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cancer survival rates

How Much Cancer Survival are We Getting for our Buck?

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It is no secret that I have been a vocal critic of national cancer organizations like the American Cancer Society and the Komen organization because of the focus on a cure instead of prevention.

The money we spend on finding a cure and increasing survival rates of cancer is monstrous.  And there have clearly been some strong advances.  But I emphasize the word “some.”  For the money we have spent collectively on the War on Cancer the result should be clear and strong.

But, much like the War on Drugs, there has been a massive amount of money wasted down avenues that have little payout while the target (whether cancer cells or drug cartels) continue to adapt to whatever direction we apply force.  Always a day late and dollar short.

The most recent Annual Report to the Nation on the Status of Cancer, put out by the American Cancer Society, the US Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association for Central Cancer Registries, gives us a report on just how well we are stopping cancer deaths.

To put this in context, you need to understand that the research on cancer prevention is very strong and clearly demonstrates that our most common cancers (lung, breast, prostate, pancreatic, colon) are largely preventable with lifestyle choices.  The American Institute of Cancer Research is the lone organization (that I am aware of) spearheading both the research and the education that we need to know (the Physician’s Committee for Responsible Medicine is also in line with the AICR, but this group’s focus is not just on cancer).

Here are the numbers:

  • The overall incidence of cancer fell by 0.4% a year from 2001 to 2010 (mostly in men).
  • Overall death rate decreased by 1.5% per year from 2001 through 2010.
  • In general, cancer patients are very likely to have other chronic diseases (32% of breast cancer patients, 30% of prostate cancer patients, 53% of lung cancer patients, 41% of colorectal cancer patients).
  • For those with local and regional cancer, they were more likely to die from the other disease than from the cancer (in other words, these patients still likely would have died from the cancer, but the other disease took them first).
  • For those patients diagnosed with distant disease (metastasis), they were more likely to die from cancer than other causes.

While, from this report, it does appear that we are making some small headway against the cancer epidemic, I still contend that these results are very poor given the money we have spent over the past 40 years on cancer research.

Further, if you look at the data, it is likely that many of these patients would have died from their cancers, but were taken by heart disease or stroke (as an example) before they could become a cancer statistic.  I’m not sure how much this affects the numbers of death by cancer, but it doesn’t seem like we’re winning here by the patient’s definition of “winning.”

 

Prostate Cancer News-Observe vs Surgery on Prostate Cancer Survival Rate

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The first hints of concern over using PSA began at least 7 years ago. Since then, how many have undergoing prostate cancer surgery thinking it was the only option?

I have covered the controversy surrounding PSA screening in previous blog posts that can be read here.

In an all-too-typical scenario, a 50 year old man has his PSA levels checked during a routine office visit.  When it comes back elevated, the cascade of additional testing begins, ultimately leading to the recommendation for a radical prostatectomy.

From an emotional standpoint, this sounds like the best option.  You have cancer.  You want it out.  Decision made.

If, however, we were to take a step back and approach the problem statistically and logically, the answer may look very different.

This particular study compares the long term outcomes (median 10 years) of radical prostatectomy versus observation in a group of 731 men diagnosed with prostate cancer.  Here are the findings:

  1. 47.0% of those who had radical prostatectomy died
  2. 49.9% assigned to observation died
  3. In the prostate surgery group, 5.8% died from prostate cancer or treatment
  4. In the observation group, this number was 8.4%
  5. Radical prostatectomy was associated with reduced overall death rate among men with a PSA value greater than 10 ng per milliliter or with an intermediate-risk or high-risk tumor
  6. Adverse events within 30 days after surgery occurred in 21.4%, including one death

There are a few take home messages here.

  • There was a benefit to prostate surgery, but it was very small (2.9%)
  • This of course does not go into the potential risks of surgery such as impotence, which can massively affect quality of life
  • We can tease apart those who may benefit more from radical prostatectomy
  • But, the biggest factor here is…………………

This was all done in the context of “standard of care,” which generally does NOT INCLUDE LIFESTYLE RECOMMENDATIONS TO FURTHER LOWER RISK!!!!

So, what would happen if those who opted for observation made significant lifestyle changes that have been associated in the medical research as lowering the risk for or improving the outcomes?

You can bet these results would’ve looked much, much different.

So, if you have been diagnosed with prostate cancer, read the current prostate cancer news and decided to forgo radical prostatectomy, what lifestyle changes did you make along with your decision?