Cancer Archive

You may have heard somewhere that an aspirin a day can prevent cancer. It almost sounds too good to be true. For many people, it is, but for a select few, it might not be. We’ve taken a look at the (often confusing) evidence that gave rise to this statement.

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A research letter published online Jan. 21, 2016, in JAMA Oncology suggests that many older adults are getting unnecessary cancer screenings. Researchers looked at questionnaire answers from about 150,000 seniors (ages 65 or older) across the country, and found that about half had received prostate-specific antigen (PSA) testing or mammography in the past year. But a third of those screened did not have a 10-year life expectancy, a major guideline for screening. Unnecessary screening rates varied by state—for example, 11% in Colorado and about 20% in Georgia. "Undergoing a screening test may actually cause more harm than good, especially with older patients or those with significant medical conditions," says Dr. Marc Garnick, an oncologist at Beth Israel Deaconess Medical Center and editor in chief of Harvard's Annual Report on Prostate Diseases. So talk to your doctor about the guidelines. Both the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) recommend routine mammograms every two years for women ages 55 to 74. The ACS does not recommend mammograms in this age group if a woman has a life expectancy of less than 10 years.

For all men, the USPSTF recommends against routine PSA testing. The ACS suggests that men 50 or older (at average risk for prostate cancer) make the decision about screening with their doctor, but only if they have a life expectancy of at least 10 years, and only if they have been advised about the uncertainties, risks, and potential benefits of prostate cancer screening.

Even the newer, targeted cancer therapies may harm the heart.

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About 14 million people in the United States are living with cancer, a number that reflects the steady rise in cancer survivorship in recent decades. In 1980, only about half of people with cancer lived five years after diagnosis. Today, five-year cancer survival rates are greater than 70%.

Unfortunately, many cancer-suppressing treatments can have undesirable effects on the heart and blood vessels. The increasing awareness of these effects—coupled with the surge of older people being diagnosed with and surviving cancer—has spurred a new specialty known as cardio-oncology. Experts in this burgeoning field focus on promoting heart health in people with cancer, both during and after their treatment.

Personalizing breast cancer diagnosis and treatment has resulted in therapies that are more effective and less toxic than in the past.

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The federal government's "Cancer Moonshot," with the expressed goal of curing cancer, is getting a lot of press lately. While the initiative's stated goal may be overly ambitious because cancer is actually 200 or more individual diseases, it promises to increase research funding and speed the availability of new treatments.

Amid the excitement, it's easy to overlook the fact that there has already been great progress in treating many cancers. Patients are enduring fewer side effects and living longer. Breast cancer is a prime example. "There's no question that breast cancer treatment is improving," says Dr. Ann Partridge, senior physician at the Susan F. Smith Center for Women's Cancers at Harvard-affiliated Dana-Farber Cancer Institute.

Ask the doctor

Q: I am 68 years old, and recently my PSA level (which was normal before) increased to 5.2 nanograms per milliliter (ng/ml). My doctor repeated the test one month later, and it was normal again at 3.3 ng/ml. Should I still be concerned?

A: One of the reasons that routine PSA testing is so controversial is the inability of the test to distinguish men with prostate cancer from those without it. A common cutoff is 4 ng/ml, but this is hardly a black-and-white answer. In fact, 30% of men with a PSA result between 4 and 10 have cancer. (The remaining 70% have benign causes, like an enlarged prostate.) In men with a "normal" PSA in the 2-to-4 range, 20% have cancer. So the risk is still present.

Music therapy can calm anxiety, ease pain, and provide a pleasant diversion during chemotherapy or a hospital stay.

It's almost impossible to find someone who doesn't feel a strong connection to music. Even if you can't carry a tune or play an instrument, you can probably reel off a list of songs that evoke happy memories and raise your spirits. Surgeons have long played their favorite music to relieve stress in the operating room, and extending music to patients has been linked to improved surgical outcomes. In the past few decades, music therapy has played an increasing role in all facets of healing.

What is music therapy?

Music therapy is a burgeoning field. People who become certified music therapists are usually accomplished musicians who have deep knowledge of how music can evoke emotional responses to relax or stimulate people or help them heal. They combine this knowledge with their familiarity with a wide variety of musical styles to find the specific kind that can get you through a challenging physical rehab session or guide you into meditation. And they can find that music in your favorite genre, be it electropop or grand opera.

There’s almost always something we can do to improve our health and well-being — even at the end of our lives. Palliative care is designed to improve the quality of life for people with life-threatening illnesses and their families by keeping a person comfortable and making sure his or her values and preferences guide the medical team’s actions. For this reason, good communication with your care team — and your loved ones — is essential, even before you or a loved one has developed a serious illness.

Last year, only months after announcing that he had an aggressive form of melanoma, former President Carter declared that he was cancer free — thanks at least in part to a recently approved immunotherapy drug. Immunotherapy is a type of targeted therapy that helps boost the body’s own immune response to cancer. It does so while sparing healthy cells, thus minimizing side effects.