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A Brighter Tomorrow: Conquering Cancer
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By Meryl Davids Landau
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MediZine's Healthy Living
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 It’s the diagnosis people dread more than any other. Yet recent years have seen marked improvement in keeping the words “You have cancer” from being an automatic death sentence. The latest figures from the American Cancer Society (ACS) show that for more than a decade, death rates from all cancers combined have dropped by 1.1 percent each year. For the first time, the number of people who died of cancer also dropped, even though the number of Americans is increasing and the population is aging. “This fall is due to early detection, prevention and better treatment, depending on the cancer,” says Herman Kattlove, M.D., a medical editor at the ACS. “We consider this good progress, but we would like to do better.”
The report found that five-year survival rates are gaining ground for most of the top 15 cancers in both men and women. Lung-cancer incidence rates in women have leveled off, following constant increases over several decades. Of course, cancer remains a devastating illness, and some types, such as colorectal, ovarian and lung, are too often still deadly.
Experts are hopeful. “There is a lot of excitement about the direction of research,” says Amy Tiersten, M.D., an oncologist at the New York University School of Medicine. For example, scientists are better understanding what causes some cancers, which may lead to more precise prevention advice. They are improving diagnostic equipment to better see inside the body. And they are discovering targeted therapies, which treat more effectively and leave fewer devastating effects in their wake.
Experts have long known how to prevent many cancer deaths. “If everyone stopped smoking, ate properly and was screened for certain cancers, the cancer death rate would drop by at least half,” Dr. Kattlove says.
To give yourself the most cancer protection:
Stub out those butts. Sure, smoking causes lung cancer (a whopping 87 percent of lung cancer deaths are linked to lighting up), but it also contributes to cancers of the bladder, pancreas, liver, colon and others. Boost your odds of kicking the habit for good by using a telephone quitline.
Shun sun. To reduce your melanoma risk, wear sunscreen with an SPF of at least 15, stay in the shade whenever possible and avoid the sun between 10 a.m. and 4 p.m., when its rays are strongest.
Maintain a healthy weight. Studies link being overweight with colon, breast, kidney and other cancers. “Obesity may be responsible for 30 percent of cancer-related deaths,” says Dr. Kattlove. Researchers aren’t sure why, but the change in hormonal balance brought on by excess fat is thought to be a factor.
Eat less meat. Having a meat meal every day boosts colon cancer risk. The ACS recommends limiting red meat and choosing smaller portions and leaner cuts when you do indulge. Also, aim for at least five fruits and vegetables daily.
Exercise. Adults should be moderately active for at least 30 minutes most days each week. (More may be even better for reducing breast and colon cancer risks.) Bonus points: Exercise also protects against cardiovascular disease, stroke and diabetes—so lace up!
Get screened. The Pap test, which detects signs of cervical cancer and precancerous conditions, is the most successful example of how a screening test can save lives. And, Dr. Kattlove notes, “Very soon there will be a vaccine to prevent the viral infections responsible for cervical cancer.”
Regular use of mammograms (for breast cancer), colonoscopy (colon) and PSA/digital rectal exams (prostate) could yield similar results. For example, the five-year survival rate is 90 percent for colon cancers caught early—which, experts say, could be most cases if screening was more widespread.
As great progress is made in the treatment of certain cancers, experts are hopeful that even more promising therapies may be on the way.
For years, tamoxifen has been the gold standard for breast cancer treatment. But in the last few years, another kind of drug has elbowed in—hormonal therapies that attack cancer in a whole new way. Known as aromatase inhibitors, these medications block estrogen production in postmenopausal women (estrogen promotes the growth of about two thirds of breast cancers, says the ACS).
“Improvements in treatments are a key reason breast cancer survival rates have increased over the last few years,” says Dr. Tiersten.
Unlike chemotherapy, a bomb that blasts all fast-growing cells, including many noncancerous ones, targeted treatments aim for objects that exist or are abundant only in cancer cells. Probably the best known of these drugs is imatinib mesylate (brand name, Gleevec), which treats chronic myeloid leukemia. “By targeting this cancer’s single genetic defect, Gleevec can actually stop the cancer,” Dr. Kattlove says. Other targeted drugs with promise include erlotinib (brand name, Tarceva) for lung cancer and cetuximab (brand name, Erbitux) for colon cancer. Doctors are also hopeful that one day in the near future it will be the patients themselves who are targeted. Today, most people with a given disease are provided with similar treatment regimens; some respond, while others do not. “Gene profiling is a potentially important area,” says Dr. Tiersten. “In breast cancer, we are starting to see lab tests that can look for a panel of abnormal gene expressions to better determine which women could have hormone therapy alone, and which will need chemotherapy. In this way, we can avoid giving therapies—and their side effects—to patients who won’t benefit from them.”
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