Thursday, November 01, 2007

Medicine: Preventing the big C

According to the work of a new report, avoiding many cancers may be possible. Up to a third of our risk comes from lifestyle factors such as what we eat, how fat we are and how much we exercise. Smoking, too, causes nearly a third of cancers. So reducing one's risks of getting this disease may be possible, and can also help with our risks of other diseases such as cardiovascular disease.

This week's piece in the Economist looks at the growing body of evidence that suggests that prevention of cancer is more effective than cure. What this also means is that our idea of a "war on cancer", started back in 1971, might have been misconceived. Richard Nixon tried to turn the battle against cancer into the same kind of national crusade that had split the atom and taken man to the moon. It was believed that with enough concentrated attenion, scientists would be able to come up with a cure and make the problem go away once and for all.

Today, the problem is as big as it ever was, and the numbers of cancers are on the increase (in part because society is aging, but also because poor countries are adopting unhealthy habits). In 2002, 10m people were diagnosed with cancer and 7m died. By 2020 these figures are estimated to rise to 16m cases and 10m deaths

The problem is that even without the new cures we are waiting for, healthcare costs are already spiraling out of control, thanks partly to the high costs of drugs and treatments for cancer (which include radiotherapy and surgery). According to a new book by Devra Davis a scientist at the University of Pittsburg and the author of a new book about the war on cancer, although the American government is spending $5 billion a year on research into cancer (a total of $69 billion since the war began), the annual direct medical costs of dealing with cancer are above $100 billion and rising. The only way to contain these costs are to focus on prevention, she says, rather than cure. The same sort of concerns about rising costs of dealing with cancers can be found in many other high-income countries.

Similar points about prevention of cancer were also emphasised at a conference last Friday held by the European Society of Oncology in Rome, looking at whether or not researchers had "lost the plot". A webcast of the entire event can be found at the link above.

For some individual cancers, such as childhood leukemia, testicular cancer and breast cancer when detected early, there have been great successes in finding cures. But if we place all our emphasis on the search for a cure, rather than on preventing cancers in the first place (which requires individual action), then we are fated to repeat the mistakes of the past.

Public health: To avoid the Big C, stay small
The best ways to prevent cancer look remarkably like those needed to prevent obesity and heart disease as well. Nov 1st 2007.