US Cancer Deaths Fall Second Year In A Row Despite Growing And Aging Population
Featured ArticleMain Category: Cancer / Oncology
Also Included In: Public Health; Lung Cancer; Colorectal Cancer
Article Date: 18 Jan 2007 - 9:00 PST
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The American Cancer Society has reported that the number of cancer deaths in the US has fallen slightly again, the second year in a row.
About 3,000 fewer people died from cancer between 2003 and 2004 compared with the previous year. This is small compared to the total annual death toll of more than 500,000, but it could signify the start of a most welcome reversal.
Cancer death rates (as opposed to total deaths, this is the number of deaths per 100,000 people) in the US have been declining steadily for years and the latest report by the American Cancer Society shows that the decline has been sharper in the last reported year, 2004. And the decline is actually more significant because it has outpaced the growth in the population, and despite the fact it is getting older.
Tobacco control is thought to be the biggest reason for the decline, because of the impact on reduction of cases of lung cancer, expecially in men. The second reason is the gradual improvements in treatment and early detection of cancers, as with the increased use of colonoscopies, and breast screening, for example.
According to the chart published in the report, one can see the large reduction in the rate of lung and bronchial cancer in men, where it rose steadily from 1930, peaked at around 90 cases per 100,000 of the male population in 1990 and reduced again steadily toward a present day figure of around 75 cases per 100,000.
Stomach cancer in men shows a steady decline from above 40 cases per 100,000 in 1930 to below 10 in 2003.
Colon and rectal cancer in men are also steadily dropping, while liver cancer is staying about the same, with a slight increase over the last decade. Prostate cancer rose steadily and peaked in 1990 to around 40 cases per 100,000 and is now approaching the 1930 figure of around 20-25 per 100,000.
The only male cancers to have risen, albeit very slightly, in incidence are pancreatic cancer and leukaemia, showing a rate of around 10 to 12 cases per 100,000 of the male population.
The figures for female cancers since 1930 have followed a broadly similar pattern as the male, with the lung and bronchial rates not yet coming down but they appear to have settled around the much lower rate of 40 per 100,000 cases.
Breast cancer rates hovered at around 30 cases per 100,000 females until around 1990 when they started coming down to the 2003 rate of about 25 cases per 100,000.
Stomach, uterus, colon and rectal cancer rates in women have steadily declined and at 2003 were at under 10 cases per 100,000. As for the men, pancreatic cancer has not reduced and is around 10 per 100,000, while ovarian cancer has also stayed steady at around 10 cases per 100,000 women.
The NCS estimates that the number of Americans alive today who have or have ever had cancer is about 10.5 million (roughly 4 per cent, or 1 in 25 of the population). Some of them don't have it any more, while others may still be having treatment.
At least half of all new cancer cases are cancers that can be prevented or detected earlier and people who get them have an 86 per cent chance of surviving five years or more. This high survival rate is due to improved, earlier screening as well as reduction in deaths.
The NCS suggests that in 2007, the number of new cancer cases in America will be about 1,444,920, excluding certain types such as most of the non-invasive and the basal and squamous cell skin cancers. The numbers of these last two is expected to be around 1 million this year.
The number of people in America who will die of cancer in 2007 is likely to be around 559,650, or more than 1,500 per day.
In the US, cancer is the second biggest killer after heart disease and accounts for about 1 in every 4 deaths.
The percentage of Americans who survived cancer for five or more years after being diagnosed between 1996 and 2006 is 66 per cent. This is a significantly improved survival rate compared with 30 years ago when it was 51 per cent. The ACS point out that while this figure is useful for making statistical comparisons on effectiveness of treatment and diagnosis, it is not useful in individual cases, nor is it a measure of long term survival rate since deaths from cancer can occur after the five years.
The report states that childhood cancer is rare, and that the mortality rates for childhood cancers (up to age 14) have come down by 48 per cent since 1975. The ACS estimates that 10,400 cases of childhood cancer will be diagnosed in 2007, and 1,545 American children will die of cancer in 2007, mostly from leukaemia.
The four cancers likely to be the biggest killers in 2007 will be: lung cancer, prostate cancer, breast cancer and colon cancer.
American Cancer Society Statistics for 2007.
Written by: Catharine Paddock
Writer: Medical News Today
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
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The War On Cancer
posted by Gregory D. Pawelski on 19 Jan 2007 at 10:18 amThe needed change in the "war on cancer" will not be on the types of drugs being developed, but on the understanding of the drugs we have. The system is overloaded with drugs and underloaded with the wisdom and expertise for using them.
Cancer patients usually undergo four or five courses of chemotherapy before medical oncologists can tell whether the treatment is having an effect. By that time, the tumor may have grown so large that it is too late to switch to another chemotherapy regimen or the patient may be so weakened by the treatment that trying another approach is not immediately feasible. Medical oncologists treat a lot of patients but they don't know going into treatment if it's going to work.
A major obstacle in controlling cancer growth and metastasis in patients is the widespread inappropriate use of anti-cancer drugs. As the increasing numbers and types of anti-cancer drugs are developed, oncologists become more and more likely to misuse them in their practice. Between 2002 and 2004, 395 cancer drugs were submitted for clinical trials.
It would be highly desirable to know what drugs are effective against particualr cancer cells before these cytotoxic agents are systemically administered into the body. Cell culture assays are clinically validated drug tests on living specimens of cancer cells to determine the optimal combination of chemotherapy drugs. These assays are specifically tailored for each individual patient based on tumor tissue profiling, with no economic ties to outside healthcare organizations, and recommendations are made without financial or scientific prejudice.
Recommendations are designed scientifically for each individual patient. Various assays are performed on a tumor sample to measure drug activity (sensitivity and resistance). This will determine not only what drug or combinations of drugs will not effectively work, but which will be most effective for an "individual's cancer. Then a treatment recommendation is developed through what is know as "assay-directed" therapy.
At one time, chemosensitivity testing was considered unreliable because it was only fifty percent accurate and it took too long to get the results. Today, preliminary results are completed in about seven days and chemosensitivity testing has progressed to the point where it is <90% effective.
The key to improving drug sensitivity tests is related to the number and types of drugs tested. The more anti-cancer drug types there are in the selective arsenal, the more likely the system is to prove beneficial. In order to acquire sufficient data, tumors are tested with at least two assay endpoints, and most often three, for sensitivity in any one patient. On average, up to twenty drugs and combinations at two concentrations in three different assay systems, is an effective way to avoid false-positive or false-negative data. Careful choice of drug doses and administration intervals also improves outcomes.
Conventionally, chemotherapy is prescribed by medical oncologists according to fixed schedules. These schedules are standardized drug regimens that correspond to specific cancer by type or diagnosis. These schedules, developed over many years of clinical trials, assign patients to the drugs for which they have the greatest statistical probability of response.
However, patients with cancers that exhibit drug resistance are on the wrong side of the probability curve. They will likely receive treatments that are wrong for them. A failed attempt at chemotherapy is detrimental to the physical and emotional well-being of patients, financially burdensome, and may preclude further effective therapies.
Every cancer patient should have his/her own unique chemotherapy trial based on consultation of pathogenic profiles and drug sensitivity testing data. Research and application of drug sensitivity assays are being encouraged by growing patient demands, scientific advances and medical ethics. Drug sensitivity tests are not a luxury but an absolute necessity, and a powerful strategy that cannot be overlooked.
A chemo-induced gene mutation can happen when the original chemo received does not work. The cancer comes back. When it does this, the cancer comes back more aggressively. The mutagenic effects (changes in form) of chemotherapy on a genetically-unstable tumor, drives the tumor into a state of more aggressive behavior.
A cell culture assay uses living tumor cells to determine which drug or drug combination induces apoptosis (cell death) in the laboratory. Each patient is highly individualized with regard to sensitivity to chemotherapy drugs. A patient's responsiveness to chemotherapy has its own unique individuality.
There has been a veritable deluge of new approvals of cytotoxic drugs in recent years as the tortuous FDA process has been speeded and liberalized. In many cases, a new drug has been approved on the basis of a single very very narrow indication. But these drugs may have many useful applications, and it may take years to find out. Cell culture assay testing offers a way of seeing if any of these new drugs might apply to an individual's specific cancer.
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