The American Cancer Society has just published its latest statistics for 2013. I always scan through this document every year because I find it full of little cancer tidbits and factoids that are interesting from the patient point of view. You can view the document here.

The best little factoid this year's statistics provide is that cancer deaths are down 20% since 1991 when they peaked. This is the result of many advances and programs:

- smoking reduction since the 1960's
- screenings - mammograms, colonoscopies
- treatment options - radiation, chemotherapy protocols, hormonal treatments, and more.

 

While this is good news, we still have a long way to go in treatment, prevention, and cure.

DNA mapping

Hmmm.... I like this concept of mapping the DNA of  cancer patients. Actually the UK's National Health Service has announced a plan to map the DNA of 100,00 patients with rare diseases and cancers. (And the immediate comments on the article are how did the British government come up with the 100 million pounds to pay for this during the time of austerity.)

Politics and financing (and squabbling) aside I think this is a good idea. I have always wondered why I have been lucky enough to have cancer twice while the rest of my family remains healthy. If my DNA would tell something about it, I would welcome the opportunity to learn more about me.

Actually I would not be surprised if a lot of the secrets of us less than healthy people could be discovered in our DNA. Now that the price has dropped significantly to between 5 and 10 thousand pounds, it is getting within the range of affordability (come on, work with me if some cancer drugs can cost upwards of $100,000/year this is affordable). Maybe a little more money should be spent on looking at why some people seem to get the ailments. (I could be their poster child.) Instead of just throwing money at a cure.

An ounce of prevention is worth a pound of cure.

They must have a really big crystal ball

The title of an article published by the BBC screams "Cancer Death Rates Set for a Dramatic Fall" by 2030. Yup. I believe it. Not until I see it. Thats 18 years from now. There are still some cancers increasing in incidence. People are still dying from cancer. Cancer rates are increasing in third world countries as well.

They state that there will be a 17% drop in the death rate due to advances in treatment and decreases in smoking rates. They predict that the death rates will drop from 170/100,000 deaths to 142/100,000 deaths. Here is the little chart showing their data in a very simplified form.

 

Let's put some numbers to this to see how it looks on this side of the pond.

	US 2012 Predicted Deaths	%+/-	estimated 2030 death rate
All cancers	577,190	-17%	479,067
Breast cancer	39,920	-28%	28,742
Bowel/Colon	51,690	-23%	39,801
Kidney	13,570	-17%	11,263
Oral	7,850	+22%	9,577
Liver	20,550	+39%	28,565
Lung	160,340	-8%	14,7513
Ovary	15,550	-42%	9,019
Pancreas	37,390	-3%	36,268
Prostate	28,170	-16%	23,664

So if my numbers are correct (I was not the stellar math student and claim chemo brain so there is so margin for error) while it is exciting that there is an expected 42% drop in ovarian cancer death rates, that really only 6000. This would be 100,000 fewer deaths in the US in 18 years. Or a drop of 5555 less each year. At that rate it will take 86 more years to end cancer deaths in the US. That is too long as far as I am concerned. Most of us can expect to be here in 2030 but probably very very few will be here in 2116.

Goal Setting

While I admire goal setting and see it as a great strategy for getting things done. Goals need to be attainable. If you overestimate what can be accomplished, you set yourself up for failure. This means letting down yourself as well as everyone else who was relying on you.

If you set a goal of "I will lose 20 lbs before bathing suit season". Well that's good. But are you trying to do it in 2 weeks or in 3 months. The 3 month time frame is much more realistic as healthy weight loss is around 2-3 lbs/week. Attainable is 3 months, unattainable is 2 weeks - and if you don't lose it, will you be depressed and eat more?

The National Breast Cancer Coalition, or BreastCancer2020.org, was formed in 1991 and in 2010 added the aim of ending breast cancer by 2020. If you read their website now it looks like they are going after politicians.

From their blueprint:

"What does the end of breast cancer by 2020 mean? By January 1, 2020, we must understand how to prevent people from getting breast cancer in the first place and how to prevent them from dying from the disease.

NBCC will have a strategic plan in place to achieve its mission, will have implemented much of it, and will have obtained support and partnership from leadership among all key stakeholder groups."

If you read their 2012 progress report, which they say progress has been made but you need to read this report with their 2011 report. To me, it looks like a lot of spin. They are 20% through their deadline but I didn't see 20% progress.

Now MD Anderson in Texas has announced they are launching a new $3 billion war on cancer where they have assembled a team of specialist with two goals. They want to reduce the number of deaths from a group of cancers by 2020.

"...Dr. Ronald DePinho, president of the large cancer treatment and research center, is launching this project in two parallel tracks: "One is to apply the existing knowledge, to make a near-term impact in this decade," he said.

"The second is to also say, 'We do not know everything we need to know to ultimately cure the disease.'"

The cancer center calls the program "an unprecedented effort to dramatically accelerate the pace of converting scientific discoveries into clinical advances that reduce cancer deaths."

"The Moon Shots Program signals our confidence that the path to curing cancer is in clearer sight than at any other time in history," DePinho says.

Doctors at MD Anderson believe that dying from cancer can eventually be as rare as dying from pneumonia. And DePinho believes this can happen sooner rather later for patients suffering from the following five types of cancer:

• lung cancer
• melanoma
• triple negative breast cancer and ovarian cancer (which are very similar on the molecular level)
• prostate cancer
• acute myeloid leukemia/myelodysplastic syndrome & chronic lymphocytic leukemia (blood cancers)"

Is this goal a little more attainable? I don't know.  I admire both sets of goals. But what if they don't attain them? 2020 is 7 years and just about 100 days away. Can they do it? How many of us will be let down and discouraged if they don't?

Those who are living with cancer hold on for the dream of the cure for cancer. It has been talked about for decades and centuries and by putting these very short deadlines on it, will it make a difference?

Allow me to be whiney

Its my blog so I can be whiney if I want. If you don't like whininess then just go away for the day. I am going to be whiney today because I still have a cold. Back on March 20, 2008, I blogged about Cancer Vs. The Common Cold and indicated that I was waiting for a cure for cancer and a cure for the common cold. That's plenty of time. I am on day 7 of another evil cold here and I still feel like crap. This is not fair. I am sick of being sick.

I DEMAND a cure for both the common cold and cancer. I am going to be a demanding, whiney brat about this. Its time. Plenty of money has been spent on research for both of them and I do not believe there is an evil conspiracy by the pharmaceutical companies to hide any cures they have because they make so much money on the medications and treatments for both.

I am not being a good patient at this point. I am living on tylenol (no aspirin products for me because I am on anti inflammatories for my back), no decongestants (because between being allergic to decongestants and no thyroid - I can't take anything that says don't take if you have a thyroid disease), herbal tea with lemon and honey, cough medicine, and whininess.

I can't even whine to the cat because he is vacationing at my parents house - not yet returned after our vacation last week. I am whining to my husband but he makes fun of my squeaky voice.

I know if I go to the doctor she will just tell me to drink plenty of fluids, take tylenol, and wait it out. Whine, whine, whine, grr.

Celebrating?

Tomorrow is my blog's fifth birthday. Five years ago I started this little means of communication. Who knew that over 1800 posts later, I would still be writing it? And still going to the (damn) doctor all the time.

It also means its been five years since my breast cancer diagnosis. I'm not celebrating. Some people jump up and down and say five years and have a party or some other celebration. I don't feel the need.

For some reason, cancer statistics always include five year survival rates. That doesn't mean squat. Its a number that was selected and used but cancer can still recur later. I did some research on this (which means I asked Dr. Google) and found that the Mayo Clinic provides some insight. (The Mayo Clinic is a bit smarter than Dr. Google so I will believe them.)

First it gives some back ground on what a survival rate is:

"One of the questions many people ask when first diagnosed with cancer is about their prognosis. You might want to know whether your cancer is relatively easy or more difficult to cure. Your doctor can't predict the future, but an estimate is possible based on the experiences of other people with the same cancer."

"Cancer survival rates are based on research that comes from information gathered on hundreds or thousands of people with a specific cancer. An overall survival rate includes people of all ages and health conditions who have been diagnosed with your cancer, including those diagnosed very early and those diagnosed very late."

This means based on other people with the same diagnosis, this is what you can expect. If a five year survival rate is 90% it means, that 10% of the people with the same diagnosis didn't make it five years while 90% did. The cup half full says 90% is the number to focus on. Its a statistic so when you focus on these you become a statistic.

Also, as I said, they don't mean squat:

"Cancer survival rates often use a five-year survival rate. But that doesn't mean that cancer can't recur beyond five years. Cancer can recur many years after successful treatment. Discuss your risk of a cancer recurrence with your doctor"

So in other words, they are statistics and you need to talk to your doctor about your particular case. This is your standard lawyer sanitized, Dr Google medical speak, CYA language to say they are merely numbers and don't really mean anything.

So no I'm not celebrating. Not yet, I'm waiting until they find a cure.

Infections cause cancer

Who knew infections cause cancer. I think of them as completely different things. You get an infection as a result of a cut that doesn't heal or strep throat or something like that. Treat it with antibiotics and it usually goes away - unless its MRSA or something nasty. Then I think of cancer as rogue cells which go rampant and take over portions of your body unless cut out or killed off with chemotherapy. I'm not a medical person so I don't claim any education in this area but they don't seem related.

Now they (the proverbial 'them') say that one in six cancers are caused by an infection. HPV, Hepatitis B&C, and a stomach bacteria have been shown to cause cancer - primarily cervical, stomach, liver and other gastric cancers. In developed countries only 7.4% of cancers are caused by infections but 22.9% in less developed countries. That shows the power of vaccines. Younger people are more likely to get the infection related cancers.

So this is food for thought. I have also heard that they are now considering cancer to be a virus, which doesn't necessarily align with the infection idea but is another avenue to pursue. So what if more cancers are also caused by infections? Or by viruses? Cancer is not one disease but hundreds of diseases. Mankind has just lumped them together and called them cancers perhaps out of ignorance. Are we now getting closer to the truth? Perhaps this might lead to the cure.

Rethinking pink

The Komen hoopla over Planned Parenthood funding managed to put breast cancer spending under a microscope. There is a known benefit to having mammograms but more money needs to go to research which will ultimately save more lives. Mammograms only find the cancer but if you can't cure it, what's the point of the screening? Okay, that's a little harsh but I think its true.

Breast cancer charities abound. Its one of the most common cancers and that means there are lots of voices to lead the rallying cry. But what if the money spent on pink things, went to research instead of to making things pink? Who really gets the pinked money anyway?

I detest the pinkification of breast cancer. Making it pink, does not make it go away, kill fewer, or cure anyone. We have plenty of pinkification these days, primarily thanks to the Komen Foundation (for THE cure). I think they have done wonderful things to raise cancer awareness but spending all their money on races and other pinked events and things doesn't do much for me.  

'The Komen foundation allots 23 percent of its funds to research and 16 percent to screenings; 37 percent goes to education, 7 percent goes to treatment, and the rest goes to fundraising and administration.' So if I can do math this early in the day while on my first cup of coffee, 23+16+37+7=83%, leaving 17% for fundraising and administration, which isn't that great but isn't that bad either. However if they are for THE cure, why are they only spending 23% on research?  That does not do much for THE cure, does it?

Call me an early morning cynic this morning (my husband claims I woke up too early and that means I'll be crabby all day). I just think that pink does not cure breast cancer but more research just might. If you are looking for a worthy cause to donate to breast cancer research, skip the pinked, and look at some others:

National Breast Cancer Coalition - has set a deadline to end breast cancer by 2020. I admire their efforts but think a deadline is a little unrealistic. I mean if they find a cure, why do they have to wait until 2020? If they don't find a cure by 2020 are they declared a failure?

DOD's Breast Cancer Research Program - no you can't donate to this I think but an admirable effort as well. They are the ones who developed the vaccine that is in stage III clinical trials (that I didn't get into) to prevent breast cancer recurrence.

I also like Avon Foundation Breast Cancer Crusade.  "...the executive director of the Avon Foundation Breast Cancer Crusade, says his organization splits its funding for screenings and science fairly equally. The foundation allots 75.5 percent of its funds to grants, including breast-cancer research and programs that include screenings; the rest goes to fundraising and management. “Research will end the disease,” he says, “but we have to take care of women who have the disease today." I like the part about taking care of women who have the disease. Some one has to. Pink things don't take care of us.

Let's take care of those of us with cancer and do some research to find a cure so there don't have to be as many of us in the future. You can do that without being pink.

Wishing for what isn't

I came across an article and video from a young mother dying of cancer who wants the FDA to release a drug for her that might help her live a little longer. (I admit I didn't watch the whole video.) The article wanders on and discusses the costs of having cancer which is a completely separate, but very important, issue that I won't get into here today. Probably another day that will end up here, again.

While I feel for this young mother who is dying of cancer, I would like to make a point here. She is pleading with the FDA to release a drug which might extend her life. The article notes at the end that the drug manufacturer is working with her doctors on getting her the medication.

But my point is that we can wish for everything we want but we can't assume that we will get what we want and that it will help us the way we want. At every cancer or other icky diagnosis, we wish they could make it go away. But wishes don't solve problems.

As cancer people, we want to be optimistic as we go through treatment. We hope that with every treatment all the evil cancer cooties in our bodies are being killed off. We dream of the days when we have hair, can eat a meal without fighting nausea, and all our treatments and surgeries are done. Optimism goes a long way in treatment. It keeps us positive.

I also think that wishes can cloud our judgement. We can't wish for things that don't exist. We would like to have that cancer free world that exists in Star Trek but we aren't there yet.

This young mother is getting the drug she believes will give her more time before dying. But do we know if it will really work for her and relieve her pain and let her live a little longer? No we don't. So she gets her wish but there is no guarantee.

Not one but ten different diseases

In case you missed it here and here and here and I am sure many other places there was a new study that found that breast cancer is actually a group or a 'clutch' of ten different diseases. This means that by looking at the genetic markers in your tumor, doctors can treat you better and are better able to predict your survival rate. This is a big breakthrough and I am sure the media needed to post it in millions of places online so that we are sure to read it (but it hasn't been turned into one of those stupid slide shows yet). I am not the first to blog about it, Stephanie beat me to it.

But I am happy about it. It represents a giant leap of progress and will lead to more personalized medicine instead of the slash and burn approach used now. This goes back to the ismycancerdifferent.com people's principle. It may not help me much but will help others.

Now we just need cures for the ten different diseases, not just the one. Big sigh.