EXPERT VOICES

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

American Cancer Society Expert Voices

The American Cancer Society

The FDA and Tobacco Regulation Three Years Later

October 29, 2012

By Thomas J. Glynn, PhD

 

As the official sponsor of birthdays, the American Cancer Society has every reason to be proud of a "toddler" celebrating its third birthday this year. The Family Smoking Prevention and Tobacco Control Act - aka the Tobacco Control Act - was strongly supported by ACS and ACS CAN and signed into law by President Barack Obama on June 22, 2009.


For the first time and after nearly 2 decades of debate, this historic legislation gave the U.S. Food and Drug Administration (FDA) the authority to regulate tobacco products. In doing so, Congress enabled the FDA to establish the Center for Tobacco Products (CTP), which is charged with regulating the manufacture, marketing, and distribution of tobacco products in order to reduce tobacco use by children under 18 and protect public health.


More specifically, the Tobacco Control Act authorizes the FDA to act in a number of ways, including:

  • Restricting tobacco sales, distribution, and marketing
  • Requiring stronger health warnings on packaging and in advertisements
  • Requiring disclosure of tobacco product ingredients
  • Reducing (but not eliminating) the amount of nicotine in tobacco products
  • Creating standards for tobacco products
  • Regulating "modified risk" (i.e. potentially harm reducing) tobacco products, such as e-cigarettes, snus, dissolvables, etc.


So, with the authority to take these types of action, how is the Tobacco Control Act doing 3 years later? Is it having its intended effects? Are Americans - tobacco users and non-users alike - beginning to see its hoped-for health benefits? To best address these questions, it will help to take a small step back and consider the history of the Tobacco Control Act, take a brief look at the Act's accomplishments to date, and then look a bit into the future. More...

Does Being Overweight Cause Breast Cancer?

October 11, 2012

The Relationship between Weight and Breast Cancer

By Lauren Teras, PhD

 

Breast cancer is the most common cancer among women today. More than 1 million women world-wide are diagnosed with this cancer each year, mostly in the 50 and older age group.  Breast Cancer Awareness Month highlights this international public health problem, and it is a good time to consider ways in which we can reduce our risk of this cancer.  While many factors beyond our control contribute to risk, like age and family history, we do know of a few ways we can lower the risk of breast cancer.


Worldwide obesity has more than doubled since 1980. Once considered a problem only in high income countries, being overweight and obese is now dramatically on the rise all over the world, particularly in urban areas. As of 2008, the World Health Organization estimated that 1.4 billion adults were overweight, including 300 million obese individuals.  In the year 2000, for the first time in human history, the number of adults worldwide who were overweight was greater than the number of adults who were underweight. In fact, approximately 65% of the world's population lives in countries where being overweight and obese kills more people than being underweight. The U.S. is near the front of the pack as the country with the 4th highest rate of obesity; about 2/3 of people in America are overweight, including approximately 1/3 are obese. More...

On the difference between 'disparities' and 'differences'

September 27, 2012

By Tim Byers, MD, MPH

 

There are many definitions of health disparities, but my favorite is disparities are differences that should not exist.  This definition reflects the social injustice in how some races and ethnicities suffer more from cancer than others.   


I like this definition of disparities (or health inequity, as many people are calling it) because it can motivate us to fix the problem - the social, economic, cultural, and political barriers that keep some racial and ethnic minorities from getting  cancer prevention, early detection, and state-of-the-art cancer treatment.  This obviously can be harmful to racial and ethnic minorities.


But this definition is also a problem. It can cause us to focus so much on the differences that should not exist (the social and economic inequalities) that we ignore  factors driving racial and ethnic differences that may actually have a positive influence on people's risk of developing or dying from cancer.  Why is that important? More...

Filed Under:

Disparities

Cancer Statistics About Hispanics Released

September 17, 2012

Hispanics have lower cancer screening rates; are diagnosed with cancer at later stages


By Rebecca Siegel, MPH


A new Cancer Facts & Figures for Hispanics/Latinos has been released in conjunction with National Hispanic Heritage Month. This publication is updated every 3 years and is a resource for current information about cancer among Hispanics. But you may be wondering why we produce a 35-page report devoted solely to cancer statistics for Hispanics.


For 60 years the American Cancer Society's Research department has promoted cancer prevention and control by providing cancer data in a user-friendly format called Cancer Facts & Figures. Over the years, new Facts & Figures publications have been developed to highlight a particular cancer type or a specific population. In 2000, to answer the increasing demand for more in-depth information on cancer in the growing Hispanic community, the inaugural Cancer Facts & Figures for Hispanics/Latinos was introduced.

 

Hispanics Fastest-Growing Minority in US

 

Promoting cancer prevention and control in the Hispanic community is more important than ever because Hispanics are the largest and fastest growing minority population in the United States. As we learned from the 2010 census conducted by the U.S. Census Bureau, more than 16% of Americans, 50.5 million people, identify themselves as Hispanic. The 43% increase in the Hispanic population over the past decade -- compared to a 10% increase in the total population -- accounted for more than half of the overall population growth. By 2050, approximately 30% of all Americans will be Hispanic, which means that more and more new cancer patients will be Hispanic. More...

Filed Under:

Breaking News | Disparities

Can Removing Fallopian Tubes Prevent Cancer ?

August 28, 2012

By Debbie Saslow, PhD

 

I've seen a few articles recently about removing the fallopian tubes to prevent ovarian cancer, a procedure called "prophylactic bilateral salpingectomy". And not just in women who are at high risk for ovarian cancer, which is already recommended by gynecological medical societies in the United States, but for all women who are not planning to have any more children and who are about to undergo abdominal surgery for any reason.


I can see the appeal given that many, if not most, ovarian cancers actually originate in the fallopian tubes. In fact, it is more common to find microscopic fallopian tube cancer than microscopic ovarian cancer in women with a BRCA1 or BRCA2 mutation when they have their ovaries and fallopian tubes removed. (These mutations put them at higher risk for ovarian and breast cancer.) And unfortunately we don't yet have an accurate test to screen women for ovarian cancer, so these cancers are usually found at a late stage when they are often fatal. 


It is common for women to get their "tubes tied" (i.e. tubal ligation) as a form of permanent birth control, and we know this reduces the risk of ovarian cancer. But removing the fallopian tubes is a more invasive procedure, and the potential benefits and potential harms are largely unknown. Is it worth it? Does it really reduce the risk of ovarian cancer and, if so, by how much? More...

Cancer Drugs: Long Odds and Magic Bullets

August 13, 2012

By William C. Phelps, PhD

 

During 2011, the Food and Drug Administration (FDA) approved 30 completely new therapies (new molecular entities, as opposed to the modification of an old drug), 7 of which were for treatment of different types of cancer.  One of them, the lung cancer drug crizotinib, was decades in the making. For a new drug, that isn't necessarily a lot of time.


Why does it take so long to get cancer treatments to the patients who need them? The answer lies both in the complexity of cancer and the complexity of the drug development and testing process. More...

The Bottom Line on Soy and Breast Cancer Risk

August 02, 2012

By Marji McCullough, ScD, RD

 

EDITOR'S NOTE: Dr. McCullough added the following statement 4/8/14 in response to questions related to sources of isoflavones:

Research on soy and cancer is highly complex, controversial, and evolving.

When concerns about soy are raised, they generally focus on findings from rodent models of cancer which tend to use isolated soy compounds like soy protein isolate or high doses of isoflavones (compounds found in soy).  However, soy is metabolized differently in humans than it is in mice and rats, so findings in rodents may not apply to people. (See: http://www.ncbi.nlm.nih.gov/pubmed/16614407 for more on this.)(Setchell, AJCN, 2011).  There is no evidence in the medical literature that soy protein isolate is bad for humans, compared to other forms of soy. Soy protein isolate is often used as a supplement in randomized studies of the effects of soy on health and none of these studies have shown harm.

Most of the studies suggesting benefits of soy consumption in people have measured how much soy foods people are eating, including tofu, soybeans, and soy milk.  These foods are more commonly eaten in Asian countries. In the U.S., purified forms of soy are used in the food supply, including in energy bars and soy hot dogs.  The few US studies that have measured these forms of soy do not suggest harm.    

More research is needed to understand the relationship between specific forms of soy and doses of isoflavones on cancer risk and recurrence. We also need to learn more about childhood exposure to isoflavones and risk of cancer. Until more is known, if you enjoy eating soy foods, the evidence indicates that this is safe, and may be beneficial (but note that miso, a fermented soy product, is high in sodium.)  It is prudent to avoid high doses of isolated soy compounds found specifically in supplements, as less is known about their health effects. As for other "hidden" sources of soy proteins, the evidence to date does not suggest harm or benefit. However, if you are concerned about these products, you can choose to avoid them.  


 

Before writing a blog about soy and breast cancer, I took an informal poll of a few friends to get a sense of what women believe about soy.  I asked them, "What do you know about eating soy food?  Is it good for you? Not good for you?" (I didn't even mention breast cancer.)  The responses I got were,  "I think it acts like estrogen in the body"; "Consuming any soy products increases the risk of breast cancer"; "I don't eat it a lot because I heard something negative but I can't remember what it was;" and "I've heard you should only have it in moderation."  Apparently, people are hearing that soy may not be good. But what's the truth? In this blog I'll walk you through what we know and what we don't know about soy and breast cancer, and give you some practical tips on eating soy. More...

Health Equity, Health Disparities: What's the Story?

July 24, 2012

By Alvaro Carrascal, MD, MPH

 

These days we hear a lot about health disparities, cancer disparities, health equity, etc. What is this all about? And why do these terms seem to be more discussed now?


MedlinePlus, the National Institutes of Health's website for patients, describes health disparities as "differences between groups of people. These differences can affect how frequently a disease affects a group, how many people get sick, or how often the disease causes death."


For the World Health Organization (WHO), health equity is "the absence of unfair and avoidable or remediable differences in health among population groups defined socially, economically, demographically or geographically."

 

Essentially, health equity is about everyone getting a fair shake when it comes to health and healthcare. More...

Filed Under:

Disparities

Weight Gain during Cancer Treatment

July 05, 2012

By Michele Szfranski, MS, RD, CSO, LDN

 

When I talk with people who have gained weight during their cancer treatment, they are often shocked. For people who lost considerable weight before their diagnosis and then felt better once their treatment started, weight gain can be a welcome change. But more often I speak with people who were at a healthy weight or overweight before treatment and did not realize that their treatment might cause some weight gain. More...

Filed Under:

Survivorship

Expert Voices blog: Cancer Vaccines -- Fulfilling the Promise

June 26, 2012

By William H. Chambers, PhD

 

Vaccines are not new. In fact, there is evidence that the ancient Egyptians and Chinese used them many centuries ago.  Vaccines work by preparing your own immune system to attack invading pathogens, thus preventing disease. Vaccines have helped us make great inroads against many deadly diseases over the past 60 years, when they became used more widely.


Using vaccines against cancer is relatively new, though. Cancer researchers have been trying to make vaccines for tumors, just like others have made vaccines for measles, mumps, and tetanus. More...

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