EXPERT VOICES

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

American Cancer Society Expert Voices

The American Cancer Society

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

Can eating chocolate prevent cancer?

February 12, 2014

By Ted Gansler, MD, MPH

 

In the course of my routine medical journal reading last year, I came across a short article in The Lancet Oncology about chocolate and cancer prevention. I saved that file on my computer (without reading it), thinking that it might serve as the point of departure for a lighthearted and slightly romantic Valentine's Day essay on this blog.

With that deadline only a few days away, I opened the file and read the article, as well as a few others. The good news is that chocolate does not cause cancer and that moderate consumption of dark chocolate may have a positive impact on heart disease risk. The rest is more complicated.

If you try an Internet search for words like "chocolate prevents cancer," you will find several thoughtful summaries of the available evidence. You will also find some cute but misleading articles implying that eating a lot of chocolate candy prevents cancer. And, you will find a lot of articles with cute headlines and introductions that save their unsweetened facts for the conclusion.

My favorite scientific reviews of cancer and chocolate evaluate information from pre-clinical studies, observational epidemiological studies, and clinical trials separately, and I will follow this approach to get the most thorough view of the topic.

What lab studies can tell us

 

Most pre-clinical studies are experiments that use lab animals (in this case, mice and rats) or cells growing in lab dishes. The theme of the cell experiments involves adding specific chemicals from chocolate (such as polyphenols, catechins, and proanthocyanidins) and observing what they do to various cell processes that are known to have an effect on cancer formation, growth, spread, etc. Some of the rat and mouse experiments added specific chemicals from chocolate to the animals' food, whereas others used liquid chocolate extracts or unsweetened cocoa powder. More...

Filed Under:

Diet/Exercise | Ted Gansler

The HPV vaccine could do even more

January 23, 2014

EDITOR'S NOTE: The President's Cancer Panel has released a report that says increasing HPV vaccination is one of the most important opportunities in cancer prevention. The report calls for re-energized efforts to promote vaccination and reach the HPV vaccines' potential to save lives by preventing avoidable cancers in men and women. It explores underuse of HPV vaccines, identifies key barriers to increasing vaccine uptake, and provides actionable recommendations for overcoming these obstacles. To coincide with the release, here is our recent blog on the subject.

 

By Debbie Saslow, PhD

The HPV vaccines (Gardasil and Cervarix) have been recommended for girls in the US for nearly 10 years. They protect against human papillomavirus (HPV), the virus that causes most cases of cervical cancer, and Gardasil also protects against nearly all cases of genital warts. Uptake of HPV vaccination has been slow in this country, though; less than 35% of girls have gotten all 3 recommended doses.

Despite low vaccination rates, we have already seen HPV infections (related to the types of HPV targeted by the vaccines) drop by 56% in the United States. In countries that have higher vaccine rates, there are even larger drops. Indeed, data published last year suggest that higher vaccination rates could reap great benefits.

The potential to eliminate genital warts

 

A study from Australia, where more than 70% of adolescent girls are vaccinated, suggests that in countries where vaccine coverage is high, genital warts may be eliminated in the coming decades.

The government-funded Australian HPV vaccine program has provided free vaccine in schools to 12- and 13-year-old girls since 2007. From 2007-2010, free vaccine was also offered to girls and women ages 14-26.

The number of cases of genital warts among young people has dropped dramatically since the program began. More...

The Landmark Surgeon General Report on Smoking and Health, 50 Years Later

January 15, 2014

By Richard C. Wender, MD

 

Fifty years ago, on January 11, 1964, Luther Terry held a press conference to announce the results of the first Surgeon General's report on smoking and health, the most impactful public health document in history. The report laid to rest over a decade of debate about the health risks of smoking by definitively stating that smoking causes lung and laryngeal cancer in men, chronic bronchitis, and other diseases.

Research conducted by the American Cancer Society and other groups had already demonstrated the adverse health effects of smoking, but, until the Surgeon General's report, the tobacco industry had been successful in hiding the truth. The extraordinary methods used by the Surgeon General to ensure that the report was completely unbiased -- including allowing the tobacco industry to veto nominees to serve on the panel -- the thoroughness of the research, and the clarity of the conclusions, all led to one outcome: the end of the debate about the health risks of smoking and the launch of the true fight to end the use of tobacco products. The progress in the tobacco fight over the past 50 years represents one of the most successful, life-saving public health campaigns in our nation's history.

Learn more about the 50th anniversary of the Surgeon General's Report on Smoking and Health:

The Hammond/Horn study

The effects of tobacco control

Rates Drop for New Lung Cancer Cases in the US

Tobacco and Cancer

Guide to Quitting Smoking

 

The public health victories, and the challenges



Forty-three percent of Americans smoked prior to the Surgeon General's report; 18% smoke today. Smoking in airplanes, restaurants, and places of employment has largely disappeared.  We're now fully aware of the addictive nature of the nicotine in tobacco products, and the importance of preventing and treating that addiction. Tobacco executives were eventually forced to admit, before Congress and the country, that they were long aware of the addictive nature of their products as well as the harmful health effects. 

We've learned that raising the cost of a pack of cigarettes is the single most effective way to reduce the number of people who start using tobacco products and the most effective way to promote quitting. Tobacco tax increases have been implemented in many states.  As of 2009, the FDA was granted the authority to regulate tobacco products, although the tobacco industry has placed substantial roadblocks in the path of effective FDA action. The United States is not alone. Smoking rates in most high-resource ("Western") nations like England, Canada, and Australia have substantially declined, comparable to the progress that we've seen.  We've witnessed 50 years of amazing progress; we truly do have much to celebrate.  

And much to lament. More...

Filed Under:

Tobacco/Smoking

How I talk to patients about clinical trials

December 02, 2013

By Fadlo R. Khuri, MD, FACP

 

As a physician focused on the treatment of patients with cancer, many of whom face a potentially incurable disease, I make 3 promises to my patients:

1) We will always tell them the truth.

2) We will always do our very best for them, placing their interests and those of their families above all others.

3) We will never abandon them. 

These are important words to relay to a patient, particularly those who are considering participating in clinical trials.  The question, then, is, "Why should cancer patients participate in clinical trials?"

Cancer clinical trials are one of the most important methods we have to move the field forward. After all, it was through clinical trials that we have developed cures for childhood acute leukemia, Hodgkin disease, and testicular cancer, how we developed long-term highly effective therapies for chronic myeloid leukemia and breast cancer, and how we created personalized genetic therapies for lung cancer, melanoma, and other diseases. Cancer clinical trials also let us know how patients are feeling about their care, and can improve approaches for the treatment, prevention, and cancer screening tests for cancer patients. 

One of the first things I do as the treating physician is to complete a history and physical exam of the patient. The information I gather helps me form an opinion, and it helps me gain the trust of the patient and his or her family. 

After obtaining the history and physical information that I need, I discuss standards of care and explain why this care, like radiation or chemotherapy, might work (or not work). It is important to acknowledge our limits while reassuring patients of our considerable experience in treating others with a similar disease. I have occasionally seen physicians who rush to discuss the clinical trial before going through the full range of standard treatment options available. Identifying the standards of care and presenting them as a viable option for patients is far more likely to reassure patients that all options have been carefully considered. More...

Filed Under:

General

What really works to help you quit and avoid tobacco?

November 17, 2013

By Thomas J. Glynn, PhD


The American Cancer Society's first Great American Smokeout was celebrated November 18, 1976. Gerald R. Ford was President of the United States, the "War on Cancer" had begun just a few years before, Barack Obama was 15 years old and, according to a Gallup Poll taken that year, 37% of American adults smoked cigarettes.

This year, the 37th anniversary of that first Great American Smokeout, the percentage of Americans who smoke has nearly been cut in half, to 19%. And, those who do smoke use far fewer cigarettes than in 1976, from about 4,000 cigarettes per year for every U.S. adult then, to about 1,200 now.

Certainly, we know that any cigarette smoking is dangerous to the smoker and non-smokers who inhale cigarette smoke. We also know that far too many Americans continue to smoke - 44 million, at last count. Still, astounding progress has been made in combatting what is the nation's largest cause of preventable death and disability.

How do we know what works?

How was such progress made? What actions were taken to achieve such significant changes in the face of the tobacco industry's relentless, illegal, and well-funded efforts to addict men, women, and children to their deadly products? There is no easy answer to that question. But we do know that, over the past 37 years, a wide range of interventions - in communications, education, policy change, and medicine - have been undertaken. Interventions in all of these areas have been effective, but some have been more effective than others. More...

Stigma presents an extra burden for many lung cancer patients

October 28, 2013

By J. Lee Westmaas, PhD

 

Some of us, at some point in time, have felt judged negatively by others or discriminated against because of some personal characteristic or behavior. Researchers refer to this as feeling stigmatized, and lung cancer patients report feeling this way more than patients with other types of cancers.

Many individuals with lung cancer fear that others will react to their diagnosis with blame, exclusion, rejection and/or discrimination. Many actually experience this as well.  A primary reason is that smoking is so strongly linked to lung cancer.

Blaming the victim


Lung cancer was one of the first diseases to be identified as caused by smoking. Smoking rates have decreased dramatically since the 1960s due to laws to restrict smoking, greater publicity on the many harms of smoking, and a change in public attitudes toward smoking. More...

Filed Under:

J. Lee Westmaas | Lung Cancer

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