Professional Documents
Culture Documents
Matthew DeVlieger
1 May 2017
Running Head: The Realities of Cancer 2
Abstract
With cancer being the second leading cause of death in the United States, increasing emphasis
Cancer is responsible for about 25% of all deaths in America, and approximately 40% of people
will develop the disease at some point in their lifetimes, assuming no change. Risk factors
include obesity, radiation exposure, excessive alcohol consumption, and the number one cause:
smoking. Due to medical research and technological advances, treatment options for cancer
have been improving. The most common treatments are surgery, chemotherapy, and radiation.
Tens of billions of dollars are spent by the American government on direct costs from cancer, and
this drives the national health care expenditures up significantly. The individuals with cancer
also face drastic financial hardships due to the disease, as well as experience reduced
productivity and disability. The American Cancer Society provides many services that assist with
cancer treatment, support, and follow-up. However, prevention is the best option, and more
emphasis needs to occur on educating the public about ways to reduce development of the
disease.
Running Head: The Realities of Cancer 3
The purpose of this paper is to document the harsh realities of cancer and its treatment in
the United States. Cancer is one of the leading causes of death annually, and is also one of the
most costly diseases to treat. In the U.S., cancer is second only to cardiovascular disease as the
leading cause of death, and in the U.K., it is the leading cause (Jemal et al., 2008). Cancer is
responsible for about 25% of all deaths in the United States, and 30% of those are from lung
cancer. Smoking is the leading cause of lung cancer, and significantly reducing this activity
nationwide will dramatically improve the health of Americans. In men, prostate cancer is the
most prevalent, and in women, breast cancer, with each about 25% of new cases. In 2016, an
estimated 1.7 million new cancer cases were diagnosed and 600,000 people died from the
disease. Also, approximately 40% of men and women will be diagnosed with cancer at some
point during their lifetimes, based on 2010-2012 data. In 2014, an estimated 15,780 children and
adolescents up to age 19 were diagnosed, and close to 2,000 died from the disease (American
About half of those patients receiving treatment for invasive cancer die from that cancer
or its treatment (Jemal et al., 2011). Survival is worse in the developing world, as the types of
cancer most common there are more difficult to treat. Those survivors of cancer treatment
develop a second primary cancer at about twice the rate of those never diagnosed in the first
place (Rheingold, Neugut, & Meadows, 2003). This is projected to be due to the same risk
factors still present, which include obesity, smoking, excessive alcohol consumption, and
radiation/chemotherapy from the first cancer treatment. Therefore, even those “cured” of the
disease need to be consistent and thorough with cancer screening and prevention. Short or long-
term survival depends on many factors, but some of the most prominent include the cancer type,
Running Head: The Realities of Cancer 4
the patient’s age, and overall quality of health. Those with other health issues have significantly
lower survival rates than otherwise healthy people. The older one becomes tends to reduce
likelihood of survival when diagnosed. This is concerning because the American population is
living longer, and thus more will be diagnosed at an older age. Also, those who report a higher
quality of life tend to survive cancer more than others (Montazeri, 2009).
Further, cancer care and treatment takes a significant toll on the national health care
budget. In 2010, national expenditures for cancer care totaled nearly $125 billion. In 2020,
estimates have projected expenses could reach $156 billion based on the increased costs of care
(National Cancer Institute [NCI], 2017). Increasingly more focus has been on cancer prevention
and screening, which should reduce cancer treatment costs in the long term. The further cancer
progresses, the more expensive treatment becomes, so early detection and prevention has become
a priority. In order to reduce national health care expenditures, techniques need to be produced
and maintained which will lower the American cancer incidence rate.
Background
Cancer can form in any area of the body. It occurs when abnormal cells start growing out
of control and crowd out normal cells. Cancer is not just one disease--there are over 100
different types. Cancer can start in one area of the body and spread to another. When it spreads,
it is called metastasis. The type of cancer is named from where in the body it originated, so if
lung cancer spreads to the bones, it is still called lung cancer. Tumors are often associated with
the presentation of cancer, and when cancer is inside the tumor, it is called a malignant (as
Cancer is caused by changes in a cell’s DNA. Some of these changes could be inherited
from parents, but most are due to environmental factors. These factors include outside exposures
to many different stimuli. Anything that is thought to cause cancer is called a carcinogen.
According to medical research, one such factor that contributes to cancer is the type of lifestyle
one lives. For example, those who eat more nutritiously with fruits and vegetables tend to
develop cancer to a lesser extent. This is likely due to the antioxidants and polyphenols that will
prevent cancer from taking place. Tobacco use also is a major contributor to the development of
cancer, especially of the lung. Additionally, alcoholic beverages have been identified as
carcinogenic agents. Further, those who are more physically sedentary typically have a higher
risk of developing cancer. Obesity is a leading risk factor as well. Other carcinogens include
ultraviolet light, radon gas, infectious agents, pollution, and medical treatments, such as hormone
drugs and those that suppress the immune system (ACS, 2016). Carcinogens, however, do not
cause cancer every time one is exposed. Some may simply cause cells to divide at a faster rate,
which increases the likelihood of DNA mutation. Others may only be dangerous after prolonged,
high levels of exposure. Also, the type of exposure and each individual’s genetic makeup are
Treatment for cancer is usually one of three different modalities: surgery, chemotherapy,
or radiation. The surgical approach would physically remove the cancer, along with any body
parts in which it metastasized. For example, breast cancer patients might remove the entire
breast or just the section the cancer was localized in. However, surgeries can’t treat all types of
cancers, like leukemia, where the cancer is in the blood. Drugs more effectively treat this type.
Chemotherapy is the usage of drugs that either kill cancer cells or impede their growth (ACS,
2015). The drugs can be administered through an IV or pills taken orally. This is one of the best
Running Head: The Realities of Cancer 6
treatment options for Stage 3 and 4 cancers, which are the final stages after it has spread
throughout the body. The third common treatment option is radiation, which also slows cancer’s
growth. It can be given in combination with the chemo and surgery, or can be a stand-alone
The effects of cancer reach far and wide. From an individual perspective, it takes a
significant toll on those diagnosed, both from a social and financial aspect. American cancer
survivors are facing larger burdens of medical costs treating cancer, missed work, and reduced
productivity overall. In the next ten years, the percentage of American cancer survivors is
projected to increase by more than 30 percent, resulting in more than 18 million more Americans
facing the realities of cancer treatment (Centers for Disease Control and Prevention [CDC],
2014). Most of these survivors will be above the age of 65, since medical science is helping
America live longer. Researchers studied data from the Agency for Healthcare Research and
Quality’s Survey to estimate annual medical costs and productivity losses among adult cancer
survivors and those without a cancer diagnosis. The study findings indicate that male cancer
survivors had annual medical costs of more than $8,000 per person, and productivity losses of
$3,700, compared to males without cancer at $3,900 and $2,300 respectively. Female survivors
of cancer had more than $3,200 in additional medical costs and $1,300 in productivity losses
compared to those not diagnosed with cancer. The study also indicated that about 25% of
employed cancer survivors felt less productive at work. Employment disability accounted for
75% of lost productivity among survivors. Additionally, the researchers found that 32% of
cancer survivors experienced limitations in their activities of daily living outside of work, and
42% had to make changes to their work hours and duties due to cancer (CDC, 2014).
Running Head: The Realities of Cancer 7
Cancer also takes a significant toll on the American health care system as a whole. Since
it is the second largest cause of death in the United States, the system has deemed it permissible
to spend tens of billions of dollars on cancer research and treatment. The Agency for Healthcare
Research and Quality estimates that the direct medical costs for cancer in the U.S. in 2014 were
$87.7 billion. Of these costs, about 60% were for hospital outpatient or doctor’s office visits,
and 27% were for inpatient hospital stays (ACS, 2017a). One of the most significant financial
impacts of cancer is the cost of treatment. However, lack of health insurance and other
socioeconomic barriers prevent many Americans from receiving optimal cancer prevention/
treatment. According to the U.S. Census Bureau, about 30 million people (10% of the American
population) were uninsured in 2015. The percentage was up to 17% in Texas (ACS, 2017a).
Uninsured patients are much more likely to be diagnosed with cancer at a later, more deadly
stage, where treatment is more extensive, expensive, and less effective. This will drive up health
care costs on a national scale. However, the Affordable Care Act (ACA) should help provide
more screening and prevention of cancer progression due to its provision of more health care
There are many modalities and techniques to treat cancer. Besides the most common,
surgery, chemotherapy, and radiation therapy previously discussed, immunotherapy has been
giving people hope. It is a biological therapy, which uses substances made from living
organisms as treatment. This technique utilizes your immune system to eradicate cancer cells.
The goal is to strengthen the system so that it naturally fights off the cancerous parts of the body,
such as malignant tumors. White blood cells, called T cells, are grown from your body and
reintroduced via an IV. The influx of these cells will help reduce malignant tumor size, since
Running Head: The Realities of Cancer 8
they attack cancer cells. Research is also ongoing to cause the immune system to identify tumors
if they ever resurface, and cause them to diminish and eventually die off. (NCI, 2015). Another
emerging trend in cancer treatment is called targeted therapy, utilizing certain drugs. This
treatment is the foundation of precision medicine, and seeks to block the changes in cancer cells
that help them grow, divide, and spread. Cancer cells thrive because they are able to mask
themselves from the immune system. Some targeted therapies put markers on cancer cells, thus
permitting the immune cells to more easily identify and destroy them. Other therapies cause
cancer cells to undergo cell death. Still other techniques cause blood vessels to shrink which had
previously supplied the tumors with blood supply, or cause hormones feeding cancer cells to stop
In addition to consulting with health care practitioners, those diagnosed with cancer have
many opportunities to further network and educate themselves about the disease. Obviously,
reputable sites on the Internet will contain a wealth of information. The American Cancer
Society (ACS), a national organization, also has many ways to stay connected, help loved ones
understand cancer, and find the emotional support they need. The ACS is affiliated with the
National Cancer Information Center, which provides free information and advice 24 hours a day,
365 days a year, in 12 different languages. Trained cancer experts are available via phone or
online live chat, providing accurate and up-to-date information to patients and caregivers, as well
as connecting them with valuable resources and services within their communities. They can
advise about many different topics, including specific cancers, treatment options, coping skills,
prevention, cooking, screening, medical equipment, financial assistance, insurance, and much
more. They provide a service that matches volunteers who will give cancer patients a ride to the
Running Head: The Realities of Cancer 9
hospital/treatment facility at no cost. They also can assist in finding lodging if cancer treatment
is far from home at little to no charge. The society also has free online support groups, and often
assigns a personal cancer care navigator who will direct and help individuals through the cancer
Conclusion
As seen, cancer can and does take a devastating toll on the American population. As the
second leading cause of death in the United States (Jemal et al., 2008), it is very important that it
be researched and treated effectively. Understanding has progressed by leaps and bounds in the
recent years, and headway is being made on the disease. Early detection has increased and
treatment has improved, with state-of-the-art medical technology and surgical techniques being
implemented. Thus, many more diagnosed will have a better chance at survival. However,
prevention is the best treatment, and education needs to continue at a national level about causes
and ways to reduce the likelihood of development. For example, smoking is the leading cause of
lung cancer, and this activity should be minimized across America, especially in public spaces
where many can be affected through second-hand smoke. With approximately 40 percent of
Americans likely to be diagnosed with cancer at some point (ACS, 2015), obviously we need to
conduct more research and implement more educational programs for the American public to
curb this statistic. With tens of billions of dollars spent on treating the disease (ACS, 2017a),
reducing its incidence by prevention and education will also significantly reduce this increasing
trend.
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References
https://www.cancer.org/cancer/cancer-basics/economic-impact-of-cancer.html
American Cancer Society (2017b). Finding support programs and services in your area.
American Cancer Society (2016). Known and probable human carcinogens. Retrieved from
https://www.cancer.org/cancer/cancer-causes/general-info/known-and-probable-human-
carcinogens.html
https://www.cancer.org/cancer/cancer-basics/what-is-cancer.html
Centers for Disease Control and Prevention (2014). U.S. cancer survivors face significant
cancer-survivors.html
Jemal, A., Bray, F., Center, M.M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer
Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J., Murray, T., & Thun, M.J. (2008). Cancer
doi:10.3322/CA.2007.0010
Montazeri, A. (2009). Quality of life data as prognostic indicators of survival in cancer patients:
an overview of the literature from 1982 to 2008. Health and Quality of Life Outcomes.
7(102). doi:10.1186/1477-7525-7-102
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National Cancer Institute (2017). Cancer statistics. National Institutes of Health. Retrieved from
https://www.cancer.gov/about-cancer/understanding/statistics
National Cancer Institute (2015). Immunotherapy. National Institutes of Health. Retrieved from
https://www.cancer.gov/about-cancer/treatment/types/immunotherapy
National Cancer Institute (2014). Targeted therapy. National Institutes of Health. Retrieved
from https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies
Rheingold, S.R., Neugut, A.I., & Meadows, A.T. (2003). Secondary cancers: Incidence, risk
factors, and management. In Cancer Medicine (6th ed., 156). Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK20948