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Dr. Len answers COVID-19 medical questions

Check out this new video - and share!

Our Deputy Chief Medical Officer Len Lichtenfeld, MD, answers lingering medical questions from volunteers and staff about COVID-19 in a 22-minute video released today. 

Dr. Len shared his insight on questions ranging from testing and social distancing to the impact the virus is having and will have on cancer treatment and early detection. 

The video was recorded in conversation with Renee Kelley, director of volunteer and staff communications, and can be shared with volunteers and constituents. 

In addition, Dr. Len will answer medical questions that are submitted to coronavirus@cancer.org

Check Twitter for other videos about coronavirus featuring Dr. Len in conversation with David Sampson, strategic director, medical & science communications.   

An article titled Common Questions About the New Coronavirus Outbreak is updated regularly on cancer.org.  Additional information about COVID-19 can be found at cancer.org/coronavirus.


  • Research – Did you know?

    Collaborative effort among Research, Global Prevention, and ACS CAN yields results in Peru!

    Did you know, our Economic and Health Policy Research program, led by scientific vice president Jeffrey Drope, PhD, does research on policy interventions that impact cancer, including cigarette taxes and trade agreements?

    Recently, Jeffrey and Michal Stoklosa, PhD, principal scientist, taxation and health, joined forces with Jacqui Drope, MPH, managing director of Global Cancer Prevention; Gregg Haifley, ACS CAN director of federal relations; and members from our partner, Cancer Research UK, to support and provide assistance to a prominent economic think tank in Peru named GRADE. Their task was examining increases in cigarette excise taxes in Peru.

    Jeffrey explained that the Ministry of Economy and Finance (MEF) in Peru has been steadily increasing excise taxes on cigarettes over the last five years, despite pushback from the tobacco industry. MEF has been looking for strong, local research to support its strategy, as the last relevant research was more than 15 years old.

    Working with the local tobacco control coalition, ACS, ACS CAN, and Cancer Research UK found that tobacco price increases are an outstanding way to deter youth from starting to smoke. A 10% increase in price of cigarettes leads to more than a 4% decrease in consumption.

    Using this research as part of the justification, MEF was not only able to defend its recent tobacco tax increases successfully, but at the beginning of 2020 made a very important adjustment in the way excise taxes are calculated. According to Jeffrey, analysts predict that adjustment alone will lead to nearly a 20%  increase in price, which will save thousands more lives, mainly through young people NOT starting to smoke in Peru.

    “I’m extremely proud of the collaborative work by our Economic and Health Policy Research program, Global Prevention team, and ACS CAN,” said Jeffrey. “It’s a really nice illustration of different teams working together to attack cancer from several angles and save lives!”


  • Our Extramural Research program answers the question – Why does it matter?

    Read brief summaries of how current research indicates real progress

    To highlight some of the advances being made against cancer by American Cancer Society-funded scientists, our Research department wants to answer the simple question, “Why does it matter?” about various extramural research developments around the country. 

    These “Why does it matter?” articles aim to briefly summarize recently published work from current or past ACS funded scientists across the United States, emphasizing the progress research is making in the prevention, detection, and treatment of cancer, and quality of life for cancer survivors. 

    Here are some brief summaries of relevant research from our six Extramural Programs, as well as from the ACS Professors program, and why it matters:

    Extramural Research ProgramClinical Cancer Research, Nutrition, and Immunology

    • Why Doesn’t Immunotherapy Always Work? It’s a powerful idea: Use your own immune system to fight cancer. But why don’t immunotherapies work the same for all cancers? Former ACS grantee Dr. Padmanee Sharma and colleagues at MD Anderson Cancer Center in Houston are working to answer this question for glioblastoma multiforme, an aggressive cancer of the brain and spinal cord. Sharma’s team studied immune cells that are found in and around human tumors that either did or did not respond to immunotherapy. She discovered that a unique population of immune cells actually stopped immunotherapy from working in glioblastoma. However, in a mouse model, when these unique cells were not present, immunotherapy was more effective, and the mice survived longer. This study has two major impacts. First, Sharma may have found a potential therapeutic target to help immunotherapy work better for glioblastoma. Second, it shows that starting with what we know – in this case, the kinds of immune cells that surround tumors – can help generate hypotheses that can be tested in the lab and rapidly translated to clinical trials.
    • What comes next?  To test whether therapeutic removal of the inhibitory cells (CD73+) will work in human cancers as it did against mouse brain tumors to convert unresponsive cancers into tumors that are effectively eliminated by immunotherapy.
    • Read more about this study.

    Extramural Research Program: Health Professional Training

    • Improvements in the Management of Long-Term Effects of Cancer Treatment: If you are a survivor of cancer that was diagnosed when you were a child, teenager, or young adult, your chances of living a cancer-free life are very good thanks to advances in treatment. Unfortunately, you may experience significant and permanent side effects. Hearing loss is a common side effect of radiation and chemotherapy treatments, but we don’t know much about how these patients experience it and what impact it has in their lives. Emily Tonorezos, MD, MPH and other researchers affiliated with the Adult Long-Term Follow-up Program at Memorial Sloan Kettering Cancer Center in New York City interviewed adult survivors of childhood and young adult cancer to gain insight into their “lived experience” (or perception of their health-related experiences) of hearing loss. They learned that survivors don’t know that they may have hearing loss, may feel isolated or excluded in social settings as a result, and may downplay hearing loss compared to the threat from their cancer. Because hearing loss is often described as an “invisible condition,” clinicians should ask survivors about it so that they can get help. 
    • What comes next? Educating healthcare professionals about these findings may help improve quality of life for survivors of cancer diagnosed when they were young.
    • Read more about this study.

    Extramural Research Program: Translational Cancer Research

    • A Model to Accelerate New Treatments for Wilms Tumor in Children: Despite successes in treating Wilms tumor (WT), the most common kidney cancer in children, some of these tumors are associated with poor outcomes. We know which WTs tend to be high-risk – those that come back after treatment, develop in both kidneys (bilateral), or are composed of cells that don’t resemble kidney cells and structures (diffuse anaplasia). But we don’t have treatments that work well, mainly because we don’t have good ways to test them on WTs. Former ACS grantees Drs. Rani George (Dana Farber Cancer Institute), Jeffrey Dome (Children’s National Medical Center in Washington), Davidoff and Houghton (St. Jude Children’s Research Hospital in Memphis), and others may have developed a model that can help. It involves removing pieces of WT from 45 patients and grafting them into mice, where over time the tumors continue to “act” like they do in the human patient. Comparison of the patient-derived tissues (before and after engraftment), particularly in response to therapies, instills great confidence that the scientific community now has a valuable resource to accelerate the clinical impact of research on WT subtypes with poor outcomes.  
    • What comes next?  In the very near future, we should see whether this model can more accurately predict which treatments will work best for hard-to-treat WT.
    • Read more about this study.

    Extramural Research Program: Cancer Control and Prevention Research

    • Better Communication About Cancer Care: Palliative care is recommended as a standard part of care given to people with cancer and focuses on reducing distressing symptoms and improving quality of life for survivors, family members, and caregivers. Being diagnosed with cancer is life altering and communication plays a critical role. ACS grantee Dr Robert Gramling and his team at the University of Vermont are analyzing recorded palliative care conversations to see how survivors understand their experiences, what suffering means for them, and how decisions might affect them. This new research uses natural language processing from transcripts of palliative care consultation visits. Researchers hope the results will help improve communications between patients and their health care professionals about care they’re getting, and how to more clearly convey information about the patient’s cancer prognosis and treatment. The US Senate is currently reviewing the Palliative Care and Hospice Education and Training Act (PCHETA), and if it is passed, the findings from this study could play a role in the implementation of public policy. PCHETA aims to establish and expand palliative care workforce training for interdisciplinary health care professionals by increasing the number of permanent faculty in palliative care at accredited medical schools, nursing schools, social work schools, and other programs. The bill will also significantly enhance research in palliative care and launch a national education and awareness campaign. 
    • What comes next?  The next step is to ensure that what has been learned about patient communication will be translated into the health care system to ensure that all cancer patients receive timely and appropriate palliative care. 
    • Read more about this study.

    Extramural Research Program: Cancer Cell Biology and Metastasis

    • Guiding the Combination of Targeted and Immunotherapy in Melanoma: A major function of the immune system is to attack foreign cells while leaving the normal cells alone. To control this, it uses “checkpoints.” Immune checkpoints are molecules on certain immune cells that need to be turned on (or off) to control an attack on foreign cells like cancer cells. However, cancer cells sometimes find ways to overcome these checkpoints to avoid being attacked by the immune system. This is where drugs that target these checkpoints hold a lot of promise as cancer treatments. They are called checkpoint inhibitors. Immune checkpoint inhibitors, such as nivolumab, have improved patient survival and helped people with melanoma live longer. However, new immune targets are needed because about half of melanoma patients don’t respond to current immunotherapies. Among the possibilities is a protein called VISTA. ACS grantee Dr. Andrew Aplin from Thomas Jefferson University in Philadelphia has found that melanoma tumor cells have large amounts of VISTA on their cell surfaces, and that VISTA seems to interfere with the immune system’s ability to attack the tumor cells. Interestingly, he found that certain targeted therapies, like the drug vemurafenib, which is already approved to treat some kinds of melanoma, reduces the amount of VISTA on the tumor cells. That means it may make existing immune therapy work better for more patients. Also, knowing how much a drug affects VISTA may help researchers prioritize similar-acting drugs that could make immunotherapy work better.
    • What comes next?  Since both immunotherapy and vemurafenib are already approved for melanoma, researchers should be able to test the combination quickly in patients.
    • Read more about this study.

    Extramural Research Program: ACS Professors Program

    • Blocking Drug Resistance in Breast Cancer: Breast cancer patients with HER2 mutations will often develop resistance to cancer drugs, including the new drug called neratinib. ACS Professor Dr. Carlos Arteaga at UT Southwestern in Dallas is trying to find out why. His team created a lab model with neratinib resistant HER2 breast cancer cells. They found that a key step in developing resistance happens when another gene, called TORC1, is activated or “turned on.” When that happened, neratinib stopped working. There is already another drug (everolimus) that can stop TORC1 from being turned on. Arteaga’s team found that using the two drugs together prevented resistance to neratinib from developing. 
    • What comes next?  The next step is to try this in breast cancer patients as well as other cancer types such as lung and ovarian where HER2 mutations appear.
    • Read more about this study.

    Extramural Research Program: Cancer Control and Prevention Research

    • E-cigarette Use and Respiratory Disease: Smoking regular cigarettes accounts for about 30 percent of all cancer deaths in the United States, including about 80 percent of all lung cancer deaths. Lung cancer is the leading cause of cancer death in both men and women and is one of the hardest cancers to treat. Regular cigarettes also cause other lung diseases like asthma, bronchitis, and emphysema. Using e-cigarettes has been marketed as a less harmful alternative to smoking cigarettes. However, there’s still a lot that we don’t know about e-cigarettes. A recently published study by past ACS grantee Stanton Glantz, PhD from the University of California, San Francisco examined how e-cigarettes affect lungs. He found that e-cigarette users increase their risk of getting lung disease other than cancer by a third, compared to cigarette smokers who had a 2.5 higher chance of getting other lung diseases. His study also found that people who smoke traditional tobacco products and also use e-cigarettes, a common practice, are at an even higher risk for developing respiratory disease compared to those who use either product alone. 
    • What comes next? Ensure that information provided to the public about e-cigarettes is accurate and evidence based.
    • Read more about this study.

    Extramural Research Program: Molecular Genetics and Biochemistry of Cancer

    • Protein Turnover, a New Cancer Drug Target? As researchers have learned over the past few decades, the transformation of normal human cells into cancer cells can be highly complicated. A wide range of alterations to normal cells can lead to the development of cancer, so the more we know about how cells become cancerous, the better equipped we are to prevent, detect, and treat cancer. ACS grantee Patrick Potts at St Jude Children’s Research Hospital in Memphis, TN recently reported important new information about a protein called MAGE, that is normally only made in the testes, but found to be inappropriately made in more than a dozen different types of cancers. His laboratory has discovered that MAGE proteins cause cancer by allowing higher levels of other oncogenes to accumulate in cells leading to uncontrolled growth. The MAGE protein interferes with the normal process of turning an oncogene off and leads to abnormally high levels of these growth stimulating factors, which causes cells to grow out of control. This discovery opens the door for developing new drug that focused on stopping these MAGE proteins from causing the uncontrollable growth of cancer cells. 
    • What comes next?  Over the next few years we expect to see a new class of cancer drug tested that target restoration of normal protein turnover.
    • Read more about this study.



  • Cancer death rate in the U.S. continues to drop

    ​Healthy People 2020 targets met for lung, prostate, breast, and colorectal cancer deaths; some cancers on rise due to excess body weight and lack of exercise

    The death rate from cancer in the U.S. is still falling among men, women, and children, according to the latest Annual Report to the Nation on the Status of Cancer. During 2013 to 2017, cancer death rates fell an average of 1.5% per year. However, rates of new cancers diagnosed from 2012 to 2016 remained about the same in men and increased slightly among women.

    Reasons for these trends reflect changes among large groups of people in cancer risk factors and screening test use, as well as how doctors diagnose cancer and treatment advances.

    The American Cancer Society, the North American Association of Central Cancer Registries, the Centers for Disease Control and Prevention, and the National Cancer Institute work together to create the report, which has been published each year since 1998. It provides an update of new cancer rates, death rates, and trends in the U.S., plus a special section, which this year focused on progress toward Healthy People 2020 goals.

    The report was published March 12, 2020 in Cancer, a peer-reviewed journal published by ACS.

    Cancer rates and death rates among men and women

    • Overall rates for new cancers dropped an average 0.6% per year from 2012 to 2016. They stayed about the same in men and increased by 0.2% per year in women.
    • Overall cancer death rates went down by 1.8% per year in men from 2013 to 2017, and by 1.4% per year in women.
    • Among men, death rates decreased for 11 of the 19 most common cancers. Some of the steepest decreases were for lung, colorectal, and melanoma skin cancer. Death rates went up for 4 cancers, with the steepest increase for mouth and throat cancer. Rates stayed about the same for 4 cancers, including prostate cancer.
    • Among women, death rates dropped for 14 of the 20 most common cancers, including the 3 most common (lung, breast, and colorectal) as well as melanoma skin cancer. But rates rose for 5 cancer types, with the steepest increases for endometrial and liver cancers.  
    • The rate of new cases and deaths in the U.S. has been declining over time for several cancers related to smoking, including  lung, bladder, and laryngeal cancers. But the rate of new cases is increasing for some cancers related to excess weight and lack of exercise. These include kidney, liver and pancreatic cancers, as well as endometrial and breast cancer in postmenopausal women.

    Cancer among children, adolescents, and young adults

    • For the first time, the Annual Report to the Nation provided rates and trends for the most common cancers among children, adolescents, and young adults. Overall cancer death rates among children 14 and younger dropped an average 1.4% per year from 2013-2017. The rate of new cancers went up an average of 0.8% per year from 2012-2016. The most common cancer types among children included leukemia, lymphoma, and brain and spinal cord tumors.
    • The study authors say that better treatments are most likely the reason why death rates among children keep dropping. They are less certain about why rates of new cancers are going up, although part of the reason may be changes in how cancer is diagnosed and tracked.
    • Among teens and young adults 15 to 39 years old, cancer death rates decreased by 1% per year from 2005-2017. This continues a slowing trend, as rates decreased by 3% per year during 2001–2005. The rate of new cancers rose an average of 0.9% per year from 2012–2016. The most common cancer types in this age group were female breast, thyroid, and testicular cancer, as well as lymphoma.
    • The report showed an increase in colorectal cancer death rates among young adults. This increase came during a time when risk factors – including excess weight and diabetes – have increased.

    Special section: Healthy People 2020 goals

    The U.S. government launched Healthy People 2020 10 years ago to improve the health of all Americans. Some of its goals include reducing cancer risk factors while increasing use of recommended screening tests. This year’s special section, published in part II of the report, Progress Toward Healthy People 2020 Objectives, checks up on progress in goals related to 4 common cancers:  lung, colorectal, female breast, and prostate.

    Goals for reducing deaths from cancer were met overall, but not among males, blacks, or people who live in rural areas. However, these groups did have larger decreases in rates than other groups. During 2007–2017, cancer death rates fell 15% overall.

    Measuring progress on cancer screening and risk factors:

    • Colorectal cancer screening increased from 52.1% in 2008 to 62.4% in 2017. However, screening rates did not reach the goal of 70.5% in any group except people with advanced educational degrees.
    • Breast cancer screening increased slightly among Hispanic women from 2008 to 2015, but dropped among other groups, especially Asians, women in rural areas, and those with public or no health insurance.  The only group to meet the goal for breast cancer screening (81.1%) was those with advanced educational degrees. Screening was lowest among uninsured women (35.4%).
    • The goal for prostate cancer screening – to increase the percentage of men who had discussed prostate cancer screening with their doctor to 15.9% – was met overall (16.7%) and in all race-ethnic groups except Asian men, men in metropolitan areas (cities), and men with at least a college degree.
    • No goal was set for lung cancer screening because it wasn’t recommended by the US Preventive Services Task Force until 2013. It’s currently recommended only for people at high risk for lung cancer. The report found screening was very low (less than 7%) overall, although the rate did go up between 2010 and 2015. The authors say both doctors and patients need more education about lung cancer screening.
    • Cigarette smoking dropped from 2008 to 2017 overall, but fell short of the goal of lowering the percentage of adults who smoke to 12%. People who live in rural areas, those with public insurance or no insurance, and those with less than a high school education had the highest percentages of smoking and the smallest improvement.
    • Overall, exposure to secondhand smoke fell to 39%, exceeding the goal of 33.8% in most groups. Exceptions were blacks (43%) and people with public health insurance (36%).
    • From 2008 to 2017, the percentage of adults who met physical activity guidelines increased, and many groups met the goal of 20.1%.
    • Goals were not met for reducing excessive alcohol use or lowering the percentage of adults with obesity. Obesity rates increased among all groups between 2005 to 2008 and 2013 to 2016. From 2013 to 2016, 39% of all adults were obese.

    The authors conclude that efforts to reduce cancer risk factors and promote healthy behaviors, although proven to work, are not helping every community reach Healthy People 2020 goals. They say more effort is needed to make sure all Americans can access a path to long, healthy, cancer-free lives.

    This story by Stacy Simon first appeared on cancer.org.



  • Colorectal cancer burden shifting to younger individuals

    ​Half of new diagnoses are now in people 66 and younger; 49 new cases and 10 deaths per day are expected in people under 50 in the U.S. in 2020

    The burden of colorectal cancer is swiftly shifting to younger individuals as incidence increases in young adults and declines in older age groups, according to the latest edition of Colorectal Cancer Statistics 2020. The median age of diagnosis has dropped from age 72 in 2001-2002 to 66 during 2015-2016. In other words, half of all new diagnoses are now in people 66 or younger. 

    The consumer version of this report, Colorectal Cancer Facts & Figures 2020-2022, is available on cancer.org/statistics.

    Colorectal cancer (CRC) is the third most commonly diagnosed cancer and the third leading cause of cancer death in both men and women in the U.S. Rapid declines in CRC incidence occurred in people 50 and older during the 2000s, largely because of increased screening with colonoscopy, which can prevent cancer by removing premalignant polyps.

    In recent years, however, declines in incidence have been confined to people 65 and older, among whom rates dropped by 3.3% per year from 2011 through 2016. Among those 50 to 64, declines in incidence of 2% to 3% per year during the 2000s have reversed in recent years, with rates increasing by 1.0% per year during 2011 through 2016. This is similar to the uptick occurring in people under 50, in whom incidence rates have been increasing since the mid-1990s and rose by 2.2% per year from 2011 to 2016. These increases likely reflect elevated disease risk in generations born since 1950 that is being carried forward over time as people age, a phenomenon referred to as a birth cohort effect.

    Although rising incidence in those under 50 was previously driven by rectal tumors, in the most recent five years of data (2012-2016), incidence rates rose by 1.8% per year for tumors in the proximal and distal colon as well as in the rectum. Rising incidence in people younger than 65 is driven by trends in non-Hispanic whites, although rates in American Indians/Alaska Natives are also increasing steeply.

    • In 2020, there will be about 18,000 cases of CRC (12%) diagnosed in people under 50 in 2020, the equivalent of 49 new cases per day

    • Also in people under age 50, 3,640 CRC deaths (10 per day) are expected in 2020, partly owing to delays in diagnosis
    • 1 in 4 patients (26%) younger than 50 is diagnosed with metastatic disease compared to 19% of those 65 and older.

    CRC death rates overall have been decreasing since the late 1940s in women, but only since 1980 in men, likely reflecting differences in incidence trends, which are unavailable prior to 1975. However, incidence and mortality trends have been very similar between the sexes over the past three decades.

    Like incidence, CRC mortality patterns vary by age, with rapid decreases in the oldest age groups and increasing trends in young adults. Over the past 10 data years (2008-2017), death rates declined by 3% per year in people 65 years and older but by only 0.6% per year in people 50 to 64, while increasing by 1.3% per year in those under 50. The uptick in CRC death rates in adults under 50, which is most rapid among non-Hispanic whites (2% per year), began around 2004 and was preceded by declines of 1% to 2% per year since at least 1975. Rapid declines in overall CRC death rates of approximately 3% per year during the 2000s decelerated to 1.8% per year from 2012 to 2017, perhaps reflecting slower gains in screening uptake and lower rates of first-time testing, as well as rising trends in younger adults.

    Racial and ethnic disparities

    Rates of colorectal cancer cases and deaths vary among different racial and ethnic groups. Some of the differences are due to risk factors including smoking and excess body weight, as well as access to health care and colorectal cancer screening.  The incidence rate during 2012-2016 ranged from a low of 30 per 100,000 among Asian/Pacific Islanders to 46 per 100,000 among blacks and 89 per 100,000 Alaska Natives. The pattern for mortality is the same, although the magnitude of the disparity is twice as large as that for incidence. For example, CRC incidence rates are about 20% higher in blacks (46 per 100,000) than in non-Hispanic whites (39 per 100,000) whereas death rates are almost 40% higher in blacks (19 versus 14 per 100,000). Even more striking are death rates among Alaska Natives (40 per 100,000), which are double those among blacks. American Indians/Alaska Natives are the only racial group in which overall CRC death rates are not declining.

    Of all racial/ethnic groups, black patients are the most likely to be diagnosed with distant-stage CRC (25% vs 20% of non-Hispanic whites and Asians/Pacific Islanders) and also have the lowest overall 5-year survival rate (60% vs 66% among non-Hispanic whites and 68% among Asians/Pacific Islanders). These disparities are largely driven by socioeconomic inequalities that result in differences in access to early detection and the receipt of timely, high quality treatment.

    Screening rates

    Two-thirds (66%) of individuals 50 and older were current for colorectal cancer screening in 2018, ranging from 58% in Puerto Rico and 60% in Wyoming to 76% in Massachusetts. However, less than half of people ages 50-54 years were up-to-date, which is particularly concerning given increasing CRC incidence and mortality in this age group. Screening is also low among immigrants in the U.S. less than 10 years (26%), people who are uninsured (30%) or Medicaid-insured (53%), and Asian Americans (55%).

    “Although overall colorectal cancer incidence and mortality continue to decline, this progress is increasingly confined to older age groups and is marred by vast disparities,” said Rebecca Siegel, MPH, lead author of the report. “Unfortunately, tools that are very effective at reducing the burden of this disease are not being fully utilized. One in three people 50 and older is not up-to-date on screening; many of them have never been screened at all. We could save countless lives by increasing access to screening in rural and other low-income areas, especially in Alaska, and incentivizing primary care clinicians to ensure that all patients 45 and older are screened, as well as facilitating healthier lifestyles in our communities.

    “More timely diagnosis among younger patients remains critical while we await answers to why CRC incidence is rising in young and middle-aged adults,” Rebecca said.

    The American Cancer Society recommends regular colorectal cancer screening for people at average risk starting at age 45. People with a family history of the disease or who have other risk factors should talk with their doctor about starting screening at a younger age.


  • Relay Leap Day challenge was a success!

    Thanks to the fundraising efforts of our volunteers we exceeded our goal. 

    On February 29, the Relay program had one simple goal, to raise $175,000 – the average cost to fund a research grant for an early career scientist. Relay participants exceeded our goal of $175,000 by raising nearly $261,000 in one day!  

    All "1 Day of Change" donations will directly support researchers and the vital work they do every day to fight cancer. Researchers like:

    • Rebeca San Martin, PhD, who learned about cancer at a young age and went on to dedicate her life to research. Today she studies how genes are folded and packaged in the nucleus to better understand prostate cancer.
       
    • Barzin NabetPhD, who sees cancer research as important and challenging work and currently focuses on translational lung cancer research to better understand which patients respond to certain therapies and why.

    Thanks to our supporters, we funded potentially lifesaving cancer research in one day!


  • ACS announces Medal of Honor recipients

    ​The Medal of Honor selection workgroup is pleased to announce the recipients of our 2020 Medal of Honor, the American Cancer Society’s highest award. The award is presented to individuals who have made outstanding contributions in the categories of basic research, cancer control, clinical research, and philanthropy. 

    This year's recipients will be recognized at a black-tie ceremony in New York on November 11. Attendees will include ACS and ACS CAN Board members, volunteers from around the country, Area Board members, corporate partners, prominent scientists from the research community, cancer control partners, and others.

    The 2020 recipients are:

    • Medal of Honor in Basic Research: Lewis C. Cantley, PhD, Meyer Cancer Center, Weill Cornell Medical College, New York, New York. This award honors scientists who have made significant fundamental research contributions with lasting impact on the cancer field or important discoveries or inventions within the field. Cantley is a cell biologist and biochemist who has made significant advances to the understanding of cancer metabolism. Among his most notable contributions are the discovery and study of the enzyme PI-3-kinase, now known to be important to understanding cancer and diabetes mellitus. He is currently a Meyer director and professor of Cancer Biology at the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine in New York City. He was formerly a professor in the Departments of Systems Biology and Medicine at Harvard Medical School, and the director of Cancer Research at the Beth Israel Deaconess Medical Center, in Boston. 
    • The Medal of Honor in Cancer Control: Leslie Bernstein, PhD, MS, City of Hope, Duarte, California. As a biostatistician and epidemiologist, she was instrumental in identifying physical activity as a means to reduce the risk of breast cancer. She is involved in projects to explore the links between hormone exposures, physical activity, obesity, and cancer. She is also examining how breast cancer impacts the lives of women after they are finished with treatment. This award honors individuals who have conducted research in and/or created and/or greatly advanced public heath, public communication, or public policy that has had a major impact and/or stimulated new directions in cancer control. 
    • The Medal of Honor in Clinical Research: Ching-Hon Pui, MD, St. Jude Children’s Research Hospital, Memphis, Tennessee. Dr. Pui is a pioneer in translating biomedical advances to treatments, helping increase the survival rate of childhood acute lymphoblastic leukemia (ALL) to 94 percent. His work has improved survivors' quality of life by successfully abolishing cranial irradiation. His leadership has increased global treatment access and survival rates for childhood ALL.

    Originally called the American Cancer Society Award, the Medal of Honor was first presented in 1949. Since then, the award has been presented to those who are dedicated to help ease the burden of cancer. Some have earned the award by stemming the spread of the disease through exceptional work in cancer control. Others have devoted their careers to understanding cancer’s causes and cures through basic and clinical research. Still others have made a major impact on cancer through their generosity and philanthropy.  

    Candidates for the Medal of Honor are nominated by members of the American Cancer Society Board of Directors and other individuals interested in honoring leaders in the cancer community.

    Past recipients include former U.S. President and First Lady George H.W. Bush and Barbara Bush; former U.S. Vice President Joe Biden; Edward M. Kennedy, senator from Massachusetts; George N. Papanicolau, MD, inventor of the Pap test; Robert C. Gallo, MD, recognized for his achievements in pioneering the field of human retrovirology; Judah Folkman, MD, a leading researcher in the field of antiangiogenesis; former U.S. Surgeon General C. Everett Koop, MD; advice columnists Ann Landers and Abigail Van Buren; and American journalist Katie Couric.

    If you have questions about this award, please email medalofhonor@cancer.org.


  • ACS study identifies states with highest UV-associated melanoma burden

    The range is 15 cases per 100,000 in Alaska to 65 cases per 100,000 in Hawaii

    A new study finds a wide state-by-state variation in rates of melanoma caused by ultraviolet (UV) exposure with highest rates in several states on the East and West Coast including Hawaii, but also a few landlocked states, including Utah, Vermont, and Minnesota. The report, appearing in the International Journal of Cancer, finds state-level incidence rates for UV-attributable melanoma ranged from 15 cases per 100,000 in Alaska to 65 cases per 100,000 in Hawaii. The authors say variations between states likely reflect a combination of the strength the sun’s rays, participation in outdoor activities, sun protection, indoor tanning, and early detection.

    For the new study, investigators led by Farhad Islami, MD, PhD (pictured here) estimated the number, proportion, and incidence rates of malignant melanomas attributable to UV radiation in each state. They did so by calculating the difference between observed melanomas during 2011-2015 and a baseline of expected cases.

    Estimating the contribution of UV exposure required a novel approach. Without a population completely unexposed to UV radiation, researchers used the best data available: historical melanoma incidence rates from 1942-1954 in Connecticut, which had the country’s first statewide population-based cancer registry and is in a high-latitude (generally lower UV rate) environment. For most adults, melanomas diagnosed during those years likely reflected UV exposure accumulated in the 1930s or earlier, when exposure was minimized by clothing style with more complete skin coverage and limited recreational exposure. This reference population acted as the theoretical minimum UV exposure.

    UV-exposure accounted for 91.0% (338,701/372,335) of the total melanoma cases diagnosed during 2011-2015 in the United States; 94.3% (319,412) of UV-attributable cases occurred in non-Hispanic whites.

    To highlight state differences, researchers highlighted results for non-Hispanic whites rather than the total population, because a lower burden in some states could largely reflect higher proportions of non-whites in the population. Melanoma incidence rates in the United States are lowest in blacks (1.0 per 100,000) and are also substantially lower in other minorities (e.g., 4.5 per 100,000 in Hispanics) than in non-Hispanic whites (27.2 per 100,000).

    By state, the attributable age-standardized rate among non-Hispanic whites ranged from 15.1 per 100,000 in Alaska to 65.1 in Hawaii. Multiple states along the East and West Coast had UV-attributable incidence rates exceeding 25 per 100,000 among non-Hispanic whites: Delaware (37.1), Georgia (36.5), California (33.8), Maryland (32.6), North Carolina (29.5), Florida (29.2), Oregon (28.5), South Carolina (28.1), Washington (27.8), New Jersey (27.7), New Hampshire (26.5). Rates were also above 25 per 100,000 in Alabama (25.4) and several landlocked states: Utah (40.4), Vermont (31.4), Minnesota (27.9), Idaho (27.6), Kentucky (25.7), and Colorado (24.5).

    In addition to states with a high UV index like Hawaii, California, and Florida, UV-attributable melanoma rates are high in many states with relatively low UV index, such as Minnesota and Idaho, likely reflecting high prevalence of outdoor activities (e.g., going to beaches, lakes, or outdoor swimming pools; recreational boating; skiing; and perhaps occupational activities such as farming) and insufficient sun protection. Many UV-related melanomas are preventable using appropriate measures.

    The report also finds higher UV-attributable melanoma burden in younger females than males. “High indoor tanning prevalence among teen girls in the late 1990s is likely a contributing factor,” said Farhad.

    Article: Cutaneous melanomas attributable to ultraviolet radiation exposure by state; Int J of Cancer 2020; doi 10.1002/ijc.32921


  • Higher lung cancer incidence among young women than young men is a global phenomenon

    The increase is largely driven by adenocarcinoma of the lung – which occurs more frequently in women than men.

    A study published Feb. 5 by four researchers, including two from ACS, finds that the emerging pattern of higher lung cancer incidence among young women than young men is widespread across geographic areas and income-levels.

    The authors say this pattern "is not fully explained by sex-differences in smoking prevalence, underscoring the need for etiologic studies." They also warn that "our findings forewarn of a higher lung cancer burden in women than men at older ages in the decades to follow. Further work is therefore needed to intensify anti-tobacco measures and identify factors for the higher incidence of lung cancer among young women."

    The study was published online in the International Journal of Cancer

    The two ACS researchers contributing to the study are Lindsey Torre, MSPH, and Ahmedin Jemal, DVM, PhD. This new study extends an earlier study led by Dr. Jemal that found that in the U.S. the incidence of lung cancer in young women is higher than that in their male counterparts.

    The researchers examined lung cancer incidence rates from 1993 to 2012 in women and men, ages 30 - 64, in 40 countries across five continents. Among men, the age‐specific lung cancer incidence rates generally decreased in all countries, while in women the rates varied across countries with the trends in most countries stable or declining, albeit at a slower pace compared to those in men. As a result, rates in ages 30-49 years became higher in young women than in young men in Canada, Denmark, Germany, New Zealand, the Netherlands, and the United States, reversing the historically lower rates in women than men. This crossover was largely driven by growing adenocarcinoma incidence. 

    The researchers posit that "it is possible that females may be at an increased risk of lung cancer compared to males.” They cite a pooled analysis of 13 studies that “found that lifelong female nonsmokers of European, African American, and Asian-descent had higher rates of lung cancer compared to their male counterparts." It's possible, they write, that women have a higher susceptibility to lung cancer because of various gene variants. "Research has suggested that women with lung cancer have impaired DNA repair mechanisms compared to men, which makes them especially susceptible to lung cancer," the researchers wrote. 

    Historically, lung cancer rates have been higher among men because they start smoking in large numbers earlier and smoke at higher rates, the researchers explained. However, there has been a convergence in lung cancer incidence between men and women. 

    With an estimated 2.1 million cancer cases in 2018, lung cancer is the most common cancer worldwide among men and the second most common cancer among women. By histologic type, it is grouped into four major categories: nonsmall cell carcinoma, adenocarcinomas, squamous cell carcinomas, and large cell carcinomas.  

    Cigarette smoking is the main risk factor for all lung cancer subtypes, though the risk of lung cancer associated with smoking is greater for small cell and squamous cell lung cancers than the other types. Other known risk factors for lung cancer include exposure to secondhand smoke, mineral and metal dust, asbestos, and radon.

    The best way to avert future lung cancer cases and deaths among current smokers is through smoking cessation. The risk of dying of lung cancer can be reduced substantially by quitting at any age.


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