Saturday, January 3, 2015

Health and Pure, Dumb, Luck

I couldn't help but smirk at yesterday's story that despite all of our anguishing about eating the right things and avoiding all the wrong things that are causing cancer, two thirds of the time getting cancer comes down to pure, dumb, luck

I've posted before about our experiences with cancer - probably the best summary here.   In our talks with oncologists one of them left me with a quote that I'll never forget, "sometimes cells just freak out".  I think the study confirms that view.

Research published in Science (the house journal of the American Association for the Advancement of Science), showed two thirds of the cancer types analyzed were caused just by chance mutations rather than lifestyle.  Naturally, the chattering class is saying this doesn't mean you can just do what you want.  Who do you think you are?  You're not allowed to live as you want. 

Certainly smoking is so strongly linked to lung cancer that when doctors find non-smokers with the disease, they're considered remarkable cases, and the study doesn't say you can ignore that and go light up a few. 

Beyond smoking, though, I personally think the links are weaker.  Sun exposure is linked with skin cancer, but it's not the strongest link you can imagine.  For example, melanoma, the most lethal type of skin cancer is often found on the soles of feet and in other places where most people don't expose themselves to the sun.  The British Medical Journal published an article back in 2008 saying sunlight was not a major cause of melanoma.  Chances are you've heard that you should get lots of fiber to prevent colon cancer, but that link has been discounted many times, such as this summary link to a 2005 JAMA article.  I recall reading an article in student science journal saying the same thing about 20 years before that.

Cross-cultural dietary studies that give rise to "eat this, not that" links always seem to be more tenuous when they're closely studied.  If you've got the time and interest, Denise Minger's fisking of the China Study is worth reading - and probably got her the contract to write her book
(lung cancer cells dividing - highly processed image from the BBC)

When Mrs. Graybeard had her bout with breast cancer, one of her coworkers gave us another quote that stuck with me: "what did you do to get cancer?".   Too often, people seem to live with the idea that if they just live this one right way, or eat this one super food, or take this one supplement, they'll never get cancer, and consequently, if you do get cancer it's because you did something wrong.  Another one of those things I heard that stuck with me was the director of the bone marrow transplant clinic who said, "I have a clinic full of women who were doing everything right" - about that idea. 

Maybe this study will remove some of accusatory tone directed at cancer patients.   Lord knows they have it tough enough without that.

Speaking of which, Lawyer With A Gun, who has been in my linked blogs for as long as I can remember, reports his wife is in the worst of it right now.  Stop by and send prayers, good wishes, or just kind words.  I certainly do the same for any of you readers who might be in the same spot.   


  1. One of my wife's best friends is just completing 6 weeks of chemo and radiation therapy.

    So far she's gotten a clean bill of health from her oncologist, but it sure knocked the stuffing out of her.

  2. Bravo to you for repeating the message.More people need to hear that. We can do a few things to improve our odds, and most of them are well known: exercise every day, don't smoke, don't drink too much, quit eating stuff that you know isn't good for you.("you don't go to a cathouse for conversation, and you don't go to a fast food joint for a healthy meal")But improving the odds is all you can do. Cancer, or whatever, is not a judgement.

  3. I suspect there are a number of factors in our environment that alter that "bad luck" regarding cancer. A huge number of chemicals are introduced into our bodies through the process of making and packaging foods such as BisphenolA that the FDA tells us is OK. Problem is it sometimes takes decades to establish the link between a chemical and a disease. And even then it's usually a statistical link with no definitive correction. I suspect that a lot of the "random" factors causing cancer aren't so random, we just don't know what they are.

  4. BPA would have to be in your body a thousand more then the tiny amount detected in order to cause problems. One of the things that confuses this issue is that we can detect a single atom of something like BPA hidden in a trillion atoms of other stuff. Then it is just one speculation away to decide that single atom caused an unexpected illness. But the truth is in spite of the huge number of chemicals the rates of most cancers and other illnesses have not increased. If BPA caused cancer then everyne who ate food from cans would have cancer.
    I would also like to disagree with the often stated claim that excercise somehow prevents illness. I am 71, I excercised all my life so I'm not simply disagreeing because I don't excercise. But in my family all of the women lived into their late 80's and 90's and none of them ever got a lick of excercise in their life. All of them were overweight and some were obese. All of the men worked hard and died in their 70's and 80's (not bad but not great). Again I wish it were true that you can excercise and live longer but it isn't true. There may be people with health problems that excercise can help mitigate but that does not conflate to excercise makes us all healthier.
    People grasp at straws when they become ill. A friend who is in the early stages of cancer has recently begun eating "better". She only eats organic now, no meats, fats and other "bad" stuff. I sympathize with her but it is merely human nature to want to believe that somehow you can "fix" yourself with these superstions and magic food.

  5. I would go farther on the BPA thing and say that the effort against BPA was largely led by one scientist ( Frederick vom Saal, from the University of Missouri) and his work has been pretty soundly rejected by everyone else. Even the EPA, who jumps at jump science like a kid in a candy store, has given up on it. I did a piece on it, and junk science in general, here.

    It turns out it may well be, as Steve Martin said in The Jerk, a profit thing. Von Saal was making money consulting for attorneys suing over BPA.

    Exercise is a quality of life thing. It's pretty much worthless as a means to lose weight (has everyone forgotten the phrase "work up an appetite"?). And as for longevity, most studies show tiny extensions of life; a few months at best. The benefits are largely simply feeling better - which I don't take lightly.

    You have to go where the data leads you. Over and over again in the last hundred or 150 years, scientists started pushing some pet theory and despite data coming in that clearly showed they were wrong, they kept pushing their agenda. The war against saturated fat in the diet is a classic example. There was never any sound evidence for that, and the case has never gotten any stronger.

  6. ooops. That should have been, "Even the EPA, who jumps at junk science like a kid in a candy store"

  7. We have a patient who is in his 40s, fit as a fiddle, eats right, has always taken good care of himself. His labs came back a little out of whack (liver), and it was discovered he's got liver cancer that's spread to his bones and muscles. We're hoping he'll live another year or so. You just never know. It sucks.

  8. My brother in-law late 30's died within a month of being diagnosed with pancreatic cancer. His first symptom was a massive bloating of his abdomen which they sucked out the fluid with a needle. He told no one he was sick and one day he collapsed and died within 8 hours 30 days from diagnoses to passing.
    Another shirt tail relative I saw him one day and talked for a while a week later he was diagnosed with late stage lung (smokers) cancer and was dead within three weeks. He was 63.

  9. Wow, Chipmunk, that sucks. Sounds sort of like what happened to a friend's wife. She had a distended abdomen, thought it was gas or something. Turned out to be liver cancer and she was gone within a year.

    And Anon, I lost a friend about 10 years ago: in his early '40s. He was out on a Saturday doing some stuff and went to lift a leg to step on a dolly to carry some boxes and his leg wouldn't respond. Went to the ER fearing a stroke. Within two or three days they diagnosed a brain tumor. Within a week after that he was gone.

  10. Sometimes all it takes is ONE molecule of a chemical to trigger the mutation that leads to cancer.
    Just as it only takes ONE PHOTON from an x ray to damage one molecule in your DNA to trigger the runaway cellular growth that is cancer. Just as that one day at the beach triggers that skin cell to become a melanoma.

    The larger the volume of a chemical the more opportunity said chemical has to cause mutations and damage. But there is no level where it is totally safe.

    It's a matter of odds. The smaller the exposure to something
    the less the risk but for many modern chemicals in our environment the risk can never be zero.....just small. But add up the number of exposures and factor in the millions of people involved and you will then get a measurable number of people developing cancer.

  11. Dan, what you said sounds reasonable and if you were talking about polonium yu would be correct. But to apply that logic willy nilly to whatever chemicals you dislike isn't reasonable. If a common chemical in very small amounts caused cancer then there would be a trail of cancers attributable to that chemical. There are none. Sometimes massive exposures to pesticides or other dangerous chemicals do indeed cause illness or death but the more insidious casual exposure causing massive numbers of cancers simply isn't true. Most cancers are related to old age. You are twice as likely to have a skin cancer at 65 then at 55 and you are ten times more likely to have a skin cancer at 75 than at 55. This applies to "most" cancers. Most cancers are still distributed throughout the population at the same rate they were 20 years ago and 50 years ago and even 100 years ago. About the only difference today is thanks to modern medicine we are more certain today of what a person dies from then we were 100 years ago. With the exception of smoking there are few cases of cancer as a direct result of exposure to chemicals or something mysterious in our food. Interestingly the great Love Canal story where massive amounts of chemicals were buried near homes and leaked into the ground water resulted in no cases of cancer or disease that could be traced to the canal and it's chemicals. Most "scares" turn out to be bogus or greatly exaggarated. They have made movies about them and they were totally false stories. A lot of they hype is more about lawyers winning class action lawsuits than they are about truth and facts.

  12. I was diagnosed with thyroid cancer when I was a senior in high school. It (the thyroid) was removed, I did a little bit of radiation, but just enough to sit in the bedroom for 24 hours, not have to be in an isolation ward.

    I turn 37 on Saturday, by the way, and every January I get bloodwork to make sure my pills work, and are still working, and there's no cancer. So far, so good.

    I just have to take a pill, Synthroid, every day for as long as I want keep living. Which, I'm hoping is a good long while, as I have a 5 year old son I'm raising by myself.

    Cancer is no joke. I know (and knew) many people who have, had, or lost the battle with it.

  13. Andrew, of all the things you could be left with, having to take synthroid every day isn't bad. I know a bunch of people (all women) on synthroid for life just for underactive thyroids. I guess a couple of them think the chemo or radiation for their breast cancer killed off or damaged their thyroids although it's hard to know.

    You're also a good example of the "Bad luck" hypothesis. I don't think anyone could suggest a 17 or 18 year old had a long life of being exposed to something toxic.

  14. Hard to reply to people who hide behind the "anonymous" label. But cancer rates ARE increasing and have been doing so for years. Part of that is people live longer thus have more time to get cancer, also other diseases are better controlled allowing cancer an opportunity to strike but in addition there is a myriad of chemicals in our daily environment that didn't exist decades ago. These also can play a part. Just as I can't tell you that the cancer you were diagnosed with today was caused by the CT scan you had 20 years ago only that it is a possibility nobody can directly tie a chemical to a cancer unless the exposure is massive.

  15. But cancer rates ARE increasing and have been doing so for years. That's one of those things we hear that I'm not sure is true. I think it's dicey statistically. Hard to demonstrate, although I'd be like to read real data.

    For one thing, we have much better diagnostics and pathology today so we catch cancers that would not have been caught before. For another, records are kept differently today; in the past, older people were often reported to die of "natural causes" but these days we assign a pathology to everything. Not saying either is right or wrong, just that the difference makes comparing rates tricky.

    I did read a well-referenced paper that says that cure rates are not really improving. We see more people surviving cancer today because we catch it earlier and it has always been easier to cure if caught in time. That's the whole "staging" thing cancer patients go through. (Stage I, II, III or IV cancers).

    An important point is that all of us develop cancers all the time, as an oncologist told me, but our immune system recognizes them as foreign and kills them. The trouble comes when the immune system doesn't do that.

  16. “Certainly smoking is so strongly linked to lung cancer ...”

    Actually it's only strongly linked if you manipulate the data (as has been done almost continuously for decades) to make it appear so. The actual figures show that, for lung cancer, morbidity and mortality are identical for smokers and non-smokers.

    Like so much other pseudo-science nowadays they do so blatantly too. Consider (here in the UK) how the rates of eg. elderly admissions to hospital or domestic fires are recorded. The figures are not based on how many are actually smoking related but are 'calculated'. The anti-smoking 'experts' decide what percentage of every disease, condition or untoward occurrence fits with their ideology and … then insist that is must be recorded as such (so granny has never smoked? Never been near a smoker? Doesn't matter, her hip fracture from a fall, or that electrical fire caused by fifty-year old wiring, 'will' be recorded as smoking related to fit the narrative). (and that's not counting the failure to account for other variables in samples such as working environment, lifestyle and environment).,

    Consider smoking. The inhalation of smoke from the burning of one particular type of leaf/organic product. And this is supposed to cause the majority of cancers (not to mention everything else from alopecia to zits). So … what about all those coal/wood/gas fires (not to mention all those cars, buses, trucks, power-stations, … burning organic fuels)? They produce all the same particulates and 'carcinogens', from the self-same combustion of identical organic compounds. Where are all the log-fire related cancers?(incidentally and indicatively, recent research showed that a single exposure to cooking for the typical half hour over a barbecue was the equivalent in inhaled particulates/carcinogens as smoking …. 240,000 cigarettes – make you think?).

    But … that means it must be related to the only unique(ish) chemical in tobacco, nicotine, doesn't it? Hmm, nicotine a chemical found in sizeable amounts in tomatoes, potatoes, egg-plant, …. So just where are the ketchup related cancers too? (We won't mention its normal role in the body or the presence of nicotinic receptors throughout the body – a 'fact that so upset the anti-smoking zealots that they had to change the name to niacin, vit B3).

    The truth is it has been known for decades that cancers have a major genetic component, with individuals and families showing a propensity towards particular types. There may be an environmental component (think more diesel than smoking though). There is, however, growing evidence that there is/may be a viral 'trigger' component too (Remember the demonisation of pipe-smoking due to their significantly increased risk of mouth/throat cancers? Well, finally, someone did some 'real' research and it turns out that they really do show some ... er oral fixation. They are apparently are much more likely to give 'oral pleasure' to their partners/spouses than non, or cigarette, smokers. As such they are much more likely to be colonised/infected with Human PapillomaVirus HPV which … causes mouth and throat cancers, Duh!). (There is some evidence that lung cancers may be linked to Coxsackie B, and others, exposure for example).

    I'm not saying it's good for you, but that almost all it is blamed on causing is simply, and nothing more than, anti-smoking bovine-excreta.

  17. Able - I had never looked into that rabbit hole (that smoking may not be as bad as it's cracked up to be) until just after posting this. I must say it deserves a closer look. I was aware of the way the second-hand smoke numbers were fudged, but not some of these other things. This could be another post.

  18. Hiding behind anonymous here. Why would you think it was "hiding"?

    Cancer rates for most cancers are the same. That is they are the same as 20 years ago, 50 years ago and to the extent possible to determine 100 years ago. What has changed is that people live longer. Now those older people, say 70-80's, get cancers at the same rate as the few people who lived that long 100 years ago. So that is why the rates haven't changed even though there are indeed more deaths from cancers. In the U.S. and most of the Western world we have beaten so many diseases that used to kill us in our youth and even in our 40's and 50's. In the West we live long lives and succumb to diseases of old age; heart disease, cancer and strokes. Often individuals or groups with an agenda will take the raw data and imply or claim that the U.S. has the highest rate of heart attacks or cancer etc. Then they will make a claim that in Africa where people eat "natural" foods as aopposed to "processed" foods they don't get cancers or heart disease. Well of course they do but their health care is so poor very few even know what their relatives even died from. But more to the point most don't live long enough to die from a disease of old age. So it is common for the stats to be misused and exagarrated to serve some agenda. Now in this country where we all took science in high school and many took science classes in college we still have those who deny science and claim that vaccinations cause autism or alar on apples causes cancer or white rice kills you or butter and eggs cause heart disease. They make an appealing arguement and if you slept through your science classes it is easy to be swept up in their fantasy. But the real data isn't there to support it. If there were some big increase in cancer from some food or common chemical or something we would sure know it. And honestly I have enough faith in the FDA and other government organizations to believe they would do something about it. But there isn't this trail of evidence and in fact there really isn't some increase in cancers to point to. I have to admit it could happen and in fact there are certain chemicals that are banned from use because they have been linked to illness or death. But there is no vast conspiracy to poison us all to somehow benefit Monsanto or big pharma.