New insights, treatments, tests in disease 'war'

Medical community is starting to believe less is more when it comes to cancer treatments 

More and more doctors and patients apparently are using less aggressive weapons to fight cancer these days.

Dr. Justin Bekelman

A story by Laurie McKinley in yesterday's Washington Post quotes Dr. Justin Bekelman, a radiation oncologist at the University of Pennsylvania, about the medical community's focus on the "war on cancer."

Historically, he says, that phrase "implied that more is better and decimation is desired."

McKinley's story contends, however, that the idea is "falling out of favor," not only because it "subtly blames patients" who die "but also because it doesn't capture a world of new biological insights, improved treatments and molecular tests that are transforming how cancer is treated."

According to Bekelman, "Knowing when not to treat" can be "great medicine" — because, the story charges, oncologists equipped with new tools and evidence can cut back on toxic and costly approaches likely do more harm than good.

Cancer, nevertheless, is not monolithic, the story indicates.

Rather, some cancers "need to be bludgeoned, but others can be treated with more tailored therapies or simply watched."

Although the latest mindset of "doing less in the face of danger" can be "emotionally difficult" for both patients and physicians, the article notes, proof that less is more has been frequently popping up lately, including a landmark clinical trial published in June that found more than "two-thirds of women with early-stage breast cancer can safely avoid chemotherapy." 

Not to mention the fact, according to the piece, that "men with early-stage, low-risk prostate cancer are rapidly embracing 'active surveillance' over surgery — and avoiding possible complications such as incontinence and sexual dysfunction," and that throat cancer caused by human papilloma virus, because it varies from other types of the disease, allows a cutback "in a brutal treatment regimen and [reduces] the risk of potentially devastating disfigurement."

The Post story also mentions the emergence of immunotherapy, usually less toxic than chemo, "as a first-line treatment for many patients," and cites a recent study showing that "people with advanced kidney cancer can skip surgery to have their kidneys removed and instead go right to drug treatment."

De-escalation isn't happening universally, however. 

McKinley contends that the "most common form of thyroid cancer, which poses little risk, is often still treated with unnecessary surgery, experts say. And some malignancies, such as pancreatic cancer, are so lethal that doctors are racing to find ways to ramp up treatment."

Details on trends and clinical trials in treatment 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.

TV star joins disease-awareness initiative

Julia Louis-Dreyfus happily returns to  Emmy-winning 'Veep' role after breast cancer

Instagram selfie with 'Veep' crew.  

TV stalwart Julia Louis-Dreyfus, who'll undoubtedly remember her breast cancer diagnosis and treatments for the rest of her life, is happily back at work at HBO's satirical "Veep."

And she's also involved in her first cancer-awareness initiative.

According to an Associated Press story by Leanne Italie today, the 57-year-old star says it feels "fantastic" to be acting again.

Louis-Dreyfus disclosed her cancer diagnosis last September, shortly after having garnered her sixth consecutive Emmy Award for her Selina Meyer role.

According to the AP, the seventh and last season of "Veep," which will air in the spring, evoked this from the former "Seinfeld" co-star: "I feel good. I feel strong. I've got energy and, yeah, back o my old tricks. It feels like I never left."

Her wading into the cancer-awareness waters, the piece continues, comes through her "helping Carolina Herrera designer Wes Gordon design a flower-adorned T-shirt as part of Saks Fifth Avenue's 20th year raising money through its Key to the Cure program."

Over two decades, the program has donated almost $40 million to cancer research and treatment organizations.

All proceeds from the shirt that will sell for $35 during October, which for decades has served as Cancer Awareness Month, reportedly will go to the AiRS Foundation, which the AP describes as "a nonprofit Louis-Dreyfus supports for its work in helping women with the costs of breast reconstruction after mastectomy."

The shirt features three poppies (in red and pine tones) and a slogan: "We are fighters & we are fighting for a cure."

Noted the actor about the design process, "It was a super-fun endeavor," elaborating that she "wanted it to have a sort of femininity and a powerful message at the same time because I believe the two can go hand in hand. I liked the idea of talking about fighting."

Regarding reconstruction, she'd noted that "up to 70 percent of breast cancer survivors who have had a mastectomy are really unsure or unaware of their reconstruction options, and many of those women who desire to have surgery don't have sufficient insurance or other resources to cover it."

Regarding her participation in the awareness program, she said that while she now was "putting my whole self into Key to the Cure," she'd previously been "very careful about managing my time and conserving my energy. You can't spread yourself too thin."

After going under the knife for breast cancer, Louis-Dreyfus had been perhaps a bit less eloquent and a bit more dramatic. She'd written on Instagram, "Hoorah! Great doctors, great results, feeling happy and ready to rock after surgery. Hey cancer, f**k you!"

More details about both reconstruction and awareness can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.