Tuesday, May 14, 2013

Guns and Cancer

If you saw a stranger carrying a gun enter your neighbor’s house, would you get involved and call the police?  I think most people would agree that's the right thing to do. Recently, guns have been a main topic of conversation because of their most recent role in the senseless tragedy at the Sandy Hook school and the subsequent political efforts to make obtaining guns more difficult.  Major gun violence like Columbine and the DC Sniper always grip the national attention. Yet, according to statistics published for 2010, the death rate for guns in the US is about 1 in 10,000.  According to a 2004 report published by the Centers for Disease Control, there are over 100 more likely causes of death than guns. (See  http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_05.pdf).  Nevertheless, gun violence remains one of the most hotly debated and media covered issues in our country.

Cancer, on the other hand, according to the American Cancer Society, is responsible for 25% of male deaths and 20% of female deaths. So why in our society is there relatively little discussion about preventing cancer? True, there are plenty of public efforts around early cancer detection like getting colonoscopies and mammograms. Pink lapels are everywhere, but it's not nearly enough. (See my blog on Cancer: Prevention or Detection? at http://mdprevent.blogspot.com/2013/05/cancer-prevention-or-detection.html.)

Yet, other than encouraging smokers to stop and people of all ages to avoid the sun, we barely scratch the surface of the cancer topic.  (By the way, speaking about the sun, except for those most prone to skin cancer, most people should get at least 15-30 minutes of direct sun each day at non-peak hours to naturally produce Vitamin D and melatonin. One interesting recent study showed that higher blood levels of melatonin were associated with a lower rate of diabetes.).

So even though cancer is ubiquitous and everyone knows someone who has been diagnosed, treated, or passed from it, we as a society generally prefer to ignore the topic when possible. Why? As my wife likes to say, "it's just morbid to discuss it." I agree. Discussing cancer neither makes for good table-talk nor is it very popular topic at almost any other time.

It may be polite to avoid the topic, but is it smart? Is it time to overcome our distaste for the subject and bring it front and center?  Should we discuss it with friends and neighbors, our children and other relatives, co-workers, and even strangers? Should the halls of congress echo with debates on this topic greater than virtually any other? The answers depend on how much we value life and to what extent we are willing to go to preserve it.  What's the alternative? Continue to by and large avoid this difficult topic and in turn, sacrifice meaningful collective efforts to identify the major culprits.

The other question you may be asking is can and will such discussions change anything other than the mood of those involved? The scientifically valid answer of the moment is for some people, it simply won't matter. That's because scientists believe today that cancer is the result of damage to one's DNA and random mutations. In other words, some people are so genetically susceptible to developing cancer, that they cannot reasonably be expected to avoid all environmental triggers that have already and will continue to damage their DNA. Also, as far as researchers know right now, no one can completely avoid the random mutations that create cancer cells.

But for many, if not most, people, vigilance and caution could make a huge difference. For example, next on the list after smoking, being overweight is probably the most significant cancer risk factor. Obesity has recently become a hot topic, but mostly because of its effects on heart disease and diabetes, even though being overweight is the second greatest risk factor for cancer. Is it the extra weight, the type of food consumed, or the lack of exercise that creates the added risk? The answer is unclear.  Maybe it's all three. For example, a new study reveals the mechanism behind why exercise decreases a woman's risk for breast cancer. It is related to the changes to estrogen brought about by exercise. Exercise is good and women who exercise are less likely to develop breast cancer. When was the last time you heard that exercise prevents cancer?

When it comes to guns, we recognize their implicit danger. Guns take lives unexpectedly and can create peril at any time.  Most Americans agree that limiting the spread of guns is a necessity and a moral imperative. Unfortunately, efforts to limit gun access usually only affect law-abiding citizens and not those able to obtain firearms by criminal means.  In contrast, except in relation to children, and even in that regard the efforts are paltry, there is virtually little effort by citizen groups or the government to limit the hazards of chemically infested foods we regularly consume.

Some isolated groups are waging campaigns. For example, the Environmental Working Group (ewg.org, a non-profit organization, has developed a list of fruits, vegetables, and other household mainstays with the highest pesticide and chemical residues.  However, the truth be told, the science showing a cause and effect relationship between these products and cancer is relatively limited and inconclusive. Is it limited because there isn't any link, because it doesn't exist, or because Big Food prevents it from seeing the light of day, I can't tell you. While the dangers may be real, they are unproven.

Yet, although I'm not trying to instill paranoia, I still think the principle of what you don't know may still harm you, may apply.  One cannot imagine much benefit to our body from the countless chemicals we consume.

That's why caution is in order when consuming conventional fruits and vegetables. Although a major study from Stanford showed that such produce is no less nutritious than organically grown counterparts, soft-skinned conventionally raised produce is full of chemical contaminants. If unavoidable or the only type you can afford, then wash it thoroughly before eating.  Choose your household cleaning products carefully, opting for more environmentally friendly products when you can, and always protect your skin and  airways when using such products. Avoid, whenever possible, and otherwise limit consumption of all processed foods replete with a multitude and variety of potentially harmful chemicals.

If you saw a stranger with a gun entering your neighbor's house, you would probably assume the worse. Just because you do, doesn't mean he intends harm to your neighbor. Yet, you would still be alarmed. So why are you any less cautious about the foods and products you come in contact with and allow to invade your body that are strongly linked to cancer and other diseases?

No one can promise you that you will crimp your own cancer development. With 50% of men developing cancer and 33% percent of women doing so, your odds of avoiding cancer are not great.  (I'm sorry for being morbid, but those are the facts.)  However, I can tell you with confidence after reviewing over twenty thousand related studies, that living a healthy lifestyle will shift the odds in your favor.

If you value your health and your life, isn't it worth the effort? Again, there are simple things you can do such as avoiding processed foods full of chemicals, taking precautions with cleaning products, and carefully washing your produce to remove as much residue as possible. Little things may actually matter. This may be one of those situations where you can actually create your own luck. Avoiding cancer is important because prevention really is preferable to cure.  Hippocrates knew this 2,500 years ago and it's even more true today. As Louis Pasteur once said, "Chance favors the prepared mind."

No one should experience the daily agony my relative must now bear.  Please heed my words and decrease the probability that you or a loved one will ever experience the same.  Bet on yourself and your loved ones.

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