The journal Science recently published a study suggesting that the "bad luck" of random mutations plays the predominant role in cancer.
That is an ironic nonscientific term in a complex math explanation. One hundred years of cancer research and the big news is "bad luck"?
If I were communicating something related to an unknown risk, I might say a lack of evidence does not equate to safety. However, I am not sure how an "unknown" trend or pattern translates as "bad luck." Because while the investigators observed a particular trend, the only explanation they seem to be able to offer for that trend is "bad luck."
I am a marketing person and not a scientist. It is clear to see how this study could open many doors for funding new research focused on this one "bad luck" view and "rebranding" of cancer. From a marketing perspective, the "bad luck" approach to this horrible disease is not a war on cancer, but rather a war on cancer prevention.
Nothing in the Science paper focused on preventing cancer. Nothing was said about stopping the unknown -- now termed "bad luck" -- before it starts.
Graham A. Colditz, M.D., DrPH, serves as Niess-Gain Professor of Surgery, professor of medicine, and associate director of prevention and control at the Alvin J. Siteman Cancer Center at the Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis. On Oct. 14, 2014, Dr. Colditz had a blog posted on the American Association for Cancer Research website that said, "70 percent of breast cancers could be prevented by efforts started very early in life, whereas a smaller, but still quite large, 50 percent could be prevented by efforts started in mid-life." Dr. Colditz suggested breast cancer prevention can start as early as age 2. He continues:
The first is to effectively expand the targeted ages of breast cancer research and prevention efforts to include the key years of childhood and adolescence. The second is to garner the political will to boost the funding of prevention research and implementation to levels commensurate with its potential impact. Only 7 percent of all National Institutes of Health breast cancer research projects currently focus on prevention, a small proportion given that we know that effective efforts could prevent well over 100,000 cases of the disease each year.
I speak for many when I say that this one view of "bad luck" is not what the public is seeking. It is this type of hype that causes the public to mistrust medicine. The public needs better answers, not more avenues for early treatment. Each day, I hear what people want, and they want an end to cancer. The public wants proactive, not reactive, responses to cancer. People are looking to see cancer stopped before it starts.
The World Health Organization (WHO) says cancer is on the rise. A report by the WHO's International Agency for Research on Cancer (IARC) claimed that new cases of cancer rose to an estimated 14.1 million in 2012, with 8.2 million cancer-related deaths. The estimated number of annual new cancer diagnoses is expected to jump to 22 million over the next decade, with developing countries most at risk.
We need answers about the causes of those diagnoses. We have our eye on the wrong questions, and in turn pursue the wrong solutions. Correlation has been confused with causation.
Turning back the hands of time and rebranding cancer as "bad luck" gives a push to early treatment rather than prevention in a day and age when we are faced with more cancer.
Understand that I am not against treating cancer. I just believe that we need to be smarter about our approach to cancer, which of course means treating it and saving lives, but also leading with prevention. If we do not figure out how to stop cancer before it starts, we will only see increased diagnoses of cancer.
Margaret I. Cuomo, M.D., Less Cancer board member and author of the book A World Without Cancer, says in her book:
We've allowed pharmaceutical companies to position cancer drugs that extend life by just weeks and may cost $100,000 for a single course of treatment as breakthroughs. Where is the bold leadership that will transform our system from treatment to prevention? Have we forgotten the mission of the National Cancer Act of 1971 to 'conquer cancer'?
In my view, our current cancer response model is broken. Dr. Cuomo is correct when she asks if we have forgotten the mission of the National Cancer Act. We have some people living marginally longer but on the whole, more incidences of cancer. Attributing the problem to "bad luck" is not the answer.
My concern is simply this: By writing off two-thirds of cancer cases as "bad luck," people get a message that their lifestyles and habits have little to no impact on their susceptibility to cancer. This report also must be music to the ears of makers of products with health concerns -- anything from e-cigarettes to snack foods to carbonated beverages. After all, if individuals are subject to "bad luck," how important could their lifestyles really be? As a marketer, I imagine this must be delightful news to some sponsors and funders for whom prevention may not be a priority.
The fact that almost half a million people a year in the United States alone die from cigarettes is simply not "bad luck" -- it's cigarettes! In the New England Journal of Medicine, an article on the global effects of smoking says:
There were about 100 million deaths from tobacco in the 20th century, most in developed countries. If current smoking patterns persist, tobacco will kill about 1 billion people this century, mostly in low- and middle-income countries. About half of these deaths will occur before 70 years of age.
There are times when people work to prevent cancer and it doesn't work, but it's not unlike a seat belt in a car: The fact that it doesn't always help is not a reason to not wear a seat belt. Just because we might know one person who was killed while wearing a seat belt doesn't mean the rest of us should not wear them.
We can stop many premature deaths through prevention.
David Katz, M.D., director of Yale Cancer Prevention Research, recently posted a blog on The Huffington Post on this subject, stating that:
Studies show that some populations around the world get much less cancer, as well as other chronic diseases, not because of genetic advantage, but because of lifestyle advantage, mediated by culture. And perhaps most relevant for those of us not yet living in a blue zone, intervention studies show -- over and over and over -- that a constellation of healthful lifestyle practices translates into less cancer along with other chronic diseases, just as it translates into more years in life, more life in years.
When we work to prevent cancer, it prevents many other illnesses as well and improves human health and the environment. Cancer prevention can prevent not only cancer but also obesity, heart disease, and diabetes, to name a few other diseases. Is cancer prevention going to prevent all cancers? No -- just like seat belts are not going to save the life of everyone who is in a car accident.
Will this new study lead to saving lives? I am hoping so; no one more than me would like to change history's cruel reality of cancer and loss. I, more than anyone, would like to see lives saved. More importantly, though, we need to end cancer before it starts. For our children and their children, the future must be free of cancer.