EXPERT VOICES

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

American Cancer Society Expert Voices

The American Cancer Society

Choosing the best prostate cancer treatment for you

June 13, 2013

By Durado Brooks, MD, MPH

 

Much of the recent news about prostate cancer has focused on screening. In reality, screening is only one piece of the prostate cancer picture.  More than 238,500 men in the United States will be diagnosed with prostate cancer this year. Most of these men will have to weigh a variety of treatment options and make a series of decisions about managing their disease.

So let's look at some of the important questions men need to ask when facing a diagnosis of prostate cancer, and information they can use to help make these important decisions.


Question: "Does my cancer need to be treated?"

Answer: The fact that this is even a question comes as a big surprise to many men. The idea that they have cancer - but not treating the cancer - runs counter to the widely held belief that doing something is always better than doing nothing. In fact, most prostate cancers grow very slowly, and men diagnosed with prostate cancer often have other health concerns (like heart disease or lung disease). In many cases these other health issues pose a greater threat to a man's health than does the prostate cancer. It is also clear that the most commonly used treatments for prostate cancer can all cause significant side effects and complications (detailed in the next sections) in some men. This combination of slow growing cancer + other health issues + possible treatment complications means that, many times, treating the cancer will cause harm to the man but will not improve his health or extend his life. In other words, the treatment can actually be worse than the disease for some men. More...

Cancer Survivors: Make Changes for Long-term Health Gains

May 28, 2013

By Corinne Leach, MPH, MS, PhD

If you are a cancer survivor, whether you're currently in treatment or completed treatment long ago, you are far from alone. The estimated number of cancer survivors in the United States is currently 13.7 million and will continue to grow as our population gets older. By 2022, we expect there to be 18 million cancer survivors.

Cancer researchers are working hard to find cancers earlier, improve treatment, and decrease the negative side effects commonly associated with treatment, like fatigue, pain, lymphedema, and chemo brain. Many people come into the cancer experience with other chronic health conditions (e.g., diabetes, hypertension, arthritis), and many more develop additional conditions after their cancer treatment ends.

An important question is:  what can I do to stay as healthy as possible and feel as good as I can after cancer? The good news is that making changes in your lifestyle can make a difference in your long-term health. Here at the American Cancer Society we recently developed physical activity and healthy eating recommendations specifically for cancer survivors. But what do they mean for you? More...

Filed Under:

Survivorship

Can breastfeeding lower breast cancer risk?

May 07, 2013

By Debbie Saslow, PhD


There are a limited number of things that women can do to lower their risk of breast cancer, including getting regular physical activity, limiting alcohol, and maintaining a healthy weight. Breastfeeding has often been included in the protective behaviors against breast cancer, but the research has been inconsistent.

Looking at the research on breastfeeding and breast cancer risk, it is clear that this has been a difficult area to study. If breastfeeding does lower risk, the level of protection is small and depends on women breastfeeding for a long time.  In countries such as the U.S., most women who breastfeed their babies stop after several months, or they breastfeed less frequently as they start to supplement with formula and baby food. Women who have many children and breastfeed each baby for a long time seem to be at somewhat lower risk of breast cancer than women who have smaller families and breastfeed for a shorter time. Studies that have found that breastfeeding does lower breast cancer risk have also found that protection builds up over time (that is, duration of breastfeeding) and number of children that are breastfed.

The major study (Collaborative Group on Hormonal Factors in Breast Cancer; Lancet, 2002 Jul 20; 360 (9328): 187-95) that supports breastfeeding as protective against breast cancer was published in 2002. The researchers analyzed 47 studies in 30 countries; these studies had information about 50,000 women with invasive breast cancers and 97,000 women without breast cancer.  The study authors found that the rate of breast cancer diagnoses was slightly lower among women who had breastfed and among women who had breastfed for longer periods of time. More...

Filed Under:

Breast Cancer | Debbie Saslow

Is it a mole or melanoma?

April 30, 2013

By Daniel Mark Siegel, MD, MS


Winter is ending and the temptation to shed some layers comes alive.

But if you do show off your body, pay attention -- particularly if you are a mole-y person with dozens of moles, especially funny looking irregular ones all over the place. You may have a condition called "dysplastic nevus syndrome" or "familial atypical multiple mole-melanoma syndrome," which makes you more likely to develop melanoma.  Nevus is the fancy Latin word for "mole," which is a benign growth, but melanoma is a skin cancer that if not diagnosed and treated early can be lethal.

The difficulties of diagnosing melanoma


Fortunately, there are a lot more nevi (not nevuses) than melanoma.  So how do you tell them apart? Sometimes it is easy for your doctor to reassure you, but other times, even with the use of the skilled eyes of the dermatologist and added magnification, dermoscopy, and other evolving imaging techniques, it's still not clear. In such cases, a biopsy is needed.

A biopsy is where all or part of a mole is removed, sent to the lab, and a report of the analysis comes back. Sometimes the report is straightforward and says "benign mole" with no need for further treatment. Other times it reports a melanoma with descriptive staging terms that guide further therapy. More...

Filed Under:

Skin Cancer

Can you trust that medical journal?

April 18, 2013

By Ted Gansler, MD, MBA, MPH

 

Ed. note (10/10/13): Dr. Gansler has an update to this blog, originally published 4/18/13.
In an interesting update on this topic, Science magazine recently published results of a "sting operation" intended to identify bogus journals. A journalist from Science fabricated an intentionally bogus article about a fictitious anti-cancer drug, with errors so obvious that, "Any reviewer with more than a high-school knowledge of chemistry and the ability to understand a basic data plot should have spotted the paper's short-comings immediately." Shockingly, the vast majority of journals that received this article failed to notice these obvious flaws and agreed to publish it... for a fee. For more details, see http://www.sciencemag.org/content/342/6154/60.full.

An article in the April 8 New York Times titled "Scientific Articles Accepted (Personal Checks, Too)" caught my attention. It describes the growing availability of free online medical journals that use questionable tactics to gather and publish research of questionable quality.

The article piqued my interest because the experiences of some researchers described in it are similar to my own. I am also an editor of CA: A Cancer Journal for Clinicians, one of the American Cancer Society's medical journals, so I have an interest in the world of journal publishing.

But more importantly, I wanted to write about this topic because this is an issue that can affect cancer patients, survivors, and their loved ones, all of whom increasingly seek out information from medical journals. More...

Filed Under:

General | Ted Gansler

Does being obese cause colon cancer?

March 13, 2013

By Durado Brooks, MD, MPH


Suppose that, during your next doctor's visit, you look at your medical record and your doctor has written "53- year-old diabetic white female, here today for a check-up." Would you be bothered by that description? Probably not. Your doctor is just discussing your medical condition, right? But what if, instead of "diabetic" the note read "53-year-old obese white female?" How would you feel now? Hurt? Angry? Sad? Would you think, "Why is my doctor being so mean?"

For many, the term "obese" brings to mind a massively overweight individual (like "Fat Albert" in the old Saturday morning cartoons). In reality most obese people don't look like Albert.

Obesity is a medical term

Obesity is actually a precise medical term that is based on a measure of body fat called the Body Mass Index (BMI). The BMI is calculated from a person's height and weight. In general, a higher BMI indicates a higher amount of body fat. Adults with a BMI between 18 and 25 are in the "healthy" body fat/weight category. People with a BMI between 25 and 30 are considered overweight, and a BMI greater than 30 signifies obesity. Many people who view themselves as having a "normal weight" (or at most "pleasingly plump") are shocked when they do this calculation and realize that 180 pounds on their 5 feet 6 inch frame means they are medically obese.  

Our obsession with body image creates an emotional context for obesity that doesn't exist for most other medical issues. But make no mistake about it - obesity is a medical condition, and like other medical problems it has important long-term implications for health and well-being.  More...

Filed Under:

Colon Cancer | Durado Brooks

The obesity-cancer connection, and what we can do about it

February 28, 2013

By Lewis E. Foxhall, MD

It's almost impossible to get through the holiday season without gaining a few pounds, and for many of us that means we are even more likely to be over our ideal body weight.  Sure, we all want to look good in our clothes, but being obese is not just a condition that affects our appearance.  And in March, during National Nutrition Month, it's a good chance to talk about it.

Weight gain happens when we take in more calories from food (energy) than we use up through our basic biological requirements and exercise. After a while, enough fat stores up and makes us obese. Our bodies are very efficient at taking in energy and storing it for times when it is hard to find, but in our modern environment this is working against us and our health.  For most of us it is easy to get as much food as we want, and most of us do not need to exert ourselves much for work or daily living activities.


Link between obesity and cancer


The problem with being overweight or obese, as measured by weight and height, is that it raises our risk of chronic diseases like diabetes and heart disease.  But did you know that being obese can actually increase our risk of getting cancer and may even worsen our chances of surviving after a cancer diagnosis?  In fact, the American Cancer Society Cancer Prevention Study II showed significant increases in cancer occurrence in people who are the most overweight.  This link is stronger in some cancer types --including breast cancer after menopause, and cancers of the colon and rectum, pancreas, kidney, esophagus, and endometrium -- and can be associated with a major increase in risk. More...

Is proton beam therapy for prostate cancer worth the cost?

February 20, 2013

By Durado Brooks, MD, MPH


Thousands of men are diagnosed with prostate cancer each month. These men and their loved ones often turn to the internet to learn about their disease and treatment options, and these searches may lead to medical centers offering proton beam therapy.  These centers espouse the benefits of this treatment approach, and some include glowing testimonials from men who have undergone the treatment.

So is proton therapy the "magic bullet" for prostate cancer? 

 

The difference between proton therapy and traditional radiation

Proton therapy is a type of radiation treatment. Traditional radiation therapy has been used to treat cancers for a century using radioactive energy rays called "photons."  When radiation is directed at a cancerous tumor inside the body the rays must pass through normal, healthy tissue in order to reach the cancer cells. In doing so, photons often cause harm to these healthy cells in their quest to get to the tumor. 

In the case of prostate cancer, the radiation beams must pass through the skin, the bladder and the rectum on the way to the prostate gland, and once they reach the gland they encounter normal prostate cells and the nerves that control penile erections.  Damage to these tissues can lead to the complications that often accompany radiation treatment for prostate cancer, including bladder problems, rectal leakage or bleeding, and difficulty with erections.

Proton therapy is a new way to deliver radiation to tumors using tiny, sub-atomic particles (protons) instead of the photons used in conventional radiation treatment. Proton therapy uses new technology to accelerate atoms to 93,000 miles per second, separating the protons from the atom. While moving at this high-speed, the particles are "fired" at the patient's tumor. These charged particles deliver a very high dose of radiation to the cancer but release very little radiation to the normal tissue in their path.  In theory, this approach minimizes damage to healthy organs and structures surrounding the cancer.  More...

Cancer Statistics about African Americans Released

February 04, 2013

By Carol DeSantis, MPH

 

In conjunction with Black History Month, the American Cancer Society has released Cancer Facts & Figures for African Americans, statistics published every 2 years. The 2013 issue reveals encouraging cancer trends for African Americans, as well as areas where significant disparities remain or are growing. Cancer disparities, or health inequity, are caused by a number of societal problems that result in greater suffering and more people dying from cancer.

 

Death rates drop, but inequity remains

The great news is that overall cancer death rates have steadily decreased for African American men and women. In fact, the most recent data show that death rates dropped faster for African American men than men in any other racial or ethnic group. That's caused the disparity in cancer death rates between African American and white men to shrink considerably. Cancer death rates among African American women are declining at a similar rate as those of white women. 

Despite these declines, however, death rates for all cancers combined remain 33% higher in black men and 16% higher in black women, compared to white men and women. African American men also have higher death rates for most of the major cancer sites (including lung, prostate, colon/rectum, liver, pancreas, and others). Notably, the higher overall cancer death rate in African American women compared to white women occurs despite lower incidence rates for all cancers combined and for breast and lung cancer.

For African American men, the drop in cancer death rates is mostly due to decreases in lung cancer; other smoking-related cancers like oral cavity, pharynx, larynx, esophagus, pancreas, bladder, and kidney; and prostate cancer. Remarkably, the disparity in lung cancer death rates among black and white men has been cut in half for men overall, and has been eliminated in younger adults (ages 20-39). This progress is mostly due to the fact that more African American men are quitting smoking, compared to white men. Although African American men have historically higher smoking rates compared to white men, over the last decade smoking rates have become more similar. In addition, smoking rates are lower among African American than white high school students. It is believed that if current smoking trends persist, racial differences in lung cancer death rates will be eliminated in the next 40 to 50 years. More...

Filed Under:

Breaking News | Disparities

Cervical Cancer is an International Issue

January 30, 2013

By Debbie Saslow, PhD

A lot has happened in the area of cervical cancer this past year. The American Cancer Society, the U.S. Preventive Services Task Force and the American College of Obstetricians and Gynecologists all released virtually identical screening guidelines, leading to less confusion and higher acceptance from health care professionals and the public.

Thanks to screening, cervical cancer is not very common in the U.S., with about 12,340 new cases of invasive cervical cancer expected to be diagnosed in 2013. Unfortunately the same is not true around the world, where more than half a million women are diagnosed with cervical cancer each year.  It is actually the 2nd largest cancer killer among women in most low- and middle-income countries.

Sadly, this disease threatens to undermine the important gains worldwide that have been made in sexual and reproductive health, maternal and child health, HIV/AIDs and other infectious diseases. For women in many countries in Africa, Asia, and Latin America, cervical cancer is often detected late, when there is little hope for successful treatment. And it can be devastating to the whole family, both emotionally and financially.

The good news is that a lot has been happening in global cervical cancer.  Indeed, many underserved societies have been actively advocating for improved cervical cancer control policies. In response, governments are increasingly making the HPV vaccine available through their health systems and are supporting new cervical cancer screening methods appropriate for their needs and resources. More...

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