ANNAPOLIS – By the time doctors caught Norwood Beauchamp’s lung cancer, the disease had already spread to his lymph nodes. They gave him six months to live.
After more than a year, he’s still fighting. His cancer has gone into remission, but he’s not getting any stronger, either.
The former truck driver and lifetime smoker from Princess Anne discovered he had cancer during a yearly physical in November 1997. His mother and father died of the disease.
Beauchamp, 63, and his family are part of the unfortunate statistics of the Eastern Shore. More people per capita die of cancer in Somerset County than in any other place in Maryland — a state with one of the highest cancer rates in the nation.
No one seems to know why exactly.
Could it be something in the air? The water? Is it related to age or socio-economic status? Does heredity play a role? Cancer experts are baffled by what’s causing such high disease rates in certain pockets of the state.
“We don’t totally understand. That would require more studies,” said Dr. Sanford Stass, director of the University of Maryland Greenebaum Cancer Center.
There are a few theories. Heavy smoking, sun exposure and poor diet all contribute to the disease, according to Liz Williams, a community educator with the American Cancer Society. All these lifestyle factors are present in abundance on the Eastern Shore.
“When you begin smoking at a young age and eat a high cholesterol and fat diet and have never used sunscreen before in your life, it’s hard to tell people to change their lifestyle,” Williams said.
Some cancer experts say people’s attitudes toward health care play a role. Self-employed workers, such as chicken farmers and watermen, tend to be uninsured until they are 65 and eligible for Medicare.
In poorer counties, people “tend to see a doctor when they have to rather than when they should,” said Dr. Scott Edwards, a radiation oncologist in Salisbury. “Then they’re not going to do as well.”
Although the Baltimore metropolitan area and counties in Southern Maryland also exceeded national cancer averages, Somerset County had the highest cancer rates in the state in four categories: overall mortality for men; overall mortality for whites; colon and rectum cancer; and lung and bronchus cancer.
Residents of Somerset County have about a one-third higher chance of dying of cancer than the state average. The Somerset County mortality rate is 2.4 per 1,000 people. The state’s rate is 1.8.
“That is significant,” Stass said.
Pockets of the Eastern Shore surpassed both state and national mortality rates, according to Maryland Cancer Registry data for 1996, the latest year for which figures are available.
State cancer experts know that certain activities are associated with cancer, such as smoking, but they don’t know why Maryland or areas of the Eastern Shore have such high incidence of certain cancers and mortality rates, Stass said.
Some say the rate is just perceived as high.
“It’s not high. Age is high. People live longer on the Eastern Shore. The longer they live, the chance of getting cancer increases,” said Neil Bayne, Edward’s business administrator. “Young people leave the Shore after graduation to get employment on the western Shore.”
A greater proportion of the Eastern Shore’s population is over 65 than any other region of the state, according to Census Bureau estimates.
The region tallied 2,090 new cancer cases in 1996 and 903 cancer deaths.
Lung cancer alone caused almost a third of all cancer deaths in men and more than a fourth of the deaths in women on the Eastern Shore. Prostate and colon and rectum cancers accounted for about 16 percent of male cancer deaths in the region. Breast and colon and rectum cancers caused about 28 percent of female deaths.
An increase in smoking among women has bumped lung cancer up as the leading cause of cancer for women statewide, according to the Maryland Cancer Registry, which monitors and compiles cancer data for the state.
A higher incidence of lung cancer usually equates to a higher overall incidence of cancer, and is typically tied to smoking, said Dr. Lynn Khoo, director of the Maryland Cancer Registry.
“Once you stop smoking, your lungs will recover and the risk of lung cancer can decrease,” Khoo said. But smoking at an early age can lead to irreversible damage, she said.
Of the new cancer cases reported from the Eastern Shore for 1996, 31 percent were tobacco-related. Of those, 64 percent were fatal.
Kent County had the highest mortality rates in the state for overall cancer in women, colon and rectum cancer in blacks and breast cancer, especially in white women.
Some rates differed widely among races. Black men get prostate cancer more than white men on the Shore by a ratio of about 2 to 1.
High cancer rates in the state are hardly a new phenomenon. Maryland, which had ranked worst in the nation for cancer rates at the beginning of the decade, dipped to fifth in 1995 and then dropped to sixth in 1996.
Education is a key to reducing cancer, according to Khoo.
“People are getting wiser, especially about tobacco,” she said. “They know how to take care of themselves…. They eat better and exercise better.”
Screenings for certain types of cancer, over-the-counter home test kits, state programs to help pay for treatment and health education have also helped fight cancer, lowering mortality rates, Khoo said.
Prostate, lung and rectum and colon cancers accounted for about 56 percent of new cancer cases among men on the Shore in 1996. Breast cancer is the most common cancer among women from the region, accounting for 31 percent of new cases. Lung and bronchus and colon and rectum cancers made up 29 percent.
Statewide, there were 23,650 new cancer cases in 1996; 10,147 Marylanders died of the disease. Cancer is expected to surpass heart disease as the leading cause of death in the United States by the year 2000, according to the Maryland State Council on Cancer Control. As Baby Boomers get older, cancer experts predict that cancer rates will increase significantly.
So will costs. Cancer will represent an estimated 20 percent of health care expenditures in the state by the year 2000 and now costs the state about $1.8 billion annually, Stass said.
Beauchamp knows the price — literally and figuratively. The 10 or so medicines and painkillers he takes daily cost “an arm and a leg.”
Worse, though, is the physical toll.
A short walk to the mailbox, he said, leaves him “panting like a lizard.”
His weight dropped from 170 pounds to 130 pounds, but now is up to 181 pounds.
“I feel all right,” Beauchamp said. “They still say I ain’t out the six months and I’ve lived a year. It’s up to the good Lord.”