I remember the day I met Margaret “Peg” Geisler, who has now been living with breast cancer for 40 years, and with metastatic disease for 36 of those years.
In its just-published guideline on screening for colorectal cancer, the American Cancer Society revised its 2008 CRC screening guidelines, recommending that screening begin at age 45 instead of 50.
As I read the latest offering from the US Preventive Services Task Force, this time another encyclical on prostate screening, I felt a recurrence of the extreme irritation left over from the last time they wasted my (and their) time. Borrowing from Molière's “The Imaginary Invalid”, I conceived an Imaginary Interview with an un-named representative of this band of bozo's that seem to have few boundaries, a high level of comfort in wasting taxpayer dollars and editorial space, and who seem set on providing useless homilies that, at best, provide no value. This is couched as a Paul Goldberg-style low-key interview… and so the play begins:
Fourteen years ago, I was recruited to the University of Miami to develop a program in cancer disparities.
Ibrutinib is a selective and irreversible inhibitor of Bruton's tyrosine kinase (BTK) that entered phase 1 clinical trials in 2009 based on preclinical efficacy in models of B-cell malignancy and autoimmune disease.[1, 2] The initial phase 1 trial showed clear efficacy in a number of lymphoid malignancies at doses as low as 1.25 mg/kg/d. Furthermore, full receptor occupancy was demonstrated at 2.5 mg/kg/d. Despite these pharmacological and early clinical findings, development of ibrutinib continued at doses of 420 mg qd and 560 mg qd, levels 3-4 fold higher than suggested by the pharmacological data. In addition, the absorption of ibrutinib is enhanced by administration of food, which may explain why even the lowest dose showed efficacy in some patients.
Despite much progress in lung cancer over the last decade, lung cancer is the most frequent cause of cancer death.
Cancer immunotherapy, and in particular immune checkpoint blockade, has transformed oncology with the potential for durable responses even in patients with metastatic disease. To date, regulatory approvals and clinical trials have focused on the study of these agents in relatively more common tumor types, such as melanoma, non-small cell lung cancer, bladder cancer, and kidney cancer, amongst others.
Could diet and exercise really cure breast cancer?
Diversity is to be celebrated in our society as enriching our experiences, our cultures and the richness of our lives. Diversity within the context of cancer care and research has appropriately grown to include considerations of diversity of race, ethnic heritage, age, gender, and experiences.
Imagine a hospital ward 100 years from now. Will multi-drug resistant infections be as prominent as they are today? I suspect so, because as antibiotics evolve, so will the infectious diseases they target. It's an arms race in which both sides have a capacity to learn and adapt. Not so cancer. Cancers can't learn from each other. But cancer patients can. This profound imbalance in the capacity for learning is an advantage that all cancer patients share. It is our super power. And we barely use it.
