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Cancer – 25 Years Later

by Neil Fiore, PhD, 30-year survivor of a "terminal" cancer diagnosis

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When the first edition of my book Coping with the Emotional Impact of Cancer: Become an Active Patient and Take Charge of Your Treatment was published in1984, the stigma associated with the word cancer was so strong that I had to fight to get the word cancer included in the title. Twenty-five years ago, it was considered controversial for patients to actively participate in their medical treatment. And a battle of correspondence ensued in The New England Journal of Medicine when I and others suggested that you might improve the quality of your life – and possibly your chances of survival – by learning how to cope with the stress and emotional impact of cancer.

Twenty-five years ago when a person passed away from cancer, the newspapers stated that they had “died of a long illness.” Seldom was the word cancer used in the press, except as a metaphor for something dreadful that was “spreading like a cancer.”

Now, 25 years later, daily newspapers, television shows, and magazines such as Coping® candidly bring us news about new cancer treatments, offer ways that people with cancer and their families can cope with the disease, and share the stories of well-known people living and thriving in spite of cancer. Much of the credit for this change in attitude and for the lowering of the public’s fear of talking openly about cancer belongs to American women. For decades, they lobbied for an alternative breast cancer surgery that was less physically and emotionally scarring than Dr. William S. Halsted’s radical mastectomy – first used in the 1890s and then remaining the main treatment for breast cancer until the 1970s.

Seldom was the word cancer used in the press, except as a metaphor for something dreadful that was “spreading like a cancer.”

When research published in the 1980s finally proved that partial mastectomies and lumpectomies – for early stage and small tumors, usually followed by radiation or chemotherapy – were as effective as a radical mastectomy, women persuaded their doctors to stop using the Halsted radical mastectomy.

Prominent women in the media, politics, and entertainment began to speak openly about their cancer and gave us evidence that it is possible to cope with and survive cancer. Consider the names of women who have openly coped with a cancer diagnosis: former first lady Betty Ford, Jane Brody of the New York Times, singer Sheryl Crow, and news anchor Robin Roberts, who is living proof that it is possible to work in television – on Good Morning America, no less – while bald from chemotherapy.

Women made it easier for men to talk about prostate cancer (General Colin Powell, Arnold Palmer, and Senator Bob Dole), leukemia (Jose Carreras), testicular cancer (Lance Armstrong and Scott Hamilton), and colon cancer (Ronald Regan).

Those who have gone before us have lessened the stigma associated with cancer and have lowered our fear of making an appointment to see a doctor, seeking treatment, and hoping for a cure. And today, we have good reason to be hopeful. The National Cancer Institute’s 2007 report states that death rates for the four most common cancers (prostate, breast, lung, and colorectal), as well as for all cancers combined, continue to decline.

Just take a look at the improvement in survival rates. In the period between 1950 and 1954, the five-year survival rate was just 35 percent. During the period between 1999 and 2005, the fiveyear survival rate rose to 66.1 percent! Advances in early detection, improved treatments – especially in chemotherapy – and the public’s willingness to seek information, change health habits, and seek treatment earlier are factors that have contributed to this vast improvement in cancer survival rates:

  • Some of the biggest increases in survival rates over the past 25 to 30 years have been seen in childhood cancers – from 58.1 percent in 1975-1977 to 81.3 percent in 1999-2005.
  • Prostate cancer, one of the most common types of cancer for men, had a five-year survival rate of 68.9 percent in 1975 and improved to 99.2 percent by 2000.
  • Survival rates for colon (or colorectal) cancer have been steadily improving for more than 30 years – in 1975, the survival rate was 50.8 percent; in 2000, the survival rate jumped to 66.8 percent.

Twenty-five years ago, the word cancer was considered a death sentence, and it carried with it a stigma. That’s not true today. Twenty-five years later, we all have a better chance of having cancer detected earlier, of surviving longer, and of being cured.

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Dr. Neil Fiore is a psychologist, keynote speaker, and metastasized testicular cancer survivor residing in Berkeley, CA. He is the author of Coping with the Emotional Impact of Cancer: Become an Active Patient and Take Charge of Your Treatment (Bay- Tree, 2009). For more articles and helpful tips from Dr. Fiore, go to neilfiore.com.

This article was published in Coping® with Cancer magazine, January/February 2010.

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