Tuesday, September 29, 2015

A World Without Cancer (and Obesity)

Before driving cross-country a few weeks ago, I happened to see that Amazon now offers free audio narration with many of their Kindle books that are part of their Kindle Unlimited program.  With a 30-day free trial (and only $9.99/mo if I wished to continue), I signed up and have enjoyed listening to books this month as I drive and do my daily walks.

The first book I tried out was simply mind-blowing—Dr. Margaret Cuomo’s 2012 book, A World Without CancerDr. Cuomo is a radiologist, and sister of New York Governor Andrew Cuomo.

Dr. David Chan of Stanford wrote an excellent article (“Where Do the Millions in Cancer Research Dollars Go Every Year?”) summarizing the staggering dilemma highlighted in Dr. Cuomo’s book.  Since the start of President Nixon’s “War on Cancer” in the early 1970’s, and despite the billions of dollars spent on researching treatments and cures, the incident and death rates of cancer (per SEER) are slightly higher today than they were in the mid 1970s--

Incident_Rate_Trend_-_All_cancersDeath_Rate_Trend_all_cancers

As the only developed nation in the world to lack any kind of price regulation controls over drug and treatment costs (and a nation of aging baby boomers), direct cancer treatment costs are skyrocketing in the U.S. to simply unsustainable levels (projecting to grow to $158 billion in 2020—over double the 2004 cost of $70 billion). 

Dr. Cuomo’s book walks us through the “business as usual” challenges of the current cancer “industry”—the challenges of unregulated pricing of new drug treatments, challenges with drugs being approved (and paid for by insurance/Medicare) before results are fully understood (and “break-thrus” hailed when initially released rarely being realized), and challenges with our “silo’d” and duplicative research approaches (rather than collaborative and cumulative).

While our “War on Cancer” has led to a few great treatment success stories, and some modest incremental improvement in survival times, the war is still far from won.

However, Dr. Cuomo highlights a better approach—rather than such a lopsided allocation towards treatment research, and expensive new drug therapies that do little more to improve survival over than cost-effective generics they replace, she advocates a more balanced approach that promotes prevention as much as treatment research. 

Currently, the National Cancer Institute (NCI) and the various cancer charities that follow its lead, prioritize the overwhelming percentage of their funding towards treatment research—70% (nearly $1.2 billion) according to NCI’s 2013 budget fact book.

NCI_2013_Budget_Fact_Book    

The NCI currently only spends 6.2% of their budget ($232 million) on prevention, even while it states that “Much of the progress against cancer in recent decades has stemmed from successes in the areas of prevention and control.” 

According to the research studies cited in Dr. Cuomo’s book, known lifestyle changes and existing vaccines could prevent 50% of all new cancer cases—50%!!!!  How?  By stopping smoking, losing weight & exercising, and (to a lesser extent) vaccinating ourselves against Hepatitis B (to prevent liver cancer), and HPV (to prevent cervical, vulvar, vaginal, anal, and penile cancers).

In the daily Facebook and Twitter posts this month for #GynCAN, I’ve come across a couple of truly incredible infographic statistics related to cancer prevention. 

I knew that being overweight or obese put me at greater risk for diabetes and heart disease, but I had no idea that excess weight and lack of exercise also put me at higher risk for endometrial, breast, colon, throat, stomach, and other obesity-driven cancers.  

cancer-prevention-bubbles 

women-and-cancer-infographic

My type of uterine cancer tumor was caused/fed by excess estrogen in my body.  The estrogen was not being created by my ovaries, but rather, by my excess body fat (and excessive time sitting rather than moving).  Why did I never know that this was a risk for endometrial, breast, ovarian, and other estrogen-fueled cancers?

endrometrial-prevention_jpg

I also learned this month that nearly all cervical, and half of vaginal/vulvar cancers are caused by the Human Papillomavirus (HPV). 

HPV_bar_graph

We have an HPV screening test, and for the last 10 years, have had a vaccine available to prevent most strains of HPV (and therefore reduce risk to these cancers).  And yet--- 40% of U.S. girls and 60% of boys are still unvaccinated!

vacc-coverage-hpv-800x1035 

Clearly, Dr. Cuomo is right-- we should be investing much, MUCH more in prevention and awareness in this country.  Not only will it save and extend lives, but it’s the one thing we as a society can do right here, right now to significantly reduce our overall healthcare costs.

In the midst of a growing obesity epidemic in the U.S., I think we as individuals must finally start talking about (and taking full individual responsibility for) our unhealthy bodies.  Yes, the government could change their farm bill subsidies to make fruits and vegetables more affordable (and corn/soy-based junk food less so).  Yes, the government could change their funding priorities to focus more on disease prevention and wellness than subsidizing expensive healthcare treatments and drug therapies that provide minimal gain.

But there is no reason for us to wait for the government to act! 

Each one of us who smokes or is overweight/inactive needs to finally acknowledge the elephant in the room.  We have no one else to blame but ourselves for many of these cancers (and other health conditions).

According to the CDC, today:

  • 64% of adults are overweight or obese
  • Only 22% of adults each vegetables more than once a day
  • Only 20% meet daily aerobic and muscle strengthening guidelines

It’s time to get moving and start earning our way back to better health!

Since my cancer treatment ended, I’ve lost 14 pounds, and this month will have walked100 miles.  I plan to keep at this until I finally get to my “healthy weight” BMI range.   

Maybe it’s too little, too late.  Maybe the toxic sludge surrounding my waistline (from decades of eating unpronounceable ingredients) can never be undone.  Maybe it’s already too late to avoid another cancer fight in my future.  But I’m going to give it my best shot to improve and maintain my good health for as long as I possibly can.

If you’re in a similar situation, I hope you will join me and do the same! 

17 comments:

  1. Good Luck! Every time you need motivation just re-read this post!
    mark

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    1. sage advice Mark! Or, I can think of all you elders who climb, hike, and bike circles around me-- but hopefully, I'll get there someday soon too!

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  2. Very good for you, everything you said makes a lot of sense. We all need to eat less, and exercise more.

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    1. well maybe not all of us, but a growing majority for sure. One thing this month has taught me is just the simple act of briskly walking 30 minutes or more per day can do wonders. No need for fancy gym memberships or expensive gear. Just head outside or to the nearest mall or superstore and walk away!

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  3. Great post, Lynne! This is so true about losing weight. Did Dr Cuomo mention reducing stress?

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    1. Interesting you mention that. I'd always heard that stress could be a factor, but I don't recall her mentioning it. She focused on diet, exercise, smoking, and environmental factors. Another really excellent "cancer prevention" book is called "Anti-Cancer" by Dr. David Servan-Schrieber. He did an hour-long presentation at Univ of California that was posted to YouTube. Really excellent if you have the time & internet bandwidth to watch: https://youtu.be/XaDt3AJQ98c

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  4. It's never too late to make a change. Kudos to you on those 14 pounds. Great post.

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    1. thanks. I'm trying to catch up to you (both in weight lost and daily steps!)

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  5. Interesting that on your charts from, I presume, the NCI, blood cancer is not on there yet there has been an 80% increase in leukemia, lymphoma, Hodgkin's disease in the last 20 years. Why? It is an environmental cancer caused by the carcinogens from benzene which is largely in gasoline but also in plastics. The huge incidence of service station attendants who developed blood cancer was astounding and one of the reasons YOU now pump your own gas. So, don't breathe those fumes which you smell while putting gas in your tanks. Benzene is traded on the Stock Exchange and still being produced at refineries worldwide! Many cancers are environmental, sadly.
    Don't get me wrong, your post is very enlightening but I just wanted you and others to know that cancer doesn't have to be about lifestyle. Glad you're doing so well.

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    1. Yeah, the infographics above were mainly focused on obesity-caused and HPV-caused cancers, but Dr. Cuomo's book highlighted a number of environmental, radiation, and consumer product carcinogens to avoid. I don't recall her mentioning the gas station risk, so thanks for that reminder, but she did cover plastics (i.e. avoiding them for food/drink etc).

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  6. Great post, Lynne. Another great book on this subject is "The End of Illness" by David Agus. It's so frustrating to see how little is spent on cancer research ($5B per year) versus $12B/yr for the State Dept and $700B/yr for Defense. Just not right. Sorry for the rant. Congrats on that 14lbs!
    J. Dawg

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    1. Very true, but absolutely maddening that we currently know that 50% of cancers can be prevented, and yet only spend $232 million a year on prevention. Dr. Cuomo advocates more money for this and developing more/better early screening tests and vaccines rather than continuing to solely focus on expensive new drug treatments that offer minimal improvements. She believes that research is still important, just not the ONLY thing we should fund and focus on as NCI and most drug companies and charities do today.

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  7. Profound motivation - go Lynne!

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  8. It's never too late! Keep trying and don't give up! :)

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  9. Wonderful post! I never knew the statistics of being overweight and the chances of cancer. More reason to get to a healthy weight! Thank you for sharing!

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