Early Cancer Detection

This blog entry is not about me, it is about cancer in general. I came across a fascinating article in the online version of Wall Street Journal yesterday (10/08/07) on lung cancer. The online address for this article is…

http://blogs.wsj.com/health/2007/10/08/tangled-web-of-conficts-over-lung-cancer-screening/

Here’s the article’s paragraph that caught my attention…

In a study published in the New England Journal of Medicine last year, the Cornell group reported that CT screening of more than 30,000 smokers discovered first-stage lung cancer in 412 of them. Of those, all but eight received some kind of treatment. The overall survival rate for those found to have early stage cancer was 88% after 10 years. The eight patients who declined treatment all died within five years of diagnosis. Currently, the five-year survival rate for lung cancer is just 16%, mainly because the disease is often detected too late for treatment to work. That article concluded by noting “no potential conflict of interest relevant to this article was reported.”

Please stop and think about this for a just a minute. If this study had statistics that gave mortality rates after 10 years, then the study was over ten years old. It is not a recent study. 88% of the people with early detection were still alive after 10 years. That means that 12% of the people died who had been treated. The mortality rate table for people aged 45 – 55 is a little over 4%. I could have picked a younger or higher age group (which had a lower and higher mortality age rate respectively), but I choose one which seemed reasonable for smokers. That means that only 8% (12% - 4%) more of this population died than those published in current mortality tables. This is compared to 100% of the population that died (8 people) within 5 years without treatment. The 8% also compares to 84% of people who die within 5 years from this disease. That, my friend, is a huge difference! It begs more questions. Compared to a CT scan, treating cancer is a very expensive proposition. So, why isn’t this being employed as a way to avoid the cost of treating a deadly disease and eliminating the suffering of cancer patients? I may dig into the cost a bit more and if I do I’ll report the findings in this blog. If early detection in lung cancer is the silver bullet for lung cancer, could it also be the silver bullet for Head and Neck cancer?

A study published in mid-April of this year (2007) showed a 90% success rate in detecting H&N cancer with the analysis of a simple mouth rinse before any physical signs of H&N cancer were present. It also estimated a dramatic increase in survival rates for those detected early with the disease. Those finding were written up in the following article…

http://www.medscape.com/viewarticle/555283

Another H&N cancer article references the negligible progress made in the 5 year survival rate of H&N cancers over the past few decades and further highlights the physical and emotional distress of those with this disease…

http://www.oralcancerfoundation.org/dental/screening.htm

Again, this raises further questions. With 34,000 people in the US diagnosed with H&N cancer annually and 8,000 deaths per year from this disease, how long will it be before this oral rinse analysis becomes part of the annual or bi-annual screening process, much like breast and prostrate screenings are today? This is too late in my case, but I can tell you, an extra few minutes doing a mouth rinse test during my periodic physical exams could have saved 100s of thousands of dollars in treatment cost, 100s of thousands of dollars in lost productivity, and avoided severe pain and suffering that goes beyond myself, but affects all those that are close to me. Yea, it would have been worth it.

In summary, why can’t we look at early detection like we look at the elimination of polio? We rarely treat people with polio today. It is practically non-existent in the US. I know this raises other questions. For example, who pays for this early detection? Are the above articles accurate in their finding? I for one will be following this train of thought and once again, as new conclusions are reached, I’ll be sharing them in this blog.

Your thoughts on this subject are welcomed. Thanks for listening.