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
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
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.