CANCER MORTALITY RATES ARE DECREASING! HOW IS IT IN TURKEY?

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CANCER MORTALITY RATES ARE DECREASING! HOW IS THE SITUATION IN TURKEY?

According to data from the American National Cancer Institute, the cancer-related death rate has declined by a total of 31 percent in the last 30 years. The study, conducted in America, highlights that positive developments in lung, colon, breast and prostate cancers, the four most common types of cancer, play a role in these long-term declines. So is the same true in Europe and our country? What is the most common type of cancer in Turkey?

One of the most prominent health problems of our time is cancer! It is known as a serious and chronic disease that involves helplessness and uncertainty, causing panic and confusion. But today, advances in cancer-related diagnosis and treatment have increased patients’ survival rates.

For example, death rates from cancer had increased significantly after the 1900s due to the increase in smoking habits, lifestyle changes and the negative effects of lifestyle changes caused by urbanization.

But this increase began to decrease after 1991 in United States. in 1991, 215 out of every 100 thousand people died due to cancer, while in 2018-2019, it showed a decline in the form of 149 out of every 100 thousand people losing their lives due to cancer.

The latest report by the American National Cancer Institute said that over the past 30 years, cancer-related death rates have declined by a total of 31 percent in America. This situation is very pleasing in terms of showing the distance traveled in cancer treatments around the world and is a great hope for humanity.

CEO of the American Cancer Society also explains this situation as follows:

“Long-term decreases in lung, large intestine, skin, breast and prostate cancers, reduction of smoking rates and targeted correct drug treatments played an important role in reducing cancer-related life losses. This development will bring about even more positive results.”

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APART FROM AMERICA, HOPE IS ALSO GROWING IN EUROPE

We have applied to the President of the Turkish Radiation Oncology Association and the Head of the Department of Radiation Oncology at Hacettepe University Prof. Dr. said, “The good news is not only on the US side. When we look at the World Health Organization data, we see similar positive developments in Europe,” he said and added:

“The probability of cancer-related death was 10.1 percent in continental Europe in the early 2000s, and we see that this rate was 8.4 percent in 2015. it is estimated that this rate will decrease to 5 percent in the 2030s being.”

Oncology specialist Prof. Dr. also said that ”when evaluating in general terms in Europe, there is a decrease in cancer death rates.” However, Prof. Dr. underlined that when countries in Europe were examined one by one, differences were observed in cancer-related mortality rates and shared the following information:

– For example, in Poland, cancer death rates have increased rather than decreased in recent years. The overall cancer mortality rate in the entire European Union was reported as 257 out of every 100 thousand people for the year 2017. During this period, 1.9 million people died from cancer. There are two reasons for this differentiation between the European continent and the United States, which is seen favor of the United States.

– Firstly, the European population is decisively older than the US, and secondly, the difference in the quality of health care provided and screening due to differences in the health infrastructure between countries within the European Union changes in the rate of testing… But if we look at the picture broadly, there is also a decrease in cancer-related mortality rates in Europe”

So how is the situation in our country with cancer-related mortality rates? Which types of cancer are most common? Are there any new steps being taken in cancer treatments? All the questions I have in mind are answered by Prof. Dr. who gave quite detailed and important information.

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POSITIVE DEVELOPMENTS IN DRUG TREATMENTS ARE VERY EFFECTIVE

A report by the American National Cancer Institute points out that there are long-term declines in lung, colon, breast and prostate cancer, the four most common types of cancer, in reducing life losses caused by cancer. Have there been significant improvements in the treatment of four diseases in recent years?

Prof. Doctor, There are more than 50 types of cancer in humans. According to the incidence, prostate cancer is the most common in men in the United States (26 percent of all new cases), and breast cancer is the most common in women (30 percent of all cases).

Again, lung, breast, prostate and colon cancers account for about 50 percent of all cancer cases. The decrease in cancer death in the United States over the past 30 years is actually related to the improvements seen in these four types of cancer.

Indeed, in the last 20 years, there has been a transformation in drug treatments in these four disease branches, which are becoming more obvious. For example, there were no immunotherapy drugs (treatment with antibodies that stimulate the immune system) that could be used in breast cancer 30 years ago, while more than 7 immunotherapy drugs are currently used to treat breast cancer.

Again, 30 years ago, there were no drugs that could be used other than hormone therapy and smart pill treatment, and now more than 10 smart pill treatments have been used for breast cancer, both for early stage disease and advanced stage disease. The same situation is observed with lung cancer.

While there was no immunotherapy and smart pill treatment used for lung cancer 20 years ago, more than 5 immunotherapy drugs today, more than 10 smart pill-shaped drugs have become used in the early and advanced stages.

A similar situation applies to prostate and colon cancers. As it is, these practices have incredibly increased the success rates in the battle against the disease.

70 percent of cancer deaths occur in middle- and low-income countries. Due to the shortage of radiation oncology centers and limited access to expensive cancer drugs, millions of cancer patients die every year.

Prof. Doctor, Among other factors in the reduction of cancer deaths, decisional innovations in diagnosis and treatment are also included. There have been incredible innovations in the fields of genetics, pathology, radiology and nuclear medicine aimed at diagnosing cancer.

Now we know our target better with pathological and genetic analyses. With diagnostic innovations, we are able to capture cancerous areas much earlier and when they are much smaller. There have been revolutionary developments in the field of radiation oncology in parallel with the computer technologies that have become widespread and developed in the 2000s. Now, with radiotherapy, we can protect healthy tissues very well while giving the tumor the dose we want. Great strides have also been made in cancer surgeries.

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CT SCANS TAKEN FOR COVID-19 MAY HAVE INCREASED EARLY DIAGNOSES OF LUNG CANCER

The report also highlights a positive decline in lung cancer deaths. Covid-19 is also known to affect the lungs the most. In this context, could CT scans taken for the virus in recent years have increased early diagnoses of lung cancer?

Prof. Doctor, “First of all, it is necessary to say that the coronavirus has no role in the decrease in lung cancer deaths contained in the data of the American National Cancer Institute. But as you said, because a lot of lung CT scans were taken during the pandemic period, early stage lung cancer diagnoses may have increased. But it is too early to see the positive effect of this condition on lung cancer deaths.

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ALTHOUGH THERE IS DECREASE IN MORTALITY RATES, SMOKING CONTINUES TO INCREASE LUNG CANCER

Although there have been decreases in cancer-related mortality rates, lung cancer remains the most commonly diagnosed type of cancer in men in the United States. Why is this species so widespread?

Prof. Doctor, “Lung cancer is one of the types of cancer that is most affected by habits and environmental factors. The habit that has the most impact on this type of cancer is smoking. Smoking is not yet widespread in the 1800s, when it was not used, lung cancer was very rare. However, after the beginning of the 1900s, and especially in the last 50 years, lung cancer has become the first common cancer in men.”

Lung cancer was the second most common cancer in women due to the increase in smoking over the past 50 years. For example, if we give examples of environmental factors other than smoking, for example; from diesel fuel taxi drivers working in large cities due to the resulting exhaust gases also have an increased risk of lung cancer.

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THERE IS ALSO A POSITIVE PICTURE IN TURKEY

What can we say if we interpret the latest report in Turkey? Is there a decrease in cancer-related death rates in our country as well?

Prof. Doctor, “Turkey is included in the class of countries that provide quality data by the World Health Organization in terms of cancer statistics. Because cancer in our country has been a mandatory disease for many years, and our cancer database also has a very solid and high-quality infrastructure thanks to the well-established universities of our country.”

According to World Health Organization data, the probability of cancer-related death in Turkey decreased from 10.8 percent in the 2000s to 8.98 percent in 2015, and according to estimates, by the 2030s, these rates had reached 5.9 percent it is expected to fall. From this point of view, our data are very similar to Europe. In other words, there is a very positive picture for our country.

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FIVE TYPES OF CANCER ARE LEADING IN TURKEY

So what is the most common type of cancer in Turkey?

Prof. Doctor, “Lung, breast, intestinal, prostate and thyroid cancers are the most common. In general, the most common causes of cancers include alcohol, obesity, poor nutrition, especially tobacco products.”

There are many different causes such as hepatitis B-C and viruses such as Human Papilloma, lack of regular exercise, air pollution, exposure to sunlight.

Genetics is also an important factor in some types of cancer, such as breast cancer and prostate cancer. But the fact that there is a family history of cancer also does not mean that there will definitely be cancer. Only in this group of individuals does the risk increase in particular, it is recommended to start screening programs earlier.

What is our country’s position in the world regarding cancer education and cancer treatment methods? Are there any steps taken at this point, any new developments?

Prof. Doctor, “Given the geographical region in which it is located, Turkey is the country that uses the latest technologies and treatment methods to treat cancer best in neighboring countries.”

The best indicator of this is the rapid increase in foreign patient applications that has occurred in recent years. Compliance with the rapid development of both surgical techniques and the use of newly developed radiotherapy techniques and devices we have a special position with the guarantee.

We are pleased to see that the society has been trying to do its part in cancer education in recent years, both official institutions and the media and other organizations. October should be done in this regard in order to facilitate access to information about cancer at a more micro level, it is necessary to plan for what new applications can be made.

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A ‘PROTON THERAPY CENTER’ IS URGENTLY NEEDED IN TURKEY

Many experts who have important studies in the field of cancer emphasize that there should urgently be a proton therapy center in Turkey. Why is the proton therapy center so important, what role does it play in treatment can he play?

Prof. Doctor, “Proton therapy is a new radiotherapy (Radiation therapy) technology applied in the department of radiation oncology. Currently, all the radiotherapy devices we use in Turkey treat X-rays devices that use it for this purpose. However, the device used in proton therapy uses protons instead of X-rays.”

The difference of the proton from the X-ray is that it causes much less damage to normal tissues in structure, and in this way the side effect is less. For example; eye, brain, heart, vessels, nerves or spinal cord, such as effective doses of more it allows you to treat it with few side effects.

Breast cancer in Turkey is currently the most common type of cancer in women. Although it is considered to be more of an advanced age disease, the incidence of it in women under the age of 40 is increasing more and more in our country. Therefore, experts she points out that every young woman, starting from the age of 20, should start self-examination by hand.

Prof. Doctor, “But unfortunately, there is no proton therapy center in Turkey. We’re too late for that. we are talking about a technology that has been used in treatment since the 1950s. Based in the world there are hundreds of active centers. For our country, two or three centers will be enough at the first stage, especially in Ankara and Istanbul.”

Of course, proton is not an effective method of treating every cancer, but the effectiveness of proton therapy in many types of cancer, especially childhood cancers and skull base tumors, is a well-known technology. This the main disadvantage of the technology was the installation and maintenance costs. However, these have now gone down from 80-100 million dollars to 20-30 million dollars.

Today, when we send a proton patient abroad, the cost of treatment alone is about 150 thousand dollars in the United States and 25-30 thousand euros in Europe. The nearest proton center in our region is in Prague. But Cairo and even in Tbilisi, the installation of proton therapy centers was started.

In addition, proton centers should not be considered only for therapeutic purposes. Because these are miniature particle accelerators. In other words, technologically, it is also very important in the research and development activities of our country, especially in physics it’s about them playing an important role.

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THE DRUG THAT STOPS THE GROWTH OF CANCER TUMORS HAS BEEN DEVELOPED

“One of the most important breakthroughs in the last 20 years”

Last September, there was a significant improvement in cancer treatments. The National Health Service (NHS) said in a statement that the drug ‘Sotoracib’, a state-of-the-art therapy, is a new generation cancer treatment it was predicted that it would provide a significant improvement in their work. This drug, taken as a tablet, binds to the KRAS G12C mutation, neutralizing the mutation and stopping the growth of cancer tumors.

In clinical trials, it was proved that the drug in question stops the growth of lung cancer for 7 months. In the light of this data obtained, the drug will be given to patients and its follow-up will be carried out. For the drug in the description of the NHS it was stated that an early access agreement was reached. In this context, it was also stated that the drug will be given to about 600 patients diagnosed with lung cancer in the UK. In addition, the statement also included pancreatic and colon cancers it was emphasized that it could also represent a major advance in the treatment of the most deadly cancers.

The Chief Clinician of the UK Cancer Research Foundation on the subject is Prof. said, “Sotoracib is one of the most exciting breakthroughs in the treatment of lung cancer in 20 years. The drug reveals the inner workings of cancer it targets a cancer gene based on decades of laboratory research. This drug is one of the treatments that help increase the survival rate of patients with limited options for cancer treatment it expands our list,” he said.

In a gratifying development, it happened in Israel. The Cell Research and Immunology team of Tel Aviv University had been conducting studies for a long time to identify and eliminate cancerous cells. Team, Using a gene correction technique called ’CRISPR Cas-9′, he was able to destroy cancerous cells in mice. Research has shown that glioblastoma is one of the most aggressive cancers, like brain cancer and metastatic ovarian cancer it was carried out on hundreds of mice suffering from its species. The scientist who conducted the study Prof “We plan to develop this method of treatment for all types of cancer. Within two years of the technique, people we think it will reach the level that we can use it on,” he said.

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President of Organ Transplant Center at MedicalPark Hospital Antalya

Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.

Physician's Resume:

Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.

Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.

In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.

Awards:

Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.

Certificates:

Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .

Professional Members:

American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.

Disclaimer:

Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.
Medically Reviewed by Professor Doctor Alper Demirbaş
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