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January 20, 2017
FDA Issues Proposed Rule to Limit Known Carcinogen in Smokeless Tobacco Products
An ACS Cancer Action Network press release reads as follows (direct quote):
WASHINGTON, DC – January 19, 2017 – Today, the Food and Drug Administration (FDA) issued a proposed rule to limit N-nitrosonornicotine (NNN), a known carcinogen, in smokeless tobacco products. This is the first time FDA has used its authority to require a standard for tobacco products. Under this authority, the FDA can require changes to tobacco products, such as removal of harmful ingredients, elimination of flavors, or reduction of nicotine levels, in order to protect public health.
A statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN), follows:
“We applaud the FDA for taking the first necessary step to limit a cancer-causing agent found in smokeless tobacco products.
“The dangers of smokeless tobacco are severe. Smokeless tobacco use is responsible for an estimated 1,600 new cases of oral cancer, 200 cases of esophageal cancer and 500 cases of pancreatic cancer in the U.S. each year. In addition to cancer, smokeless tobacco users have an increased risk of death from heart disease and stroke.
“ACS CAN strongly supports the FDA’s implementation of this rule, which over a 20-year period would prevent nearly 13,000 new oral cancer diagnoses and prevent 2,220 oral cancer deaths.
“We encourage the FDA to take the necessary actions to finalize this rule and protect the public’s health from the dangers of tobacco.”
Advocacy on this issue has helped move the ball forward. You can join the Cancer Action Network and get your voice heard at www.acscan.org.
January 20, 2017
Moonshot Deliverable: FDA Oncology Center of Excellence
StatNews reports this morning that the FDA Oncology Center of Excellence, a major initiative othe Cancer Moonshot initiative, has just been launched. It creates a clinical review system for drugs, biologics, and medical devices to accelerate bringing safe and effective products into cancer care more quickly. This offers promise for the longer term.
January 19, 2017
Learning about experimental treatments
An interesting article in Statnews today highlights the challenge facing both physicians and cancer patients in learning about available experimental treatments. At the same time that patients are dying before finding an appropriate experimental treatment, many clinical trials are cancelled because they couldn't recruit enough patients that qualified. In part, it's because so few people apply, and in part it's because they don't learn enough about the qualifications and potential benefits in time to apply.
If you're facing such a dilemma, you might want to read this story.
January 11, 2017
A Final Gift from Joe Biden: NCI Formulary
This morning, the National Cancer Institute announced an agreement between NCI and six drug companies (more in negotiations to be added) to create an NCI Formulary that will help accelerate getting new cancer treatments from investigators' labs into clinical trials more quickly. The goal is for NCI to serve as an intermediary to make it faster to explore combination therapies, which are currently getting a lot of attention as potential new directions for treatment. Negotiations are underway right now regarding 15 therapeutic agents from these six companies and with many more companies to add many more agents to the Formulary. At a time when advocates have been pressing for more Federal funding for cancer research, this initiative (an offshoot of the Cancer Moonshot) is promising. The particular focus is on investigator-initiated studies, which often lack sufficient financial support to prove the merits of new treatments and understanding of new cancer signalling pathways. As the Formulary proves itself, it will become easier to gain the participation of more pharmaceutical companies and to move more combination therapies through the research pipeline.
Signs of hope.
January 7, 2017
We're Learning from Mice How to Beat Cancer
My most recent Huffington Post article helps reveal how leading researchers are learning from Mice about chemo resistance and cancer's microenvironment. It offers promise for more effective personalized treatments. I found it fascinating to tour Dr. Dan Duda's lab at the Steele Laboratories at Mass General Hospital. You too might find it fascinating to read of their work.
January 6, 2017
Sharing Genomic Data will Advance Cancer Research and Treatment Efficacy
The American Association for Cancer Research (AACR) has just released its first set of data from AACR Project Genomics Evidence Neoplasia Information Exchange (GENIE), including de-identified genomic and clinical data from the medical records of over 19,000 patients and 59 cancer types. The data, which maintain patients' personal confidentiality, were drawn from eight major participating cancer centers worldwide. The data will be available to researchers and clinicians to help them discern correlations between genomic information and clinical activities and outcomes. This project reflects the growing trend of using "big data" analysis capabilities (the ability to digest and draw practical meaning and action implications from massive volumes of data) to help in diagnosis and treatment decisions for individual patients.
Within the cancer research and clinical communities, numerous similar data bank initiatives are underway. As such initiatives continue to grow, they offer promise to accelerate both research discovery and personalized medicine for improved clinical outcomes.
January 5, 2017
Joe Biden Creating a New "Moonshot" Nonprofit
According to the Washington Post, the Cancer Moonshot's champion won't be leaving the cancer cause behind when he leaves Washington. This is a blessing for all of us who have valued his contributions to our shared mission. Thanks, Joe!
December 20, 2016
Concern is Rising about Kids and E-Cigarettes
Use of e-cigarettes by children, adolescents, and young adults has risen at a "staggering" rate since 2010, when it was rare. This has driven the nation's Surgeon General to declare a public health emergency and to call for both increased FDA regulation and increased legislative action at state and local levels to include e-cigarette and other nicotine products ini tobacco control laws and programs. Public advocacy may be needed as regulatory modifications are proposed for legislative action. Each of us can speak out to help prevent this predictable public health crisis.
If you're concerned to learn more, check out the article in MedPage Today.
December 1, 2016
No Cut-Off Age for Mammography Benefits
A study released at the Radiological Society of North America (RSNA) 2016 Annual Meeting on November 28, 2016, reports that despite past recommendations by the US Preventive Services Task Force (USPSTF) that women undergo screening every 2 years only until age 74, analysis of mammography results in older women demonstrate conclusively the benefits of continuing screening as long as women have a life expectancy of at least 5-7 years and are willing to take appropriate action based on the test's results. The study was described in written up in the Medscape medical newsletter on Decemer 1, 2016.
November 29, 2016
An Amazing New Diagnostic Test for CML, and Pharma Generosity!
A New York Times article was published on November 28 about students at Fred Hutchinson Cancer Center in Seattle discovering a new way of diagnosing CML with a spot of blood on a piece of special paper. It's a fascinating tribute to the creativity of young investigators who are inspired by the lack of limits on what can be done to solve a scientific problem with a little ingenuity. Fascinating reading, and another inspirational tidbit for investing in the research work of young investigators. To do more of that, donate to the research programs of the American Cancer Society at www.cancer.org. Together we can save lives and create jobs.
November 13, 2016
Open Letter to the President-Elect: Save Lives While Creating Jobs
Just posted on Huffington Post is my article on why increasing Federal cancer research funding should be an important priority on the President-Elect's leadership agenda. Take a look, and if you like it, please click "like" and share it on your social media feeds. We can make this a priority if enough of us speak out.
November 4, 2016
Family Cancer Caregivers: “CHIN Up” for Coping
Just posted on Huffington Post is my article on cancer caregiving. May we all learn from each others' experiences.
November 1, 2016
No Surprise: Smoke Still Kills
Despite the number of states that have passed legislation to restrict indoor smoking, the proportion of cancers caused by smoking and second-hand smoke is still stunning. According to the Journal of the AMA (JAMA), quoted in the New York Times on November 1:
"A new study has found that 28.6 percent of all cancer deaths in the United States are attributable to cigarette smoking.
Researchers calculated the number using the relative risks for 12 smoking-related cancers, including acute myeloid leukemia, mouth cancers, and those of the esophagus, stomach and colon.
Smoking is involved in 22.9 percent of cancer deaths in women and 33.7 percent in men. In all, the authors estimate that 167,133 people died of cancers associated with smoking cigarettes in 2014. (This number does not include deaths from many other diseases linked to smoking.)"
So far, over 8 million lives have been saved by these laws, but clearly more work is needed to control tobacco use in ways that will save more lives.
October 21, 2016
Learn the Positions of Presidential Candidates on Cancer Issues
It's up to each of us to make it clear to all political candidates that cancer issues influence our decisions when we cast our votes in November.
Every four years, the American Cancer Society's Cancer Action Network asks each presidential candidate about their positions on government support for cancer early detection and research programs. If you want to know where the presidential candidates stand these issues, go to http://www.cancervotes.org/guides/national/president. Cancer has been under the radar in the campaigns, so hopefully this nonpartisan survey will provide some new information about where the candidates stand on issues like funding for the Moonshot and for cancer research that m eans so much to many of us.
October 18, 2016
FDA is Waking Up to Rare and Pediatric Diseases
The Food and Drug Administration (FDA) has just announced that it has awarded $23 million for 21 grants that will mobilize clinical trials to accelerate treatments for rare diseases, working through the Orphan Products Clinical Trials Grants Program. The program funded 31% of the proposals it received. Its focus was consistent with the National Cancer Moon shot initiative in its intent to accelerate research progress.
"24 percent of the new grant awards fund studies enrolling patients with cancer; 40 percent of these [cancer] studies target devastating forms of brain cancer, one of which recruits children with recurrent or progressive malignant brain tumors. 43 percent of this year’s awards fund studies that enroll pediatric patients as young as newborns. Of these, two focus on research in transplantation and related issues."
These studies range over time periods of 1-4 years and range in type from Phase 1 to Phase 3 clinical trials. For those who have been confronted by rare or pediatric cancers, these studies may offer new potential therapies.
October 13, 2016
Compassionate Use: How to Access Experimental Therapies
"Compassionate Use" is a term that refers to the process for gaining access to investigational drugs that are not yet FDA-approved for full-scale marketing. They may still be in clinical trials or awaiting approval.
A recent survey of 100 pharmaceutical companies identified that only 19% post their compassionate use policies (that is, ways for patients to gain access to experimental drugs). Further information about compassionate use is covered in a STAT article published on October 13. The 21st Century Cures Act which is still awaiting release from both House and Senate committees, includes some provisions to increase transparency around these policies.
Meanwhile, the Cancer Knowledge Network (CKN), an affiliate of Current Oncology magazine, is an electronic information-sharing network based in Canada but addressing North American cancer issues and resources. A recent CKN post, entitled "A Primer on Compassionate Use," addresses how to work with your physician to gain access to such therapies if standard treatments are not working and your oncologist believes you would be a good candidate for such a drug. This is a very solid information source, and the post is worthy of your attention if you or someone you love needs such access.
October 10, 2016
An October Surprise: Crowdsourcing for Metastatic Breast Cancer Research
Who would have guessed that you could advance the effort to solve the dilemmas of metastatic breast cancer by just spitting into a test tube? Well, a new initiative is well on its way that is signing up participants through social media.
When breast cancer metastasizes, it often moves to the liver, lungs, bones, and brain. Other patients who believed that a mastectomy and chemotherapy had beaten their diseases at an early stage may be faced with a recurrence many years later (like my friend, whose lobular breast cancer surprisingly re-appeared in her appendix 28 years after her initial mastectomy and chemo treatment).
While many scientists are researching the metastatic process in an effort to understand genetic mechanisms for cancer's spread that might be interrupted, too many lives are still being lost. Around 30% of breast cancer patients develop metastatic disease and have an average life expectancy of 3 years. (One friend has fought it for over 13 years, with indescribable suffering and family impact.)
The Metastatic Breast Cancer Project, run by scientists at Harvard and Dana-Farber Cancer Institute and the Massachusetts Institute of Technology’s Broad Institute, is focused on metastatic breast cancer. Funded through crowd-sourcing, has enrolled more than 2,600 patients so far since launching last October. That rate of enrollment is said to be unprecedented.
Most breast cancer patients are treated at centers that don’t do research on tumors, so participating in studies at academic medical centers far from home is cumbersome at best. For patients sick or dying from their disease, the hurdles and expense of such travel can be insurmountable.
This project is different. Patients sign up online, mail in saliva kits for genetic testing, and allow use of their tumor tissue samples and medical records. Researchers use social media to keep them posted about progress, and periodically invite participants to visit the Cambridge, Mass., lab where their specimens are being analyzed.
Another way this project is different is that so many women are treated for breast cancer at centers that are not research institutions and so lack the ability to analyze the genetic composition of breast tissue. This project lets the participant literally spit saliva into a test tube and mail it to the lab, for study. The assortment of patients isn't fully representative of the community of those fighting metastatic breast cancer, largely because it centers on social media that would appeal to the younger audience. Nevertheless, it's yet another tool for helping to solve an important problem that affects women year round and deserves special focus in October.
October 4, 2016
Precision Medicine Clinical Trial Offers New Hope for Pancreatic Cancer Patients
This morning, STAT (Boston Globe) published information about a new approach by PanCan to clinical trials that--beginning next spring--will offer precision medicine treatments and the opportunity for patients to move among treatments to pancreatic cancer patients. The article is short, so I'm including it in full below. It's a sign of new hope for one of the most lethal cancers:
New precision medicine trial targets pancreatic cancer
Today, the Pancreatic Cancer Action Network is announcing its answer to the chronic problem of how few adult cancer patients — just 3 percent — enroll in clinical trials testing experimental treatments. There’s a key reason for that shortcoming: Most trials only take patients looking for a “first line” therapy, but most patients have already had at least one treatment by the time they consider clinical trials. “There is a mismatch between what patients are looking for and the landscape of clinical trials,” said Lynn Matrisian, chief research officer of the network.
In what the group calls Precision Promise, 12 sites announced this morning will enroll patients in the first large-scale precision medicine trial for pancreatic cancer. Crucially, patients will be able to easily move between treatment options, called sub-studies, under the umbrella of a single Precision Promise trial. Patients will have their tumor molecularly profiled to identify possible therapy targets, be put on the treatment that has the best chance of success, and then can be switched to a different sub-study if that drug doesn’t help or stops working. Patients can start enrolling next spring. In an echo of the data-sharing championed by the White House’s cancer moonshot, all data from the 12 sites will be analyzed together and quickly released to researchers, Matrisian said.
September 29, 2016
Research to Save Your Own Life
Cancer researchers are amazing individuals, often driven by their own personal stories. I've met many such individuals, and their combination of training, intellect, creativity, and resourcefulness is awesome.
This morning I came across an inspirational story about a cancer researcher who is fighting metastatic colon cancer and is determined to find a way to save his own life. It reflects the passion of many cancer researchers who are inspired by their own or their family members' experiences. They won't take "no" for an answer, and they're helping us all by doing so.
Another companion article talks about the promise of immunotherapy to devise personalized treatments.
If we can press Congress for funding of the Moonshot and increased cancer research budgets within the National Institutes of Health and the National Cancer institute, we may be able to accelerate progress. For more information on how you can raise your own voice in support of increasing Federal cancer research funding, check out the American Cancer Society's Cancer Action Network. Your voice can get heard. To contribute to the Society's research support for early career researchers (whose recipients have won a total of 47 Nobel Prizes for their ground-breaking work, you can write a check to Pay-If Research Fund, ACS New England Division, 30 Speen Street, Framingham, MA 01701.
September 22, 2016
Asbestos is Still an Invisible Killer
I've just posted on Huffington Post an article about asbestos and mesothelioma. I was shocked to learn that we're still using and importing asbestos into this country. If you're concerns about asbestos, check it out!
September 22, 2016
Demand an Experienced Surgical Team
MedPage Today just released a study by the California Health Care Foundation of over 300 California hospitals. The study showed that in 2014 in California, nearly 700 cancer patients had surgery at a hospital that did only one or two surgeries of that type for the entire prior year. Thousands were reported to have had surgery at a hopital that performed no more than five such procedures.
These findings are shocking. Your best strategy, if you're facing cancer surgery, is to seek out an experienced surgical team, no matter what referrals you get from your primary care physician. You're your best advocate; make sure you're getting the best care, and the best care usually comes from the most experienced care providers.
September 20, 2016
Caregiving: A True Heroine
Dana Berson is a tiny and beautiful young woman who truly packs a punch. She's barely 30, and she's a widow.
The love of her life, Jon, was diagnosed with a rare Stage IV rhabdosarcoma in his sinus (usually a pediatric condition) at age 35, after they'd been married only one year. He died one year later, about a year ago.
I met her for the first time at a major cancer advocacy event in Washington where over 600 advocates representing the American Cancer Society's Cancer Action Network conducted 509 personal meetings with legislators on September 13 to ask them
- to support allocating $680 billion to the cancer Moonshot research initiative and
- to move both a palliative care bill and a bill to close the Medicare colorectal screening loophole (which pays for a colonoscopy but not for removing polyps that may be discovered) to the floor of the House and Senate for a vote before the end of the year.
That evening, we attended a Lights of Hope ceremony featuring 24,000 luminary bags around the reflecting pool, honoring loved ones who survived or succumbed to cancer. Dana addressed the crowd, describing the palliative care that her husband received during his treatment and expressing her wish that all cancer patients would have such a positive benefit. In spite of the fact that they knew he was dying, they had a fulfilling year filled with trvel and good times with close friends, and he had a good quality of life. The palliative care team was as helpful to her as to him.
You can listen to her inspiring words at https://vimeo.com/182716545; her poise (both in telling her story and in remaining cool while her notes blew off the podium and the CEOS rof both CAN and Merck ran to gather them up for her) was stunning. The video is only 9 minutes long, I think, but it may help you understand the power of advocacy in support of a cause you care about. The whole experience was incredibly moving and reinforced our belief that we can and must stop the carnage from cancer.
Dana Bernson has the grace, poise, and presence of a true hero and is committed to making Jon's legacy matter.
September 16, 2016
Moonshot Blue Ribbon Report and Advocacy Offer Hope
The September 7 Blue Ribbon Panel Report on the Cancer Moonshot offers a blueprint for charting out ways to make a decade's worth of advances in cancer prevention, diagnosis, treatment, and care in five years. In summary, the Recommendations are:
A. Establish a network for direct patient involvement in cancer research and clinical trials.
B. Create a clinical trials network devoted exclusively to immunotherapy.
C. Develop ways to overcome resistance to therapy.
D. Build a national cancer data ecosystem accessible to researchers, doctors, and patients to fuel information sharing and accelerate progress.
E. Intensify research on the major drivers of childhood cancers.
F. Minimize cancer treatment's debilitating side effects.
G. Expand use of proven prevention and early detection strategies.
H. Mine past patient data to predict future patient outcomes (so we can understand genetic and other factors that distinguish which patients will best benefit from clinical trials).
I. Develop a 3D cancer atlas (to help oncologists make more informed treatment decisions for each patient).
J. Develop new cancer technologies that are showing remarkable promise.
Funding for the Moonshot was one need that led over 600 American Cancer Society Cancer Action Network representatives to visit 509 legislators in person on Capitol Hill in Washington on September 13 to ask for $680 billion in cancer research funding to be authorized for the National Cancer Institute in the current round of budget deliberations and for the passage of the 21st Century Cures Act which increases NIH research funding by $2 billion over two years.
More information on how you can help push for that funding can be found at CAN's press release on this year's Lobby Day. Additional requests asked that two other bills--one expanding access to palliative care for relief of pain, nausea, and anxiety (Palliative Care and Hospice Education and Training Act) and the other closing the Medicare loophole that provides coverage for colonoscopies but not for removing polyps found during colonoscopies--receive full House and Senate votes during this session.
September 5, 2016
Why You Want an Expert Radiologist
On September 1, 2016, Medscape, a medical newsletter affiliated with WebMD, cited the results of a research study of breast cancer diagnoses made from mammograms. The study results were reported by senior author Jeremy Wolfe, MD, a radiologist at Harvard Medical School and Brigham and Women's Hospital in Boston, and a team of colleagues.
In the study, 49 radiologists each of whom had 15-20 years of experience reading mannograms (averaging 7,000 scans by each) identified visual indications that allow such experts to identify even small and subtle breast cancers based on viewing mammograpy images for as little as a half second. While the authors would not recommend such fast diagnosis, they were reported that these experts achieved a 75% accuracy rate, which is substantially higher than the 50% that would have been achieved by chance. In addition, they concluded from a smaller study that even when the breast cancer is only visible in one breast, there are tissue changes visible in the other breast that may indicate the presence of "contralateral" breast cancer.
The message is clear for anyone being tested for the presence of breast cancer: Make sure your mammogram is read by an expert!
August 15, 2016
Why are More Teens "Vaping"?
Kids are using e-cigarettes in increasing numbers. MedPage (staff writer Molly Walker) reported, on August 8, on a study performed about why teens (middle school and high school students) are still attracted to e-cigarette usage, despite its negative health consequences. Key reasons given were low cost and use as a nicotine substitute. Curiosity and the "cool factor" tend to drive them to try vaping, and less than 6% start using e-cigarettes for smoking cessation. In fact, the study reports that 80% of users who said they had started vaping to quit smoking were still smoking traditional cigarettes.
Krysten W. Bold, PhD, of Yale University, in New Haven, Conn., and colleagues, writing in Pediatrics about studies conducted in 2013 and 2014, said that preventing teens from starting e-cigarette usage was the most important factor in controlling their use. E-cigarettes' continued appeal after the first usage tends to correlate, she reported, with good flavors, the ability to use them nearly anywhere, and the principle of hiding their usage from adults. The most significant predictor of continued usage was low cost in comparison to the cost of tobacco products. Longitudinal studies are ongoing.
These factors underlie the priority that the American Cancer Society's Cancer Action Network (CAN) and other anti-smoking organizations are placing on state-level legislation to place the same restrictions on e-cigarette purchase and usage as exist for tobacco products and to raise taxes on both.
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