The "C" Word

When I was growing up, if someone had to pass the bad news that a friend or relative had cancer, they would lower their voice to a whisper and draw the word out when saying cancer.

Saying "cancer" meant "he's going to die" since nobody lived very long once they were diagnosed with the disease. Heart attacks and strokes were deadly too, but cancer held a special place in most people's closet of fears.

The medical and pharmaceutical communities have, however, over the last 50 years have redefined the yardstick by which we measure survival rates. Where weeks and months were the norm in the 50's and 60's, we now measure survival rates in the percentage of survivors after 5 or 10 years.

Still, over 500,000 will die this year from cancer in the United States.

In the face of tens of billions of dollars spent each year in the public and private sectors, 1,500 people will die every day of some form of cancer.

Last week, in the aftermath of the announcement that Supreme Court Justice Ruth Bader-Ginsburg had been diagnosed with pancreatic cancer, Hollywood actor Patrick Swayze wrote an open letter to Congress urging action on $10 billion of cancer research funding.

Having survived thyroid cancer myself and after losing my father (lung), an uncle and my best friend (pancreatic) in succession, I am sympathetic to the desire by survivors and their families for a cure. In these days of increased reliance on government it is also natural to believe that increased research funding by Congress will bring these cures to us more quickly.

Unfortunately, because the government and pharmaceutical research communities have stubbornly clung to the goal of treating and curing late-stage cancer victims, the $10 billion Swayze asks Congress to dedicate will be money Quixotically wasted on a recalcitrant disease that has defied virtually every attempt at late-stage cures. Cure rates for late stage breast, pancreatic and ovarian cancer have barely budged in the last 30 years while cure rates for early stage victims of the same disease have increased substantially.

This is why, in addition to lobbying Congress to set aside funds for cancer research, it is critical that this money be earmarked for programs designed to catch cancer in its earliest stages. Patients diagnosed with Stage I or II ovarian cancer have a 10-year survival rate approaching 90%. That rate drops below 10% for cancer patients diagnosed in the later stages. Pancreatic Cancer - the type afflicting Justice Ginsburg - is highly deadly because only 3% of cases are detected in the early stages where survival rates are high. Justice Ginsburg's pancreatic cancer was detected incidentally during a recall appointment for her colon cancer.

Most Americans do not have the quality of health care afforded Supreme Court Justices or movie stars and as a result do not get scanned for cancer until they are symptomatic. In most cases - this is too late.

Cancer treatments is less expensive and highly effective in the early stages - dramatically more expensive and less effective in the lates stages. Deaths from breast cancer and ovarian cancer have dropped precipitously as the mammogram and pap smear have become a routine part of the American standard of health care. Deaths form lung and pancreatic cancer would experience a similar decline if Congress would redirect the billions of dollars currently being thrown into late-stage cancer cures towards a national effort to support early detection of all types of cancer.

Money could and should be spent on programs that lower the cost of cancer screening. Early detection can increase the quality of life for those stricken with these deadly diseases and ultimately lower the cost of American health care. The National Institutes of Health estimates that 140 million Americans will be diagnosed with some form of cancer during their lifetime.

At a time when every dollar of government spending is precious, let us ensure that whatever money Congress spends is spent effectively -- focused on catching those cancers at the earliest possible moment so that doctors can have the best possible chance to treat the cancer successfully and save lives.