January 26, 2007

Doctor’s Corner:

There is good news on the cancer front

By Eduardo Grunvald, M.D.

Last week the American Cancer Society released a report showing a drop of over 3,000 cancer deaths in the U.S. from 2003 to 2004, the most recent year these types of statistics are available. A year earlier, 2002-2003, saw a drop of 369 deaths, the first time in 70 years of recorded data that there was a decline in actual number of cancer deaths.

The most recent report now provides some hopeful evidence that decades of medical research and clinical advancements may be paying off in the fight against cancer.

The rate of deaths from cancer in the U.S. have actually been declining since 1991, but until now the actual number of people dying from the disease continued to rise because of the growing and aging population.

Despite this promising data, we still have a long way to go.

The American Cancer Society predicts that in 2007, nearly 1.5 million Americans will be diagnosed with the disease, and 560,000 will die from it. Among Hispanics, and other racial and ethnic groups except for African Americans, the incidence of cancer and death rates are lower compared to whites. However, most Hispanics in this nation are still more likely to be diagnosed with cancer at more advanced stages compared to their non-Hispanic white counterparts.

What accounts for this promising drop in cancer deaths? Similar to many phenomena in medicine, there is not one sole explanation.

One very important factor is a reduction in the number of people who smoke. This is a great example of political resources paying off in terms of public policy, legislation, and prevention programs. Smoking has been linked to multiple types of cancers. Unfortunately, lung cancer rates have not dropped for women, probably because not only did women generally start smoking later than men in society, the decline in female smoking has also lagged.

Early detection, through screening tests and exams, has also made an impact. Cancers that have been affected include colon and rectal cancers (with colonoscopies and sigmoidoscopies), breast cancer (with mammograms), cervical cancer (with pap smears), and prostate cancer (with physical exams and a simple blood test called a PSA).

Breast cancer is an interesting case. Although it is still the leading cause of cancer death in women younger than 60, the incidence of this killer has leveled off, and death rates have actually decreased. One theory is that many women, as a result of recent studies linking hormones to an increased risk of the deadly disease, have stopped using them in the last several years. Breast cancer treatments have also improved greatly.

But contrary to popular belief and expectations, you will probably never see newspaper headlines that read, “Cure for cancer found.” Advancements are made, one treatment at a time over a long period. Take colorectal cancer for instance. The end of the 1990s saw the development of several new drugs and therapies, probably explaining the increased number of patients surviving this form of cancer.

One of the more exciting areas in the battle against cancer is the development of novel strategies. The most recent example is that of cervical cancer. This is a disease caused by a sexually transmitted virus, the Human Papillomavirus, or HPV. Now there is a vaccine available that, if given to girls and young women before they become infected, could prevent up to 70 percent of cases of this female cancer.

Not too long ago, if one got diagnosed with cancer, treatment options were often quite limited, and no form of the disease was considered preventable.

That’s not the situation today. We can take charge of cancer. Besides quitting or not starting to smoke, getting regular check ups, and staying informed and educated about your health, what else can you do to stay healthy?

The importance of weight control and regular exercise to reduce your risk of diabetes, heart disease, and stroke cannot be stressed enough. And here is yet another reason to exercise and watch what you eat. Body fat increases the body’s levels of insulin and estrogen, two hormones that have been shown to stimulate the growth of cancer cells. And more and more clinical studies are starting to support the link between obesity and increased risk of many cancers.

Live a healthy lifestyle, and you, along with doctors and medical researchers can contribute to next year’s further drop in deaths from cancer.

Dr. Grunvald is Assistant Clinical Professor, Department of Medicine at the Perlman Internal Medicine Group, UCSD Medical Center.

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