Dr. Len's Cancer Blog

How often have you heard the phrase, “If the world were perfect…?”

We don’t live in a perfect world, but a recently published study in the medical journal Circulation shows what would happen if we lived in a perfect world when it comes to the impact of universal, effective medical prevention on the incidence of cardiovascular disease.

The heart of the question is what would happen if we did everything right as a country when it comes to undertaking preventive strategies, in this case for cardiac disease, and would we save any money if we did so?

There is something that fascinates the public about the possibility of treating cancer with a vaccine.  Perhaps that explains why so many abstracts and journal articles about the latest cancer vaccine research find their way into our newspapers, magazines and television reports.

A research article appearing today in the British medical journal The Lancet describes a clinical trial which investigated whether a vaccine called vitespen could improve the survival of patients with primary kidney cancer. 

Unfortunately, the study points out—yet once again—that we may be hopeful that cancer vaccines will work, but we are a long way from success.

What is even more startling about this report is the editorial which discusses the results.  The author of the editorial made some not-so- kind comments about how vaccine companies distort reports of vaccine trials, and how investigators make inappropriate claims regarding their research.

There is a revolution going on in prostate cancer surgery over the past several years since the introduction of robot assisted surgery in 2000. But the question that has not been answered to date in a meaningful way is whether or not all the hype about the robot is in fact born out by the evidence.

A recent article in the Journal of Clinical Oncology, along with an accompanying editorial, suggests that the advantages of the robot may be real in some respects, but may not be so great when it comes to the most important outcome, which is whether or not a man’s prostate cancer is effectively treated.

For those of you who are interested, the American Medical Association has posted the video of Dr. Davis' speech on their website.

The URL is:

http://www.ama-assn.org/ama/pub/category/18187.html

Imagine…

You are a physician in your 50’s.  You have devoted your professional life to public health, and are a recognized international expert on tobacco control.  You are highly regarded by your colleagues and your friends (many of whom fit both categories).  You are reflective and admired for your accomplishments and your insights.  You have unusual level of humility for one who has achieved so much.

In March, 2008—while actively serving in your capacity as a leader of medicine, you become ill.  You are diagnosed with Stage IV pancreatic cancer, and you know the outlook is not good.  You openly share your disease with your family, friends and colleagues around the world—and there are literally thousands of concerned people from all walks of life who care about this man.

Such is the real life story of our current President of the AMA, Ron Davis MD.

Having cancer is difficult enough.  Getting treatment is even more stressful.  But imagine having cancer, being in the midst of treatment, and having a natural disaster to deal with at the same time.

That’s the situation cancer patients and their families are now facing in many parts of the Midwest as heavy rains result in flooding in small and large communities to a degree not seen for many years.

There is a recurring question I simply cannot get out of my mind as I am flying back from ASCO’s annual meeting in Chicago: “What the heck goes on in those little rooms?"

The little rooms, my friends, are the sound-proofed spaces that are an intrinsic part of many of the drug companies’ booths on the ASCO convention floor. 

From what I can tell, they must be part of another sovereign country. 

Did you ever wonder how your oncologist knows which drugs to give you at what doses if you are receiving chemotherapy?  Or how they stay up with the latest chemotherapy recommendations for the treatment of your cancer?

This is actually a very important question, and one that has intrigued me for many years.

After all, our knowledge about cancer treatment is constantly increasing.  There is no way the typical physician can stay abreast of all there is to know about chemotherapy recommendations for all the different types of cancers.

That’s why I find the recent release of “chemotherapy order templates” by the National Comprehensive Cancer Network (NCCN) so interesting. 

A study being presented this afternoon at the plenary session of the American Society of Clinical Oncology (ASCO) annual meeting reports on the success of cetuximab (Erbitux) on improving survival for patients treated for advanced non-small cell lung cancer.

Cetuximab is a drug which was found several years ago to improve the response to treatment for patients with advanced colorectal cancer, and more recently in advanced head and neck cancer.

Today's report suggests that by using cetuximab in addition to chemotherapy, the outlook for lung cancer patients may be a small bit brighter.  The improvement in survival may be limited, but it is a step in the right direction.

It is always fascinating to learn about a new cancer treatment that essentially comes out of nowhere and ends up helping to improve the lives of patients with cancer.

Such is the story of zolendronic acid, commonly known by the trade name Zometa.  This drug—which was originally developed and used to prevent the destruction of bone in cancers that can spread to the bone and more recently has been approved to treat osteoporosis—has apparent direct anticancer treatment benefits in breast cancer.  The study is being reported this afternoon at the annual meeting of the American Society of Clinical Oncology.

Working with Zometa, researchers recognized that the drug had other actions beyond its impact on the bone to prevent destruction from cancer cells.