Almost half of all Canadians will be diagnosed with cancer in their lifetime, the Canadian Cancer Society says in a new report.
Prognoses for cancer patients are improving all the time — some of the most common forms of the disease now have survival rates over 90 per cent. But for conditions like pancreatic cancer, a diagnosis is still virtually a death sentence.
In its latest annual report on cancer statistics, The Canadian Cancer Society tells a tale of progress and stagnation, and the vast disparities between different forms of the illness.
“Cancer is a complicated disease,” said Dr. Robert Nuttall, Assistant Director of Health Policy at the Canadian Cancer Society. “It is really a hundred different types of diseases all (grouped) together.”
Cancer is still the leading cause of death in Canada, accounting for over 30 per cent of all mortality in the country. Heart disease, the second leading cause of death, accounts for less than 20 per cent, according to the report, produced with Statistics Canada, the Public Health Agency of Canada and provincial resources.
It’s sobering to think that one in every two Canadians will be diagnosed with cancer at some point, said Nuttall.
“The important thing to remember here is that the biggest driver behind this is the aging population,” he added. “Canadians continue to live longer, and cancer is primarily a disease that affects older Canadians.”
Nearly 90 per cent of all cancer diagnoses in Canada are for people aged 50 or over. About 45 per cent are for people 70 or over.
Overall cancer survival rates are rising all the time.
Defined as the proportion of patients alive five years after their diagnosis, and adjusted for patient age, the survival rate for cancer as a whole is now approximately 60 per cent.
In the 1940s, it was just 25 per cent.
Cathy Telfer, 67, survived diagnoses of malignant melanoma in 1996 and 2007.
Both times, the cancer was caught early and doctors were able to treat it by removing moles on her leg, Telfer said.
Her father, now 92, has faced malignant melanoma and survived four times, she added.
Melanoma, like breast cancer and Hodgkin’s lymphoma, has a survival rate of above 85 per cent, according to the Canadian Cancer Society report.
Testicular, thyroid and prostate cancers have survival rates of 95 per cent or more.
“This is one of those numbers that we do see improving every time we get new (statistics) coming out,” said Nuttall.
Not all cancer diagnoses come with such a positive prognosis.
The survival rate for pancreatic cancer is one of the lowest of any form of the disease.
The Canadian Cancer Society estimates that 5,500 Canadians will get pancreatic cancer in 2017. Only about half of them will be expected to survive longer than four months.
“We don’t fully understand the biology of it, so we don’t have a good way of screening for it or preventing it,” said Dr. Eva Grunfeld of the Ontario Institute for Cancer Research.
Symptoms of pancreatic cancer rarely become apparent until the illness is fairly advanced, Grunfeld said.
Pancreatic cancer is often only detected because it has grown to the point that it is putting pressure on other organs or changing a person’s metabolism, she added.
“And, because of where it is anatomically, we aren’t necessarily able to visualize it (whereas) with breast cancer we can get a sense of what’s happening there.”
Pancreatic cancer can also be resistant to chemotherapy and other forms of cancer treatment, said Nuttall.
It will take more research to understand how better to detect and treat.
“Pancreatic cancer … is something we need to be doing more research on so that we can make progress,” Nuttall said.
“It’s really about an increased effort of research so we can improve outcomes for people.”
Even when it comes to forms of cancer with very high survival rates, more work is needed to decrease the incidence of the disease, Grunfeld said.
An estimated 40 to 50 per cent of cancer cases could be prevented through actions like quitting smoking, getting more exercise, improving diet, practicing sun safety and doing a better job of screening for the illness, she added.
Telfer, for instance, recalled that her father did not consider their vacations to be a success unless he got a sunburn, which would develop into a tan.
“Both of us were sunbathers back in the day…. and I am, or was, a redhead and have freckled skin and I burned very easily,” Telfer said.
“I look back now and say, ‘If only I’d used sunscreen. If only I hadn’t laid out in the sun.’ But we didn’t know back then.”
It’s those lifestyle choices that can play a major role in ensuring fewer people ever have to deal with cancer, no matter how good the prognosis, Grunfeld said.
“It’s great that survival rates for (many cancers) are improving, but if you think of it either at the individual level or at the level of the health care system, it’s not just about survival,” Grunfeld said. “It’s about the entire diagnostic and treatment process. That has a huge impact.”