USA — Doctor Emphasizes Prevention in Cancer Fight

WASHINGTON — Smok­ing ces­sa­tion, annu­al phys­i­cals and rou­tine screen­ings are the best ways to decrease the risks of can­cer, said a Navy doc­tor who rou­tine­ly sees active-duty and retired mil­i­tary per­son­nel and fam­i­ly mem­bers for chemother­a­py.

“We see a lot of lung can­cer patients who have nev­er smoked in their lives,” said Navy Lt. Cmdr. (Dr.) Erin Larkins, an oncol­o­gist and hema­tol­o­gist at the Nation­al Naval Med­ical Cen­ter in Bethes­da, Md. “But it’s known that smok­ers, espe­cial­ly heavy smok­ers, are def­i­nite­ly at increased risk for lung can­cer.”

And can­cers of the head, neck, mouth, throat and voice box — and the num­bers of those cas­es thought to be linked to smok­ing — have increased, Larkins said.

“When [smok­ing is] com­bined with drink­ing the num­bers go even high­er,” she added.

The most com­mon can­cers in the Unit­ed States, Larkins said, are breast can­cer in women and prostate can­cer in men. Colon can­cer rates No. 2 for men and women, she added.

“Lung can­cer has been No. 3 for a long time,” she said, not­ing lung can­cer has the high­est death rate of any can­cer.

“We’re expand­ing treat­ments, but it’s still an aggres­sive can­cer usu­al­ly found in advanced cas­es, which makes it dif­fi­cult to treat,” Larkins said.

Rou­tine pre­ven­tive screen­ings, such as mam­mo­grams and colono­scopies, have cre­at­ed high rates of ear­ly can­cer detec­tion, Larkins said, adding that treat­ment at ear­ly stages increas­es chances of sur­vival.

When to start get­ting mam­mo­grams is a deci­sion usu­al­ly made between the doc­tor and the patient, the doc­tor said. “There’s some debate now about whether to start mam­mo­grams at 40 years old or 50 years old,” she explained. “The opin­ions are var­ied through­out the med­ical field right now.”

Women with a moth­er or sis­ter who had breast can­cer at age 40 should start get­ting mam­mo­grams 10 years ear­li­er, Larkins added.

Colono­scopies are rec­om­mend­ed after age 50 and are known to be a very effec­tive screen­ing for colon can­cer, Larkins said.

Anoth­er pro­ce­dure for detect­ing colon can­cer is the “vir­tu­al colonoscopy.” Sim­i­lar to a CAT scan, she said, this pro­ce­dure can detect tiny polyps and oth­er con­cerns.

Prostate can­cer is the most com­mon can­cer that occurs in men, Larkins said. A test for prostate-spe­cif­ic anti­gen mol­e­cules in the blood — com­mon­ly known as “PSA screen­ing” — is rec­om­mend­ed for men old­er than 50, Larkins said, and stud­ies indi­cate that African-Amer­i­can men should start PSA tests at 40.

Cer­vi­cal can­cer in women has become rel­a­tive­ly rare, the doc­tor said, thanks to ear­ly detec­tion by Pap smears. No screen­ings exist for pan­cre­at­ic and ovar­i­an can­cers, she said, but “stud­ies are being done all the time to finds screens” for those can­cers and oth­ers that are dif­fi­cult to treat because a patient often has no symp­toms until the can­cer is advanced.

Vac­cine ther­a­pies are under study, Larkins said, but are not in com­mon use to pre­vent cer­tain can­cers. “The main thing is be aware of screen­ing and know it’s some­thing you should do, based on your age [or] fam­i­ly his­to­ry,” she said. “Be aware of your own health.”

Mean­while, stud­ies and tri­als to detect and treat dif­fer­ent can­cers remain an ongo­ing process, the doc­tor said.

“One of the biggest changes in the last sev­er­al years has been look­ing at tumors indi­vid­u­al­ly as much as we can,” she said. “We know not all breast tumors behave the same — some are much more aggres­sive than oth­ers.”

World Can­cer Day is observed Feb. 4. It was estab­lished by the Inter­na­tion­al Union Against Can­cer to raise aware­ness and encour­age can­cer pre­ven­tion, detec­tion and treat­ment. The IUAC is a glob­al con­sor­tium of 350 can­cer-fight­ing orga­ni­za­tions in more than 100 coun­tries.

The World Health Orga­ni­za­tion esti­mates that with­out treat­ment, 84 mil­lion peo­ple will die of can­cer between 2005 and 2015.

“If can­cer spreads,” Larkins said, “it is most­ly still incur­able. If we can pre­vent it, rather [than] treat it, that’s a much bet­ter option.”

U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs)

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