EXPERT VOICES

Timely insight on cancer topics from the experts of the American Cancer Society

American Cancer Society Expert Voices

The American Cancer Society

Recent progress in cancer research, prevention, and treatment

April 22, 2015

By Fadlo R. Khuri, MD, FACP

2014 was another banner year for cancer research, particularly in the areas of treatment, prevention, and early detection. While there were several significant spheres of progress, we find the following five major advances particularly noteworthy.   

Targeted therapies

First is the development of new targeted therapies for cancer. Targeted therapies specifically block key molecules that are crucial for cancer cell growth and survival.

The promise of such therapies was first established about 15 years ago by the development of imatinib (Gleevec), which blocks the oncogene (cancer-promoting gene) responsible for development of chronic myelogenous leukemia (CML), and led to dramatic responses in patients with this cancer. Many more targeted agents have since been developed. This development has been greatly helped in recent years by the sequencing of the human and the cancer genome, which has led to a more complete understanding of genes that drive cancer. 

Targeted agents have transformed modern cancer care by keeping cancer under control for longer periods of time and reducing side effects. However, for all but a handful of patients, cancer is able to develop resistance to targeted therapy over time.

A number of newer, more potent targeted therapies were developed in 2014 that further reduce side effects and help overcome resistance, at least for some time. Targeted therapy treatments have evolved and improved for patients with certain forms of lung cancer, leukemia, breast cancer and renal cell carcinoma.

Patients with cancer and their family members should be prepared to ask how specific the targeted treatment is for their own type of cancer (how well does it target their type of cancer cell), how long most people stay on the treatment, the benefits from the treatment, and what the side effects could be like. More...

Filed Under:

Promising Research

Making End-of-Life Plans

March 24, 2015

By Agnes Beasley, MSN, RN, OCN

A lot of us are planners. We plan work projects, celebrations, careers, family vacations, and retirements. However, the one area that most of us avoid thinking about, much less planning, is the end of our life. After all, we don't plan on having a terminal illness. We don't plan on dying any time soon. Decisions about end-of-life care are deeply personal, and are based on personal values and beliefs. No one wants to think about end-of-life issues when there are so many other happier activities to fill our calendars.

Still, at some point in time many of us will face making decisions about the dying process. How do you bring up the topic? When do you bring up the topic? Who do you talk to? Thinking about your end-of-life wishes, also known as advance care planning, can be hard and overwhelming. Most people expect their doctors to start the conversation about end-of-life planning - but only when it's necessary and not a moment sooner! That's especially true for people with cancer, especially when treatment may no longer be working. Many cancer patients and close family members may be thinking about discussing end-of-life issues with their doctor when the time comes, but where do they begin?  More...

Filed Under:

Caregiving | General

What keeps people from lifesaving colon cancer testing?

March 12, 2015

By Richard Wender, MD


We have made amazing progress in reducing colon cancer death rates. This progress is a direct result of increasing screening for colon cancer and pre-cancerous polyps. We are actually preventing thousands of cancers by finding and removing pre-cancerous polyps. The nation has embraced the goal of increasing national screening rates to 80% by the end of 2018 - an achievement that will substantially reduce the terrible toll that colon cancer exacts every year.  Everyone is at risk for colon cancer, whether or not someone in your family has ever had a colon polyp or colon cancer. For that reason, everyone has to start being screened for colon cancer at age 50, and people with inflammatory bowel disease or a family history of colon cancer or polyps have to start before they reach age 50. Colon cancer screening is one of the best opportunities to prevent cancer that we've ever discovered.

Despite this compelling reason to be screened, many people either have never had a colon cancer screening test or are not up-to-date with screening. Interestingly, nearly all of these unscreened people know that they should be screened, In fact, awareness about colon cancer screening recommendations approaches 100%. The American Cancer Society asked more than 2,000 unscreened adults a series of questions about screening, and we now have a pretty clear idea about what's stopping people from taking that lifesaving step:

  • Some people are concerned about the cost of the test
  • Others have heard that the test is difficult or painful, and they may be embarrassed to discuss colon cancer screening
  • Some people think screening is only for those who have symptoms
  • Others think that having no family history of colon cancer means that they are not at risk and don't have to be screened

Finally, and perhaps most importantly, many people are concerned about the complexity and cost of having a colonoscopy, like the need to take time off from work, the need to have a ride home, and the potential for high out-of-pocket expenses, which all combine to discourage them from having a colonoscopy. More...

Celebrating 25 Years of Smoke-Free Airplanes

February 25, 2015

By John R. Seffrin, PhD

Twenty-five years after a federal law passed banning smoking on all domestic flights, many of us don't even notice the lit "No Smoking" sign above our airplane seats. Until that landmark public health legislation took effect on February 25, 1990, flight attendants were subjected to deadly secondhand smoke during every flight and travelers who sat in "non-smoking" sections couldn't escape the fumes.

As a member of the American Cancer Society National Board of Directors 25 years ago, I agreed it was imperative for the Society to utilize its scientific expertise and passionate volunteer base to counteract the tobacco industry and protect non-smokers and flight attendants from the hazardous effects of secondhand smoke on every flight. We had the evidence to prove that smoke-free laws saved lives, so we decided to take the issue to Capitol Hill. The Society and its public health partners had champions in Senators Dick Durbin (D-IL) and Frank Lautenberg (D-NJ), whose unwavering support was instrumental in passing the legislation. (You can hear more about Senator Durbin's involvement in this video.)

The smoke-free airplanes legislation sparked a nationwide movement in support of smoke-free workplaces. In 2002, Delaware became the first state to enact a comprehensive smoke-free law covering all workplaces, including bars and restaurants. Since then, 23 other states and the District of Columbia have followed suit, and today nearly half of the U.S. population is protected by a comprehensive smoke-free law. 

The Society's advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), believes that the momentum that began 25 years ago cannot stall, especially with a tobacco industry that continues to use egregious tactics to addict kids to its deadly products. There are still 26 states lacking comprehensive smoke-free laws, 58 million Americans exposed to secondhand smoke and minority and low-income populations disproportionately subjected to the deadly impact of tobacco. It's hard to imagine that cigarettes were ever allowed on flights, and smoking in other workplaces, including restaurants and bars should become relegated to history books as well.

Tobacco will claim the lives of nearly half a million Americans this year. Evidence shows that enacting strong smoke-free laws that cover all workplaces, increasing tobacco excise taxes on a regular basis and fully funding tobacco prevention and cessation programs help people quit using tobacco and keep kids from ever starting. ACS CAN is working to make strong tobacco control laws a priority with elected officials at every level. From passing local smoke-free ordinances, to increasing the meager $1.01 federal cigarette tax, to funding tobacco education and cessation programs, to supporting strong federal regulation over the tobacco industry, ACS CAN is strengthening public policies in ways that help to change cultural views of tobacco use and will lead to a smoke-free, tobacco-free generation. 

 

Dr. Seffrin is the chief executive officer f the American Cancer Society and its advocacy affiliate the American Cancer Society Cancer Action Network.

Palliative care is part of good cancer care

February 16, 2015

By Diane E. Meier, M.D., FACP

Deborah, a 36-year-old mother of two young children, was diagnosed with breast cancer 2 years ago, and the disease has metastasized (spread) to her bones. The pain is severe, making it hard to care for her children or get to work.

Like any young mother, Deborah is determined to fight her cancer and be present for her son and daughter as they grow up. Deborah's oncologists, doctors at the top of their field, are intensely focused on controlling her cancer and identifying the chemotherapy plans that are most likely to work for her. But they have been unable to manage Deborah's pain. It had become so bad that she was unable to sleep or eat, spending much of the day curled on her side in bed. She missed a course of chemotherapy because of her pain, and she had to hire outside help to get her kids to and from school.

Deborah's long-time internist finally referred her to the palliative care team at her local hospital. They prescribed a low-dose opioid medicine and within 2 days, Deborah's pain was well controlled, she was up and around, sleeping and eating, and back to normal life with her family. She has been able to complete her latest course of chemotherapy and her oncologist feels her scans are showing a good response to the treatment.

Deborah's story is not unique. She is one of many thousands of people with cancer who have benefitted from palliative care, so that she can enjoy some normal day-to-day function and quality of life while she fights cancer. 

Palliative care for any stage of disease

 

Palliative care, sometimes called "supportive care," is medical treatment for people with serious illness. It's most often begun by the cancer care team, and referrals to or visits with palliative care specialists may happen later. Teams of palliative care specialists typically include doctors, nurses, social workers, and other healthcare professionals who work together with the patient, their family, and their other doctors to provide an added layer of support. The team works with the patient to provide relief from the pain and other symptoms, as well as the distress of their illness, so that the patient can live as well as possible. More...

Less Food Marketing, Healthier Children

January 20, 2015

By Colleen Doyle, MS, RD


Have you seen all those fun and flashy commercials encouraging your kids to eat more fruits and vegetables? No? Neither have I. And there's a reason for that. 

Out of the $1.79 billion that the Federal Trade Commission says major food and beverage companies spent marketing foods and beverages to kids and teens (in 2009 - the most recent data available), less than .05% was spent marketing fruits and vegetables. Unfortunately for those of us who care about children's health - which I hope is all of us - the majority of those dollars was spent on marketing unhealthy foods and beverages. Forty percent was spent to market fast food and other restaurant foods, and another 22% was spent promoting high-sugar sodas and other carbonated beverages.

And consider these additional statistics:

  • Two BILLION advertisements for foods and drinks appeared on websites directed at kids in 2009, mostly for sugary cereals and fast food.
  • Dollars spent to market foods and drinks to kids via online games, mobile apps, social network ads, and other digital media increased by 51% from 2006 to 2009.
  • Companies spent $149 MILLION in 2009 to market sugary drinks and food in schools.
  • Companies spent $113 MILLION in 2009 on packaging with marketing aimed at kids (think SpongeBob, Hello Kitty, and other characters).
  • Fast-food restaurants spent over $700 MILLION in 2009 on marketing to kids, nearly half of which was spent on kids' meal toys and giveaways.
  • Kids saw 12 to 16 TV advertisements per day for unhealthy foods or drinks in 2011.
  • Eighty-four percent of foods and drinks advertised to kids on Spanish-language television are unhealthy. More...

Chemo 101: What you need to know

January 12, 2015

By Agnes Beasley, MSN, RN, OCN

"What should I expect from chemotherapy?" 

I've heard those very words spoken by newly diagnosed cancer patients on many occasions in my extensive oncology nursing career. It's normal for a newly diagnosed patient to try to make sense of what is happening to them. Questions swirl like a tornado in a cancer patient's mind. You may feel that way right now. Some of the questions you may have are:

  • What can I expect on the day of chemotherapy (chemo)?
  • What can I expect when I go home after chemo?
  • What happens in the "chemo room?"
  • How long will it take to get my chemo?
  • Can I have someone with me during chemo to keep me company?
  • What am I allowed to bring with me to keep me busy?
  • Is it okay to sleep?
  • Will there be other people getting treatment around me or can I be in a private room?
  • I'm feeling anxious, overwhelmed, upset, and angry. Is what I'm feeling normal?
  • If I have questions, who do I call for the answers? More...

Filed Under:

Survivorship

The Cancer Atlas Reveals the International Burden of Cancer

December 03, 2014

By Ahmedin Jemal, DVM, PhD

The American Cancer Society has released the second edition of The Cancer Atlas book and, for the first time, a companion website. The Cancer Atlas provides in-depth information on the global burden of cancer, major risk factors, and cancer prevention and control measures.

Changes in developing countries leading to more cancer

 

It is estimated that the global burden of cancer is expected to rise from 14.1 million new cancer diagnoses in 2012 to 19.3 million in 2025 simply due to the aging and growth of the population. This is because the risk of getting cancer is greater as you age. During this period, even more cancers are diagnosed in less economically developed countries, increasing from 59% to 68% of the total cancer cases worldwide. In addition to aging, the burden is likely to increase as countries transition from a farming-based economy to an industry-based economy and as people change their work environments (office instead of farm), modes of transportation (driving instead of walking), and dietary habits (eating out instead of home cooked) - all of which lead to more obesity and physical inactivity, known risk factors for many common cancers.

Also, women are having fewer children and, therefore, also breastfeed for less time over the course of their lives, both of which may increase the risk of breast cancer. In addition, economically developing countries are being increasingly targeted by the tobacco, fast food, and beverage industries in search of new markets, leading to greater obesity, less physical activity, and more smokers. As a result, in many less developed countries more cancers such as lung, colorectal (colon), and breast are being diagnosed, and more people are dying from cancers typically associated with western lifestyles. In more developed countries, including the United States, rates of cancer diagnoses and deaths are decreasing or leveling off for the same cancers.  More...

Filed Under:

Global Cancer

Continuing to smoke after a cancer diagnosis

November 17, 2014

By J. Lee Westmaas, PhD


While the American Cancer Society and other organizations traditionally focus on getting smokers to quit before they develop cancer, there's a group of smokers who are especially susceptible to the negative effects of smoking. They are cancer survivors - some of whom have been diagnosed with a smoking-related cancer. It's easy to say, "If you get cancer, then you should know better and quit, and stay quit," but that's not the whole story.

Getting a cancer diagnosis does motivate some smokers to quit. Using data from the American Cancer Society Cancer Prevention Study-II, we found that about 1 out of 3 smokers quit smoking when they were diagnosed with cancer. That compares with only 1 out of 5 smokers who quit but were not diagnosed with cancer during the same time periods studied.

Even smokers whose cancer was not strongly linked to smoking (like breast cancer) quit at higher rates than undiagnosed smokers. These results were not caused by the smokers being unable to smoke due to their illness; those people were excluded from the study.

Smoking: Risky for patients and survivors

Quitting is particularly important for cancer patients and survivors because smoking can increase the likelihood of a recurrence, delay wound healing, and make cancer treatments less effective. This is true even for cancers that aren't related to smoking. 

Unfortunately, there are some cancer survivors who find it very hard to quit. We looked at data from the Study of Cancer Survivors (SCS-I), a nationwide quality-of-life study conducted by the Behavioral Research Center at the American Cancer Society. The study surveyed 2,938 survivors of 10 different kinds of cancers approximately 9 years after their initial diagnosis.

We found that 9.3% of these survivors were current smokers. Survivors of bladder, lung, and ovarian cancers had the highest smoking rates in this study. Most (83%) current smokers smoked daily, averaging almost 15 cigarettes per day. In fact, 40% percent of daily smokers smoked more than 15 cigarettes per day. More...

Are lung cancer breath tests more than hot air?

November 10, 2014

By Ted Gansler, MD, MBA, MPH

Can breath tests (like those used to check whether drivers have been drinking alcohol) be used for lung cancer screening? Or, is this (pardon the pun) just a lot of "hot air?" Although breath tests for lung cancer are "not ready for prime time," there has been some encouraging research.

There are 3 main ways to fight cancer - prevention, screening, and treatment. Although lung cancer remains the leading cause of death from cancer worldwide and in the United States, researchers are making progress against this disease on all 3 fronts. 

Over nearly a half century, researchers tried several tests for lung cancer screening, none of which were accurate enough for widespread use. Because of research results released in 2010, the American Cancer Society and several other organizations now recommend that people at high risk for lung cancer (certain groups of current and former smokers) ask their doctor about CT scans for lung cancer screening.

On average, people in these high risk groups who have this test every year according to the ACS guidelines can reduce their risk of dying from lung cancer by about 20%. This can save a lot of lives and prevent a lot of suffering, so if you are a current or former smoker, you should read more about our lung cancer screening recommendations.

Research into easier lung cancer screening

One challenge with CT scans is that they find some lung nodules that are neither clearly cancer nor clearly benign (not cancer). This question is usually figured out by follow-up scans, but sometimes biopsies are needed. These biopsies can pose significant risks, which is one reason screening isn't recommended for people whose risk of lung cancer isn't as high as that of heavy smokers. So researchers are looking for ways to make screening easier and more accurate, faster and more affordable. More...

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