Cancer death rates in United States show largest single-year decline
Courtesy of Allegheny Health Network
Allegheny Health Network cancer patients have been receiving breathing therapies during radiation therapy to assist with the targeting of the treatment.
Dr. David Bartlett
When Beatrice Little came home from work one day early last year, she noticed something wasn’t right.
“I’ve been fighting this since last January, that’s when I found it,” said Little, 72, of Houston. “I was working, I came home and felt something sore in my breast and found a lump. The next day I called my doctor and it went from there.”
That lump turned out to be breast cancer.
Doctors moved quickly to remove the lump and four lymph nodes, one of which was also cancerous. Radiation and chemotherapy followed, but then Little’s doctors put her on a relatively newer form of treatment called Kadcyla.
“Now I get infusions of antibodies,” she said.
As for side effects?
“Nothing whatsoever,” she said. “Yes, I was losing my hair after chemo so I just shaved it all off.”
She also benefited from a new breath-hold technique during her radiation therapy.
“That was neat,” Little said. “It’s like breathing down a snorkel like you’re going scuba diving.”
Holding breath allows patients to remain still so doctors can focus radiation as exactly as possible on the tumor without hitting nearby areas like heart tissue.
These new targeted therapies and techniques are helping to make cancer treatments even more effective and are helping to improve care for patients like Little, who is one of a growing number of cancer survivors across the United States.
New numbers released by the American Cancer Society show the death rate from cancer nationwide dropped 2.4% from 2017-2018 – the latest data tracked – which marks the largest single-year decline on record.
Doctors attribute much of that drop to new treatments like the antibodies that Little is receiving.
Dr. David Bartlett, a surgical oncologist and system chair of the Allegheny Health Network Cancer Institute, said that big drop arose because of many factors.
“Predominately the decrease in smoking, earlier detection due to improved screening, and better therapy,” Bartlett said, “most notably immune therapy and new drugs targeting specific mutations and defects within cancer.”
The cancer mortality rate nationally has dropped 31% since its peak in 1991 according to the American Cancer Society.
The number currently stands at 149 deaths per 100,000 people, which leaves cancer as the second leading cause of death in the United States behind heart disease, the American Cancer Society said.
“The incidence of cancer has dropped significantly over the last 30 years, but has been mostly stable over the last five years, suggesting that the behavioral modifications have leveled off or new contributing factors to cancer incidence are fighting against the drop in smoking behavior,” Bartlett said.
This is the second year in a row with a record-setting drop in cancer mortality rates and Bartlett pointed to that as a sign of progress.
“It is definitely progress, but we have a long way to go,” he said. “The rate of new drugs being approved to treat cancers is increasing exponentially and patients are living longer with their disease. Breakthroughs such as immune therapy have had a dramatic impact and similar discoveries will continue to occur.”
The largest drop in mortality is in lung cancer cases, according to the American Cancer Society.
Progress in reducing colorectal and breast cancer deaths has slowed and prostate cancer death rates have not improved. Almost a quarter of all cancer deaths are because of lung cancer.
“Lung cancer mortality rates have markedly improved due to the cessation of smoking and the unique fact that the most common forms of lung cancer respond to checkpoint inhibitors (immune therapy),” Bartlett said. “Whereas the majority of breast, prostate and colon cancers do not respond to checkpoint inhibitors. Nevertheless, we have seen a steady decline in deaths from colon cancer over the last 30 years and many new treatments for breast and prostate cancer are being discovered regularly.”
Bartlett said 98% of prostate cancer patients are alive five years after a diagnosis and 90% of breast cancer patients are alive at five years versus only 21% for lung cancer.
One area that has not seen improvement is the disparity in cancer deaths among minority groups compared to white people.
“The disparities issue continues to be a problem,” Bartlett said. “Black patients present with more advanced cancers compared to white patients and the relative risk of dying from a cancer after having been diagnosed is 33% higher for Black patients compared to white patients. We have work to do to eliminate these differences.”
The COVID-19 pandemic has caused delays in cancer screening and treatments and doctors are concerned what effects that could have on patients.
“I am very worried about the impact of the COVID pandemic on cancer diagnosis,” Bartlett said. “We have seen a marked decrease in cancer screening visits such as mammograms and colonoscopies during the pandemic and subsequently a decrease in new cancer diagnoses. The cancer does not go away on its own, so this will lead to an increase in more advanced cancers in the months and years to come.”
He said he this may negatively affect cancer mortality rates.
As for Little, she is moving forward with her infusions and a positive attitude. She said she receives the treatment every three weeks and has five more sessions to go.
“I’m a strong person and when they told me, I said, ‘well, you know it is what it is,'” Little said. “I am in God’s hands now, and I will bear whatever he has given me.”