No doubt treatment has never been better for various forms of cancer, such as leukemia, lymphoma, Hodgkin’s disease and testicular cancer. But the best treatment will be prevention, by adopting a healthy lifestyle, avoiding tobacco use, maintaining a good body weight, and limiting alcohol use to moderation, all of which can make a world of difference.
Sadly, lung cancer kills more than 150,000 people per year and is the most common cancer in our country. A typical chemotherapy regime for non-small cell cancer costs more than $40,000 and helps extend a patient’s life by an average of just two months, according to the book “Super Freakonomics,” by Steven Levitt and Stephen Dubner.
The age-adjusted mortality rate for cancer is essentially unchanged over the past half-century: about 200 deaths per 100,000 people. This is a disappointing fact, despite President Nixon’s declaration of a “war on cancer” more than 30 years ago. For people 20 years of age and younger, mortality has fallen by more than 50 percent and those 20 to 40 have seen a decline of 20 percent. Nevertheless, the incidence of cancer is on the rise. This is exactly why current studies in epidemiology are being continued by the American Cancer Society so that we can try to avoid cancer in the first place.
Smoking, obesity and alcohol use all increase the risk of developing cancer. Thanks to the American Cancer Society, the association between smoking and lung cancer has been known since 1955, although the tobacco industry tried — and failed — to undo the scientific evidence.
The Society’s lead epidemiologist, Dr. Morton L. Levine, was at the Roswell Park Memorial Institute in Buffalo, N.Y., where he was recruited years before to look for a connection between viruses and cancer. He designed a hospital in-take questionnaire which was completed by patients with cancer and those without. After a few years, Levine and his colleagues noted the statistically significant link between lung cancer and smoking.
More than a century ago Louis Pasteur said, “Chance favors only the prepared mind.” By this he meant that sudden flashes of insight don’t just happen — they are the products of preparation. Levine prepared by designing the questionnaire which included a question on tobacco use. Up to then, everyone from solders to physicians were encouraged to smoke.
The reasons I am sharing this wonderful story of scientific discovery, which has helped all of us live longer, happier and healthier lives, is that I had the privilege and pleasure of being a National Science Foundation summer student in high school, with the opportunity of working for Dr. Levine. His team was still looking for other causes of cancer, which we now know include the risks of obesity and alcohol.
Since this first influential epidemiological study, other studies have been successfully completed by the American Cancer Society; these show the association between obesity and cancer, particularly esophagus, pancreas, colon, endometrium, kidney, thyroid, gall bladder and breast. Further, links show that the heavy and/or regular use of alcohol adds calories and, therefore, increases the risk of developing cancers of the oral cavity, lips, throat, voice box, esophagus, liver, breast, colon and rectum.
Alcohol and smoking together are far worse than either is alone, as causes for cancer. The smoke irritates the lining of the digestive track, allowing the alcohol’s irritants to be more toxic than they would be otherwise.
The dreaded sentence, “You have cancer,” will be heard by one in three of us. We can improve our odds substantially by avoiding tobacco, keeping our weight in line and being prudent with alcohol consumption.
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Allen Weiss, MD, MBA, FACP, FACR, is the president and CEO of the NCH Healthcare System.