Early Detection: Catching Cancer When It's Curable - Hardcover

Ratner, Bruce; Bonislawski, Adam

Hardcover

ISBN 10: 1682193519 ISBN 13: 9781682193518

Verlag: OR Books, 2024

Inhaltsangabe

The Second-Leading Killer in the USA Shouldn’t Be This Deadly

Written by Bruce Ratner and Adam Bonislawski, ….

Catching cancer early remains the single best way to combat a disease that is the second-leading killer in both the US and worldwide. But the vast majority of resources in the fight against cancer are devoted to relatively ineffective late stage treatments. ‘Early Detection’ examines this important anomaly in an accessible and expertly researched survey.

In a co-authorship that brings together the passion and urgency of someone touched deeply by the experience of cancer with the knowledge of a skilled science writer, Ratner and Bonislawski narrate compelling case studies across a range of screening programs and different forms of cancer.

In this book, you’ll discover:

• Importance of Early Detection: Understand the critical role early detection plays in combating cancer and why it’s more effective than late-stage treatments.
• Expert Insights and Research: Gain knowledge from expertly researched information on various screening programs and the scientific principles behind them.
• Compelling Case Studies: See the personal and emotional side of cancer through stories that bring urgency and passion to the importance of early detection.
• Necessary Social Change: Understand the need for government and medical establishment support in expanding screening resources, particularly to economically disadvantaged and traditionally underserved communities.

Early detection remains our most powerful tool in the fight against cancer, offering hope and better futures for countless individuals.

Pick Up Your Own Copy to Learn How Together, We Can Save Lives with Early Cancer Detection!

Über diesen Titel

Über die Autorin bzw. den Autor

In his long career, Bruce Ratner served as New York City’s Commissioner of Consumer Affairs, an NYU law professor and the founder, chairman, and CEO of Forest City Ratner Companies, a major property developer. He led the economic revival of Downtown Brooklyn, built the Barclays Center arena, brought the Nets NBA basketball franchise to Brooklyn, and helped restore Times Square, including building The New York Times headquarters. For more than two decades, Mr. Ratner has applied his deep interest and background in the sciences by serving on the boards of Weill Cornell Medicine, the Memorial Sloan-Kettering Cancer Center and the Cold Spring Harbor Laboratory. He also founded the Michael D. Ratner Center for Early Detection of Cancer, in memory of his brother, to advance the cause of expanding the adoption of life-saving cancer screening and research into new diagnostic tests. Through the center, Mr. Ratner has promoted early detection testing for lung cancer, particularly in low income and underserved populations. Mr. Ratner is also Chairman of the Museum of Jewish Heritage – A Living Memorial to the Holocaust. He was founding chairman of the New York City Parks Foundation and, for a decade, served as chairman of the board at the Brooklyn Academy of Music.

Adam Bonislawskiis a science writer with more than 10 years of experience covering genomic and proteomic research and diagnostics development with a focus on cancer and early detection. His writing ranges widely over academic research, companies and technologies. The publications he writes for, GenomeWeb and 360Dx, are read by thousands of cancer researchers and doctors as well as a wide range of healthcare entrepreneurs and investors, and he has scientific and media contacts at many of the major cancer and academic research centers in the United States and Europe. In addition to his work as a science writer, Adam writes about business and real estate for the Wall Street Journal, New York Post, and Commercial Observer.

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From Chapter 1: No Way to Fight a War

On December 23, 1971, flanked by Christmas greenery and a set of gaudy yellow curtains, Richard Nixon stepped before some 130 scientists and legislators gathered in the White House dining room and announced the enactment of the National Cancer Act.

Neither the text of the bill nor the President’s remarks made any reference to a “war” on cancer, but that’s how the effort Nixon inaugurated that afternoon became known, and today we’re nearly six decades into the longest, albeit metaphorical, military engagement in United States history.

Which raises the question—how are we doing?

To be blunt, not so great. We’re fifty years in with no end in sight.

There are many reasons our battle against cancer has proceeded so haltingly, not the least of which is the basic fact that cancer is a devastating disease and exceedingly challenging to treat. It hasn’t helped, though, that from the very beginning we’ve fundamentally misplaced our priorities in fighting it.

Each year, the American Cancer Society publishes a report detailing cancer incidence and mortality trends. According to the organization’s most recent figures, the US cancer death rate peaked in 1991 and has declined since then by around 1.5 percent a year. All told, that amounts to a 32 percent drop, from 215 deaths per 100,000 people in 1991 to 146 deaths per 100,000 in 2019[i] (the last year for which data is available).

That’s respectable, if hardly stunning, progress. It’s been largely driven, however, by two things: a drop in smoking rates and the earlier detection of breast, prostate, and colorectal cancers. Take away those developments, and the cancer landscape looks very much like it did five decades ago.

A quick survey of survival statistics makes this clear. For example, from 1974 to 1985, 14 percent of patients diagnosed with late-stage colon cancer survived for five years or more[ii]. Three decades and billions of research dollars later, that figure hadn’t budged. Patients diagnosed between 2011 and 2017 (the most recent years for which data is available) still had a five-year survival of 14 percent[iii].

Just 1 percent of late-stage lung cancer patients diagnosed during the 1974 to 1985 window lived five years or more. By 2011 to 2017, that number had risen, but only to 8 percent.

For breast cancer, the figures are 19 percent and 29 percent[iv], respectively. The story is the same for prostate cancer. Five-year survival for late-stage patients was 30 percent between 1974 and 1985. It was 31 percent during the 2011 to 2017 span[v].

The converse is also true. Patients diagnosed with early-stage cancer had, and continue to have, relatively good five-year survival rates. Between 1974 and 1985, 84 percent of patients with localized colon cancer survived for five years or more. Between 2011 and 2017, 91 percent did. For breast cancer, the corresponding figures were 91 percent and 99 percent, respectively. For prostate they were 84 percent and 99 percent. For lung cancer they were 37 percent and 64 percent.

With a few exceptions like testicular cancer and certain leukemias and lymphomas, this pattern holds across the board and has for half a century. If you catch and treat your cancer early, your odds of survival are fairly good. If you find your cancer only after it has spread, you are probably going to die fairly soon.

The European Society for Medical Oncology (ESMO), a professional organization for cancer doctors, maintains what it calls its Magnitude of Clinical Benefit Scale[vi], a compilation of approved cancer drugs scored according to their effectiveness. The database is divided into two sections—one for drug-cancer combinations that are potentially curative and the other for those that aren’t expected to be curative but that could possibly extend a patient’s life. Of the 318 treatments regimes currently detailed in the database, just thirty-eight fit the first category. That means the other 280, roughly 90 percent of the list, offer not the possibility of a cure but only of somewhat longer survival.

Probably not for very much longer, though. Even for the most effective agents, survival gains are almost always measured in months, not years.

Take, for instance, the ESMO scale’s scoring of Merck’s immune checkpoint inhibitor Keytruda as a treatment for patients with advanced lung cancer. Checkpoint inhibitors work by inactivating proteins on the surface of cancer cells that let them hide from a patient’s immune system. By attacking these proteins, the drugs clear the way for the body’s own defenses to fight off the cancer.

Heavily hyped, these immunotherapies have on occasion actually lived up to expectations, with some late-stage patients experiencing miraculous responses. Perhaps the most famous case is that of President Jimmy Carter, who received Keytruda for metastatic melanoma and is alive and essentially cancer-free five years after his diagnosis. In 2018, MD Anderson Cancer Center researcher James P. Allison and Kyoto University’s Tasuku Honjo were jointly awarded the Nobel Prize in Physiology or Medicine for their work illuminating the science underpinning these drugs.

All of which is to say it’s perhaps unsurprising that the ESMO guide rates Keytruda a 5, the top score available, indicating a “very high benefit.” But what does that score actually mean? Another five years of life? Four years? Three?

Not even. According to the studies upon which the ESMO score is based, Keytruda offered the median patient an extra 11.7 months of overall survival compared with the previous standard of care, the chemotherapy docetaxel. Docetaxel by itself provided 14.2 months of overall survival. Add them together and you’re at almost thirty months total. That’s what the war on cancer’s most cutting edge weaponry gets you—about two and a half years[vii].

Most people, though, are in the dark about this situation. In 2012, a team led by doctors at Boston’s Dana-Farber Cancer Institute set out to learn how realistic late-stage cancer patients were about the effectiveness of chemotherapy. They surveyed 1,193 patients, 710 with stage IV lung cancer and 483 with stage IV colorectal cancer, asking them whether they thought chemotherapy might cure them. Like the majority of stage IV cancers, both diseases are almost invariably fatal, and yet 69 percent of lung cancer patients and 81 percent of colorectal cancer patients said they believed that chemotherapy offered them a chance of being cured[viii].

This sort of false hope is a shame, but it’s understandable. Most patients aren’t cancer experts, after all. Vastly more troublesome is the fact that a similar misapprehension has underpinned our entire cancer fighting strategy. Our successes have come overwhelmingly from improved prevention and early detection, but if you were to look at how we spend research dollars, you’d almost certainly come to the opposite conclusion.

Bert Vogelstein is one of the preeminent cancer biologists of our time. An oncologist at Johns Hopkins University in Baltimore, he was one of the first to characterize the role of certain genetic mutations in cancer development. Our fight against the disease has been “too focused on the idea of retaliation,” he said. “Cancers are only incurable once they have spread… and in the future we need to focus on detecting them before they have spread.”

Most common cancers take decades to develop, Vogelstein noted. “We have this huge window of opportunity… to intervene in that...

Details zur Ausgabe

• Verlag: OR Books
• Erscheinungsdatum: 2024
• Sprache: Englisch
• ISBN 10: 1682193519
• ISBN 13: 9781682193518
• Einband: Gebundene Ausgabe
• Anzahl der Seiten: 256
• Kontakt zum Hersteller: Nicht verfügbar
• Verantwortliche Person: Buchbär; info@buchbaer.de; ; Weberstr. 67; Osnabrück; 49084; Deutschland