The results are inspiring. After decades of research, screening, new treatments and public education, the death rate from cancer is decreasing (by 20 percent over the last 20 years) and the chances of getting cancer are lower in men and stabilizing in women. The American Cancer Society is celebrating this accomplishment and estimates that 1.3 million more lives have been saved over two decades because of the decreasing rate of cancer deaths.
Why is this? Risk of having cancer is less because of cancer prevention. Smoking cessation is more effective due to better support or smokers, improved medications, and better advice from primary physicians (but even now 19 percent still smoke). Knowledge of what is a healthy diet is more widespread. Exposure to chemicals in the environment is less due to regulations. HPV vaccination is increasing. But obesity remains high, with 63 percent of Americans overweight.
Since cancer screening is more available, cancers are being diagnosed at more limited stages (stage 0 or stage I), which are more curable. This includes mammography, PSA screening for prostate cancer, colonoscopy and stool blood test screening for cancer and polyps, PAP smears and HPV testing, skin examinations, and CT scans for smokers to detect curable lung cancers.
Because of research, cancer treatments are more effective with newer robotic surgery, better radiation therapy with IMRT and proton beam, and combinations of hormonal, biotherapy, targeted therapy and chemotherapy which increase cure rates.
But the estimates for 2014 are still frightening. In this Year of Health (my phrase), 1.66 million people in the United States will have cancer diagnosed and 585,000 will die. With health care reform, many patients may find it more challenging or expensive to go to their physicians, possibly decreasing access to prevention and screening, even though prevention is now paid for.
So what should you do now? Here are my five tips to stay cancer-free or get cured:
• See your doctor for a screening examination. Be sure to undress so your physician can examine all of your skin area for early cancers.
• Discuss screening tests with your doctor, including mammography, PSA testing, PAP smear, colonoscopy, stool blood check, and low dose CT scan of the chest if you have been a smoker.
• Have your doctor review your family history carefully to help determine your risk of certain cancers. You can calculate your own risk of breast cancer by using the breast cancer risk tool from the National Cancer Institute. Then ask your doctor how she/he is going to prevent the cancers you might be more likely to develop. Be certain to discuss tamoxifen, raloxifene, exemestane, finasteride, statins and aspirin for breast, prostate and colon cancer prevention. Enlist your doctor's support and get a program to stop smoking. If your doctor is unaware of how to do prevention, get a second opinion (see the chapter on second opinions in my book Surviving American Medicine for my 10 Commandments of Second Opinions).
• Diet is important to review with your doctor to get the best diet for preventing cancer (less red meat, five helpings a day of fruits or vegetables, and a helping of nuts daily). Establish an exercise program to reduce breast and colon cancer and to maintain a normal weight, which reduces your risk of cancer. Avoid toxic chemicals at work or in your house.
• Emphasize healthy lifestyles, cancer prevention and cancer screening with your family. Get HPV vaccination and hepatitis B vaccination for you and/or your family at the appropriate ages.
Still the most feared of all diseases, cancer now has some good news. But the responsibility is yours to make sure you are one of the good statistics, not one of the bad ones.