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Cancer: the Good, the Bad, and the Ugly

We've made great progress since President Nixon declared war on cancer 30 years ago, but can the war be won?

Victories in the Fight Against Cancer continued...

Overall, "if you look across the board, there are very few cancers in which we are not seeing declines in mortality," Glynn says. "We are seeing reductions in prostate, colorectal, and breast cancers, and stomach cancer has basically fallen off of the edge of the earth in the U.S.," he says. "In lung cancer among men, we are seeing a drop, and we will be seeing a drop among women by 2010," he predicts. Still, lung cancer remains the top cancer killer in both sexes, according to the ACS. It is responsible for nearly one in three cancer deaths in men and about one in four among women.

According to the latest ACS statistics, death rates for all cancer sites combined decreased 1.5% per year from 1993 to 2001 in men and 0.8% per year from 1992 to 2001 in women.

"Five-year survival for all cancers combined used to be about 50% and now it's 75%," Glynn says. "We have made a lot of progress in early detection," he says. "Fewer than 1/2 of all women were receiving mammograms several years ago and now it's close to 80%, we have mapped the human genome, which will eventually lead to individual treatment and prevention, and smoking is down in women to under 20%," he says.

Five-year survival describes the percentage of people still alive within a five-year period after diagnosis or treatment of cancer.

The Katie Couric Curve

Survival is way up in colon cancer because it is caught earlier due to routine colonoscopy (which is the method recommended by most major medical institutions), says Vijay Trisal, MD, an assistant professor of oncological surgery at the City of Hope National Cancer Center in Duarte, Calif. After her husband died of colon cancer, NBC newswoman Katie Couric had a colonoscopy live on national television. In the following weeks and months, the numbers of people across the country having colonoscopies increased more than 20%, according to researchers at the University of Michigan Health System and the University of Iowa.

"We are picking up earlier cancers and that's making a difference, and part of the difference is also very good chemotherapy for colon cancer," he says. For example, it used to be that if colon cancer had spread to the liver, "survival was nine to 11 months, but now we can resect the liver and chemotherapy kills the microscopic disease, so we seeing survival in the range of 50%," he tells WebMD.

Overall, "advances in cancer have been in treating the microscopic disease," he says. "Chemotherapy for breast cancer and colon cancer has significantly improved because we can kill the small disease that is not visible and regrows either in the vicinity of the cancer or spreads throughout the body." Chemotherapy can knock out errant cancer cells along with the main tumor.

The rates of colorectal cancer have dropped between 1998 and 2001 in both men and women. Prostate and female breast cancer rates have continued to increase, although at a slower rate than in the past. However, the increase may be due to increased detection because of higher rates of screening using prostate specific antigen test for prostate cancer and breast X-ray or mammography for breast cancer.

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