Dr. Len's Cancer Blog

Twenty years ago, Surgeon General C. Everett Koop wrote, “The right of smokers to smoke ends where their behavior affects the health and well-being of others.”

Today, the current Surgeon General, Richard Carmona, MD, emphasized that statement and added evidence to the argument that secondhand smoke, or involuntary exposure to tobacco smoke, has severe health consequences. 

His report released this morning and titled “The Health Consequences of Involuntary Exposure to Tobacco Smoke” is thorough and hard hitting, with a clear message.

The evidence cannot be overlooked: secondhand smoke kills, secondhand smoke harms, and secondhand smoke has no safe limit of exposure.

And, according to the Surgeon General, the only effective strategy to reduce the adverse health effects of secondhand smoke is to remove it from our work, home, recreational and hospitality environments.  Anything less than a complete ban simply won’t work.

About 10 days ago the New England Journal of Medicine published two articles and an editorial about some exciting advances in the treatment of chronic myelogenous leukemia.

It wasn’t just the research that got my attention.  It was the implications attached to the research that were captured in the accompanying editorial that show once again we are in a new era of cancer treatment and drug discovery.

The major health news today is that the FDA has approved a new vaccine which will prevent many cases of cervical cancer.

The vaccine, called Gardisil and developed by Merck, has been approved for administration to girls ages 9 through 26 who have not begun sexual activity.

In my opinion, this development is transformational for medicine and medical practice, and will have a substantial impact on the health of women in this country and elsewhere.

Yesterday I posted a commentary on the STAR Trial presented at the ASCO meetings.

One of the issues that has received considerable attention in discussions about this trial is the importance of the increased risk of uterine cancer as a determining factor in which drug--raloxifene or tamoxifen—is a better prevention strategy for post-menopausal women who have a high risk of developing breast cancer.

But there is another factor that has received somewhat less attention, and that is the observation that the women taking tamoxifen had over twice as many hysterectomies during the trial compared to women who took raloxifene.  There was no clear explanation for this difference, according to the researchers.

Maybe I can shed some light on the reasons for this, and why this may be an important consideration for women who are contemplating taking one of these medications to decrease their risk of breast cancer.

Several weeks ago, prominent researchers announced the results of a large clinical research trial called the STAR Trial (for “The NSABP Study of Tamoxifen and Raloxifene P-2 Trial”).

This trial was designed to find out whether a drug called raloxifene, which is commonly used to prevent and treat osteoporosis, was as effective as a drug called tamoxifen in preventing breast cancer in women at high risk of developing this disease.

The enthusiasm of the researchers who spoke at the news conference that the “new drug” (raloxifene) was clearly superior to the “older drug” (tamoxifen) resulted in numerous articles and comments by experts that perhaps their excitement was perhaps a bit premature.

Yesterday, some of the questions about the trial were answered.

But I still don't think we have a clear "winner."

I am presently sitting in a lecture hall at the American Society of Clinical Oncology annual meeting listening to a presentation by one of the world’s experts on the sequencing of the human genome. 

The expert, Dr. Francis Collins, is discussing how much we have learned over the past several years about our genes and how they relate to cancer, and how much we will continue to learn about this topic over the next several years.

The progress we have made in this arena has been truly astounding.  And it is exciting to anticipate how much more we are going to learn in the near future.

So much can happen in a year, or so it seems when listening to the presentations currently underway at the annual meeting of the American Society of Clinical Oncology in Atlanta.

At last year’s gathering, the news that Herceptin (trastuzumab) reduced the recurrence of breast cancer after primary treatment in a select group of women whose tumors had a gene called HER/neu2 was greeted with unprecedented cheers and applause from the thousands of cancer specialists in attendance.

This year, the chair of the session which reviewed the current state of knowledge on the use of Herceptin and similar drugs as treatments for breast cancer in the adjuvant and recurrence settings made a startling statement.