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Understanding the Nexus of Aging and the Increase in Cancer Risk

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As Americas’ Greatest Generation continue to age studies are revealing that with the increase in the age of the population comes an increase in cancer risk. The nexus of age and cancer is supported by National Cancer Institute (NCI) research. The convergence of an overall aging population and a peak cancer incidence among those aged 65 to 74 will result in a significant rise in the number of people diagnosed with cancer. In addition, as people age the types of treatments and the eligibility and ability for older patients to participate in clinical trials diminishes.

According to the most recent statistical data from NCI’s Surveillance, Epidemiology, and End Results program, the median age of a cancer diagnosis is 66 years. The median age at diagnosis is 61 years for breast cancer, 68 years for colorectal cancer, 70 years for lung cancer, and 66 years for prostate cancer.

Healthcare professionals treating older cancer patients often discover other health conditions that may limit the use of specific therapies. Unless there is sufficient evidence that older patients can benefit from standard dosage of some therapies, clinicians can be reluctant to give older patients potentially beneficial treatments. This practice of less intensive therapy in aging patients is historically understandable; however, a growing field of geriatric oncologists now consider chronological age insufficient evidence for denying aggressive cancer therapy.

The solution to this aging dilemma, like the disease, is complex and we need to better understand how the biological underpinnings of aging affect the onset and trajectory of cancer. Reasons for this increase of cancer with aging can be contributed to the fact that living longer increases our exposure to things that have been shown to be contributing factors in determining cancer risk, such as exposure to sunlight, radiation, environmental toxins and noxious by-products of metabolism that increase with age. “Most aging cells develop genomic changes that make them more susceptible to the carcinogens in the environment,” says oncologist Lodovico Balducci, who studies and treats cancer in the elderly at the Moffitt Cancer Center in Tampa, Fla. In addition, the various immune defenses that keep our tissues healthy begin to break down with age.

Some of the more serious health conditions that are more common in adults over 65 that may impact the response to a cancer diagnosis include; high blood pressure, heart disease, lung disease, diabetes, kidney disease and arthritis. These co-existing conditions must be taken into account when designing cancer treatment protocols for older patients. For those older patients with cancer, knowing how treatments will be affected by these contributing factors is important to understanding how to respond to the process of therapy.

But progress towards better understanding is underway. A joint collaborative effort with the National Institute on Aging (NIA) and the Samuel Waxman Cancer Research Foundation is underway which will promote and support interdisciplinary research projects, sharing of resources, and development of new technologies and approaches to better understand how the physiological changes associated with aging affect cancer development, progression, and response to therapy. NCI is also committing more resources aimed to increase enrollment for older patients in clinical trials.

Cigarette Smoking a Leading Cause of Preventable Death in United States

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On the last Sunday in November 2017, television viewers and print media readers experienced a dramatic moment that continues into this year. The three major U.S. tobacco companies were ordered by the Federal Drug Administration (FDA) to issue the first in what will be a series of five “corrective statements” about their products. The corrective statements are the result of a federal racketeering lawsuit brought against the tobacco companies in 1999 by the Department of Justice. These court-ordered statements, which cover five different topic areas, explain in detail and in plain language the reality of the health harms inflicted by tobacco products upon users. Not that the harmful effects of cigarette smoking on a smoker’s health is anything new. Since the 1960’s, smokers and non-smokers alike have been bombarded with packaging warnings, public awareness campaigns and tobacco advertising bans. In case someone missed the multitude of discussions, the new statements should leave little doubt about the dangers of smoking tobacco.

Cigarette smoking is the leading cause of preventable death in the United States, causing nearly 30 percent of cancer deaths across the country. Of the more than 7,000 chemicals in tobacco smoke, at least 250 are known to be harmful, including hydrogen cyanide, carbon monoxide, and ammonia. Among those, at least 69 can cause cancer. While we are all aware that smoking causes cancer, smoking also harms nearly every bodily organ and organ system in the body and diminishes a person’s overall health. Among the cancers caused are: lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum, as well as acute myeloid leukemia. Smoking also causes heart disease, stroke, aortic aneurysm, chronic obstructive pulmonary disease (COPD) (chronic bronchitis and emphysema), diabetes, osteoporosis, rheumatoid arthritis, age-related macular degeneration, and cataracts, and worsens asthma symptoms in adults. There is no safe level of smoking. Smoking even just one cigarette per day over a lifetime can cause smoking-related cancers and premature death.

Despite all the good reasons to quit, kicking the smoking habit is extremely difficult. Studies show that most smokers picked up the habit as a teenager. Cigarettes contain various amounts of Nicotine, the highly addictive drug primarily responsible for a person’s addiction to tobacco products, so quitting can be very difficult even for those already diagnosed with cancer. A study by American Cancer Society researchers found that about 1 in 10 cancer survivors still reports smoking about 9 years after a cancer diagnosis. Lead author Lee Westmaas, PhD, American Cancer Society Director of Tobacco Control Research, says, “Doctors and health care providers must continue to ask survivors about their smoking and provide resources, including medications and counseling, to help them quit.”

Cessation has immediate benefits to a smoker. Ex-smokers suffer from fewer illnesses, lower rates of pneumonia and are healthier overall than people who continue to smoke. Regardless of age, smokers can substantially reduce their risk of bad health. Smokers who quit before age 40 reduce their chance of dying prematurely from smoking-related diseases by about 90%, and the reduction for those who quit by age 45-54 is about two-thirds.

The National Cancer Institute (NCI) and other agencies and organizations can help smokers quit. For more information on organizations that can help you quit smoking, contact the NCI Smoking Quitline at 1–877–44U–QUIT (1–877–448–7848) for individualized counseling, printed information, and referrals to other sources.

Cancer Mortality Rates Continue to Decline in The U.S.

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Continuing a positive trend for the last two decades, cancer death rates declined again last year. According to annual statistics reported from the American Cancer Society, the cancer death rate for men and women combined has fallen 26% from its peak in 1991. This decline translates to nearly 2.4 million deaths averted during this time period.

“Cancer Statistics, 2018,” was published in the American Cancer Society’s journal CA: A Cancer Journal for Clinicians. The information is also available in a companion report, Cancer Facts and Figures 2018, and on a website, the Cancer Statistics Center. Although cancer death rates continue to decline, a total of 1,735,350 new cancer cases and 609,640 deaths from cancer are projected to occur in the US in 2018.

The decline is mostly due to steady reductions in smoking and advances in early detection and treatment. “This new report reiterates where cancer control efforts have worked, particularly the impact of tobacco control,” said Otis W. Brawley, M.D., chief medical officer of the American Cancer Society. “A decline in consumption of cigarettes is credited with being the most important factor in the drop in cancer death rates. Strikingly though, tobacco remains by far the leading cause of cancer deaths today, responsible for nearly 3 in 10 cancer deaths.”

Lung, breast, prostate, and colorectal cancers are leading the way in lower death rates. Lung cancer death rates declined 45% from 1990 to 2015 among men and 19% from 2002 to 2015 among women. Early detection of breast cancer resulted in a 39 percent decline in death rates in women for the same period. Prostate and colorectal cancer experienced a 52 percent reduction between 1970 and 2015, primarily due to increased routine screening.

According to the report, the reduction in death rates is not equal across all ethnic, racial and social economic classes of population. The rates of new cancer occurrence are generally highest among African Americans and lowest for Asian Americans.

Cancer remains the second most common cause of death among children ages 1 to 14 in the U.S. Leukemia accounts for almost a third of all childhood cancers, followed by brain and other nervous system tumors. While child death rates due to cancer have continuously declined since 1975, cancer incidence rates increased in children and adolescents by 0.6% per year for the same period.

The report also reveals that the lifetime probability of being diagnosed with cancer is 39.7% for men and 37.6% for women. The most common cancers to be diagnosed in men are prostate, lung, and colorectal cancers. The most common cancers to be diagnosed in women are breast, lung, and colorectal cancers. Breast cancer accounts for 30% of all new cancer diagnoses in women. Liver cancer incidence continues to increase rapidly in women, but appears to be stabilizing in men.

The good news is particularly rewarding to the professionals at Gettysburg Cancer Center where their understanding of cancer and how to treat it is constantly evolving toward the day when they have a cure. Testing new procedures for identifying and diagnosing certain diseases and conditions, finding ways to prevent certain diseases or conditions before they have a chance to develop, and exploring new methods of supportive care for patients with chronic diseases are at the core of the ongoing clinical trials at the Center.

The Resulting Dread of Cancer Survival

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One of the most prolific progressions in research and development over the past decade has been the discovery and development of new treatments and drugs for cancer, for good reason. According to National Cancer Institute (NCI) statistics, cancer has a major impact on our society, both in the United States and around the world.  In 2016, an estimated 1,685,210 new cases of cancer were diagnosed in the United States and 595,690 people died from the disease. Nearly 39.6% of men and women will be diagnosed with cancer at some point during their lifetimes. It is rare to find anyone who has not dealt with the dreaded disease personally or had a family member or acquaintance suffer from one type or another of cancer.

To answer the call for action in defeating the disease, researchers, oncologist and drug companies have turned-up the pace of research and discovery. Over the past 5 years, 68 new cancer drugs have been approved for various cancers, many producing significant improvement in outcomes for patients. In just the last ten years, drug developers and regulators have successfully shortened the R&D path for approving new cancer drugs safely and efficiently. The global market for cancer immunotherapies, cancer drugs that enlist the body’s immune system to improve patient survival rates, are expected to grow more than fourfold globally by 2022. The number of new drugs in the cancer pipeline has swelled by 45% over the past decade alone.

With the increased activity and availability of promising new therapies for the masses suffering from cancer, one would expect that a downward trend in costs would be a positive result of the new competitive environment. But increased competition and quicker access to market is not producing the expected. In previous decades, new drugs might cost around $10,000 for a year’s treatment. However, according to one recent study, today’s newly approved cancer drugs can cost a patient a staggering $120,000 to $170,000 per year.

The result of this revolution appears to come at a high cost for patients. In the past decade patients paid just 5% of healthcare provider revenue. Today the shifting responsibility to patients for these costs has risen to 35%, and the trend is expected to continue as employers continue to transfer the high cost of healthcare insurance to their employees, the trend to higher insurance deductibles and rising operating and regulatory costs. The result is that too many Americans are struggling to afford the care. Many healthcare consumers are avoiding or delaying needed care or abandoning treatment because of concerns about their ability to pay.

In a system where the patient first learns of the price of their treatment after it has been rendered, many are shocked at the staggering high price and confused and amazed by a complicated and convoluted system of service codes and the seemingly unending list of often unseen providers.  The euphoria and promise of this revolution of discovery is leading many to dread the unfathomable price of recovery and survival.

Gettysburg Cancer Center takes pride in seeking alternative financial resources that can assist its patients in managing the costs of their cancer treatment. To learn more, please contact: Erin or Kasey by calling 717.334.4033 or visiting the website at http://gettysburgcancercenter.com/patients/patient-assistance/.

Cancer of the Vallecula Can be Difficult to Treat

The Vallecula is an anatomic term for a crevice, furrow or depression and while several vallecula can be located in several areas of the body the term is most commonly used to describe a depression just behind the root of the tongue between the folds in the throat. Cancers involving the vallecula are classified as oropharyngeal cancers.

When David Magee was diagnosed with cancer of the vallecula in March 2016, he learned that his cancer was particularly difficult to treat, given the close proximity of the vallecula to the base of the tongue and voice box. “I was particularly nervous going into it (treatment) for that reason, says David. Early stage cancers of the oropharynx are generally treated with radiation therapy because of the difficulty of surgical access. Squamous cell carcinoma of the oral cavity and pharynx accounts for over 48,250 cases per year in the United States with approximately 9,575 deaths per year. Symptoms of head and neck cancers include: persistent pain, difficulty swallowing, voice changes, mouth sores, dry mouth, changes in appearance, and/or taste changes. Patients with a history of tobacco and alcohol use are at a high risk for these cancers.

David sought treatment at Gettysburg Cancer Center in Gettysburg Pennsylvania, a small town in the central part of the state famous for the great Civil War battle. “I have recommended others to come over here to this Cancer Center who may have sought treatment elsewhere at places like John Hopkins or Hershey Medical Center or places like that. People don’t always realize that there are places with this kind of expertise right here in Gettysburg.”

“No one has been more scared about the treatment process than I was…right away I was put at ease…I always felt that I was in great hands,” Said David. “I had thirty-five radiation treatments which were a little intimidating, but everything went well and I actually began to miss the people here when I was finished with my treatments.”

For David’s complete thoughts on his cancer and experience at the Gettysburg Cancer Center click on https://www.youtube.com/watch?v=yWe0x6PCwmQ.

The Value of a Second Opinion Provides Alternative Treatment to a Cancer Patient

When faced with a cancer diagnosis, it becomes critical to find the right oncology center that will provide the appropriate medical treatment and emotion support to fight the battle. One Gettysburg resident, when faced with a stage-4 cancer diagnosis, found the right support at Gettysburg Cancer Center (GCC), a growing comprehensive cancer center.

Greg Wale received an initial oncology evaluation and treatment at another local oncology center in Gettysburg, Pennsylvania. The diagnosis showed that cancerous tumors had grown to 4 and 5 inches in diameter and had migrated to the liver, bone, thyroid glands and colon. Greg was just 57 year’s old and was told by oncologists that he had little time to live. There simply were no treatment options for his advanced stage of cancer. The disease, he was informed, had just progressed too far.

“At that point,” Greg says, “I went home, very down about things”. After several weeks of distress and depression over the state of his situation, he drew upon his faith and was “spiritually lead” to the Gettysburg Cancer Center (GCC), just down the block from where he had previously received the bad news. It was here that the centers principle oncologist, Dr. Shah, sat down with Greg to review his case. “I felt very comfortable here where there was a lot of very concerned people with caring hearts,” recounts Greg.

He immediately felt the staff at GCC wanted to help and he sensed that things were going to be different in this place where everyone seemed like family. Dr. Shah and his expert team designed a plan to attack his disease and provide as much time as possible for Greg’s future. With no guarantees, the team embarked upon an individualized course of treatment. After a couple of months, new tests revealed that the progression of the disease appeared to be slowing. According to Greg, “None of us knows how much time we have but it looks like I’m going to have more of it than what was told to me when I was first diagnosed thanks to Dr. Shah and this facility.”

For more than 25 years, Gettysburg Cancer Center has been committed to providing cancer care in a community-based setting close to home. The all-encompassing oncology and hematology programs provide a complete range of diagnosis and treatment. “Here at Gettysburg Cancer Center we understand that each patient and their disease are unique, requiring different approaches to insure the best possible outcome for each patient. Our family of caring and educated staff strives to provide insightful, compassionate care to all of our patients.” says Dr. Shah.

In this case, the value of a second opinion meant a new treatment option and more time for this cancer patient. To view the full patient testimonial: https://www.youtube.com/watch?v=448eg4F_SEg&feature=youtu.be.