Survivorship Series - Surviving Cancer
Fifty years ago cancer was largely thought of as untreatable. The few treatments available had limited effectiveness and were difficult to tolerate for most patients. All of that began to change when President Nixon declared a war on cancer and signed the National Cancer Act of 1971. This act led to the development of numerous drugs that better targeted specific forms of cancer, drastically improved surgical techniques and enhanced understanding the importance of combining treatments and managing side effects.
Cancer is normally a “symptom free” disease until the very late stages. Because our research taught us that advances in treatment were most effective when applied during the earliest stages of cancer, researchers shifted much of their focus to improved screening techniques. Primary care physicians schooled their patients on simple techniques for self-examination for breast and testicular cancer. Mammograms, pap smears, PSA testing, colonoscopies, and simple digital rectal exams helped to identify more cancer at “treatable” stages as well as to raise the public consciousness of the disease.
These advances have led to unprecedented improvements in five-year cancer survival rates. The table below illustrates the trend in survival from 1990 – 2012.
Although this is terrific news, it is not evenly spread by age, race, gender or type of cancer. For example, while relative survival as a result of cancer treatments has increased 14.7% since 1990, this was driven mostly by males, who improved by 17.3%. Females, on the other hand, only improved by 11.8% over the past 22 years. Additionally, while five-year survival rates have improved by as much as 66% for some cancers (esophagus), they have remained level for others such as cervix/uteri during this same period, or worsened in the case of larynx cancer.
Despite astounding improvements in survival for many forms of cancer, incidence remains a persistent problem. The graph below illustrates that while incidence among males has decreased by more than 18% since 1990, female incidence has essentially remained the same. Combined improvement is a mere 8.1%.
While efforts continue to improve diagnostic techniques and treatment of cancer, public policy has shifted in the direction of preventative measures. Many hail the smoking cessation campaigns of the past 30 years as one of the most effective public health campaigns ever. Today's efforts focus on lifestyle choices - such as tobacco use, alcohol consumption, obesity and dietary choices, and exposure to sunlight - and the view that individuals can actively reduce their risks of cancer.
When Dr. Marius Barnard developed the first Critical Illness insurance policy he understood that medicine had advanced to the point where survival would often have greater financial consequences than death. We have reached that point, and even as we celebrate the advances in life saving treatments, we need to recognize that living benefits such as Critical Illness and Disability Income insurance are more important than ever. These benefits are crucial in covering the out-of-pocket costs from deductibles, co-pays and non-covered expenses that can reach into the tens of thousands of dollars and beyond; otherwise, the cost of treating a critical illness or disability can be financially devastating, as demonstrated in our Critical Illness Fast Facts infographic.
For more information on mortality improvement and the need for living benefits view our complete Survivorship Series.