An Inconvenient Cancer Truth

Cancer is a term that inspires a broad range of feelings: from fear, anger, and helplessness to curiosity and determination. Cancer, as a force, has given rise to a massive infrastructure of cultural and clinical responses, and many of these are highly visible and virtually iconic. We see Lance Armstrong talking about cancer, we see children wearing colored wrist bracelets, we are asked to participate in bike rides and walka- thons for cancer research. The majority of this energy is focused on what is called cancer “prevention” and research.

In the case of breast cancer, for example, the main thrust of cancer advocacy is towards “prevention” in the form of mammograms. Question: If 100% of all women in the United States between the ages of 40 and 80 had regular mammograms, how would this affect US cancer rates?

Answer: Not in the slightest degree, unless you include the iatrogenic factor of applying ionizing radiation to breast tissue in otherwise healthy women, in which case it could be stipulated that the rates would naturally rise. Mammograms don’t prevent cancer; they detect cancer that is already there, and probably has been for a long time.

I read a recent issue of a local women’s magazine titled, “Quest for the Cure,” about breast cancer research and fund raising. The word “cure” is defined by Taber’s Cyclopedic Medical Dictionary as “course of treatment to restore health.”

“Health” is defined as “a state of optimum physical and mental well-being, not just the absence of disease or infirmity.” This would suggest that individuals seeking a cure would be not merely investigating new treatments for sick people, but seeking to enhance health and discover the cause of the disease and address those causal factors so that future generations are less likely to contract the disease.

But the magazine featured little to no discussion of things like risk factors, causes, or prevention. The report was on the development of screening and treatment options for women with cancer.

Unfortunately, women appear to be acquiring highly inconsistent beliefs about screening and cancer. A recent study of 4,000 women found that 68% believed screening prevents or reduces the risk of contracting [my emphasis] breast cancer.

It is unusual, if not outright disingenuous, that the idea of screening is being used synonymously with the idea of prevention. Screening detects disease that has already occurred, and hence, has failed to be prevented. Screening is, in a way, the opposite of prevention. It’s what we do to determine how much we have failed at prevention.

And this miscommunication is not limited to breast cancer. Another article recently published was titled, “Colon Cancer—the Number Three Cancer Killer—is Largely Preventable.” Yet the article was actually about screening technologies for colon cancer. There was no real mention or discussion about how to avoid getting colon cancer in the first place.

It has been stated that certain types of cervical and colorectal cancer can be “prevented” by screening for and removing “precancerous lesions” before they are categorized as cancer. But this is a semantical argument; the surgical removal of a potentially dangerous lesion may be helpful to a patient, but it is not preventive just because the lesion is not called cancer yet.

The American Cancer Society publishes an informational pamphlet called “Cancer Facts for Women,” which discussed several different types of cancer. This brochure begins each section with a paragraph about the type of cancer, followed by a series of bullet points under the heading, “What You Can Do.” Virtually every bullet point offered refers to screening, testing, and medical treatments for women after they already have cancer. References to causes—known dietary contributors to colon cancer, for example—are marginal and not mentioned in the “What You Can Do” sections.

One of the problems with perpetuating the focus on screening and treatment as primary preventive measures is that it gives the public the impression that, if they just follow the recommended guidelines, they will be protected. It promotes a fatalistic attitude toward serious illness, a paradigm which should be subjected to far more scrutiny than it is currently.

Screening may prevent a certain percentage of deaths from cancer, but even this theory has been questioned, as in the recent report in Lancet which found no evidence that routine mammography reduces the death rate from breast cancer. A 2006 study from the Cochrane Center in Copenhagen, Sweden, confirmed screening mammograms reduce the absolute risk of dying from breast cancer by 0.05%.

Furthermore, the potential risks of mammography are either understated or ignored completely. Many women are unaware that mammograms apply radiation, in the form of low dose x-rays, to breast tissue. All x-rays use ionizing radiation, a known carcinogen. According to the Department of Energy, a typical mammogram applies 25 times the radiation of a standard chest x-ray.

Perhaps the best reason to question the way in which cancer screening is promoted is that it does nothing to ensure that our daughters or granddaughters or great-granddaughters will be less likely to contract this disease.

In fact, despite the 3 billion dollars spent by the American Cancer Society alone since its inception in 1946, worldwide deaths from cancer are expected to rise from 6.7 million in 2002 to 10.4 million in 2020.

One possible reason for the lack of attention to authentic preventive measures in cancer research is that the medical establishment seems to believe that we are “programmed” for cancer; that cancer is a “natural” occurrence. A recent interview with a prominent member of the University of Vermont medical school teaching staff included the statement that cancer is a normal part of aging and that nothing can be done to actually prevent it. Comments like these make it easy to get the impression that, in terms of this issue, medicine has assumed an alarmingly defeatist position.

For example, the following are the primary risk factors identified by the American Cancer Society for women and breast cancer. This is the scientific wisdom gleaned from millions of dollars raised by bike marathons and fund-raising walks and pink magnetic ribbons on cars. These are the things women are being instructed to avoid; the things we are telling our daughters to avoid: 1. Being a woman. 2. Growing older.

Evidently, if we want to prevent cancer in American women, we have some serious work to do. As a matter of fact, there is a term for this type of reasoning. It is called, “blaming the victim.” And women hoping for words of wisdom about preventing ovarian cancer don‘t have much to show either. According to the National Ovarian Cancer Coalition, here are the options for reducing the risk of this disease: