Mixed messages

Last week, the Canadian Cancer Society released the findings of its annual report showing that almost one in two Canadians can expect to be diagnosed with cancer in their lifetime.

Every media outlet picked up the story, with headlines that screamed, “1 in 2 Canadians will get cancer,” or the even more dramatic, “1 in 4 Canadians will die from cancer.”

As a person living with a rare blood cancer, this was a hard headline to read. It was scary, anxiety provoking, and well, hopeless. They might as well have written, “Canadians: You are screwed.”

As a journalist, I scoured each article, looking at the numbers, searching for the light, the hope, the empowering message. But all I got was a different version of the same: a list of the most common cancers – prostate, lung (the one most likely to kill you), breast and colorectal – a quick mention of the really scary one that no one has yet figured out – pancreatic cancer – and brief stories from a handful of survivors. Oh, and then the unanimous wrap-up, the prevention toolkit: eat well, exercise, don’t smoke, wear sunscreen. Seriously. We are talking 1 in 2 people will be diagnosed with cancer and 1 in 4 will die, and that’s the best you got? Anyone want to add a little luck to it?

In any other realm, this terrifying statistic would have had the phones of policy makers buzzing. Imagine if the headline had read, “1 in 2 children will die on slides this summer.” You can bet that we would have awoken the morning after to caution tape securely fastened to every slide in every playground.

I was at the Princess Margaret Cancer Centre this morning. There was no caution tape.

The numbers are “indeed sobering,” says Dr. Rob Nuttall, assistant director of health policy at the Canadian Cancer Society. Though he points out the 1 in 2 number is a new statistic for Canada, resulting from an updated methodology, he notes that the high number is also partly due to an aging population.

“In 2017, almost 90% of all cancers will be diagnosed in Canadians 50 years of age or older, and 45% in those over 70,” he says. “This is a bit of a reality check about the huge toll that cancer takes in Canada.”

A frightening reality check.

And while I get the point behind the gloomy media headlines – after all, I use numbers to advocate for patients all the time. Sadly, potential mass illness and death can push policy. Sometimes. But what is the average Canadian supposed to do with such dire statistics, other than feel really scared and really sad? Am I the only one getting that sense of something too powerful to overcome? It seems that reporting the odds in such a blatant way has created an ominous when-not-if dialogue about cancer – a dialogue that doesn’t leave much room for hope. Or optimism.

“Who cares? I’m going to get cancer anyway,” I overheard a construction worker say to his buddies this morning, as he lit a cigarette. I wanted to tell him to look past the headlines. To make him see that his 50% chance of developing cancer hinges on a whole slew of things like type of cancer, effectiveness of treatment, genetics, health history, family history, a little luck, and yes, lifestyle choices. That it’s totally worth it to stop smoking today. That we all need to take the headlines for what they are worth – a headline.

“It’s so easy to take these reports out of context,” says Claire Edmonds. The Toronto-based registered psychotherapist and breast cancer survivor reminds us that it isn’t surprising to see more cancers as the population ages. She urges Canadians not to forget the story behind the headlines, such as treatments that are extending life and early diagnosis.

Through her decades of work with cancer support organizations like Wellspring (check out The Healing Journey Program), and her own life experience, Edmonds is very familiar with the anxiety that thoughts of a potential diagnosis can bring. But she also knows firsthand the importance of pushing through the fear and being proactive. “Screening is efficient, and in most cases, reliable,” she says. “It saved my life. Rather than be scared, be activated to look after yourself.”

Nuttall also talks about the importance of screening, mentioning the Canadian Cancer Society’s online tool It\’s My Life!, which helps users assess their cancer risk.

Clearly, contrary to the apocalyptic media headlines, there are still lots of reasons for hope. A few minutes spent glancing at the Canadian Cancer Society’s media fact sheet and the light peeks through, with details like the 179,000 cancer deaths that have been avoided since 1988 as a result of cancer prevention and control efforts; the 5-year cancer survival rate is up to 60% today, from 20% in the 1940s; and deaths from colorectal, lung, prostate and breast cancers are declining because of treatment advances.

Whew. Sort of. As someone living with a rare leukemia that 20 years ago would have killed me, I am a direct beneficiary of those treatment advances. And while these stats are hopeful, they are also symbolic of how slowly cancer survival has actually improved. After all, has it really taken us 77 years to get the survival rate to a dismal 60%?

“We have made enormous progress with many cancers,” says Nuttall, adding that cancer is a complex set of diseases, more than 100 in fact, for which there will never be a one-size-fits-all cure. “Today, 60% of Canadians are alive five years after a cancer diagnosis, but some cancers like thyroid, prostate and testicular cancer have 5-year net survival rates of over 90%.”

If one were to take the annual report as the state of the union for cancer care as it is meant to be, the takeaways are clear. While we have made some significant steps in terms of treatment advancements in some areas, in many others, people continue to die. The projected number of cancer diagnoses and deaths are both staggering and overwhelming.

But Canadians must not be scared into apathy. It is more important than ever to get regular screening and make healthy lifestyle choices. And don’t let stories of people like me – the ones without a cancer history, who did everything “right,” and still developed blood cancer – get you down. You need to give yourself the best shot at beating these crazy odds.

For policy makers, this report must serve as a catalyst for policy change in the cancer space unlike anything we have seen. Nuttall says the Canadian Cancer Society is committed to making sure the report’s data is used to develop programs for prevention, screening, early detection, treatment, palliative and supportive care. I also hope it drives oncological education for GPs, reductions in specialist wait times, lower prices for life-saving cancer medications, increased access to clinical trials, and more resources for the biotech companies that choose to tackle the deadly cancers that have been deemed hopeless. And maybe while we are doing a better job of treating people, we can also increase our support of the research aimed at solving cancer’s riddle.

We are all depending on it.



Lisa Machado is a former financial journalist who, after being diagnosed with a rare leukemia in 2008, now writes about the patient experience, and the challenges of living with illness. She is the founder of the Canadian CML Network, and the author of the award-winning \”Living Well with CML: What you need to know to live your best life with Chronic Myelogenous Leukemia.\” Lisa has been interviewed by CTV News, Rogers Media and the CBC on what it means to live with a serious chronic illness. She has also been featured in a number of newspaper articles, and has written for The Caregiver Network and Cure Today magazine. Lisa writes a regular column for Montreal-based website CML-IQ, and a blog for cmlnetwork.ca. Lisa can be reached at lisa@cmlnetwork.ca



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