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Medical Forum / General / General / January 2005Good News about America's Top Killers
Americans learned yesterday that cancer has surpassed heart disease as the leading killer of Americans under age eighty-five. So says Cancer Facts & Figures 2005 by the American Cancer Society. While this may at first seem to be a scary indication that the rate of death from cancer has been rising significantly (as many of today's headlines proclaiming cancer the new "leading killer" imply), the truth about recent trends should actually cause more comfort than alarm. The rate of cancer death in Americans under eighty-five has actually declined in recent years, due to improved prevention, detection, and treatment of cancer. However, the rate of heart disease deaths has decreased even more so, mostly due to lower smoking rates. Because of the greater decline in rates of heart disease deaths, cancer now has the dubious distinction of being America's "top killer." Obviously, while the declines in death rates from both cancer and heart disease are good news, the still-high death rates are hardly cause for celebration. Since both diseases have many modifiable risk factors, we should not let the trends cause complacency. Lung cancer, approximately 90% of which is due to smoking, continues to be the top cause of cancer death. The American Cancer Society's report estimates that about a third of America's cancer deaths in 2005 will be due to tobacco use and another third will be related to nutrition, overweight, obesity, and physical inactivity. Modifying these cancer risk factors can also greatly reduce the risk of heart disease. Therefore, while the current trends among those under age eighty-five are positive, they reinforce the value of addressing these main risk factors in order to further reduce the prevalence of Americans' two top causes of death. ((For a version of this posting which includes hyperlinks, see http://www.acsh.org/factsfears/newsID.497/news_detail.asp )) Rivka Weiser American Council on Science and Health Resources on smoking: - Kicking Butts in the 21st Century: What Modern Science Has Learned About Smoking Cessation ( http://www.acsh.org/publications/pubID.220/pub_detail.asp ) - www.TheScooponSmoking.org - Cigarettes: What the Warning Label Doesn't Tell You ( http://www.acsh.org/publications/pubID.206/pub_detail.asp ) Resources on nutrition and physical activity: - ACSH.org's Nutrition/Lifestyle section ( http://www.acsh.org/healthissues/categoryID.5/category_detail.asp ) - Dietary Guidelines for Americans, 2005 ( http://www.healthierus.gov/dietaryguidelines/ ) - The President's Council on Physical Fitness and Sports (www.fitness.gov) >Obviously, while the declines in death rates from both cancer and heart >disease are good news, the still-high death rates are hardly cause for >celebration. Since both diseases have many modifiable risk factors, we >should not let the trends cause complacency. Well can you tell me just what in God's name are we SUPPOSED to die of? PF Yes - obviously SOMETHING is going to be the leading cause of death. The point with these stats, though, is that the death rates are for those *age 85 and under.* So reducing these particular death rates from cancer and heart disease would mean preventing earlier deaths (before age 85) so that people are dying at an older age (of these causes, or any others). -Rivka Weiser >Yes - obviously SOMETHING is going to be the leading cause of death. >The point with these stats, though, is that the death rates are for >those *age 85 and under.* So reducing these particular death rates from >cancer and heart disease would mean preventing earlier deaths (before >age 85) so that people are dying at an older age (of these causes, or >any others). You realize, of course, that not everyone would agree with you that our ultimate goal is to get everyone to live to be as old as they possibly can, right? PF >>Yes - obviously SOMETHING is going to be the leading cause of death. >>The point with these stats, though, is that the death rates are for [quoted text clipped - 8 lines] > > PF We're already halfway there. We haven't found out how to always make people live longer, but we certainly know how to always make it seem longer.......... >>We're already halfway there. We haven't found out how to always make people live longer, but we certainly know how to always make it seem longer.......... << That's an old joke but a goodie. If you give up red meat and alcohol you may or may not live longer, but it will certainly SEEM like longer... >>Yes - obviously SOMETHING is going to be the leading cause of death. >>The point with these stats, though, is that the death rates are for [quoted text clipped - 6 lines] > our ultimate goal is to get everyone to live to be as old as they > possibly can, right? The goal of any medical professional is to allow the longest and most comfortable life possible for his patients. While some medical professionals believe in "mercy killing", that is simply because they value the quality of life over the length of life; they still value primarily those two qualities. Certainly other people have other goals - teen angst in specific loves to rave about how we're oh-so-stupid for trying to make everyone live longer - but those other people usually are not practicing members of any medical field. >>Well can you tell me just what in God's name are we SUPPOSED to die of?<< COMMENT: Well, if you must know--- Realistically, getting cancer at an advanced age is a pretty good way to go. Not as good as a sudden MI in the middle of the night from unexpected and previously unnoticed vascular disease. And not as good as being shot by a jealous husband at the age of 97. But pretty good. The thing that makes cancer at advanced age stand out as epidemiologically desirably, is that cancer compresses morbility time before death pretty well. Most people need institutional or total nursing care less than a couple of months. They actually die of malnutrition and infection as proximate causes, and these are usually not painful. Nor, half the time at least, is the cancer itself. People WANT to die of heart disease, but the problem with that is, half the time heart disease doesn't kill people right away, but makes them go through a long series of heart attacks and surgeries and periods of recovery and sometimes outright dependency with chronic heart failure. There's no way to insure that coronary disease will kill quickly and without long illness, and usually it doesn't. On the whole cancer's a lot faster. once you get sick. The other main causes of death related to aging are morbidity and institutional care disasters. Stroke and all kinds of dementia are, for obvious reasons, nightmares for both patients and health care planners. Osteoporosis and hip fracture also, for the same reasons. As for infection due to immune decline with aging, it seems to be a proximate cause of death but is usally secondary to something else underlying. Most people otherwise healthy and mobile are pretty resistant to dying of infection. Most infections nail people who've become immobilized with malnutrician/cancer, hip fracture, dementia/stroke, and so on. They generally consist of pneumonias and the urosepsis which takes off anybody immobilized, who has a chronic catheter for incontinence. Cheefully, SBH >>>Well can you tell me just what in God's name are we SUPPOSED to die >of?<< [quoted text clipped - 7 lines] >unexpected and previously unnoticed vascular disease. And not as good >as being shot by a jealous husband at the age of 97. But pretty good. I couldn't disagree more. My father is dying of a GBM. "Good" is not a word I would use in any way, shape or form about this disease. It's a disgusting, evil, vile way to die. If I'm ever told I have one, I shall be booking my trip to Switzerland(*) a few weeks later. (* Assisted suicide is legal there, as it should be in all societies that have the arrogance to call themselves "civilised".)  Signature"The road to Paradise is through Intercourse." [email me at huge [at] huge [dot] org [dot] uk] There will always be exceptions, and please note what I said about stroke and dementia. Cancers of the brain in many ways model those better than they do other cancers, so of course it's not the same clinical picture. Brain and bone lessions are mostly what give cancer a bad name. SBH > ... and the urosepsis which takes off anybody immobilized, who has a > chronic catheter for incontinence. Then why use catheters instead of diapers? SignatureKeith F. Lynch - http://keithlynch.net/ Please see http://keithlynch.net/email.html before emailing me. Convenience of staff, in part. Also, skin breakdown and bedsores are worse with chronically wet skin, so you're damned if you do, damned if you don't. |
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