CANCER                     Winter 2007
Volume III, No. 1

Health Status

þ          Cancer (all forms) continues to be the second (after heart disease) leading cause of death in the United States.  Overall, cancer mortality has been gradually declining since the early 1990s.  However, it remains an urgent health concern and the disease many fear most.  This year, more than 1.3 million new cancer cases will be diagnosed in the US and more than half a million people will succumb to the disease.  Source: www.cancer.gov

þ          There will be more than 44,200 new and serious cancers diagnosed in Michigan this year.  Men have a one in two chance and women have a one in three chance of developing cancer. Source:  American Cancer Society

þ          19,654 Michigan residents died from malignant neoplasms (cancer – all forms) in 2004.

þ          Overall, West Michigan’s cancer incidence rate per 100,000 people of 480.5 is below the State rate of 510.8.  Counties that are higher are: Muskegon at 550.6, Lake at 538.7, Osceola at 537.6, Mason at 512.8 and Montcalm at 504.6.  Counties that are lower are:  Mecosta at 412.1, Kent at 439.7, Allegan at 445.9, Ionia at 449.0, Newaygo at 449.9, Ottawa at 452.4 and Oceana at 472.9.  Source:  MDCH

Cost

þ          In 2002, per case payments for cancer treatment in Michigan, including professional fees and laboratory, inpatient and outpatient costs, for a select five types of cancer were – Breast ($8,780), Cervical ($7,268), Colorectal ($14,423), Lung ($17,968) and Prostate ($7,651).

þ          In 2002, total payments for cancer treatment in Michigan, including professional fees and laboratory, inpatient and outpatient costs, for a select five types of cancer – Breast ($71,975,445) Cervical ($4,128,882), Colorectal ($26,950,121), Lung ($42,245,175) and Prostate ($34,429,664) – were about $179 million.

Source:  “The Cancer Burden in Michigan” – Michigan Public Health Institute and the Michigan Cancer Consortium, December 2005.  Blue Cross Blue Shield of Michigan rates.

þ          Nationally, cancer accounts for more than $70 billion annually in lost productivity alone. Source:  American Cancer Society

Access

þ          For certain populations, access to cancer care services can be limited.  These populations can include older women, minority races, the socio-economically disadvantaged and the uninsured.

þ          Indirect costs of care, such as transportation, lodging and work days lost can also be a barrier to treatment.

þ          Help may be available – see the attached list of resources.  An excellent place to start looking for help is by contacting the American Cancer Society.

Quality & Outcomes

þ          The Commission on Cancer of the American College of Surgeons approves hospitals and facilities that have committed to provide the best in cancer diagnosis and treatment.  Its list of approved facilities includes about 1,400 cancer centers throughout the US.  Approved programs must provide state-of-the-art diagnostic and treatment services and offer follow-up treatment.

þ          Increasingly, physicians are being rated, by the health plans they contract with, for quality of care.  Check with your health plan to see if your physician has high ratings for cancer prevention and screening.

þ          U.S. Survival Rates – 5 year survival rates – 1995-2001 - for various cancers in white patients include:  Breast (89%), Cervical (75%), Colorectal (65%), Lung (16%) and Prostate (99%).  For each of these cancers, survival rates in black patients are 3-13% lower.       Source: NCI SEER Program www.seer.cancer.gov/

þ          Cancer treatment is most successful when it is detected early!

Feature Article

So You Have Cancer – What Next?
How Do You Choose Which Cancer Center & Which Doctor is Best for You?

Today, many cancers can be prevented.  Living a healthy lifestyle – eating well, exercising, not smoking, getting regular medical checkups and practicing sun safety – could reduce your risk of getting cancer by up to 50%.  Taking advantage of recommended screening protocols such as breast exams, mammography, colon screening and prostate screening are also important preventive measures.  Contact your medical care provider for recommendations.   

Know the Warning Signs of Cancer – If symptoms appear, it is important to pay attention to them and discuss the following with your medical care provider:  How frequent are the symptoms?  How long do they last?  What makes them better? What makes them worse?  Some general signs and symptoms of cancer can be:  

·          Unexplained weight loss – an unexplained weight loss of approximately 10 pounds may be the first sign of cancer, particularly of the pancreas, stomach, esophagus or lung.

·          Fever – can be very common with cancer, particularly if the immune system is affected

·          Fatigue – may be a significant symptom as the cancer progresses.  It may also occur early if the cancer is causing a chronic loss of blood.

·          Pain – usually a symptom of advanced disease, but may occur early with some cancers, such as bone or testicular cancer

·          Skin clues – in addition to cancers of the skin, some cancers produce skin signs such as darkening, excess pigmentation, reddening, itching or excessive hair growth.

Some specific cancers, such as skin cancer, have their own set of warning signs, such as the ABCD rule for examining moles:

·         Asymmetry: One half of the mole does not match the other half.

·         Border Irregularity: The edges of the mole are ragged or notched.

·         Color: The color over the mole is not the same. There may be differing shades of tan, brown, or black, and sometimes patches of red, blue, or white.

·         Diameter: The mole is wider than 6 millimeters (mm)—about one-fourth inch—across, although in recent years doctors are finding more melanomas between 3 mm and 6 mm.

If you or a loved one is diagnosed with cancer, there are many things to consider, especially who will treat your cancer and where.

Finding a Doctor

·         Get referrals from people you trust, like your primary care doctor.

·         Try to speak with other patients who have been treated with your type of cancer to see who they used.

·         Find out who the leading authorities in the field are. Visit a medical library or do research on the Internet. Look for doctors who have written about your type of cancer and whose work is most often quoted. Learn more about their approach to cancer treatment.

·         Check your health plan’s list of doctors.

·         Make sure the doctor accepts your health insurance. Otherwise, be prepared to pay for your health care yourself.

·         Make sure the doctor is permitted to practice at a hospital that you find acceptable. Doctors can only send patients to facilities where they have admitting privileges.

·         The doctor should have experience with your type of cancer. Studies show that doctors have better success treating a condition if they have a lot of experience with it.

·         Find out how long the doctor has been in practice. Ask about the number of people with cancer he or she has treated. Ask about the number of procedures she or he has performed. How much experience does he or she have with your type of cancer?

·         Find out if the doctor practices at a cancer treatment center and if the Commission on Cancer or the National Cancer Institute approves the center, indicating it meets certain standards and offers total cancer care.

·         Is the doctor affiliated with any medical schools? Teaching affiliation with a respected medical school may suggest a doctor that is a leader in his or her field. Doctors who teach and also practice medicine often are in contact with medical experts from around the country. They may know more about the latest treatments and may also be involved in clinical trials (medical studies) of new treatments.

·        Schedule appointments with one or more doctors. Be sure to check your insurance plan’s guidelines for second opinions. If you are meeting with surgeons, find out how often they perform the type of surgery you need, how many of these surgeries they have performed before, and what their success rate is.

·         Take note of how comfortable you are with the doctor. Ask yourself the following questions after your appointment:  Did the doctor give you a chance to ask questions? Did you feel like the doctor was listening to you? Did the doctor talk to you in a way that you could understand? Did you feel like the doctor spent enough time with you? Trust yourself when deciding whether this doctor is right for you

·         It’s helpful to ask around about a doctor’s reputation, but in the end, trust yourself. You should feel comfortable not only with your doctor’s ability to treat your cancer but also with how he or she treats you as a person. If it doesn’t feel right, keep looking.

Choosing a Good Hospital

Most doctors working with cancer treatment centers work with hospitals that are good at cancer care. Keep in mind that good doctors rarely treat their patients at substandard hospitals. Ask other doctors and nurses for their opinions on hospitals in your area. Cancer experience is also important for hospitals. For example, larger hospitals may have more experience dealing with various cancers and offer more services for cancer patients. If you live in a small town, you may need to travel to a larger city to find a center with enough cancer experience.

The Commission on Cancer (COC) of the American College of Surgeons approves hospitals or facilities that have committed to provide the best in cancer diagnosis and treatment. Approved programs must provide state-of-the-art diagnostic and treatment services. They also must offer follow-up treatment. This ensures patients receive continuing care and that recurrences or new cancers are detected as soon as possible.

The National Cancer Institute (NCI), part of the US National Institutes for Health, has the goal of enhancing the quality of clinical cancer research. The NCI works with over 60 cancer treatment centers in the United States, including two in Michigan, Karmanos Institute and the University of Michigan Hospital.  Research is heavily emphasized.

You may also go online to find out if nearby hospitals meet certain quality standards and are accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).  However, accreditation does not necessarily mean the hospital has expertise in cancer care.

Complementary and Alternative Methods of Treatment

The terms "alternative" or "complementary" refer to non-traditional methods of diagnosing, preventing, or treating cancer. Many cancer patients find that these therapies relieve symptoms or side effects, ease pain, and enhance their lives during treatment. The following questions may help you decide if these approaches are safe and if they can help you:

·         What claims are made for the treatment? Does it claim to cure cancer?

·         Is it supposed to help your medical treatment work better or to relieve symptoms or side effects?

·        What are the credentials of the people or organizations supporting the treatment? Are they recognized experts in cancer treatment? Have their findings been published in trustworthy medical journals? Be skeptical of treatments promoted by people or organizations giving vague credentials such as "expert."

·         How is the method promoted? Is it promoted only in the mass media (books, magazines, TV, radio, etc.)? Is it mentioned in scientific journals?

·         How much does it cost?

·         Is the method widely available for use within the health care community, or is it controlled with limited access to its use?

·         Does the method require that you give up regular medical treatment? If so, will doing so affect any chances for cure? Is the cancer likely to become more advanced during the delay?

Support Groups

Many find it comforting to talk and interact with others who share experiences similar to their own.  Check with your local American Cancer Society for groups that may be available in your area.  The attached list of Web Resources may also be of help.  Message boards and chat groups are widely available online.  Just remember to check sources and not believe everything you read online, as nearly as much misinformation can be found as accurate information. 

If you need more information

Sources of more information and help are available in almost every community.  Contact your local American Cancer Society.  Also, see the following list of reputable websites:

NCI – SEER (Surveillance Epidemiology and End Results) - http://seer.cancer.gov/ - phone: 301-496-8510 

Information on cancer statistics to help reduce the burden of the disease on the US population.

view the Summer 2006 Scorecard
view the Winter 2006 scorecard
view the Spring 2005 Scorecard
view the January 2005 Scorecard
view the October 2004 Scorecard
view the July 2004 Scorecard