Communication breakdown: Is cancer preventable or inevitable?
January 12, 2016
Response to recent cancer prevention confusion, in interviews on CBC Radio’s The Current
CBC Radio’s The Current
January 6, 2016
To whom it may concern:
I Chair a national Canadian group, Prevent Cancer Now. As citizens from many walks of life, including science, health care, education and others, we provide public education and advocate to stop cancer before it starts. We aim to eliminate exposures that contribute to cancer’s complex developmental paths. Distinct from other cancer organizations, we identify “least toxic” approaches to eliminate unnecessary risks, based upon reasonable interpretations of our scientific knowledge (limited though it may be).
Your Monday interviews highlight not only differences between researchers’ analyses and interpretation of data, they highlight difficulties in scientific communication.
The program presented two simplistic possibilities – either cancer is “bad luck” resulting from random mutations, or it is the result of informed choices to smoke, drink, not exercise, eat poorly, etc. The reality is that many common exposures that are beyond an individual’s control may contribute to pathways leading to cancers. In 2015, a major series of scientific publications was spearheaded by the group Getting to Know Cancer, in its Halifax Project. They highlighted common chemicals that are not considered to cause cancer, but that trigger “hallmarks of cancer” in everyday, low doses.
These contributors to cancer include common, ubiquitous environmental contaminants as well as chemicals in everyday products. For example, “promoters” may cause a cell with a heretofore harmless mutation, to advance to full-blown cancer. A few examples include: chemicals that interfere with hormone actions and may promote common cancers of the sexual organs or thyroid; or substances that cause inflammation. Such chemicals include softeners in plastics, some personal care product ingredients, anti-stick chemicals and flame retardants; low-cost, popular, sub-optimal foods; petrochemicals, exhaust fumes; pesticides; plastics at work and elsewhere; and air or water contaminants, to name just a few. We would add to the list, radiation from wireless communication devices, and ionizing radiation (natural, and from nuclear operations and medical imaging).
See also: BBC News, December 17th, 2015
Cancer is not just ‘bad luck’ but down to environment, study suggests
The notion that much less than half of cancers are preventable is soundly disputed by the US President’s Panel on Cancer, and is counter to Canadian data. A large majority of cancers should be prevented, but this may be painted as affecting commercial bottom lines and as undue governmental interference. On the other hand, does a young mother not have the right to assume that products on the shelf are indeed safe for her baby? – that the government would only allow “safe” products to be in commerce?
Cancer is a measure of:
- quality of life and diet;
- exposures permitted by regulatory systems, while regulators are restrained from identifying risks and are not mandated to restrict exposures to least-toxic options;
- environmental justice for individuals living in polluted communities impacted by industries; and
- social justice.
In support of the last point, as well as a direct rebuttal of the low prevention figures cited in your interviews, please see a Canadian study published last summer. “Social determinants of lung cancer incidence in Canada: A 13-year prospective study” indicates among other things:
“An inverse risk between lung cancer incidence and educational attainment, income and occupation emerged among men and women … If all cohort members had experienced the rate of those with a university degree, lung cancer incidence would have been 56% lower in men and 55% lower in women. …”
Smoking is not the only cause – asbestos-related and radon-associated lung cancers should be 100% preventable, as should most occupational lung cancers. Justice is slow – Ontario firefighters are finally being recognized as being at risk of lung cancer among others, but Canada has a patchwork of provincial eligibility and compensation for work-related cancers.
A “blame the victim” mentality for people developing cancers related to exposures from pollution (e.g. under-privileged communities adjacent to industries and resource extraction), from their work, and from commercial products is also unjust. Rather than products being proven safe before they are marketed, Canadian commerce is flooded with products for which there is “no evidence of risk” only because there is no evidence whatsoever.
Cancer is a complex disease and prevention touches many aspects of life, so Prevent Cancer Now broaches a broader range of topics than other cancer or environmental health organizations. Canada faces enormous potential to prevent cancer and other chronic diseases. Indeed, our overburdened medical system requires that research and risk assessment methods and priorities must shift focus to true health care rather than sickness care. Cancer incidence will not shift overnight, but it is urgent to recognize approaches and to take the first steps to initiate changes.
Prevent Cancer Now is a Canadian national civil society organization including scientists, health professionals and citizens working to stop cancer before it starts, through education and advocacy to eliminate preventable causes of cancer.
— Prevent Cancer Now (@PreventCancerNw) December 24, 2015