There are not too many drugs that improve overall survival in prostate cancer.  Right now, the list is pretty short: Taxotere.

So the announcement that researchers have survival improvement with a new drug, cabazitaxel, is pretty exciting for us oncologists.

It's easy to become discouraged, but once in a while we get something to be happy about.  Today is one of those moments.

A new study shows that the vast majority of high-risk women are not taking tamoxifen to prevent breast cancer, even though tamoxifen is very effective for just this problem.

BRCA1 mutations account for less than 5% of breast cancers, but up to 1% of the Jewish population has such a mutation. Up to 80% of BRCA1 carriers can go on to devlop breast cancer.

The BRCA research group in Toronto looked at which chemotherapy works best in patients with a BRCA1 mutation and breast cancer. The paper is published in this week's JCO.

As an oncologist, I deal with more than my share of tobacco-related cancers. Many patients with these malignancies refuse to quit smoking, and the argument goes, "What's the point? Besides, it's one of the few things I have to look forward to anymore."

Let me preface this by saying that there are almost no randomized clinical trials in radiation oncology. There are probably not enough in medical oncology, but the FDA holds the drug makers to a higher standard than the equipment makers, so they demand improvement in survival (most of the time) from a randomized clinical trial before they will approve a new chemotherapy treatment.

So I got one of these letters in the mail where it's a radiation oncology group seeking to promote their local radiosurgery center.

NEJM has a pair of papers this week about two new drugs for multiple sclerosis: cladribine, which I use as a chemotherapy drug, and fingolimod, which is an immunosuppressive drug affecting lymphocyte function.

The findings were presented today at the ASCO GI malignancies symposium that disease free survival was improved with oral Xeloda versus conventional intravenous 5FU in patients with early colon cancer. Dr. Daniel Haller from University of Pennsylvania presented the data; he has been working on colon cancer research protocols for many years.

The media perhaps overreacted to the news: headlines such as

NYT has a nice small item about Milk Thistle this week. It is reported to protect the liver, though we have no good data to support this.

This week, a patient asked about it. The idea got additional air time last year when a small trial showed a possible benefit in chemotherapy patients. A 2007 review of the data showed no clear benefit.

Of course absence of benefit never really stopped sales of a supplement. Milk thistle is an idea that hasn't gone away, and perhaps some day there'll be some actual data to support it.

NYT has a nice small item about Milk Thistle this week. It is reported to protect the liver, though we have no good data to support this.

This week, a patient asked about it. The idea got additional air time last year when a small trial showed a possible benefit in chemotherapy patients. A 2007 review of the data showed no clear benefit.

Of course absence of benefit never really stopped sales of a supplement. Milk thistle is an idea that hasn't gone away, and perhaps some day there'll be some actual data to support it.

Andrew Pollack is probably the single most influential health writer in America. He has the bully pulpit the closest thing to a national platform. His reporting is excellent balanced and thorough. I had the privilege of speaking with him in April 2009 for a tamoxifen article though he did not quote me in the story. So it was somewhat provocative that Mr. Pollack seems not altogether happy about the trend towards maintenance therapy. Higher costs longer treatment.