Cancer and Focus

From The Conversation:

The fixation on potentially cancer-causing chemicals in the air, food and consumer products is diverting attention from the real risks, according to a review of global evidence by an Australian cancer researcher.

Writing in the medical journal The Lancet Oncology, Professor Bernard Stewart, from the University of New South Wales, said that lifestyle factors – driven by “personal choices” – were the most significant proven causes of cancer.

“Measures known to prevent cancer include smoking cessation, reducing alcohol intake, curbing obesity and avoiding deliberate sun exposure,” said Professor Stewart, who reviewed medical literature from around the world on known and suspected cancer hazards.

“Diverting attention from these messages threatens to undermine their efficacy to deliver proven benefits.”


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  • Kelly

    This is interesting to me because it seems that the messages around the risks of smoking, obesity, and sun exposure have increased in the recent past yet the cases of cancer seem to be on the rise (I’m coming at this as an unscientific observer). What appears to be happening is the opposite of what is said here.

  • Joe Canner

    Kelly #1: In the US, some cancers are increasing and some are decreasing.

    Lung Cancer is decreasing, likely due to anti-smoking campaigns and perhaps also to clean air standards.

    Skin Cancer is increasing, but it will probably take a while for education to have an effect since sun exposure many years in the past can put you at higher risk.

    Esophogeal Cancer (for which both alcohol and smoking are risk factors) is decreasing.

    The link between obesity and cancer is not as straightforward (as in smoking->lung cancer or sun->skin cancer) and there are other factors (e.g., screening) that could also impact cancer incidence. In any case, we all know that anti-obesity campaigns have not been very successful anyway.

    All that said, the fact that a certain cancer is increasing is not necessarily evidence that there aren’t enough messages about the personal risks. In fact, it could be evidence to support Dr. Stewart’s contention: that the messages are getting lost because people are blaming external factors that are less important at the expense of personal factors that are more important.

  • EricG

    As someone who has advanced stage cancer, something that always irks me is that people assume that there is a known cause for most cancers, and that the person fighting cancer had something to do with their illness. I had none of the risk factors or inherited traits, took care of myself very carefully, and still developed it at a young age.

    It is like the modern day version of Job’s friends: “What did you do to earn this?” Perhaps it makes modern-day Job’s friends feel better if they can attribute it to something, because then they feel safer themselves.

    But the reality is we really don’t know yet what causes a lot of cancers, other than the obvious ones like smoking/lung cancer and sun burns/skin cancer.

    The other thing we know is that it usually isn’t one thing that causes cancer in someone. That said, there are steps you can take to reduce risk, and the ones the article lists are good. Another obvious one, which isn’t listed, is lack of exercise, which is linked with cancer rates for some people.

  • Susan N.

    EricG (#3) – Job’s friends…adding insult to injury.

    We humans like to think that we are in control of everything, and that we can outwit and conquer all. Life has a way of disabusing us of these notions.

    I’m so sorry. My prayers are with you, EricG.

    I have a sense of late that I’m wearing out my welcome on Jesus Creed. =o

    I win no friends with my perpetual pessimism, but…”studies” like this irritate me, too. (I know, angry South Pole elf. I gotta work on my attitude.)

    Smoking, drinking, sun exposure, obesity, sedentary lifestyle – yeah, I get it. When we’re young, it doesn’t seem like we’re hurting anything. It all catches up to you in middle age. Natural consequences and all that; you reap what you sow. There is some truth in this, and I take the point to heart.

    But, as you shared EricG, sometimes bad stuff just happens. I know people who have done everything right, and get sick or lose their job or whatever. Other people take every foolish risk and abuse their health, and come out right as rain.

    The ax that I was going to grind is processed food. I grew up fairly poor, and we ate what was cheap — usually the processed foods. The healthier foods are the most expensive. That’s truer than ever these days of high inflation. I think the cumulative effect of nutritionally-depleted, processed (loaded with artificial ingredients and preservatives) foods take a toll in health, and certainly contribute to obesity, heart disease, and diabetes. Plus, if you do not have time (working two jobs?) to prepare whole foods (such as dried beans and peas, which require multiple-stage cooking), your options are reduced to quick foods. The health effects are more difficult to quantify, I suppose, than skin cancer from sun exposure, or lung cancer from tobacco or radon gas exposure.

    Peace, friend.
    ~Susan N.

  • Joe Canner

    Susan, I hear you… I inherited from my mother a slender frame (don’t have to watch my weight) and a propensity for high cholesterol. Go figure. My father, wife, and in-laws eat fatty foods like there’s no tomorrow and their cholesterol is fine. It’s all in the genes…

    I don’t care so much about when I die (although I guess my wife and kids might), but I would like to feel good in the meantime. So, if scientists could come up with diet for comfortable living and then dying suddenly at a reasonable age (not too young), I’d be all over that.

    And, yes, it’s a crime that eating healthy is more expensive. I keep hoping that healthy food is like new technology: when the novelty wears off and it is adopted widely the price comes down. I hope I live to see the day (still feeling good, of course).

  • David Wayne

    Hi, Scott, thanks for opening this issue up. I am, like EricG, someone who suffers from an advanced stage cancer (will pray for you brother). I want to echo and say amen to his comments. I’ve battled this now for almost 5 years and have read quite a bit (for a layman) about cancer and have talked to many doctors and nurses and it just seems to me that EricG is spot on. What I would call the “more responsible” doctors understand that cancer is very complicated, in fact, it is not one disease. It is hundreds of diseases, each one with its own genetic code and its own trajectory. And as I said, those I consider to be the “more responsible” (sorry, I know that’s a perjorative term) doctors know that there are so many possible causes of cancer that it is almost impossible to nail down any one or two or three or more factors in any given person’s cancer. I know that since Nixon started the “war on cancer” over 40 years ago the progress against cancer seems painfully slow. But I also think that the reason the progress seems painfully slow is because of natural human hubris. Nixon launched the “war on cancer” probably before his troubles began, at a time when Americans were putting men on the moon and we were quite full of ourselves. We seemed to have this attitude that if we could put a man on the moon, we could do anything, so curing cancer would be one of these. In the meantime lots of work and research has gone into cancer study and it looks to me like it is not so much a case of incompetent, corporate-lackey, doctors and researchers failing to make progress, or as the alt-med community likes to say, hiding the truth about cancer from us. It seems it is more a case of our best doctors and researchers learning the truth about cancer, that it is a far more complicated and menacing disease than we ever thought and if I may personify cancer, it is a very smart and devious disease that is able to outwit our best treatments. I’m not trying to defend all that goes on in mainstream medicine but I do think that a lot of the alt-med pushbacks and articles like these from Dr. Stewart (I’m aware he is legit, but other legit cancer specialists may see things differently) stem from man’s unwillingness to admit that there are some things out of his control, as well as unwillingness to come to grips with the depths of the effects of the fall. For example, how do we explain that 20% of the women who get lung cancer never smoked? What about EricG, who lived a healthy life? What if it turns out that we are unable to cure most cancers, but only offer mostly palliative relief? Would that not be consistent with the fact that we live in a fallen universe, would it not also be consistent with God’s promises that we will endure troubles and suffering in this world, and might it not also be a back door into some of the greatest experiences of God’s love and grace, since He is near to the broken hearted, and is strongest when we are weakest. One final thing, and I do apologize for going so long and monopolizing this comment thread. We ought not to forget that, by and large, cancer is an old person’s disease. In other words, our bodies were made in such a way that they are designed to break down at a certain age. Due to the vast advances we have made in health and hygiene over the last century, people are living longer, healthier lives than ever before. This in and of itself is sufficient to cause a significant rise in the rate of cancer. In the past, people were normally dying in their 40’s and 50’s, they didn’t live long enough for cancer to manifest. Now that we are living longer and pushing the boundaries on the length of time we were created to live, it makes sense that we would see more cancer. The body is going to break down and waste away in some fashion, cancer is one of those. Ok, enuf, again sorry to monopolize and God bless all of you and especially EricG.

  • Susan_G1

    (physician, and former molecular biologist working on co-carcinogenesis)

    Agree with the folks below me that this conversation vastly oversimplifies. Breast cancer was thought to have had behavioral contribution. The precise behavior kept changing (smoking, fat consumption, etc.) Now we have two breast cancer genes. Promise you, many, many more to come. Why do some people (my father) smoke 2 ppd x 60 years and never even get bronchitis, let alone COPD/cancer? My belief is that this, too, will come down to genetics. My mother had three cancers, two very rare, one that killed her. Lifestyle? Not at all. For decades we called this a bad gene pool. The rise in esophageal cancer is thought to mirror to some extent the rise in gastro-esophageal reflux disorder. Cancer is not a stationary target.

    The conscientious scientist will admit that cancer is a multifactorial and very complicated disease, and the more we learn about our genome, the more we will see genes that cause, facilitate, or inhibit cancer. There is little we can do about these, so why not concentrate, perhaps, on the ones that we might prevent with lifestyle changes? The problem with this is that there are no guarantees whatsoever, and it places an element of guilt on cancer sufferers which may be totally undeserved.

    To brush off the impact of environmental carcinogens is foolhardy. Cancer clusters (such as the one associated with flooding affecting a small student housing complex at Susquehanna U. in the late 90s with a stunning 18 students from that small complex developing rare cancers before the age of 30) prove the effect of carcinogens in our environment. Not to be too paranoid, but Big chemical companies are going to do everything they can to confuse the association with these truly preventable cancers.

    The honest truth is that cancer research, now faced with the human genome studies, is in it’s infancy. I say this even knowing all the studies being done when I was in grad school doing skin cancer research more than 35 years ago.

    My deep sympathies to those struggling with cancer now.