While the specter of the disease haunts modern living – and in its various forms it is one of the leading killers of both men and women worldwide – physicians and patients seem to be winning the war on cancer.
Early Detection is Key
By Mike Haskew
An arsenal of cancer treatment options, including surgery, chemotherapy, radiation and other therapies, are being refined and improved regularly. However, the most potent weapon against cancer may simply be an individual’s awareness of his or her own well-being and a commitment to prevention.
Early detection is the key to beating cancer. Proactive involvement in the management of one’s own health reduces risk factors associated with cancer and offers the best prospect for defeating the disease.
According to the American Cancer Society, the term “cancer” applies to a group of diseases characterized by the uncontrolled growth and spread of abnormal cells within the body. Cancer is caused by both internal and external factors. The National Cancer Institute estimates that more than 11 million Americans are living with cancer today, and that nearly 1.5 million new diagnoses of cancer are expected in the United States during 2009.
Occurrences of cancer are evaluated, or staged, based upon the extent or spread of the disease at the time of diagnosis. Cancers which are localized or have not yet begun to metastasize may be more responsive to treatment. Therefore, early detection is critical. When cancer does occur, treatment may sometimes become a process of management rather than an eradication of the disease.
“The first question people talk about is cure,” says Dr. John McCravey, a medical oncologist with University Oncology and Hematology Associates in Chattanooga, “but we don’t cure hypertension or diabetes – we control them. We are beginning to increase the chronicity of some patients with therapy. So, in the management of malignancies that are not curable, we have also done a good job with survivability. We have become more effective in turning these cancers into chronic conditions. Sometimes the issue of cure or no cure is valid, and in some cases it is in managing the disease.”
Dr. Stephen Golder, medical director of the Sarah Cannon Cancer Center at Parkridge Medical Center in Chattanooga, explains, “Cancer is not one disease, but instead a variety of diseases, depending on the origin of the cancer and the type of cell that gives rise to the uncontrolled growth and spread of the tumor. Individual cancers behave differently, but certain common threads connect them. One of these is the simple fact that, for virtually every type of cancer, the earlier the cancer is found the better the chances of a cure are. Along with an improved chance of cure often comes a wider range of options for the treatment of the cancer.”
For men, the top five incidences of cancer are prostate, lung, colorectal, bladder and skin melanoma. For women, the top five incidences are breast, lung, colorectal, uterine and non-Hodgkin’s lymphoma. The American Cancer Society recommends a number of screenings for cancers. In order to help individuals understand what screenings are needed and at what age, the society has developed an online questionnaire, the Great American Health Check Challenge, which creates a personalized health action plan. Additionally, the society will provide regular cancer screening reminders for anyone who signs up for the service.
“Early detection is critical for the prognosis and treatment of all malignancies,” notes McCravey. “You want to find malignancies early so that they are usually more responsive to therapy, leading to better outcomes for survival – whatever malignancy you are talking about.
“For a female, it is important to get a yearly mammogram after the age of 40 and to have a gynecological exam with a pap smear regularly,” continues McCravey. “Chest X-rays should be performed by primary care physicians during routine physical examinations at least yearly, especially if the individual is a smoker, and an active surveillance colonoscopy is recommended regularly after the age of 50. Report to your physician if you bleed at any site. For men, besides the colonoscopy and chest X-ray, get a PSA (Prostate Specific Antigen) test after the age of 50, and before that if there is a family history of prostate cancer.”
A major component of the American Cancer Society’s early detection efforts is an ongoing public awareness campaign that prompts individuals to take charge of their own health care. The results of such campaigns are encouraging. For all cancers diagnosed between 1996 and 2004, the five-year relative survival rate is 66 percent, a substantial increase from 50 percent in those diagnosed between 1975 and 1977. The positive survival trend may be attributed both to improved courses of treatment and the benefits of early detection. While it must be acknowledged that some cancers respond better to treatment than others – particularly in advanced stages – there is reason for growing optimism. Early detection pays great dividends.
The American Cancer Society reports that campaigns to increase usage of Pap testing and mammography have contributed to a 70 percent decrease in cervical cancer incidence rates since the introduction of the Pap test in the 1950s and a steady decline in breast cancer mortality rates since 1990. In the past five years, the society has launched ambitious multimedia campaigns to encourage adults age 50 and older to get tested for colorectal cancer. The society also continues to encourage the early detection of breast cancer through public awareness and other efforts targeting poor and underserved communities.
The treatment of precancerous conditions is the equivalent of a preemptive strike against a growing enemy within. Regular screenings allow the detection and removal of precancerous tissue of the cervix, colon and rectum, while early detection screenings are also available for cancers of the cervix, prostate, rectum, colon, oral cavity and skin. Early detection has proven to reduce death rates among those diagnosed with a variety of cancers. Preventable cancers and those that can be detected with screenings account for at least half of all new cancers diagnosed.
“There are genetic predispositions for some tumors, including about 25 percent of breast tumors,” adds McCravey. “It is also true that genetics plays a role in certain prostate and colon cancers. So, those with family histories of these cancers should be more aggressive in their screenings. A lot of malignancies are out of the blue, like a lightning strike, and you can’t necessarily do much about them. However, major cancers can be diagnosed at much earlier stages, particularly prostate, breast, colon and lung.”
Hand in hand with a commitment to screenings for early detection of cancer, an individual should commit to a healthy lifestyle. Research has linked the following contributing factors to the onset of cancer:
• Tobacco use, which contributes to the deaths of approximately 5 million Americans each year, primarily due to malignancies.
• Excessive sun exposure may increase the risk of skin cancer, which is diagnosed in more than 1 million people each year in the U.S., including as many as 60,000 of aggressive malignant melanoma.
• Diet and dietary fat, which may impact the incidence of colon and other cancers.
• Alcohol consumption may increase the risk of developing cancer of the esophagus, larynx, oropharynx, liver, rectum and breast.
• Viral and bacterial infections have been linked to some forms of cervical and stomach cancers, lymphoma and leukemia.
• Decreased physical activity contributes to higher cancer risk levels. Obesity has been linked to risks of developing colorectal, breast, endometrial, renal and esophageal cancers, which are 30 percent more likely to occur in overweight individuals than in those of average weight.
Individuals should continually exercise, watch their weight, eat a healthy diet that includes fruits, vegetables, whole grains and low fat, limit their alcohol intake, protect themselves from sexually transmitted diseases, avoid tobacco, and avoid prolonged exposure to sunlight.
“Do not smoke. Do not smoke. Do not smoke. This cannot be stressed enough,” asserts Golder. “Do not use snuff or other tobacco products. Do not engage in sexually promiscuous behavior. Avoid alcohol, especially when linked to smoking. Exercise regularly, and eat a healthy diet. Have regular medical checkups, including rectal exams for both sexes, mammograms and pap smears for women, and PSA testing per the American Cancer Society guidelines for men. Women should do a monthly breast self-exam, and men should do routine testicular self-examinations.”
While the treatment of many types of cancer is continually improving, early detection and prevention remain the first line of defense for individuals. When it comes to fighting cancer, knowledge is power and vigilance is key to a healthy life.
Mike Haskew is a graduate of the University of Tennessee at Chattanooga and holds a degree in history. He is a native Chattanoogan and is currently an executive with First Citizens Bank.