December 19, 1996 in City

We Need To Press Assault On Cancer

Vincent T. Devita Jr. Special To The Hartford Courant
 

More than 10 million of our family members, friends, neighbors and co-workers are alive today because of cancer research.

Their survival is linked to 25 years of advances in cancer prevention, diagnosis and treatment methods. These advances have provided doctors with the information and tools needed to cure this complex constellation of diseases that have killed so many.

It was 25 years ago - Dec. 23, 1971 - that Congress declared war on cancer, approving the National Cancer Act. With the infusion of resources into cancer research came an explosion in our ability to understand and manipulate the cancer cell. Although a magic bullet for curing cancer is still not likely any time soon, the genetic revolution is providing for dramatic growth in our knowledge about the disease. That knowledge, in turn, provides hope for reducing the United States’ cancer burden.

In 1971, only 38 percent of patients survived cancer. Today, more than half of all people diagnosed with cancer will survive.

New data released last month indicate cause for even greater optimism - a virtual turning point in the war on cancer. The figures show a drop in the overall cancer death rate in the United States of nearly 3 percent between 1991 and 1995, the first sustained decline since national record keeping began in the 1930s.

On several fronts:

Death rates for children’s cancers have declined by more than 60 percent since the early 1970s. Because of advances in chemotherapy, radiotherapy and bone-marrow transplantation, most cases of childhood leukemia are now curable.

Improvements in chemotherapy and hormonal treatments, as well as better access to and greater use of mammography, has finally slowed breast cancer mortality - down 6 percent since 1991.

The mortality rate for prostate cancer also posted a 6 percent decline.

Deaths from colon and rectal cancers were down as well - by 7 percent among men and nearly 5 percent among women since 1991.

Most cases of Hodgkin’s disease - a blood cancer that strikes young adults in the prime of their lives - and testicular cancer can be cured.

We can expect even more advances from new approaches to cancer treatment.

Yet, for all the progress we have made, more than one in four Americans will still develop cancer, and more than one in five will ultimately die from it.

At the rate at which new cases are being detected, and because mortality from heart disease is falling in the United States, cancer will, within five years, surpass heart disease to become the leading cause of death in the United States.

Despite these advances, progress until now largely is due to relatively crude tools such as surgery, radiotherapy, chemotherapy and some biologics. The real promise in taming the outlaw cell that causes cancer lies in molecular medicine.

New techniques, such as chemoprevention, coupled with genetic tests of susceptibility, may help us treat high-risk patients with pre-malignant lesions, stopping cancer before it develops.

Gene therapy, in which defective cancer-causing genes are altered or corrected, is here.

Biological response modifiers can harness the body’s own defenses in the battle against cancer.

It’s time to renew our commitment - as a nation - to cancer research. During the last decade, public support for cancer research rose only 18 percent, while support for all biomedical research increased 33 percent.

A recently released study by the Harvard School of Public Health, the World Health Organization and the World Bank pointed out that governments, in their view, are spending too many of their precious health dollars on infectious diseases and too few on chronic conditions such as mental illness, heart disease and cancer. The study predicts the biggest health problems of the next 25 years to be those chronic conditions which largely affect the elderly. The changing pattern is caused primarily by the aging of the world’s population, as well as by more deaths related to the growing use of tobacco.the year 2020, tobacco-related disease will become the world’s greatest killer, causing one in every 10 deaths, the study says.

The implications are clear: Although AIDS has reminded us of the dangers of infectious diseases and the need to remain vigilant in developed countries, health resources need to be focused to prepare for this onslaught of age-associated, chronic conditions - cancer chief among them. We stand on the verge of dramatic breakthroughs in treatment and prevention.

The 25th anniversary of the National Cancer Act is no time to sit back and pat ourselves on the back. Rather, it is an opportunity to look ahead to all that has yet to be accomplished. Let this anniversary renew national vigor and support for cancer research.

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