Screening for Lung Cancer in Rural Areas

WHEN THE U.S. PREVENTIVE SERVICES TASK FORCE offered its first-ever recommendation for lung cancer screening in 2013, it was big news. The studies the Task Force based its recommendation on had found screening could reduce lung cancer deaths by 20%. But the initial impact of the screening recommendations, which call for annual low-dose CT scans for high-risk individuals, was small.

In 2015, an estimated 8 million high-risk individuals were eligible for screening. Data from the 2015 National Health Interview Survey show that only about 4% of high-risk individuals had a low-dose CT scan that year. Efforts are underway to get more people to talk to their doctors about screening.

The need for increased screening is especially great in rural areas. Rates of smoking and cancer diagnoses are higher in rural areas than they are in urban areas. Rural areas also have higher rates of late-stage lung cancer diagnoses. A study in the April 2019 Journal of the American College of Radiology highlights two of the potential challenges rural individuals face if they are interested in screening: geographic access to a low-dose CT scan screening program and a lack of providers trained to discuss the risks and benefits of screening.

Read the full story in the Winter issue of Cancer Today.

BRCA: Who Should Be Tested?

MARISOL ROSAS ​was 8 years old when her mother, Celia Bazua de Rosas, died from ovarian cancer in 1981. It was her mother’s second cancer diagnosis. She had been diagnosed with breast cancer at age 42, shortly after Rosas, her sixth and last child, was born. For Rosas and her brothers and sisters, who were all raised in Baja California, Mexico, “there was always a concern,” she says, “that this could happen to any of us.” ​

As the siblings got older, their worries grew as three cousins on their mother’s side of the family were diagnosed with cancer. “One had breast cancer that spread to her brain,” says Rosas. “Another had breast cancer and then had a recurrence. Another had breast and ovarian cancer and then died of pancreatic cancer. I knew there was something going on, but I didn’t know what to do about it.”

Then, in 1998, Rosas got a call from a cousin who had moved from Mexico to California. Her cousin explained that her doctor had told her about a new blood test that could look for signs of an increased risk for breast or ovarian cancer. Her test had come back positive. She was calling to tell Rosas that she and her siblings should get tested, too.

Read the full story in the Winter 2019/2020 Issue of Cancer Today.

Learning How to Prevent Multiple Myeloma

Multiple myeloma is the second ​most common blood cancer in the U.S. It can be treated but not cured. This year, an estimated 32,100 people will be diagnosed with multiple myeloma and close to 13,000 will die from the disease. Multiple myeloma begins in plasma cells in the bone marrow. Most people diagno​sed with multiple myeloma initially 2-learning-how-to-prevent-multiple-myeloma-1500-WEBhave one of two plasma disorders: monoclonal gammopathy of undetermined significance (MGUS) or smoldering multiple myeloma. The disorders are called myeloma precursors. They can be spotted on a routine blood test, but they are not routinely screened for because they typically don’t cause any symptoms and can’t be treated.

Irene Ghobrial, a medical oncologist at the Dana-Farber Cancer Institute in Boston, believes that studying the molecular changes that occur as these precursor conditions advance to multiple myeloma could help researchers identify ways to stop them from progressing.

Read my Q&A with Dr. Ghobrial about how this study could help identify ways to prevent precursor conditions from turning into cancer in the Summer issue of Cancer Today.

Focusing on Proton Therapy

For about a century, radiation therapy has been a mainstay of cancer treatment. Standard radiation systems use photons, or X-rays, to kill cancer cells. Proton therapy uses particles that can be targeted at the tumor more precisely. Studies have shown that proton therapy is safe and effective. Less clear is which patients with which types of cancer should receive it instead of standard radiation.

13-focusing-on-proton-therapy-1500-WEBClinical trials that compare proton and photon therapies are now underway, but enrolling patients hasn’t been easy. And in the years that it takes for the answers to come in, thousands of cancer patients will find themselves having to consider whether the benefit is worth the higher price tag.

What do you need to know?

Read my article in the Summer issue of Cancer Today.


Exciting News

Today, the Association of Health Care Journalists announced its 2018 Awards for Excellence in Health Care Journalism—and I’m one of the winners!

I received the Third Place award in the Trade Journalism category for my article “Survivors Cast Adrift,” which was published in the Summer 2018 issue of Cancer Today.

I’m hoping to make it to Baltimore in May for Health Journalism 2019, the AHCJ’s annual conference, where the winners will receive their awards.

Read my winning article here.

Pharma banks on cancer patients who are ‘determined to keep fighting’

Promoted ads and videos for the cancer drug Cyramza (ramucirumab) began showing up on Twitter in May. They’ve also appeared in print publications. The ads encourage you to read the words of “determined Cyramza patients” whose faces come alive with color as phrases such as “I want to keep a flower garden” “I want to dance off-beat with my wife, while my daughters laugh and call us embarrassing” animate.

The ad, which has been viewed more than 1.1 million times, sells the idea that Cyramza will breathe new life into patients who are “determined to keep fighting.” The drug’s manufacturer, Eli Lilly and Company, didn’t introduce the idea that cancer is a war to be fought as aggressively as possible. But its ad is banking—literally—on the fact that people with cancer and their family members and friends believe it.

That belief is not innocuous. In fact, it causes real patient harm.

Learn more in my newest blog post on HealthNewsReview

Will a new flu drug ‘upend treatment’?

The headline on STAT makes a bold statement: “A flu drug—shown to reduce duration of symptoms—could upend treatment in U.S.” The next two paragraphs ramp up the excitement regarding the FDA’s announcement that it has granted priority review to a new single-dose flu drug—baloxavir marboxil—that is “unlike anything else on the market.”

We’ve seen this excitement before. There was a lot of enthusiasm about Tamiflu when it was first introduced. But in all the hoopla about Tamiflu being able to reduce the duration of flu symptoms—by a day!—an important point was lost. Yes, the flu makes you miserable. But the real concern about the flu is that in some populations—in particular children, the elderly, and those with impaired immune systems or other health conditions—the flu can be deadly. Yet there is limited evidence that Tamiflu will prevent flu-related complications, hospitalization, or death.

It would be great if there was a drug that reduced deaths from the flu. But Genentech has provided no evidence that baloxavir marboxil is this drug.

Read the full review of STAT’s story and learn more about the new flu drug in my blog post for

About That New Migraine Drug

I am one of the millions of Americans who suffer from migraine attacks. I’m also one of the millions of Americans who has tried a wide array of medication that are supposed to help prevent these attacks from occurring or stop them as they are starting.  GettyImages-681797068-300x270My friends and family are well aware of the impact my migraines–and the side effects of the drugs I take to prevent them–have had and continue to have on my quality of life (and, by extension, on them as well). So, not too surprisingly, they were eager to tell me about this great new drug they had read about that would surely end my pain.

Also not too surprisingly, the pharma hype they heard about this new drug, Aimovig, far exceeds its benefits. As the title of this story review I wrote for HealthNewsReview about an NBC article that covered the drug’s approval explains, decreasing migraine frequency by 50 percent sounds great–until you read the fine print.

You can read my full review here.


Liver Cancer on the Rise

Liver cancer incidence and death rates are increasing rapidly. Although there is no screening test for the disease, minimizing risk factors—hepatitis B and C, smoking, obesity and type 2 diabetes—could prevent many cases from developing.

WHEN FRANK GARDEA was diagnosed with liver cancer in March 2013, he never expected he’d live to ring in 2014—let alone see the calendar turn to 2018. Neither did his doctors.8.5-liver-cancer-on-the-rise-1500-WEB-1

That March day, the 59-year-old resident of Woodland Hills, California, showed up at a Los Angeles County emergency room with severe abdominal pain. The pain itself wasn’t new; he’d been talking to doctors about it for two years. But the intensity was. Soon, the ER team discovered what Gardea’s other doctors had not seen: an 8-centimeter tumor on his liver.

Tests showed Gardea had hepatocellular carcinoma (HCC), the most common type of liver cancer in adults. He also had hepatitis C and early stages of cirrhosis. Gardea says his doctors told him that the tumor’s size and the underlying liver disease left him with a poor prognosis, and they advised him to get his affairs in order. Gardea felt certain he had only a few more months to live, but then, by chance, other doctors doing rounds saw his chart.

Read my full article in the spring issue of Cancer Today.