Any excuse to celebrate, and millions of birthday parties around the world tell the story – cancer, though still a big public health concern, is not a death sentence.

Since reaching a peak in the early 1990’s, cancer death rates have been steadily falling – at around 20% for women and over 25% for men. This is according to Cancer Research UK and the American Cancer Society.

Probable reasons for this improvement are:

– fewer people smoking

– improved screening and early diagnosis for common cancers

– more treatment options

– targeted drug and/or radiotherapy treatment

– new surgical techniques

– more effective treatment and prevention of co-occurring conditions such as diabetes, obstructive airways disease, stomach ulcers, chronic infection and so on

“We needed to give patients more options and better news about their future. I was impatient for more advances sooner and I still am. But clearly we’re moving in the right direction” – Prof Peter Johnson, Cancer Research UK

There are still challenges. Pancreatic cancer appears to be on the rise, and amongst women, lung cancer has increasing by around 8% (whilst falling amongst men).

This is thought to be the tragic harvest of 1960’s cigarette marketing, which successfully targeted millions of women by promoting tobacco smoking as an aid to slimming.


Whilst older women tend to take better care of their health, younger women sometimes fail to notice or to report symptoms that could serve as early warnings of cancer. These include:

– unexplained weight loss

– bloating

– breast changes: lumps, thickening, persisting rash, discharge, nipple changes

– unusual bleeding

– skin changes (moles, pigmentation, scaling)

– difficulty swallowing

– blood in urine or stool

– gnawing abdominal pain especially associated with depression (may indicate pancreatic cancer)

– indigestion for no apparent reason

– white patches or spots in the mouth (especially if you are or were a smoker)

– unexplained pain: not likely to be cancer but get it checked out

– a swelling under the armpit, in the neck, or anywhere else

– unexplained fever (sometimes associated with early blood cancers)

– persistent fatigue, even if you think you have reasons to be so tired

– persistent coughing

There are a few ‘wild cards’ in our future whose effect on rates of cancer diagnosis and death are still unknown. The most worrying of these is the so-called “obesity epidemic”, especially insofar as it affects younger people.

Recent research has connected excessive sugar consumption with a variety of conditions including auto-immune and inflammatory conditions which may predispose to some forms of cancer. We really need to start dealing with this!