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By Mike DuBose with Blake DuBose and Surb Guram, MD
The first mention of cancer in historical texts took place in Egypt more than 5,000 years ago, and the disease has plagued humankind ever since. Although scientists in recent centuries have gained a greater understanding of cancer and its treatment, cancer rates across the globe are “surging at alarming rates, and there is an urgent need to implement strategies to prevent and curb the disease,” according to a 2014 USA Today article by Nanci Hellmich. Hellmich cites a 2014 World Health Organization report estimating that new cases of cancer will multiply from roughly 14 million individuals in 2012 to 22 million per year two decades later, a truly staggering increase.
The United States is no exception to this worldwide trend: cancer is the second most common cause of death in America, surpassed only by heart disease. American men have a slightly less than 1 in 2 chance of developing cancer in their lifetimes, and women have a 1 in 3 chance. With current medical knowledge, cancer is not always a death sentence, but survival rates vary drastically based on the type of cancer experienced. To maximize one’s protection against cancer, it’s important to understand its causes and to change the risky behaviors that can lead the disease to develop.
Understanding Cancer and Its Forms
The National Cancer Institute (NCI) describes cancer as a group of more than 100 diseases in which “abnormal cells divide without control and are able to invade other tissues.” Cancers are often named for the places they occur (i.e. breast cancer or colon cancer). They can also be grouped into more general categories defined by the place that the cancer originates. The NCI lists five of these categories:
- Carcinoma,cancers that begin in the skin or in tissues that line or cover internal organs.
- Sarcoma,cancers that begin in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
- Leukemia,cancers that begin in blood-forming tissue such as the bone marrow and cause large numbers of abnormal blood cells to be produced and enter the blood.
- Lymphoma and myeloma,cancers that begin in the cells of the immune system.
- Central nervous system cancers,cancers that begin in the tissues of the brain and spinal cord.
Depending on the type, cancer can often be difficult to diagnose. Some kinds of cancers mimic other diseases or medical problems; in fact, it is often called the “great imitator.” Thus, it is not uncommon for people with cancer to mistakenly receive treatment for other diseases based on their symptoms.
The most common form of cancer in humans is skin cancer, accounting for about half of all cases, according to the American Cancer Society. Although 1 in 5 Americans will develop some type of skin cancer in their lifetimes, most of these cases are easily diagnosed and can be stopped before they spread to other parts of the body.
American Cancer Society statistics estimate that there were roughly 1.7 million new cancer cases diagnosed in 2013. Of these new cases, the following ten types were most commonly diagnosed, with number 1 being most common:
- Prostate (roughly 14% of new cancer cases in 2013)
- Breast (14%)
- Lung (14%)
- Colon and rectal (9%)
- Melanoma (5%)
- Bladder (4%)
- Non-Hodgkin’s Lymphoma (4%)
- Thyroid (4%)
- Kidney (4%)
- Endometrial (3%)
*Above percentages rounded to the nearest whole number
Some geographic areas tend to have higher rates of some cancer types than others. For example, the northeastern US has more cases of pancreatic cancer than other areas of the country, and the southeast has higher rates of lung cancer (particularly in men). Stomach cancer occurs more often in Japan than in the United States, where it is very uncommon. Lung cancer occurs frequently in the United States but is uncommon in Tanzania.
Causes of Cancer
There is no sole source of cancer, and many of its causes are still unclear. The Stanford School of Medicine does note that “over 90% of cancers are observed to have some type of genetic alteration,” which can be either inherited (passed down within the genes) or sporadic (caused by environmental exposures or by chance). Generally, cancer results from the combination of several different factors, many of which are preventable.
The National Cancer Institute notes that: (1) cancer cannot be caused by an injury; (2) cancer is not contagious (although having other diseases like HIV can make people more likely to develop cancer); (3) exhibiting one or more risk factors does not make it certain that you will get cancer; and (4) some people are more sensitive than others to risk factors.
Family history is a minor risk factor for cancer. Some types of cancer do occur more frequently in some families than in the general population, including melanoma and ovarian, prostate, and breast cancers. This may be caused by a genetic mutation, but shared environmental factors (such as using tobacco) are more likely culprits. In fact, as the American Cancer Society reports, less than 10% of cancers are strongly inherited. Conversely, some families have genes that help protect against cancer. Cancer has become so common that most extended families include a person with some form of the disease, so family history alone isn’t a reason to assume that a person will contract cancer.
Some behaviors raise the risk of certain types of cancer more than others, but there are several important shared risk factors for most major types of cancer. Most of them can be changed or avoided, significantly lowering a person’s cancer risk. These major risk factors are:
Age: While cancer can strike at any age, most cancers are detected in individuals who are over the age of 65, according to the NCI. The American Cancer Society reports that about 77% of all cancer cases occur in adults aged 55 years and older.
Using tobacco products (or exposure to secondhand smoke): Smokers are a whopping 23 times more likely to get cancer than nonsmokers, according to the American Cancer Society, which also attributes at least 30% of all cancer deaths and 87% of lung cancer deaths to tobacco use.
Poor nutrition: Studies have shown that diets high in processed and red meats, potatoes, refined grains, full-fat dairy products, and sugar-sweetened beverages and foods lead to increased risk of developing and dying from a variety of cancers. Research has also suggested that people with low levels of vitamin D are more susceptible to cancer. But don’t reach for the vitamins just yet—the American Dietetic Association notes that nutrient-rich whole foods are the best sources of cancer-preventing nutrients, rather than dietary and antioxidant supplements.
Physical inactivity: The American Cancer Society reports that individuals who exercise at least 2.5 hours each week have a smaller chance of experiencing cancer than persons who live an inactive lifestyle.
Obesity: “In the United States, it has been estimated that overweight and obesity contribute to 14 to 20% of all cancer-related mortality,” the American Cancer Society’s Cancer Facts & Figures 2013 report states. Also, once cancer occurs, being overweight increases the risk of recurrence and decreases the likelihood of survival. At this time, approximately 36% of Americans are obese.
Some hormone therapies: Studies have shown that menopausal hormone therapy (medications containing female hormones that replace the ones the body no longer makes after menopause to reduce hot flashes and other menopausal symptoms) increase health risks such as heart disease (including heart attacks), stroke, blood clots, and breast cancer.
Drinking alcohol in excess: Women who drink more than one drink per day and men who drink more than two drinks per day have higher odds of experiencing cancer. If you combine excessive alcohol consumption with tobacco use, the likelihood rises even more.
Exposure to certain chemicals: According to the National Cancer Institute, people who work in some jobs—such as painters, construction workers, mechanics, and those in the chemical industry—have an increased risk of cancer due to exposure to harmful chemicals in pesticides, paint, used engine oil, and solvents.
Viruses and bacteria: People who are infected with hepatitis, HIV, HPV, and a few other illnesses may have an increased risk of cancer. These viruses are often contracted through unprotected sex, sharing needles, or exposure to body fluids or blood.
Ultraviolet (UV) radiation: While the sun’s rays can be beneficial in small doses, excessive time spent in the sun exposes humans to UV radiation, which can also be absorbed through sunlamps and indoor tanning booths. People who have experienced one severe, blistering sunburn in their lives have double the chance of contracting melanoma, according to the NCI.
Ionizing radiation: Ionized radiation comes from rays that enter the Earth’s atmosphere from outer space, radioactive fallout, hard-to-detect radon gas (often found under homes), x-rays, and other sources. This type of radiation can cause cell damage, which can then lead to cancer.
Although excessive radiation can be harmful, it is actually often used by doctors in smaller amounts to detect cancer and other problems. The radiation absorbed when getting an x-ray is insignificant, but there is growing concern among medical researchers on the use of CT scans, which generate large amounts.
Cancer Symptoms
The symptoms of cancer vary according to type, but the following are common across most types: chills, fatigue, fever, loss of appetite, malaise, night sweats, and weight loss. Certain cancers have very distinct symptoms—such as lung cancer, with its coughing, shortness of breath, and chest pain—but others may have no symptoms at all. Melanoma, a deadly type of skin cancer, can even hide in rarely-examined areas such as the sole of the foot, under a fingernail, or in an eye.
Mortality Rates
A cancer sufferer’s chance of living depends on the type of cancer he or she has and how quickly it is detected. Breast cancer patients, for example, have a roughly 90% chance of surviving five or more years after being diagnosed. On the other end of the spectrum is pancreatic cancer, with a five-year survival rate of just six percent. A cancer’s progression in the body is described in stages, with higher numbers indicating a more advanced progression of the disease. The earlier the stage when it’s diagnosed and treated, the higher the chance of survival.
The age of the person diagnosed also affects his or her survival chances. The Stanford University School of Medicine reports that the five-year cancer survival rate for children is about 80%, while it is 68% for adults. This may be because children typically respond better to treatment and can tolerate more aggressive treatments. Frail individuals have less of a chance of survival than healthy people do.
Although surviving cancer is certainly possible, it does point to an increased risk of recurrence: once a person has had cancer, he or she is more likely to contract another form of cancer than someone who has never been diagnosed with the disease before.
Cancer Prevention Strategies
Fortunately, most major cancer risks can be avoided simply by changing one’s lifestyle. Even those who have practiced negative behaviors in the past, like smoking, can begin repairing their bodies and cutting their likelihood of getting cancer simply by stopping those activities. There are also habits you can form, such as getting regular medical attention that will further protect you. The choice is yours!
All of the following recommendations are based on scientific studies (when possible, those with large populations over a long period of time), but many promising theories and ideas about preventing cancer have not been studied deeply enough to be conclusive. Effectiveness may vary from person to person and will depend on other factors like genes and family history. Therefore, you should also speak to your physician to determine an individualized plan to ward off cancer.
Listen to your body’s cues: Our bodies oftentry to signal us when something is wrong. If you begin to feel strangely or notice differences in your body, document your findings in detail (circumstances when symptoms or feelings occur, how often, how long they last, etc.) and schedule an appointment with your doctor. Don’t ignore problem signals or put them off until later! Stay aware of any visible changes by having a partner look over most of your body for trouble signs like suspicious moles, which can be a sign of melanoma. You could also use a mirror to check hard-to-see places.
Schedule regular medical visits: You should see a medical doctor, ophthalmologist, and dermatologist (for a full visual body scan) at least annually. Those in poor health may need more frequent medical attention. Whomever you see, make sure it’s an excellent physician who listens to you, doesn’t rush, and makes you feel comfortable. (For a listing of quality doctors we use, see our 2014 Quality Vendors Guide at www.mikedubose.com.) An internist is ideal because they receive advanced training in diagnosing medical abnormalities. Women should also see a gynecologist each year.
Before your visit, make a list of any medicines you take, their dosages, and any unusual issues or symptoms you are experiencing. Even those that just seem minor (like pains, shortness of breath, dizziness, fatigue, or nausea) may be major warning signs. The more details you can tell your doctor, like the timing and frequency of the symptoms, the more likely it is that he or she can correctly diagnose and treat the problem. It’s also helpful to keep track of when you last had important tests in case you need additional assessments.
The U.S. Preventative Services Task Force recommends that patients be screened for colon cancer annually and have a colonoscopy starting at age 50. Although mammograms have been criticized for missing some types of breast cancer, most doctors still recommend that all women older than 40 have one each year. New, digitized mammograms are now producing higher-quality results.
Generally, you should take any tests that your doctor recommends. For some controversial tests, however, you may want to do some research and have a thorough discussion with your doctor on possible risks and alternatives. For example, CT scans help doctors see within the body to diagnose internal issues, and more than 70 million of these scans are performed annually in the US. However, patients absorb much more radiation from CT scans than they would from an x-ray, causing scientists to fear that they raise cancer risks. In a 2014 New York Times op-ed, cardiologist Rita F. Redberg and radiologist Rebecca Smith-Bindman say they believe that “unless we change our current practices, 3 percent to 5 percent of all future cancers may result from exposure to medical imaging.”
If your physician orders a CT or other high radiation scan, you may want to speak to him or her about any concerns. Redberg and Smith-Bindman recommend several questions: “Will it lead to a better treatment and outcome? Would they get that therapy without the test? Are there alternatives that don’t involve radiation, like ultrasound or MRI? When a CT scan is necessary, how can radiation exposure be minimized?” If you have already had a CT scan recently, obtain a copy of the imaging to give to your doctor; you may not need another.
Most of the time, though, it’s better to be safe than sorry when it comes to medical tests. In Mike’s case, an EKG, administered by Dr. Guram, triggered additional examinations that discovered his life-threatening heart aneurysm. He also had a friend who died of cancer who commented that his former doctor ran “too many medical tests.” Had the friend stayed with that internist, he might be alive today!
Secure good health insurance: While it is often easier said than done, having good medical insurance is key in detecting and treating cancer. Those who lack insurance or have barebones policies may put off expensive medical tests and appointments, allowing the cancer to advance. Late-stage cancer is not only harder to beat, but more costly and difficult to treat as well.
Study your genes: If possible, review your family tree (including grandparents, parents, and siblings) for a history of health problems. Some illnesses can travel through families, so knowing your relatives’ health histories can help your physicians know what to watch out for. A family history of cancer doesn’t mean that you will absolutely inherit it, but it may place you at a higher risk for certain types. As surgeon Dr. Mehmet Oz, MD, said, “Your genetics load the gun. Your lifestyle pulls the trigger.”
Exercise: As with other problems like heart disease, stroke, type 2 diabetes, and depression, exercise is one of the best medicines you can take. It strengthens your body, controls weight, and helps ward off sickness. The NCI reports, “Most scientists agree that it is a good idea for an adult to have moderate physical activity (such as brisk walking) for at least 30 minutes on 5 or more days a week.” Even if you can only squeeze in 15 minutes here and there, do it—your body will thank you!
Avoid using tobacco products or breathing secondhand smoke: The deadliness of tobacco products has been well-documented in many scientific studies, yet approximately 18% of the US citizens still use them! Tobacco smoke contains at least 70 compounds known to cause cancer in humans and animals, and people who smoke are up to 30 times more likely to experience lung cancer than nonsmokers, according to the Centers for Disease Control and Prevention (CDC). CDC director Thomas Frieden underscored the deadliness of tobacco in a January 2014 USA Today article: “Even after 50 years, we’re still finding new ways that smoking maims and kills people.”
If you smoke, don’t wait another minute to quit! Former smokers still have a higher risk of cancer than those who never smoked, but a significantly lower risk than if they were still smoking. Ten years after quitting, your chances of dying from lung cancer will be 50% less than if you were still smoking! Your doctor can suggest medications and methods to help you break the habit, and you may want to consider alternative therapies like hypnotism as well. Mike was impressed by Dr. Frederick Mau of Watermark Hypnosis’s ability to cure an acquaintance’s nicotine addiction through hypnosis in one session!
Examine the chemicals in your house: Homes and offices are now being built airtight to save on heating and cooling bills, but this prevents fresh outside air from coming in (and stale air from leaving). If hazardous chemicals are being used in these buildings, they linger in the air and are inhaled by the inhabitants. Pesticides, bug sprays, and cleaning products are common offenders, often containing harmful chemical compounds that can contribute to cancer risk. According to a 2014 Huffington Post report, certain brands of laundry detergent contain a chemical called 1,4-dioxane, which has been proven to grow tumors in rats. Although it has not been conclusively linked to cancer in humans, it should still be viewed with caution. Styrofoam is also a health threat. It is made from a chemical called styrene, which can disrupt your DNA. (Fortunately, though, drinking water from plastic bottles does not cause cancer as was previously speculated, the American Cancer Society says.)
To minimize the effects of harmful compounds in the air, make sure that your building is well ventilated, especially if you are using chemicals inside. When we built our Columbia Conference Center, we created a healthy work environment by adding additional air cleaners and equipment to replace stale air with fresh outside air. We also use only natural pest control substances like boric acid. You can also purchase radon tests at building supply retailers such as Lowes.
Many products (including laundry detergents) may not be required to list their ingredients on their packaging, but you may find them on a website or by calling the company’s 1-800 number. If you can find an ingredient list, look for these chemicals to avoid: polyethylene or polyethylene glycol, oxynol, or the letters “eth,” which indicates that the product may contain dioxane. According to the May 2014 Consumer Reports magazine, a new database implemented by the California Department of Public Health is now available for consumers to search products that contain cancer-causing chemicals at safecosmeticsact.org/search.
Reduce stress: Although stress has not been conclusively proven to cause cancer, the effects of excessive stress on humans’ mental and physical health are undeniably negative. Experimental studies have also shown that stress can affect the ability of cancerous tumors to grow and spread, according to the NCI. Thus, reducing stress—whether through job or relationship changes, counseling, meditation, exercise, or safe use of medications—helps maintain overall health.
Lose weight: The Mayo Clinic notes, “Maintaining a healthy weight might lower the risk of various types of cancer, including cancer of the breast, prostate, lung, colon, and kidney.” The American Cancer Society recommends staying as lean as possible without being underweight. If you are overweight, use a combination of diet and exercise to lose weight in a gradual, healthy manner. The CDC shares many weight loss tips at its website, www.cdc.gov, and our article “How I Lost 35 Pounds…While Still Eating Fried Chicken” contains practical tips and can be read at www.mikedubose.com. It may not be easy, but the health benefits are well worth it.
Eat a healthy, well-balanced diet: Fast food cooking techniques—deep frying French fries and cooking meat at high temperatures—can form cancer-causing compounds in the food, according to a 2013 Huffington Post report. Cut out processed and junk foods and replace them with fruits, vegetables, beans, and whole grains. You want to eat a diet that is high in fiber and vitamins and low in saturated fat. Generally, the more color on your plate—think bright red tomatoes, green spinach, and juicy blueberries—the healthier the meal.
One surprising note: a Consumer Reports study found that some brands of brown rice can contain higher levels of arsenic than white rice. Arsenic can inhibit the body’s DNA repair abilities, and damaged cells are more vulnerable to mutations, which can cause cancer. You can still eat brown rice; however, wash it thoroughly before use to remove traces of the toxic metal.
Reduce inflammation: Inflammation is produced naturally when the body comes into contact with an irritant or suffers an injury. However, chronic inflammation leads to DNA damage, which in turn can allow cancer to develop. Two Massachusetts Institute of Technology studies definitively confirmed the inflammation-cancer link in 2008, according to Medical News Today.
Your doctor can assess your inflammation levels through an hs-CRP blood test, which measures C-reactive protein. If you find that you need to reduce inflammation, many simple methods are available to you. Altering your diet to contain more omega-3 fatty acids (which are found in salmon and walnuts), fiber, and low-fat dairy products will help. Also, because sickness causes inflammation, get a flu shot each year. Regular brushing and flossing can reduce inflammation in the gums, and some studies have suggested that low-dose aspirin can also be used to fight inflammation.
Have a frank talk with your doctor about your sexual history: Many people are uncomfortable discussing sex, but speaking honestly about your sexual past can allow your doctor to recognize dangers to your health. Hepatitis C, which can cause liver cancer, can be contracted through sexual activity, sharing needles, or even through blood transfusions (pre-1992). Its symptoms can remain dormant for 20 to 40 years before developing, meaning that many who have hepatitis C are unaware of it. The CDC urges baby boomers (those born from 1945-1965) to get tested for hepatitis C, noting that people this age are 5 times more likely than others to have the disease.
The human papilloma virus (HPV) is also very common in humans, and many people—including men—are carriers without even knowing it. Half of Americans who have ever had sex will contract some strain of HPV, according to the U.S. Food and Drug Administration. Many strains of HPV are harmless and go away on their own, but others can lead to cervical cancer. If you have never had a test for HPV or hepatitis C, speak to your physician about it, even if you are married or in a long-term relationship. Although it may mean an uncomfortable conversation or two, your health is a higher priority!
Get some sleep! The CDC calls insufficient sleep “a public health epidemic,” noting that people who are sleep-deprived “are also more likely to suffer from chronic diseases such as hypertension, diabetes, depression, and obesity, as well as from cancer, increased mortality, and reduced quality of life and productivity.” For many people, it’s a matter of turning off the TV, cutting out caffeine at dinner, and going to bed earlier. However, others have sleep disorders like sleep apnea, which is characterized by snoring and even briefly ceasing to breathe during the night. If you think you may have a sleep disorder, speak to your doctor about participating in a one-night medical sleep study.
Consume enough vitamins: According to the American Cancer Society, “the overall evidence related to dietary supplements does not support their use in cancer prevention.” The society also says that “the scientific study of nutrition and cancer are highly complex, and many important questions remain unanswered. It is not presently clear how single nutrients, combination of nutrients, over-nutrition, and energy imbalance, or the amount and distribution of body fat at particular stages of life affect a person’s risk of specific cancers.” In fact, as Consumer Reports revealed in a 2012 investigation, taking too much of some vitamins, including A, D, E, and K, can actually cause health problems! Your best bet is to strive to consume vitamins in their natural form: your food. Eating a healthy, well-balanced diet as previously described should provide you with most of the vitamins you need, and getting some sunlight can help you obtain vitamin D.
Consume alcohol in moderation: Drinking in excess raises the risk of cancer of the mouth, pharynx, larynx, esophagus, liver, colon, and breasts. According to the CDC, acceptable ranges of alcohol consumption are one drink per day for women and two for men. The mechanism for how alcohol affects breast cancer is not known with certainty, but it may be due to increases in estrogen or other hormones in the blood, reduction of folic acid levels, or the effects of alcohol on breast tissue.
Protect yourself from the sun: Guard against cancer-causing UV rays by applying sunscreen daily and avoiding the midday sun. If you are going to be outside, stay in the shade when possible, and cover exposed areas of skin. Avoid tanning beds altogether. Make an annual appointment for a dermatologist to scan your entire body for potential melanomas.
The bottom line: Cancer is a class of diseases, so it is unlikely that there will be a single vaccine or cure for all types of the disease. Currently, it is the second most common cause of death in America, but some scientists believe that cancer will overtake heart disease as the number one killer within the next decade. However, most cases of cancer could be avoided by taking preventative measures against the disease, such as changing unhealthy habits and avoiding environmental factors that cause cancer.
The conclusion we drew from our extensive research is that we all have a choice: make healthy and preventative changes now, or die early! This does not mean that we have to drive ourselves crazy with fear (after all, nothing beats the occasional juicy cheeseburger); rather, we should gently train ourselves to choose healthier habits that will expand our life spans. Although it takes a lot of thought, planning, and work to change, it’s never too late to start!
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About the Authors: Our corporate and personal purpose is to “create opportunities to improve lives” by sharing our knowledge, experience, success, research, and mistakes.
Blake DuBose graduated from Newberry College Schools of Business and Psychology and is president of DuBose Web Group. View our published articles at www.duboseweb.com.
Mike DuBose has been in business since 1981, authored The Art of Building a Great Business, and is a field instructor with USC’s graduate school. He is the owner of four debt-free corporations, including Columbia Conference Center, Research Associates, and The Evaluation Group. Visit his nonprofit website www.mikedubose.comfor a free copy of his book and other useful articles.
Dr. Surb Guram, MD is a board-certified internist and is a graduate of the University of South Carolina School of Medicine. He is a partner with the SC Internal Medicine Associates in Irmo, SC and has practiced internal medicine in the Midlands for the past 30 years. See www.scinternalmedicine.com for more information on Dr. Guram and his practice.
Katie Beck serves as Director of Communications for the DuBose family of companies. She graduated from the USC School of Journalism and Honors College.
© Copyright 2014 by Mike DuBose and Blake DuBose—All Rights Reserved. You have permission and we encourage you to forward the full article to friends or colleagues and/or distribute it as part of personal or professional use, providing that the authors are credited. However, no part of this article may be altered or published in any other manner without the written consent of the authors. If you would like written approval to post this information on an appropriate website or to publish this information, please contact Katie Beck at [email protected] and briefly explain how the article will be used and we will respond promptly. Thank you for honoring our hard work!
