Cancer

Anil Mitra, December 2023

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Contents

Purpose

The most common cancers

Breast cancer

Lung cancer (including bronchus)

Prostate cancer

Colon and rectal cancer

Melanoma (skin)

Bladder cancer

Non-hodgkin’s lymphoma

Most aggressive common cancers

Palliative care vs treatment

Watchful waiting

Diagnosis to treatment: when to begin?

Risk

Philosophy

Regret?

My attitude toward western medicine

Cancer

Purpose

I wanted to clear my head about my choices. There’s nothing perfect about them or this document—it’s just a stab.

The most common cancers

Breast cancer

Estimated yearly new cases:

Female: 268,600

Male: 2,670

Estimated yearly deaths:

Female: 41,760

Male: 500

5-year survival rate:

Female: 90 percent (2008–2014)

Lung cancer (including bronchus)

Estimated yearly new cases: 228,150

Estimated yearly deaths: 142,670

5-year survival rate: 23 percent (2008–2014)

Prostate cancer

Typically slow growing, prostate cancer is the most common cancer and second leading cause of cancer death among American men.

Estimated yearly new cases: 164,690

Estimated yearly deaths: 29,430

5-year survival rate: 98 percent (2008–2014)

Colon and rectal cancer

Colorectal cancer refers to cancers found in the colon or rectum. Together they make up the large intestine.

Estimated yearly new cases: 145,600

Estimated yearly deaths: 51,020

5-year survival rate: 64 percent (2008–2014)

Melanoma (skin)

Melanoma is cancer that begins in specialized cells that make up the pigment that gives skin its color (melanin). While more common on the skin, melanomas can also form on the eye and in other pigmented tissues.

Estimated yearly new cases: 96,480

Estimated yearly deaths: 7,230

5-year survival rate: 92 percent (2008–2014)

Bladder cancer

Bladder cancer usually affects older adults and occurs more frequently in men than it does in women.

Estimated yearly new cases: 80,470

Estimated yearly deaths: 17,670

5-year survival rate: 77 percent (2008–2014)

Non-hodgkin’s lymphoma

Non-hodgkin’s lymphoma is cancer that begins in the lymphatic system. It’s characterized by tumors developing from a type of white blood cell known as a lymphocytes.

Estimated yearly new cases: 74,200

Estimated yearly deaths: 19,970

5-year survival rate: 71 percent (2008–2014)

Most aggressive common cancers

Lung cancer

Colorectal cancer

Breast cancer

Pancreatic cancer

Prostate cancer

Palliative care vs treatment

Treatments—radiation, ultrasound, surgery, and chemotherapy, individually or in combinations, may be recommended. Whether treated or (due to other conditions, untreatability or aggressive nature of the cancer, or old age), there is most likely to be discomfort and pain, often severe.

Therefore palliative care—symptom management and reduction; and psychological and physical support—is often recommended as an alternative or adjunct to treatment. Palliative care may improve treatment outcomes.

Palliative chemotherapy has significant benefits—pancreatic, small cell-lung, and breast cancers, and is commonly routine.

Watchful waiting

Some cancers are slow to grow. Therefore, ‘watchful waiting’ may be recommended. Many prostate cancers are of this type.

Diagnosis to treatment: when to begin?

If at all, early. However, unless the cancer is aggressive or is impacting function, e.g., by pressing on other organs, waiting a few weeks generally will not hurt.

Risk

Though I reflect on society, I write for myself.

Philosophy

There are benefits to early detection and treatment and risks to avoidance (though there are economic incentives to pushing detection and treatment, this does not invalidate the fact of the benefits).

However, the choice is individual, the role of experts is to provide information. Too much emphasis on medicine, whatever that means in fact, can detract from living well vs living long.

What I select to do is partly based on subjective and incompletely articulated factors.

Regret?

I’m aware that I might regret my choice.

My attitude toward western medicine

The purpose of the comment that follows is to defuse the thoughts that I think I’m rational or that I have a negative opinion of western medicine.

I’m impressed by its power, science, and accomplishments. I wouldn’t be alive if it weren’t for it. And in no way am I implying it is deficient or that I know or could even dream of knowing more or better.