Health Care/Joan Retsinas

The Fabulist-in-Chief Takes on Cancer

Enough! The Tweeter-in-Chief is the Fabulist-in-Chief. The crowds at his inauguration were humongous. He is the greatest President ever, also the most abused. He has made our country safe from foreign entanglements. All absurd: the inauguration crowds were sparse; he does not rank with Washington, Lincoln, or FDR. Other Presidents have spurred critics. And we are now cemented in the Middle East. Maybe his supporters find the fables charming, like those of an impish child who simply cannot tell the truth.

But his fables about cancer mortality are dangerous. They detract from the real heroes.

The good news is true. Mortality from cancer has fallen. We should celebrate those statistics. From 1991 to 2017 the rate of deaths from cancers, all kinds, dropped 29%, an average drop of 1.5% a year. 2016 to 2017 was a banner year: statisticians recorded a 2.2% drop, the largest annual drop since statisticians compiled those numbers. Deaths from lung cancer, the leading cause of cancer deaths, declined the most, with deaths from colorectal, breast and prostate cancers also showing a steady decline. So did mortality from melanoma, leukemia and lymphoma. The one outlier: deaths from cervical cancer, which could be prevented with screening and HPV vaccines, did not decline. (Deaths from cervical cancer are the largest cause of cancer deaths for women ages 20-39).

President Trump, who took office in 2017, traces the decline to his reign. He tweeted: “US Cancer Death Rate Lowest In Recorded History!” … “A lot of good news coming out of this Administration.” His timeline is askew: he took office after the decline, which was happening under his predecessor, President Obama.

Researchers point to a few reasons for the plunge. Fewer people smoke. A slew of state laws have made smoking almost taboo, and the public health warnings on billboards, coupled with the admonitions from physicians, have broadcast the dangers of lighting up. And, crucially, we have more effective treatments, including immunotherapy and targeted therapies. Researchers and clinical trials, in part subsidized by the government, undergird those treatments.

Ironically, this President may reverse that decline. He proposed, but Congress nixed, major cuts to the National Institutes of Health cancer research budgets. He still sees the NIH as a target for cuts.

He has cut funds for local public health initiatives; he sees those admonitions about smoking, as well as diet, unnecessary. His latest target: the Obama-era regulations for more fresh fruits and vegetables in school lunches. Under the guise of “flexibility,” he wants to let schools retrench.

Under his watch, more people cannot easily get the super duper treatments behind the drop in mortality. He has presided over an increase in people without insurance, or with inadequate insurance, who are less likely to get screened for specific cancers, less likely to get prompt state-of-the-art treatment. He has paved the way for insurers to re-institute exclusionary periods where they will not cover pre-existing conditions — a codicil that will leave patients with cancer waiting at clinic doors. Furthermore, the prices of those treatments have soared: he has not stemmed the rise.

The heroes behind the drop in cancer mortality are the researchers, the physicians, the public health staff.

We have not vanquished cancer. In 2020, statistician predict that 1,600 Americans will die each day. We must lower those rates, save more lives. The Fabulist-in-Chief is not helping.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, March 1, 2020

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