• 9/21/2004
  • Columbus, Ohio
  • Larry Gierer
  • Ledger Inquirer

Still, many survivors and doctors shy away from the word ‘cure’.

Mary Starke Harper, 85, knows something about cancer. The Columbus resident has doctorate degrees in clinical psychology and medical sociology and a master’s in nursing. She’s been an adviser on health issues to four Presidents of the United States. And she’s had the disease. In 1968, she had her left breast removed. In January, more than 35 years later, cancer was found in her other breast. “I don’t think you can use the word ‘cured,’ ” Harper said, “because there is always a chance of recurrence. People who have had cancer are always haunted by it. Every time something goes wrong with their body, they think it has returned.”

Nearly 10 million Americans have battled cancer, including 1.4 million who had it more than 20 years ago and are called “long-term survivors” by those afraid to call them cured. At a time when more people are cured of cancer than ever before, fewer doctors seem willing to say so. “The medical community has backed off the term ‘cured,”‘ said Julia Rowland, a psychologist who directs the federal Office of Cancer Survivorship, which was started in 1996, the year Lance Armstrong began treatment for testicular cancer that had spread to his lungs and brain. The cyclist has since boasted of beating the disease, and this summer he won his sixth Tour de France.

Some cancers — certain lymphomas and leukemias in particular — never go away completely yet are controlled so that they’re no longer life-threatening. Some call that a remission, but others consider it a cure. Other cancers look like they’ve gone away — no signs of them can be found by exquisitely sensitive and sophisticated tests — but recur many years later, suggesting that they weren’t really cured after all. Breast cancer is notorious for this.

Even before she was diagnosed a second time with breast cancer, Harper knew the harsh realities of the disease. “Cancer runs in my family,” she said. Her daughter Louise died from cancer at age 25, and her son Michael has received treatment for prostate cancer. He’s been “clean” for two years, she said. “His tests have all had good results lately, but is he cured? Well, I don’t know. I guess he is for now.”

Ellen Stovall, who had Hodgkin’s disease and now heads an advocacy group, the National Coalition for Cancer Survivorship, tries to ignore the issue. “Cure is a term that I don’t need to have in order to feel well and healthy,” she said. “It’s a word without meaning in some respects. It may be useful for testifying before Congress or getting a job,” but it doesn’t predict future health.

Cautious optimism

Columbus oncologist John Cabelka isn’t afraid to say “cured.” He just isn’t in a hurry to say it. “I do consider certain cancer patients curable,” he said. “If every last cancerous cell can be removed, then the patient shouldn’t be concerned about its return.” Associated with the John B. Amos Cancer Center, Cabelka said with some cancers, if the patient is cancer-free for five years, “there’s an excellent chance it won’t come back.” With throat cancer and some others, make that only two years, he said.

“Some of these people have long-term survival, and some of them are going to be cured of their disease,” said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society. “We don’t know what to tell them.” Which is why many doctors turn to statistics, and five-year survival is their favorite. By that measure, cancer surely is being cured: Nearly two out of three patients make it to that point today; only half did 25 years ago. However, there is nothing magical about that benchmark. Survival is a continuum, and five years is no more meaningful a dividing point than two, three, six or nine years.