Cancer death rate drama

Townsend Letter for Doctors and Patients, May, 2007 by Ralph W. Moss

If the projected 2007 figures prove accurate, as those for previous years generally have, then the alleged "turnaround" in the cancer mortality figures between 2002 and 2004 will turn out to have been a temporary phenomenon, a statistical hiccup that, absent the political agendas of the various key players, would normally have passed without notice outside a narrow circle of biostatisticians.

Enter the Baby Boomers

There are also other reasons for skepticism. Cancer is primarily a disease of one's later years. According to government (SEER) data, the median age of US cancer patients at death is 73 years. Of course, this varies by tumor type as well as other factors: for example, the average age at death is 69 years for breast cancer, 71 for lung cancer, 75 for cancers of the colon and rectum, etc. Ethnicity is also relevant: for example, African-Americans in general die of cancer at a younger age than so-called Caucasians. All other things being equal, however, a nation's death tally from cancer largely depends on the age of its population. Put another way, the larger the senior citizen segment of the population, the more cancer deaths there will be overall.

As is well-known, a great many people alive today were born in the post-World War II era, between 1946 and 1958. They are collectively known as the Baby Boom generation. (Some experts now contend that the definition of this postwar generation should be expanded to include people born through 1964.) This cohort began when GIs returned from the war, and the US economy expanded rapidly. The birth rate during this period was more than 50% greater than for the preceding generation, which was born during the Depression years. In fact, there were over 79 million babies born into the Baby Boom generation. On Meet the Press (February 4, 2007), host Tim Russert said: "There's 40 million people on Social Security and Medicare now. The next 15 years it's going to go to 80 million." (2) This gives some idea of the surge in the aging population that we can expect very shortly.

Warburg Revival

One of the most remarkable developments of recent years has been the resurgence of interest in the cancer theories of Otto Warburg (1883-1970). Over 75 years ago, Warburg postulated that cancer cells differ fundamentally from normal cells in the way they generate energy, i.e., in their basic metabolism. Cancer cells, Warburg said, do not utilize the full machinery of cellular oxidation that is characteristic of normal mammalian cells. Instead, their energy-generating mechanism has reverted to a more primitive--and less efficient--method, i.e., glycolysis. This system of generating energy is characteristic of the lower anaerobic life forms, such as yeast, and does not involve direct oxidation. Fermentation yields lactate (lactic acid), acetic acid, ethanol (alcohol), or some other simple product. One of the best-known examples is the manner in which yeast turns the sugar in grape juice into alcohol and carbon dioxide. This is the method of energy production of all life forms that evolved before there was abundant oxygen in the earth's atmosphere.