Can cancer be beaten?

Editorial / SF Chronicle 7jun01

FOR ALL the scare stories about cancer clusters, dangerous chemicals or fast-food diets, it's a relief to learn that cancer cases and deaths are down.

Just as gratifying are the reasons. Public health crusades have led to a drop in smoking and lung cancer. Early detection has enabled doctors to stem the disease in its many forms before it spreads beyond control. Better treatment plus a general awareness about benefits of exercise and proper food also play a role, according to the government study.

Americans care about their health and heed expert advice. The example of tobacco best illustrates the case. As evidence piled up of tobacco's malignant effects and cigarette firms paid billions in damages, smoking tailed off among adults. Think of how many thousands of lives could have been saved if the greedy, obscene behavior of these companies had stopped earlier.

The overall drop in cancer cases may sound slight: Over most of the last decade, the number of cancer cases sank by about 1 percent a year. But 8 of the 10 leading cancers leveled off or dropped during the 1990s, reversing rises noted in prior decades. It's a genuine change in direction.

The job is hardly finished. The Boomer generation is growing older. Science needs to expand research into the links between nutrition, the environment and the mystifying nature of cancer itself.

The good news of a drop in cancer rates may lull many into thinking the worst is over. The report, in fact, argues for more far-reaching effort. The progress in treating a wide-ranging disease strengthens the case for basic health care that can catch and treat cancer early on.

Not all cancer retreated. Breast cancer, which strikes older woman disproportionately, increased at a time when the country's population is aging.

The reasons are unclear. Obesity, hormone replacement treatments for menopause and delayed child-bearing may all be factors. It's a variant of cancer that is due the ample publicity and study it is finally receiving.

Other, less prevalent, cancers -- such as melanoma, non-Hodgkin's lymphoma and thyroid -- rose during the 1990s. There are also disparities in rates along racial lines, with different groups hit harder by one variant. These findings suggest research and testing must be tailored.

Cancer is a frightening experience. Costly medicines, debilitating treatments and a gloomy air of hopelessness are the norm. The new study provides a more optimistic view. Cancer may slowly and steadily be controlled.

Yes, it can...

Response by Paul Goettlich  7jun01

Printed in the SFC

Dear Editor,

In answer to your question, can cancer be beaten; yes, I believe it can be. However, drastic changes will be required if we are to get serious with cancer. 

Most people think the "cancer rate" refers to incidence, or how many people get cancer. It actually refers to the survival rate--after getting cancer.

The dramatic reduction in the number of deaths by healthcare's costly technology is impressive. But the primary target should be prevention because it would have an infinitely more satisfying effect on both the economy and the relationships of families. 

To set the record straight, the National Cancer Institute SEER Pediatric Monograph states that the incidence of all cancers among infants less than one year old has risen 36% when comparing the years 1976-1984 to 1986-1994. While adolescents, 15-19 year-olds, the climb is less dramatic, but it is regrettably pointing up.

Trends in childhood cancer age-adjusted to the 1970 US standard population rates, all races, both sexes, age <20 SEER incidence & US mortality, 1975-1995

Source: National Cancer Institute. Cancer Incidence and Survival among Children and Adolescents: United States SEER Program 1975-1995

• More tables and link to NCI publication online.

At what cost does this reduction in the death rate come? Is it the most cost-effective method of reducing cancer? I think not.

What about those "scare stories," as you call them? From my perspective, they get short shrift by journalists focusing on creating uncluttered stories that their editor thinks the public wants to hear. 

The answers are right in front of our noses at an infinitely more reasonable price. We need to expect far less from technology and more from the real world before it's completely gone along with us. For now, lets have a little honesty.

Best regards,
Paul