did not get the vaccine.

It is day two of the annual meeting of the American Society of Clinical Oncology in Orlando.  Over the next three hours, we will hear the four papers which have been selected for the plenary session of the meeting for presentation to thousands of researchers, doctors, and other cancer professionals.  These are, in one sense, the best of the best—the ones which will likely get the most media coverage and be of interest to largest number of meeting attendees.

The first paper that is being presented in an interesting one, if for no reason other than for its seeming simplicity (I promise you, nothing in cancer medicine is simple).  The bottom line: trying to seek out evidence of ovarian cancer recurrence after successful treatment for  metastatic disease and starting immediate treatment made no difference in survival when compared to waiting until a woman had symptoms related to that recurrence and starting treatment at that time.

This morning I am in Orlando at the annual meeting of the American Society of Clinical Oncology (ASCO) in Orlando, listening to an address by the outgoing President of ASCO, Dr. Richard Schilsky from the University of Chicago.

Although these types of talks are generally perfunctory and organizationally oriented, this one actually made some interesting points that show how far cancer care has come, how far it has to go, and how many obstacles stand in the way of progress.

When it comes to communicating, the world has certainly changed a great deal.  Instant access, instant information, immediate worldwide coverage of events—these are just a few of the things that we now take for granted.

Today, cancer patients, their families, friends and colleagues can take one step forward in that information world as the American Cancer Society in partnership with Microsoft’s HealthVault unveils a new internet tool on our website called “Circle Of Sharing™” that will help cancer patients take charge of their care, and communicate information more effectively to those friends, families and others who support them through the difficulties of their illness

Every year the American Cancer Society publishes a detailed analysis on the incidence and deaths from cancer in the United States. This year’s report—released today—is no exception.  It shows in clear and graphic detail the impact of cancer in terms of the number of times each cancer is diagnosed, and how many deaths we can expect. 

It is hard to reconcile the raindrops falling outside my office window this morning with the fact that this weekend marks the beginning of the summer vacation season.  But that is what it is, and I know that somewhere someone(s) will be trekking off to a beach, a lake, a mountain, or an outdoor activity for a couple of days of fun and relaxation. 

So today is still a good day (the rain notwithstanding) to remind all of you that sun safety should be at the top of your mind as you head off to your well deserved and well earned weekend of fun.

Today is also a good day to introduce you to something new, which hopefully will remind you throughout the summer that sun safety is an important part of your outdoor lifestyle.  That “something new” is the first annual “Don't Fry Day” sponsored by the National Council on Skin Cancer Prevention. 

Events of the past three weeks have left me thinking once again about what we do as oncologists and the impact of our decisions on our patients and their families for better or worse.

The primary driver of these thoughts was something that happened in my own family.  But the recent news about the boy in Minnesota with Hodgkin’s disease and his mother’s decision to forgo additional chemotherapy serves as a stark contrast to the circumstances that my own family has had to deal with around the very same question.

We now have the “final answer” from Centers for Medicare and Medicaid Services as to whether or not they will provide coverage for colorectal cancer screening with CT colonography under the Medicare program.  And the answer is: no.

To say the least, I am personally very disappointed.  Not that my opinion should be the driving force on a decision that may affect the lives of thousands of people.  But this is something that became a bit of a “cause” for me, in no small part because I felt it represented an opportunity to advance our medical science and knowledge at a time when lives could be saved.  It was an opportunity in my view to start setting the stage on how we can do things the right way in health care going forward, which will be a critical part of any reform effort.

In my opinion, we have failed to meet the challenge.

I participated in a meeting convened by the Food and Drug Administration this past Monday that addressed a new program the FDA has to put in place to address problems with certain pain medicines. 

The purpose of the program—called Risk Evaluation and Mitigation Strategy, or REMS—is to deal with the two conflicting goals of adequately and effectively treating pain with powerful medicines while making certain these medicines are used as intended and don’t end up in the wrong hands causing harm. 

Depending on how this program is designed and implemented—and those decisions are a long way off—we could either enhance pain control or significantly reduce access to these medications for patients who truly need them, frequently at the end of life.