Limits are being placed on profits doctors can make on some cancer drugs, causing oncologists to search for new income. Some fear these physicians may resort to prescribing additional treatments for some patients. Not just any treatments, though -- just the ones with the best reimbursements.

Until 2005, Medicare paid a markup of 20 to 100 percent for many cancer drugs. In 2005, Congress changed the reimbursement system to pay physicians just six percent more than the average price for a given treatment. This decrease has made it difficult for small practices to break even on cancer drug purchases because the purchases are not large enough to receive rebates or discounts from drug manufacturers.

According to a recent New York Times article, some oncologists have attempted to increase profits by performing chemotherapy more often, ordering more diagnostic scans, and by putting pressure on patients to make out-of-pocket drug co-payments.

Say it isn't so.

Elizabeth Edwards, wife of Democratic presidential candidate John Edwards, has had many routine medical follow-ups since her 2004 breast cancer diagnosis. And all of them -- until just a few days ago -- resulted in what is generally termed a clean bill of health.

The term doesn't always come with a sense of relief for those of us surviving breast cancer -- or any cancer for that matter -- because it only really defines what our bodies are telling us at one specific moment. There are no magic blood tests, no special body scans, no conclusive ways of determining whether or not cancerous cells have gone astray and will one day surface again.

I asked my oncologist after my first six-month follow-up how he would know if my cancer returns. He told me it's really up to me to determine whether it comes back. It's up to me to get mammograms and ultrasounds and MRIs. It's up to me to report any symptoms and suspicions. It's up to me to track my general well-being so that it will be clear when something feels not-so-right. If I have a persistent cough or headaches that won't subside, my doctor will take action with X-rays and scans and tests. But as long as I feel fine and nothing troubling presents itself, then I remain in the clean-bill-of-health club.

Edwards no longer has a clean bill of health. But she is determined to use her newest diagnosis -- stage four metastatic cancer of the bones, considered treatable but not curable -- to work toward the best health she can acquire for as long as she can hold onto it. And that is about as good as any of us can do.

As Leroy Sievers says, "Most of you know me as someone with cancer. Google my name -- and yes, I confess, I've done that -- more often than not, it comes up linked to one other word: cancer. But what about all the other things I've been?"

Sievers has been a journalist for most of his adult life. He's also been a baker, a short-order cook, a teacher, and an aspiring author. Yet cancer is the word most often used to describe this man.

But maybe not for long.

Could it be that Sievers -- a man whose life has been derailed by a deadly cancer traveling throughout his body, a man who has been contemplating death with each passing day -- may soon be rid of cancer altogether?

Actually, Sievers already sees glimpses of cancer falling to the wayside.

Having undergone a new procedure called Radio Frequency Ablation -- where needles are stuck into tumors, burning them away from the inside out -- Sievers sees a brighter future. He's seen his latest scans. He's seen the black holes where tumors once lived. He's seen that no new tumors have appeared. He's seen that he may actually survive cancer.

Months ago, this man, who blogs his cancer journey for NPR, was told he would likely not survive the year. Now he realized he may outlive this prediction. And while this is great news, Sievers finds himself a bit unsure about a life without cancer.

"Will I be somebody who used to have cancer?" he says. "I think most cancer patients don't ever think it's really gone. It's just hiding, waiting to jump out and scare us when we least expect it. Will I be able to resume my old life? To rebuild my battered body into what it was before? I don't know. But I know this disease has changed me dramatically in so many ways. I am a different person. Hopefully a better person. You cannot go through an ordeal like this and not be profoundly affected."

Now that's what a call a fresh perspective.

To read previously-written posts about Leroy Sievers, click here.

It seems screening for lung cancer doesn't save lives and it doesn't prevent advanced disease. But it does lead to potentially unnecessary and harmful treatment.

This isn't the final word on the use of CT scans to screen smokers and former smokers for the disease. But right now, the hope some experts had for the special X-rays to detect tiny lung abnormalities has been diminished by a large study that is still in the works. And until conclusive evidence says the screening is useful, the American Cancer Society will not endorse the test.

While CT screening did increase diagnosis and treatment -- those screened were three times more likely to be diagnosed with lung cancer and 10 times more likely to have lung surgery than predicted -- study co-author Dr. Peter Bach of Memorial Sloan-Kettering Cancer Center in New York says, "We don't see a trace of evidence that a single life was saved, that a single case of advanced cancer was avoided."

And because CT scanning led to more biopsies and surgeries, patients were put at risk for complications such as lung puncture, bleeding, and infection, according to Bach, whose work is published in the Journal of the American Medical Association.

"Getting screened for lung cancer with CT scanning is not only unproven, it's potentially a risky endeavor," he said.

Until an effective screening tool emerges -- possibly still years away -- experts say there is one surefire way to protect yourself from lung cancer. Stop smoking.

A drug commonly used to minimize the toxic effects of chemotherapy has been shown in mice to cause bone loss and promote tumor growth, according to the results of a recent study.

This drug, granulocyte colony-stimulating factor (G-CSF) -- also known as Neupogen, Neulasta, and Granocyte -- helps restore white blood cell counts that take a beating during chemotherapy, protecting cancer patients from an increased risk of infection.

According to researchers, G-CSF -- essentially a growth factor -- encourages bone breakdown. And any therapy that decreases bone density can enhance tumor growth in bones. So doctors are urged to closely monitor their patients during chemotherapy with regular bone density scans. They can also prescribe medications to prevent bone loss if necessary. And patients can protect their bones by consuming enough calcium and vitamin D and engaging in regular exercise.

Currently, research on cancer patients treated with G-CSF have not yielded the same strong results researchers found among mice.

The details of this study appear online in the journal Blood, and will be published in an upcoming print issue.

It has just recently been discovered that CT scans for children have been inappropriately used in two Ontario hospitals. As a result, some children have received excessive doses of radiation, putting them at greater risk of developing cancer later in life.

Staff at the two hospitals -- Peterborough Regional Health Centre is one -- reported that in close to 50 percent of selected cases, the appropriate equipment settings were not used.

Herein lies the problem -- developing organs are more susceptible to damage, and giving a small child an adult dose of radiation in a CT scan delivers the same amount of radiation as 4,000 traditional X-rays. Research shows that increased exposure to radiation over time can cause radiation-induced cancer.

CT scans are valuable diagnostic tools because they create 3-D images of organs, offering a better view of head injuries, chest trauma, cancer, and fractures. So they should not be disregarded -- but clearly, hospitals need to improve the management of all scanning procedures.

In Ontario, a diagnostic image safety committee has already been formed. The goal of this committee is to develop standards and do a better job of tracking radiation levels.

Experts are encouraging Ontario parents to refrain from worry unless their children have received many CT scans. And all parents are encouraged to speak up before their children receive CT scans. "Is my child receiving a pediatric protocol?" is all it takes.

Human touch with someone you trust and share a strong bond can bring immediate relief from stress, according to University of Virginia neuroscientist Dr. James A. Coan. The findings are based on the study of magnetic resonance imaging (MRI) brain scans that measured the participant's response to a threatening situation when they were either holding the hand of a spouse, the hand of a stranger, or when they were alone.

"This is the first study of the neurological reactions to human touch in a threatening situation, and the first study to measure how the brain facilitates the health-enhancing properties of close social relationships," stated Dr. Coan.

For this study, the participants were women who expressed a high degree of satisfaction in the relationship with their husband. Holding their husband's hand while experiencing a threatening situation prompted the most dramatic decrease in stress level as reflected by the readings of a brain scan.

Based on previous studies that indicate beloved pets have the affect of lowering blood pressure and reducing stress for their owners, it seems logical that this current research finding will extend to include the close trusted bonds we share with both humans and pets. Anecdotal evidence has suggested that touch facilitates the healing process. This research offers scientific evidence that touch calms during times of stress and adds support to popular belief -- touch has the power to promote better health.

Journalist, commentator, and cancer patient Leroy Sievers -- the guy we've written about before, the guy who has covered many wars and witnessed countless deaths, the guy who is now observing his own death as cancer in his lungs and spine chip away at his life -- has realized that getting good news takes some getting used to.

Sievers got some good news recently. He learned that the new combination of chemotherapy drugs he's been receiving has shrunk the tumors in his lungs. And scans show the tumor on his spine is healing. It's taken him days to truly understand this concept -- this concept of hope that has miraculously delivered him more time. He didn't expect it.

Sievers fully expected that he would soon be dead. That's why he's been savoring the cold, crisp fall days -- because he was not certain he would ever see such a season. He was sure he would never host another Halloween party either -- a party he canceled this year due to his health. But now, as he takes in this new sensation of hope, he considers the possibility he may be around for another party. And he thinks he'll dress up as a tumor. Halloween is one time when good taste is never important, he says.

Sievers, who offers a weekly personal health update for NPR, available in print or in podcast format on his blog, plans to keep living in the moment. He doesn't want to overdo this hope thing. So right now, he is simply enjoying the colorful leaves -- and the season he calls one of his favorites.

Dr. Chandra Belani, Professor of Medicine and Oncology at the University of Pittsburg Cancer Institute, is a leader in the study of lung cancer. During a podcast interview, Belani shares some thoughts on the state of lung cancer -- currently the most common cause of cancer death in the United States.

Belani reveals that progress in the areas of lung cancer prevention, screening, diagnosis, and treatment can best be described as modest. There has been some progress -- and there are many on-going studies in these areas -- but there are no major breakthrough stories. Belani says there has been modest progress in diagnosis with the use of CT scans and PET scans -- and a combination of the two. There has been modest progress in chemotherapy treatment options. There has been no significant advance in detection -- and prevention is mostly in the hands of each individual since 90 percent of lung cancer cases are related to smoking.

Belani shares that true achievement would come with the discovery of a biomarker to detect lung cancer early and to lower overall mortality rates. He would also like to determine why he is seeing an increase in lung cancer cases among non-smokers.

The bar is being raised, says Belani. But it's slow going.

Why do we shy away from the colonoscopy? It just seems like such a fun experience! Well, I'm sure it will never be that but music seems to help with anxiety and the need for higher doses of medication before the procedure. There is a 90% cure rate when colon cancer is caught in its earliest stages.

We know that music can soothe us, lift our spirits, make us sad, give us energy and many other emotional responses. Its seems like a given that it would help patients better tolerate scans and procedures. If the tests are more anxiety free then more of us might actually make those appointments we keep putting off.

A study done by the doctors at Temple University in Philadelphia showed that music played during a colonoscopy procedure made some patients able to relax enough to require less sedation, without sacrificing comfort.

According to Benjamin Krevsky, M.D., M.P.H., "Over all, colonoscopies are very, very safe and while the risk of sedatives are relatively small, in general, less medication is always better. Offering music has no down side, it may prove beneficial, and patients appear to be satisfied with the procedure."

I myself am guilty of putting off the colonoscopy. Since I was diagnosed with breast cancer my oncologist has been recommending the procedure. ok, so ..

What kind of music goes with a colonoscopy? hmmmm...

For the almost two years I have been receiving treatment for breast cancer, I have traveled the same path -- over and over and over again -- from my house to the hospital and back again. And while I have seen different doctors and received different treatments and visited various departments and locations for all sorts of surgeries and tests and scans and X-rays, the path has remained the same. And after all the time that has passed, the power of the path has never diminished -- despite how familiar it has become.

Today I drove from my house to the hospital for a counseling appointment. I drove the same stretch of highway for a few miles, got off on my usual exit, drove for a few more miles past all the typical shopping centers and restaurants, and came to the light where I always turn left into the Cancer Center. I drove into the parking lot, found a parking space -- thankfully -- and displayed my yellow patient parking permit that allows to park without fear of a $20 ticket. I got out of my car and began my walk to the main hospital where the psychology clinic is located. I passed -- as usual -- the startling crowds of people smoking outside the Cancer Center, the groups of medical students who gather outside the medical facilities, the masses of people in white coats racing around and checking beepers and talking on cell phones. I entered the hospital, traveled to the ground floor, and turned a few corners until I reached my clinic. I checked in, paid my $25 co-pay, and waited for a just a few minutes until I was greeted by my counselor. We walked to a private room, talked for an hour, and then I followed my path in reverse.

The path is always the same. It is routine and predictable and rarely varies. But it has never become dull and I have never become numb to it -- because the power that is wrapped up in my drive and my subsequent steps that take me to and from my destinations still has a tight hold on me. I can travel the same path for other purposes -- to shop or have dinner -- and the power is lost. But when I travel for reasons all about cancer, the power overwhelms me. It happened today -- as I drove listening to the same CD I always play on these missions, as tears filled my eyes. I was not sad -- just overflowing with emotion. Emotion about all that I've encountered -- the encounters with fear and dread and total repulsion and the encounters with hope and joy and pure contentment. Today I felt powerful. Simply powerful. Because I have overcome what has faced me so far and because I am still traveling the same road, the same path to ensure my future health and well-being -- which is something I hope to become all too familiar with.

There is no major test or screening tool or exam that reveals the definite presence of cancer in the body. There are mammograms that can detect suspicious masses in the breast and there is a blood test that might raise concerns about the health of ovaries and there are various x-rays and scans that allow doctors to peek into the intricacies of the human body -- and some tests, like the mammogram clearly do save lives -- but some tests that seem harmless can damage the psyche while accomplishing little else.

I asked my oncologist how he would know if my breast cancer returns. He said I will receive regular mammograms and ultrasounds of my breasts. And he will perform in-office exams every few months. He will complete a breast exam and will feel my neck for enlarged lymph nodes. He will listen to my lungs and feel my stomach. But largely, he will rely on me to report symptoms and signs and complaints -- because these are the true indicators that something is amiss.

I imagined myself getting a whole host of tests on my whole body to rule out that cancer is invading every part of me. But this won't happen without reason -- because some tools, like imaging tests, may detect noncancerous abnormalities and false positives that lead to unnecessary psychological stress and tests -- and sometimes even surgery. So if I develop a persistent cough that can't be controlled, perhaps my oncologist will order a chest x-ray. If headaches begin to plague me and relief is not in sight, then perhaps a scan of my head will be in order. But as long as I feel well, the assumption is that I am well. It's better for my soul this way -- to live life without the constant worry that cancer will return. And it's a whole lot more cost effective too.