Cancer Today—Winter Issue 2012-2013

The Winter issue of Cancer Today is now available.

I encourage you to take a look at the stories covered in Forward Look, which I developed and edited. It includes stories on genetic ancestry, the link between childhood obesity and adult cancer risk, lung cancer’s stigma and the role of patient navigators, and more.

This issue also includes my article “Missing the Mark,” which continues my exploration into cancer clinical trials. Many people are not aware that only one-third of new cancer therapies or drug combinations tested in phase III clinical trials prove to be better than the standard of care. This article explores why—and how researchers are aiming to improve the odds.

Missing the Mark

If you are a person who likes to gamble, the Super Bowl may be the event for you. Some Vegas oddsmakers have correctly predicted 16 of the last 21 winners—a 75 percent success rate. 

Even so, odds are just that: odds. Time after time the team that just can’t lose does. In the wake of such upsets, sports announcers typically turn to clichés like “misplaced expectations” and “false hopes.”

 Similar platitudes are often heard when a large phase III clinical trial falls short—when a therapy or drug combination that companies have often spent hundreds of millions of dollars and more than a decade developing doesn’t do better than the current standard of care, or does even worse. The difference, however, is that cancer is not a game. Read more

[Note: Special thanks to Larry and Scott for their deadline oddsmaker insights.]

The Winter issue also includes my interview with Margareta Timofti, the new first lady of Moldova. Timofti is committed to lowering her country’s cancer death rates, and she and I spoke (through a translator) while she was in San Francisco on an educational mission sponsored by the Institute of International Education.

Q&A  Gaining the Benefits of Early DetectionWhen Nicolae Timofti was elected president of Moldova by the country’s parliament in March 2012, his wife, Margareta Timofti, rose to international prominence as well. As the country’s new first lady, Timofti intends to use her position to draw attention to women’s health issues—in particular, the thousands of deaths that could be prevented through cancer screening programs.​ Her work will not be easy. Moldova, which is about the size of Maryland and is home to nearly 4 million people, is one of the poorest countries in Eastern Europe. The parliamentary vote that brought her husband to office followed nearly three years of deadlock between Moldova’s ruling, pro-Western Alliance for European Integration and the opposition Communist Party. Even so, since 2009, with the assistance of the International Atomic Energy Agency’s Programme of Action for Cancer Therapy, the country has been taking steps toward implementing its first national comprehensive cancer program. Timofti’s work can build on this foundation. Read more

This issue is also special to me because In the Moment includes this lovely photograph of my friend Julia, who was diagnosed with stage IV breast cancer in 2010. Julia and I first met in the early 1980, when we worked at the UCSD Food Coop selling fruit, vegetables and other new-fangled organic goodies. We’re both still organically inclined, but now we talk about kids, college, new restaurants—and cancer.

Family Politics

I submitted this piece to the New York Times Motherlode parenting blog, but it was turned down. (The editors had decided the blog should stay nonpartisan.) So, I’m posting it on my own blog.

Family Politics

“I really like Mitt Romney. So does my Dad. And my Mom, too.”

When my 11-year-old niece spoke those words over breakfast during a family get together in Denver, it was with no ill will. She wasn’t looking for a debate. She wasn’t trying to rile her feminist aunt, as her Dad likes to do. (Stirring the pot, as my nephew would say.) But could I really not respond?

It’s certainly no family secret that my partner and I, lesbian moms raising a son in San Francisco, vote democratic, whereas my partner’s brother is a staunch Republican. When our children were younger, the political jousting wasn’t something they really understood. But that’s no longer the case.

Last year, when it was our son’s turn to co-write the weekly first-grade blog, one of his posts read, in part: In Mindfulness we thought about the things we are grateful for and listed those in ourMindfulness journals.I am thankful for President Obama becausehe is the first president to say that gay people should be able to be married.

We want to protect our kids. But when the politics of the day is about your family, it’s not always possible to shield them. One tactic is to explain that it’s people who don’t know us who feel that way. But what if it’s not?

This was what was on my mind when I read a New York Times article about Frank Schubert, the former corporate PR executive who was the chief strategist behind Proposition 8 in California and is now leading campaigns against marriage equality initiatives in Maine, Maryland, Minnesota and Washington State. As the article explains:

For his part, Mr. Schubert, who has a lesbian sister raising two children in a domestic partnership, says, “It’s hurtful to know that many people think I dislike gays and lesbians and wish them harm.”

A lesbian sister raising two children in a domestic partnership? How in the world does Mr. Schubert’s sister explain him and his work to her kids? Do they just not talk about his work, or their lives, while cutting the Thanksgiving turkey? Does she return his calls? Are they friends on Facebook?

Mr. Schubert’s family is, of course, in good company. It’s practically de rigueur for republican politicians to have lesbian relatives. Newt Gingrich’s half-sister is lesbian activist Candace Gingrich-Jones. Dick Cheney’s daughter Mary Cheney is an out lesbian. It’s also wonderfully convenient, allowing them to bolster their anti-gay rhetoric in a “love the sinner but hate the sin” kind of way.

For my brother-in-law, voting for president is not the same as voting for or against gay marriage; it’s about the economy, which he thinks Mitt Romney will turn around. The issue I’m grappling with is not which is salient, as I could certainly ask the gay Log Cabin Republican group the same question. It’s about how you discuss politics with children who are at an age where they can clearly differentiate between right and wrong, and how you explain that an election is not just about a winner and loser, but a world view, with repercussions that affect people you care about.

In the end, I walked the line between my niece’s love for her dad and my feelings about his politics, explaining that while her parents support Mitt Romney I never would because he, and the party he represents, do not respect or support our family. Her response: “I can understand that.”

Will our son be as understanding about his uncle? Do I want him to be?

Cancer Today — Fall Issue

The Fall issue of Cancer Today —for which I’m a contributing editor— is now on the stands. It is the consumer magazine published by the American Association for Cancer Research, the oldest and largest scientific organization in the world focused on every aspect of high-quality, innovative cancer research.

This issue includes my article “A Genetic Legacy,” which explores inherited cancer risk:

A Genetic Legacy
When Kevin Lewis’ daughter, Katie, was born in 2007, he fell in love all over again. And like new parents everywhere, he couldn’t help but wonder how her life would unfold, what interests they would share, which family traditions she would choose to carry on. But Lewis also had a deeper concern: Had Katie inherited the genetic mutation he carried that would greatly increase her risk of developing cancer? Read more

It also includes my article, “Bridging the Distance,” a Q & A with medical oncologist Ana María López, medical director of the telemedicine program at the University of Arizona Cancer Center in Tucson, on the benefits of teleoncology programs for people living in rural areas.
Bridging the Distance
​For patients living in rural areas, obtaining cancer care can easily require a three- to four-hour car ride. Factor in the challenge of finding a driver, the cost gas, child care or elder care, the return trip or, if necessary, the cost of a hotel, and it’s not hard to understand why rural residents might skip a routine screening, have difficulty getting to oncology appointments, or choose not to take part in a clinical trial. But what if the medical expertise of oncologists were accessible in rural areas? Read more