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Cancer

Why is Cancer Still Beating Us?

While it is true that the rate of cancer deaths in the US has fallen about 25% since a peak during the early 1990s, improved treatments are not the important reason.  Far more important has been the reduction in smoking and improvements in screening.

The result has been a reduction of almost 40% in deaths due to the more common cancers (lung, colorectal, breast, and prostate).  Interestingly, for all these gains, cancer rates have only been brought back to the rates seen in the 1930s before smoking became so prevalent, and diets took a change for the worse.

Once cancer is detected, patients often have the same treatments that were available 50 years ago –  surgery, chemotherapy and radiotherapy. Far too often, these procedures are damaging to organs, costly, and reduce the quality of life while sometimes providing only months of added survival.  Granted, there are some bright spots where early detection and new drugs can be used along with older therapies to offer better outcomes. Unfortunately, some of the newest immunotherapies are quite expensive – costing millions.  Complicating matters, even the most expensive therapies sometimes come with substantial side effects and often add only a few months or years of life. While it’s wonderful to have more options, it’s hard to see how some of the newer treatments can become part of a sustainable healthcare system.  There has to be a better way.

That better way will need to begin with a recognition that the most common cancers are often lifestyle-related and that our body holds within itself the ultimate cancer-fighting tools if we keep ourselves in good health.  While traditional cancer therapies are an important part of treatment when cancer has been diagnosed, without help from the body’s immune system, none of the traditional treatments should be expected to provide a lasting cure.

The ideal cancer therapy is one in which the first cancer cell is quickly detected and with precision eliminated before it begins to replicate. Fortunately, this is what a healthy human immune system routinely does as part of its daily housekeeping job.  In contrast, surgery, chemotherapy, and radiation can be effective at reducing the number of cancer cells but almost always miss some of the cancer.  When the number of cancer cells has been reduced to an undetectable level, a cure may appear to have been realized.  More often, the cancer is in remission with the potential to reappear months or years later.  Chemotherapies that attempt to destroy the last cancer cell unfortunately come with side effects that can be harsh, dangerous, and degrade quality of life.

In fairness, the field of oncology has not entirely failed us.  A person diagnosed with lymphoma, cancer that begins in infection-fighting cells of the immune system, now has a much higher survival rate.  Also, survival rates for patients with melanoma, a skin cancer, and multiple myeloma, a cancer of bone marrow plasma cells, have significantly improved outcomes.

While these recent discoveries are welcomed, the most dramatic results for treating cancer were achieved more than 20 years ago for two blood cancers.  In each case, the cancer was responsive to a drug that targeted a single cellular abnormality. Unfortunately, most cancers are far more complex and defy such simple treatments.

Over the years, enormous resources have been invested in the hunt for single mutations in other cancers that could be treated with “precision oncology.” Unfortunately, pairing mutations to drugs has seldom produced reliable results.  When matches are found, the few that do respond often lose their effectiveness within six months.  While research results have been disappointing, hope springs eternal, and there may yet be breakthroughs. 

Despite the billions spent on research, about 95% of cancer drugs fail to win FDA approval. Among the other 5%, many offer little more than a few months of added life.  One notable exception has been the introduction of new immunotherapies like CAR-T (chimeric antigen receptor T cells), which have allowed some patients with melanoma, lung cancer, lymphoma, and acute lymphoblastic leukemia to live years longer. Unfortunately, even advances like this tend to be difficult to tolerate and not universally curative.

You may wonder, what is the solution?  To begin with, we first have to ask, “Why are cancer rates higher today than they were 100 years ago?”  Secondly, we must question whether our reductionist perspective is flawed.  Perhaps advances in genetics and precision oncology will never be a match for the complexity of cancer. For now, many cancers are too complex for available drug therapies.  It’s becoming increasingly likely that unless there is a breakthrough, significant advances in cancer cures may make little more progress in the next 50 years than in the last 50 years.

For now, the best that we have for further reducing the rate of cancer is prevention through lifestyle and early detection.  For early detection, mammography, colonoscopy, pap smears, and testing for prostate specific-antigen (PSA) are usually recommended.  The dilemma is that some tumors may progress so slowly that a patient will be more likely to die of something else before the tumor becomes threatening.  In contrast, some tumors can remain undetectable until they reach a point where it’s too late to cure them.

The good news is that screenings for breast cancer, colorectal cancers, and cervical cancers, save lives.  For other cancers, the value of screening has not been as encouraging.  While screening for lung cancer may detect cancer, three randomized trials failed to show a reduction in lung cancer deaths from screening.  Often, the treatment for late-stage cancers is harmful and, at best unnecessary.  While some patients may benefit, the averages demonstrate that not all types of cancer screening are beneficial.  Currently, there is no reliable screening method for cancers of the ovary, liver, stomach, pancreas, and esophagus.  For these difficult to detect cancers, the best hope is from observation by a doctor that may notice subtle year to year changes.

The most important need today is an admission that current strategies have largely failed to make the progress needed and awareness that prevention through lifestyle changes is where the best opportunity exists.  When the health of the body supports the immune system, the root cause of cancer is often eliminated or at least minimized.  While we wait for research to produce better methods for cancer detection and removal, the best that we have is prevention supported by healthy lifestyle choices.  The human body has an amazing ability to protect us when supported by a healthy diet, appropriate exercise, quality sleep, reduced stress, and quality social connections.

Nancy Neighbors, MD

Does Fasting Fight Cancer?

            Growing preclinical evidence shows that short-term fasting protects from toxicity while enhancing the efficacy of a variety of chemotherapeutic agents in the treatment of various tumor types.  Read more at Can Fasting Improve Chemotherapy’s Effects?, and Effects Of Short-Term Fasting on Cancer Treatment.

            Fasting is an ancient treatment that has grown in popularity as people look for alternative ways to lose weight and fight disease.  While fasting can be beneficial, it’s not for everyone.  To be on the safe side, seek medical advice before beginning a fast. For more about the safety of fasting, read “Is Fasting Healthy.”

            One of the leading researches investigating fasting as a cure for diseases is Dr. Valter Longo at the University of Southern California. For more about his interesting research read, “The Longevity Diet.

The Next Step for Cancer Survivors?

            Finding a treatment and surviving cancer is only the beginning.  When the treatment ends, watchful waiting begins.  There is always a chance cancer will reappear.  For many treatments, there is also a need to recover from the side effects of the treatment.   Side effects can include collateral damage to the heart from radiation or worsening blood pressure and diabetes.  Other side effects may include difficulty managing personal relationships, depression, fatigue, and worry that cancer will return.

            Far too often, cancer is described as being a disease state that only the doctor has control over.  For the most common cancers, lifestyle is a significant factor in defeating reoccurrence. Unfortunately, few fully appreciate the relationship between lifestyle and cancer.   For now, lifestyle education is seldom covered by insurance and therefore, rarely a topic that receives more than casual mention in the transition to routine life after cancer treatment.

Tofu Scramble

            An eye pleasing and healthy way to quickly create a tasty meal in about 15 minutes.

Ingredients:

            1 block firm tofu

            1 onion diced

            1 large ripe tomato or veggies of choice

            1 bell pepper or veggies of choice

            2 cloves garlic, minced

            1/2 teaspoon ground turmeric

            1/2 teaspoon paprika

            1 tablespoon soy sauce

            Salt & pepper to taste

Preparations:

  1. In a large pan, sauté the onion and garlic in water until fragrant, about 5 minutes.
  2. While sautéing, chop up the tomato and bell pepper.
  3. Drain the block of tofu and then crumble it into the pan of onion and garlic.
  4. Mix in the turmeric, paprika, soy sauce, and veggies. Toss well and season with pepper.
  5. Cook for another 8 minutes, until the vegetables are tender.  Serve warm.

By Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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