As I prepare to leave the office for a much needed two week vacation, I thought it would be interesting to glance back at the news of 2006 and pick out the stories that I think represent the “news of the year” in cancer research, treatment and other various topics.
This wasn’t some sort of scientific analysis. Simply, I reviewed my blog entries and my list of press notes in my email file to remind me which stories garnered the most interest or, in my opinion, had the most impact.
Not all of it is “news” in the traditional sense. But these stories do reflect what has happened over the past year, and include some personal musings.
I won’t provide links to each of the stories, but you can easily search them by month and date and find the blogs I am referring to. Also, I have talked about some of these topics several times over the past year. Unfortunately, I can’t list every blog where a particular topic is mentioned.
So, without further discussion, here is what I consider the important stories of the year, and why I think they are important: (please note these are listed by date, not necessarily in order of significance):
1/6/06 and other dates: Vitamin D
The vitamin D saga continues, and I find it personally very interesting. There appears to be some support that vitamin D can decrease the risks of various cancers. We have had reports this year on risk reduction for colorectal and pancreatic cancer, among others, and interest continues in developing effective research and public education programs to answer the many questions that have been raised by experts and the public.
2/9/06: Decreased death rates in cancer
An absolute decline in the number of deaths from cancer year over year from 2002 to 2003 represents potential real progress in the fight against cancer. Whether or not this is real and sustained remains uncertain, and we look forward to subsequent reports to the nation on this topic. This particular report garnered widespread media attention because of a significant increase in the number of thyroid cancer deaths in women and to a lesser degree in men. I reported a decline in breast cancer deaths, but this didn’t much notice (literally) until yesterday (see comment below and blog posted earlier today).
2/22/06 and other dates: HPV vaccine
The approval and introduction of Gardisil to prevent HPV vaccine is a real breakthrough. The question now is whether young women who are at greatest risk will be able to afford the vaccine. Over time, we anticipate a significant worldwide decrease in cervical cancer deaths as a result of this vaccine and another soon to be likely approved. Note that the American Cancer Society will soon be releasing its guidance on who should receive this vaccine for the greatest benefit.
4/11/06 and other dates: Estrogens and breast cancer
This report from the WHI study showed that for most women at average risk for breast cancer, who are post-menopausal and have had a hysterectomy, estrogen alone does not increase the risk of breast cancer when used for hormone replacement therapy. There were numerous other reports on various topics during the year from the WHI study, and even yesterday a major study discussed the declining incidence of breast cancers from 2002 to 2003, which was attributed in large part to the decreased use of hormone replacement therapy after the initial WHI report in July, 2002.
4/17/06 and other dates: The STAR Trial
This trial, which compared raloxifene to tamoxifen to reduce the risk of breast cancer in post-menopausal women at high risk of developing the disease over five years, created quite a stir. The end result is that raloxifene had an equal efficacy profile compared to tamoxifen in preventing invasive breast cancer, and had a better safety profile in the opinion of the experts. Whether that will translate into more women at high risk considering a prevention strategy for breast cancer by taking raloxifene remains unclear at this time.
5/2/06 and other dates: The costs of chemotherapy
The new targeted therapies represent real hope, and there are more to come. Whether we can afford our dreams remains unclear due to the phenomenal costs of these medicines. This is a topic that is certain to garner considerable debate and discussion in 2007.
6/4/06 and other dates: New targeted therapies for various cancers, including kidney cancer
A session at the annual meeting of the American Society of Clinical Oncology highlighted the science behind targeted therapies and serves as a symbol of the many papers presented at the ASCO meeting demonstrating potential efficacy of several new targeted drugs. For the first time in a while, a new targeted treatment was reported to be effective in treating patients with recurrent kidney cancer.
6/27/06: The Surgeon’s General report on second-hand smoke
The Surgeon General finally has a report which puts the kabosh on second-hand smoke, showing conclusively that is harmful to non-smokers. The only people still wondering whether or not smoking is bad for you and whether exposure to second-hand smoke can kill you are some of our dedicated legislators who for one reason or another still appear to be living in 1960.
8/8/06: Genomic prediction of lung cancer prognosis
This study demonstrated reasonably accurately which patients with early stage non-small cell lung cancer are likely to have a recurrence, and thus might benefit from preventive chemotherapy. It is a model for other diseases, including breast cancer, where there is considerable interest in being able to take material from a cancer, analyze it, and predict outcome. As these methods are refined, we will hopefully be able to limit our toxic and inconvenient adjuvant therapies to those who really need them. It is a further example of how we are moving forward using genetic knowledge to tailor our treatments for cancer.
8/30/06: Genetic engineering results in durable remissions for patients with metastatic melanoma
This study from the National Cancer Institute demonstrated that in patients with advanced melanoma, we can use genetic material to transform lymphocytes from patients into effective cancer fighting weapons. Although the results were modest, this research demonstrates the convergence in genetic knowledge that holds the promise for striking breakthroughs in the treatment of cancer in the not-too-distant future.
9/13/06: Genomic mapping
This article, shortly after the one published on 8/30/06, again shows how our knowledge is rapidly progressing in understanding what makes a cancer cell a cancer cell. This research holds out the hope that we will be able to analyze cancer cells, and determine their specific genetic abnormalities. Using that information, we will be able to apply specific targeted therapies to a person’s cancer. In other words, we will be able to provide customized treatment, rather than using a shotgun or cannon to treat the disease.
10/25/06: Lung cancer screening with CT scans
An article in the New England Journal of Medicine showed that in a select group of patients, if you find the lung cancer early, a patient can have an excellent chance of a long-term survival. There were criticisms of the study, and isn’t clear that this approach is ready for widespread adoption. That said, many people who are heavy smokers or have a past history of being a heavy smoker probably heard about the article and are asking their doctors what they should do. A randomized study currently underway will hopefully answer the question more definitively, but the results won’t be available for several years.
11/13/06: The AMA votes to hold their future annual and interim meetings in smoke free cities
This may not seem like big news, but to me it is. The AMA House of Delegates has resisted this resolution in the past, but the situation at a meeting in Las Vegas was intolerable. The real message is that there are enough smoke-free venues in this country today that can accommodate this and other similar meetings. At least some communities are listening, and they should be the (economic) beneficiaries of their efforts (read that: Washington, DC, Chicago, New York, Hawaii and California among others). By the way, “smoke-free” should not mean its ok to smoke on the casino floor, which is the result of legislation in Nevada and New Jersey. Smoke-free means smoke-free, as noted in the Surgeon General’s report.
12/7/06: Chronic myelogenous leukemia is now truly a chronic disease, thanks to Gleevec
This is not new news, but it is important nonetheless for what it represents: effective, tolerable, durable treatment for a formerly fatal disease. It means that yesterday’s promise can become today’s reality. Thousands of people are alive today, leading productive, meaningful lives as a result of this breakthrough.
Now, for some personal favorites that I enjoyed writing:
3/6/06: Honey, What Happened To The Haze?
What it was like to suddenly realize we were eating dinner in a smoke-free environment in one of our favorite Atlanta restaurants. The message here is to say thank you to the establishment—they need to hear that. By the way, I have had similar experiences at several restaurants I have visited subsequently around the country.
5/15/06: The "Eat Right Challenge: A Journey For Life"
A summary of my own issues regarding my weight and my health, and facing the knowledge that I had not done everything I could have done to keep myself in the best condition medically. Just because you are a doctor doesn’t mean you always do what you are supposed to do.
8/26/06: You Are What You Weigh
The risks of being overweight and/or obese demonstrated increased mortality in a New England Journal of Medicine article. A leading researcher, in a commentary article in the same issue of the Journal, admitted to his own weight issues and what he was doing about it, and I shared my own thoughts on the topic.
9/20/06: The American Cancer Society’s Cancer Action Network “Celebration on the Hill”
For me, Celebration On The Hill had an incredible—and unexpected—personal impact. Through a series of blogs I wrote that day and the next I tried to impart what I was seeing and what I was feeling. Words, however, were not adequate to reflect that experience. The survivors and their supporters were incredible folks, and drawing together that evening around the reflecting pool was an experience many of us will never forget.
Celebrities occupy a special place in our society for a number of reasons.
We can’t let the year pass without acknowledging the deaths of three in particular:
Dana Reeve
Ann Richards
Ed Bradley
That concludes my summary of the year in review, so to speak. There are other stories that deserve to be noted, but there simply isn’t enough time or space to do justice to every deserving event.
What we have seen over the past year is an incredible leap forward in cancer research, diagnosis and treatment, and I suspect there are going to be even more exciting developments in the coming year.
It has taken us many years to achieve the “stories” I highlighted above. What this means to me is that we can never lose hope or lose our focus on what we all need to do in our own way to continue the fight against cancer in all its forms.
I look forward to 2007 with great anticipation.
Have a wonderful, meaningful holiday season, and a healthy New Year!!!
