Increased screenings, better behaviors help lower cancer rates

Patients and providers alike say cancer is making a shift to be a chronic disease that in many cases can be managed and quality of life maintained.

Over time, the mortality rate from cancer has declined 11 percent in Ohio, and 12 percent in Butler County, from 2003 to 2012. The rate of new cancer cases being found each year also dropped 7 percent statewide and 9 percent locally over the same period, according to data from Ohio Department of Health.

“There have been tremendous advances in the field of oncology in last six to seven years,” said Dr. Ed Crane, oncologist and hematologist at Oncology Hematology Care in Fairfield. “It doesn’t surprise me people are living longer.”

Nationally, cancer mortality and incidence decreased by 0.5 percent per year from 2001 to 2010, according to the National Cancer Institute.

Crane says there are several factors leading to this decline, including a stronger emphasis on and better technology for screening of cancers and improved behaviors such as less smoking and more sunscreen.

“It’s encouraging to see; with our improved treatments, cancers that killed within a year are becoming more like chronic diseases,” Crane said. “It’s fantastic to see that bar being moved where we’re able to extend the lives of more and more people.”

Becky Hughes, 61, of Middletown has been living with cancer for 12 years. She was first diagnosed with breast cancer in 2003 after her husband discovered a lump on her chest.

The cancer, found in stage 1, was treated through surgery to remove the breast, and with it seven tumors. She followed that up with chemotherapy.

Hughes was 49 at the time and had had a couple mammograms in the past but not for a few years.

“I’m guilty; so many women get caught up in life and don’t take the time to get the mammograms they should,” Hughes said.

Her oncologist, Dr. Albert Malcolm, of Signal Point Hematology/Oncology in Middletown, said there are several “screenable” cancers, including lung, breast and colon that account for the most deaths from cancer.

While lung and breast cancer screenings can catch a cancer in the early stages, screenings for cervical and colon cancers can actually “prevent the cancer from forming,” Crane said, by removing cervical lesions and colon polyps before they become cancerous.

Over 1.5 million people develop cancer each year, according to Centers for Disease Control and Prevention.

There are over 14.5 million cancer survivors in the U.S. — a figure that will reach 19 million by 2025, according to the American Cancer Society.

Hughes was just shy of her five-year mark for the breast cancer being in remission, when it re-appeared in her sternum and liver in January 2008. It was in stage 4 then but has since been maintained with continuous chemotherapy treatments.

Advancements in treatment

Dr. John Morris, medical oncologist with University of Cincinnati Health, said the biggest advancement in cancer treatment has been the development of better drugs for chemotherapy and immunotherapy.

Morris added that genetic testing has also helped in the cancer arena by analyzing an individual’s tumor to then “tweak” the drugs to block specific pathways of the cancer cells.

Crane added that it’s through clinical trials of new drugs that “personalized medicine” and the “tailoring” of drugs can become more widespread.

Morris said with the aid of the computer there have also been advancements in radiation therapy, including being able to adjust radiation beams to the size and shape of the tumor in order to preserve surrounding healthy tissue.

Malcolm said the development of better chemotherapy drugs has also helped to reduce side effects such as nausea.

“When I started in the early 1990s, and trained in the 1980s, we couldn’t do much to help people with cancers,” Malcolm said of side effects. “Through time, technology and the development of drugs, we’ve helped minimize that.”

Hughes said she’s all too familiar with the side effects of chemotherapy drugs. She’s had them all — nausea, tremors, dehydration, diarrhea and neuropathy in her hands and feet.

“I’ve lost my hair four times now,” Hughes said.

She’s been on many different medications, most of which remain effective for six to nine months before the cancer cells take over again.

“I’m always going to be on treatment; there’s no cure for me,” Hughes said. “It’s to manage the disease,” she said like diabetics using insulin.

Hughes said she makes it a point to participate in as many clinical trials as she’s eligible for. She said if anything, she hopes it helps future generations.

“I don’t know what’s around the corner with new drugs,” Hughes said. “I really think it might be a breakthrough time for cancer treatments. There’s always that hope.”

Lung cancer on the decline

A major feat to celebrate in the fight against cancer is the reduced rate of lung cancers and the declining number of American smokers.

Now around 18 percent of U.S. adults smoke — down from a high of 45 percent in the 1950s, according to the U.S. Surgeon General.

“So there’s been a dramatic decline in lung cancer from smoking,” Morris said.

It takes about 20 years of heavy cigarette smoking to develop lung cancer, Morris said. The decline of new cases of the cancer in men started in the 1980s, and for women in the 1990s.

Morris, who specializes in lung, head and neck cancers, said however, Ohio remains in the top 10-15 states for lung cancer, and the tri-state area of Ohio, Indiana and Kentucky has one of the highest smoking rates.

“Nationally lung cancer is declining but it’s a slow process,” Morris said, adding it remains the second most frequent cancer in men and women.

Screening for lung cancer — recommended for those who’ve smoked a pack a day for over 20 years or two packs a day for 15 years — reduces the risk of dying from lung cancer by 20 percent, Morris said.

Malcolm said a decline in smoking rates doesn’t just mean less lung cancer, but other cancers like bladder, stomach, gastric, head and neck and oral that can develop from smoking.

“We are winning the battle but it’s a slow and tough battle,” Morris said.

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