I'm still reeling from reading about what Kris is going through and I just feel so bad about it. I wish there was something I could do. My heart truly goes out to Kris and her family, I know how difficult a time this is.

Cancer scares me, it really does. I have an unbelievable family history of cancer--pretty much every single one of my relatives has had it (except my parents). All 4 grandparents had/died of cancer, including bladder, uterine and lung x 2. Thyroid and pancreatic cancer also run in my family. A huge percentage of my aunts and uncles have cancer, and MS and diabetes has been diagnosed in my cousins. In other words, many, many people in my extended family have been sick and I know how difficult a time it is to deal with the diagnosis and the treatments.

I've been scared of cancer since around age 22, when I started to become hyper-vigilant. Sometimes I feel like my fear of cancer gets overwhelming at times.

Hearing of a cancer diagnosis/ experiencing another person's illness vicariously also makes you realize that life is too short to "sweat the small stuff."

I realized this firsthand when I had an illness in high school that has left me with some residual problems today. When I was in the hospital because of this problem, as a high school student, I vowed that I would never again let the small things get to me, and I've pretty much kept that promise in the ensuing years.

In the same vein, it always gets to me when I hear friends complaining about the size of their butts or how they hate their nose and I think to myself, "for goodness sake, just thank God that you're healthy!!!" It reminds me of that old adage, "I was crying because I had no shoes unitl I met a man who had no feet." My father says this a lot and I think it's very deep. It amazes me how many young people take their health fo granted. That was something I did too before I got sick in high school, but after that I never took my health for granted again, and I think about on a daily basis how thankful I am for it.

I often think about the fact that progress in our modern times has very likely led to an increased incidence of many cancers, as more and more chemicals are being used, as our air becomes more polluted and as people live more unhealthy lifestyles of convenience. Personally, I'd trade off all this progress for simpler times in an instant, like those of our grandparents' era, when we didn't have all our modern conveniences and options but where people didn't have as many cancer diagnoses and weren't exposed to as many nasty things. I remember my grandmother recently saying that when she was a young woman no one she knew ever was diagnosed with cancer, that it was a majorly shocking diagnosis in those times. Now, it seems like it's an everyday occurrence that you hear about someone being diagnosed regularly, and it seems that cancer in young people is on the rise.

Thoughts of cancer and other diseases are also in the back of my mind when I think about my own career search and whether or not I want to apply to med school and go down the MD path. On the one hand, thinking about cancer makes you really aware of wanting to "carpe diem"--to really sieze the day and do everything you're passionate about in this lifetime, because you realize that at any point you may be diagnosed with cancer or some other illness and your life changes in an instant. And how, like Kris, it can come upon you suddenly, with little or no warning signs, and with no time to prepare--or adjust to your new reality.

At the same time, however, I know from my husband being an MD the huge sacrifies involved and don't know if I want to spend my healthiest years studying and under so much stress, instead of actively experiencing life without the constraints of a career with such enormous sacrifices--both in med school and residency and beyond. Yet at the same time, medicine is what I'm most passionate about. These thoughts have been on my mind for the past few years as I try to resolve my own career issues with medicine and I still haven't resolved it.

Hearing about a cancer diagnosis, especially in a young person and especially in someone you know, whether online or otherwise is always upsetting and always puts me in a philosophical mood. I start thinking about my priorities and wonder whether they're in the right place. What's really important, when it comes down to it? Family? A career you love? Making sure you do things everyday that make you happy? Why don't I just spend my time watching movies, reading, and taking naps, my favorite activities, and why don't I stop doing things that don't make me happy, like my current job? Why am I doing a job I hate right now (editing?) Why am I staying in it when it makes me unhappy, just so I can have an income and not be unemployed? What is the right balance and how can you order your life so that it reflects your priorities but so you balance that with the things you "have" to do?

These questions are always on my mind, but have especially been so in the past few days since Kris shared her diagnosis with us. Hearing about a peer's cancer diagnosis naturally makes you contemplative, and makes you re-evaluate things in your own life and also makes you stop and remember not to "sweat the small stuff."

Is there enough cancer support out there in general, in the form of counseling and support groups? One of my other career aspirations, besides medicine, is to be a clinical psychologist/ therapist for cancer patients, helping them adjust to their diagnosis and helping them get through it. I always thought this would be such a rewarding career on so many levels. I hope that Kris is able to get the emotional support she needs during such a difficult time.

First off, I'm glad somoene started this thread because dis-ease while tragic when it happens is nothing to fear, IMHO. You put on your armor and prepare to fight! :yes:

I began my career as a cancer researcher 4 months after my father died from cancer and applied for the fellowship which would be the beginning my life's passion while caring for my father during his last months. I also have a family history of cancer and I've had 3 biopsys myself. (breast - negative, breats ADH(atypical ductal hyperplasia, precancer for lack of a better term, and thyroid - negative). So like you, I think about cancer more than is probably normal but my reaction to it as it relates to life, particularily school is VERY different than yours. You know, I've read a ton of books about folks dealing with and surviving cancer (includign an undergraduate thesis project) and how they lived thier life seems to be directly related to who lives and who dies, who gets cancer and who doesn't (please exclude childhood cancers with soem notable exceptions).

My thinking is that if I had less than 6 months to live, Id rather spend those last months IN medical school than out. Yeah, life is short, but I personally wouldn't be a happy dying without having at least have made an attempt to achieve a life long goal. In one sense, this is why I admire people who die doing something they loved as opposed to the myriad of others ways to die.

On another note, there are some VERY proactive things I do to prevent as much as I can cancer from "showing up" in my future:

1) I exercise EVERYDAY

2) I eat organic/natural foods most of the time

3) I don't sleep in deodorant (sounds crazy until you review the research)

4) I juice organic fruits/veges a couple X/week. I'm trying hard to bump this up to 6 days/week.

5) I don't smoke and rarely drink alcohol.

6) I avoid breathing in fumes of ANY kind which is more related to the fact that I have asthma.

7) I maintain a decent weight.

8) I do my best to keep myself form being "stressed out" which is related to #1 on this list.

Most of cancer has an environmental component and that's a proven fact. While I don't have any control over what plans God has for my life no matter what happens I'd at least be able to say that I did my part in keeping myself healthy.

It's not about avoiding death, which we all know is impossible. It's about living and dying in peace.

Part of the reason we are seeing more cancer in the modern era is that people are living longer. The longer the life expectancy, the more cancer you will see. People used to die of infectious diseases mainly (in fact, TB was once the number one cause of death in the US, as recently as the early 20th century) Vaccines and antibiotics have dramatically cut the risk of dying of what used to be major killers. My mother can still remember summers when parents panicked everytime their kids had a fever, thinking it might be polio (and I can remember standing in long lines to get oral polio vaccine when it was first released to the public). If we went back to our grandparents' era when life was simpler, many of us would not be here. I sometimes wonder if I would have survived past the age of 21 had I been born 100 years earlier (ruptured ovarian cyst with massive hemorrhage when I was 21). Some, but certainly not all cancers are somewhat preventable through diet, avoidance of cigarettes, sunscreen use, safer sexual habits, etc. I do the best I can to avoid known carcinogens and leave the rest up to God, but when it strikes out of the blue, it can be devastating.

My understanding is that the increases in cancer incidence/mortality is NOT related to living longer at all (a good example is that elderly men who die of other causes like heart disease upon autopsy are many times found to have prostate cancer as well). The elderly while often Dxed with later stage thus more deadly cancers do not make up a significant proportion of those afflicted with cancer.

Interestingly,the mortality rates of some cancers such as esophogeal and pancreatic cancer have not changed much in our 30 plus year national fight against cancer. What has changed drastically is that present day societies are more obese and nonmotile now than in the history of man. Couple this with the chemical insults on our environment and you've got a recipe for disaster.

I should also mention that I'm a HUGE fan of alternative medicine and believe that this field has a significant role to play in diseases, especially cancer.

A final thing I forgot to add to this list is that I make it a habit to surround myself with positive and encouraging people and have taken this so far as to avoid my own family when I have to. This is probably as crucial as any other thing on my list.

In 1850, the average life expectancy in the US was about 38 years old. In 1900, it was about 50. Now it is about 75 for men, 80 for women. Cancer is less common in people under 40 or 50, so therefore you see a lot more cases now that people are living past those ages. Overall, however, the incidence RATE of cancer is stable to slightly DECREASED over the past 30 years, and the mortality rates are falling about 1% per year, so i'm not sure that anything in our environment (except perhaps cigarette smoke and radon) is having a big impact. And part of the reason we are seeing a decrease could be the greater restrictions on public smoking and decreasing exposure to second-hand smoke. In looking this stuff up, I also came across a comment that one of the biggest drops in mortality rate of any cancer in the last several years has been in lymphomas.

law2md,

Life is short. Embrace it and go for your dreams. If you want to go to medical school...then DO IT! We only get one chance at life and there are no guarantees for any of us that tomorrow will come. Live you life in a way that is fulfilling to you and will make you happy....and to hell with what anyone else thinks.

kris

I agree about being put into a philosophical mood, actually this whole experience has just intensified the questions.
mommd2b thanks for the advice.
Iwant to have a child, I want to be a part of another human being and she a part of me. It must be themost amazing thing in the world to feel your baby move inside you.
I've wanted this for a long time but feel I must keep pushing as far as my career is concerned.
The MD is not enough you need to do more and be more so you can be somebody in medicine.
Is that really important to ME?
I really don't give a @!$%!
Why is it so hard for us to figure out what WE want? And then to go for it?

When people speak "environment", they're speaking of the microenvironment of our body's cells as well as the environment we physically inhabit.

You must be a statistician because you're REALLY playing around with the cancer data. :rolleyes: Cancer incidence/mortality OVERALL for EVERYONE had about a 1.1% decrease (which ain't worth mentioning, IMHO) but for WOMEN there was axctually a slight increase. Also lead-time and lenght-time bias mkae up enough of the statistical "error" to obliterate the 1.1% DECREASE. As an African American female I tend to focus on those trends which affect me for obviously reasons and the fact is that blacks have a ~50% greater overall cancer incidence/mortality increase over whites. Here's the deal, a white woman Dx with cancer has a far better chance of surviving it over a black woman with ALL THINGS, including SES, access to healthcare, being equal so why should we consider a 1.1% for EVERYONE in 30 years a "victory"??? This is NOT a success, it a blip on the radar screen and for ethnic minorites it means absolutely NOTHING at all!

Simply put, the 1.1% DECREASE primarily pertains to white dudes and when you account for statistical bias, it doesn't exists.

So, Path, what can be done? What's causing the discrepency between white women and black women with regards to cancer dx, tx, and survival? Is it cultural? Is it a difference in time to diagnosis...in treatment? Access to healthcare. Willingness to undergo treatment?

On another note -
what do you think about the debate regarding obtaining CT scans of the head/chest/abd/pelvis as a screening tool for cancer?

Didn't declare it a victory, didn't intend to play around with cancer data, and didn't feel the need to get into racial differences among specific groups. All I intended was to dispel the notion that the incidence of cancer is somehow mushrooming out of control (which is what seems to be worrying lawtomd). I know people can do all kinds of things with statistics, and no, I am not a statistician. As I said, all I intended was to put some folks' minds at ease with the fact that, over the last 30 years, the OVERALL incidence of cancer is not spiraling out of control, but is in fact, flat to possibly slightly decreased. I realize, of course, that any given individual's risk depends on a number of things, including race, family history, SES, smoking, drinking, eating, and sexual habits, etc. My personal risk is probably somewhat higher than average, with a strong family history of colon polyps and a new family history of breast cancer, but I would not take offense if someone quoted me overall statistics.

No offense taken. My concern is that we are FAR, FAR away from putting a serious dent into cancer incidence/mortality given the 30 year serious "fight" and when statsitics get published which say that say that cancer is decreasing, people will mistakenly conclude that cancer research no longer needs to be a national priority. And that means, less funding dollars for cancer research and potentially increases in "risky" behavior like smoking, sex (IE multiple sex partners/HPV), weight gain, and lack of exercise.

So again, many more racial/gender/ethnic groups need to be concerned about thier overall health as it relates to cancer risk. And I'll admit that cancer research (previously in cancer epidemiology and lab research which I hope to parlay into pathology one day;) ) is a career and personal passion of mine so I tend to get a little "overinvolved" when the issue of cancer comes up.

Cultural- In the minority communities, especially the black communty, there's a serious mistrust of the health care system (ie Tuskegee expt). So even when a minority woman has health insurance, is educated, and is middle to upper class, there's what I think is an EXTREME reluctance to trust the "system". This is one reason why I'm so glad and thankful people like YOU are in place as physicians.

On another note, balck folks are real keen on saying "Baby ain't nothin wrong wit' you, just go pray it away". When I had my first biopsy my mother, who is a CRNA with 2 Master's dergrees in health fields told me that I "Needed to reject the devil, and go pray". She even told me that getting the biopsy was a waste of time. Now this is a highly educated Nurse, with 25+ years of expereince at the time telling me to go pray. Needless to say, I was DEVASTED, but had what turned out to be a precancerous lesion removed anyway. Other family memnbers told me I was cursed by someone, and my former church was the WORST in terms of support!!!!

Time to Dx - Related to cultural, black women are most often Dx when cancer is in stage II or III, or course depending on the cancer. Bottom line is that they often wait to get things checked even when they have the means to do so. In other situstion, the "established" guidlines form cancer prevention don't apply to minority women, IMHO. For example I think black women should get baseline mamograms at age 30 instead of 35 as is currently recommended and ther are a number of big name minority cancer researchers who feel the same( I had to demand a base line before age 35 even with my family history! ). The reason I feel this way is related to the pathology of the tumors black women get, highly aggressive, highly undifferntiated, many mitotic figures, prominant nucleoi, ect.ect and often N1, NOT a good situation.

Treatment- A study recently showed that blacks are less likely to be given the same treatment options as whites form most of the "big 15" cancers and this boils down to racism plain and simple. This is why it's crucial to have more minority doctors and/or doctors willing to work wiht minority populations for reaosns otehr than they couldn't find a gig elsewhere. Obvioulsy, with larger and more advanced tumors upon presentation, this one fact is so very crucial to survival from cancer. OTOH, my father didn't take the chemo because he did'nt want his hair to fall out. WTF!!!!!! An uncle wouldn't have his prostate removed because he wanted to keep what little "ying" he had left in his "yang"!!!

So when you analyze the data with all things being equal, access to healthcare, SES, educational leves, minorities are STILL disproportionately afflicted with cancer and a good portion of it is our own doing.

I think if your name is Kennedy, Jordan, Bush, Cosby, or Lopez you get the latest and the greatest preventions available. With a strong family history of cancer, I'd get it too. In the end, the number of "false positives" from this tool combined with the cost, doesn't justify the expense................................. unless of course you or someone you know could have benefited from it.

We had a bunch of oncology lectures right before we got out of school and there were some really interesting points raised in them. One was that the only type of cancer with a really large increase in incidence rate, was lung cancer. We can all see why that would be the case. Breast cancer has also had a slight increase in incidence. On the other hand, stomach cancers in both sexes have decreased dramatically. Uterine cancer in women has also decreased thanks to screening and the fact that we can now remove precancerous lesions before they turn into cancerous lesions. Almost all the other cancer incidence rates have remianed stable - that includes colon and rectum, bladder, ovarian, lymphoma etc. There is a blip on the graph in the late 90's where it looks like prostate cancer went up, but that's due to how strongly prostate cancer screening was pushed at the time - obviously, if you screen more people, you'll find more cancer. Since then it has remained steady. I wonder if this may be the case with the apparent increase in breast cancer?(Source for these statistics: Surveillance, Epidemiology, and End Results Program, 1973-1999, Division of Cancer Control and Population Sciences, National Cancer Institute, 2002. These people come out with a new study every few years so a more updated one should be out soon).

I only went into all of this to say that while some cancers (mainly lung) have become much more common, most have remained steady, and some have greatly decreased. This study went back to 1973, but some studies going back until 1900 have shown the same thing. Based on these facts, I think we need to be realistic that there are certain lifesyle choices we can make to reduce our chances of getting cancer (many of which Path mentioned). I don't think, however, that we need to be fatalistic and assume that because we are alive in 2005 we have a greatly increased chance of receiving a cancer diagnosis. It just doesn't appear to be the case based on the stattistics. So rest as easy as you can (and don't smoke or eat char broiled meat!)

USA has the highest rate of diseases. I'm amazed at how many people are sick here (physically & mentally) and by population how much healthier other nations are without all these toxins in the food & environment.

Just look at food biotechnology. Europe & Japan think USA is crazy modifying nature's food. They don't allow these foods to enter their markets. 70% of the produce has been genetically modified already. God knows what will show up later. A lot of things are not evident at first.

My mom is all excited about this Dr in Germany that is in jail...his findings are that cancer is mostly an emotional issue....I really don't have all the details, but one thing I do believe in is that for a long time USA will keep investing in the treatment more than the prevention. There's more money to be made in treatments than anything else.

I saw on CNN that Germany has found the cure for cancer at stage 1.....I haven't seen/read anything anymore.

It's all about money, money and more money here :no: It will change one day when more and more people become aware of this and make the change. We are consuming way too much drugs--no other country in the world is doing this.

We do need to go back to basics with the new healthy things we have found. The rest is garbage. Until then, we have to stay informed and do our best every day to stay healthy and truly appreciate it.

If I were to be granted on wish it would be a cure for cancer. I watched my mother battle cancer from when I was young (she was diagnosed when pregnant with me) until the cancer took her from me when I was 10yrs old. I watched my friend die from leuchemia at the age of 15, a close friend of my fiance passed away 2 months ago from stage 4 brain cancer, and my friend has a cancerous brain tumor and she is only 28yrs old. This disease is not fair, as all are not, and I wish there were something to stop it. This is one of my main factors for persueing medicine, even though I plan to specialize in psychiatry, cancer was what brought me here, and I hope to see a more productive treatment or cure throughout my jouney in medicine.