Working to Reduce Cancer Deaths
- The government launched the National Cancer Plan to significantly reduce the number of cancer deaths in our country by 50% within the next 25 years.
- Our experts say it can be done, but the plan is not perfect.
- One step the plan suggests to reduce cancer deaths include people making lifestyle changes to reduce their risk, which requires hard work from people in their everyday lives.
- Meanwhile, suggested steps to increase access to necessary care may not fully take into consideration the financial barriers that many cancer patients face when paying medical bills.
- And eliminating inequities in health care requires us to address longstanding factors that hinder diversity, such as the mistrust of the medical community.
The plan’s not perfect, but it can be done — with caveats, our experts say.Read More
What Are the Goals?
Under the U.S. Department of Health and Human Services (HHS), the National Cancer Plan sets realistic objectives that respond to the current needs of cancer patients today, like improving the quality of life of those living with cancer and increasing diversity in cancer research.
Within these eight goals, some do recognize the critical issues, but do they consider the context necessary to actually achieve them?
Reducing Your Cancer Risk
The plan encourages everyone to adopt proven strategies that reduce the risk of cancer, such as losing weight, quitting smoking and other healthy lifestyle habits.
Dr. Uberti points out that while this may be necessary, it’s extremely hard for people to do in their everyday lives.
“Lifestyle and behavioral changes are tough to make,” Dr. Uberti says. “It’s difficult to quit smoking. It’s hard to decrease our exposure to environmental carcinogens, which are all around us.
“Losing weight, eating a healthy diet with fewer processed foods, limiting our alcohol intake and developing an exercise program, all take our individual efforts. But it’s possible to reduce, even prevent some cancers by making these kinds of strategic lifestyle changes – and we need to do it.”
SurvivorNet knows how hard it can be to change habits you’ve had for a long time. But it’s true, smoking and drinking can increase your risk of developing cancer.
So if you need a little guidance, here are our tips to help stop smoking and stop or moderate drinking, which can help reduce your cancer risk.
WATCH: Yes, You Should Stop Smoking
Working Through Financial Barriers
The National Cancer Plan prioritizes getting people the cancer care they need, but key financial barriers may still stand in the way of that happening.
It stresses the importance of detecting and treating cancers at earlier stages, saying this enables more effective treatment and reduces morbidity and mortality. However, cancer survivor Laurie Adami says that not everyone has the luxury of early screening.
Adami, a 63-year-old mom, was diagnosed with incurable adult non-Hodgkin lymphoma at 43.
“If you can’t get a colonoscopy, for example, because your insurance won’t approve it until you’re 50 years old, and you can’t afford the out-of-pocket expense for the procedure, guess what? It might be too late,” she told SurvivorNet.
A colonoscopy is a screening test for colon and rectal cancer (also called colorectal cancer). The test uses a long, thin tube attached to a camera, which lets your doctor check for polyps throughout your whole colon and rectum.
WATCH: Finding Polyps With Colonoscopies
If you’re at average risk, meaning you don’t have risk factors like smoking or a family history, the American Cancer Society advises getting regular colonoscopies once you turn 45. You’ll get one colonoscopy that will serve as a baseline, and, if your doctor doesn’t find any polyps, you’ll have another one in 10 years.
“So, the big elephant in the room is inadequate or costly insurance and the barriers to patient care because of it,” she says.
The plan also wants to work on developing effective treatments with minimal side effects and making them accessible to all people with all cancers, including those that are rare, metastatic (cancer that has spread) and treatment-resistant.
But along the same lines, Dr. Uberti says that even if a treatment is made available to people, the financial burden on patients can still be great enough that they consider not taking it.
“The expense continues to rise and much of the chemotherapy we give our patients these days is outpatient. So, when we write a prescription for a patient, the retail price could be $15,000 a month,” he said.
“Even if a patient has insurance, it usually only pays a portion of the cost. Some patients may end up asking themselves: ‘Am I going to feed my children or am I going to live?’”
Cancer bills and health costs can be overwhelming. If you need help paying the bills, we have some guidance on navigating the costs and finding people and organizations who can help you.
WATCH: How a Social Worker Can Help With Bills
Eliminating Health Care Inequities
It’s no secret that disparities exist within the healthcare system. One reason for this is the mistrust of the medical community, which lingers from the Tuskegee syphilis experiment that started in 1932.
More than 600 African American men in Alabama were enrolled in the study by the U.S. Health Service, but they were never told what the study was truly about. The 399 men that had syphilis were never given the proper treatment to cure the disease.
Not much time has passed, and earning back that trust is essential to combating the huge disparities that exist for minorities when it comes to cancer care.
The National Cancer Plan set some goals to help provide better care to underserved communities.
One goal is to eliminate inequities in cancer risk factors, incidence, treatment side effects, and mortality by making prevention, screening, treatment, and survivorship care accessible.
Adami knows how important this is. She considers herself lucky to live in Los Angeles, where she was near National Cancer Institute-designated cancer centers. This gave her easy access to clinical trials, which are studies that help doctors better understand cancer and discover safer and more effective ways to treat it.
Every life-saving or life-extending treatment that’s available today for cancer started its journey in a clinical trial. These studies give patients a chance to try a treatment before it’s approved by the U.S. Food and Drug Administration. And they can be life-changing for patients.
Adami knows not everyone has access to these facilities.
“If you’re living in a rural area and you don’t have access to good healthcare, you’re automatically at a severe disadvantage,” Adami says. “I wouldn’t have gotten these trials if I had lived in an under-served rural area.”
And this coincides with another goal of making sure every person with cancer or at-risk for cancer has an opportunity to participate in research and barriers to their participation are eliminated.
“I was one of the lucky ones who was able to participate in clinical trials,” says Adami. “It should be made available to everyone in need.”
If you’re considering or interested in clinical trials, use our Clinical Trial Finder to help discover ones near you and for your specific disease.
WATCH: How to Address Racial Disparities in Cancer Care
Taking it further, the plan supports building a workforce that reflects the people it serves to better care for those people. This would require us to address longstanding factors that hinder diversity. And that means including scientists and doctors from underrepresented groups that were previously excluded.
Dr. Marilyn Fraser, CEO at the Arthur Ashe Institute for Urban Health, previously told SurvivorNet that increasing the number of people of color and the diversity of nationalities and ethnicities within healthcare professions can help provide better care to the people they serve
“Diversity helps to bring to the forefront equity, and it brings to the forefront some of the challenges that we may have and that we can come together to try to tease those out,” she said.
Delivering Quality Care
Meanwhile, the health care system is tasked with delivering to all people evidence-based, patient-centered care that prioritizes prevention, reduces cancer morbidity and mortality, and improves the lives of cancer survivors.
Dr. Uberti sees where this can be achieved.
“Mammograms are a good example,” says Dr. Uberti. “This screening is a standard recommendation to reduce the risk of extensive breast cancer. If we pick up breast cancer earlier, we have a better chance of curing our patients. Other things such as vaccines against HPV can also decrease our risk for cancer.”
Working Toward These Goals
The government has outlined a few actionable steps to help achieve these goals.
One action item is building up areas of research that specialists find most promising, such as immunotherapy.
Immunotherapy is a type of biological therapy that ushers the power of a person’s immune system to recognize and conquer cancer cells. This includes recruiting internal mechanisms like the body’s proteins, white blood cells, tissues, and organs or through external mechanisms by synthesizing molecules in the lab.
Each type of immunotherapy works differently depending on many factors. While some will work to kill or destroy cancer cells, others will only stop them from growing and spreading to other organs.
Still, it can activate, enhance and expand the immune system to fight cancer.
“I feel excited about immunotherapy because immunotherapy can offer the benefit of taking your immune system to a different level,” explains Dr. Jing Christine Ye, a multiple myeloma specialist at the University of Michigan Health.
WATCH: Dancer Oswald Peterson: Immunotherapy Gave Me My Life Back
Immunotherapy is already transforming care for some hard-to-treat cancers, but the Catch- 22 of this treatment is that scientists don’t fully understand why immunotherapy, which is less toxic than most standard chemotherapy, works for some patients and not for others.
To try to uncover why, the National Cancer Plan suggests creating a national clinical trial network specifically devoted to immunotherapy.
Regardless of what’s still unknown about immunotherapy, it continues to be a life-saving treatment for many people.
One of them is Laurie Adami. For a dozen years, she was enduring continuous and often toxic treatments. Laurie credits CART T-cell therapy, an immunotherapy treatment, for her beating the disease.
CAR T-cell therapy is a revolutionary treatment made from your own blood cells to help slow or stop cancer when other treatments have failed. It’s currently used to treat certain blood cancers and is being studied in other cancers, according to the National Cancer Institute.
The immune system’s main soldier in fighting off viruses and bacteria is the T-cell. Under this treatment, a patient’s immune T-cells are removed from the bloodstream and sent to a lab to become more efficient cancer killers. The modified cells are then returned to the body where they can travel through the bloodstream to destroy cancer cells.
“If you looked at my PET scan one week before my CART T treatment began, you would have seen 10 pounds worth of tumors inside my body,” she told Survivornet during a telephone interview.
“But one month later after immunotherapy, my cancer was completely gone.”
Adami has been cancer-free for more than five years and is a legislative advocate for the Leukemia & Lymphoma Society.
The government also wants to spend more time investigating genes. Scientists have long known that genetic differences inside tumors help explain why one person’s cancer is more aggressive than another patient’s and why treatments work better for one person versus another.
WATCH: What Is Genetic Testing and Why Is It Important?
Major cancer centers are increasingly “profiling” patient tumors to help guide treatment.
Colon cancer is a good example of this practice. About 5% of colorectal cancers are fueled by certain inherited genetic mutations.
The NCP encourages the use of technology to identify folks at a higher genetic risk. If a colon cancer patient has the gene, then their family members can be tested too. If they share the gene, they can be offered early surveillance and possibly prevent a future case of cancer and a cancer-related death.
The NCP also recommends creating a national network to give more patients in our country access to tumor profiling. This would enable patients to share their genetic data with researchers, as well as volunteer for cutting-edge clinical trials that match their genetic profile.
The National Cancer Plan has lofty aspirations, but it’s clear there are obstacles. As Dr. Uberti said, it will take a concerted effort from everyone to change the way we live and think about cancer.
SurvivorNet is proud to do our part in making expert cancer information and prevention resources accessible for people.
Plus, the current circumstances on Capitol Hill are creating a challenging funding outlook for the National Institutes of Health (NIH) for the 2024 fiscal year.
Republican lawmakers in the House have stated that they will not approve a debt ceiling increase without major cuts to spending programs, and House Speaker Kevin McCarthy (R-California) is expressing support for his colleagues’ plan to cap federal discretionary spending at the FY 2022 levels.
Capping discretionary spending would severely weaken NIH during a time of great promise and abundant opportunity to change the future for the millions of Americans who are touched by cancer and other diseases.
People can reach out to their leaders in Congress and let them know they care about supporting cancer research and care, which can markedly improve public health and save lives from cancer.
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