Cancer care has come a long way. There are treatments for many types, and in some cases, even cures.
But there’s still a long way to go. Cancer remains the No. 2 cause of death in the U.S., just behind heart disease. Do you know which cancers take the greatest toll, and most importantly, which ones you can get checked for?
5. Prostate Cancer
U.S. deaths in 2020: 33,330
How common is it? One out of every 9 men will get this cancer.
What puts a man at risk? Men are more likely to get prostate cancer after age 50. Doctors usually find it in men older than age 65. It’s more common among African-Americans than whites, Asians, or Hispanics, but experts don’t know why.
The disease can run in a man’s family. Some gene changes can also cause it. Men who eat a lot of red meat or high-fat dairy foods (and fewer fruits and vegetables) may be slightly more likely to get it, the American Cancer Society says.
Are there screening tests? Yes. Men should talk with their doctors about which tests they need, when to get them, and the pros and cons.
A man might get a blood test that checks for high levels of PSA (prostate-specific antigen).
If your doctor is concerned about your result, they might perform a digital rectal exam, in which they insert a gloved finger into the anus and feels the prostate for hard, lumpy, or abnormal areas. They might send you to a urologist (specialist) for a prostate biopsy. which uses a small needle to take a sample, or “biopsy,” of the area to check for cancer. They may also use MRI to look at the possible tumor.
If you get it, what’s the outlook? It’s very good when the disease is found early. Almost all men are still alive 5 years after finding out they have early-stage prostate cancer. It usually grows slowly and stays in the same area where it started. But when it starts to spread to other areas of the body, it can move fast. When doctors find it after it has spread far from the prostate, the odds of survival aren’t as good. Among those men, 72% die of this cancer within 5 years.
What are scientists working on? Like other cancers, it helps to find it while it is still localized to the prostate. Prostate cancer is easy to find it early with a PSA test, but doctors are using blood, urine and genetic testing to figure out which cancers are highest risk so they can calibrate treatments.
4. Pancreatic Cancer
U.S. deaths in 2019: 47,050
How common is it? About 1 in 67 people gets it.
Are there routine screening tests? No. This cancer is hard to find early.
Location is part of the problem. The pancreas is deep inside your belly. It’s hard to feel any lumps or growths there, so you might not know that you have it.
What’s the outlook? By the time symptoms show up, the cancer has usually already spread. Just 6% of people diagnosed with pancreatic cancer are alive more than 5 years later. But everyone is different, and doctors can’t predict who will live that long or longer.
What are scientists working on? Researchers want to make gene tests to screen people in families struck by the disease.
New drugs are also in the works. Some aim to stop the spread of cancer cells. Other medicines would teach the immune system to fight the cancer.
3. Breast Cancer
U.S. deaths in 2020: 42,170
How common is it? Roughly 1 in 8 women in the U.S. will get breast cancer. Men can get it, too. But it’s much less likely: 1 in 1,000.
What puts people at risk? There’s more to it than gender. Age also matters. Breast cancer is most common after menopause.
You’re more likely to get this disease if:
- It runs in your family.
- You have certain gene changes.
- You’re obese.
- You drink alcohol.
- Your breasts are dense.
- You got your first period at or before age 11.
- You started menopause late.
- You’re a woman who has never been pregnant, or you first got pregnant after age 35.
- You’ve taken “combination” hormone replacement therapy.
- You’ve been exposed to radiation.
Are there screening tests? Yes. Mammography, a special X-ray of the breast, is the main test to look for possible tumors. Doctors may also use ultrasound and MRI to check further.
It’s very common to have a lump in your breast. If that happens to you, try not to worry. Many breast lumps are not cancer. You should get a doctor to check on what it is. You may get a biopsy, in which the doctor uses a thin needle to get a sample to test it for cancer.
No single test is perfect, and experts don’t all agree on when women should start to get mammograms or how often they need them. Newer versions like the digital and 3-D mammogram could be more accurate at finding cancers in some women, especially those who are young or who have dense breasts. That’s progress, but whether it will save lives remains to be seen.
A woman’s best move is to talk with their doctor about how often they need to get checked -- and then to make that appointment.
If you get it, what’s the outlook? Like other cancers, the earlier it’s found, the better. Almost all women who find out they have stage I breast cancer are still alive 5 years later. So are 93% of those with stage II breast cancer, 72% of those with stage III, and 22% of those with stage IV. There are more breast cancer survivors than ever before.
What are scientists working on? Some breast cancers grow or spread more quickly. They are harder to treat than others. Genes in the tumors could be a target for new treatments.
2. Colorectal Cancer
U.S. deaths in 2020: 53,200
How common is it? About 1 in 20 people in the U.S. will get colorectal cancer.
What puts people at risk? Age is one reason. Your chances of getting colon cancer rise as you get older. You’re also more likely to get it if it runs in your family, you have more than three alcoholic drinks a day, you smoke, or you’re obese.
Are there screening tests? Yes. Find it early enough, through a colonoscopy or other screening tests, and the odds of survival are very good.
But a lot of people don’t get those tests. Less than half of colon cancers are found early. More than a third of Americans age 50 and over aren't up to date on their screening.
If you get it, what’s the outlook? Most people -- more than 90% -- live at least 5 years after finding out that they have colorectal cancer that’s in its earliest stages.
New tests, including ones that look for certain genes in colon tumors, could make this cancer even easier to find early. And one promising treatment uses cancer vaccines to "train" the immune system to attack colon cancer cells. Those vaccines treat cancer, but they don’t prevent it.
What are scientists working on? A key goal is to be able to predict which colorectal cancers are more likely to spread. Doctors are also working on new chemo drugs. “Robotic surgery,” in which the surgeon guides robotic arms that can do very precise work, is also on the horizon.
1. Lung Cancer
U.S. deaths in 2020: 135,720
How common is it? About 1 in 15 men get lung cancer. So do about 1 in 17 women. Doctors usually find it in people age 65 and older.
What puts people at risk:Smoking is the top cause. Breathing someone else’s smoke (“secondhand smoke”) is also a threat. You’re also more likely to get it if it runs in your family or if you’re exposed to radon and to certain other chemicals (asbestos, arsenic, chromium, nickel, beryllium, cadmium, tar, and soot). Lung cancer is more common among people with HIV than those who don’t have the virus, but experts don’t know why.
Are there screening tests? Yes, but doctors don’t recommend routine screening for everyone. Some insurance, including Medicare, now covers yearly CT lung scans for people ages 55-77 who are heavy smokers (or were in the last 15 years) and have no symptoms of lung cancer. Check your plan for details.
If you get it, what’s the outlook? Like other cancers, it’s easiest to treat if you find it early. It also depends on what type of lung cancer you have. Overall, only 17% are still alive 5 years after they find out they have it. But that number doesn’t tell the whole story.
For those whose cancer is “local,” meaning that it hasn’t spread, slightly more than half -- 54% -- are still living 5 years later.
If it has spread to nearby parts of the body but not far, roughly a quarter are still alive after 5 years.
Among people whose lung cancer has spread to far parts of their body, 4% live at least 5 years.
Remember, that’s the big picture. The same disease may act differently in different people. Ask your doctor what you can expect as you start treatment.
What are scientists working on? New medicines could help put the brakes on the disease. Some prime the immune system to attack certain lung tumors. You may want to ask your doctor if there are clinical trials you could join. If you do, ask what the pros and cons would be.