If you were told you were at high risk of getting cancer, what would you do?

So genomics is progressing. The newest research shows that through genomics they can account for the causes of 50% of breast cancer cases. They also state that if you are at high risk, you can lower your risk by maintaining a healthy lifestyle - good weight, not smoking etc.

"When researchers looked at the top 25% of risk scores, they found that these would account for about half of breast cancer cases in the future. Using previous models, genetic variants could account for only 35% of future cancer cases...."

"The model found that lifestyle factors, which are in a woman’s control, can generally lower the genetic risk by half. And the higher a woman’s genetic risk, the more she can reduce it with healthy behaviors. So avoiding excessive amounts of alcohol and smoking, or maintaining a healthy weight, for example, can bring a genetic risk of 30% down to around 15%, while a woman with a 4% genetic risk of developing breast cancer can reduce her risk by 2%."

So those statements beg a few questions.

1. What would you do if you were told if you were at high risk of getting breast or any other kind of cancer?
2. Does the high risk seem as much of a concern if you can lower it by maintaining a healthy lifestyle?

Other research has talked about what you do at a younger age can impact your cancer risk later. But do teenagers really care about healthy lifestyles? The teenagers I know often eat a lot of junk food, drink soda and other sugary drinks, and are not as concerned with getting a healthy meal three times a day. Then twenty-somethings seem to switch to some healthier habits as they mature and settle down. College is a big time for alcohol consumption and other risky behaviors. In recent decades the rates of teen smoking are way down. I know these statements are generalizations and there are exceptions but I am using them to make a point.


So if you knew at 15 that you were going to develop breast or any other cancer at age 50, would you change your lifestyle?  Or at 15 are you less concerned with cancer and more concerned with being a teenager and getting in to college?


My opinion is that at 19 at my first cancer diagnosis, I was somewhat concerned with how long I would live, accepted the fact (eventually) that I was at higher risk of another cancer, and that I was going to live my life as I wanted.

When I was at the end of my treatment - surgery and radioactive iodine - I was told to live a healthy lifestyle and not to take unnecessary risks. My thoughts were summed up as I would rather live my life as I wanted than sit around waiting for another cancer visit. I did eat relatively healthily but I also traveled a lot, drank alcohol and smoked (yes!) cigarettes.

I don't really want any predictive modelling done on me, any more than a friend of mine could get me to go see a psychic. I'm happy with my life, I wish I was healthier but I can't undo the past.

The Pessimistic Side of Curing Cancer

Two blog posts caught my eye this week on the problems with finding a cure for cancer. There is lots of hoohaa going on with we can cure cancer. There is even the deadline(?) of 2020 to find a cure for breast cancer. But here is a look at the other side of finding a cure for cancer.

The first article is on "Coming Together to Fight Cancer" that lists the five issues involved:

1. Cancer is not one disease. Its many diseases. 
2. There is a lot of effort going into treatment - chemotherapy, surgery, and radiation. Those are not cures. And a lot of the diagnostic advances (CT/PET scans) are also cancer causing tools.
3. Modern life styles are contributing to cancer rate increases - 10 fold in the last century.
4. There is not a lot of political will behind it. Politicians only care about the things that get them votes. They may say they support curing cancer, but is there budgetary support behind those words?
5. Apathy. Those touched by cancer range from rabidly vigilant to fairly laid back on their stance on finding a cure for cancer. But the lack of action prevails.

The next article refers to cancer as "An Unstoppable Killer: New Research Shows Cancer Cant Be Eradicated". Think of it this way. Cancer cells have been known to form going back millennia on the simplest of beings. So if they form on very simple organisms, could they be part of the intrinsic basis of life? If so, can we cure cancer without destroying some of the very basics of life? There is a lot more detail in the article itself so please read it.

Now all that being said, what can we do if we can't eradicate cancer? We can help lower the rates of cancer by returning to simpler lifestyles without chemicals, synthetic food made of chemicals, no tobacco use, more exercise, etc.

What if we tried that? In Australia, there used to be soaring rates of skin cancer. Now there has been a dramatic decline. Why? They started promoting sun screen use, put shades over public pools, encourage people to wear hats etc. That doesn't sound hard does it? A few little changes can make a big difference.

Remember the big hole in the ozone? With the decline in use of aerosols and pollution reductions with the Clean Air Act, the ozone hole is in showing signs of repair.(I read it somewhere this week but of course I cant find it now.)

So lifestyle changes may be able to help decrease cancer rates. If we can't cure it, maybe we need to focus  on decreasing its presence.
So instead of spending billions on expensive medications that might extend a patients life by up to six months, what if those billions were spent on promoting healthier lifestyles and

Red meat, too? Really?

No more steak??? Bummer. Not that we eat that much red meat but I can appreciate a really good steak and sometimes a juicy burger. But really? Living under a rock doesn't work either because of radon as someone commented here recently.

So how much do all these cancer risk factors really matter after all. We have the things we can't affect for any ailment. In the case of beast cancer, we have things we can't change like genetics, family history, child birth, aging, dense breasts, etc. Then there are the things we supposedly can change such as obesity, alcohol use, tobacco (a whole other kettle of fish, so to say in the cancer world), exercise, steak (now), breathing, BPA, blah, blah, blah... but if we have all the primary risk factors we can't change, how much can our diets and lifestyles really make a difference?

Yes we cab be healthier and make better choices for our bodies, but if the main factors can't be changed how much does it matter if we do? And the statistics can be hard to decipher.

Red meat consumption can raise a risk factor I think 13% for each serving per week. That doesn't mean that if your risk is 10% over your lifetime of getting breast cancer, it doesn't mean that a steak a week puts you at 23%,  or 11.3% etc., it probably means 10.13%, if that much.

I am ready to give up on all this risk factor business now because I can't figure out where I can hide from it all either...

Leading by example

You know when you go to your doctor and they tell you to eat a healthy diet and you stop at the cafeteria for lunch before your next appointment and they offer fried chicken and fries with a danish for dessert. Well now that is starting to change. The newest trend for hospitals is to become healthier themselves.

No more Dunkin Donuts in the hospital lobby for one. No more fried anything for most. This is part of a new initiative started in 2012 nationally to make hospitals healthier instead of contributing to chronic illness through unhealthy food options. This includes reducing red meat consumption and providing more vegetarian and fish options. Hospitals are also encouraged to try to source food locally. Some have even started rooftop gardens.

In addition, hospitals are taking steps to reduce waste, use of toxic chemicals, more efficient heating and cooling systems, safer chemicals in cleaning products, and increased recycling efforts.

I am very happy to hear this as this is a trend toward 'practicing what they preach' instead of 'do as I say, not as I do'.

I have noticed this at the local hospital where I go. They provide water stations through out the building where patients, visitors and staff can refill water bottles or provided paper cups. Recycling bins are evident. Food choices are leaning toward healthier choices and the cafeteria salad bar has expanded greatly. I had a yummy salad there the other day which was full of sunflower seeds and other healthy options.

This should be the way of the future. I would hope to see all these efforts visible at hospitals nationally and at other commercial and industrial buildings.

If you were told you were at high risk of getting cancer, what would you do?

So genomics is progressing. The newest research shows that through genomics they can account for the causes of 50% of breast cancer cases. They also state that if you are at high risk, you can lower your risk by maintaining a healthy lifestyle - good weight, not smoking etc.

"When researchers looked at the top 25% of risk scores, they found that these would account for about half of breast cancer cases in the future. Using previous models, genetic variants could account for only 35% of future cancer cases...."

"The model found that lifestyle factors, which are in a woman’s control, can generally lower the genetic risk by half. And the higher a woman’s genetic risk, the more she can reduce it with healthy behaviors. So avoiding excessive amounts of alcohol and smoking, or maintaining a healthy weight, for example, can bring a genetic risk of 30% down to around 15%, while a woman with a 4% genetic risk of developing breast cancer can reduce her risk by 2%."

So those statements beg a few questions.

1. What would you do if you were told if you were at high risk of getting breast or any other kind of cancer?
2. Does the high risk seem as much of a concern if you can lower it by maintaining a healthy lifestyle?

Other research has talked about what you do at a younger age can impact your cancer risk later. But do teenagers really care about healthy lifestyles? The teenagers I know often eat a lot of junk food, drink soda and other sugary drinks, and are not as concerned with getting a healthy meal three times a day. Then twenty-somethings seem to switch to some healthier habits as they mature and settle down. College is a big time for alcohol consumption and other risky behaviors. In recent decades the rates of teen smoking are way down. I know these statements are generalizations and there are exceptions but I am using them to make a point.


So if you knew at 15 that you were going to develop breast or any other cancer at age 50, would you change your lifestyle?  Or at 15 are you less concerned with cancer and more concerned with being a teenager and getting in to college?


My opinion is that at 19 at my first cancer diagnosis, I was somewhat concerned with how long I would live, accepted the fact (eventually) that I was at higher risk of another cancer, and that I was going to live my life as I wanted.

When I was at the end of my treatment - surgery and radioactive iodine - I was told to live a healthy lifestyle and not to take unnecessary risks. My thoughts were summed up as I would rather live my life as I wanted than sit around waiting for another cancer visit. I did eat relatively healthily but I also traveled a lot, drank alcohol and smoked (yes!) cigarettes.

I don't really want any predictive modelling done on me, any more than a friend of mine could get me to go see a psychic. I'm happy with my life, I wish I was healthier but I can't undo the past.

The Pessimistic Side of Curing Cancer

Two blog posts caught my eye this week on the problems with finding a cure for cancer. There is lots of hoohaa going on with we can cure cancer. There is even the deadline(?) of 2020 to find a cure for breast cancer. But here is a look at the other side of finding a cure for cancer.

The first article is on "Coming Together to Fight Cancer" that lists the five issues involved:

1. Cancer is not one disease. Its many diseases. 
2. There is a lot of effort going into treatment - chemotherapy, surgery, and radiation. Those are not cures. And a lot of the diagnostic advances (CT/PET scans) are also cancer causing tools.
3. Modern life styles are contributing to cancer rate increases - 10 fold in the last century.
4. There is not a lot of political will behind it. Politicians only care about the things that get them votes. They may say they support curing cancer, but is there budgetary support behind those words?
5. Apathy. Those touched by cancer range from rabidly vigilant to fairly laid back on their stance on finding a cure for cancer. But the lack of action prevails.

The next article refers to cancer as "An Unstoppable Killer: New Research Shows Cancer Cant Be Eradicated". Think of it this way. Cancer cells have been known to form going back millennia on the simplest of beings. So if they form on very simple organisms, could they be part of the intrinsic basis of life? If so, can we cure cancer without destroying some of the very basics of life? There is a lot more detail in the article itself so please read it.

Now all that being said, what can we do if we can't eradicate cancer? We can help lower the rates of cancer by returning to simpler lifestyles without chemicals, synthetic food made of chemicals, no tobacco use, more exercise, etc.

What if we tried that? In Australia, there used to be soaring rates of skin cancer. Now there has been a dramatic decline. Why? They started promoting sun screen use, put shades over public pools, encourage people to wear hats etc. That doesn't sound hard does it? A few little changes can make a big difference.

Remember the big hole in the ozone? With the decline in use of aerosols and pollution reductions with the Clean Air Act, the ozone hole is in showing signs of repair.(I read it somewhere this week but of course I cant find it now.)

So lifestyle changes may be able to help decrease cancer rates. If we can't cure it, maybe we need to focus  on decreasing its presence.
So instead of spending billions on expensive medications that might extend a patients life by up to six months, what if those billions were spent on promoting healthier lifestyles and

Red meat, too? Really?

No more steak??? Bummer. Not that we eat that much red meat but I can appreciate a really good steak and sometimes a juicy burger. But really? Living under a rock doesn't work either because of radon as someone commented here recently.

So how much do all these cancer risk factors really matter after all. We have the things we can't affect for any ailment. In the case of beast cancer, we have things we can't change like genetics, family history, child birth, aging, dense breasts, etc. Then there are the things we supposedly can change such as obesity, alcohol use, tobacco (a whole other kettle of fish, so to say in the cancer world), exercise, steak (now), breathing, BPA, blah, blah, blah... but if we have all the primary risk factors we can't change, how much can our diets and lifestyles really make a difference?

Yes we cab be healthier and make better choices for our bodies, but if the main factors can't be changed how much does it matter if we do? And the statistics can be hard to decipher.

Red meat consumption can raise a risk factor I think 13% for each serving per week. That doesn't mean that if your risk is 10% over your lifetime of getting breast cancer, it doesn't mean that a steak a week puts you at 23%,  or 11.3% etc., it probably means 10.13%, if that much.

I am ready to give up on all this risk factor business now because I can't figure out where I can hide from it all either...

Participating in the post cancer life without criticism

Yes we must participate in our lives post cancer. We need to do the right things in order to stay healthy and help reduce the chance of recurrence. The best things we can do are the things that all adults should do - they simply become more important:

• eat right
• maintain a healthy weight
• exercise
• reduce/avoid alcohol consumption

But as an additional stressor, we tie in the emotional impact of our cancer diagnosis.

Dr Bechold, here, writes about life post cancer as not a passive sport. I agree with her points but disagree with her tone. First of all, clearly although she has been a doctor for 30 years, she clearly has never been diagnosed with cancer herself. Back to if you haven't walked the walk, you can't talk the talk.

Second of all, she seems to blame the patients for their non compliance with recommendations for exercise, healthy lifestyle, and recurrence risk reduction.

"You can’t see that breast cancer survivor every 3 to 6 months, watch her weight balloon up, and not ask her what is causing this to happen. We must take time to talk to people and ask about their lives and how they are living each day with an eye on remaining cancer free. I had one patient who was clearly having some anxiety issues. As we talked, I found out that she was self-medicating every evening with a bottle of wine. While she graded papers! After I picked my chin up off the floor, I advised her that this was not an acceptable coping mechanism."

Hmm... so back to the patient whose weight was ballooning up. Did she ask about weight gain caused by Tamoxifen or aromatase inhibitors or chemotherapy or just plain emotional stress? Maybe what we used to eat and maintain a healthy weight, now makes us gain weight? I know I have tried to eat healthy and my weight has definitely increased. I go to the gym regularly but my medications cause weight gain and my other ailments have reduced my ability to move around. I know many other cancer patients who deal with similar issues.

And to the patient who self medicates with a bottle of wine - clearly a destructive behavior - but why was she so astonished? If the patient had anxiety issues, why hadn't other interventions been taken previously such as therapy?

Finally, I am somewhat appalled by this closing paragraph:

"No more excuses. No more “I don’t have time,” or “It’s too cold out,” or “I know I should, but…” It has to be done. Just like getting up every morning and going to your job—no-shows are fired! If you don’t buy gas for your car, it will not run. If you do not buy food, you will be hungry. There are just things you have to do. Compliance is required for a pill or a lifestyle and failure to comply will compromise the outcome. No matter how many tests we order."

From the point of view of a relatively healthy, active doctor, who looks fairly thin in her picture, without a cancer diagnosis under her belt, I am sure she thinks its easy. But she needs to walk a mile in hour shoes before she can criticize us. I am just glad she is not my doctor.

Leading by example

You know when you go to your doctor and they tell you to eat a healthy diet and you stop at the cafeteria for lunch before your next appointment and they offer fried chicken and fries with a danish for dessert. Well now that is starting to change. The newest trend for hospitals is to become healthier themselves.

No more Dunkin Donuts in the hospital lobby for one. No more fried anything for most. This is part of a new initiative started in 2012 nationally to make hospitals healthier instead of contributing to chronic illness through unhealthy food options. This includes reducing red meat consumption and providing more vegetarian and fish options. Hospitals are also encouraged to try to source food locally. Some have even started rooftop gardens.

In addition, hospitals are taking steps to reduce waste, use of toxic chemicals, more efficient heating and cooling systems, safer chemicals in cleaning products, and increased recycling efforts.

I am very happy to hear this as this is a trend toward 'practicing what they preach' instead of 'do as I say, not as I do'.

I have noticed this at the local hospital where I go. They provide water stations through out the building where patients, visitors and staff can refill water bottles or provided paper cups. Recycling bins are evident. Food choices are leaning toward healthier choices and the cafeteria salad bar has expanded greatly. I had a yummy salad there the other day which was full of sunflower seeds and other healthy options.

This should be the way of the future. I would hope to see all these efforts visible at hospitals nationally and at other commercial and industrial buildings.