EXPERT VOICES

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

American Cancer Society Expert Voices

The American Cancer Society

Can we predict who will become addicted to cigarettes?

July 24, 2014

By Victoria Stevens, PhD

Every day in the United States, nearly 4,000 young people under the age of 18 smoke their first cigarette, according to the Centers for Disease Control's Youth and Tobacco Use Fact Sheet. About 1,000 of these kids will go on to become daily smokers, which is the next step on the pathway to becoming addicted to nicotine. Over the course of a year, that is 365,000 new daily smokers. About 60%, or almost 220,000, will still be regular smokers 7 to 9 years later. 

When they tried that first cigarette, did they expect to become dependent on nicotine and unable to quit smoking whenever they want to? Of course not, because they feel young and invincible. In fact, only 3% of the regular smokers expected to be still smoking 5 years later. 

Is nicotine addiction in our genes?

A paper published in JAMA Psychiatry may give some clues to why so many young people continue smoking after that first try. Please note: the research is preliminary, and much more needs to be done before any conclusions are reached and recommendations made. But it's also intriguing. More...

E-Cigarettes – It’s Complicated

June 24, 2014

By Thomas J. Glynn, PhD

Editor's note: This blog is the last one frequent contributor Dr. Glynn will write before his upcoming retirement. We wanted to thank him for his expertise and ability to break down a topic and offer insight, as well as his excellent writing. We offer him best wishes for a long, happy retirement.


In May 2011, I had the opportunity to write the first Expert Voices blog on what was then a new, but growing, public health concern - the emergence of e-cigarettes.

At that time, I wrote that "e-cigarettes have been described both as a miracle answer to the devastating effects of cigarette smoking and as a grave danger to the public health;" that they "are a source of controversy;" and that we need "to put science to work (and) obtain, solid, independent data" regarding e-cigarettes.

Now, 3 years later, more than 1,000 research papers, commentaries, and opinion pieces have been published about e-cigarettes. There's been continuous public debate about and media attention paid to e-cigarettes, and there's a proposed FDA rule regarding e-cigarette regulation.

Now, it is finally possible, at long last, to say that... e-cigarettes continue to be described both as a miracle answer to the devastating effects of cigarette smoking and as a grave danger to the public health; that they remain a source of controversy; and that more independent, objective data are needed.

Consensus remains elusive

Yes, the old French adage - plus ca change, plus c'est  la meme chose  (the more things change, the more they remain the same)-- is an apt description for the state of affairs regarding e-cigarettes in June 2014. Despite the considerable research, debate, media attention, Congressional hearings, and, yes, blogs, over the past 3 years, the public health, advocacy, scientific, and medical communities are little closer to a consensus regarding e-cigarettes than they were in May 2011. More...

The Same, Only Scarier -- The LGBT Cancer Experience

June 05, 2014

By Liz Margolies, LCSW


Getting a diagnosis of cancer is frightening for everyone. But for many lesbian, gay, bisexual, and transgender (LGBT) patients, the immediate concerns about treatment options and survival are compounded by an additional set of worries: 

  • "Should I come out to my healthcare providers?"
  • "Will I be safe if I do?"
  • "Will my chosen family be welcome?"
  • "Will I be able to find the information I need to take care of my relationship, my sexuality, my fertility and my family?"

LGBT cancer patients and survivors are underserved and that is partly as a result of being underreported. No cancer registries collect information about gender identity or sexual orientation, leaving LGBT cancer survivors buried in the data and often invisible to healthcare providers. Treatment facilities and social service organizations may also be unaware of the true number of LGBT people they serve because their intake forms do not invite disclosure (coming out as lesbian, gay, bisexual, transgender), and fear of discrimination keeps many patients in the closet. As a result, the healthcare system often fails to recognize LGBT patients and isn't trained to meet their needs.  

The American Cancer Society estimated in January 2014 that there were approximately 14.5 million Americans living with a history of cancer. Approximately 4% of Americans identify as LGBT, and LGBT people are known to have increased cancer risks and decreased screening rates. Considering all these factors, the National LGBT Cancer Network, estimates that there are more than 1 million LGBT cancer survivors in the country today. You might even know one or more of them. More...

Filed Under:

Disparities | General

Indoors or outdoors, there's no such thing as a safe tan

May 22, 2014

By Gery P. Guy Jr., PhD, MPH


If you read no further, know this: there is no such thing as a safe tan. Indoor tanning is just as dangerous, if not more, than tanning outside in the sun. In fact, indoor tanning injures thousands of people each year badly enough to go to the emergency department. Indoor tanning can cause sunburn and damage to your eyes that could lead to vision loss. Indoor tanning can also cause premature skin aging, including loss of elasticity, wrinkling, age spots, and changes in skin texture.

Most dangerous of all, indoor tanning is a recognized cause of skin cancer, including deadly melanoma. Skin cancer is the most common form of cancer in the United States. Approximately 3.5 million cases of non-melanoma skin cancers are treated each year, and more than 70,000 melanomas are diagnosed yearly. While many cancers have been on the decline in recent years, rates of melanoma, which causes the most skin cancer-related deaths, have been on the rise. Increased exposure to ultraviolet radiation (UV) through indoor tanning may be partially responsible for the continued increase in melanoma, especially among young women. Indoor tanning is particularly dangerous for younger and more frequent users.

Tanning myths


There are a lot of misconceptions about indoor tanning, so it's important to know the following:

  • Tanned skin is not healthy skin. That "healthy glow" from the tanning bed indicates damage to your skin. Whether tanning or burning, you are exposing yourself to harmful UV rays. In fact, every time you engage in indoor tanning, you increase your risk of melanoma. The truly healthy glow is your natural skin color. More...

Cell Phones, Bras, and Breast Cancer Risk

May 13, 2014

By Ted Gansler, MD, MPH

 

Like other contributors to the Expert Voices blogs, I am occasionally asked to reply to questions from journalists about various cancer-related topics. The most recent question I received is whether it is true that women who carry a cell phone in their bras are at increased risk for developing breast cancer.

This kind of question is surprisingly difficult to answer. It's relatively easy to write about things that are known to cause cancer. It's more difficult to be confident that something does not cause cancer, but one can still provide some guidance if there have been at least a few carefully-conducted epidemiologic studies with negative results. The most challenging requests we receive are often about questions that researchers have not addressed by scientific studies of humans populations. This is one such question.

Cause or Coincidence?


There are a few known instances of breast cancer in young women who have kept cell phones in their bras. (Even when cell phones are not being used for conversation or texting, if they are on then they still periodically emit low energy electromagnetic signals to stay in touch with nearby cell towers.) Because breast cancer is an uncommon and tragic occurrence among young women, these cases have received significant attention on television and on the Internet. But it is the nature of these media to emphasize unusual events, so of course we don't hear much about the millions of women and men who carry phones close to various organs and still remain healthy. More...

What we can do to end health disparities

April 15, 2014

By Kassandra I. Alcaraz, PhD, MPH

During National Minority Cancer Awareness Week and National Minority Health Month, the American Cancer Society, health agencies, and other organizations seek to raise awareness of health disparities, or health inequities, among racial and ethnic minority groups. Most of us have probably seen or heard the phrase "health disparities." But what, exactly, does this phrase mean? And why is it important?

The U.S. Department of Health and Human Services defines a health disparity as "a particular type of health difference that is closely linked with social or economic disadvantage." 

These disadvantages include things like racial discrimination, racially-segregated neighborhoods, and social stratification (the inequitable distribution of privilege, power, wealth, and resources in our society), and they have resulted in unequal access to quality health care, health information, and health programs for racial and ethnic minority groups. These "root causes" not only make the nation unhealthier as a whole but also present real challenges to eliminating disparities.

Although health disparities are not limited to racial and ethnic minority populations, this particular month gives us a dedicated time to better understand disparities among these groups. In the United States, racial and ethnic minority populations bear a disproportionately high burden of disease such as cancer. Generally these groups have worse outcomes than non-Hispanic whites when diagnosed with the same disease. More...

Filed Under:

Disparities

What to keep in mind when you see STUDIES SAY

March 31, 2014

By Alvaro Carrascal, MD, MPH

You may have seen some of these headlines recently in national newspapers and online:

More coffee linked to higher mortality rate: study

Four cups of coffee a day may raise early death risk in younger adults

4 Cups of Coffee a Day Can Be Deadly

New Study: Coffee Can Kill You

Under 55? Think twice before you reach for that extra cup of coffee, researchers say

After seeing these reports on the web and morning news, I had a thought as I reached for my morning cup of joe: Should I consider tea instead?

As a person who grew up drinking 2-3 cups of coffee a day, should I change my habits based on these news reports? What would happen if I don't? Should these reports stop my life-long friendship with Juan Valdez? More...

Filed Under:

General

A national effort to help end colon cancer

March 12, 2014

By Richard C. Wender, MD

About a year ago, U.S. Assistant Secretary for Health Howard Koh, MD, invited a small group of people to his office to discuss the opportunity for the nation to start a full court press to end colorectal (colon) cancer as a major public health problem in the United States. The meeting idea came from a conversation on his back porch with his college friend Ron Vender, MD, who had just been elected President of the American College of Gastroenterology (ACG). Howard asked Ron how he could most effectively work with the ACG and, together, they decided that it was the right time to tackle colon cancer in a big way.

Dr. Koh invited leaders of the organizations that were at the center of public health efforts to increase colon cancer screening rates to attend the meeting. Screening is looking for cancer in people who have no symptoms of the disease. In the case of colon cancer, screening can find the disease at an early, more treatable stage, and it can also prevent it altogether. This is because colon cancer screening tests often find polyps, which can then be removed before they have a chance to become cancerous.

Leaders from the American Cancer Society and Centers for Disease Control and Prevention (CDC) were joined by leaders of several other vital governmental agencies, gastroenterologist organizations, and the National Colorectal Cancer Roundtable (NCCRT). The NCCRT is an organization co-founded 17 years ago by the American Cancer Society and CDC. Today, the NCCRT brings together close to 80 organizations with a single common goal: to increase colon cancer screening rates, our most effective way to fight the disease. The key to the NCCRT's success has been its commitment to joining diverse organizations as equal stakeholders, to do the kind of work that no one organization can accomplish alone. It's a great example of public health in action. More...

International Women's Day, a Chance for Change

March 06, 2014

By Ambassador Sally G. Cowal


We celebrate International Women's Day March 8. Originally, it was an event to promote equal political rights, including the right to vote, for women. As a Chicagoan I'm proud to say that one of the earliest Women's Day observances was held in that city in 1908!

Today, although women have the right to vote almost everywhere, health inequalities and disparities between women in the developed and developing worlds -- and between men and women in many countries and regions of the world -- continue to exist.

Women's health is important, not only for women, but for men and for families. Women are the caregivers in most places in the world, and when a woman is ill or dies prematurely, her family -particularly her children - carry the burden.  That is one of the reasons why it is so important to prevent premature illness and death in women from cancer. Although we think of cancer as a disease that affects people in high income countries, the reality is that 57% of cancer cases and 65% of cancer deaths are in low and middle income countries - that is 5.3 million deaths a year.  And the trends point to a continuing shift of the burden to lower income countries.

In addition, the cancer experience in lower income countries is very different from the experience of cancer patients in the US. For example, in the US, 60% of breast cancer cases are diagnosed in the earliest stages of disease, whereas in Brazil only 20%, and in Mexico, only 10% are diagnosed at an early stage. When cancer is caught later, treatment is less likely to be successful.  As a result, advances in cancer survival that we have experienced over the last few decades in the US are not reflected in the experiences of people with cancer in lower income countries. More...

Does it matter if a cancer center is accredited?

February 25, 2014

By Katherine Sharpe, MTS

 

Recently, in a meeting, a representative from another patient advocacy organization made a comment that caught my attention. He said, "People vet their plumbing company more than they do their hospital." I reflected on this comment and for many people that is probably true. The Better Business Bureau has long offered "grades" on businesses, based on certain criteria. But with about 5,000 hospitals nationwide, how do you know which are the most trustworthy and are best to give treatment?

What is accreditation?


One way is through accreditation. Accreditation, simply put, is a formal process to show that a hospital meets certain standards. The standards are designed to improve the safety and quality of care provided to patients and encourage continuous improvement efforts within a hospital.

The standards focus on how patients receive care, what kinds of rights patients have, and hospital functions that are essential to providing safe, high-quality care. These might include things like clinical ethics (the making of "right" decisions in the delivery of health care), infection control and prevention, how the building is managed and maintained, and how patient information is managed. Accreditation standards are usually seen as cutting-edge yet achievable for hospitals.

These quality measures have been developed for several disease types. In cancer, for example, a facility might be required to have wide-ranging diagnostic and treatment services on-site and participate in cancer-related clinical research.  

Also, there can be varying categories of accreditation, so that the best fit can be established for a particular type of center. Standards for pediatric cancer facility might be different from those for an adult cancer center, for instance. More...

Filed Under:

General

About the Blog

Expert Voices will give you more than the statistics: it will give you insight. More