Columnist suggests three strategies that could possibly reduce your risk of contracting cancer

By employing three strategies, you may reduce your cancer risk. 

That, at least, is the opinion of Dr. Jerry Saliman, whose Senior Life column in an earlier-this-month edition of j. the Jewish News of Northern California, focused on those strategies — being on the lookout, catching symptoms early, and paying attention to risky behavioral factors.

Dr. Jerry Saliman

Regarding the first strategy, Saliman writes that unfortunately only four types of cancer screening have received a high-level record recommendation from a U.S. task force: colon, lung, breast, and cervix.

As to the second line of reasoning, the columnist, a Bay Area physician who retired from Kaiser South San Francisco after a 30-year career and now is a volunteer internist at Samaritan House Medical Clinic in San Mateo, suggests that "by catching cancer early, the survival rates may be four times higher compared with later-stage detection."

Saliman adds, about the last strategy, that the American Cancer Society's prevention studies have been crucial in detailing risk factors — including, in the 1950s, being the first to identify smoking as a major reason for cancer. The ACS has since, via its ongoing research, "found that older age and smoking have the highest relative risk for developing any cancer for both men and women."

Additional risks for men, his column says, "are family history of cancer, red meat consumption, alcohol intake, and physical inactivity."

More information on risks can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

American Cancer Society vs. U.S. advisory group

Agency and task force disagree on when people should start screening for colon cancer 

Whether U.S. adults should start colon cancer screening at age 45 or 50 is still in doubt.

The most recent guidelines from the American Cancer Society advocate the former, but an influential government advisory group, the U.S. Preventive Services Task Force, still believes the latter age is perfectly okay.

According to an Associated Press story by Mike Stobbe a while back, the cancer society admits its recommendation of the earlier age "could cause confusion for doctors and patients." 

Both groups, however, apparently recommend six other kinds of screening exams, "from inexpensive take-home stool tests performed every year to colonoscopies done every 10."

Dr. Rich Wender

The best test, the cancer society's Dr. Rich Wender is quoted as saying, "is the test that gets done. All of these tests are good tests, and the choice should be offered to patients."

Most colon cancer occurs, according to the story, "in adults 55 and older, and the good news is rates of cases and deaths have been falling for decades."

Colon cancer, combined with rectal cancer, is the second leading cause of cancer deaths in the United States — the top cause being lung cancer.

Some 140,000 Americans were expected to be diagnosed with colon cancer this year, "and about 50,000 will die from it," Stobbe's piece reports.

Only "about two-thirds of people 50 and older have been following screening guidelines," the article notes, quoting Dr. Marcus Plescia of the Association of State and Territorial Health Officials as saying that "it's hard enough to get people to do it at all."

But Dr. Andrew Wolf, lead author of the American Cancer Society study, reportedly said his agency had considered and rejected that reasoning.

More information about conflicting research and findings can be found in "Rollercoaster: How a man can survive his partner's breast cancer,"  a VitalityPress book that I, Woody Weingarten, aimed at caregivers

Deaths from lung, breast, prostate cancer dip

United States cancer mortality rates have dropped 26% since 1991, new report indicates

The good news: U.S. cancer death rates have continued to fall.

The bad news: While the incidence has dropped for some cancers, it has risen for others.

Those conclusions, according to a story by Judy George on the MedPage Today website yesterday, are based on a statistical report from the American Cancer Society.

Cancer mortality in the U.S. fell 1.7% from 2015 to 2015 — a decline that "continued a long-running trend, with a 26% drop since 1991," George's piece indicates. 

Rebecca Siegel

Her story notes that "the reduction was fueled largely by fewer deaths from lung, breast, prostate and colorectal cancer," and cites information from Rebecca Siegel of the ACS and colleagues in CA: A Cancer Journal for Clinicians. 

"Steady reductions in smoking, plus better detection and treatment, accounted for a significant part of the decline," the MedPage Today article adds.

Dr. Otis W. Brawley

The article also quotes Dr. Otis W. Brawley, chief medical officer of the ACS, from a statement: "A decline in consumption of cigarettes is credited with being the most important factor in the drop in cancer death rates."

Over the past decade of available data, the story continues, "the overall cancer incidence in men fell by about 2% per year, with the pace accelerating in recent years."

But in women, "declines in lung and colorectal cancers were offset by increasing or stable rates for breast, uterine corpus and thyroid cancers and for melanoma."

Liver cancer incidence has also continued to rise in women.

Siegel's piece also says that researchers have predicted "1,735,350 new cancer cases and 609,640 cancer deaths in the United States in 2018."

More information about mortality rates can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

New chemotherapy plan echoes AIDS deal

2 major drug manufacturers slash prices to help fight cancer in six poor African countries

In a deal similar to the one that turned the tide against AIDS, manufacturers and charities will make chemotherapy drugs available at steep discounts, according to a recent story by Donald G. McNeil Jr. in The New York Times.

Two major pharmaceutical companies —  Pfizer and Cipla, based respectively in New York and Mumbai— are working with the American Cancer Society to make it happen, the story indicates. 

They've apparently agreed to charge "rock-bottom prices for 16 common chemotherapy drugs," McNeil's piece says — "just above…manufacturing costs."

As an add-on, top American oncologists plan to "simplify complex cancer-treatment guidelines for under-equipped African hospitals, and a corps of IBM programmers will build those guidelines into an online tool available to any oncologist with an internet connection," the story continues.

Dr. Anthony S. Fauci

The piece also quotes Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, that "this gave me goose bumps. I think this is a phenomenal idea, and I think it has a good chance of working."

Fauci said it reminded him "of his work in 2002 helping design the President's Emergency Plan for AIDS Relief" — a plan that's been successful (24 million Africans are currently on HIV drugs).

Cancer, the story says, "now kills about 450,000 Africans a year. By 2030, it will kill almost 1 million annually, the World Health Organization predicts." 

Most common African cancers, it continues, "are the most treatable, including breast, cervical and prostate tumors."

But in contrast to the United States, where 90 percent of women with breast cancer survive at least five years, in Uganda, "only 46 percent do; in Gambia, a mere 12 percent,"  McNeil's story asserts.

One major African problem is that there are few cancer specialists. 

For example, in Ethiopia, one of the six countries that will be covered by the new agreement, there are "only four oncologists for its 100 million citizens," according to the Times piece. "Nigeria has about 40 for its population for 186 million."

Uganda has only 16 oncologists "and its only radiotherapy machine…has been broken for over a year. Before its 21-year-old gears gave out, the machine's cobalt source had become so week that irradiation sessions meant to last minutes took an hour."

Caution about how well the program will work is being urged.

According to McNeil's story, "even with cheaper drugs, progress against cancer in Africa will be slower than it was against AIDS, all parties to the deal warned" — partially because cancer "comprises an entire family of diseases," unlike AIDS, which "is caused by a single pathogen that can be suppressed, albeit not cured, with a daily three-drug pill."

More information on cancer drugs and treatments can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

24% dip in the disease's recurrence is possible

Exercise can help breast cancer patients diminish risks and bolster their quality of life

Exercise is hardly a cure-all for breast cancer.

But it can help.

Stacy Simon

According to an American Cancer Society story by senior editor Stacy Simon that I just found on the cancer.org website, exercise "is not only safe and possible during and after breast cancer treatment, but it also can reduce symptoms and improve quality of life."

The ACS article states that studies have shown "certain kinds of exercise appear to help breast cancer survivors at high risk for arm, breast and chest swelling (lymphedema) avoid the condition."

The studies have also shown that "some types of exercise can improve symptoms" for those who already have breast cancer.

And, as might be expected, that regular exercise "significantly improves physical functioning and reduces fatigue."

Perhaps most important is that Simon's piece notes, too, that physical activity "has also been linked to a 24% decrease in breast cancer coming back, and a 34% decrease in breast cancer deaths."

Her story cautions, however, that women should first check with their doctors to determine the exercise best suited for them (and to ensure their safety) — and then, after surgery, to wait to heal properly before starting a physical regimen.

The ACS story also lists possible exercise benefits as strengthening of muscles (or, at least, lessening muscle deterioration), heightening self-esteem and lowering anxiety and depression risk, and, finally, helping to control weight — "itself a risk factor for breast cancer recurrence."

Details about the healing process can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

You can learn about radiation, lumps, self-exams

Kansas City newspaper debunks seven popular myths about mammograms, breast cancer 

Lisa Gutierrez

Ignorance about breast health can can be fatal.

But it's now questionable if determining whether obtaining information via mammograms is the most intelligent way.

The American Cancer Society recently issued new guidelines that urged most women to get mammograms yearly only between the ages of 45 and 54. Other groups, however, still recommend starting them at 40.

Virtually all organizations have hedged their bets by insisting that testing be voluntary, meaning woman still can choose to have mammograms earlier or more often. 

No matter what, consultations with physicians are strongly advocated.

According to a recent story by Lisa Gutierrez in the Kansas City Star, there are at least seven popular misconceptions — or myths — about breast health. They are:

Myth No. 1: "Annual mammograms increase your risk of cancer because of the radiation they use."

Fact: The amount typically used is low and safe. Older machines that used higher amounts have been discontinued.

Myth 2: A negative mammogram means you're safe.

Fact: Tests fail to detect from 10 to 20 percent of breast cancers. 

Myth 3: Lumps always mean cancer.

Fact: About 80 percent of breast lumps are benign.

Myth 4: Your self-exam showed no lumps so you must be safe.

Fact: Breast cancer can present itself in other ways. Good breast health means routine checking for pain or nipple tenderness, changes in how breasts feel and look, lumps or thickening near a breast or in the underarm area, red or swollen skin on a breast, a breast that feels warm to the touch, and nipple discharge.

Myth 5: Small breasts mean no cancer.

Fact: Size means nothing. But larger breasts can be harder to examine and might be less comfortable with the mammogram procedure.

Myth 6: Men don't get breast cancer.

Fact: Wrong. More than 2,000 males are diagnosed with the disease each year.

Myth 7: Coffee, antiperspirants, underwire bras and chemical hair straighteners cause cancer.

Fact: None of them have been proved to be causal. Some research, in fact, shows coffee can lower your risk.

To read about other myths and facts concerning the disease, check out "Rollercoaster: How a man can survive his partner's breast cancer," the VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Mortality disparity up between blacks and whites

Breast cancer incidence among African-American women in U.S. jumps to a new high

Blacks have lower mammogram follow-up rate.

A new study says breast cancer incidence among African-American women in the United States has equaled whites, according to a story by Tara Parker-Hope in The New York Times.

That's bad news because it's been less common (although deadlier) in the past.

The report, from the American Cancer Society (ACS), showed "that advances in diagnosis and treatment that have dramatically improved survival rates from breast cancer and saved countless lives [in whites] have largely bypassed African-American women."

Over all, Parker-Hope's Well blog in the Times said, "a black woman given a breast cancer diagnosis is 42 percent more likely to die from the disease than a white woman with breast cancer."

It also noted that in some major U.S. cities, according to an analysis published last year in "Cancer Epidemiology," the rate is even worse. In Los Angeles, for example, a black woman is "70 percent more likely to die," and in Memphis the risk rate is double that of a white woman.  

Why the disparity?

Black women, the report said, are more likely than white women "to be given a diagnosis with later stage, and less treatable tumors" — and twice as likely as whites "to be found to have an aggressive form of the disease called triple negative breast cancer, which has a poorer prognosis."

According to the Times, "researchers say…rising obesity rates among African-American women may explain some" of the jump — in contrast with a stabilized rate of 33 percent for Caucasians.

Obesity has been connected to a larger "risk of estrogen-receptor positive breast cancers," the type of tumor now being found more in black women, the Parker-Hope piece indicated.

The obesity rate in blacks leapt from 39 percent between 1999 and 2002 to 58 percent from 2009 to 2012.

But other reasons for "the racial divide in breast cancer mortality may be due to…disparities in the quality of care available to black women, who may have less access to quality screen and treatment."

Carol E. DeSantis

In addition, "lower rates of follow-up after a mammogram, cultural distrust of doctors, and lack of insurance coverage among black women may also play a role," Parker-Hope writes.

The Times writer quotes Carol E. DeSantis, senior epidemiologist at the ACS and lead author of the report, as predicting "the widening mortality disparity is likely to continue."

Comparisons between different groups of women can be found in the VitalityPress book I aimed at male caregivers, "Rollercoaster: How a man can survive his partner's breast cancer."

Screenings urged at age 45 rather than 40

American Cancer Society suggests women start getting mammograms at a later age

Mammograms: At what age to begin?

The American Cancer Society has done an about-face on mammogram screenings by recommending women get less testing.

In new guidelines released Oct. 20, the ACS, the nation's largest cancer charity and previously the main advocate for those screenings, said women at average risk of breast cancer should begin yearly screenings at age 45.

That's "five years later than it had previously recommended," the Associated Press noted.

By age 55,  the AP paraphrased the new guidelines, because the cancers "tend to grow more slowly after menopause," women should be screened only every other year if they're healthy and expect to live another 10 years. 

That conclusion stems from the notion that if women have a life expectancy of less than a decade, they're then apt to die with breast cancer, not from it.

Breast screenings: Still controversial.

If adopted as policy in the United States, the new practice would result in a major shift from the aggressive screenings that had been standard since the 1990s.

The action puts the ACS more in line with many other organizations (excluding the American College of Radiology, which still suggests starting at age 40). 

According to The New York Times, the National Comprehensive Cancer Network, an alliance of prominent cancer centers, all "recommends mammograms every year starting at age 40" — and the America College of Obstetricians and Gynecologists suggests them every year or two from age 40 to 50 and every other year after that.

As the cliché goes, ya pays yer money and takes yer choice.

But some skeptics, including me, think the medical profession is being unduly lobbied and influenced by big insurance companies that simply don't want to pay for the tests.

Those advocating the later start maintain, however, that the chief reasons are women's changing risk as they age and a growing concern some mammograms may produce more harm than benefit (because of "false positive" results that could lad to unnecessary follow-up tests, including invasive biopsies).

Still, according to the AP story, mammograms actually "reduce the risk of dying from breast cancer by as little as 15 percent to as much as 40 percent."

Another oft-cited issue is over-diagnosis, when screenings find slow-growing cancers that may never imperil life but still may lead to doctors choosing surgery, radiation or other treatments the patients really don't require.

Although some studies claim up the 50 percent of breast cancers don't need to be treated, the ACS has said in the past that the actual number is only between 1 and 10 percent.

The new guidelines, which have reignited debates over the testing, only take into account women of average risk, not those with family histories of the disease or genetic mutations.

In 2009, the U.S. Preventive Services Task Force had decided that women could wait until 50 to start routine mammograms — and then get them every other year.

The newest guidelines also suggest that "doctors no longer need to perform breast exams during women's checkups, since these exams have not been shown to save lives" — yet another ACS change in policy.

Those six-minute examinations, according to the latest flip-flopped medical consensus, simply don't accomplish much.

The latest American Cancer Society guidelines were published online in JAMA, formerly the "Journal of the American Medical Association," sharply contrasting with public ACS opinions as recently as 1992 that urged women to get a "baseline mammogram" between the ages of 35 and 39 so physicians could compare later screening results.

The constant flip-flopping of researchers, physicians and, in fact, the entire cancer industry is detailed in the book I, Woody Weingarten, aimed at male caregivers, "Rollercoaster: How a man can survive his partner's breast cancer."