Trends in Cancer Survival Rate

(9/2/06)- Recently, we have had a number of individuals ask us about survival rates in patients with various types of cancer. After explaining how much variance exists in the data around this subject and the criteria used to evaluate the changes that were occurring, we based our answer on a paper that appeared in the Journal of Internal Medicine (2006; 260:103-117) written by PW Dickman and HO Adami of the Karolinski Institute, Stockholm Sweden, from which the following information was abstracted.

The good news is the survival rates for breast cancer "have improved gradually, but importantly over several decades. The main contribution comes from early diagnosis by means of mammography screening and from widespread use of systematic adjuvant treatment with chemotherapy, anti-estrogen or both".

The same would seem true for rectal cancer survival rates. This real progress appears due to improved surgical technique and from preoperative radiotherapy.

For prostate cancer, "there is no empirical evidence for any true underlying upward trend in prostate cancer incidence, [yet] the annual number of newly diagnosed cases has almost doubled in little more than a decade in the United States of America".

The bad news is that there appears to be a lack of therapeutic progress for lung and pancreatic cancer. "Amongst lung cancer patients, the 5-year relative survival remained virtually horizontal while the mortality rate closely mimicked the incidence rate". This is despite the proven relationship between smoking and lung cancer and all the money poured into educating the public about this relationship.

The survival rate for pancreatic cancer is even more elusive. It is less preventable as opposed to lung cancer. It is surgically less accessible and metastasizes rather early, making for elusive curative treatment. Dickman and Adami indicate: "Over a 25-year period, 5-year relative survival varied little around 5%".

As scientists begin to understand more about the underlying process of tumor growth and the etiology of the pathological dynamics, we can begin to see trends that show more positive survival rates. They are beginning to apply the detailed recognition and processing of clinically useful therapeutic agents to the treatment of cancer.

They are designing better ways to deliver drugs, particularly drugs based on proteins to their specific target. For example, by discovering that tumor cells tend to express more folate receptors than normal cells, they can start developing anticancer dendrimers -a polymer in which the atoms are arranged in many branches and subbranches along a central backbone of carbon atoms (Also called cascade molecule)- in which targeting is achieved through covalent addition of folic acid.


Harold Rubin, MS, ABD, CRC, Guest Lecturer
September 2, 2006

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