Treatments - Cancer Treatment: Prolonged Life

Cancer has no cure, but cancer can be treated. Cancer is the uncontrolled multiplication of cells, beginning in one of the body's organs ("the site"). Multiplying cells produce a tumor ("malignancy"). Cancer can spread from one site to other parts of the body. When that happens, the cancer is said to "metastasize" (Greek for moving from one place to another).

Modern medicine fights the destructive character of a cancer — by cutting it out in surgical procedures or trying to kill it with radiation directed at the site or by trying to destroy the cells with chemicals. Chemotherapy works on a wider front than radiation and can thus also destroy metastasizing cancers.

Cancer in the body is in a way analogous to a fire in a building. The sooner it is noticed, the easier it is to put out. Early detection through screening or inspection — mammography, pap smears, lung X-rays, PSA blood tests (for prostate cancer), a fecal occult blood and colonoscopy (for colon cancer), etc. — are really part of the treatment. As in buildings unsafe practices invite fire, so also in the body smoking and obesity, to name two risk conditions, can be controlled and thus prevent cancer.

How goes our fight against cancerous cells? One general view of outcomes is to look at cancer survival rates. The graphic shows five-year survival rates for whites and blacks during two periods 15 years apart: for the 1974 to 1979 period and the 1989 to 1996 period. This measure, in percent, shows what percentage of individuals diagnosed with a cancer were still alive five years later. The worst results shown here were for whites with pancreatic cancer in the 74-79 period (2.5% — 97.5% died). The best results shown are for whites with urinary bladder cancer in the 89-96 period: 81.9% survived for five years.

Survival rates for whites improved across the board. Survival rates for blacks are lower than for whites in all but one instance — stomach cancers in the 89-96 period. In the case of mouth and throat cancer, the black survival rate has worsened between the two periods.

In the next panel, where we shall look at female-male differences (and cancers specific to each sex), we shall discuss specific treatments in some moderate detail. In what follows, please note some of the following points:

• The easier it is to detect a cancer early, the higher, generally, will be the survival rate. Early detection requires (a) strong, early symptoms, (b) screening tests that catch the disease before its onset or just at onset, and/or (c) a combination of the two. Pancreatic cancer produces symptoms like stomach ache, fatigue, loss of appetite, and back pain.
• Where surgery is easiest to perform, survival rates will be highest. In the case of pancreatic cancer, for instance, only 20% of cases are operable. Colorectal cancer is relatively easy to detect — and screening methods are available. Early detection means that surgical intervention is possible — hence a high survival rate. Lung cancer manifests as a cough, a shortness of breath, breast pain, blood in the sputum. Here, again, surgical intervention is possible if the disease is detected early. Once the cancer has spread, only chemotherapy and radiation therapy remain.
• Where the treatment is primarily by chemical or radiological means, survival rates are lower.

Black survival rates are probably lower than white because detection of the disease happens at a later point. This may be due to less access to health care which, in turn, may have economic and social causes for at least a portion of the black population.

We continue exploration of this subject in the next panel.

Source: National Institutes of Health, National Cancer Institute, from Health, United States, 2001, Table 56.