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Better screening, healthier living and new treatments have all continued to help cut the annual number of cancer cases and deaths in the United States, a new report says.

The findings showed that new cancer cases and deaths from cancer have declined significantly for both men and women and for most racial/ethnic populations.

These decreases were largely due to decreased incidence and death from lung, prostate and colon cancer among men and a drop in two of the three leading cancers in women (breast and colon cancers). New diagnoses for all types of cancer in the United States declined almost 1 percent per year from 1999 to 2006 and cancer deaths dropped 1.6 percent per year from 2001 to 2006.

The report, which appears in the Dec. 7 online edition of Cancer, was compiled from data by the American Cancer Society, the U.S. Centers for Disease Control and Prevention, the U.S. National Cancer Institute and the North American Association of Central Cancer Registries.

“For me, when I see the downturn in some cancers it says we can actually address the cancer burden through a variety of efforts,” said report author Brenda K. Edwards, associate director of the Surveillance Research Program at the U.S. National Cancer Institute.

But the battle against cancer continues, she stressed. “We see the downturn in mortality, but we still have almost 1.5 million people with new cancer diagnoses in 2009. So, we still have a large number of people affected. For some of them, we have relatively effective treatments and for others not so.”

Edwards noted that for the cancers that have seen the biggest decreases, such as breast and colon cancer, effective screening methods probably explain the downward trend, although there are still too few people who take advantage of them.

Cancer rates are still higher for men than for women, but men had the biggest declines in new cases and death, the report showed.

This year’s report focused on trends in colorectal cancer. Colorectal cancer, the third most-diagnosed cancer in both men and women, is also the second-leading cause of cancer deaths in the United States. Overall, colon cancer rates are declining, but the decline is mostly among those over 65. Increasing numbers of cases in men and women under 50 is worrisome, the report noted.

Among both men and women, there were major declines in colorectal cancer cases from 1985 to 1995, minor increases from 1995 to 1998, and significant declines from 1998 to 2006. Since 1984, death rates also dropped, with accelerated rates of decline since 2002 for men and since 2001 for women.

In fact, from 1975 to 2000, cases of colorectal cancer fell 22 percent; 50 percent of which was most likely due to changes in lifestyle, and 50 percent to more people being screened.

In addition, deaths from colorectal cancer fell 26 percent during the same time; 9 percent of the drop came from lifestyle changes, 14 percent came from screening and 3 percent came from improved treatment, according to the report.

Going forward, if there were no changes in lifestyle, screening or treatment, there would be a 17 percent drop in colorectal cancer deaths from 2000 to 2020. However, if current trends remain the same, there will be a 36 percent drop in colorectal cancer deaths.

But, if more Americans adopted more healthy lifestyles, such as quitting smoking, and were screened for colon cancer and had access to optimal treatment (such as more effective chemotherapy), deaths from colon cancer could be reduced by 50 percent by 2020, the report predicted.

Other highlights from the report were that among men, cases of prostate, lung, oral cavity, stomach, brain, colon and rectum cancers have declined, but cases of kidney/renal, liver and esophageal cancer, along with leukemia, myeloma and melanoma, are increasing.

Among women, cases of breast, colorectal, uterine, ovarian, cervical and oral cavity cancers decreased, but cases of lung, thyroid, pancreatic, bladder and kidney cancers, along with non-Hodgkin lymphoma, melanoma and leukemia are on the rise.

Where cancers have increased, Edwards noted that in most cases there are no effective screening tests to catch the cancer early. In addition, for many of these cancers, the causes aren’t known and there aren’t effective treatments, she said.

Cancer death rates remain highest among blacks and lowest among Asian/Pacific Islanders. Although death rates by race/ethnicity were similar for most cancers, deaths from pancreatic cancer, the fourth most common cause of cancer death in the United States, increased in white men and women but dropped among black men and women.

Among men, except for Asian/Pacific Islanders, the three leading causes of cancer death were lung, prostate and colorectal cancer. Among Asian/Pacific Islanders, lung, liver and colorectal cancers were the top three causes of cancer death.

For women, except Hispanic women, the three leading causes of cancer death were lung, breast and colorectal cancer. For Hispanic women, breast cancer was the leading cause of cancer deaths, the study authors noted.

These differences in death rates may be due to differences in risk behaviors, socioeconomic status and access to and use of screening and treatment, according to the report.

While these trends are expected to continue, they could be accelerated if more people would make the lifestyle changes needed to reduce their risk of cancer. These include not smoking, maintaining a healthy weight, eating a healthful diet and exercising.

In addition, lives could be saved if more people were screened for cancers such as breast and colon cancer, and if there was more access to newer treatments, the report said.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said that “there is enormous detail in this comprehensive report, but the take-away message is as clear as it is compelling: the incidence and death toll from cancer are both steadily, if gradually, declining.”

If you’ve got a painful, swollen bump at the base of your big toe known as a bunion, you probably want to know what can be done for relief.

The American Podiatric Medical Association offers these possible options:
Apply a non-medicated bunion pad.
Wear comfortable shoes with plenty of room in the toes, and a low heel.
Apply an ice pack over the bunion when it becomes swollen, red or painful.
Tape up the foot to help keep the toe in position.
Take an anti-inflammatory medication to ease swelling and pain. Ask your podiatrist if you’re a candidate for a cortisone injection.
Use orthotic shoe inserts to help keep the feet in better alignment.

The spread of breast cancer cells from the main tumor to other parts of the body is controlled by a growth factor known as TGFb, which may prove a promising target for new drugs to prevent metastatic breast cancer, British researchers say.

Previous studies have shown that TGFb (transforming growth factor beta) regulates normal cell growth and movement. In this new study, a team from Cancer Research UK used an advanced microscopy and analysis technique to document the movement of cancer cells from primary breast tumor sites in mice.

The researchers found that single breast cancer cells broke away from the main tumor and entered the blood system when TGFb turned on messenger genes in the cancer cells and then turned them off.

When TGFb was inactive, clumps (but not single cells) of breast cancer cells broke away from the main tumor. Because these clumps can spread only through the lymphatic system, not through the blood, the spread of cancer was local, the study authors explained.

“The results helped us to find the set of genes that are behind the spread of breast cancer — and that the genes need to be first turned on and then off in order for single cancer cells to be able to ‘relocate,’” study author Erik Sahai said in a news release from Cancer Research UK.

He noted that in “a medium-sized tumor there could be a billion cells — and only a small proportion might break away and spread. So it is like trying to find — and understand — a moving needle in a very big haystack.”

Measuring body mass index or waist size in overweight people can accurately predict the risk of heart disease, Dutch scientists said on Monday.

A large 10-year study found that half of all fatal heart disease cases and a quarter of all non-fatal cases are linked to being overweight and having a high body mass index (BMI) or large waist.

Body mass index and waist circumference are well known risk factors for cardiovascular diseases but the Dutch researchers said their work showed BMI and waist size could actually help predict the risk of dying from or developing heart disease.

“What this study shows is the substantial effect which (being) overweight and obesity have on cardiovascular disease, whether fatal of non-fatal,” said Ineke van Dis from the Netherlands Heart Foundation, who led the study.

“In the near future the impact of obesity on the burden of heart disease will be even greater.”

Dis and colleagues at the monitoring project on risk factors for chronic diseases at the Dutch National Institute for Public Health and the Environment measured between both BMI and waist circumference in 20,500 men and women 1993 and 1997.

When age-adjusted BMI and waist sizes were correlated with hospital records and cause-of-death data over 10 years, more than half (53 percent) of all fatal heart disease cases and around a quarter (25-30 percent) of all non-fatal cases were in people defined as overweight and obese.

Overweight people are defined as having a BMI of between 25 and 30 and obese people of 30 or more, according to the World Health Organization (WHO). BMI is calculated by dividing weight in kilograms by height in meters squared.

Waist circumference measurements in men were defined as between 94 and 101.9 cm for overweight and more than 102 cm for obese. In women these measurements were 80-87.9 cm for overweight and more than 88 cm for obese.

Obesity is increasing throughout the world and is now recognized as a major global public health concern.

“These findings underline the need for policies and activities to prevent overweight in the general population,” Dis said in the study, which was published in the European Journal of Cardiovascular Prevention and Rehabilitation.

A drug for people with a form of leukemia holds promise as a possible treatment for ovarian cancer, new research suggests.

The drug dasatinib (Sprycel) is used to treat chronic myeloid leukemia. Researchers at the University of California at Los Angeles report that the drug limited the growth and invasive powers of ovarian cancer cells.

It also proved to have even more cancer-fighting powers when it was combined with chemotherapy and used to fight certain kinds of ovarian cancer cells known as Src dependent, according to the report published in the Nov. 10 issue of the BMJ.

Ovarian cancer is the most deadly cancer that strikes the female reproductive system and is expected to kill 15,500 women in the United States this year. The cancer is very difficult to treat.

“It is important to remember that this work is only on cancer cell lines, but it is significant enough that it should be used to justify clinical trials to confirm that women with this type of ovarian cancer could benefit,” Gottfried Konecny, an assistant professor of hematology/oncology and first author of the study, said in a UCLA news release.

An estimated one-third of women with ovarian cancer have the type known as Src dependent.

“We were able to identify markers in the pre-clinical setting that would allow us to predict response to Sprycel,” Konecny said. “These may help us in future clinical trials in selecting patients for studies of the drug.”

Researchers report that a drug used to treat pneumonia might serve as an effective treatment against a type of muscular dystrophy.

They tested the drug pentamidine in mice and found that it appears to combat genetic defects that lead to type 1 myotonic dystrophy, one of nine types of muscular dystrophy. The muscle-wasting condition is also known as DM1 and Steinart’s disease.

The levels used in mice would be poisonous in humans, but University of Oregon chemist J. Andrew Berglund, whose lab tested the drug, said it could be modified.

Pentamidine is approved to treat several conditions, including a severe type of pneumonia in people with compromised immune systems, some yeast infections and sleeping sickness.

“Pentamidine is an exciting lead compound because it is relatively easy to chemically modify, and hopefully one of these modified compounds could lead to a safe, long-term treatment for DM1 in the future,” said Berglund.

After decades of progress, the number of Americans who smoke hasn’t budged over the last five years and actually rose slightly from 2007 to 2008, according to a new report from the U.S. Centers for Disease Control and Prevention.

Over the longer term, smoking rates have declined. From 1998 to 2008, the percentage of smokers in the United States dropped from 24.1 to 20.6 percent.

However, the report notes that “during the past five years, rates have shown virtually no change,” and in fact the percentage of Americans who smoke has begun to creep up again, rising from 19.8 percent in 2007 to 20.6 percent in 2008.

Many experts blame the turnaround on recent cutbacks in funding for state tobacco-control programs, which had proven successful.

“Tobacco is the leading cause of preventable death in the U.S., and we know what to do,” said Dr. Thomas Frieden, the CDC director. “We want to provide support to states and localities to implement proven programs, and if we do that, we can save literally millions of lives in the decades to come.”

The report is published in the Nov. 13 edition of the CDC’s Morbidity and Morality Weekly Report, and arrives just before the American Cancer Society’s annual quit-smoking day, the Great American Smokeout, set for Nov. 19.

According to the report, from 2007 to 2008 the number of Americans who smoked remained constant, at about 46 million. Smokers were more likely to be male (23.1 percent) than female (18.3 percent).

The majority of smokers are people who did not graduate from high school, and the lowest rates are among those with a college graduate degree, the report found.

Asian Americans had the lowest smoking rates (9.9 percent), and American Indians and Alaskan Natives had the highest (32.4 percent), the researchers found.

The CDC investigators place much of the blame for the stagnation in smoking rates on states’ underfunding of their tobacco-control programs. They point out that from 2000 to 2009, states have received $203.5 billion in tobacco-related revenue. However, less than 3 percent of the funds have been earmarked for tobacco-prevention and smoking-cessation programs in the states, according to the report.

The researchers added that if states were to use just 15 percent of the money they receive from tobacco, they could adequately finance tobacco-control measures at CDC-recommended levels. However, in 2009, no state funds its program to that level, according to the agency.

Frieden noted that in states where tobacco-control programs are supported, “we continue to see a substantial decline” in smoking rates.

“In contrast, too few states are making that kind of progress,” he said. “And we are seeing reductions on the spending on tobacco control, despite the fact that we take in, as a country, $25 billion from the Master Settlement Agreement and tobacco taxes. We spend only about 3 percent of that on tobacco control.”

Another report in the same issue of the CDC’s weekly report examined people’s exposure to secondhand smoke, looking at data from 11 states and the U.S. Virgin Islands.

Exposure to secondhand smoke in homes ranged from 3.2 percent in Arizona to 10.6 percent in West Virginia, researchers found. At work, exposure ranged from 6 percent in Tennessee to 17.3 percent in the U.S. Virgin Islands.

In West Virginia, 68.8 percent of the people said they do not allow smoking in their home, as did 85.7 percent of those living in the U.S. Virgin Islands.

“Still, half the people in this country are not protected by comprehensive smoke-free laws,” Frieden noted.

The CDC maintains that passing more smoke-free laws and encouraging people not to smoke at home could go a long way toward reducing the danger to nonsmokers from secondhand smoke.

On the plus side, Frieden noted that in 2009, the federal tobacco tax was raised and some states are also raising their tobacco tax. “We know that those increases make a big difference,” he said.

In addition, more places are becoming smoke-free, he said. “Going smoke-free not only protects the health of nonsmokers but also encourages smokers to quit,” Freiden said.

He added that the U.S. health-care system needs to better encourage people to quit smoking. “If you want to quit, you can double your chances by getting medicine or counseling or both,” Frieden said.

Stanton A. Glantz, professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, agreed that underfunded state tobacco-control programs are at the heart of the problem.

“The pro-tobacco forces around the country have used the fiscal mess to justify whacking state tobacco programs,” he said. “The tobacco companies are still out there spending around $15 billion a year promoting their products, and the money being spent by public health in de-promoting it has been cut back dramatically.”

Glantz’s group has also just released a report that takes states to task for allowing film companies to promote smoking in movies — many of which get state tax breaks and other financial concessions to help with their production.

“Movies are now getting a very large subsidy from state government, adding up to about a quarter of their total production costs, giving the public a really direct interest in those movies,” Glantz said. “They are now actually spending more money subsidizing movies that promote smoking than they are spending on their state anti-smoking programs.”

As a condition of granting these subsidies, the states should not grant them to films being made for the youth market that promote smoking, Glantz said.

“If these studios are going to be at the trough taking taxpayer’s money, they shouldn’t be using it to sell cigarettes,” he said.

About half the exposure to smoking that children get comes from youth-rated films, he said.

“Smoking in the movies causes kids to smoke,” Glantz said. “The more smoking they see in films, the more they smoke.”

Many American smokers do want to quit, but a survey of these would-be quitters released Thursday by the American Cancer Society found that many are not well-prepared for the effort it may take.

The survey, involving visitors to the Great American Smokeout Web site, found that 22 percent said they planned to quit over the next 24 hours and 30 percent planned to quit “within a week or two.”

The Cancer Society stresses that planning ahead — getting nicotine replacement aids, for example, and figuring out how to deal with cravings — is crucial to kicking the habit.

Not a big fan of dieting? Join the club. But new research in rats hints at why weight loss is so tough — perhaps as tough as kicking drug addiction.

In the study, rats weaned off a high-calorie diet showed the same effects on the brain as withdrawing from drugs and alcohol.

Rat brains aren’t the same as human brains, of course, and human neurology may work differently. But study author Pietro Cottone said the research suggests there’s indeed a link between yo-yo dieting and cycles of addiction and withdrawal.

Yo-yo dieting, “a common habit of many chronic dieters, generates dependence,” explained Cottone, an assistant professor Boston University School of Medicine. And when people who typically overeat stop overeating, stress hormones in their brain jump into action, he said, potentially leading to “anxiety, decreased motivation and rejection of other food alternatives.”

In other words, their diet fails.

Scientists are fascinated by overeating, in part because of its link to evolution. In the resource-poor world of long ago, humans evolved to understand the importance of finding and recognizing food and coping with its scarcity, Cottone pointed out. Now, however, food is available in many cases, and this “sudden abundance” is killing people through diabetes and heart disease, he said.

Researchers know that food activates circuits in the brain that give us a feeling of reward, he said. Sex and occasional drug use can do the same thing.

But what about the reverse — the brain activity that makes people stressed when they withdraw from drugs? Could it work the same for food?

To find the answer, Cottone and colleagues gave rats a regular diet for five days and then switched them to a chocolate-flavored food that was high in sugar.

Not surprisingly, the rats didn’t want to switch back to the ordinary chow after their glory days of dining on the equivalent of rat junk food. When deprived of the sugary food, they showed signs of anxiety, and their brains acted as if they were withdrawing from alcohol or drugs.

“A history of dieting and relapse generates anxiety. The next attempt to avoid junk foods is going to be more painful and stressful than the previous one, and therefore the likelihood of relapse is going to be progressively higher and higher,” Cottone said.

But there was one bright spot: Researchers found they helped the rats do better by inhibiting a system in the brain that contributes to stress. It’s not clear, though, if a treatment for human obesity could ever arise from this.

The findings were published online in this week’s Proceedings of the National Academy of Sciences.

Cynthia Sass, a registered dietitian and author in New York City, said the study results fit into the wider picture of how people deal with food. “Often, people with compulsive eating blame themselves or feel that if they just had enough willpower they could stop,” she said. “Understanding that this is a disorder similar in nature to drug addiction can help people see that they need formal treatment.”

After all, she said, “the body is really one big chemistry lab, and the chemicals in our body react with chemicals from food or substances like alcohol or drugs. We are seeing that food may parallel the effects of drugs in terms of creating chemical reactions in the body that allow people to avoid negative emotions. The differences are that each drug may carry unique side effects.”

The U.S. Food and Drug Administration today approved use of the seasonal influenza vaccine Fluarix for children ages 3 years to 17 years. Previously, this vaccine, which contains inactivated (killed) influenza A and B viruses, had been approved for use in adults, ages 18 years and older.

The safety and effectiveness of Fluarix for use in children ages 3 years and older is documented by a U.S. study comparing 2,115 children who received Fluarix with 1,210 children who received Fluzone, a different influenza vaccine already licensed by the FDA for use in children ages 6 months and older. Study results showed that children 3 years and older vaccinated with Fluarix and Fluzone produced similar amounts of antibodies in the blood at levels considered likely to be protective against seasonal influenza.

Fluarix is a seasonal influenza vaccine not intended to protect against the 2009 H1N1 influenza virus.

“This approval of an additional seasonal influenza vaccine for children provides help in protecting them against influenza,” said Karen Midthun, M.D., acting director of the FDA’s Center for Biologics Evaluation and Research. “Children are very vulnerable to the influenza virus and are more likely to be hospitalized for associated problems.”

With today’s approval, there are now four companies approved by the FDA to manufacture seasonal influenza vaccine for use in children.

Influenza is far more dangerous than the common cold for children, who often require medical care, especially if they are younger than 5 years. It is best to vaccinate children each fall, but vaccination also can occur in the winter months when influenza season often peaks.

Common adverse events experienced after administration of Fluarix are typical of those for flu shots and include pain, redness, and swelling at the injection site as well as irritability, loss of appetite, and drowsiness.

Because Fluarix contains a small amount of egg protein, it should not be administered to anyone allergic to eggs or egg products.

Fluarix is manufactured by GlaxoSmithKline Biologicals of Dresden, Germany.

Folic acid is particularly important for pregnant women, and should be taken, if possible, beginning at least three months before they become pregnant.

The U.S. Centers for Disease Control and Prevention says this B vitamin can reduce the risk of major birth defects affecting the spine and brain by as much as 70 percent.

Women who are pregnant or planning to become pregnant should take 400 micrograms of folic acid daily. It can be contained within a multivitamin, or as a separate supplement.

Women also can get folic acid in fortified breakfast cereal. Just make sure the cereal has 100 percent of the recommended daily amount.