[MOL] Cancer war registers steady gains...... [01623] Medicine On Line

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[MOL] Cancer war registers steady gains......

Cancer war registers steady gains
National snapshot shows death rates
are falling in several key areas

Health Reporter
Friday, April 14, 2000

Canadians are gaining ground on several fronts in the battle against cancer as death rates drop for children, women with breast cancer and men with lung cancer.

In its first snapshot of the disease as it affects Canadians at the turn of the millennium, the Canadian Cancer Society says the good news can be chalked up to improved treatments and savvier consumers -- who are asking for the tests to detect the disease earlier and making lifestyle choices that can narrow the risk of getting it in the first place.

While heart disease is Canada's top killer, cancer is still the country's leading cause of premature death.

Absolute numbers of Canadians being newly diagnosed with some form of the disease are up to an expected 132,100 this year from an estimated 129,300 in 1999. Lung cancer leads the way as the No. 1 killer, followed by colorectal, breast and prostate cancers. It's estimated 65,000 Canadians will die from cancer in all its forms in the next year, according to the report.

The society released the 12th annual report, called Canadian Cancer Statistics 2000, in collaboration with Health Canada and Statistics Canada.

As a 51-year-old, Hajera Hussain of Mississauga, Ont. falls into the group of women with breast cancer, aged 50-69, who have been particularly successful at cheating death. Since 1985, the death rate has declined by 25 per cent among this group. (This year, 19,200 more Canadian women will get the diagnosis and it will claim 5,500 lives.)

Ms. Hussain also represents the new vigilance among consumers -- she conducted a breast self-examination, detected a lump in her breast and badgered a nonchalant family doctor for a year until she was finally referred to a specialist and diagnosed with the disease in 1998.
"My doctor was taking it easy. I thought it was painful, it started to grow," said Ms. Hussain. "I insisted to the doctor that I should see the surgeon. My doctors said it was because of menopause. So I would go every two to three months to the doctor for a year until I was finally referred to a specialist."

She had a lumpectomy followed by chemotherapy and radiation and has been cancer-free since.

"I was lucky."

Lifestyle choices are another tactic being used by Canadians to beat the odds of getting the disease. While lung cancer incidence and death rates among women have increased five times in nearly 30 years -- mirroring the time period when smoking increased among women -- mortality from lung cancer among men is down 24 per cent since 1986.

"We can relate that directly to the fall in smoking rates among men which started in the mid-'60s," said Barbara Whylie, director of medical affairs and cancer control at the Canadian Cancer Society. "Thirty per cent of all cancers are related to tobacco use."

This year, 20,600 Canadians will be diagnosed with lung cancer, the report predicts, and there will 17,700 deaths from the disease.

The decreasing incidence of colorectal and stomach cancers among Canadians can also be attributed to better lifestyle choices -- in this case, improved diets according to Dr. Whylie. (Still, colorectal cancer will be newly diagnosed in 17,000 Canadians this year, and 6,500 people will die from the disease.)

And, of course, treatments are improving. While cancer is the second leading cause of death among children aged five to 19 years, the death rate in that age group from the disease has been cut in half since the 1970s according to the cancer society.

"People are more aware, the diagnoses are being made earlier and we have more aggressive therapies with very specific agents," said John Doyle, a hematologist-oncologist at the Hospital for Sick Children in Toronto.

University of Toronto law student Sarah Millar, 24, was diagnosed with Hodgkin's disease when she turned 20. She said she had to "cattleprod" her family doctor to take a lump on her neck seriously. But after a course of chemotherapy and radiation, she has been disease-free for four years.

"I have an excellent prognosis," she said. "My doctor is fuzzy on when he is going to use the word cure."

While over all the incidence of childhood cancer has remained flat for the past several years -- about 1,300 children are diagnosed annually -- brain cancer and lymphomas are on the rise in younger Canadians, Dr. Whylie noted.

Prostate cancer will continue to be the most frequently diagnosed cancer for men in the next year with an expected 16,900 new cases, according to the Canadian Cancer Society. Incidence rates peaked in the early '90s and have begun to decline, but the death rate from this form of the disease has not dropped off. (This year, 4,200 men will die from the disease.)

"There's some positive progress if you look at the money that is going into research," said Doug Scott, 67, a prostate cancer patient and the founder of the advocacy group, the Prostate Cancer Network.

But delays in being diagnosed are still a worry in prostate cancer, he said. Mr. Scott was at Toronto's Princess Margaret Hospital yesterday receiving radiation treatments. He was diagnosed with prostate cancer five years ago, and had surgery, but not all the cancer was caught. Mr. Scott believes the 2-year wait from the time he showed up at his doctor's office with the symptoms of a disease -- enlarged prostate gland and trouble urinating -- until the cancer was confirmed five years ago allowed the disease to spread.

"The best chance is to get it early," he said yesterday.

New cancer cases will increase by another 70 per cent in the next 15 years as Canada's population both ages and grows, according to Health Canada's Cancer Bureau.

"The fight is not over," said Hospital for Sick Children's Dr. Doyle. "But the outcomes are better."

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