Despite drop in cancer death rates, docs worry about continued high numbers among Blacks

A new study indicates that, despite a drop, cancer deaths in Black people remain higher than those of every other category.

Lindsey Tanner's recent Associated Press story notes that the death rates among Blacks have steadily declined — as they have for all Americans for the past two decades — apparently because of lower smoking rates and advances in early detection and treatment.

But the continued high rates among Blacks remain a concern. 

Wayne Lawrence

Those rates, according to the AP article that quotes National Cancer Institute researcher Wayne Lawrence, who led the study published online in "JAMA Oncology," likely reflect "social and economic disparities including poverty, less access to care and mistrust of doctors." 

Carla Williams, a Ph.D. and a Howard University expert in cancer-related health disparities, who had no role in the research, also was quote regarding the finding: "It's showing that we simply can't rely on medical care as a way to address and eliminate the disparities."

Tanner's article also says "an earlier report from the American Cancer Society found the racial gap was narrowing mostly because of a bigger decline" in smoking. The largest dips, it postulates, "were in lung cancer among Black men and stomach cancer in Black women."

The piece cites the following data: "Rates among Black people fell each year from 1999 to 2019, from 359 cancer deaths per 100,000 to 239 deaths per 100,000, according to the report."

The rates, however, are "almost double the lowest rate in Asian Americans and Pacific Islanders."

Carla Williams, Ph.D.

Cancer prevention expert Dr. Otis Brawley of Johns Hopkins University is quoted by the the story as saying, "Other data show Black Americans get worse cancer care than White people. That's in part because they're more likely to be treated at hospitals with overworked doctors and fewer resources, and less likely to have a college degree."

Why the emphasis on a college degree? Because, the AP story quotes Brawley again, "evidence suggests that people with college degrees are more likely to exercise, not be obese, and to seek medical care when they notice changes that could signal cancer."'

More information about racial inequities and disease 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.

Can laparoscopic surgery spread cancer cells?

New data shows less invasive operation causes more deaths for women with cervical cancer

In news that may appear counter-intuitive, two studies have shown a higher death rate for a less invasive version of a cancer operation in women.

According to a recent Associate Press story by Carla K. Johnson, the new evidence challenges standard practice "and the 'less is more' approach to treating cervical cancer."

The article notes that the unexpected findings already "are prompting changes at some hospitals that perform radical hysterectomies for early-stage disease."

Dr. Pedro Ramirez

Dr. Pedro Ramirez of the University of Texas MD Anderson Cancer Center in Houston, who led the more rigorous study, says that after the results became known "we immediately as a department changed our practice and changed completely to the open approach."

Findings from his study, which was conducted at more than 30 sites in a dozen countries and were published in the New England Journal of Medicine, showed "women who had the less invasive surgery were four times more likely to see their cancer return compared to women who had traditional surgery."

Dr. Jason Wright of New York-Presbyterian Hospital, a co-author of the other study, says "we're rethinking how we approach patients. There's a lot of surprise around these findings."

And Dr. Amanda Fader of Johns Hopkins Kimmel Cancer Center, explaining that the Baltimore hospital "has stopped doing less invasive hysterectomies for cervical cancer until there is more data," is quoted as saying the new research "is 'a great blow' to the [newer] technique and the findings are 'alarming.'"

Surgeons, she adds, ""should proceed cautiously."

In both studies, Johnson's story says, "researchers compared two methods for radical hysterectomy, an operation to remove the uterus, cervix and part of the vagina. The surgery cost around $9,000 to $12,000 with the minimally invasive version at the higher end."

Traditional surgery involves a cut in the lower abdomen; in the newer method, laparoscopic surgery, from which patients recover more rapidly, small incisions are made for a camera and instruments.

Some experts believe the reason for the higher death rate is because "there may be something about the tools or technique that spreads the cancer cells from the tumor to the abdominal cavity," AP's article reports.

More information on research into cancer for both men and women 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.