Cancer cases declining at the same time treatments improving

by Becky Gillette

Published: April 21,2008

There is good news on the cancer front. As cancer treatments become more sophisticated and effective, the survival rate is increasing.

Since the 1990s, the survival rate from cancer has increased by 1% to 2% per year, said Dr. Bert Duncan, a radiation oncologist with the North Mississippi Medical Center (NMMC), Tupelo. Another piece of good news is that cancer rates are falling.

“According to the American Cancer Society, the estimated number of new cancer cases has decreased by 2,650 from 2006 to 2007 in Mississippi,” Duncan said. “This means we are screening, and educating people about better prevention methods. And, the public is taking notice.”

Advances in radiation oncology treatment include new targeted chemotherapy applications that target specific cells, IMRT (intensity modulated radiation therapy) and image guided therapy (IGRT).

“Together with surgeries, these have made the treatment of cancer much better for the patient as it is more sparing of tissue/organs and is not as toxic,” Duncan said. “And it is able to target the appropriate tumor cells that need to be dealt with and eliminated.”

For many years, cancer patients have left the state to get treatment. But, Mississippi hospitals have technology that is up-to-date and state-of-the-art. Duncan said radiation oncology at NMMC and other hospitals in major urban areas of the state rivals anything that can be found at M.D. Anderson or the University of Alabama at Birmingham.

“Patients in Mississippi have access to national clinical trials just like others across the U.S.,” Duncan said.

Dr. Ralph B. Vance Sr., a professor of medicine, Division of Medical Oncology, University of Mississippi Medical Center (UMC), said in the past 30 years there have been tremendous advances in cancer treatments. In 1978, the five-year survival rate for cancer was in the mid-30’s. Now, two-thirds of people with cancer are surviving more than five years.

“We are now having less side effects with chemotherapy agents and radiotherapy,” said Vance, who was national president of the American Cancer Society in 2003-2004. “We used to be limited because people couldn’t stand the side effects, so we couldn’t give them enough therapy to make a difference. But, now we can give it and it is more targeted. It used to be more of a shotgun approach. While we were trying to get tumor cells, we were also damaging normal cells. Now instead of a shotgun, it is more like a rifle. We can better target the defects, and then be more specific in our therapy.”

One example of improvements is with lung cancer. Thirty years ago, 95% of people with lung cancer died. Now, doctors are getting a treatment response on approximately 70% of people with lung cancer and increased survival rates.

Weapons in the war on cancer now include not just chemotherapy, but also different types of tumor growth inhibitors including techniques to cut off the blood supply to the tumor. There are also vaccines for tumors.

“These are things that we had no knowledge about 30 years ago,” Vance said. “Basic research and clinical trials have led us to now have more avenues for beating the cancer.”

UMC participates in several nationwide clinical cancer groups that allow doctors to register their patients to be enrolled in clinical trails to ascertain if new drugs and therapies work better than older state-of-the-art therapies. The trials are the Children’s Oncology Group, Gynecologic Oncology Group and the Southwest Oncology Group (which includes areas outside of the Southwest). Additional studies are available through the Cancer Trials Support Unit (CTSU).

Vance said that pediatric cancer patients are registered in clinical trails greater than 90% of the time. But, less than 10% of adults are registered in clinical trials. Vance said he wishes they could get more adults to register for the clinical trials.

“It is just more difficult to get people as adults to consent,” Vance said. “Pediatricians started making huge headway in leukemia and other childhood cancers, so it became something parents wanted. For adults, this has not been the case. They may prefer to get cancer treatments at hospitals close to home where they have family and friends to support them rather than traveling to a larger medical center to get enrolled in the clinical trials.”

Dr. Robert “Buster” Mobley, executive vice president of medical affairs and quality, St. Dominic-Jackson Memorial Hospital, said the field of oncology has seen tremendous changes in how cancer is diagnosed and treated, with advances in diagnostic imaging, radiation technology and chemotherapeutic drugs, early diagnosis, more precise treatment and improved life expectancy of patients.

“The goal of hospital officials in 1988 was simply to offer the best cancer treatment available at that time,” said Mobley. “St. Dominic’s Cancer Center has proven to be highly successful, both in the number of patients treated and their outcomes, but I firmly believe that it is still in its infancy in terms of ultimate potential related to exemplary cancer treatment. We’re on the cutting edge in introducing new technologies and treatment options to the community.”

St. Dominic-Jackson Memorial Hospital’s Cancer Center, which recently celebrated its 10th anniversary, has brought many cutting edge treatment modalities to the Central Mississippi area. Mobley said the center was the first in the state to implement Varian’s Dynamic Targeting IGRT, which heightens accuracy by conducting daily imaging to pinpoint the tumor just prior to treatment. The hospital is also a leader in IMRT, which conforms radiation as closely as possible to tumor shape.

St. Dominic’s also makes a strong effort to provide a holistic treatment by treating the mental, emotional and spiritual aspects of cancer. The center offers a wide range of support services to help patients and their caregivers including St. Dominic’s Camp Bluebird, the area’s only adult cancer camp. Other unique clinical programming includes lymphedema therapy, palliative care, oncology education and patient navigation. In addition, the center offers the services of a dedicated on-site dietician, social worker and pastoral care provider.

A promising new type of cancer treatment is getting a lot of attention, said Kelly Lindsay, communications and marketing director for the Mississippi American Cancer Society in Jackson. The CBS News show “60 Minutes” aired a segment April 13 on inventor and cancer patient John Kanzius, whose invention uses radio waves and nanotubes to kill cancer cells in animal and test tube experiments.

Lindsay said the treatment that uses nanotechnology to deliver therapies to cancer cells before they form large tumors is an exciting approach. An article in the March/April issue of the American Cancer Society’s peer-review journal, CA: A Cancer Journal for Clinicians, said doctors already use local radiofrequency ablation to treat metastatic cancer tumors, especially in the liver.

The article said that while having the ability to target microscopic cancer cells throughout the body while avoiding normal cells would be a major scientific accomplishment, it is also likely one of the biggest hurdles in turning this technique from theory into practice.

Contact MBJ contributing writer Becky Gillette at 4becky@cox.net.

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