How to Spot Signs and Symptoms of Cancer

There Are 9 steps to indicate Cancer signs

Step 1

Experiencing change in bowel habits or abdominal pain can be a sign of cancer.

Step 2

Having pain in the throat or a sore throat that will not go away is a symptom that should be checked for cancer.

Step 3

Bleeding or discharge from any part of your body that is unusual should be considered a reason for a doctors visit.

Step 4

Finding lumps or thick spots in the breast, testicles, or anywhere on the body could be a sign of cancer and should be checked.

Step 5

Swallowing problems or indigestion should not be taken lightly. If you have this for over a couple of weeks, see your doctor. It may be more serious than acid reflux disease.

Step 6

Seeing a change in a sore, mole, or spot in your mouth is a definite concern that should be addressed. Any change or bleeding constitutes a visit to the doctor.

Step 7

Coughing that will not go away or hoarseness is also a sign of possible cancer.

Step 8

Having a headache that will not subside should be checked by a doctor as well.

Step 9

Loss of weight or decreased appetite is also a reason for concern. A healthy person will have a desire for food, and should maintain body weight.


Tips & Warnings

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Check your symptoms
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Get a physical exam
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Have screenings done
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These signs or symptoms may or may not constitute cancer. If you have any of them, they are reason for concern and should be checked by a physician to determine the underlying cause.
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Farrah Fawcett's Anal Cancer: Fighting the Stigma

The iconic photo of Farrah Fawcett smiling in a red swimsuit marked her as the face of sexy, natural beauty in the 1970s.

Now, after her death Thursday at age 62 from anal cancer, her fight against the illness may help give a face to a potentially stigmatizing condition that can be the result of infection with the human papilloma virus (HPV), a sexually transmitted infection.

"This does not mean that she was promiscuous," noted Dr. Jay Brooks, chairman of the department of hematology and oncology at Ochsner Clinic Foundation and Hospital in Baton Rouge, La. "It simply means that she, at some point in her life, was probably exposed to the human papilloma virus."

Indeed, estimates for the percentage of anal cancers as a result of infection with HPV ranges from 45 to 90 percent. Although the exact cause of anal cancer is not known, the American Cancer Society reports that most anal cancers seem to be linked to HPV infection.

And HPV, the most common sexually transmitted infection in the U.S., is associated with a number of other cancers, including cervical and oral cancers. High risk HPV types accompany about 99 percent of cervical cancer cases.

Stigma of Anal Cancer Is Promiscuity

While HPV infection seems to be important in the development of anal cancer, the vast majority of people with HPV infections -- about 20 million Americans -- do not get anal cancer.

A 2007 study from the CDC determined that one in four females between 14 and 59 were infected with HPV, which is equivalent to 25 million American girls and women. Since only a small fraction of the millions of women affected with HPV develop anal cancer, risk factors beyond sexual activity, including smoking, a genetic predisposition to cancer, or being over 50, must be at play.

A great deal of research is underway to learn how HPV might cause anal cancer. There is good evidence that HPV causes many anal squamous cell carcinomas. But the role of this virus in causing anal adenocarcinomas is less certain.

"This was not necessarily the result of a sexually transmitted disease, and if it is, so what?" said Dr. Otis Brawley, chief medical officer of the American Cancer Society. "We need to not stigmatize this disease and the people who have it."

Rarity and Embarrassment Prevent People From Seeking Treatment

Anal cancer is rare -- much less common than cancer of the colon or rectum. The American Cancer Society estimates that in 2009 about 5,290 new cases of anal cancer will be diagnosed in the United States. The number of new anal cancer cases has been on the rise for many years.

But the stigma, coupled with the rarity and the cancer's location, may make those affected slower to respond to symptoms.

"For some people, this stigma is a critical factor in determining how quickly they respond to the symptoms or signs of disease," said Dr. Richard Wender, national president of the American Cancer Society, at the time Fawcett was diagnosed in 2006. "Just out of embarrassment, some people don't go to the doctor and say they have a pain in their anal area or that they have bleeding there."

Fawcett's Openness a Beacon for Many

Anal cancer can be a serious condition and the symptoms, which include changes in bowel habits, bleeding and pain, are not specific to anal cancer, making it difficult to catch in the early stages and almost impossible to prevent. An estimated 710 people (450 women and 260 men) will die of anal cancer in 2009, according to the ACS.

But treatment for anal cancer is often very effective, and most patients with this cancer can be cured. Fawcett's openness about her anal cancer, which included a documentary about her experience that aired in May, raised awareness about the disease.

"Her openness and honesty about this disease has probably helped to heal a lot of people. So she may have done a significant service by doing that," Brooks said. "You've got a woman who was known as a sex symbol who had a great deal of inner character and helped a great deal of other people."
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Fatty Diet Linked to Pancreatic Cancer

To the risk of obesity and heart attack, the government had added yet another reason to avoid eating lots of fat, especially from meat and dairy products: pancreatic cancer.

The National Institutes of Health has determined that people who indulge heavily in meat and dairy fats are likely more to develop this deadly disease, which will strike more than 42,000 Americans this year and kill more than 35,000, according to the American Cancer Society.

Men and women who consumed large amounts of saturated fat were 36 percent more likely to suffer from pancreatic cancer, researchers reported online in the Journal of the National Cancer Institute.

The study found that the link between fat intake and cancer was strongest for saturated fat from animal food sources, which were associated with a 43 percent increase in cancer risk.

To reach their conclusion, NIH researchers analyzed records of more than 500,000 people enrolled in the National Institutes of Health-AARP Diet and Health Study.

Participants completed a food frequency questionnaire in 1995 and 1996 and were followed to track a variety of health issues, including pancreatic cancer.

Over an average follow-up of 6.3 years, 865 men and 472 women were diagnosed with exocrine pancreatic cancer.

Among the participants who consumed the highest amounts of total fats, the rate of cancer was 53 percent higher for men and 23 percent higher for women, compared to participants with the lowest fat diets.

Combining the data for men and women, the researchers found that total fat consumption was associated with 23 percent higher rates of pancreatic cancer, while high intake of monosaturated fats was associated with 22 percent higher cancer rates.

They theorized that the association between fat intake and pancreatic cancer could be related to the so-called exocrine function of the pancreas, which excretes enzymes such as those that help digest fat.

They also noted that studies have linked saturated fat to insulin resistance and that diabetes and insulin resistance have been associated with increased pancreatic cancer risk.

Diet Link to Pancreatic Cancer Needs More Study

In an accompanying editorial, two prominent cancer researchers praised the NIH team, although they noted that more research would be necessary to definitively prove a direct link between fat intake and pancreatic cancer.

Dr. Brian Wolpin of the Dana Farber Cancer Institute in Boston and Dr. Meir Stampfer of the Harvard School of Public Health noted that pancreatic cancer kills 95 percent of its victims, and though it's far less common than many other types, it's the nation's fourth leading cause of cancer deaths.

Overall, they called on scientists "to push our research efforts in novel directions and provide hope for meaningful progress in this highly lethal disease."
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FDA Approves Drug for Dogs' Cancer

Having raised and bred show dogs, Lisa Peterson knew there was something wrong with her 9-year-old Norwegian elkhound Basia when she put her up on the table to groom her -- and noticed something unusual in the dog's mammary chain.

"It was a lump that was getting bigger; it was suspicious," she said.

Peterson took Basia to her veterinarian, who scheduled exploratory surgery. But on the day of the operation, it was already too late. Basia had cancer, and the tumor was already too big to be operated on. And she had to be put down.

Peterson's experience is not unusual when it comes to a type of tumor known as canine cutaneous mast cell tumors, which account for roughly one-fifth of all skin tumors in dogs. And they often are deadly.

But now a new drug -- the first to be approved by the U.S. Food and Drug Administration to treat cancer in dogs -- may soon change that outcome for some pet owners.

Palladia, manufactured by Pfizer Animal Health, has elicited optimism from veterinarians and pet owners alike.

"It is a real breakthrough for a cancer drug to be made specifically for animals," said Lawrence McGill, a veterinary pathologist at ARUP Laboratories in Salt Lake City, Utah.

"Hopefully, this is the start of many products coming forward so that we can help pets with cancer. I strongly suspect that veterinary medicine will continue to utilize human anti-cancer drugs where appropriate, but new drugs directed towards improving the health and welfare of dogs, cats and other pets will be greatly utilized and appreciated," he said.

Dog Cancer Drug Shows Attitude Shift

The fast-growing nature of canine cutaneous mast cell tumors makes them particularly dangerous, veterinary experts say.

"Unfortunately, this tumor can double in size overnight," said Gregory K. Ogilvie, a veterinary oncologist in Southern California.

This type of cancer can be lethal for other reasons as well.

"The tumor is unlike any other in that it releases chemicals in the bloodstream that can cause swelling, inflammation, bruising bleeding, stomach ulcers and therefore anemia and significant abdominal pain," Ogilvie said.

For these reasons, many owners view the new option as a godsend. Peterson noted that the approval of the drug shows "companies catering to consumers' needs to care for their pets at a high level," as well as a shift in many people's attitudes toward dogs.

"I think it shows that in our culture, dogs are really considered valued family members," said Peterson.

Assuming pet insurance will cover the cost of the drug, Peterson said, "It's going to be win-win for the pet owner who needs to care for their animal should they get cancer."

Insurance and cost remain a concern, but it is too soon to tell whether it should be.

Ogilvie said he and other veterinarians spoke with Pfizer officials who were trying to determine a fair price for the drug.

"From the veterinary community, the hope is it will be affordable for the average client for many months, if not years of therapy, and the company has assured us that it will be," he said.

Rick Goulart, a spokesman for Pfizer Animal Health, confirmed that a price has not been set. He said that the drug was currently available, but only through veterinary oncologists, who are attempting to figure out the best protocol for administering the drug. Because of this testing, the drug is provided to the oncologists without cost.

"The drug is made available to this specialist, who through the end of the year will be able to advance their experience with it," he said. "Veterinarians who now have access to the product are gaining experience with Palladia as they determine what protocols are right for bringing a pet owner in to get [a dog] treated for mast cell tumors."

Palladia will be available for sale through veterinarians in 2010.

Optimism For The Future

Like other cancer drugs, Palladia has unpleasant side effects that can include impaired mobility, diarrhea, loss of appetite and weight loss. However, it differs from many conventional cancer therapies in pets.

"This is a therapy that has capitalized on decades of basic research to understand how cancer survives thin the body and how to beat it," said Ogilvie.

The drug attacks the tumors' communications systems and ability to spread through the body.

Perhaps its most important for pet owners is that it is an oral medication that can be administered at home.

"Most cancer therapies have to be administered by a high-technology system and oftentimes in the hospital," said Ogilvie. "This oral therapy removes our patients from the clinic and places them on the couch with their families and therefore allows their families to provide this therapy ... in [a] loving environment.

"It really adds the personal touch that our clients can provide in their home along with the greatest advancement in molecular therapeutics and veterinary medicine."
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Possible HRT Link to Lung Cancer Death

In what may be another nail in the coffin of combination hormone replacement therapy (HRT), researchers said the menopause treatment is linked to an increased risk of dying of lung cancer.


In findings from the landmark Women's Health Initiative, using estrogen and progestin lead to a 59 percent increase in the risk of death if a woman developed non-small cell lung cancer, Dr. Rowan Chlebowski of Harbor-UCLA Medical Center in Los Angeles said at the annual meeting of the American Society of Clinical Oncology.

"This is one of a series of problems, especially with cancer, that work against widespread use of estrogen and progestin," Chlebowski said.

But despite those earlier problems -- increased risk of stroke, blood clots and breast cancer -- many postmenopausal women are use the combined hormone therapy to fight the symptoms of menopause, Chlebowski said.

He said between 25 and 30 million prescriptions are written every year, and 15 percent of postmenopausal women still use the combination.

The Women's Health Initiative study of combined hormone therapy enrolled 16,608 postmenopausal women ages 50 through 79 and randomly assigned them to receive either a dummy placebo treatment or the two hormones.

The study was stopped early when it became obvious that a range of harms from the treatment outweighed the benefits, Chlebowski said.

As the researchers followed the participants, they noticed a significant increase in both fatal and nonfatal cancers among those who got the hormones.

To try to explain the increase, they looked at the effect of the hormones on lung cancer, he said.

Research Shows Possible Link Between HRT, Lung Cancer Death Risk

For small cell lung cancer, there was no difference in incidence or mortality between the arms of the study, Chlebowski said. But for non-small cell lung cancer, analysis showed:

A significant increase in the risk of dying if a woman taking the hormones developed cancer.

Median survival of 9.4 months in women receiving hormones arm, compared with 16.1 months among women taking the placebo who got the disease in the placebo arm.

A trend to more cases of the disease in women taking the hormones.

All told, there were 67 deaths among the 8,052 women on hormones and 37 among the 7,678 women in the placebo group, Chlebowski said.

He added that, while smoking behavior was balanced between the study arms, smoking and taking the hormones led to an increase in the risk of death from the disease.

About one in 100 current smokers in the study had an avoidable cancer deaths associated with the combined hormone therapy, he said.

"Women almost certainly shouldn't be using both combined hormone therapy and tobacco," he said.

The finding is "a bit in contrast to the majority of case-control studies, where you see either no difference or a reduced risk," said Dr. Bruce Johnson of the Dana-Farber Cancer Institute in Boston, who was not part of the study.

"This is likely more accurate," he said, "since this is controlled in a prospective randomized study."
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Vaccine Slows Recurrence in Skin Cancer

In what researchers are calling a first, a vaccine that targets skin cancer cells shrinks tumors and cuts the chance that the disease will return.


In a large clinical trial, more than twice as many people who got the vaccine saw their tumors shrink compared to those who didn't get the drug, Dr. Douglas Schwartzentruber of Indiana University told colleagues at the annual meeting of the American Society of Clinical Oncology.

The study is "one of the first to show positive, promising results for a cancer vaccine" to fight the often-deadly skin cancer melanoma, Schwartzentruber said.

When it spreads from its original site, melanoma is difficult to treat and resistant to most therapies, he said. "These results will give patients and the oncology community hope that we are making some progress against this disease," Schwartzentruber said.

The vaccine consists of a molecule -- dubbed gp100 -- that is on the surface of melanoma cells. The idea is that the immune system will attack not only the molecule itself, but also the cancer cells that display it.

In previous trials, Schwartzentruber said, the vaccine has had little effect.

But in a new wrinkle, this time it was given with interleukin-2, a signalling molecule known to stimulate the immune system. In some studies, one in four patients treated with the interleukin-2 alone has had measurable tumor shrinkage, Schwartzentruber said.

The study, which is continuing, enrolled 185 patients with melanoma that had spread to other sites, such as the lungs. Half were treated with interleukin-2 alone and half were given the vaccine as well.

Among those who got both drugs, 22 percent saw their tumors shrink, Schwartzentruber said, compared to 9.7 percent of those who got interleukin-2 alone.

The vaccine also added about a month and half to the period before the cancer shook off the effects of the drug and began to spread again.

The differences may seem small, Schwartzentruber said, but in many cancer treatments, progress is measured in small steps that eventually add up. Skin Cancer Vaccine Study a 'First Step'

Schwartzentruber said this combination is only a first step. Other combinations of drugs that stimulate the immune system and target cancer cells need to be developed and tested in order to improve the results, he said.
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Promising Results for Experimental Lymphoma Vaccine

A vaccine that uses cancer cells against themselves significantly slows the progress of a deadly form of blood cancer, a researcher said at the annual meeting of the American Society of Clinical Oncology (ASCO).


In patients with follicular non-Hodgkin's lymphoma, the vaccine -- dubbed BiovaxID -- nearly doubled the time before the disease recurred, compared with a control drug, according to Dr. Stephen Schuster of the University of Pennsylvania School of Medicine in Philadelphia.

In the small trial -- 76 patients got the vaccine and 41 did not -- the vaccine extended time to relapse by more than a year: 44 months versus 30 months.

"The problem with this kind of lymphoma is that chemotherapy doesn't actually cure anybody," said ASCO president Dr. Richard Schilsky of the University of Chicago Medical Center, who was not involved in the study.

"They all go into remission with chemotherapy but they all relapse," Schilsky said. "Each time you use chemotherapy, the remission lasts less time and eventually they just become refractory."

So, he said, "The longer you can keep them in remission the better."

The therapeutic vaccine is tailored to each patient's cancer and given with a drug that stimulates the immune system, Schuster said during the annual ASCO meeting.

"We've now moved into an era where we can safely use a patient's immune system to effectively fight follicular lymphoma and enhance the response to conventional chemotherapy," Schuster said in a statement.

The key outcome is that in a "very select group of patients," the approach significantly lengthens the time before cancer returns, according to Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, who was not involved in the study.

But Lichtenfeld said it has taken many years to reach this point, with many false steps along the way. "Maybe we're finally learning something," he said, " that will translate hope to reality."

There are about 65,000 new cases of non-Hodgkin's lymphoma diagnosed each year in the United States, and despite aggressive chemotherapy and recent advances in therapy, the disease is almost uniformly fatal.

In the follicular form of the disease, 90 percent of patients die within seven years of diagnosis.

The vaccine itself is made by extracting cells from lymph nodes and identifying a cancer marker -- an "idiotype" -- that is unique to each patient, Schuster said. This idiotype is then fused with chemicals designed to stimulate the immune system.

Lymphoma Vaccine Approach May Have Implications for Other Cancers

No serious adverse events were associated with the vaccine, Schuster said.

The researchers commented that the approach might be useful in other forms of B cell cancer, such as chronic lymphocytic leukemia. Schilsky noted that, unlike other forms of cancer, the B cell cancers display a range of cell surface proteins that are distinctive.

"That's what makes this a feasible approach, because you can use that to develop a unique vaccine for each kind of lymphoma," he said.
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Conflicting Data on Breast Cancer, Tamoxifen and Antidepressants Emerge

Thousands of breast cancer survivors take antidepressants to ward off hot flashes caused by tamoxifen, a chemical agent that helps prevent the disease from returning.

Thousands of breast cancer survivors take antidepressants to ward off hot flashes caused by tamoxifen, a chemical agent that helps prevent the disease from returning.
But some researchers worry about the mix: They think some popular antidepressants may keep the anti-cancer drug from working as well as it should.

Doctors and patients hoped two large studies would resolve the issue, but they were disappointed this weekend: Scientists in the United States and the Netherlands reached opposite conclusions at the annual meeting of the American Society for Clinical Oncology.

The antidepressants, known as selective serotonin reuptake inhibitors (SSRIs), are a class of drugs that includes fluoxetine (best known under the brand name Prozac) and paroxetine (Paxil).

One particular group of these antidepressants works by inhibiting an enzyme known as CYP2D6, which coincidentally helps the body process tamoxifen. Researchers want to know if the potential for conflict between the two agents yields real problems for breast cancer survivors.

In the U.S. study, an analysis of medical records of almost 1,000 breast cancer patients showed that use of CYP2D6 inhibitors almost doubled the risk of breast cancer recurrence within two years after patients started tamoxifen.

The records showed a two-year breast cancer recurrence rate of 13.9 percent in women taking tamoxifen along with a CYP2D6 inhibiting antidepressant, compared with a 7.5 percent recurrence rate among women taking tamoxifen alone, according to Dr. Ronald E. Albert of Medco Health Solutions in Franklin Lakes, N.J.

In contrast, Dutch investigators reported just the opposite when they looked at the records of 1,962 breast cancer patients who took tamoxifen between 1994 and 2006. They found no evidence that CYP2D6 inhibitors increased the risk of breast cancer recurrence in women taking tamoxifen.

In fact, during more than four years of follow-up, the group taking CYP2D6 antidepressants had a recurrence rate of 13.3 percent, compared to 14.6 percent among women who took tamoxifen alone or took a CYP2D6 inhibitor for less than 60 days while on tamoxifen.

Studies Conflict on Antidepressants' Effect on Breast Cancer Recurrence

"Based on our findings and previous studies, we don't have strong evidence that it's unsafe to use 2D6 inhibitors during tamoxifen therapy," Dr. Vincent Dezentje of Leiden University Medical Center, said in a statement.

None of this pleased physicians who were looking for a definitive answer. Noting that the number of women who took both tamoxifen and CYP2D6 antidepressants was relatively small in both studies, they called for research involving larger groups.

"We still have a lot of work to do," said Dr. Lori Pierce, a breast cancer specialist at the University of Michigan, who was not involved in either study. "These two conflicting studies show that we still don't have a definite answer about how important CYP2D6 function is. We need to do more validative studies to find out whether or not we should be testing women [for CYP2D6 status] who are on tamoxifen."

Until the issue is resolved, Pierce added, women taking tamoxifen have alternatives to CYP2D6 inhibitors. Some SSRIs do not inhibit the enzyme. Using a different drug known as an aromatase inhibitor instead of tamoxifen to prevent breast cancer recurrence is another possible option.

"You should make the best judgment in terms of the appropriate medication for the patient, given her disease," said Pierce. "There are ways to work around the problem if tamoxifen is the best drug for a patient. But certainly aromatase inhibitors are very important drugs in our armamentarium for postmenopausal women with breast cancer."
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No Benefit From Surgery for Metastatic Colon Cancer

Surgeons who plan to operate to remove the original tumors from patients with metastatic colon cancer might do well to put down their scalpels and rely on chemotherapy instead, according to a new study.

Researchers at Memorial Sloan-Kettering Cancer Center in New York reviewed more than 200 cases and found that more than 90 percent of patients had no complications that required surgical intervention.

Of those who did require surgery, only two had complications leading to unsuccessful procedures.

"In this era of modern chemotherapy, routine surgery to remove the primary tumor in patients with unresectable metastases is no longer supported by the data," Dr. Philip Paty told colleagues here at the American Society of Clinical Oncology meeting.

"In addition to being an unnecessary procedure that carries its own risks of morbidity and mortality, surgery delays the start of chemotherapy for several weeks, and in some cases may make the patient less fit for and less tolerant of chemotherapy," Paty said. "Unless there is an immediate need for surgery, patients should begin chemotherapy first."

About 147,000 Americans will be diagnosed with colorectal cancer this year, and almost 50,000 will die from the disease, according to the American Cancer Society.

These findings came from a retrospective analysis of 233 patients from a much smaller group who had metastatic colorectal cancer at diagnosis -- which means their cancers had spread beyond their original location.

The researchers wanted to find out whether a longstanding procedure -- removal of the primary tumor -- would matter once the cancer had spread.

All of the patients received a standard three-drug chemotherapy combination. In a subsequent follow-up, 217 patients (93 percent) had no complications that necessitated surgery for the primary tumor.

Of those, 55 eventually had elective surgery on the original tumor when surgeons removed lesions elsewhere, while eight others opted for it when surgeons implanted a hepatic-artery infusion-pump -- a device that pumps chemotherapy medications directly into the liver.

For Colon Cancer, Surgery May Not Be Best Option

Of those who actually required surgery for primary tumor obstruction or perforation, 14 had successful procedures, suggesting that the delay posed little risk to the patients.

For the entire group, operative mortality -- the rate of death within 30 days of the surgery or while the patient is still hospitalized -- was 0.8 percent.
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U.S. Cancer Death Rates Continue to Fall

WEDNESDAY, May 27 (HealthDay News) -- Some 650,000 people are alive today who wouldn't be were it not for advances in cancer prevention, detection and treatment over the past 15 years, new statistics show.

The American Cancer Society's Cancer Statistics 2009 report finds an encouraging 19.2 percent drop in cancer death rates among men from 1990 to 2005, as well as an 11.4 percent drop in women's cancer death rates during the same time period.

Overall, cancer death rates fell 2 percent per year from 2001 to 2005 in men and 1.6 percent per year from 2002 to 2005 in women. By comparison, between 1993 and 2001, overall death rates in men declined 1.5 percent per year and, between 1994 and 2002, 0.8 percent in women.

"We continue to see a decrease in death rates from cancer in both men and women and this is mainly because of prevention - mostly a reduction in smoking rates; detection which includes screening for colorectal cancer, for breast cancer and for cervical cancer; and also improved treatment," said report author Ahmedin Jemal, strategic director for cancer surveillance at the American Cancer Society.

"To put this in perspective, the number of lives saved is more than the population of Washington, D.C.," said Dr. Louis M. Weiner, director of the Lombardi Comprehensive Cancer Center at Georgetown University. "In my mind, that's a cause for some celebration. However, there are some sobering trends that we have to be aware of. The death rate for cardiovascular disease has dropped much more dramatically over that period than has the death rate from cancer, indicating the difficulty of developing new strategies to reduce the incidence of cancer and also to treat it more effectively. This is a very complex set of diseases. While we have come a long way, we have a lot further to go."

Hopefully, continued reductions in smoking rates, especially among women, should push cancer rates further down in the future, the researchers noted.

Although some 45 million Americans continue to smoke, for a prevalence rate of about 20 percent, "smoking prevalence is going in the right direction," Jemal said. "We're going to see a reduction in lung cancer death rates, although I don't know when it might be. In particular, we will see a reduction in cancer death rates among women that's going to drive [down] the overall cancer death rate."

Better screening could also further fuel the trend. Only 50 percent of Americans over the age of 50 currently get regular screening for colorectal cancer, he said.

Here is a summary of the report's findings:

# In 2009, an estimated 1,479,350 new cases of cancer will be diagnosed in the U.S. (766,130 in men and 713,220 in women) and 562,340 people will die of the disease (292,540 men and 269,800 women). This means 1,500 deaths from cancer every day).

# Between 2001 and 2005, the incidence of cancer in men declined by 1.8 percent per year; from 1998 to 2005 the incidence rate in women dropped 0.6 percent per year. In men, the gains were largely as a result of decreases in the incidence of lung, prostate and colorectal cancer (the three most common cancers). In women, the decline was largely attributable to declines in both breast and colorectal cancer, the two most common tumor types in women.

# Cancer death rates dropped by 11.4 percent for women between 1991 and 2005, with a 37 percent decline in deaths from breast cancer and a 24 percent decrease in deaths from colorectal cancer.

# The three leading cancer killers in men are lung, prostate and colorectal cancer. In women, they are lung (accounting for 26 percent of all cancer deaths), breast and colorectal cancer.

# Men have a 44 percent chance of developing cancer during their lifetime and women a 37 percent chance, although women are more likely to have the disease earlier (before age 60).

# Lung cancer shows the greatest regional variation in cancer incidence, ranging from a low of 39.6 cases per 100,000 in men and 22.4 per 100,000 in women in Utah to 136.2 in men and 76.2 in women in Kentucky. These statistics correlate directly to smoking rates in the two states, with Utah having the lowest prevalence in adult smoking in the country, and Kentucky the highest.

# Blacks still assume a disproportionate share of the cancer burden, with black men being 18 percent more likely to develop cancer and 36 percent more likely to die. Black women have a 6 percent lower incidence rate but this is more than made up for with a death rate, which is 17 percent higher than that seen in white women.

# The five-year survival rate for children with cancer is now 80 percent, up from only 58 percent for those diagnosed in the mid-1970s. But cancer is still the second leading cause of death in youngsters aged 1 to 14 (after accidents), with leukemia being the most common cancer diagnosed.

# And in a special section, the report finds that cancer survivors are about 14 percent more likely to develop a new cancer than individuals who have never had a cancer diagnosis; almost 900,000 cancer survivors have been diagnosed with more than one cancer. Patients diagnosed with tobacco-related cancers, such as cancers of the oral cavity, lung, esophagus, kidney, and urinary bladder, have the highest risk for a second cancer because smoking is a risk factor for at least 15 types of cancer. Breast cancer survivors comprise almost half of women who develop a second cancer.

Unfortunately, cancer remains the leading killer (surpassing heart disease) for persons under 85, and one-quarter of deaths in the United States still come from cancer, the report stated.

"It's good news that the death rates for the most common cancers are on the decline, but there are still too many Americans dying of cancer every year," said Dr. Alan Astrow, director of medical oncology and hematology at Maimonides Cancer Center in New York City. "It's troubling that African-Americans continue to experience higher rates of mortality from cancer than whites. It's also troubling that Americans with less education have higher death rates. There are continued high rates of deaths from lung cancer. It's hard to feel good about 160,000 Americans dying of lung cancer every year. That's a disturbing statistics which we, as a nation, need to address."
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Fighting Cancer With Daughter's Breast Milk?

When Tim Browne sits down to a bowl of corn flakes in the morning, he slurps up one unusual, and controversial, extra ingredient: his own daughter's breast milk.

He doesn't do it for the taste -- Browne initally said his daughter Georgia's breast millk tasted "not unpleasant, but slightly pungent" -- but for his health.

Nearly two years ago, the retired teacher and musician from Wiltshire, England, was diagnosed with colon cancer. He went into surgery a week before his daughter's wedding, but a month later, doctors told him the cancer had spread to his liver and lymph nodes and was terminal.

Surgery was ruled out this time, so Browne began a course of chemotherapy. Desperate to help, his daughter Georgia came up with the idea while watching a show about breast milk.

"[It was] a man in America. It was prostate cancer this man had and he'd been drinking breast milk every day," she said. "Anyway, this guy really swore by the breast milk and said that it had reduced his tumors."

Georgia was nursing her 8-month-old son Monty and offered to set aside a few ounces of milk every day for Browne. Browne started calling Monty his "milk brother."

"If I have a lactating daughter, why not take advantage of her? As long as Monty didn't mind," Browne said.

Browne had to stop taking his daughter's milk when nausea from the chemotherapy made the taste intolerable to him. He is not cured of the cancer, but he is convinced that taking the milk was the right thing to do.

"It's very difficult to tell if something is working or not," Browne said. "What we feel comfortable about is the process of doing it has been amazing and has helped all of our family."

ABC News medical contributor Dr. Marie Savard said that even though breast milk is known to have benefits and it's make up can't be reproduced, "there's no research to say those same proteins in human breast milk will benefit this man."

Savard said the placebo effect in this case, though, is very real.

"I think the most tender part of this piece is providing hope," she said. "They both together strengthen their relationship. Does it work? We don't know."

Scientists Cautiously Optimistic About Breast Milk Potential

Browne is not the only cancer fighter turning to what scientists call the "highly alternative" treatment of drinking breast milk.

According to the Food and Drug Administration, there have been "intriguing new developments [which] indicate that breast milk may ... reduce the risk of childhood cancer."

A protein in human milk can cause cancerous cells to "self-destruct," the FDA said on its Web site. That unique characteristic of the protein could potentially help battle cancer in adults, some doctors say.

"There's promising research that would indicate that in the future the solution for not only preventing cancer, but even treating and curing cancer might be in human milk," said Dr. Lori Feldman-Winter at Cooper University Hospital in New Jersey.

But for the relatively few adults seeking the alternative treatment, breast milk is expensive, requires a prescription and is difficult to find, unless they happen to be near one of the six milk banks in the United States that were created specifically to provide breast milk to adults.

"In the past we have had one to two inquiries a month," said Dr. Deborah Tuttle of the Mothers' Milk Bank at Christiana Hospital in Newark, Del.

Other milk banks give their milk to premature infants, where doctors prefer to use breast milk because research shows a greater chance of benefits.

As far as breast milk becoming a common treatment for terminal cancer patients, Savard pointed out that there's not enough milk in the country for premature babies. And because they are known to benefit from breast milk, that's where the focus needs to be, rather than cancer treatments.

But because Browne gets his milk from his daughter -- after her son eats -- "I think there's not harm done in this situation," Savard said.
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Cancer chemicals: Pool herbicides put kids at risk

It seems a lot of Australian homeowners are turning to carcinogenic herbicides to keep their pools the right shade of blue.

Authorities are considering placing a ban on the use of herbicides which have a key ingredient called simazine which is of particular risk to children.

There are almost 1 million swimming pools in Australia. In a sun-soaked land they provide fun for children and relief from the heat.

Dr Alison Bleaney is a GP in Tasmania and for a long time has had concerns about the use of chemicals in swimming pools.

"The concern is that children are more susceptible to the effects of chemicals in their bodies than adults are, just by the fact that they're smaller, their systems are not capable of detoxifying nasty chemicals the way an adult is," she said.

"We know that the trizines, atrazines, simazines, are immune modifiers, they modify our immune systems, they affect our hormone systems in extremely small levels.

"In swimming pools they can be taken in through the skin surface ... as well as children of course just gulping it down."

Her concerns have been ignored for a long time despite moves on the other side of the world to ban the use of simazine as a cleaning agent.

"They've been withdrawn in the United States in the early 1990s, aren't used at all in Europe, and the fact that they're allowed to be used in our swimming pools, where our young children are swimming, can only be described as disgraceful," she said.

The Australian Pesticides and Veterinary Medicines Authority is independent of government and says it is prepared to review the evidence presented to it.

The regulator's spokesman is Doctor Simon Cubit.

"We undertake reviews when we have information that suggests that there might be concerns about a particular chemical," he said.

"We're at the scoping stage of that review. So what that means is that we'll get together and determine what we know now about the chemical, information that raises uncertainty about its continued use.

"The current advice that we have from our advisors, which are other commonwealth government departments, has not suggested that there are any causes of concern."

A spokeswoman for Federal Agriculture Minister Tony Burke says the Government welcomes the review.

She says the Minister believes the community needs to remain vigilant on the use of chemicals with the potential to have an impact on human health.
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Drink for Your Heart but Abstain for Cancer?

The latest piece of evidence on the risks of drinking alcohol comes from researchers at Oxford University who studied more than 1.2 million women in the United Kingdom. They found that drinking alcohol may account for about 13 percent of all breast , liver, rectal and upper digestive tract cancers in women.

More shocking, even small amounts of alcohol seemed to increase the cancer risk. When compared with women who drank two or fewer alcoholic beverages per week, those drinking up to six alcoholic beverages had a 2 percent greater risk for cancer in general; those consuming between seven and 14 drinks per week had a 5 percent increased risk for cancer; and those consuming 15 or more per week had a 15 percent increased risk for cancer.

Using these findings, Dr. Michael Lauer, director of the Division of Prevention and Population Sciences at the National Heart, Lung, and Blood Institute in Bethesda, Md., wrote in the study's editorial that "there is no level of alcohol consumption that can be considered safe."

But with all we've heard in the past about the supposed health benefits of alcohol, can this really be the case?

Most experts say no.

"The editorialists … seem to be rather extreme in their views," said Dr. Charles Poole, associate professor of epidemiology in the Gillings School of Global Public Health at the University of North Carolina. "I have seldom seen such a one-sided dismissal of the hypothesis that moderate alcohol use may have cardiovascular benefits."

Alcohol for a Healthy Heart?

A study published in the British Medical Journal in May 2006 found that women who drank alcohol at least one day a week had about a 35 percent lower risk of coronary heart disease than women who drank alcohol less than once a week. For men, however, those who drank daily saw the largest reduction in risk when compared with nondrinkers -- about 41 percent.

The Fine Line Between Health and Illness

But it seems that the quantity of alcohol consumption plays a big role in whether you will see the risks or the benefits of a good buzz.

A meta-analysis (or overview of old studies) published in the Journal of the American Medical Association in 2003 found that light to moderate alcohol consumption could lower the risk for stroke, while heavy alcohol consumption raised the stroke risk.

Researchers found that those who consumed more than about 60 grams of alcohol per day, or about five drinks, had a 64 percent increase in overall stroke risk. But those who drank 12 grams of alcohol per day, or about one drink, experienced an 83 percent decrease in overall stroke risk.

Based on the body of available evidence on the benefits and risks of alcohol consumption, the American Cancer Society recommends that drinkers limit intake to one drink per day for women and two drinks per day for men.

Drink for Your Heart, or Stop Drinking for the Cancer Risk?

For some, this decision to start drinking for the heart benefits or stop drinking because of the increased cancer risk should be based on personal medical history.

"In light of the findings from [this study], women who are concerned about their cancer risk versus their risk of cardiovascular disease might want to discuss the potential risks and benefits of even low alcohol intake with their health care providers," said Susan Gapstur, associate director of Cancer Prevention and Control within the Robert H. Lurie Comprehensive Cancer Center at Northwestern University in Chicago.

And for those with a history of certain diseases such as breast cancer, experts said the heart-protective benefits of alcohol might not outweigh the overall increase in cancer risk caused by drinking.

"I think women at high breast cancer risk due to strong family history, or due to their own personal history, might be better off if they were to restrict alcohol intake to under one drink per day on average," said Dr. Tim Byers, associate dean of the Colorado School of Public Health at the University of Colorado at Denver.

The End Result: Alcohol's Effect on Life Expectancy

But for those whose personal history offers no added risk for alcohol consumption, taking a look at the overall life expectancy of alcohol drinkers might help to sway one's decision on whether the buzz is really worth it.

A study published in the journal Epidemiology in November 1998 found that light to moderate drinkers had the lowest risk of death compared with nondrinkers. Those who drank between one and seven alcoholic beverages a week experienced a 20 percent reduction in overall mortality.

When the researchers looked more closely at why light to moderate alcohol drinkers had less risk of death, they found that this group experienced a reduction in death from heart disease, thereby suggesting that the moderate alcohol consumption could have some protective benefits for the heart.

The Final Word on Alcohol

Based on the many studies finding that moderate alcohol consumption can have a heart-protective benefit, many experts said that moderate drinkers should not worry about this latest research finding an increased risk in cancer.

"A small decrease in [cardiovascular] risk more than compensates for an increased risk of rare cancers," said Dr. Alan Kristal, member and associate head of the Cancer Prevention Program at the Fred Hutchinson Cancer Research Center in Seattle. "You have to die of something, and no doubt how you live affects what you die [from], but not 'if' and maybe not 'when.'"
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Pregnancy No Hindrance to Breast Cancer Treatment, Study Says

Pregnant Women Can Get Chemo; Early Detection Still Lags.

That was when she found out she was pregnant. But it was also in April 2007 that she learned she had breast cancer.

"It definitely was not expected," Sanchez recalled. "It was scary -- it was very, very scary, actually."

She had noticed the lump in her breast herself, and by the time a doctor examined it, it had developed into stage 2 breast cancer. To delay treatment would put her life at risk. But doctors at the time told her that to go forward with chemotherapy could pose a health threat for the baby growing inside her.

"My gynecologist at the time, she told me that I was not going to be able to keep the baby," she said.

Sanchez is not alone. Dr. George Perkins, an associate professor in the M.D. Anderson Cancer Center's Department of Radiation Oncology, said a growing number of women face a breast cancer diagnosis while pregnant.

"In the midst of this joyous occasion is the somber news that there might not be hope for them," he said. "Usually ... they have been told that the only way they can receive treatment is through the termination of their pregnancy."

But mounting evidence suggests that women in this situation do not necessarily have to decide between their own health and their baby's survival. The latest study to suggest this, which Perkins co-authored, was published today in the current issue of the journal Cancer.

Perkins, lead study author Dr. Beth Beadle and colleagues at M.D. Anderson studied 652 breast cancer patients. What they found was that there was no difference in the odds of surviving 10 years -- widely considered as the point at which a woman can be considered cured of breast cancer -- between the women who were not pregnant during or slightly before their diagnosis and those who were.

The primary difference in treatment, Perkins said, was that pregnant women should not undergo chemotherapy during the first trimester, as this is the time when the baby's organs are forming and they are particularly vulnerable. But past studies have shown that when chemo begins in the second or third trimester, the children that are born are just as healthy as babies born to mothers without breast cancer -- and their mothers have the same chance of survival as their breast cancer-free counterparts.

Perkins said that this is good news for those women who find themselves in a situation similar to Sanchez's.

"The overall outcome of the newborn child, as well as the mother, can be taken into account [during treatment]," he said.

'Minimal Harm to Baby' From Chemo Later in Pregnancy

Dr. Eva Singletary, associate director of M.D. Anderson's Nellie B. Connally Breast Center, said in an interview with ABC News' OnCall+ Breast Cancer resource site that it is true that women who are further along in their pregnancies can take advantage of chemotherapy.

"In the second and third trimester, we can use chemotherapy very successfully with minimal harm to the baby," Singletary said.

But, she added, if a woman already has a breast cancer diagnosis, it is still wise for her to avoid getting pregnant because of how it could possibly complicate treatment.

"[I]t is important to use birth control, because chemotherapy can have harmful side effects to the fetus in the first trimester," she said. "However, in the second and third trimester, we can use chemotherapy very successfully with minimal harm to the baby.

Diagnosis During Pregnancy Becoming More Common

According to statistics from the American Cancer Society, breast cancer associated with pregnancy is rare, but it does happen in about one in 3,500 pregnancies.

And current trends suggest that this rate could be on the rise.

"We are noticing that we are seeing more patients being diagnosed with breast cancer during pregnancy," Perkins said.

The primary reason for this is that pregnant women, on average, are getting older. In 1982, the median age of a pregnant woman was 26.0 years; in 2002, this figure stood at 27.4 years.

"As the age at which child birth increases for women due to career goals and other reasons, we are expecting the incidence to increase," Perkins said. "We receive several phone calls a month from women who have been diagnosed with breast cancer and who are pregnant who have been told that overall they have an abysmal diagnosis."

When Cancer Goes Undetected

While the new study has good news to offer women who require breast cancer treatment while pregnant, it also exposes a disturbing fact -- pregnant women with breast cancer tend to be diagnosed later than those who are not pregnant. This means that by the time their cancers are found, they are generally worse.

"Women who present with breast cancer while pregnant on average have more advanced disease," Perkins said. "This represents a phenomenon of delayed diagnosis. In many cases they don't find out that they have breast cancer until after delivery."

Part of the problem is the fact that pregnant women naturally experience changes in the breast. These expected changes may mask breast cancer symptoms, making detection less likely by both these women and their doctors.

"The natural tendency is to say that this is a benign process, and that we don't have to be concerned about it," Perkins said.

But Perkins added that he remains hopeful that as more evidence comes out that pregnant women have little to fear from cancer treatment, more will have stories similar to Sanchez's. On Nov. 26, 2007, her baby, Isabella, was born. And Sanchez said that thus far, her daughter is meeting all of the normal benchmarks for children her age.

As for her own health, Sanchez is looking forward to this June, when it will be a year since she was declared cancer-free.

"I don't really feel like a survivor yet, but everything looks good so far," she said.
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Smoking Marijuana May Be Tied to Testicular Cancer, Researchers Say

Internet photos of swimming phenomenon Michael Phelps, 23, possibly indulging in an Olympian lungful of marijuana smoke scandalized many and may have caused him to lose face and the faith of some of his fans -- not to mention a lucrative sponsorship from Kellogg.


But according to new research, if Phelps makes a habit of smoking up, he could stand to loose more than a fan base.

For the first time, researchers have linked frequent marijuana use to an increased risk of testicular cancer, according to an article published today in the journal Cancer.

"There's been very little research done on marijuana use and its association with cancer risk," said Janet Daling, the senior author of the article and an epidemiologist and member of the Public Health Sciences Division at the Fred Hutchinson Cancer Research Center (FHCRC) in Seattle. "This is the first time this association has been shown."

Using a population-based, case-control study, Daling surveyed 369 men diagnosed with testicular cancer and 979 healthy men between ages 18-44 about their history with marijuana use.

After controlling for family history and lifestyle factors, including alcohol and tobacco use, which could also be associated with testicular cancer, the researchers found that being a marijuana smoker was associated with a 70 percent increased risk of testicular cancer.

Heavy Users at Risk

Participants who used marijuana once a week or more or who had long-term exposure to marijuana since adolescence were at twice the risk for testicular cancer than those who never used marijuana.

In addition, the association between frequent marijuana use and testicular cancer was more pronounced among men who had nonseminomas, a more aggressive form of testicular cancer, than those who had seminomas. Nonseminomas also tend to strike in younger men.

Although this research has the most implications for habitual users, it goes against commonly held beliefs that marijuana is one of the more benign recreational drugs, a potential concern given the number of people who have tried marijuana in their lives.

According to the National Survey on Drug Use and Health, in 2006, 14.8 million Americans age 12 or older used marijuana at least once in the month before they were surveyed, making it the most common illicit drug of abuse.

Testicular cancer is the most common cancer in white American males ages 15-34. Between 2001 and 2005, nearly half of all testicular cancer diagnoses were in men between ages 20-34, according to the National Cancer Institute.

Established risk factors include family history, undescended testes, and abnormal testicular growth. However, with about 8,000 cases diagnosed each year, testicular cancer is one of the rarer types of cancer.

But some have mixed feelings about the report.

"It is both surprising and not surprising," said Dr. Omer Kucuk, an expert in cancer and nutrition and a professor of hematology and medical oncology at the Winship Cancer Institute at Emory University in Atlanta. Kucuk was not associated with the research.

Kucuk pointed out that while this was the first paper amid limited research on marijuana and cancer to show a causal effect, there is evidence that marijuana does affect parts of both the male and female reproductive systems, including hormones and sperm quality.

Trusting the Tokers

In addition, Stephen Schwartz, co-author of the study, epidemiologist and member of the Public Health Sciences Division at the FHCRC, indicated that there may be room for improving the quality of the data gathered.

"We're reliant on them telling us what they did," Schwartz said. "We have to be a little skeptical of the accuracy of the reporting."

But the results showing that men with the aggressive, nonseminomal testicular cancer were more frequent drug users than those with seminomal cancer made Daling believe that patients were telling the truth overall, or were at least being consistent in their answers.

"If, when you're doing a cancer study, you might suspect that the cancer cases might be more honest when answering a question that is not routine," Daling said. "If that was the case, you'd see it across both histology groups. But we saw it only in nonseminomas, which indicates it's not just recall bias."

More substantial research on marijuana use being linked to increased risk for lung, head and neck cancers does exist, although it is not definitive. Kucuk said that trying to uncover the mechanism of how marijuana might be associated with cancer -- whether it could be hormonal or receptor-related -- could help focus future studies.

"Research like this is not meant for people to change their habits or ideas," Schwartz said. "It is one study out of many more that need to be done."
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Cancer Care Costs Squeeze Millions of Americans

Millions of Families Struggle to Pay for Care, Even Those With Health Insurance

Even people who have health insurance can be bankrupted if they come down with cancer, says a new report from the American Cancer Society.

The Kaiser Family Foundation and the American Cancer Society unveiled a new joint report today that outlined the serious financial consequences families face when a member is diagnosed with cancer. In addition to dire statistics and figures, the report featured the stories of 20 patients who have faced severe debt and other challenges in their struggle to get treatment for their disease.

Some lost their life savings; others lost their jobs. Some found it nearly impossible to find insurance to help them pay for the care they needed. And some had to file for bankruptcy.

John Seffrin, the national chief executive officer of the American Cancer Society, noted during the briefing that these stories, unfortunately, are all too common.
"Two million cancer survivors today are forgoing care they need simply because that care is unavailable because they cannot afford it," Seffrin said, adding that lack of access to quality care is now a major case of cancer death in the United States.

"This issue is not only a serious public health issue; it is a moral imperative for change."

Christy Schmidt, one of the report's authors and a cancer survivor, told ABCNews.com that the report is even more frightening considering that all of those profiled had health insurance.

"Just because you're insured doesn't mean that you're not going to have... very, very serious financial problems," she said. "The very design of insurance policy itself can cause significant expenditures, even leading to bankruptcy or loss of home for some people."

"One in five people with cancer use up all or most of their savings, and those are people who have insurance."

Losing Your Home to Cancer Costs

Anna Nunes of Lake in the Hills, Ill., is not one of the 20 patients whose story appears in the report. But she is among the millions of Americans who have suffered financial problems after recovering from cancer. She and her family lost their home in nearby Crystal Lake after she was diagnosed with and treated for breast cancer two years ago.

She was diagnosed in July 2007 and had her first surgery -- mastectomy and reconstructive surgery -- in October of that year. Despite coverage through her husband's job, she was unable to keep up with the bills.

"As much as I knew that we were probably going to lose our house... it just got to the point where there was no recovery," she said of the cost of treatment. "I just figured at this point, it's just money and it's just a house. It doesn't really matter where we live as long as we're all together and healthy."

Nunes had what she hopes is her last surgery -- for reconstruction -- last week. But she said she considers herself luckier than most cancer survivors.

"It was actually caught very early. I was lucky that I didn't have to go through any chemo or radiation."

Fortunately, Nunes' apartment, where she lives with her husband, a postal worker, and their two teenage daughters, is only half a mile from their old home, so the daughters attend the same schools. A real estate agent before cancer, Nunes still works in that field part time, also working part time in retail.

But she said the financial situation after she began receiving treatment was overwhelming.

"The medical bills didn't help. The diagnosis and not being able to work didn't help," Nunes said. "You're just at the point where you do what they say because you are devastated. ... You just don't think of that stuff when you're told something like this."

Getting Cancer Costs Under Control

Robert Zirkelbach, a spokesman for America's Health Insurance Plans, said the American Cancer Society's report exposes the need for reform.

"This report highlights the needs to get health-care costs under control," he said. "You're seeing that especially when it comes to cancer treatments. Cancer drugs are a driver in these rising costs."

Zirkelbach pointed to a report issued by his group in December that he said addressed the group's ideas for comprehensive health-care reform.

Among the group's proposals, he said, is one that addresses the concern of many that insurance will not cover pre-existing conditions. He said the new proposal would alleviate that concern, but that it would go hand in hand with people maintaining coverage, without gaps.

Zirkelbach added that his organization also advocates creating a government agency that tests treatments, comparing them to see which is the most effective, so that costly treatments do not take up unnecessary health-care dollars. This would complement the Food and Drug Administration, which simply tests that new drugs work, without considering how they compare to current treatments.

But Zirkelbach stressed that the issues in health insurance go beyond cancer care.

"A lot of these issues that this report talks about need to be addressed on a comprehensive basis, not just with regard to cancer treatment. ... The cost of treatment is only part of the financial obligations that an individual has."

Indeed, many with cancer lose their jobs. Zirkelbach cited this as a reason why individuals should consider long-term disability insurance, which would help pay bills when they are out of work because of illnesses. According to U.S. Department of Labor statistics, about 30 percent of workers in private industry -- in all, about 40 million Americans -- have employer-sponsored long-term disability insurance.

Long-term disability through private insurance can help provide some level of income for people ineligible for government programs, which require disability for a significant time. Social Security disability, which is for people who expect to be out of work temporarily but for more than a year, does not kick in until a person has been out of work because of a medical disability for at least five months. While it is rare to have delays with cancer patients, a delay in hearing time can lead to a longer waiting period for benefits. The payments, based on a complex government formula, will never be equal to job income levels.

Medicare, which is paid to people who are permanently disabled and can never return to work and covers only medical expenses, will not kick in until two years have passed since someone has started collecting Social Security disability benefits, so cancer patients who apply will not receive benefits until 29 months after their diagnosis.

Additionally, Schmidt said, the co-payments with insurance are often too high for people who need continuous treatment, the annual limits may be exceeded by some patients and sometimes the treatments are too limited for what a patient actually needs.

"I think what we want from this report is we need to understand that there needs to be adequate insurance that is affordable," she said.

Of cancer survivors, she said, "You shouldn't have to go $100,000 in debt; you shouldn't have to lose your house."
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Heart CT Means High Radiation Exposure

Test Packs Dose Equal to 600 X-Rays; Doctors Say Scan Indispensable for Some Patients
A test commonly ordered by cardiologists across the country to diagnose heart disease exposes patients to radiation doses equivalent to 600 chest X-rays, researchers have found.

The test is called a cardiac CT angiogram, or cardiac CTA for short, and it is a relatively new way to look for potentially dangerous blockages in the heart arteries.

The study, released Tuesday in the Journal of the American Medical Association, is the first to look at radiation exposure from this test, and it is important because of the risk for developing cancer from radiation exposure.

"The strength of [this study] is that it is the first available survey of radiation doses in cardiac CTA," said Dr. Thomas Gerber, study author and associate professor of medicine and radiology at the Mayo Clinic in Rochester, Minn. "That information wasn't known, but it is conceivably important because of the risks of ... radiation."
However, the authors and experts in the field caution that this study should not send patients and doctors fleeing from an important way to diagnose heart disease.

"Not all cardiac CT is evil," said Gerber. "It is valuable in patients who have symptoms of heart disease."

Cancer Risk and Radiation

The risk of dying from cancer because of the radiation exposure from one cardiac CTA is difficult to estimate, but the American Heart Association puts the additional risk at around 0.05 percent in a statement released in the journal Circulation.

The actual radiation dose here may also not be as big as it initially sounds.

Radiation is commonly measured in units called millisieverts, or mSv. Authors studied almost 2,000 patients who had a cardiac CTA, and they found that the average radiation dose from these CT scans was 12 mSv.

Gerber said, "This is four times the annual background radiation [that everyone gets] from substances [in the environment] such as radon."

So in other words, an encounter with a heart CT scan equals four years worth of the radiation one would encounter in their day-to-day lives.

"It is important for patients' understanding to compare the test dose to annual background radiation ... instead of to chest X-rays," said Dr. Gilbert Raff, director of the Ministrelli Center for Advanced Cardiovascular Imaging at the William Beaumont Hospital. "Modern technology has reduced the chest X-ray [radiation] dose so substantially that it is no longer a fair or reasonable target to use."

Comparing Cardiac CTA to Other Tests

It is also important for patients to recognize that the radiation dose from cardiac CTA is comparable to the radiation exposure with other common tests used by cardiologists to look at blockages in the heart arteries.

Gerber says patients getting a stress test with imaging (where pictures are taken of the heart during exercise) get about the same dose of radiation. A cardiac catheterization procedure, in which a cardiologist puts a catheter and contrast dye into the heart arteries and takes pictures, typically exposes patients to about half as much radiation, but it is an invasive procedure and carries other risks.

"I think the most important ... lesson is that the dose is comparable to noninvasive imaging with stress scanning, which is the most common test we use in patients with ... chest pain," Raff said.

Dr. Christopher Cannon, senior investigator for the TIMI study group at the Brigham and Women's Hospital agreed. "We need to review all cardiac tests, not just CT angiograms."

More Can Be Done to Lower Radiation Exposure

The study also examined several techniques that are used to reduce radiation exposure when doing a cardiac CTA.

Researchers found that, while these techniques were associated with a significantly reduced radiation dose, not all centers were using these methods consistently. Importantly, these radiation reducing techniques did not affect the quality of the image obtained.

"One objective of this type of study [is] to raise awareness and make sure that [we] use all the means that we have available to reduce radiation dose," Gerber said. "The techniques available today are better than those studied in 2007. We [now] have revolutionary new technology that will probably reduce radiation dose from an [average] of 12 mSv to an [average] of 3 mSv."

Dr. Armin Zadeh, associate director of Cardiac CT at the Johns Hopkins University agreed. "The take-home message is that if you use cardiac CT responsibly, you can achieve good results with radiation exposures, which are very reasonable compared to other imaging tests."
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Some Lip Gloss May Promote Cancer

Spring is here, legs have been reacquainted with the razor and women are buying lots of shimmery lip gloss on impulse.

But have you heard the buzz that cheap, fun, non-SPF gloss can possibly increase your skin cancer risk?

Here's the theory: Some dermatologists have said that the translucent sheen helps ultraviolet rays penetrate the already fragile skin of the lips -- thereby increasing your risk. These dermatologists may be on to something, according to some of the top experts in the field.

Dr. Jessica Fewkes, a face and neck skin cancer specialist at Harvard, draws a cautious analogy between wearing non-SPF (sun protection factor) lip gloss in the sun and using baby oil to promote tanning. "You might be able to infer that they both enhance UV exposure," she says.

Dr. Kevin Cooper, chairman of the dermatology department at Case Western Reserve in Cleveland, explains that any increased penetration of ultraviolet rays would be due to "enhanced optical passage" of the dangerous rays. But the increase, he qualifies, would be small.

Here's the catch: There are no large, targeted studies proving or disproving this theory, which makes Fewkes, Cooper and the American Cancer Society reluctant to draw fixed conclusions.


Dr. Len Lichtenfeld, the society's deputy chief medical officer, says that it seems "like just a theory."

"It's OK," he adds, " to have theories about how diseases are caused or influenced, but we have to see evidence. There should be an effort made to do large, population-based studies."

And, in the absence of such studies, it's hard to get a simple yes or no from a doctor.

Nevertheless, specialists agree that just as it's universally recommended that people wear at least SPF 15 on their faces, it makes sense to do the same for the lips. And in these UV-ray conscious times, it's not hard to find gooey pink gloss that comes with protection.

And consider this: According to Cooper, squamous cell carcinoma (the kind of cancer that makes up 90 percent of new cases of lip skin cancer each year) has a higher risk of metastasis on the lips. That means that it's more likely to aggressively spread if it starts on your lips than if the same kind of cancer appears first on other parts of the skin.

Bonus: If you really need another reason to make sure your gloss is SPF 15, think about the prematurely wrinkle-mouthed look you probably want to avoid. Fewkes says that if gloss does, in fact, increase lips vulnerability to UV rays, it stands to reason that it promotes photoaging as well.

"The damage done short of a true cancer can be very difficult to treat," she says, referring not only to painful fissures, but to solar keratosis -- nonmalignant yet unpleasant crusty bumps.
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