"Some Better News About Cancer" By Allen Weiss, MD, MBA, President and CEO

Some Better News About Cancer
August 1st, 2011 - The American Cancer Society has excellent statistics showing the overall cancer death rate has decreased by 1.9% per year in men and 1.5% per year in women, between 2001 and 2007. This decrease is far better than an increase but we have tremendous opportunity to continue this improvement.

Cancer is a group of diseases characterized by uncontrollable growth of abnormal cells which can overwhelm the body’s normal defenses. Cancer is thought to be caused by external factors such as smoking, obesity, heavy alcohol intake, infections and many chemicals superimposed on internal factors like genetic mutations, immunological changes, hormonal variations or alterations in metabolism. Some of these external noxious factors can be controlled by us as noted in a recent New England Journal of Medicine.

About 41% of Americans will develop some form of cancer in their lifetime. This high number includes common skin cancers which, generally, are not as dangerous as all other forms of cancer. One fifth of Americans will die of cancer which is typically second only to heart disease as a cause of death. In Collier County this order of causes of death is reversed as more people die of cancer than heart disease. The Save-A-Heart program at NCH has lowered heart attack mortality, since its inception in 2000, to the point where people with heart disease live long enough to die of something else… such as cancer or another dread disease. We still have opportunity to improve until we can decrease the chances of dying of all diseases.

Men have declining rates of death from lung, prostate and colorectal cancer. Women have lower death rates from breast and colorectal cancer, presumably due to better early detection and better treatment. Use of tobacco by men has decreased since the connection of lung cancer and tobacco was confirmed by epidemiologist Dr. Morton Levin in 1950 at the Roswell Park Cancer Institute in Buffalo, NY. I had the honor and privilege to work with Dr. Levin decades later, when I was a student at a National Science Foundation summer research program at Roswell Park, which focused on biostatistics.

The good news, if there is ever any good news with cancer, is that lung cancer in women is starting to decline as more and more women kick the smoking habit. Smoking cessation and obesity control are the two best ways to continue to decrease the incidence of cancer for everyone. Predictions are that by 2020, obesity will cause more cancer than smoking.

Prostate cancer in men and breast cancer in women are still the second most common types of the disease. Tragically, breast cancer tends to occur in younger women whereas prostate cancer in elderly men can be somewhat less noxious and progressive. Both can be detected early and treated well in multiple ways.

Colon and rectal cancers are the next most common category. These tumors can also be easily detected by appropriate surveillance, including a colonoscopy starting at age fifty and periodically thereafter depending on risk factors.

Cancer also discriminates against those without insurance or without easy access to medical care. We still have many people who are not being screened due to lack of resources, fear, ignorance, denial, and just laziness. These are not legitimate reasons to play the cancer lottery. You may be lucky and never have any problems; if you do, however, you are far better off knowing early, instead of too late.

Better still: avoid the known causes of cancer—smoking, obesity, excess alcohol, preventable infectious diseases, and lack of education about the early warning signs. Male smokers have twenty-three times greater risk of getting lung cancer than non-smokers; so don’t start smoking—or if you do, quit!

You control your health and your risk to a very great extent. Take care of yourself. It is always better to prevent rather than treat.

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.