By Vikki Blevins
When you are an advocate for cancer screening and prevention in a state with the nation’s highest cancer mortality rate, you must be an optimist in order to keep pushing forward. The fact is, when it comes to Kentucky and cancer, there is reason to believe a healthier future lies ahead. Some of this optimism is based on steps we have already taken, while part is based on recent strides in technology the benefits of which are just over the horizon. The War on Cancer, which launched nearly 50 years ago, may be poised to take a dramatic step forward.
To be sure, too many Kentuckians are still dying of cancer. The American Cancer Society projects we will see over 10,000 deaths this year, a higher per capita rate than any other state. A high proportion of these individual tragedies are taking place in the rural areas of eastern Kentucky, where poverty, transportation challenges and a relative lack of healthcare providers all play a role in limiting the level of cancer screening that could save lives.
But the trend lines are moving in the right direction. Over the last five years, the cancer mortality rate in the state has dropped by just over two percent, with the lung cancer death rate – long our greatest health problem – declining by more than double that. We’re succeeding in getting more people in for cancer screenings and, in fact, concerted screening campaigns in eastern Kentucky have had a favorable impact.
These successes, though, have built-in limitations. No matter how much success we have in linking Kentuckians with mammograms, colonoscopies and lung exams, the fact is that there are only five cancers for which screening technologies even exist. Seven of every 10 cancer deaths are from variations of the disease for which there are no screening examinations.
These cancers progress to the point where it is highly difficult to effectively treat them because they have spread to other parts of the body. And our loved ones only find out they have cancer when they go to the doctor with signs and symptoms.
This is borne out by the statistics. In the areas where we have seen declines in cancer mortality, they are largely with the cancers – lung, breast, cervical, colon and rectal, and prostate – where screenings are enabling early detections. The cancers that are still driving increases in mortality, including liver, esophagus, pancreas and bladder, are those for which our hands are tied because we don’t have the tools to catch them early.
A possible answer to this problem is undergoing clinical trials right now. Companies are testing a new technology that uses genomic sequencing to screen for many different cancers from a single blood draw. Scientists have discovered that cancerous tumors shed DNA in the bloodstream. Blood testing can detect those DNA signatures and, with them, can predict location of the tumor.
This technology, which would be used in tandem with current screenings, could transform cancer outcomes in Kentucky and throughout the country. For example, a simple blood test is easy to administer throughout the rural parts of our state. We would have the ability to test significantly more people and, in so doing, could cut down our mortality rate to levels once unimaginable.
As with all cutting-edge medical technologies, the key will be affordability and accessibility once this is approved by the Food and Drug Administration. Congress will have an important role in this. Medicare, which provides health insurance to millions of America’s seniors, may have to be modernized to allow coverage of this preventive screening without years of expected bureaucratic delays.
If the right, forward looking decisions are made, our natural optimism over the future of cancer care in our state may be bolstered by a new weapon in our arsenal to fight this terrible disease. The War on Cancer, 50 years since its start, is turning in a positive direction.
Vikki Blevins is the Founder of Kentucky CancerLink