Angry Toxicologist

So cancer death rates are going down. This is good. What’s left out of all the news coverage is the question: So what’s going up. Face it, we all die. The all cause, all age mortality rate isn’t changing as fast as cancer, stroke, and heart disease. What’s going up then? Alzheimer’s, Parkinson’s, and Hypertensive Disease among others. Now, the increases in these diseases aren’t as large as the decreases for the others (our life expectancy is going up), but it’s the other side of the coin that you rarely see in news coverage.

Cancer is down, so is quality of life.
By getting better at treating disease, we’ve got more people with disease on our hands. This isn’t about me thinking that the press should be scientific, it has real consequences. I’ve posted before on the horrible job we do taking care of the elderly (if you haven’t read the New Yorker article I link to in the post, go do it now!). The real challenge to medicine right now is how to train doctors to take care of the elderly, who many times have multiple disease processes and bodies that can’t keep up with the wear and tear of daily life anymore. It’s a pretty un-glamourous job but nothing could be more important.

“Curing” cancer may be exciting, prestigeous, and result in numbers we can all talk about, but when we neglect the care of those elderly persons who have had their lives extended, the victory seems pretty hollow for me.

PS Heart Disease is down but apparently “people aren’t scared enough of heart disease”. I say ‘good!’; this is how I want to go, you can keep your stroke, cancer, alzheimer’s, and parkinson’s.

Comments

#1 Russell
October 16, 2007

Like the poet Roger McGough, I would prefer a young man’s death, meeting a violent death at 104 at the hands of a jealous mistress, as immortalized in his poem. A massive heart attack that kills all at once wouldn’t be bad. The problem with heart disease is that it doesn’t necessarily do that. Some people survive the heart attack, suffer a stroke or two among the sequelae, and end up in a nursing home disabled from the stroke, and with heart disease to boot.

Strokes also are the scary risk to hypertension. Much hypertension can be cured by keeping sodium intake to less than 1,200 mg/day. Few manage to do this.
#2 Abel Pharmboy
October 16, 2007

And what is the #1 cause of death for men diagnosed with prostate cancer? Not prostate cancer. Instead, it’s heart disease. So, when men ask us what they can do to prevent prostate cancer progression, the best advice is to eat a heart-healthy diet.
#3 Evinfuilt
October 16, 2007

Reading through that New Yorker article really points to one thing over and over again, we see time and again.

The time spent with the Doctor, going over the non-glamorous parts of life is really key. Sad to see that fading away for another quick fix.
#4 Susannah
October 16, 2007

Every member of my mother’s family, her generation, either has Alzheimer’s or has already died of it.

I have a 50% chance of getting it, as far as I have heard.

I’d prefer the heart attack.
#5 Nat
October 16, 2007

Abel

Following on from ATs argumnet that dying of CVD saves you from cancer…

I would think that the best way to prevent prostate cancer progression in men with prostate cancer with regard to cardiovascular disease would be to eat a unhealthy diet. This, of course, would be stupid to actually do.
#6 Anna
October 17, 2007

Since sugar and refined carbohydrate consumption increasingly appears to be linked to certain cancers, particularly breast and colon cancer, perhaps the renewed interest in lower carb diets is part of the decline. No mention of that in the article, though…

Also, there has been more publicity about the role of Vitamin D in cancer prevention, with recommendations for supplementation higher than the RDA. Another possible role?
#7 ozzy
October 18, 2007

Anna:
Where is the research linking sugar and refined carbohydrates to increased breast and colon cancer? I am aware of the obesity link but one can get obese from eating a low carb diet. Yes, eating a lot of fat and protein can make you fat also. It’s all about the calories.
Also, this article refers to mortality rates, not incidence rates. In fact, overall incidence rates are higher now than they were 10-20 years. So, if it was true that sugar and refined carbs “caused” cancer then increased awareness of low-carb diets would result in decreased incidence. However, that is not the case as incidence is increasing. Therefore, the decreased mortality is primarily due to better detection and treatment strategies.
#8 laura
October 18, 2007

As a 40 year old woman diagnosed with cancer at 39, I’ll take the cancer cure, and deal with old age issues later on, thank you very much!
#9 Abercrombie
December 1, 2009

Also, this article refers to mortality rates, not incidence rates. In fact, overall incidence rates are higher now than they were 10-20 years. So, if it was true that sugar and refined carbs “caused” cancer then increased awareness of low-carb diets would result in decreased incidence. However, that is not the case as incidence is increasing. Therefore, the decreased mortality is primarily due to better detection and treatment strategies.