Cancer: No Longer a Death Sentence


Chandrakanth Are, MD

The six letter word “cancer” can still hit a serious blow to the mind, heart and soul. Even for someone blessed with enormous fortitude, the diagnosis of cancer can be devastating. But there is good news around. While we may not have found the magic bullet for treating cancer we are definitely better than a few decades ago. The survival of all patients for five years from their initial diagnosis from all types of cancer has increased from 50 percent in the 1970’s to 66 percent in the 1990’s. Similarly, we have also seen a decrease in the death rates from all types of cancer since 1990 in men and since 1991 in women. Compared to the peak rates in 1990 for men and 1991 for women, the cancer death rate for all sites combined in 2006 was 21 percent lower in men and more than 12 percent lower in women.

While the figures on a broad scale look somewhat reassuring, what does it mean to an individual patient? The patient that is seen in the clinic and told that she has colon or rectal cancer that has spread to the liver. Less than three or four decades ago, there really were not that many options to treat these kind of patient other than provide palliative care. We have come a long way from there to current day that many of these patients go on to live beyond not just five years but even ten years. How did this happen? This is due to the combination of improved radiology, better chemotherapy and safe surgery.

The current state-of-the-art radiological tools such as CT scan and MRI tell us exactly the extent of the disease which helps us plan clearly as to who needs an operation and more importantly who does not. While it is important not to deny a patient that needs an operation it is even more important and paramount not to operate on someone that does not need one. For a long time there was only one chemotherapy drug available for treating patients with colon and rectal cancer that has spread to the liver. Within the last 15 years, we have seen an impressive introduction of new drugs that has created a paradigm shift in the management of these types of patients. Lastly, surgery for removing a portion of the liver has also evolved significantly. These procedures were very risky and associated with a very high mortality rate in the 1970’s. We can currently perform these procedures safely with minimal mortality and most of the patients go home to resume normal lives.

These advances do not give us reason to sit on our laurels but they provide us the impetus to go out and tell patients and public that there is more to do. More to do so as to, increase the awareness, that there is a state-of-the-art Cancer Center within the heart of Nebraska that can provide cancer care unparalleled to any other institution in the world. More to do so as to, keep the patients and public educated of the options available to treat cancer. More to do so as to, promote the cutting edge research taking place at the Nebraska Medical Center to find novel treatment options for cancer. Finally, more to do so that we can take care of patients with cancer and heal not only the disease but mind, body and soul. For, cancer these days does not always have to be synonymous with a death sentence.

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