Cancer Patients are Living Longer!

Longer that what you ask?

 

A recent article, published in JAMA Oncology, reported an analysis of more than 1,000,000 cancer patients diagnosed between 1990 and 2009. The study started with people diagnosed between 1990 and 1994 and then compared their survival with those diagnosed between 1995 and 1999, 2000 and 2004, and 2005 and 2009. Each five year segment showed a better five-year survival rate than the previous five year segment. 

All cancers are not equal, however, and survival rates vary greatly. Prostate and breast cancer survival rates increased significantly. Liver, pancreatic, and lung cancer survival rates were lower, but there was still an improvement. Any overall improvement is a bit of good news in a disease that has been and continues to be extremely hard to manage and cure.

Age is a factor

Younger patients—50 to 64 for this study‑‑had better survival rates than older patients—75 to 85, but the older group also showed a significant survival increase.

What should I do?

Is there a magic bullet that we should all know about to improve our survival? Probably not. Nobody has identified any one thing that will work for everybody. Preventive measures can impact some cancers such as skin and lung, but in other cases it is likely a combination of early diagnosis, new medications, and overall improved treatments.

Bottom Line

The best option is to NEVER GET CANCER. Most of us with cancer didn’t imagine that we’d ever be diagnosed. The longer we survive (12 years for me) the better the likelihood that there will be new drugs and other treatments that can help us manage our disease. The drugs I am now taking did not exist five years ago. The drugs I will take five years from now are probably still experiments in a petri dish in some basement lab. So, hang in there.

A cure would be nice, too.

axman

A Stern Lecture to My Geriatric Self

Dear Body,

Shame on you! We’ve been together for nearly 75 years. 75 years! And now you’ve become unfaithful—betraying me. At first there were the endless good times running, climbing, dancing, and lifting. My wish was your command: jump, sprint, swim, or backflip (well, maybe not that one). Now if I so much as wish to walk briskly you quietly limp away, very slowly. You have created pain in my knees, hips, shoulders, fingers, and most of the rest of my body for no apparent reason. Did I hurt your feelings? Are you punishing me?

I’m sorry if you think I’ve abused you—but it wasn’t too much or too often, was it? You used to recover quickly, even from those more serious and sometimes questionable-choice injuries. Now you just sit there and groan. You’ve quit trying. You’re not playing by the rules (my rules). Can we talk about it? Let’s go for a walk! No? A glass of wine? Are you listening to me? 

Dear Mind (such as it is),

Remember all those great times as a kid, going to college, raising a family, travel, jobs? Well I don’t. You served me well, so I’m told, for many years. So what happened? I still treat you well and feed you every day—reading books (at least Facebook entries), listening to Public Radio, and then there are those daily sessions with Jeopardy! But you don’t pay much attention any more.

Every day you taunt me by hiding my keys, my phone, and even my half-empty  coffee cup! Not funny! You erase the names of my friends from my memory bank—and probably laugh about it. You won’t even discuss phone numbers and addresses with me. Where the heck have you gone? It feels like I’m losing you. What have you got to say for yourself? Where did I go wrong? How can I win you back?

Love,

Me

 

Bottom Line

If you can’t count on your own body and mind to support you in your old age then there’s no justice in this world. All you can do is keep on keeping on—I actually can’t remember what that means but it sounds good. Does all this sound familiar to you?

axman

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Getting Older—an Exercise in Extremes

As I get older (and older) the dialogues in my life have changed. It is interesting and a bit amusing, in a black humor sort of way. Several times someone has said, “You’re looking pretty good‑‑for someone your age!” Meaning if I were younger they might be concerned? I can opt out of jury duty because I qualify as too old. Some of my friends have been told they’re too old to drive (they’ll have to pry my keys out of my cold dead hands). 

Recently my Doctor became concerned that my heart rate was too slow (as a lifelong runner my heart rate has always been slow—in the 40s and 50s). Turns out a low heart rate can be a concern for old geezers. I’m often too cold (takes a long time to warm up), too hot (hot flashes), too tired (fall asleep

while watching TV), and always too stubborn (so says my wife). Extremes all!

Then there are those extreme “trigger” words that all of us cancer survivors dread to hear in any form: terminal, incurable, late stage, life threatening, inoperable, off the charts, etc. The older you are, the worse they sound.

More than once I have redefined what I mean by “a good quality of life.” When I was 40 it meant everything worked at 100%. At 60 maybe 80% was OK—a few aches and pains. Now, in my 70s, my requirements for “a good quality of life” are less stringent. If I can stand up, get dressed, eat, lift a glass of wine to my lips, walk (albeit slowly), drive a car (at least for now), and remember who I am and approximately what day it is (most of the time) it is a good day!

Trying to focus on what I can do and not what I can’t do is a challenge, but worth the effort when it works. A fading memory is an asset in this endeavor.

axman

Do Not Go Gently—

But DO go as much, as far, and as often as you can…

 

Both Carol and I vastly overused the medical system in January and February. It seems we had more than our share of medical maladies, slow recoveries, new pills, multiple tests, and it went on and on… We normally head south in early February to soak up some desert sun while the rain dominates our home in Oregon. This year we got away a month late, which is better than not leaving at all, and we have been basking in the Arizona sun for about a month now. We left the day after the last doctor gave us the last OK (or what we interpreted as an OK).

We are healthy, relaxed, tan, active, and have seen nary a doctor, clinic, or hospital in a while. Hooray! Of course, like so many of our friends, our life seems to revolve around the regular medical appointments we have for blood tests, med updates, exams, and the odd x-ray and scan. We accept that as part of our long term survival plan.

It’s those dratted unplanned health events that mess up our schedule. You can’t actually plan to get the flu a week from Tuesday, twist your ankle the day after the grandkids go home, or slip on the ice next month. All these things can, and do, happen whenever they jolly well please.

We are getting more stubborn (if that’s possible) about doing what we want, when we want, and finding ways to shortcut those medical procedures and that time consuming healing process. For example, we have learned to remove stitches (actually pretty simple) and perform other medical procedures that might otherwise keep us close to home. We haven’t mastered brain surgery yet, but never say never… 

As more and more health challenges can (and do) occur, it takes more and more planning to do what we need to stay alive and mostly healthy and at the same time live our life our way. So far so good, but it can sometimes require a bit of diabolical plotting. Isn’t life supposed to be challenging, exciting, and interesting?

axman

There is NO free lunch—and NO miracle drugs

Cancer treatments can have unintended side effects‑‑forever

 

Many of us have had treatments and taken multiple medications for all sorts of cancer related conditions. Many of these common and widely used treatments and meds have significant side effects—as you surely know by now, but were not necessarily aware of at the beginning of treatment. 

Revisiting this has been triggered by my recent bladder procedure (cystoscopy) to remove cancer cells and cauterize ‘bleeders’ from my bladder cystitis. The cancer is a continuation of my prostate cancer and the cystitis was likely caused by radiation therapy I had ten years ago, for prostate cancer diagnosed twelve years ago. I was unaware all these years that radiation could cause such a ‘side effect.’ 

On the medication side, one purpose of clinical trials is to determine if the side effects of the experimental medication is within tolerable limits. No one expects new drugs to be free of side effects but, in fact, different people have different levels of unintended results. If the side effect is worse than the disease the FDA won’t approve it (probably). I have had many medication side effects. My list of med side effects has included loss of body hair, growth of hair on my head, significant breast growth, joint pains, hot flashes, upset stomach, fatigue, etc. My wife says ‘crankiness’ is another side effect. 

Treatments such as Chemo and Radiation kill all the bad cells and all the good cells they come in contact with. The ‘bad’ (cancer) cells are supposed to stay dead and the ‘good’ cells are supposed to grow back, mostly. That works often enough for these treatments to be used regularly. These treatments may help, or not. But there will likely be side effects. In my case the radiation did not work and the long-term side effects have been significant. I probably should have done my ‘homework’ a little better and a little sooner.

Pills and injections are less traumatic treatments but if you read the fine print that comes with your prescription, you are at risk some for every disease and condition known to medical science. I take pills to counteract the side effect of other pills. You may be doing the same thing. Why do we do it over and over? It all has to do with our quest to stay alive a little longer.

Of course I will continue to undergo treatments, take pills, and have injections in the hope that I will stay alive and be able to manage the side effects…just a little longer. I also pledge to do more and better homework so I know what to expect.

axman