If nothing changes and patterns for cancer diagnoses hold steady from a year ago, that will not be a good thing in Colorado. Why? Because if this year is like last year, approximately 22,000 Coloradans will learn that they have cancer.
This week, as it is every week in Colorado, cancer will change some family’s life. Doctors will break the news to more than 400 patients — men, women or children — that they have been diagnosed with cancer. For Latinos, this is particularly bad.
For some, the diagnosis will not end well. According to the American Cancer Society, about a third of Coloradans diagnosed with this disease will die as a result. Latinos in Colorado and elsewhere will also bear their share of this burden.
Cancer is now the leading cause of death among Latinos — now exceeding rates of even heart disease. But the news is not all bad. Cancer mortality rates among Latinos, the state’s and nation’s fastest growing population, are actually dropping, however slightly. Also encouraging is that more than 14,000 of these cancer victims, including many Latinos, will become cancer survivors.
Cancer is not a single disease but rather a group of approximately 100 diseases. And while it strikes both sexes, more men will be diagnosed and die from it than women. A recent cancer study determined that men die at a rate one and a half to two times as frequently as women from leukemia as well as liver, colon and rectal cancers.
Despite enormous sums spent on research — which has resulted in amazing advances in the treatment of certain forms of cancer — science has not yet figured out why cancer occurs. So far, research has determined only that cancer begins when there is an uncontrolled division of abnormal cells.
“It is very difficult to determine what causes cancer,” says Denver oncologist, Dr. Ana B. Oton. “Each cancer is a different disease.” But some cancers are not only easier to diagnose but also easier to explain.
“Lung cancer is one of the preventable cancers,” says Oton, a native Spaniard via Venezuela who splits her practice between the University of Colorado School of Medicine and Denver Health and Hospital. But despite it being preventable, lung cancer, incontrovertibly linked to tobacco, continues to exact a toll.
This year, nearly half a million Americans — nearly 1,700 in Colorado — will die from lung cancer. Nearly a third of this number will be smokers. But family history — genetics — also plays a role. “We see lung cancer in patients who have never smoked,” Oton says.
Research has yet to put its finger on why non-smokers can contract or die from lung cancer. “These are multi-factorial events that happen,” Oton says. A simple theory is oncogenes, genes that mutate, adopt unexplainable traits causing them to drastically alter their roles. For nearly a generation, oncogenes have been isolated in human cancers.
While lung cancer will claim its share of cancer victims, it will be just one strain of the disease impacting Americans and the world population. It is estimated that more than ten-million cancer cases will be diagnosed in 2013. Amazingly, doctors think that only 5-10 percent of all cancers are genetic. The rest, they say, are preventable and can be attributed to lifestyle or environment.
Even though smoking and tobacco have been linked to cancer mortality rates, they actually follow diet in causal factors of the disease. Diets imbalanced with an excess of fried foods and red meat figure in up to 35 percent of cancer deaths. Excessive alcohol, sun exposure and pollution — lifestyle issues — are also contributors.
Last year in Colorado prostate and breast cancer lead in gender-based diagnoses. More than 3,800 men were diagnosed with prostate cancer. There were slightly more than 3,400 hundred cases of breast cancer among women. Colorectal, melanoma (skin cancer) and leukemia all placed high as cancers affecting Coloradans.
There is much that is not known about cancer, but advances are occurring regularly and dramatically. Breast cancer, Oton says, is a perfect example of how personal responsibility and research have crossed paths.
“How we treat cancer has changed enormously,” Oton says. “Fifty years ago, if you had the diagnosis of cancer, it was a death sentence. ‘This is how you’re going to die.’” But today, things are different.
Oton says early detection of breast cancer — often the result of self-examination — dictates a whole different approach and treatment. “Right now, it’s a chronic disease,” Oton says. Caught early, “it’s like being diagnosed with diabetes or hypertension; we can cure a lot of breast cancer now.”
Leukemia is another cancer whose survival rates have skyrocketed. Forty years ago, the five-year survival rate for leukemia was 14 percent. Today it is above 50 percent. For some leukemias — especially among children under age five — the survival rates can exceed 90 percent.
But Oton, whose work puts her in contact with underserved populations — mostly undocumented Latinos — , says fear keeps many women from seeking screening. “They’re afraid of looking for, searching for medical care because that’s how they’re (authorities) are going to find out they’re illegally in the country.”
The unknown is another factor among Latinos. “They’re afraid of having the tests,” Oton says, because of what it might turn up. As a result, many learn they have cancer in later and more difficult to treat stages of the disease.
Other factors that retard early and effective treatments, Oton says, are access to good medical care, lack of insurance and, culture. “But we also cannot blame them,” she says, “because cancer doesn’t always have symptoms in the very early stages.”
Dr. Oton would like to see more Latinos involved in clinical trials. “Latinos have the least representation” in these trials. “Clinical trials are the future,” because what is learned as a result will render the best treatments for fighting the disease in the future.
Oton is also adamant that a person’s immigration status should not stand in the way of volunteering for a clinical trial. At Denver Health, she says, “you can be undocumented and still participate.”
The cancers that affected the population fifty years ago remain in this oftentimes misunderstood cancer equation. But some, like leukemia or breast cancer, have, in a very short time, become remarkably and successfully treatable. The same, Oton says, can hold true for others, too.
A cure for cancer, say doctors and researchers like Oton, is not out of reach. Cancer may not be defeated in a decade or even several decades. But through education as well as smart decisions and personal responsibility — lifestyle choices — there are plenty of good reasons to hope that a generation not too far into the future will come to see cancer as a bump in the road and not the end of the line.