Doctor Emphasizes Prevention in Cancer Fight

By Terri Moon Cronk

American Forces Press Service

WASHINGTON, Feb. 3, 2011 – Smoking cessation, annual physicals and routine screenings are the best ways to decrease the risks of cancer, said a Navy doctor who routinely sees active-duty and retired military personnel and family members for chemotherapy.

“We see a lot of lung cancer patients who have never smoked in their lives,” said Navy Lt. Cmdr. (Dr.) Erin Larkins, an oncologist and hematologist at the National Naval Medical Center in Bethesda, Md. “But it’s known that smokers, especially heavy smokers, are definitely at increased risk for lung cancer.”

And cancers of the head, neck, mouth, throat and voice box -- and the numbers of those cases thought to be linked to smoking -- have increased, Larkins said.

“When [smoking is] combined with drinking the numbers go even higher,” she added.

The most common cancers in the United States, Larkins said, are breast cancer in women and prostate cancer in men. Colon cancer rates No. 2 for men and women, she added.

“Lung cancer has been No. 3 for a long time,” she said, noting lung cancer has the highest death rate of any cancer.

“We’re expanding treatments, but it’s still an aggressive cancer usually found in advanced cases, which makes it difficult to treat,” Larkins said.

Routine preventive screenings, such as mammograms and colonoscopies, have created high rates of early cancer detection, Larkins said, adding that treatment at early stages increases chances of survival.

When to start getting mammograms is a decision usually made between the doctor and the patient, the doctor said. “There’s some debate now about whether to start mammograms at 40 years old or 50 years old,” she explained. “The opinions are varied throughout the medical field right now.”

Women with a mother or sister who had breast cancer at age 40 should start getting mammograms 10 years earlier, Larkins added.

Colonoscopies are recommended after age 50 and are known to be a very effective screening for colon cancer, Larkins said.

Another procedure for detecting colon cancer is the “virtual colonoscopy.” Similar to a CAT scan, she said, this procedure can detect tiny polyps and other concerns.

Prostate cancer is the most common cancer that occurs in men, Larkins said. A test for prostate-specific antigen molecules in the blood -- commonly known as “PSA screening” -- is recommended for men older than 50, Larkins said, and studies indicate that African-American men should start PSA tests at 40.

Cervical cancer in women has become relatively rare, the doctor said, thanks to early detection by Pap smears. No screenings exist for pancreatic and ovarian cancers, she said, but “studies are being done all the time to finds screens” for those cancers and others that are difficult to treat because a patient often has no symptoms until the cancer is advanced.

Vaccine therapies are under study, Larkins said, but are not in common use to prevent certain cancers. “The main thing is be aware of screening and know it’s something you should do, based on your age [or] family history,” she said. “Be aware of your own health.”

Meanwhile, studies and trials to detect and treat different cancers remain an ongoing process, the doctor said.

“One of the biggest changes in the last several years has been looking at tumors individually as much as we can,” she said. “We know not all breast tumors behave the same -- some are much more aggressive than others.”

World Cancer Day is observed Feb. 4. It was established by the International Union Against Cancer to raise awareness and encourage cancer prevention, detection and treatment. The IUAC is a global consortium of 350 cancer-fighting organizations in more than 100 countries.

The World Health Organization estimates that without treatment, 84 million people will die of cancer between 2005 and 2015.

“If cancer spreads,” Larkins said, “it is mostly still incurable. If we can prevent it, rather [than] treat it, that’s a much better option.”