Our futile war on cancer

[Re-entry]

In 1971, the US passed the National Cancer Act. We were assured that cancer would be cured by 1976.
Well the unembellished statistics from 31yrs later tell otherwise.
Cancer deaths in the US for 2002: 557,272.
Cancer deaths in the US for 2003:556,902.

The facts are :-

1 in 2 men , and 1 in 3 women , are expected to get cancer at some point.
Since then, the death rate from metastatic cancer is largely unchanged.
Early diagnosis (the main advance) doesn't change the natural history of the disease.
Early diagnosis may even lead to an incorrect diagnosis of cancer that may never have killed the person.

[zerozero]

:D

Modern livin' my friend. Modern livin'.

[obgraham]

Most everyone who's cured of cancer goes on to die of something else anyway, just to mess up the figures.;)

[gingernut]

The stats you present don't really demonstrate much.

Anything more robust ??

[ORAC]

Lancet (http://blogs.thelancet.com/archive/2007/01/22/us-cancer-deaths-drop): .....Cancer incidence rates in the USA have been dropping in men since 1990 and in women since 1991. Overall, age-adjusted incidence rates for all cancers in men and women fell 13.6% between 1991 and 2004.

Despite this decline, the absolute number of deaths have continued to rise because for a time ageing and population growth outpaced the change in incidence rates. Now the effect of the decline in rates on absolute deaths is beginning to be seen......

[Re-entry]

What stats do you want, the cancer deaths for 2004?

How about the plague, smallpox, cholera, polio?

OK, from the National Center for Injury Prevention and Control.
Just the 45-54 age category:-

1. Malignant Neoplasms 49,520
2. Heart Disease 37,556
3. Accidental Injury 16.942
4. Liver Disease 7,496
5. Suicide 6,906
6. Cerebro-vascular 6,181
7. Diabetes Mellitus 5,567
8. HIV 4,422
9. Chronic Low Respiratory Disease 3,511
10. Septicemia 3,245

[gingernut]

You're presenting absolute numbers, unfortunately they mean nothing to me, what's the trend ?

What's the crux of your argument ?

And which cancer are you talkng about ?

[Re-entry]

Every one of those 'absolute numbers' left behind a grieving family.
The trend?
Well using the above mentioned numbers, let's see..

557,272-556,902= 370. In one year.

OK. 557,272/370=1504.

So 2007+1504= year 3511 ,we'll have it licked by then.

The crux of the argument.

For all the billions of dollars spent on cancer research over the last 35 years, we certainly do not have a cure, and we are no closer to even controlling the disease. The number 1 killer in the western world.

Which cancer?
Any of them. They will all go metastatic after time.

[Loose rivets]

Deaths of one type of cancer, say lung, in a specific year would be helpful.

To really paint the picture, various types, listed against their years and displayed as a graph would be enlightening.

[VH-MLE]

Unfortunately I believe Re-entry to be 100% correct. Having watched this disease ravage my wife (Maria) for the past 20 months, I am firmly of the belief we are still in the stone age with respect to metastatic cancer. I have posted previously in other threads on my wife's situation but as the situation has steadily deteriorated I will post her history once again.

Maria was diagnosed with cancer of the cervix in May 2005. She should have had regular pap smears you might think but she had been having them - the last well within the recommended 2 year period which came up "clear".

Having been diagnosed with stage 2A cancer (which meant it hadn't spread beyond the local area, with standard treatment (radiation and chemotherapy) the cure rate, we were advised, was around 85% - 90%. Her treatment all seemed to go well and we were all cautiously optimistic that she would be cured. Her primary doctor said at the end of her treatment that he would order a CT scan and chest X-ray to see how things were looking on her next appointment in 3 months time. That 3 months came and went along with a couple of others and each time no CT scan or chest X-ray. I asked him on each occasion about them and he would always mutter something that they weren't everything and that Maria was doing well. Following some strong abdominal pain and cramping in March/April of 2006 (which was put down to radiation colitus by her treating Dr) we eventually went to our GP and arranged a CT scan through him. Needless to say there were a number of enlarged lymph nodes in the pelvic area that were "presumed metastatic"). A PET scan also revealed the same. These nodes were eventually removed through surgery however this changed my wife's prognosis from good to not so good. After more chemotherapy a more recent scan showed a couple of small nodes as cancerous however when she was opened up the cancer had spread throughout her stomach, kidney and several other places - they hadn't shown up on the PET/CT scans.

Whether an earlier detection of the initial nodes would have made any difference in terms of survival I am unsure, however, what I am sure of is had they been picked up at a much earlier stage I am confident they would have given her more time because as of now, she is riddled with it and with little available in the way of treatment.

I am extremely angry and bitter at what has occurred in Maria's situation because a routine pap smear failed to identify the cancer and by and large, her doctors have been too casual for my liking and have had to be pushed into doing things. From my perspective, supposed modern medical technology has failed my wife in several ways and so has her doctor. While many doctors have their patients best interests at heart many more are in medicine for the "wrong" reasons (money, status etc).

I am confident that Maria is no better off now in 2007 than had she been diagnosed with cervical cancer in 1971 or 1976. Additionally, having 3 kids 10, 8 and 5 doesn't make the situation any easier!

There is a lot more to this than I have stated however this is the basic history.

Regards

VH-MLE

[obgraham]

VH, I've exchanged with you before over your experience, and I've wondered how things have gone for you all. I'm sorry to hear of her progression, and I simply wish you and your family peace and happier times to come.

I don't completely disagree that what we have to offer in cases of advanced and metastatic cancer is often little improvement from years ago.
_________
Graham MD

[VH-MLE]

Hello OB,

Thankyou for your thoughts and best wishes.

VH-MLE

[RobertS975]

The war against cancer has been anything but futile. But the successes have been uneven to be sure. To be sure, once someone has a metastatic solid tumor, then the liklihood of a complete cure becomes remote. Still, there have been advances in pain control and nutrition.

Each cancer has its own particular biology. A very tiny primary tumor can aggressively spread where a huge primary lesion may have failed to spread.

[Lou Scannon]

I too have experience of Cancer. I would make two points:
Firstly the treatments are gradually improving. Even if the cancer does eventually result in a premature death this may well be significantly delayed.
The medical hope is that though they cannot cure the disease, they can hold it at bay much as they do diabetes
Secondly, early detection is beneficial to many patients especially when treatment can start before there has been any spread.
To give an example of the first point, my daughter was diagnosed with breast cancer some sixteen months ago. Despite the lump being small it had already spread and she had twelve plus secondaries on her liver. The general opinion from friends in the medical profession was that she had an expectation of living between four and six months without treatment.
Fortunately her cancer was of the type that is susceptible to one of the new mono-clonal antibodies. A combination of Herceptin and two chemo-agents actually killed the lesions on the liver reducing them to scar tissue.
Unfortunately Herceptin does not penetrate the blood/brain barrier and over fifty small lesions were then discovered in her brain when she complained of headaches. Most of these have now been dealt with by radio-therapy and we have hopes that a new oral chemo called Capecetibine will keep the remainder under control. The rest of her body remains in complete remission.
We know that there are more new drugs in the pipeline and one, that may well get through this blood/brain barrier, Tykerb, will be licenced this June.
Others will follow.
The best advice that I was given at the start of her illness by an oncologist was to ignore all the published statistics on cancer, because they all refer to events five plus years ago.
Sixteen months ago she doubted that she would see her baby daughters first birthday. Now she is in with a good chance of seeing her start school.
Progress is being made, believe me. I only wish it could be made for all cancers!

[scooter boy]

:= The raw numbers presented are utterly meaningless without a degree of educated interpretation.

Life expectancy data tells you a lot more. As we live longer the greater the chance of one of our billions of cells starting to divide in an uncontrolled way - the figures don't demonstrate a cancer epidemic, just the fact that we are dying less from other causes (war, infectious diseases, stc.. in the afflusent developed world) and therefore cancer gets more time to kick off.

Several cancers are almost entirely curable now if caught early enough: lymphoma, prostate, testicular tumours (I say this as a surgeon, a pilot and a cancer survivor) - my cancer would have undoubtedly killed me if I had been born 20 yrs previously.

Advanced in imaging and therapies like surgery radio and chemotherapy are being made all the time.

Early diagnosis makes a massive difference to prognosis.

Even tumours diagnosed late can occasionally be eradicated - look at Lance Armstrong - he had liver and brain mets.

Admittedly there is a heck of a lot more work to do but impacts are being made all the time.

We will probably never eradicate cancer in our lifetimes but we can stop it in its tracks or slow it down a heck of a lot better than we could 20 or even 10 years ago.

There is hope,

SB

[pulse1]

I think that there are real grounds for hope. For the first time, AFAIK, one type of cancer has now been controlled by molecular inhibition. This gives hope for similar answers to other types of cancer.
Chronic Myeloid Leukaemia (CML) can now be treated with a new drug which inhibits the growth of cancerous cells in the blood. Although not a cure, at least so far, Imatinib has a 95% success rate in allowing CML sufferers to live absolutely normal lives indefinitely (or at least for the 5 years it has been available). Up to now, the only hope for CML patients has been a bone marrow transplant.
This shows that it is possible to repair genetic aberrations precisely. I am hopeful that the success of Imatinib will trigger similar developments for other types of cancer. It shows that it can be done.

[fernytickles]

VH-MLE - I, too, had been wondering about your wife's progress. I am sorry to hear she is having such a very rough time, and wish you all the best.
My mother was diagnosed with cancer almost a year ago and a friend of ours has also been having to deal with cancer (living as we do, in the USA, we are now organising a fund raiser to help him and his wife pay off their ridiculously high medical bills). Never having had to deal with cancer this close to home before, what I have learnt, both by direct observation and through advice, is that you have to fight your corner. Hard. Quite why this is so, I don't know, but I do know that on 3 occasions if the patient's family hadn't pushed and asked and pushed for more research and treatment, the tumours wouldn't have been located so quickly, if at all. This is from both sides of the Atlantic.
Now, I'm sure this is not the same in all cases, but I've learnt from those experiences and it has affected how I will deal with this should I ever have to.

[Lou Scannon]

Scooter boy:

Thanks for your comments. I'm not familiar with Lance Armstrong, would you update me with the type of brain mets he had and the treatment?

[Dumbledor]

'Our futile war on cancer’ WHAT!!!!!!!!
......and we are all doomed .........I had better fill my wellies with concrete and find a pier, quick smart!!
I was diagnosed with breast cancer in 1993 and the cancer had spread to my lymph glands. I had surgery, chemo and radiotherapy and I am still walking around with NO recurrences. My cancer was caught early. I appreciate I am one of the lucky ones but this survivors club is getting bigger by the day. Of course I didn't know all this in 1993 and for 10 years I was convinced that every pain was the cancer returning to kill me.
I am always deeply saddened for and understand the terror of people going through this bloody awful disease now and my heart goes out to them but those people need HOPE to help them survive, not this doom and gloom. I want them to know that if I die tomorrow I have still had 14 extra, fantastic years, extra time that could be theirs too.
Years ago cancer meant death. That is not necessarily the case now.
Of course progress has been made and to those doom and gloom merchants......... I am not ready to turn my toes up just yet.
D

[scooter boy]

"Thanks for your comments. I'm not familiar with Lance Armstrong, would you update me with the type of brain mets he had and the treatment?"

Lou, Lance Armstrong is a professional cyclist who has won the tour de France (the most gruelling of cycling challenges) a record number of times. He had a testicular primary with liver and brain mets - very bad news indeed.
He underwent surgery followed by intensive chemotherapy before he ever won the tour. His treatment eradicated his cancer and filled him with a steely determination to achieve all he needed to in this life. He has now retired from professional cycling but remains in excellent health. He has written an excellent autobiography called "It's not about the bike" which details his fight against cancer and also to regain his fitness.

If Lance Armstrong had been born 20 years before his birth date he would not have survived cancer.

Progress is being made and the miraculous recovery of Lance Armstrong only reinforces the fact that there is still hope even in the grimmest scenario.

SB

[280dt]

for what it's worth i believe the mets were in his lungs and brain - could only be treated with certain chemo so as not to damage his lungs. clearly it worked very well.

[North County Pilot]

Did read "about the bike" years ago but little did I know that I would be picking it up again for some comfort. I am a professional pilot and am currently undergoing chemotherapy for non hodgkins lymphoma (NHL). So far the treatment has not stopped me from living a normal life, except that I can't work of course. I am sure I will have to jump through hoops to get the Class 1 back. Does anyone have any experience of this?