Death and Aging

The death rate from cancer in the United States is falling. Last week the National Cancer Institute was happy to report that for the last several years a smaller percentage of people are dying from cancer. They were also happy to report that the percentage of people newly diagnosed with cancer also went down, although not as much as cancer deaths. There’s a good deal of cooking the books in these happy numbers.

Looking more closely, you’ll find that among men, death rates from cancer of the esophagus, melanoma, and liver cancer actually went up. The percent of women who died from lung, pancreatic, ovarian, and, here too, liver cancer also increased. A similar picture emerges from the statistics for the percent of people diagnosed with specific cancers. For men, the incidence of liver cancer, melanoma, non-Hodgkin lymphoma, and cancer of the esophagus went up. For women, the incidence of non-Hodgkin lymphoma and melanoma also increased as did thyroid cancer, leukemia, urinary cancer, and kidney cancer with no change in the incidence of lung cancer.

The upshot of all these numbers is that the cancer establishment has gotten better at keeping cancer patients alive. What they haven’t done is reduce the exposures that cause cancer in the first place. Both the death rate and incidence of most cancers is dramatically greater than 30 years ago.

Another way to look at these statistics is that medical interventions are turning cancer from a terminal illness into a chronic disease. These declines in some cancer deaths have contributed to another statistic that makes health officials swell with pride: the increase in life expectancy. Compared to 20 years ago, the average person lives almost 5 years longer. But for that average person, only 6 months of those added 5 years of life are without illness. The solutions being discussed are more of the same: instead of drugs, surgery, and medical devices to prevent death, the call is for an investment in drugs, surgery, and medical devices that will treat the illnesses we associate with aging.

Let’s back up. The suffering and deterioration we associate with aging are principally the effects of chronic illness. Instead of throwing more of the same solutions—which by the way aren’t doing much more than prolonging suffering for most people—why not invest in supporting the body’s capacity to resist illness and heal itself? Why not invest in eliminating the environmental exposures that are responsible for those chronic illnesses?

One reason is that it’s not where the money is. The money is in maintaining a population of perpetual patients. But there’s something more insidious at work. The dominant health institutions that guide what counts as health policy and practice, but which is in fact about medical policy and practice, don’t know how to support the body and eliminate exposures. What they know about is drugs, surgery, and medical devices. You don’t have to accept those as answers.

Even deeper is medicine’s fear of death. If a patient dies, that’s a failure. These are people trained to vanquish their sworn foe—disease—with medical interventions—drugs, surgery, and medical devices. You don’t have to accept this either.

We all have a ticket out of here. It’s just a question of when we get on the train. There is absolutely no reason why we should not be vigorous and vibrant until we get to the station—that is, until our body is ready to stop. The question we have to ask, both individually and collectively, is what our bodies need for healthy aging so we can have a good death.