Are we winning the war against cancer?

Tuberculosis and polio were once major killers in this country. TB is still a threat worldwide, but effective use of antibiotics has reduced infections and deaths in the United States and other developed countries. Thanks to the Salk vaccine, introduced in the mid-1950s, polio has been virtually eliminated.

When cancer was targeted by the National Cancer Act of 1971, expectations were similarly high. Labeled by then-President Nixon as the War on Cancer, the goal was to find more effective treatments and ultimately a cure. Those hopes have been revived again and again. Nevertheless, cancer still ranks right behind heart disease as the No. 2 killer in the United States, accounting for nearly 25 percent of deaths. Deaths from cardiovascular disease declined by 52 percent between 1975 and 2006, but the overall cancer death rate after adjusting for the age and size of the population has declined by only about 5 percent since 1950.

Thanks to ongoing research, treatments have been improved and great strides have been made against some cancers, most notably childhood leukemia, chronic myeloid leukemia, Hodgkin’s and non-Hodgkin’s lymphoma and testicular cancer. On the other hand, pancreatic cancer, lung cancer, brain tumors and metastatic melanoma remain largely incurable. Sixty percent of lung cancer patients die within a year.

SCREENING FOR EARLY DETECTION: Any time cancer has already spread by the time of diagnosis, successful treatment is more difficult. The best outcomes happen with early detection, before cancer has had time to spread. One major thrust of the war on cancer has been to increase public awareness about screening programs.

Screening with the Pap test was one of the earliest and most successful efforts, reducing by half the number of deaths from cervical cancer. Other widely publicized screening programs have targeted breast, prostate and colorectal cancers.

Some of these screenings have met with criticism in recent years from those who believe they do more harm than good, increasing the number of false positives that lead to biopsies and other procedures that are costly and may carry risks. They remain, however, the best option available for early detection.

NEW TREATMENTS: David Nathan, author of The Cancer Treatment Revolution [2007], and others are optimistic about the potential of new “smart drugs,” designed to identify and attack specific molecules of a certain type of cancer, slowing or halting their growth without causing damage to healthy tissue. Even better results can be expected as a result of knowledge gained from the Human Genome Project.

While these new approaches are promising, the drugs developed so far have been costly and the survival they offer is frequently less than two months.

The best news about cancer is that many forms are preventable by making good lifestyle choices: avoiding cigarette smoke, avoiding excessive exposure to ultraviolet radiation from the sun and other sources, exercising regularly and eating a healthy diet.

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(EDITOR’S NOTE: Dr. Bell is a board certified general surgeon with OSF St. Francis Hospital & Medical Group. He sees patients in Suite 210 of the Willow Creek Professional Building in Escanaba.)