No cure yet, but millions of us are cancer survivors

This will be my column in the Monday Gazette:

Imagine the excited news coverage if a major medical journal announced that scientists had developed a cure for cancer.

Editors would splash it across the front page of every newspaper. It would lead the evening newscasts and talk shows would chatter incessantly about it. The word would spread instantly on Twitter and blogs.

That’s probably not how we’re going to cure cancer. But the dramatic progress we have made in fighting cancer is big news that doesn’t get the big headlines or generate lots of chat or tweets because it’s happened so gradually.

Thirty-two years ago, on the same day that Elvis Presley died, my wife, Mimi, and I learned that her mother had colon cancer and my father had prostate cancer. Dad died in less than a year. Irene died in less than three years. Those were pretty common results for cancer back then. About half of all colon cancer patients and one-third of prostate cancer patients died within five years in the 1970s, according to American Cancer Society figures.

We’ve dealt with the same two cancers in my generation and the outlook is far better. I was diagnosed with colon cancer nearly 10 years ago. After surgery to remove the cancer, I’ve lived a healthy, active life (with a second surgery three years ago to remove precancerous tissue). Last weekend, I learned that my older brother, Dan, has prostate cancer.

Dan’s the same age Dad was when he died. It’s a scary diagnosis to learn you have what killed your father. But here’s the big headline about prostate cancer today: The five-year survival rate now is 98.9 percent.

The news is improving but not as good for colorectal cancer, with a five-year survival rate up to of 64 percent (90 percent if caught before it spreads beyond the colon).

Cancer remains a scary diagnosis and a widespread disease (actually, a huge family of diseases). A nephew of mine is recovering from a bone-marrow transplant to treat leukemia and a niece of Mimi’s battled lymphoma when she was in college (she’s doing fine now). The ordeals they endured were incredibly severe. Even for survivors, this remains a life-changing disease.

But lots of us are survivors and that’s progress (not yet a victory) worth celebrating.

It’s still a deadly disease, expected to kill more than 560,000 Americans this year, more than 6,000 of them in Iowa. But the fact is that most of us who get cancer beat it. The National Cancer Institute estimates 11 million Americans are cancer survivors (three times as many as in 1970, when the population was about two-thirds of its current level). About  110,000 Iowans are  cancer survivors, said Chuck Reed, the American Cancer Society’s public relations manager in Des Moines.

In 2008, the number of Iowans dying from cancer dropped for the third straight year, the first time that has happened since the Cancer Society started keeping figures in 1913, Reed said.

Dr. George Weiner, director of the Holden Comprehensive Cancer Center at the University of Iowa, says the improved outlook is a result of three factors:

• Early detection. Dan and I were fortunate that our cancers were found early. Dad’s cancer had spread from the prostate to the bone by the time it was diagnosed. Dan’s showed up in a blood test for prostate-specific antigen (PSA) while still contained in the prostate and not yet large enough to be detected in a rectal exam. “We’re catching some cancers, particularly prostate cancer, much earlier than we used to,” Weiner said. I can testify from extensive experience that a colonoscopy (mostly the prep) is a miserable experience, but far preferable to surgery and recovery. Weiner says less than half the Iowans who should be screened for colon cancer are being screened.
• Treatment. Improvements in treatment of cancer vary greatly depending on the cancer type, Weiner says.  
• Prevention. Research has not made as much progress in early detection or treatment of lung cancer, but the decline in cigarette smoking is saving lives. Disturbingly, though, use of other kinds of tobacco is on the rise. 

We still have a long way to go in learning how to prevent, detect and treat cancer, Weiner said. For instance, he said, “very little progress” has been made in battling pancreatic cancer.

From pessimism to optimism in one generation is a huge leap forward. I expect at least as much progress by the time my sons reach middle age. 

 

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