Cancer Can Be Prevented

Cancer prevention

What if I told you that only 5-10% of all cancer was genetic? What if I told you that only 1 in 20 of all of us and our loved ones that get a cancer diagnosis were pre-ordained by their genetics to get cancer, meaning 19 in 20 didn’t need to get it? You wouldn’t believe me right…well maybe you should, because it’s a matter of fact. Look it up, there are dozens of studies that show these numbers. So, why are you just hearing about this now? 3,000 people were killed in the attack on the World Trade Center in New York.[1]We mourn for the losses from September 11th, 2001 and wish that the whole ordeal could have been prevented. Our government has gone to tremendous lengths to ensure it doesn’t happen again…But, what about cancer?…The numbers from 9/11 pale in comparison to cancer. Again it’s not to say 9/11 wasn’t absolutely awful, but think of all that we do today to prevent another one. Security nearly everywhere, phone tapping, etc. etc. Where’s the equivalent for cancer?

 According to Cancer.org, “A total of 1.7 million new cancer cases and just over 600,000 deaths from cancer were projected in 2018.”[2]What!!!! Does this make you angry? Is it absolutely demoralizing? Because it should be…600,000 deaths in 2018 from cancer!!! Even as a physician, I am shocked by this number. I have given 100s of cancer diagnosis, lost close family members to cancer, and truly hate the disease.

Girl hugging mother

Remember the war on terror? Where’s the war on cancer? Actually, Former President Richard Nixon declared the “War on Cancer” in 1971. He did this in an effort to rally the troops (scientists/physicians) around beating cancer. He shifted funding and the whole World was inspired for awhile…This war language has been used in multiple ways surrounding the concept of cancer since, but unfortunately, Dr. John Bailer’s issued a May 1985 judgment of the US national cancer program as a “qualified failure.”[3]I’ve often heard and watched as Americans support our loved ones suffering from cancer in their “fight against cancer.” We’ve all heard things like keep up the good fight and don’t ever give up on your fight against cancer.

Clearly, there is a component of positive energy and the restoration of our health and healing. This is not to be minimized by what I’m about to say…AT ALL. But I do think it’s somewhat disingenuous to put the onus on the individual suffering from cancer, already sick, to “fight against cancer” without understanding that this has nothing to do with this individual’s ability to fight. No doubt there are cancers that are genetic, recall only 5-10% though, and may be impossible to avoid, but for most cancer starts with our lifestyles. The lifestyle factors include cigarette smoking, diet (fried foods, red meat), alcohol, sun exposure, environmental pollutants, infections, stress, obesity, and physical inactivity.[4]There are numerous things that we have discovered that are important and related to the cancers we all incur, but are we doing enough to prevent it? 

cold cuts

It is up to us as a community of family, friends and neighbors to uphold a cancer-free environment that offers the protection that our loved ones deserve. By waiting until they have developed cancer, we have missed the opportunity to create the conditions by which they could’ve avoided it altogether. We recognize our inability to fix the cancer in those we love and so because of this we default by supporting them in saying keep up the good fight. It would be much better to prevent it though that wait for it to happen and wish them well. Are you aware that processed meat is known carcinogen? The World Health Organization and 22 experts from 10 countries studied 800 research papers to make this determination and compared processed meat to cigarettes![5]How many of us have served bacon, deli meat, summer sausage, cold cuts, bratwurst or hot dogs to friends and family? We might as well have served them a scotch and cigarettes too…Then, when that same loved one gets cancer, we shift the onus onto them by saying, “Keep up the good fight!” That’s not fair to those who you served the carcinogenic food to. We owe it to our communities to build safety in our communities to prevent the cancer altogether. We wouldn’t serve our love ones cigarettes and then wonder why they end up with cancer, but we do it with diet all the time. The Lancet just published a new study which showed that 11 million deaths worldwide were attributable to diet, which was 4 million more than tobacco related deaths!![6]Yet, we continue to serve processed meat, sugary foods, but our platters like fruits, vegetables and whole grains. We can argue we didn’t know before, but we know now!

cigarettes

We have set our loved ones up for cancer and then shift the guilt we all harbor deep within us about the lifestyles we live to our suffering loved ones by wishing them well in their individual fights. The potential for cancer exists in every single one of us, not because we are genetically preordained to get it, but because most of us are consuming the SAD diet or Standard American Diet. Most of us don’t exercise. Most of us are chronically stressed, inflamed, and infected. By telling our loved ones that they must stage a good fight to defeat their cancer, we are implying that if you don’t defeat it, they didn’t put up a good fight. That’s not fair! It compounds the stress and anxiety our loved ones are already feeling who have cancer, setting them up for failure AND shifting the blame from ourselves for living this cancer causing lifestyle and sharing it with them to them individually for losing the fight! I can’t live with that. We all blame in this epidemic, not because we haven’t found a cure, but because we all embrace a lifestyle that causes cancer! We have to look in the mirror and take responsibility for this.

There are two ways in which we can defeat cancer and neither of them require passing the onus on to those that are suffering and sick in their time of great need by implying that they must fight harder or better or stronger.

The first is we have to fortify our immune systems to reduce the probability of development of cancer-causing cells. Cancer causing cells are occurring all the time in our bodies. They occur more frequently when our lifestyle supports cancer. Our bodies brilliantly label cancer cells and destroy them through our immune system. We must create the best immune system possible to respond and to destroy potential cancer-causing cells. One clear example of this is the human papilloma virus. HPV is a sexually transmitted disease which can result in numerous types of cancer, including most commonly cervical cancer. By obtaining the vaccination against HPV you can reduce the chances that you may develop an HPV infection thereby increasing your risk of cancer. This is one way  medicine has contributed to fortification of our immune system to avoid cancer. There are numerous others. 

The second is we have to avoid cancer causing exposures. There are numerous. In fact, far too numerous to discuss in podcast or blog time. We do have to try. This is one of the most challenging topics as it relates to cancer. Because many of us are not familiar with the chemicals that cause cancer and also not familiar with the composition of our environments both micro and macro around us we decide to throw up our hands, saying we can avoid everything and so thus we must avoid nothing. This logic is primitive. We must attempt to avoid definite cancer-causing agents in our environment so as to reduce the probability that we will all know on to develop cancer.

Environmental factors are present in the air we breathe, the water we drink, the food we eat, the places we work, the homes we live in, the clothes we wear, amidst numerous other things. As it relates to food, one area of curiosity has been pesticides. Certainly, pesticides have had a new important role in the production of food which has value in providing greater efficiency in the production of food, if that food production is used to feed an increasingly hungry world population. If however, pesticides are used to increase revenue for farmers, then the purpose of their use is questionable.

One thing that’s clear is the use of pesticides in our food is ubiquitous. The USDA or US Department of Agriculture initiated the pesticide data program or PDP in 1991 to collect data on pesticide residues in food. The program now has an important role in the implementation of the 1996 food quality protection act or FQPA. PDP data are used primarily by the US Environmental Protection Agency or EPA to assess dietary exposure during the review of the safety of existing pesticide tolerances.The USDA showed that 85% of foods tested in the pesticide data program (PDP) report issued in 2015 had pesticide residues.

In the same report 99% of the samples tested had residues well below the tolerances established by the EPA with 15% having no detectable pesticide use.[7]  We are assured that science and the EPA  have definitive and apparently timeless data which prove without a doubt what the safe threshold or tolerances of these chemical uses. While certainly, it’s easy to sit back and criticize, there has been considerable research done by brilliant researchers on this topic. It is however my personal opinion that science and in particular medicine are subject to change.  My experience with these changes is part of the reason for my skepticism as to what truly demonstrates a safe threshold. I am also personally and professionally interested in all of my exposures as well as my patients. Trusting that I am protected through these arbitrarily established thresholds is simply not enough for an increasingly  knowledgeable consumer of the 21st century, especially as it relates to the topic on hand of cancer.

Only .53% of the total samples tested exceeded established tolerance for the residues.[8]

Residues with no established tolerance were found in 3.9% of the total samples tested.[9]

The study sample 394 samples. 259 were domestic or 65.7% and 129 were imported or 32.8% and six were of unknown origin 1.5%. [10]

One example of a pesticide on our food is glyphosate. This product has been the source of lots of controversy of which I won’t bore you. What I think is so remarkable again about this debate is NOT whether or not it causes cancer or not. The issue, to me, as a consumer is can I with reasonable certainty decide when I purchase produce whether or not the food I am eating contains chemicals. Because this question can’t be answered with reasonable certainty, I personally choose organic options whenever I can. No research or governmental body can convince me to do otherwise. Whether studies can prove organic is better or not, I choose with my dollar to support produce that doesn’t use chemicals on my food. It reduces one more potential cancer-causing environmental factor in the lives of those I love. 

What about the dozens of other chemicals we are exposed to regularly. 

The National Toxicology Program or NTP is a division of the US Department of Health and Human Services. They issue a report on carcinogens on a semi regular basis. They released their 14th report on carcinogens on November 3 of 2016.[11]The report on carcinogens is a congressionally mandated science-based public health document that the NTP prepares for the HHS Secretary. There were 248 listings of agents, substances, mixtures and exposures that were known or reasonably anticipated to cause cancer in human beings.[12]

We cannot review all at one time. I think however that many of these substances will be of interest to this audience. Let’s start with a few really interesting ones. 

Tobacco smoking is  known to be a human carcinogen based on sufficient evidence of carcinogenicity from studies in humans.[13]Specifically, tobacco smoking has been shown to cause cancer of the lung, urinary bladder, renal pelvis, oral cavity, pharynx, larynx, esophagus, lip and pancreas in humans.[14]Smoking cessation is incredibly difficult. I am not an expert on how to do it. My grandmother died of breast cancer. Breast cancer is increased in smokers. “She never smoked,” my family always said, which added tragedy to the loss. “Yes, she did,” I would later contest, knowing fully that she never held a cigarette to her mouth. “She smoked every day, as she breathed the smoke, my grandfather expelled right there in her home.” If those that smoke can’t quit for themselves, maybe they can consider the cancer they could be causing in those that surround them. If not, then let’s not tell them to fight harder, if they succumb to cancer. 

Lead and lead compounds are reasonably anticipated to be human carcinogens  based on limited evidence of carcinogenicity from studies in humans insufficient evidence of carcinogenicity from studies in experimental animals.[15]Lead exposure has been associated with increased risk of lung, stomach and urinary bladder cancer in diverse human populations. What levels? This becomes more difficult. Suffice it to say, have your water and home tested for lead. If it’s high, you should ask an expert on the best ways to reduce the exposure to protect yourself and your family. 

This product may contain formaldehyde. Haven’t you ever wondered what that means? I know I have. As it turns out, formaldehyde is a known to be a human carcinogen based on sufficient evidence of carcinogenicity from studies in humans and supporting data on mechanisms of carcinogens. It was first listed in 1981.[16]  It’s not fully understood how formaldehyde causes cancer but it probably has something to do with our DNA and its effect or impact on it.  It has been associated with nasal and sinus cancer, as well as with leukemia.[17]If the  furniture you are purchasing contains formaldehyde, you might just consider buying something different. Why add to your long-list of carcinogens. 

Alcohol is a known carcinogen. It compounds the carcinogenic effects of other chemicals as well. It does seem to have a dose response, meaning the more you consume, the higher your risk, but consider your alcohol use and its implication for cancer on your life. 

There is one other potential way to avoid cancer and that is through genetic manipulation. In medical school, we talk about the two-hit hypothesis. Essentially what this is is the concept that first you need the genetic predisposition to developing cancer and the second is you need an environmental hit. These two hits then lead to cancer. If you could alter your genetic predisposition to cancer you could potentially decrease the probability of development of cancer in theory.

Overwhelmed yet? Don’t be, let’s review the simple take homes of this article. 

  1. Support those you love by reducing their cancer risks. 
  2. Be sensitive to the “fight” against cancer, because those suffering are victims and may not stand a chance. 
  3. Eat organic, when you can afford it, to avoid the pesticide exposures, even when they are “proven” to be safe. If money is an issue, take a look at the dirty dozenlist of most unsafe foods. 
  4. Avoid smoking cigarettes around anyone else. If you can and are ready, consider a smoking cessation program. If you are exposed to someone smoking, remind them kindley of the risk they are incurring for you. 
  5. Get your homes and water tested for lead. If it’s high, consider investing in mitigation. 
  6. Don’t buy products containing formaldehyde. 
  7. Reduce alcohol use when you can.

[1]“Casualites of the September 11th Attack.” Wikipedia. https://en.wikipedia.org/wiki/Casualties_of_the_September_11_attacks. Accessed April 13th, 2019. 

[2]Facts and Figures from 2018. https://www.cancer.org/latest-news/facts-and-figures-2018-rate-of-deaths-from-cancer-continues-decline.html. Accessed April 13th, 2019.

[3]Cancer is a preventable disease that requires major lifestyle changes.” Anand, et al. Pharm Res. 2008 Sep; 25(9): 2097–2116. Published online 2008 Jul 15. doi: 10.1007/s11095-008-9661-9https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/

[4]Cancer is a preventable disease that requires major lifestyle changes.” Anand, et al. Pharm Res. 2008 Sep; 25(9): 2097–2116. Published online 2008 Jul 15. doi: 10.1007/s11095-008-9661-9https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/

[5]“World Health Organization Says Processed Meat Causes Cancer.” https://www.cancer.org/latest-news/world-health-organization-says-processed-meat-causes-cancer.html. Accessed April 13th, 2019.

[6]“Health Effects of Dietary risks in 195 Countries..” DOI:https://doi.org/10.1016/S0140-6736(19)30041-8https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30041-8/fulltext

[7]

https://www.ams.usda.gov/sites/default/files/media/2015PDPAnnualSummary.pdf

[8]

https://www.ams.usda.gov/sites/default/files/media/2015PDPAnnualSummary.pdf

[9]

https://www.ams.usda.gov/sites/default/files/media/2015PDPAnnualSummary.pdf

[10]

https://www.ams.usda.gov/sites/default/files/media/2015PDPAnnualSummary.pdf

[11]https://ntp.niehs.nih.gov/pubhealth/roc/index-1.html

[12]https://ntp.niehs.nih.gov/pubhealth/roc/index-1.html

[13]https://ntp.niehs.nih.gov/pubhealth/roc/index-1.html

[14]https://ntp.niehs.nih.gov/pubhealth/roc/index-1.html

[15]https://ntp.niehs.nih.gov/pubhealth/roc/index-1.html

[16]https://ntp.niehs.nih.gov/pubhealth/roc/index-1.html

[17]https://ntp.niehs.nih.gov/pubhealth/roc/index-1.html

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