New U.S. guidelines urge doubling of people that should get annual lung-cancer cat-scans

New federal guidelines could almost double the number of people advised to get yearly lung-cancer screenings.

The point, according to a recent story by Denise Grady in The New York Times, is to include more women and Black and young people.

Early discovery of the disease, the most deadly cancer, could help "cure it in more people at high risk because of smoking," the Times piece says. In those individuals, the article indicates, "annual CT scans can reduce the risk of death from cancer by 20 to 25 percent, large studies have found."

The story quotes Robert Smith, a Ph.D. and screening expert at the American Cancer Society, as saying, "Part of the low uptake is simply lack of access to credit. Smoking in general is increasingly concentrated in lower-income populations."

He contends that "researchers have found that half the population eligible for lung-cancer screening had either no insurance, or Medicaid" — but an editorial in the medical journal "JAMA" explained that not all Medicaid plans cover the screening.

What that means, Smith says, is that there "could be a 15-year period when you might quality for screening and not have any insurance."

Grady also quotes Dr. Mara Antonoff, a lung surgeon at the M.D. Anderson Cancer Center in Houston, to the effect that some studies "have alluded to some hormonal influences in women. In terms of racial differences, we don't have an answer. We have population-based data to show they have a tendency to develop lung cancer younger and with less exposure to tobacco, but we don't have a mechanism."

The article indicates that "14.5 million people would qualify for the screening" — representing an increase of 6.4 million. But researchers "estimate that only 6 to 18 percent of those who qualify and could be helped by the screening have taken advantage of it."

One reason could well be the cost — $300. Some who need the scans most simply "may not be able to afford them," the story postulates. 

CT scans — casually called cat-scans and formally called computerized tomography — provide much more detailed information than ordinary X-rays.

The story, based on advice published in "JAMA," says the new recommendations by the U.S. Preventive Services Task Force "include people ages 50 to 80 who have smoked at least a pack a day for 20 years or more, and who still smoke or have quit within the past 15 years."

Earlier U.S. guidelines were based on males, who tend to smoke more heavily, the Times reports, further noting that women and Black Americans "tend to develop lung cancer earlier and from less tobacco exposure than white men, experts said."

Why the risk appears to differ by race and gender, the story says, "is not known."

The Times piece also suggests that Smith and other researchers believe a good portion of patients "may be missing out on lung-cancer screening because they just don't know about it" — or because some doctors may not strongly encourage it.

The statistics are grim. "There were 228,820 new cases of lung cancer in the United States in 2020," Brady writes, "and 135,720 people died from it, according to the National Cancer Institute. About 90 percent of cases occur in people who smoke, and current smokers' risk of developing the disease is about 20 times that of nonsmokers."

Book about sorcerer, fairies set for prime time

Fantasy, Grampy and His Fairyzona Playmates, and related website approach their launch dates

The pandemic, believe it or not, has had some positive impact.

For instance, it's given me — Woody Weingarten — plenty of time to tweak my new website, which is nearing completion and which will promote the fantasy book I co-authored with my then eight-year-old granddaughter, Hannah Schifrin.

It's also given me plenty of time to tweak the magical book itself, probably ensuring that Grampy and His Fairyzona Playmates will meet its hoped-for publication date next month.

Bottom line: Both the volume itself, which is aimed at 6- to 10-year-olds, and the related website are both almost ready for prime time.

The VitalityPress book, which is illustrated in full color by Joe Marciniak, a longtime artistic pro, tells the four-part tale of a sorcerer, Grandpa Graybeard, who often has to get his granddaughter, Lily, and her best friend, Penny, out of trouble when the two eight-year-old fairies mess up their magic spells.

Their misadventures become terrific fun for all three characters — and for young readers who enjoy letting their imaginations run wild.

While proofs of Grampy and His Fairyzona Playmates are on the way to me for approval, and the finishing touches are being put on the website that can be found at woodyweingarten.com after it's launched, I'm also editing The Roving I, a book that will embrace newspaper columns I'd written over an 11-year period.

This interested in caregiving might check out, through your local bookstore or Amazon, my earlier book, Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress volume I aimed at male caregivers but one that can also aid female patients and caregivers through factual information and anecdotes. It's a comprehensive memoir-chronicle and guide to scientific research, meds and where to get help.

Though I became an expert reluctantly, I at last can unflinchingly share what I've gleaned from personal experience (including a weekly support group I've run for more than 25 years). 

And that's the truth, the whole truth and nothing but the truth — no fantasy.

Survival rates jump 80% with new treatment

Clinical trial finds drug combination that might stop metastasized prostate cancer from worsening

A new study shows that an experimental drug combo that controls hormones may halt the progression of prostate cancer.

Dr. Chris Sweeney

A clinical trial led by Dr. Christopher Sweeney at Dana-Farber Cancer Institute in Boston, according to a story in the October-November issue of AARP Magazine, determined that survival rates could jump as much as 80 percent when the combination is used.

Sweeney's study, the AARP article notes, focused on what can happen when enzalutamide, an oral drug that blocks hormone reception, is combined with testosterone-suppressing medication. 

That study, like other research, was based on the notion that "testosterone and other male hormones can fuel the growth of cancer cells." 

What was being sought were ways "to either suppress the production of hormones or stop cells from receiving them."

Sweeney's study, the story asserts, did both.

The AARP article centered on one particular participant in the study, Dr. John Hammel, a psychiatrist who was diagnosed in 2016 with late-stage prostate cancer that had already begun to metastasize.

Hammel's quoted as saying "I was despondent — I didn't think I'd live a year."

That attitude made him, after initial skepticism, jump at the chance when his oncologist told him about the "real treatment" that was available, "not just palliative care." 

During the study, Hammel reportedly saw his PSA test numbers "drop from 2,000 to 450 to four and then to undetectable for six months" — and then stay there.

The trial, the story says, helped him start living again, "instead of focusing on his prognosis." 

For more information about clinical trials and their results, check out "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

New site to spotlight 'Grampy' kids' fantasy

Refreshed website to coincide with publication of children's fantasy by grandfather and granddaughter

'Grampy and His Fairyzona Playmates,' a children's fantasy co-authored by me (Woody Weingarten) and my granddaughter, Hannah Schifrin, is definitely ready for prime time.

To embellish the VitalityPress book's publication (tentatively slated for New Year's Day 2021), I'm developing a new, modernized website that will allow readers to more readily access more information more quickly and more visually. 

The exact date of the refreshed site's launch has yet to be determined but, as the cliche goes, you'll be the first to know. Meanwhile, just keep on checking here.

'Grampy and His Fairyzona Playmates,' five years in the making, is aimed at readers between the ages of 6 and 10. It's a four-part story of how a sorcerer, Grandpa Graybeard, repeatedly gets his granddaughter, Lily, and her best friend, Penny, out of trouble after they mess up their magic spells. It also shows how the girls learn from their misadventures.

Hannah Schifrin was only eight years old when she collaborated on the book, which is illustrated by Joe Marciniak in full color.

While you're waiting for 'Grampy' to be published, if you want to make sure I can put one word after another, check out your local bookstore or Amazon and get a copy of "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress volume I aimed at male caregivers. 

And look for, somewhere in mid-2021, for "The Roving I," a compilation of columns I'd written for a group of weekly newspapers over an 11-year period.

New treatments targeting HER2 tumors

Aggressive therapy set for patients with early stage of breast cancer

An aggressive new therapy that attacks an especially perilous early-stage breast cancer is ready for use on patients.

That, at least, is what's cited in an October-November AARP Magazine story regarding a type of cancer known as HER2+ER+.

The multi-disciplinary therapy was first proven beneficial in later stages of the disease, says the piece. 

The article also notes that "about a quarter of all breast cancers are HER2+" — tumors that have "higher levels of a protein called human epidermal growth factor receptor 2, which tends to make them grow and spread faster than other kinds of breast cancer."

Dr. Vered Stearns

Dr. Vered Stearns, director of the women's malignancies program at the Kimmel Cancer Center at Johns Hopkins University in Baltimore, is quoted by the magazine as saying that new treatments that specifically target HER2 can now expected to be utilized in fighting the disease. 

Accompanying the AARP Magazine article are two noteworthy short sidebars:

• "Aromatase inhibitors (which reduce estrogen), used to prevent recurrence, may prevent breast cancer from developing in the first place."

• "An immunotherapy drug, atezolizumab, is being tested in combination with chemotherapy as a new line of treatment for hard-to-treat triple-negative cancers."

More information about other treatments and drugs can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers. 

Bayer adjunct loses plea about ignoring safety

Top court in California rejects Monsanto appeal in case where jury ruled that herbicide caused cancer

The California Supreme Court has turned down both defendant and plaintiff appeals in a case where a jury decided the weed-killer Roundup was the reason the defendant contracted cancer.

A story by Bob Egelko in yesterday's San Francisco Chronicle explains that the court denied Monsanto's appeal of a "groundbreaking verdict that found the company's widely used herbicide caused a school groundskeeper's cancer and that the company disregarded public safety in marketing its product."

Simultaneously, however, it rejected a review of the plaintiff's appeal of a lower-court ruling that reduced his damages from $78.5 million to $21.5 million.

The case had been the first in the United States to go to trial among many thousands filed against the giant agribusiness now owned by Bayer, which paid $63 billion for it in 2018. Cancer victims maintain that the problem is glyphosate, the active ingredient in Roundup and a more concentrated version called Ranger Pro.

Dewayne Johnson

The plaintiff in the groundbreaking case, Dewayne Johnson, had developed non-Hodgkin's lymphoma, a blood cancer, after using the Ranger Pro from two to three hours a day over a four-year period as a groundskeeper and pest-control manager for the Benicia School District. At the time of the 2018 trial, lesions covered his body. 

The Vallejo resident testified, Egelko's story says, that "he wore protective clothing but couldn't fully protect his face from wind-blown spray, and twice was drenched with herbicide sprays from a detached hose and a leaking container."

According to the Chronicle article, the jury determined that Monsanto "should have known the product was carcinogenic, and 'acted with malice or oppression' by failing to notify Johnson's employer."

Bayer has indicated it may consider further review of Wednesday's rulings, which most likely would mean seeking a federal court judgment. The company has previously said it would pay nearly $10 billion to upwards of 125,000 claimants, as well as setting aside another billion for potential future plaintiffs. Those settlements, announced in June, haven't yet been finalized and, in fact, have been challenged by some plaintiffs' lawyers. 

Information on other suits against manufacturers can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Children's four-part tale of wizard, fairies due

Publication date set for kids' book, 'Grampy and His Fairyzona Playmates' 

Hooray! A tentative publication date, Jan. 1, has been established for 'Grampy and His Fairyzona Playmates.'

The 50-page children's book, a true collaboration of me, Woody Weingarten, and my granddaughter, Hannah Schifrin, has been — as Hollywood publicists often shout — "five years in the making."

Surprisingly, perhaps, recent delays weren't caused by Covid-19 but by our desire to make the book the best possible available for readers between the ages of 6 and 10. 

A four-part fantasy, 'Grampy and His Fairyzona Playmates' focuses on how a sorcerer, Grandpa Graybeard, repeatedly gets his granddaughter, Lily, and her best friend, Penny, out of trouble after they mess up their magic spells. It also shows how the girls learn from their misadventures.

Hannah was only eight years old when she co-wrote the book, which is colorfully illustrated by Joe Marciniak.

While you're waiting, for anybody who wants to see first-hand that I can put one word after another, why not check out your local bookstore or Amazon and get a copy of "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress volume I aimed at male caregivers (one, admittedly, that I'm considering updating). 

And look, probably in mid-2021, for "The Roving I," a compilation of columns I'd written for a group of weekly newspapers over an 11-year period.

Docs push 'peace of mind' surgeries over survival

Double mastectomies gain favor as ratio of 1 in 8 U.S. women getting breast cancer remains the same

Women with cancer in a single breast are increasingly opting to remove both — prophylactically.

That's despite more treatment possibilities now being available and despite medical experts saying the double mastectomy doesn't necessarily lead to better outcomes.

Reporting by Alexandra Sifferlin in a Time magazine story cites a study of 5,080 women with early stage breast cancer published in JAMA Surgery to the effect that a 20% increase is being driven in part by the patients' surgeons. The study, which considered women who had an average risk for cancer in the second breast, also surveyed 377 of the patients' surgeons.

Although the doctors — who generally did recommend a double mastectomy for patients at high risk — initially leaned toward breast-conserving surgery for average-risk patients rather than CPM, or contralateral prophylactic mastectomy, they were apt to change their minds, the story says.

Why? 

"To give patients peace of mind" and to "avoid patient conflict" — rather than "to reduce recurrence or improve survival."

Women whose surgeons were among those most reluctant to perform a double mastectomy "had only a 4% chance" of having one, the study showed, while the likelihood of women whose doctors were most open to getting CPM having both breasts removed was 34%.

Dr. Steven Katz

Sifferlin's story quotes Dr. Steven Katz, prof at the School of Public Health at the University of Michigan, as saying, "The emotional reactions to cancer frequently prime patients to desire the most aggressive approach. Our results underscore that most surgeons today favor less aggressive approaches to surgery, and it's challenging for them to communicate with their patients that bigger is not better."

The Time article also says that Katz's earlier research "found that a woman's fear about cancer recurrence or her desire to avoid regret can also lead to a decision between her and her doctor to choose more aggressive surgery."

Katz suggests women should consider getting a second opinion, although 95% of breast-cancer patients are treated by the first physician they see.

In a companion Time story that acts as an introduction to Sifferlin's, Alice Park notes that "women now have more information about their disease — down to the very DNA of their tumors — than ever before, so they can make more informed decisions about how aggressively they want to be treated."

She further writes that "scientists also have an evolving understanding of how women can better endure treatment with fewer side effects — and they have plenty of options to do so, from getting more sleep to practicing yoga or eating healthfully."

In addition, Park contends, "women are becoming empowered to make better decisions, and research is even revealing what they should know about the potential biases of the doctors who treat them."

More information about choices of treatment can be obtained by reading "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.