By Lauren Pecorino
The statement “cancer is personal” can have several meanings. The fact that cancer affects one in three people over their lifetimes means that it is a disease that will hit close to home for everyone. Everyone will have family or friends that will be affected and loved ones will become cancer patients. Cancer is personal. Luckily, we are living in a new age when cancer patients are more likely than ever to be cancer survivors. There are 28 million cancer survivors in the world today. Out of approximately 12 million cancer survivors in the United States, 4.7 million received their diagnosis at least ten years ago. The good news that everyone should know is that there is progress in cancer management.
There are several reasons for the impressive progress being made in the management of cancer, such as early detection due to screening and better medical imaging, and better treatments. Another reason is that people are making wiser personal lifestyle choices. The most obvious and most significant is that people are choosing not to smoke. Personal choice has been greatly influenced by both better understanding and governmental policies in the USA and Europe. In the UK, the Smoking Toolkit Study estimated that 400,000 people quit smoking in the first year after the smoking ban began in 2007. The death rates from lung cancer in the USA have decreased by 3% per year in men since 2005. Unfortunately in places like China, people are still smoking themselves to death. Although the results from a non–smoking lifestyle are encouraging, I fear that society has two more imminent battles to fight. Would you care to guess what they may be?
Obesity and alcohol consumption need to be controlled to curb increased cancer risks. Communicating how obesity and alcohol consumption increase cancer risk is a start. Fat stimulates an inflammatory response and is a source of sex hormones such as estrogen. Chronic inflammation and increased amounts of estrogen are well-known risk factors for certain cancers. Alcohol is metabolized in the body to form acetaldehyde. Similar to the components of cigarette smoke, acetaldehyde is a carcinogen that binds directly to DNA and masks the genetic code. This leads to the production of faulty proteins that can cause cancer. Many cancers now show a falling trend in mortality, with the exception of cancer of the liver and pancreas. It is noteworthy that an official report, Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective, published by the World Cancer Research Fund and the American Institute for Cancer Research (2007), classifies body fatness as a convincing risk factor for pancreatic cancer and alcohol as a probable risk factor for liver cancer. We must continue to make informed personal choices about our lifestyle to reduce cancer risk.
Cancer is personal for another reason. The genome of an individual’s tumor is a personalized item, even more than your inherited genes. The DNA of a tumor is a record of an individual’s exposure to damage from cancer-causing agents over time and so is personalized. Many recent breakthroughs in cancer treatments have come from our understanding of cancer genomics. This has been facilitated by leaps in technology that allow us to sequence tumor DNA more quickly. We have learned that some mutations allow a positive response to a certain drug and other mutations prevent a specific drug from working. There are now a few specific drug labels that recommend genetic testing to guide doctors in choosing best treatment for cancer patients. The future of cancer treatments lie in personalized medicine. Cancer is personal.
Lauren Pecorino is a Principal Lecturer at the University of Greenwich and a Fellow of the Royal Society of Medicine. She is the author of Why Millions Survive Cancer: The Successes of Science.