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.

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.


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.

New Year, New Opportunities

I’m excited to announce that I’ve been asked to be a contributor to I’ve long admired their work, and am pleased to join a team of writers and editors who are committed to helping improve how medical research is promoted in news releases, written about by journalists and understood by the public. The ultimate goal: more educated health consumers who don’t fall prey to “miracle” cures or set their hopes on”groundbreaking” discoveries that are sure to “revolutionize” care–yet have only been tested in mice.

To that end: Here’s my first blog post:

‘Clinically proven’ ear plugs for migraines make news headlines, with little evidence they work

Do you have migraine attacks?

Use a $12 over-the-counter ear plug-type device called MigraineX, a recent news release insisted, and you’ll experience an 81% improvement in weather-related migraine headaches.

Some news organizations took the PR bait.

Read the full post.  And feel free to comment.


Fearless Friends

I met Lori Marx-Rubiner in November 2016 at a two-day Think Tank coordinated and hosted by Dr. Susan Love Research Foundation’s Metastatic Breast Cancer Collateral Damage Project. (My freelance work includes writing and editing for the Foundation.)

As a woman living with metastatic breast cancer and as a breast cancer advocate, Lori was passionate about the Foundation’s project and she spoke eloquently throughout the meeting about her hopes for what the group could accomplish. As we chatted during a break, I had the feeling that had I still lived in Los Angeles we’d have made a coffee date–and kept it.

1.3-cover-fall-2017-158x203-WEBFive months later, at the American Association for Cancer Research (AACR) Annual Meeting 2017, two of the editors of Cancer Today, which is published by the AACR, met Lori and her best friend and fellow advocate AnneMarie Ciccarella. The two women were presenting a poster in a scientific session at the meeting, and as photos from that day attest, they were both beaming with pride. Within weeks, the editors at Cancer Today made the decision to break with protocol and to have the cover of the Fall issue of the magazine feature two survivors—Lori and AnneMarie. I was the lucky journalist asked to tell their story.

I interviewed Lori in early June, before she set off on a bucket-list cruise to Alaska with her husband and son. We made plans for me to follow up with any additional questions that might come up during my reporting. A few weeks later I spoke with AnneMarie. Soon I was rounding out the story with interviews with other researchers and advocates. As I was writing, I learned Lori was in the hospital. Before she had left for Alaska, she had told me her cancer had progressed and she would be starting on a new treatment. But it was no match for her cancer. She transitioned to palliative care.

Lori died on August 2, 2017, less than two months after our interview and while the issue was still in production. Before her death, Lori and AnneMarie decided they wanted the article to run in Cancer Today as it had originally been written. We have honored those wishes. Here’s their story.