Cancer survival rates

[Toro]

A recent excellent unpublished study by Samuel Preston and Jessica Ho of the University of Pennsylvania compare mortality rates for breast and prostate cancer. These are two of the most common and deadly forms of cancer--in the United States prostate cancer is the second leading cause of male cancer deaths, and breast cancer is the leading cause of female cancer deaths. These forms of cancer also appear to be less sensitive to known attributes of diet and other kinds of non-medical behavior than are lung cancer and many other cancers.

These authors show that the fraction of men receiving a PSA test, which is a test developed about 25 years ago to detect the presence of prostate cancer, is far higher in the US than in Sweden, France, and other countries that are usually said to have better health delivery systems. Similarly, the fraction of women receiving a mammogram, a test developed about 30 years ago to detect breast cancer, is also much higher in the US. The US also more aggressively treats both these (and other) cancers with surgery, radiation, and chemotherapy than do other countries.

Preston and Hu show that this more aggressive detection and treatment were apparently effective in producing a better bottom line since death rates from breast and prostate cancer declined during the past 20 [years] by much more in the US than in 15 comparison countries of Europe and Japan.

Greg Mankiw's Blog: Should we envy European healthcare?

 

[Diuretic]

Public awareness and early detection, combined with aggressive treatment - that's the ticket!

 

[waltky]

Cancer cells can spread unseen, before a tumor develops...

Studies: Cancer Can Spread Undetected, Before Tumor Develops
December 15, 2016 - Research has found that cancer cells can spread unseen, before a tumor develops, and leave a ticking time bomb in the body. But the scientists who made the discovery say it soon may be possible for doctors to target these "silent" cancer cells and kill them before they can kill the patient.

The researchers said the ability of these early cancer cells to spread while remaining silent for years explains why a patient can die a long time after being treated for what was thought to be a benign tumor, or even no tumor at all. Experts say 5 percent to 8 percent of cancer patients die of what's called cancer of unknown primary, or CUP. This phenomenon occurs when the disease metastasizes without doctors having found a primary tumor.

A radiologist uses a magnifying glass to check mammograms for breast cancer​

In other cases, cancer can be successfully treated but return decades later. For instance, small growths can be surgically removed from breast cancer patients, but the women will die of the disease 20 or 30 years later. Working with mouse models of breast cancer, U.S. and German researchers discovered biomarkers to identify these abnormal, silent cancer cells that travel from the site of an early tumor and settle in the bone marrow or lungs. These biomarkers can show whether the cells are seeds of metastasis, suggesting it might be possible to give people with cancer a definitive prognosis.

'Very difficult to treat'

Oncologist Julio Aguirre-Ghiso at Mount Sinai's Icahn School of Medicine in New York was the lead author of one of two papers on the spread of silent cancer cells published in the journal Nature. He said metastatic cancers "are very difficult to treat, and usually it's because we use information from the primary tumor." Even if one of the metastatic growths is different from the primary tumor, he said, "that may be the killer. Right? And we just didn't know that. So this just opens our eyes into focusing more on the specific biology of the metastasis" and treating such growths "in a more personal way." Aguirre-Ghiso said that when CUP is diagnosed, doctors usually take a watch-and-wait approach. If even one cancer cell is found residing in bone marrow, he said, the prognosis is usually poor.

But the discoveries by his team and scientists at University of Regensburg in Germany may lead to a shift in the way cancer is treated, he said. "I'm optimistic, because now we know we have a very long window of opportunity to treat the patients and prevent metastasis," Aguirre-Ghiso said. The scientists are working with drug manufacturer Eli Lilly and Company on the development of a drug that kills these metastatic, aggressive silent cells. Aguirre-Ghiso predicted that in the next four years, drugs will be available to treat wandering, cancerous cells emerging from "benign" tumors or unknown sites in the body . And, he said, doctors will have tools to tell whether a migrating cancer cell is active or dormant. If it turns out that even one silent cell is malignant, patients can be put on therapies that might actually cure the disease. That's something that has not happened before.

Studies: Cancer Can Spread Undetected, Before Tumor Develops

 

[Sun Devil 92]

A recent excellent unpublished study by Samuel Preston and Jessica Ho of the University of Pennsylvania compare mortality rates for breast and prostate cancer. These are two of the most common and deadly forms of cancer--in the United States prostate cancer is the second leading cause of male cancer deaths, and breast cancer is the leading cause of female cancer deaths. These forms of cancer also appear to be less sensitive to known attributes of diet and other kinds of non-medical behavior than are lung cancer and many other cancers.

These authors show that the fraction of men receiving a PSA test, which is a test developed about 25 years ago to detect the presence of prostate cancer, is far higher in the US than in Sweden, France, and other countries that are usually said to have better health delivery systems. Similarly, the fraction of women receiving a mammogram, a test developed about 30 years ago to detect breast cancer, is also much higher in the US. The US also more aggressively treats both these (and other) cancers with surgery, radiation, and chemotherapy than do other countries.

Preston and Hu show that this more aggressive detection and treatment were apparently effective in producing a better bottom line since death rates from breast and prostate cancer declined during the past 20 [years] by much more in the US than in 15 comparison countries of Europe and Japan.

Greg Mankiw's Blog: Should we envy European healthcare?

It would be interesting to see this pushed out across different groups in the U.S.

But, it does not surprise me. The U.S. isn't stupid.

It's just tough to see us spend so much relative to others.

Singapore seems to do a good job.

 

[waltky]

Early Cancer Diagnosis Could Save Millions of Lives...

WHO: Early Cancer Diagnosis Could Save Millions of Lives
February 03, 2017 — The World Health Organization reports the lives of millions of the 8.8 million people who die every year from cancer could be saved if the disease was diagnosed early.

The agency has issued new cancer guidelines in advance of World Cancer Day on Saturday, which it said could improve the chances of survival for people living with cancer. Cancer has reached epidemic proportions globally. It is the second-leading cause of death after cardiovascular disease, killing nearly one in six people around the world every year. WHO reports more than 14 million people develop cancer annually, a figure that is expected to rise to over 21 million by 2030. Once considered a disease of people in rich countries, data show that is no longer the case. WHO finds two-thirds of all cancer deaths now occur in low- and middle-income countries. The agency estimates cancer deaths in the poorer countries will rise to more than 9 million by 2030, if action is not taken to better diagnose, detect and treat the disease at an early stage.

Cost of cancer is huge

Etienne Krug, director of WHO's Department for the Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, noted that while the cost in lives lost was huge, the financial cost associated with cancer also was huge. “It has been estimated that $1.6 trillion is lost due to cancer, which is, of course, an enormous amount. These are costs to the health care system. Treating cancer is very expensive, but also the lost productivity, et cetera,” he said. Krug said cancer for a long time was considered a death sentence, but that this was changing. Cancer, he said, can be prevented by tackling risk factors such as smoking, unhealthy diets, air pollution and alcohol intake, and that much can be done to help people who already are diagnosed with cancer.

A Mongolian woman holds up her CT scan film in a hospital in Beijing, June 22, 2016. The woman was being treated for rectal cancer.​

“It does not have to be a death sentence,” he said. “There is a lot that we can do in terms of early diagnosis and screening, in terms of improving treatment, surgery, chemotherapy, radiotherapy and, when needed, palliative care.” For this year's World Cancer Day, WHO is focusing on the importance of early diagnosis, calling it key to survival. In its new “Guide to Cancer Early Diagnosis,” WHO has a three-step recommendation. The steps are improving awareness of cancer symptoms so people can get checked out for cancer; strengthening health services to conduct “accurate and timely diagnostics,” and ensuring that “people living with cancer can access safe and effective treatment.”

The stigma of cancer

 

[waltky]

Six percent of global cancer deaths annually occur in Africa...

WHO: Half a Million Africans Die From Cancer Annually
March 10, 2017 - The World Health Organization says about half a million Africans die of cancer each year, or six percent of global cancer deaths annually. The leading cancers in Africa affect the breast, cervix and prostate, according to WHO.

Dr. Andre Ilbawi, the technical officer for cancer control at WHO headquarters in Geneva, says the cause of the illness in Africa is not always clear, though factors that may contribute to breast cancer include alcohol use, obesity and lack of physical activity. Weakened immune systems also play a role, making people susceptible to many infections and diseases, including the human papilloma virus, or HPV, which can cause cervical cancer. "Women in Africa have a higher rate of HIV, which makes worse the effect of HPV," Ilbawi said, "so we see the combination of infectious causes really can explain the majority of cervical cancer cases in Africa and elsewhere."

A patient receives medication from a pharmacist at the Helen Joseph hospital in Johannesburg, South Africa​

Ilbawi says other infections, besides HPV, also can lead to cancer. "We know the immune system plays a very important role in fighting cancer. And in some situations, infections can cause cancer themselves," he said. "It's not always as easy as saying malaria triggers cancer years down the line for someone exposed to malaria, but we do know there are some cause and effects for infectious causes of cancer in Africa. Some include hepatitis B and C, [which] contribute to liver cancer. … There are infections in the stomach that can contribute to gastric cancer … so infections both directly and by weakening the immune system can contribute to cancer cases."

Early detection

Not all cancers are fatal, especially if detected early. The WHO is working to encourage governments to adopt measures that are low cost, but high impact, especially on the local, or primary care, level. "Early diagnosis has a strategic position in health expenditures because if we are able to detect cancer early, then the costs of treatment are lower," Ilbawi said. "We know from high-income countries that detecting cancer at stage one or two [out of four] reduces the cost of treatment between two- to four-fold in some settings." He also says earlier detection makes it likely that less toxic medications can be used.

WHO guidelines suggest inexpensive ways to improve cancer detection, beginning by educating the public and health workers on how to recognize potential symptoms. "We need that provider to identify high-risk symptoms and say to a patient, 'I understand you are having bleeding in your stool or a lump or mass that may be concerning to you. It could be many possible diseases. But what you need to do is get from the primary care level to the diagnostic facilities, where you can access biopsy and pathology to confirm whether it's cancer,'" Ilbawi said. "The first-level provider is critical because that's where most patients go first. And we have to bring those providers into the health system for cancer — not just focus on high-cost treatment at a centralized facility when most people can't get there, can't afford those treatments or get there far too late," he added.

Low-cost options

 

[Political Junky]

Public awareness and early detection, combined with aggressive treatment - that's the ticket!

One is much more likely to get early detection and treatment under universal care.
The US mostly treats rather than diagnose with preventive care.