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According to the American Cancer Society, in the United States, approximately 39 out of 100 men and 38 out of 100 women will develop cancer during their lifetime; 80 percent of them will be 55 years of age or older.

Cancer Defined Cancer is a group of diseases characterized by the uncontrolled growth and spread of abnormal cells. Although causes of cancer are not completely understood, numerous factors are known to increase its occurrence. Some risk factors are not within our ability to control such as inherited genetic pre-dispositions to cancer, age, race and immune conditions. However, there are many risk factors we can control by modifying our lifestyle behaviors, such as:

• Stop smoking and using any tobacco product.
• Reduce alcohol consumption.
• Maintain a normal body weight.
• Develop healthy eating habits. Survival Rate The good news is that since the early 1960s the five-year relative survival rate for all cancers combined has increased substantially. “Improvements in survival rates can be attributed to earlier detection, advances in technology and improved treatment modalities.” said Mark S. Bettag, MD, Sheboygan Cancer & Blood Specialists, SC. While survival rates can vary dramatically by cancer type as well as the cancer’s stage and the patient’s age, race, etc. survival rates are improving. “Today, more people, with many types of cancer, are enjoying a better quality of life and reaching the five-year-relative survival rate and, in many cases, living longer than ever before.”

Prevention At least 42% of newly diagnosed cancers in the US – about 740,000 cases in 2019 – are potentially avoidable, including the 19 percent of all cancers caused by smoking and 18 percent caused by a combination of excess body weight, physical inactivity, excess alcohol consumption and poor nutrition.

Of course, the highest priority is centered around prevention. “Many cancers can be prevented, including all cancers caused by tobacco use and other unhealthy lifestyle behaviors such as obesity, excessive alcohol consumption, lack of physical activity and poor nutrition,” said Dr. Bettag.

Other cancers caused by infections, such as human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV) and Hellicobacter pylori (H. pylori) can be prevented through behavioral changes, vaccinations and treatment of the infection.

Prevention of colorectal and cervical cancers is dependent upon screenings for detecting and removing precancerous lesions before they become cancerous.

Early detection A recent American Cancer Society study found that cancer death rates dropped by 27 percent in the last 25 years, primarily due to advancements in screening, early detection, treatment, and decreases in smoking.

“Screenings for specific cancers – breast, colon, rectum, cervix, prostate and, among current or former heavy smokers, lung – can detect cancers early making treatments and outcomes more effective,” said Dr. Bettag. It is also important for you to pay attention of your body and recognize changes that occur. “A heightened awareness of your body and noticing any changes that occur in the breast, skin, mouth, eyes or genitalia need to be brought to your doctor’s attention because these changes can be serious and lead to early detection.” While early detection through screenings has long been the emphasis there are new advancements that are showing results such as liquid biopsies. “A liquid biopsy is a test done on a sample of blood to look for cancer cells from a tumor circulating in the blood or pieces of DNA from tumor cells in the blood,” said Dr. Bettag. A liquid biopsy can be used for many purposes:

• to help find cancer at an early stage
• to help plan treatment
• to find out how well treatment is working
• to determine whether the cancer has returned. “Our being able to take multiple samples of blood over time may also help us understand what kind of molecular changes are taking place in a tumor.”

Genetic Testing When applicable, genetic testing provides patients with a better understanding of their risk for cancer. “This knowledge is empowering giving patients answers and the opportunity to have the cancer treated before it has advanced with greater success,” said Dr. Bettag. The following are some indications of hereditary cancer risks:

• Family member with a known inherited gene mutation.
• Breast, colon or uterine cancer diagnosed under the age of 50.
• Ovarian cancer diagnosed at any age.
• Two or more close family members who have had the same type of cancer.
• The same type of cancer in several generations of the family.

Treatment While chemotherapy continues to be the primary treatment for cancer, advancements in immune-based therapies are on the rise. Immunotherapy uses the body’s immune system to fight cancer and can be a viable treatment option for some patients. “Immunotherapy is a personalized treatment option that can be more effective and less toxic than chemotherapy for certain higher risk patients,” said Dr. Bettag.

Putting Patients First According to Dr. Bettag, “Patients, their medical teams and caregivers need to openly discuss and respect the patient’s priorities.” Today’s patients are asking questions and voicing their opinions and values because patients are becoming more knowledgeable and comfortable about discussing their concerns more openly. “As their oncologist, I encourage my patients to be active members of their care team.” Patients who are more engaged may not be able to change their treatment plan, but they will have a better understanding of it and learn what they can do help achieve the best outcome. “We cannot effectively treat the cancer with science alone; we need to have the patient onboard; to have a voice in their care plan.”
It’s in Your Blood There are more advancements on the horizon using of a variety of blood tests to detect and diagnose cancer. “As for using blood testing as a wide-spread method of testing for cancer, it’s still very early, but developments in this area are promising,” said Dr. Bettag. Data 2019 continued to see advancements in the use of data to help inform treatment plans and analyze patient outcomes. “Advancements in technology have made it possible for providers to discover new and powerful approaches in providing the most optimal care,” said Dr. Bettag. For example, patient tracking data required in the Oncology Care Model, a novel program through the Centers for Medicare and Medicaid Innovation, offers the clearest ‘big picture’ look at patients’ treatment and outcomes. “This patient data helps us better understand genetic risk, new approaches to therapeutics and trends in healthy living post-treatment – all leading to improved patient outcomes.” Diet A new National Cancer Institute- (NCI) supported study, in mice, showed that altering cancer cell metabolism by feeding mice a diet very low in the nutrient methionine improved the ability of chemotherapy and radiation therapy to shrink tumors. “There will be more about nutritional interventions that could influence cancer in the future. Afterall, dietary interventions have been treatment facets for other diseases such as cardiovascular disease and diabetes,” said Dr. Bettag. Over the last 10-15 years, diet studies have shown that cancer also has a huge metabolic component to it. Cancer cells have different nutrient requirements and different metabolic demands than normal tissue, but we need more data on how nutrition might influence demands. “Research in this area is growing and could potentially lead to an important component in the treatment of cancer.” “There are many exciting studies and technologies showing promise for the diagnosis and treatment of cancer,” said Dr. Bettag. The future of these new developments will continue to pave the way toward better outcomes and a higher quality of life for patients during and after treatment. “Ultimately we are always focused on making advancements that offer better outcomes and deliver greater hope to everyone affected by cancer.”