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Doug Harris
908-994-5138
dharris@trinitas.org

Yolanda Fleming
908-994-5139
Yfleming@trinitas.org


CANCER: IT'S NO LONGER THE “C-WORD”
By Dr. Barry Levinson and Yolanda Navarra Fleming

Once upon a time cancer was an unlikely topic of casual conversation. But perspectives have changed, and euphemisms like the "C-word" serve no purpose in a world where the word cancer can be found in every aspect of the media.

The growing awareness partially stems from the result of great strides in technology and pharmacology made in recent years. Because of advancements in detection and the availability of safer, more effective treatments, cancer is no longer an inevitable death sentence. Thankfully, the terror once associated with the disease is being replaced by facts and, therefore, hope.

The National Cancer Institute reported 14 million new cases and 8.2 million cancer-related deaths worldwide in 2012, which is bad news. The good news is the overall death rate in the U.S. has dropped 13% from 2004-2013. Even so, people are still fearful of dying, and fearful of the treatments, and their toxicities.

The four major malignancies seen in the U.S. are considered solid cancers, including lung, breast, colon, and prostate cancer, which can be treated surgically, and often with radiation and chemotherapy as well. Hematologic cancers like leukemia, lymphoma, and myeloma, originate in the blood or bone marrow, and are typically treated with chemotherapy.

The oncologist's role is to communicate and discuss the honest goals and treatments to analyze the risk/benefit ratio of any specific therapy. Surgery and radiation are focused on specific locations of tumors. Lymph nodes, where cancer cells collect, can be removed to aid in diagnosis or to keep cancerous cells from spreading. Local regional surgery is often used in conjunction with chemotherapy, which travels through the bloodstream, or hormonal therapy, to eradicate the tumor throughout the body.

Thankfully, there is less cause for fear of the high toxicity levels of chemotherapy drugs. Newer drugs like Nivolumab and Pembrolizumab, are more tolerable, more effective and less toxic. And, for this reason, outcomes have improved. For instance, 20 years ago, the survival rate of patients with myeloma was two years. Now, it's closer to 10.

As for remission, the point at which a patient is deemed cancer-free, there are no hard and fast rules pertaining to whether or not the disease is likely to resurface. But it still holds true that a five-year "cancer-free" anniversary often indicates a healthy future.

Because prevention is the best defense against cancer, information about your family medical history can steer you toward specific screening, especially if your family members have died young from colon, breast, or prostate cancer.

With this information in mind, it's more motivating to avoid feeding various cancers what they thrive on, like nicotine, second-hand smoke, and alcohol, which are known to cause oral, throat, and lung cancer. Animal fat, chemicals used in processed food, and a lack of physical exercise are often the culprits of intestinal cancers. Being vaccinated for Human Papilloma Virus (HPV), which is known to impact cervical cancer and other HPV-related cancers, is also a strong preventive measure. No matter what kind of cancer you may or may not have, conquering the fear of finding out can make the difference between life and death.

Early detection of breast cancer relies on mammography, ultrasound and tomography imaging. Although the exposure to radiation is a potential carcinogen, technology is constantly improving to diminish the risk. In some cases, tumors can be treated without affecting the rest of the body. Typical therapies include surgery, chemotherapy, hormone therapy, and targeted therapy. Targeted drugs block the growth and spread of cancer cells, while chemotherapy drugs attack all fast-growing cells.

When discovered early, outcomes tend to be excellent for prostate cancer patients treated with surgery and/or radiation therapy. It's debatable whether or not Prostate-Specific Antigen (PSA) is beneficial in screening, so ask your doctor about how it pertains to your specific case.

In hematological malignancies, such as leukemia, which may be detectable in a person's blood work, clinical trials have been essential in developing effective therapies. In this type of cancer, a bone marrow biopsy may be required for further investigation.

Oral cancers in general can be spotted by a dentist. Persistent hoarseness and coughing can be warning signs of throat or lung cancer, especially if you drink alcohol or smoke. Depending on the stage, throat cancer can often be treated without removing vocal chords.

Most skin cancers are more common, but not exclusive, to fair-skinned people. Any persistent abnormality in the skin requires evaluation. Melanoma in darker-skinned people can show up under the nails or on the bottoms of the feet, and non-sun-exposed areas.

The point of ongoing cancer campaigns is to raise awareness of the importance of prevention. According to the American Cancer Society, designated days, weeks and months are designated to focus on the awareness (and prevention) of certain cancers. September is the time to observe Childhood Cancer Awareness, Gynecologic Cancer Awareness, Leukemia and Lymphoma Awareness, National Ovarian Cancer Awareness, National Prostate Cancer Awareness, and Thyroid Cancer Awareness. In October, we hold events and publish information on National Breast Cancer Awareness, National Liver Cancer Awareness. October 20 is also National Mammography Day.

By talking to your doctor, reading reliable sources and making important behavioral modifications, you can help save your own life.

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About Trinitas Comprehensive Cancer Center
Trinitas Comprehensive Cancer Center (TCCC) is located in a state-of-the-art 28,000-square-foot, five-story building on the campus of Trinitas Regional Medical Center in Elizabeth, New Jersey. The Center offers the most advanced technology available to cancer patients, including the following "firsts" in the state: the first Trilogy Linear Accelerator for radiation therapy, the first Rapid Arc radiotherapy technology, and the first AccuBoost Image-Guided Breast Irradiation. For more information about cancer care at Trinitas Comprehensive Cancer Center call 908-994-8000.

Posted: September 27, 2017

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