Raymond Kalmanowitz has no idea how much longer he'll have with his nine-year-old son, Raymond Jr.
About three-and-a-half years ago, Beebe Medical Center doctors told 66-year-old Kalmanowitz, a Millsboro resident, that he had pancreatic cancer, and it was unclear as to how much longer he would live.
"When I returned home, I kneeled down and prayed to the Lord Jesus to please give me more time to spend with my son," he said. "During the next two-and-a-half years of treatment, there was much emotion – mentally and physically."
For a little over a year, Kalmanowitz has been able to forgo treatment, and merely visit his doctor every three months for screenings. Unfortunately, his tumor is now growing, and he must start treatment again this month.
Increased screenings and treatment availability for residents like Kalmanowitz has cancer deaths on the decline in Delaware, according to new data available through the state Department of Health and Social Services.
According to the 2005-2009 DHSS Cancer Incidence and Mortality report, released last week, the state's cancer mortality rate is ranked at 14th in the nation. In last year's report, which covered years 2003-2007, the state was ranked at 12. In the 1990s, Delaware had the second highest cancer mortality rate in the country.
"It would be great to be number 50, and we'll aim to get there," said Dr. Karyl Rattay, director of the state Division of Public Health. "But getting to number 14 is a huge accomplishment."
Officials are attributing this drop to increased preventative efforts, as well as availability to Delawareans of screening and treatment.
According to Dr. Paul Silverman, associate deputy director for health information and science for the DPH, throughout fiscal year 2012, the state's Screening for Life program screened more than 4,000 women for breast cancer, nearly 3,400 for cervical cancer, and more than 400 people for colorectal cancer. The program is available to the uninsured and to those whose insurance does not cover screenings.
The DHSS's report shows incidence declines for several cancers, including ovary, larynx, colon, cervix, esophagus, stomach, and Hodgkin lymphoma – all of which experienced a larger drop than the nation as a whole.
For the first time, according to the report, colorectal cancer incidence was significantly lower among African Americans and women in Delaware than nationally. Also, Delaware became the first state in the country to end a racial disparity for colorectal screening. In 2010, a slightly higher percentage of African American Delawareans were screened than whites.
The report also shows an improvement in early detection of breast cancer, and a breast cancer death rate decline that is over 50 percent greater than the national decline.
The last bit of good news to come out of the report is considerable improvements in mortality rates for several cancers, including cervix, prostate, colon and rectum, breast, stomach, oral cavity and pharynx, esophagus, larynx, and non-Hodgkin lymphoma.
Page 2 of 2 - However, as the report states, challenges remain.
Compared to 10 years earlier, Delaware's cancer incidence rates remain the same, with cancer of the colon, lung, prostate, thyroid, bladder, uterus, and skin at significantly higher rates than the nation.
Lung cancer, according to the report, continues to play an enormous role in the state's overall cancer burden. Throughout 2005-2009, lung cancer accounted for 15.2 percent of all newly diagnosed cancer cases and 30.3 percent of all cancer deaths in Delaware.
Female breast cancer among African American women increased 4.6 percent. However the death rate for African American women with breast cancer was significantly lower than the nation's.
Delaware's prostate cancer incidence rate increased five percent over the past 10 years, compared with a 10.7 percent decrease nationally. Officials are attributing these numbers to a greater prevalence of prostate cancer screening in Delaware. The burden disproportionately affects African American men in Delaware and across the nation. According to the report, Delaware's 2005-2009 incidence rates of prostate cancer were 80 percent higher for African Americans than for whites.
Silverman said it's unclear as to why African American men are more prone to prostate cancer than white men.
"Prostate cancer is one in which there is painfully little in what we can say that causes it," Silverman said. "I think that most of the evidence is pointing to a genetic difference. It doesn't appear to be driven by an environmental cause; but it's not clear."
Dr. James Spellman, a surgical oncologist at Beebe Medical Center, said overall, the state is seeing increased incidence in certain cancers, but at the same time, there's a decrease in mortality.
"To me, it means we're doing a very aggressive job of trying to tackle this problem up front, not only at Beebe, but across the state," Spellman said.