Cancer War

Cancer is the most curable of all chronic diseases. Today, the goal is not merely to prolong life the best that could be hoped for in the past but to cure the patient of the disease.
Everyone cannot beat cancer. Some people are going to succumb to it. If you try to fight it, however, you have a chance of beating it.

You are a unique person. You have been brought up with individual standards, practicing your own set of customs based on your beliefs from the experiences to which you were exposed. Not only is no one else identical to you, but they are not even similar to you.
I urge you to remember that these are generally not only my personal opinions or beliefs; they are the recommendations of outstanding scientists, physicians and other professionals who deal with cancer patients regularly.

It is my personal opinion that the greatest cause of mortality from cancer is the individual equating death and cancer. When an individual is diagnosed with a malignancy, their first assumption is that it will eventually kill them, and they therefore do not muster all their resources to fight this vicious disease. Cancer is a word, not a sentence.
Often the physician who makes the initial diagnosis is a contributor to the problem. If he graduated medical school only 15 years ago, over half the cancers he was told were untreatable when he was in school are today curable to some degree. Furthermore, the physician has seen the suffering that went along with some of the primitive treatments in the past, and he cannot see putting his beloved patient through this. He recommends they go home and make themselves as comfortable as possible for the time they have to live.
I am not trying to say that everyone can beat cancer. Certainly some people are going to die from it, no matter what they do. I am saying, however, that if a person does not try, there is no way they can beat it. If they do try, they have a chance. And I believe it can do nothing but improve the quality of their life. To me, there was nothing worse than waiting to die with no hope. Whatever treatments I went through did not compare to the lack of hope I had the first five days after diagnosis. I was fighting to live rather than waiting to die.
It is believed that the average person gets cancer six times a year. Their immune system destroys the cancer cells, and they know nothing about it. Occasionally, something comes along to depress the immune system, which allows these malignant cells to get a foothold and multiply. When the immune system recovers, the cancer is already too well established and they have a detectable case of cancer. It is often discovered by a general doctor who tells the patient there is no hope, further depressing the immune system. The patient has complete confidence in this doctor who represents the entire medical system, so there is no purpose in getting a second opinion or going elsewhere. The patient is totally out of control at this point, compounding the problem.
There have been numerous studies documenting the effects of stress on the immune system, both with animals and individuals. It has been demonstrated that tumors grow faster in mice under stress. Mice have fared worse and died sooner when they were made to feel helpless. The incidence of cancer in individuals following a traumatic event such as the death of a spouse or child or retirement has been shown to increase dramatically. It has even been demonstrated that individuals with suicidal tendencies have a higher incidence of cancer, indicating that cancer could be a legal method of committing suicide.

Couple this with the fact that rarely is cancer ever diagnosed by an oncologist. Around 85% of all cancer patients do not use an oncologist as their primary physician. Cancer is an extremely complex array of over 200 different diseases with at least six common methods of treatment, any one of which could successfully treat some cancer, but generally they are given in combination. If it is not treated promptly, properly and thoroughly, there usually is no second chance. Progress in cancer treatments is being made at such a rapid pace that no single individual could conceivably know all the latest and best treatments for any single type of cancer, let alone all the different cancers.
It is for these reasons that I believe the greatest single mortality factor in cancer is the patient believing that death and cancer are synonymous. Promptly getting the patient to a multidisciplinary panel or to a board-certified oncologist for a second opinion could do more to save lives than anything else. If they try, they have a good chance. If they don’t, they are as good as dead.
Cancer mortality has dropped dramatically! The age-adjusted cancer death rate has decreased by 2.1 percent per year from 2002 to 2004, almost twice the annual decline of 1.1 percent per year from 1993 to 2002. Much of this can be attributed to early detection, qualified second opinions, and prompt and proper treatment.
We agree with this completely but believe they are failing to give credit to the psychological changes that have taken place in the same period. The public has been bombarded with stories of cancer successes. Individuals who were brought up to believe that a diagnosis of cancer was equivalent to impending death were suddenly aware that if they tried to fight, they had an excellent chance, better than 60%, of beating the disease. Further, that if they caught the disease earlier, their chances of successful treatment were dramatically enhanced to 80%. And the treatments are not as bad as they have been touted because they have been improved.
One national figure in the cancer war stated, “It is likely that there will be a 25% decrease in the overall death rate from cancer, and possibly as much as a 50% decrease, in the next 20 years.” Progress is being made! There are two caveats in the data. First, the overall death rate, as compared to the age-adjusted death rate, continues to rise because the population is aging and cancer is a disease of old age. Physicians predict cancer will surpass heart disease as the nation’s leading killer.

Second, while African Americans have shown substantial improvements, the overall death rate is still 38% higher in black men than in white men. We believe that this second factor is primarily due to black men believing they cannot get “as good” medical treatment and therefore not trying to beat it, or procrastinating. A great deal of publicity of this fact should substantially reduce the adverse mortality figures.

UNDERSTANDING CANCER:

There is no type of cancer from which some people have not recovered. The road to recovery generally is not very easy and requires real determination. Currently, the statistics show that 66% of all serious cancers can be cured. The one item that you rationalize is a bother or does not apply to you can be the deciding factor that would tilt the scale in your favor or against you. You generally have one chance. Use every resource in your power.
Cancer is a unique disease. There are five factors that make it different from any other known illness. First, cancer cells grow geometrically without limitation. That means 2 becomes 4, then 8, 16, 32, 64, etc. If they grew 1, then 2, 3, 4, 5, we probably would never have heard of it. Because of this geometric growth, we must treat it promptly and properly or it can soon grow to a point where it may be untreatable. If we break our arm and it is not set properly, we can have it reset again whenever we want. It is not irreversible and terminal. (See chart.)
Growth and Detection of Cancer Cells

One million cancer cells are smaller than the head of a pin. One billion cancer cells are the size of a pea and weigh about the same as a paper clip. Below is a chart showing the geometric growth of cancer.

Number of Cells
1 = The inception of cancer = one malignant cell growing uncontrollably.
101 = 10
102 = 100
103 = 1000
104 = 10,000 etc.
105
106
107
108
109 The earliest that cancer will normally be detected by X-ray, scan, mammogram or feel.
1010
1011
1012
1013 The stage at which the patient is generally dead. This chart is meant to emphasize two critical factors: the importance of early detection and prompt treatment. Time is of the essence!

To further illustrate the way cancer grows, picture algae covering a lake. This algae doubles in area each day until, after one month’s time, it completely covers the lake. When should it be noticed? When it covers one half of the lake? That is the day before the end of the month. When it only covers one fourth of the lake? That is two days before the end of the month. If you caught yours three or four or five days before the end of the month, you must feel very grateful!
The second unique factor is the property of cancer cells to spontaneously travel to distant sites. One million cancer cells are smaller than the head of a pin. One billion cancer cells are the size of a pea. This means that they have the ability to float freely through the blood stream or the lymph system. They could be in your stomach today and in your head, your lungs or your toes tomorrow. If you break your arm, it cannot metastasize (spread) to your hip.
Third is that cancer is actually over 200 different diseases. There is no similarity between brain cancer and breast cancer other than the word cancer and the fact that they are both rapidly dividing cells. Different types of cancer should be treated by different types of medical specialists with totally different methods after being diagnosed through different means. Furthermore, the advances being made continuously in the many different types of treatments make it absolutely impossible for any one individual to know the very latest and best therapy for every type of cancer. In contrast, if you break your arm, many physicians would know the state-of-the-art way to set it.
Fourth is the unique fact that while many cancers can be treated successfully the first time, if they are not, often there is no second chance. For example, with my lung cancer, I had all the radiation my lung could take; so, if I had not been cured completely and had suffered a recurrence, I could not again have successfully had radiation therapy. I had my limit on Adriamycin, a particularly effective cancer drug but one which can do harm if given in excess of certain amounts, so it would not have been available to me if needed a second time. After you have one lung removed, there is no point in talking about surgery because you cannot live without both lungs. These are just examples in my case, but the same principles apply in many cases. This is why we not only preach prompt and proper treatment but also thorough treatment so you know you have the best chance of being through with it forever. If you break your arm a second time, generally it is not more critical than the first time.

Fifth and last is the major factor mental attitude plays in the recovery from cancer. Most oncologists agree that if a patient believes they will die from their cancer, they are right and cannot be saved. That is not to state that if they believe they will recover, they necessarily will, but at least they have a chance. If you break your arm, whether you think it will mend or not does not matter, it will generally heal in so many days.
Some people feel that because they don’t have sufficient funds they won’t receive the best treatments. In fact, these people are defeatists. They are making up their minds in advance that they are going to take the easy road out and give in to their disease. I have never seen the individual who, even though absolutely destitute, could not get the proper treatments if they applied themselves and really tried. There are resources in every major community. Remember, no one owes you anything. You have to work to get it like everything else in life. It can be done! An example of some of the resources that could be investigated are VA hospitals, state cancer hospitals, university hospitals or teaching institutions, and county or city hospitals. Treatment for patients participating in National Cancer Institute clinical research protocols at the Clinical Center of the National Institutes of Health is provided free of charge. Generally, a local, qualified physician can give you suggestions on where to look.
Some people have said I recovered because of my financial position and that I must have gotten preferential treatment. I would like to dispel this myth. First of all, I am unaware that cancer shows partiality because of financial or any other position. I believe rich or poor people have an equal chance of surviving. I also believe that tall or short people have a relatively equal chance as well as fat or thin or black or white people.
As to receiving preferential treatment, that was hardly the case. At home, where I was known and possibly could have gotten superior attention, I was told it was hopeless and to get my estate in order. If that is superior treatment, I don’t need it. When I went 900 miles away to a mammoth institution where I was a number, I did receive superb service and attention, not because of who I was but because that is the way they do things.
My doctor, before giving me any treatments, gave me his home telephone number. He said in the next two years of treatments I would want to contact him many times in the middle of the night or over the weekend. Of course, I could reach him during weekdays at the clinic. However, he did not want me to waste my energy during a sleepless night or weekend about anything that would be bothering me. He wanted me to apply all my energy to getting well. For that reason, he gave me his home telephone number and told me to call him any time anything bothered me. He did this for his other patients also as should all good doctors.

This discussion of my doctor is only for the purpose of showing you where I got my support, ideas and knowledge and what you should look for and have a right to expect from your physician.
My doctor was the greatest! Not only did he cure me from cancer, but he taught me so much along the way. In the very first telephone conversation, he started, without my knowing it, by getting my undivided attention and ascertaining my dedication.
I was diagnosed on a Wednesday with “terminal” stage 3 squamous cell lung cancer. I talked with him Wednesday night long distance, and he wanted me to fly there Thursday so I could be examined and tested Friday. The clinic is closed on Saturday and Sunday. Because I was terminal and might never have seen my home or office again, I wanted to have four days to get my estate in order at the expense of one day of testing. I wanted to fly down Sunday to be examined and tested on Monday, one working day later. My doctor said if I did not fly down on Thursday, he would not treat me.
At the time, I may have thought he was being inconsiderate. Since then, that one little remark has taught me many things. First of all, cancer is never as treatable as it is right now! At some time in the future, it is probably not treatable. Whether that time is tomorrow, next week or next month depends on the individual case. This afternoon or first thing tomorrow morning is the best time to start trying to beat it.
Possibly even more important than that, I soon came to realize he wanted to be certain that recovering from cancer had my full attention. He wanted to be certain that I would make the commitment to do whatever was necessary to get well. There is no doubt that generally it is a long, hard road with plenty of obstructions and detours. He wanted to be sure that I wasn’t going to say, “OK, Doc. I’ll do anything you tell me to do as long as it is convenient with me.” He wanted to know that getting well came first before anything and everything else in my life.
And possibly the most important thing I learned from those few words was a third factor. He wanted to know that I had the dedication and drive to do what would be required to be victorious over cancer. That day may not have been critical. But that day represented just one of the many negative options that would lie in the path of my recovery that I would have to forgo if I were going to succeed. He knew my chances of recovery were much greater if I had a truly strong, burning desire to live. This was his way of testing me. This was his way of proving it. If I would give up four days I wanted so desperately to give him his one day he asked for, my dedication to success was guaranteed.

The Act of Deciding to Fight Cancer
Until you commit yourself, there is hesitancy, the chance to draw back, ineffectiveness. Once you commit yourself to do absolutely everything in your power to fight cancer, all sorts of positive things occur. The mere act of reaching a decision causes unforeseen incidents, meetings and assistance that could not have been anticipated. Goethe stated, “Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it.” You make it happen

Cancer is often an eye-opener, teaching us that life is too short to postpone what we really want. It starts us thinking about how much we really enjoy life. In that respect, it can really be a positive experience because those who have cancer can use it in positive ways, to grow and to change their ways for the better and to profoundly affect the lives of loved ones around them in deeply positive ways.

From time to time, depression and negative thoughts will cross your mind. If they didn’t, you would not be normal. Anger, impatience and selfishness are absolutely normal and could even be considered positive reactions. The one thing you must avoid is continued depression. The mere diagnosis of cancer causes depression. Many cancer treatments are depressing. Depression decreases the function of your immune system. Your immune system fights cancer. It is important that when you do find yourself depressed, you shake this feeling. Do this by talking about your depression to your family or friends. Change your thoughts from depressing subjects to positive, pleasant subjects. Channel the energy you would waste in depression into more positive thoughts. Concentrate all available energy into fighting your cancer.

As to whether you should go to a major cancer center for treatment, Dr. DeVita states, “Experience is what really counts in this whole business...If you had cancer, wouldn’t you rather go to someone who had a lot of experience managing that cancer?” If your local doctor has had the experience of successfully treating your type of cancer, and a qualified, independent second opinion agrees with his recommended action, there should be no reason to go away from your community.

Dr. DeVita says patients have “got to be able to go to their doctors and ask a very simple question: ‘Doctor, do you take care of this kind of cancer often?’ If he says, ‘Well I treat two or three patients a year,’ I think you should say, ‘Could you find me somebody with experience?’ Then telephone Cancer Information Service at 800-4-CANCER, and we can help you find the people with experience...That’s the real crux of the situation ...The answer for anybody who has cancer is to go find the people who have experience. That is not always in a big cancer center. For example, our cancer center in Bethesda is one of the finest in the world. We study certain kinds of cancers, but there are certain kinds of cancers that we don’t study at all. So for the ones that we don’t study at all, we’re not a good place to go.

The National Cancer Institute, with the cooperation of 150 cancer centers in the United States and 22 foreign countries, has spent tremendous resources to place every known treatment for each kind of cancer on a computer. Furthermore, this is updated for each kind of cancer every month after being reviewed by 108 physicians and scientists. This information, called PDQ, is available free through your personal computer or by telephone. It is written in common, understandable English and Spanish. It not only shows the state-of-the-art therapy for each kind of cancer along with statistics, but all other options including where successful experimental therapy is being done and whom to talk to. It is also available to any physician, any patient or anyone else absolutely free by going to www.cancer.gov or by calling 800-4-CANCER and requesting PDQ for the specific type and stage of cancer including all current open protocols. You can also get this information by calling the Bloch Cancer Hot Line at 800-433-0464 or through our website at www.blochcancer.org

Progress in the treatment of cancer is moving so rapidly that the state-of-the-art statements in PDQ were modified on an average of 15 per month during one 18-month period.
A publication of the National Institutes of Health entitled Cancer Control Objectives for the Nation 1985-2000, states, “The application of the state-of-the-art treatment is complex. At all levels of the health service delivery system, from the primary care physician who has initial contact with the patient to specialists directing the cancer treatment physician knowledge is not yet optimal. That knowledge should include an appreciation for state-of-the-art treatment information and an interest in ensuring early multidisciplinary decision making...For about 70% of cancers, optimal therapy derives from multidisciplinary discussions. The relative rarity of some of the most responsive tumors means that proficient treatment can be maintained only at some major cancer centers... Malpractice considerations may result in physicians selecting ‘safe’ therapy, which neither offers significant risk nor the chance of cure...A major determinant of outcome for most newly diagnosed cancer patients with curable disease hinges on early multidisciplinary treatment planning and the availability of expertise and resources to carry out such a treatment plan.”