Economic Cost of Cancer Mortality

Two studies published in the Dec. online issue of the Journal of the National Cancer Institute show the high cost of cancer deaths in the U.S. Researchers used different methods for calculating the economic costs. Cathy Bradley, of Virginia Commonwealth University and the Massey Cancer Center in Richmond, VA, and colleagues used the human capital approach to calculate the economic burden of cancer deaths. Robin Yabroff, of the Health Services and Economics Branch of the National Cancer Institute, and colleagues calculated the cost in terms of how much people would be willing to pay to gain one additional year of life.

Bradley reports that in 2000, cancer deaths cost the U.S. $115.8 billion in lost productivity. When researchers also looked at caregiving and household duties, not just regular wages earned, the total cost more than doubled to $232.4 billion in 2000. Projecting forward, the numbers jump to $147.6 billion in 2020 for wages, and $308 billion in 2020 for total costs. An annual reduction in mortality of just 1 percent for leukemia, jung, breast, colorectal, pancreatic, and brain cancer would reduce the estimated cost by $814 million per year.

Yabroff and colleagues based their study on how much people would pay to gain one additional year of life, which in prior U.S. studies was estimated at $150,000. Based on that willingness-to -pay number, the cost of cancer mortality was $960.7 billion in 2000, and predicted to be $1,472.5 billion in 2020. Decreasing mortality by 2 percent reduces the projected cost of breast cancer deaths from $121 billion in 2020 to $80.7 billion; for colorectal cancer from $140.1 billion to $93.5 billion; for lung cancer from $433.4 billion to $289.4 billion; and for prostate cancer from $58.4 billion to $39 billion.

These two studies provide important information for decision makers to determine the costs of disease intervention programs relative to their benefits. Bradley writes, "From a productivity loss perspective, investments in programs that reduce lung, breast, colorectal, leukemia, and/or pancreatic cancer mortality are likely to yield the largest annual reduction in productivity costs for US society." According to Scott Ramsey, of the Fred Hutchinson Cancer Research Institute in Seattle, in an accompanying editorial, the numbers show that by either measure, current investment in cancer research in the US is low.

These numbers are staggering, and don't include the human cost, with which we are all too familiar. I bring these studies up in the context of exercise because of the evidence we have of the benefits of regular exercise. We know that regular, moderate exercise is useful in preventing several types of cancers, as well as other diseases. There is also growing evidence that exercise can play a role in improving survival outcomes.

Along with showing up for our treatments, or taking our pills, exercise is one of the things that we have control over. We know it improves our chances; all we have to do is start. This is in our control.

Julie

Happy Holidays

Life-Cise and Stay Fit Stay Strong wish you a very happy holiday. Enjoy the day (or days). I hope you can spend it with family and friends.

Julie

Wearing a Hat and Other Myths....

In this month's British Journal of Medicine, researchers once again dispel common medical myths. Last year, Rachel Vreeman and Aaron Carroll, of the Indiana University School of Medicine looked at several common medical beliefs and discovered they were nothing more than myths. They've done it again; the results are published this month in BMJ online.

And I'm afraid I am guilty of spreading one of the myths - that most of our heat is lost through our heads in cold weather. In a recent post I based one of my cold weather tips on that faulty information. (I'd like to point out that I'm in pretty good company in believing it. Their research found that most of the myths are commonly believed by many doctors, too.) The myth is based on an old study done in the army, where the only part of the body that was exposed was the soldiers' heads. It turns out that the head doesn't loose heat any faster than any other exposed body part. So any exposed body part will get cold. If you bundle up, but don't put on a hat, you'll get cold. And if you wear a warm hat, but no pants, you'll still get cold.

Julie

Hospitals Failing on Colon Cancer Test

I've just read a troubling article from my alma mater, Northwestern University. According to Northwestern's Feinberg School of Medicine and the American College of Surgeons, almost two-thirds of U.S. hospitals did not check enough lymph nodes after colon cancer surgery to determine if the disease had spread. Numerous oncology organizations recommend that at least 12 lymph nodes be examined to determine if colon cancer has spread. That information determines whether the patient will receive chemotherapy. (Chemotherapy is highly effective in improving survival after colon cancer has metastasized.) The study, published in the Fall in the Journal of the National Cancer Institute, found that hospitals did not follow the recommendations in nearly 65% of colon cancer cases. Colon cancer is the second-leading cause of cancer death in the United States.

What does this mean for us? It means, do your homework, ask questions, ask your doctor what he or she plans to do regarding lymph nodes and why. I know you're freaked out right now, but this is your body and your life - pay attention!

Julie

Outdoor Winter Exercise

With the first major snow of the season here in New York, I've been thinking about outdoor exercise. A whole lot of people head indoors to the gym to exercise when it gets cold (or they just don't exercise). But there are some very good reasons to put on your hat and gloves and go outside.

Because of the shorter days, we all have a lot less sunshine in our lives during the winter. Exposure to sunshine produces vitamin D, which is a factor in the prevention of osteoporosis, and in some research has been linked to decrease in the risk of breast and colon cancers. Lack of sunshine (and vitamin D) is also one of the factors for those who suffer from Seasonal Affective Disorder (SAD).

Exercising outdoors on snowy or icy surfaces can also improve balance (just be careful it's not so slick that you fall). Maintaining your balance when it's slippery can be a great workout for your core.

And, of course, weight bearing exercise (like shoveling snow) helps to keep your bones strong.

A few things to keep in mind:
- Wear a hat - a tremendous amount of body heat is lost through your uncovered head.
- Wear warm gloves - extremities, like hands and fingers are the first to get cold as the body works to keep vital organs warm.
- If you're doing aerobic activities, like shoveling snow or cross-country skiing, don't over dress. As soon as you start moving, you will warm up. If you wear too many heavy clothes, you'll sweat a lot, which will end up chilling you when your damp clothes get cold. It's best to wear layers that you can take off as you warm up and put back on when you rest.
- And make sure to stay hydrated!! It may not be as obvious to you that you need water as in warm weather, but you do. You are loosing water when you sweat and every time you exhale. Stay hydrated!

Enjoy the cold weather; enjoy the snow if you've got it. Get out, walk, ski, run - get some sunshine and fresh air.

Julie - I'm on my way outdoors now to ski - yea!!!

And, yes, emails are working again at Life-Cise.com

Life-Cise.com Emails

OK, I was a little overly optimistic in my earlier post; all is not running perfectly smoothly at Life-Cise just yet. Emails do not seem to be getting through. We've got people working on the problem and it should be fixed soon.

Julie

Life-Cise.com is Working!

We are finally back up and running. All apologies for any inconvenience while our site was down. And thanks to Dave at Launchsightsolutions and his people for getting Life-Cise functioning again.

Now back to the work of making the world a stronger place.

Julie

Life-Cise website down

Sorry, we are having some server difficulties right now. We are working on the problem; hopefully the site will be back up and running very soon. Sorry for any inconvenience.

Julie

Thanksgiving Pushups

I often write and speak quite proudly about my mother and her pushups. She is a shining example of many of the principals I try to convey to my clients at Life-Cise.com and Stay Fit Stay Strong. When I first did a fitness assessment of her, she was unable to push herself up from the floor even once. Although she was generally in pretty good shape, I talked with her about the importance of upper body strength for bone health and normal, functional activities. - What happens if she falls and no one is around to help her up? Yes, she could roll to her side, making it easier to get up; but the ability to push onesself up is pretty important.

I started her doing wall pushups, moving her feet further from the wall as she got stronger to add more of her body weight. Over a period of weeks and months she increased the number of wall pushups. As her strength increased, she began to do pushups against the counter, again increasing the amount of her body weight that she was pushing up. Eventually, she moved to the floor to do modified pushups from her knees, always keeping her torso straight. At first she could only do a couple of modified pushups, but over time kept increasing the number of repetitions. When she was comfortable with those, she decided she wanted to move on to full pushups from her toes. I think it became a point of pride with her; she was determined to do full pushups.

My mother is in her 70s, and went from being unable to push herself up to comfortably doing pushups with very good form. It did not happen over night - it was more than a year before she built up to full pushups. We modified the exercise to a level that she could start with; she made slow, incremental increases; she was consistant and diligent; and over time ended up exceeding her initial goal.

Much of my family was at my house over Thanksgiving. While waiting for the turkey, we got into some multi-generational fitness challenges (many of them ending in fits of laughter). I think Mom stole the show with her pushups. I couldn't even get her to wait while I grabbed the camera; she just kept going. And now I have the photographic evidence for all the people who doubt me when I tell them about Mom's pushups, question whether women (besides me) can or need to do pushups, or wonder if older adults really can significantly increase their strength.

Go Mom!

Love,
Julie