Is the monster growing out of control?

[lilyjohn]

I just have to ask this question. Am I alone in feeling like the monster is getting more and more out of control?

I know that all of us are more sensetive to those who have any kind of cancer than we were before we were touched so closely but I don't think it is that. I was upset thinking that there was so much cancer around and I was not sensetive enough to be aware of it. Then I got to thinking and I know that I never heard of so much cancer until recently.

My mom died in 1985 of lung cancer. After that I knew no one nor did I hear of anyone close to friends or family who had cancer until about 7 years ago when a close friend of my husband's family had lung cancer. Luckily it was caught in the earliest stage and as far as I know he is still NED.

Sense Johnny died all of that has changed. Not only is it overwhelming to see how many new members we get here every week and the losses that we have known but personally I have seen so much more. I'm sure my line of work does add to the numbers but it is more than that.

In the past 3 years I have had 3 clients ( one in the assisted living home) who are long time breast cancer survivers. I also had one client who is an 8 year lung cancer surviver. That is the good part. On the other hand the numbers are stagering. I have had one client who lost his wife to lung cancer. Another who lost her son to lung cancer, and one who lost a sister to lung cancer. My daughter in law lost an uncle to lung cancer and her cousin's husband died of lung cancer. Recently I lost my oldest friend to uteran cancer. Our pastor's wife who is a dear friend and also a surviver of uteran cancer has been diagnosed again with cancer this time it is a tumor on the outside of her colon. She is a trooper but she is not doing well. This past year she has lost about 80 pounds.

Then there are others, my son in law lost a cousin to a cancerous tumor on his brain. My neighbor has prostate cancer and I just learned that my ex husband's dad who I dearly love has prostate cancer. He is almost 84 and the doctor tells him it will not grow fast enough to be what kills him but it scares me.

It seems like everywhere I turn there is someone else the monster is after. What is going on here? Millions of dollars are spent on medicines and research yet instead of wiping out cancer it seems to be growing at an alarming rate. There has to be an answer somewhere and I can't help but think that somehow money is at the bottom of it.

Maybe I should have posted this as a rant but it is a very serious question that leaves me bewildered, angry and frightened.

[Snowflake]

Money...

BUT, Lily, cancer doesn't discriminate. Doctors get cancer, as do wealthy executives.

People in the U.S. are living longer. Cancer has been around a very long time, people died of "consumption" when our country was young, but they lived hard lives at that time and middle age was before 25!

I think we are all just more sensitive. It used to be something that other people had, feel sorry for them and know it could never happen to you...until it does. A loss of innocence, so to speak.

It's not getting bigger, it's just getting closer. For some of us, it's far too close.

[Treebywater]

Lil--I've been feeling this way too. Except I've been feeling that LIFE is just getting out of control. My family has dealt with cancer many times over so it's always been something I was sensitive to, but lately it seems like every day I hear of another friend or family member being diagnosed, or referred to hospice, or taking a turn for the worse, or passing away. It's very disheartening.

Add in a few other extra family emergencies lately and close friends struggling with terrible things other than cancer, and it just seems like life is a little too much right now. I am praying it's just a season.

((((Lillian)))) This stuff sucks, and it hurts to see so many people we love getting hurt so badly by it.

[Larry]

Lilian i too believe Cancer is on the increase and just recently read where the Medical world say's 50% of us will get Cancer now. Now i for one do not believe there is a cure being held back in order to keep the big drug companies going along with all the treament center's. I'll explain my reasoning on why and it is rather simple with common sense involved. Just think if there was a cure how much more money that could be made and the battle for patent right's and then you add the fact's that started out this discussion that more and more people are getting cancer so there will alway's be plenty of customer's. We've all heard the saying you are what you eat and there in i believe lie's the main culprit . Another thing i believe also is (i read this some where)that part of the reason for the sharp increase in lung cancer is most of us do not work hard enough anymore to cause us to be winded from our work and our lung's are not used to capacity or i guess exercised. And one last comment (see i'm on my soap box) is i recall back in the late 50's when filtered Ciggarettes started becoming popular a medical person saying that there would be more breathing and lung problem's because filtering the cig's would enable smoker's to inhale much more deeply...OK now you've all got my 2 cent's worth....

[sharyn]

I think the answer to the rise in cancer..... is simply diagnosis. I believe strongly that years ago, people died of cancer but medical technology was not sophisticated enough to diagnose as such. We have come such a long way... I remember when Daddy was diagnosed with Hodgkins Diesease back when he was 45 years old... which was about 36 years ago.... They only had one type of Chemo "MOP"... that was it... either it worked or it didn't and it was BRUTAL....They literally cut him open from breast to pubic bone to "see" what was going on...

Thank God things have changed...

[ellakc2]

I feel the same as Snowflake. Much more diagnosising , but also more cures.

Take care.

Mare

[berisa]

i understand what you are feeling....i do also aware that cancer cases are increasing and just being happening around us or on us. Longer life expectancy is the main reason, our body is just like a machine, it surely will be total loss at certain time, our immune system is no longer strong enough to fight against the cancerous cells...there is many reasons causing diminishing immune system from external environment as well as the human nature. Since the medical technology becomes more advance and our life expectancy is longer, then cancer seems to be more likely to be happened. There must be one reason causing a man dead, it's just caused by either "natural death" or "disease" or "accident".

I hope medicine can cure the cancer completely especially for one who is not old enough to die...I wish everyone will live more than age 80+.

[Bill]

It seems like everywhere I turn there is someone else the monster is after. What is going on here? Millions of dollars are spent on medicines and research yet instead of wiping out cancer it seems to be growing at an alarming rate. There has to be an answer somewhere and I can't help but think that somehow money is at the bottom of it.

LJ :

My training and experience is in mainstream medicine with only limited exposure to most of the specialty fields, unfortunately, oncology being one of them. IMO, of all of the specialty fields, oncology is the least understood. A mindboggling number of cause / effect and tx theories and discoveries that still don't add up to much more than a " crapshot at success " as one oncologist candidly put it. I stopped attending my wife's office visits with her med onc and rad onc as my propensity to ask relevant questions AND expect medically sensible replies has not only been a failure but has become detrimental to her visits. These oncologists have few if any solid answers to offer. It's usually an after the fact attempt at a make-it-fit explanation or more honestly alot of shoulder shrugging, I don't know, just lucky, prayer, miracle or some variation or combination of the above. IMO other than those individuals involved in R&D, teaching or some level of clinical study in oncology the average oncologist doesn't have much more than a basic understanding of dx and tx within the field. But, in fairness to them, and given the limited understanding of the disease, this is the normal and acceptable standard of medical care in most communities. Most of the rest of the medically team is lost on the subject. I do agree that advances in diagnostic techniques are probably largely responsible for the increase in incidence of cancer stats. RE: money, did you follow the recent story about the big pharmas sitting on an AIDS vaccine breakthrough because they are stalling and waiting for the government to do the official R&D for the vaccine $$$ ?

B

[Maryanne]

Here's another scenario..

I am the youngest of my siblings and cousins. My bro is 65 my sister 71, cousins are in their 70's and 80's. I am the youngest at 58. There were 14 of us. Not one relative of mine had any kind of cancer that includes all my Aunts and my mom who died at 95 or pneumonia, all her 5 sisters died of old age or heart failure.

Also, on my dads side not one person died of cancer. He died of Parkinsons, pneumonia.

Now on Joel’s side, there are too many Cancers to mention?

Why the difference??

Maryanne

[lilyjohn]

Maybe it has always been around but I have heard from or had people close to me who had so many people in the past 3 years who have been diagnosed. Ten times as many as I have known about in all of the rest of my life not even counting the people on this board.

As for the money part Larry that sounds reasonable but just stop and think. A cure a one time thing even if it cost a million dollars consider for a minute. Right now what goes into treatments and follow ups. You have the medications not just chemo but all of the other medications for pain, anxiety and any number of other things. You have the technitians who run tests and those who read the tests. You have oncologists both radiation and medical as well as surgons. Then there are the nurses who care for people in the hospital or help out in the doctors offices. The ones who give the chemo as well. Add it all up and think if a person is in treatment and diagnosis for at least a year. Can you imagine that one million dollars would cover all of it? That's not even counting the ones who do the paper work and the cost for those in a nursing home and hospital stays. How many people would lose a large part of their livlihood if one simple cure were found?

Then there is another thing the large research grants that drug companies get to search for the medications that are constantly changing. You have to face it cancer is big money any way you look at it. As far as morals are concerned look at the world today. Not a whole lot of people are concerned with morals or ethics anymore.

If all of these things were not available it would be reasonable to assume that it has always been as bad and we just didn't know about it. But these things are available and still we hear of more and more cancer of all types not just lung cancer.

[mjb]

The survival rate for lung cancer has not increased significantly yet the funding per person is still much, much lower than other types of cancer or AIDS. 60% of the people diagnosed today either never smoked or quit years ago but the only thing the governments seem to want to spend money on is smoking cessation. If you want funding for lung cancer research, please go to the Activism board and sign the petition - it's about the 6th or 7th message down.

Or go directly to: http://www.lungcanceralliance.org/

[Ann]

This is a very good post, Lil.

I think we are all more aware of the staggering number of lives that cancer affects after our own lives are touched by it. For years, I have read about cancer and known people that have had cancer. But...I guess I always had the thinking "it always strikes somewhere else." So many people think this way today. Now that the monster has reared its ugly head in my threshold, my eyes are really opened. Like you, it seems that everyone I know either is a patient themselves or has a family member battling cancer.

Like Becky, I believe people have always been battling this disease but just didn't always know what it was. I can remember when an older lady that lived down the road from us was diagnosed with cancer. Most people in my little neighborhood thought this a "rarity."

As for Larry's discussion about a cure, I think you all know my opinion regarding this. I formed my opinion after listening to Dennis talk about this in the months prior to his death. He was a firm believer that our government holds way too many deep, dark secrets and believed the key to a cure was one of them. He felt a cure for cancer would cripple our economy. True or false??? I hope he was wrong.

[Larry]

Say this is growing into a pretty good debate,all the reason's given as to why there is this big conspiracy that there is a secret or monetary reason or any number of reason's for no cancer cure is interesting but even if a cure was found and i still think it is within us somewhere the fact remain's there would still be billion's of dollar's spent for follow up treatment's and probaly a life long life of exam's. Hey George Bush get's blamed for everything so let's blame him.Look i'm Catholic and most of my family is anti Catholic and as Catholic's were blamed for every religious fault and conspiracy that come's down the road. the Church just like Goverment is Big" and out there and thus a prime target.So once again let's keep the arena of ideas going as i really enjoy reading other's thought's on this.....

[Bill]

He was a firm believer that our government holds way too many deep, dark secrets and believed the key to a cure was one of them. He felt a cure for cancer would cripple our economy. True or false??? I hope he was wrong.

///////////

Just speaking about the medical oncology profession, most patients and caregivers realize that the typical medical oncologist practice is basically a referral-based RX concession. The Feds even allow an exception to the physician / RX legislation to protect the medical oncologist. Commonly referred to as the " oncology concession ". IMO a cancer cure, esp. a broadbased cure involving few drugs, would wipe out the practice of medical oncology as we know it. The chemo room is where the lion's share of their money is made. I'm ambivalent about this topic as I'm both a caregiver of a cancer patient and I'm a HCP who's financial livelihood is directly impacted by pharmaceutical trends and developments, most definitely including medical oncology.

[paddy]

I must say I do wonder Lily, as, I too have had many friends and relatives diagnozed recently.

What worries me though is that more and more young people seem to be getting this disease. Paddy

[Larry]

I would like to make one more final thought on this and i am in agreement that the FDA and Drug companies are in bed together and profit does appear to be a main force on how the FDA rule's.....

[gpawelski]

Thirty years of randomized clinical studies point to the need for changes in our approach to the chemotherapy of the most common forms of adult cancers. Despite reportably doubling of response rates, there has been no hint of improved overall patient survival.

Presently used chemotherapy drugs have a high rate of failure. This was brought out in a January 10, 2002 issue of the New England Journal of Medicine, when it was noted that twenty years of clinical trials using chemotherapy on advanced lung cancer have yielded survival improvement of only two months.

It also pointed out that while new chemotherapy regimens appear to be improving survival, when these same regimens are tested on a wider range of cancer patients, the results have been disappointing. In other words, oncologists at a single institution may obtain a 40% - 50% response rate (not cure) in a tightly controlled study, but when these same chemotherapy drugs are administered in a real world setting, the response rates decline to only 17% - 27%.

Experience in metastatic lung cancer is very informative and indicates this lack of improved overall patient survival. Back in the early 70s, the median survival for metastatic lung cancer was just under two years. Today it is precisely the same, just under two years. In scores of prospective randomized trials involving tens of thousands of patients, response rates have gone up. Some patients unquestionably have their lives prolonged by years. Yet the overall survival rates have not improved.

The reason may be because it's all a zero sum game. You give more aggressive chemotherapy in diseases like metastatic lung cancer and you increase response rates, but you don't improve overall survival. The true situation is not that either chemotherapy works or it doesn't. The true situation is that ineffective, aggressive chemotherapy can diminish not just quality of life but also quantity of life, through organ toxicity, immunosuppression, or by inducing mutations in genetically unstable tumor cells to make them more aggressive. The result is no improvement in the treatment of the most common forms of metastatic cancer over the past 30 years

What you may want to do is to reserve the aggressive therapy for those patients who will derive more benefit than harm, while identifying the most promising treatment regimens for everyone. In patients with tumors very resistant to cytotoxic chemotherapy in general, the most promising treatments may include angiogenesis inhibitors, growth factor inhibitors, or more holistic therapy approaches.

It could be that a better approach for treating recurrent cancer is not to give more aggressive and toxic and mutagenic and immunosuppressive combinations, but to give targeted single agents, or to give the least toxic and mutagenic active combinations. Higher response rates don't necessarily lead to improved clinical outcomes.

The era of empiric, aggressive, multi-agent cytotoxic chemotherapy for recurrent/refractory adult solid tumors should come to an end. We should put much more emphasis on matching treatment to patient, through the use individualized testing, have more respect for minimal partial response or stable disease, when it can be achieved through the use of least toxic and mutagenic drug regimens, and reserve the use of higher dose therapy or agressive combination chemotherapy to those fortunate patients with tumor biologies most amenable to attack and be subjected to total or near-total destruction by these aggressive treatments.

The hallmark of cancer is heterogeneity. Not just many types of cancer (ovarian, breast, lung, colon, etc.), but many subtypes of cancer within a given type. Many types of ovarian cancer. Many types of breast cancer. Many types of lung cancer, etc. The biologies are very different and the response to given drugs is very different.

The hallmark of cancer treatment is heterogeneity. There are currently over 100 FDA approved cancer drugs, with hundreds more in the pipeline. All of these drugs tend to be partially effective, and even then, in only a minority of cases, and often for only a short duration of time.

The single most neglected area of cancer research has been the development of methods and technologies to be "matchmakers" between individual cancer with individual cancer treatment.

The single most neglected area of cancer treatment has been the unwillingness to utilize, or even study, the matchmaker technologies which have already been developed and which are already available. These technologies involve studies of cancer cell responses to drug exposure in cell culture systems, "outside" of the patient's body, before they are put "into" the patient's body.