How to Get the Best Cancer Care

You’ve always been calm and rational, a pillar of strength in times of adversity. Everyone has always said so. Of course, you’ve had some hard knocks in life. But they never got the better of you. You always picked yourself up and went on—to bigger and better things.

But that fateful afternoon, when your doctor folded his hands, looked you in the eye, and said, “I’m sorry. It’s cancer,” you crumbled in a way you never had before. So this is what panic feels like, you thought. The doctor’s lips moved, but you heard nothing. You seemed to be floating above the scene observing it, but disconnected from it, as though you were watching a TV show with the sound off.

Afterward, you drove home in a dream. No, a nightmare. You had cancer. CANCER. CANCER. You’d never felt so frightened in your entire life.

What’s Going On?

A cancer diagnosis is like being pushed out of a helicopter into a jungle war with no training, no maps, and no idea how to survive,” explains Michael Lerner, Ph.D., author of Choices in Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer, and a founder of the Commonweal Cancer Help Program, which hosts week-long educational retreats for people with cancer in Bolinas, California.

Lerner, a former Yale professor, had his interest in cancer piqued in 1981, when his father was diagnosed with non-Hodgkin’s lymphoma, the same cancer that killed Jacqueline Kennedy Onasis. Using only mainstream oncology, Max Lerner survived 11 years, longer than any of his doctors predicted.

During his father’s illness, the younger Lerner became fascinated by the then-acrimonious war of words between mainstream oncology and the alternative cancer therapies. He used the money from a MacArthur Foundation “genius” grant to travel around the world exploring complementary cancer centers, and became convinced that both conventional and alternative approaches have treatment value, with the best results usually emerging from a blending of the two.

Dr. Lerner also concluded that people with cancer need to be trained how best to deal with the disease. Providing that training—along with a vegetarian diet, exercise, a support group, massages and other relaxation therapies and spiritual comfort—is the mission of the Commonweal Cancer Help Program, which Lerner directs. “We don’t let health professionals treat cancer without training,” he explains. “Training is just as important for people with the disease. It’s crucial to making the many choices cancer imposes. In my experience, training improves cancer patients’ quality of life. And there is intriguing, though not conclusive, evidence that it may help extend survival.”

Cancer Survival

Before World War II, very few people survived cancer very long. In fact, the “five-year survival rates” used to gauge the effectiveness of cancer treatments were introduced in the 1930’s not because living that long signified cure, but because at the time, cancer specialists considered five-year survival an almost unattainable goal.

Some people still consider cancer a death sentence—and with some justification. Cancer is the nation’s second leading cause of death (after heart disease), claiming more than 550,000 lives a year. And some cancers do not respond well to treatment. Cancers of the pancreas, liver, and lung, usually, though not always, resist treatment.

But today, longterm survival is increasingly the rule. Currently, the overall five-year survival rate is 60 percent. About 40 percent of Americans are diagnosed with cancer at some point in life, but only 23 percent die from it. Today, 8.2 million Americans are cancer survivors. For nonsmokers, the chance of longterm survival is considerably higher because they are at low risk for lung cancer, one of the least treatable cancers.

This may come as a surprise, but since the mid-1990’s, the cancer death rate has actually been falling. Recently, researchers led by Phyllis Wingo, Ph.D., an epidemiologist with the American Cancer Society (ACS) in Atlanta, analyzed 22 years of statistics on cancer diagnoses and deaths.

From 1973 to 1990, new diagnoses climbed 20 percent, and the cancer deaths rose 7 percent. But since 1990, both trends have reversed. Diagnoses have declined 3.5 percent, and deaths have fallen 2.5 percent. These modest declines may not sound like much, but they translate to 34,250 fewer new cancer diagnoses a year, and 14,000 fewer deaths. Put another way, if you walk into a room of 33 people, chances are that one of them would be a cancer survivor.

“The cancer rate rose ever since the first reliable statistics were compiled in the 1930’s,” says Harmon Eyre, M.D., ACS chief medical officer. “The federal government declared the War on Cancer in 1971, and since then we’ve spent $30 billion on research. Some people have doubted the wisdom of that investment. But today we’re seeing the beginnings of the pay-off. I expect the cancer rate to continue declining.”

“After decades of frustration, we’ve finally turned the corner,” says James Dougherty, M.D., deputy physician-in-chief for clinical affairs at Memorial Sloan-Kettering Cancer Center in New York City.

What’s turned things around? “Not a miracle cure,” Dr. Dougherty says, “at least, not yet. But little by little, we’ve made incremental progress against the disease. We’ve learned more about how it works, and we’ve gotten better at preventing it, detecting it early, and treating it. We still have a long way to go, of course. But the death rate is falling, which is very good news.”