Cancer is still too common and deadly—even though early diagnosis and better treatments are available. Cancer death rates downward trends in mortality (cancer death rates) are the gold standard for evidence of progress against cancer. Adults overall, cancer death rates decreased 2.2% per year (on average) among males and 1.7% per year (on average) among females. In fact, for ages under 65, neoplasms (cancer) account for 26 percent of deaths while heart disease only 18 percent. For individuals over age 65, cancer fatalities drop to 22 percent, while cardiac disease deaths increase to 29 percent. Although both cancer and heart disease prognoses have improved since 1975, the rate of improvement for cancer lags behind that of heart disease.
One in thirty Americans, about 11 million people, have either had cancer or are currently being treated for it. Sixty-five percent of those diagnosed with cancer are expected to live at least five years or more after discovery of their disease.
A report from the National Cancer Institute showed decreasing rates of new cases and deaths from the three most common types of cancer for men—lung, prostate, and colorectal, and for the two most common types for women—breast and colorectal.
The above is good news but still not good enough! Too many types of cancer are still not being prevented or detected early enough to be cured. Many do not receive effective treatment even though oncology—the medical specialty dealing with cancer—has improved markedly over the past few decades.
Seven points for cancer prevention, even though they are somewhat obvious, still need to be publicized and assimilated:
The final point is screening for early detection. This is especially important and more available for most people who have health care insurance under the Patient Protection and Affordable Care Act.
No matter what screening is recommended, if a person has any signs or symptoms of disease, they should seek medical attention for further evaluation. If everything appears normal and there are no problems or family history of the disease, routine screening recommendations apply.
Screening is now centered on evidenced-based medicine—the science of understanding what works best in healthcare. This objective view has been applied to screening for cancer and has caused some recent controversies. Mammogram screening may start at age 40 and certainly yearly between age 45 and 54. After 55 every year or every other year is recommended.
Colon and rectal cancer screening just became slightly controversial. Nonetheless, with no family history or symptoms, colonoscopy at age 45 and every decade thereafter is prudent. Screening for blood in the stool is safe, inexpensive, and is in addition to colonoscopy.
Gynecological cancer screening should be routine in adult women and is highly effective in detecting cervical and uterine cancer. Unfortunately, ovarian cancer is still hard to detect early.
Prostate cancer screening was revolutionized a couple of decades ago by a simple blood test called a PSA—prostate-specific antigen. Now the controversy exists regarding the age at which this screening should start, and how to treat the disease; there are numerous effective procedures. In fact, in elderly men, sometimes treatment may not be needed at all.
The bottom line is that we can and should do better with prevention, early detection, and therapy. Many new and innovative medications are now available for very specific types of cancer. Genetic analysis of cancers holds promise, as does immunology for the treatment of certain forms of the disease.
Stay informed and optimistic; taking care of yourself and your loved ones is the most effective manner of prevention. Do take screening seriously and diligently by keeping watch on what medical science can do with evidence-based medicine for oncology.