Can we ‘prevent’ cancer?

Is preventing cancer possible? Two announcements on opposite sides of the equation made me think a lot about cancer prevention this week.

The giant pharmacy chain CVS made the brave announcement that they will stop selling tobacco products even though sale of such products contributes to their financial bottom line. Tobacco is the leading cause of preventable cancer deaths. Reducing the convenience of buying tobacco is an effective way of reducing use. The CVS announcement was greeted by well-deserved and enthusiastic approval from a number of cancer organizations including the American Association for Clinical Research, The Association of American Cancer Institutes, the American Cancer Society, the American Society of Clinical Oncology and the Prevent Cancer Foundation.

Less encouraging were predictions of the growing world-wide burden of cancer. The National Cancer Institute, the American Cancer Society and the World Health Organization all predict the worldwide burden of cancer will nearly double by 2030 due to a growing and aging population, increasing tobacco use, increasing obesity, and the limited cancer prevention and early detection efforts in many parts of the world.

So … Can we really prevent cancer?  The short answer is, “yes and no.”

Yes – our choices have a major impact on our risk of getting cancer. More than 50 percent of cancer deaths are related to lifestyle choices. A healthy lifestyle reduces our chance of getting cancer.

No – we do not know how to prevent all cases of cancer. We all know stories of people who did not get cancer despite doing everything wrong – smoking, poor diet, overweight, never getting screened for cancer. We know of others who developed cancer despite doing everything right – no tobacco, excellent diet, exercise, following cancer screening guidelines. In fact, some folks use such stories to claim “we can’t prevent cancer” and continue poor health choices.

Because the word “prevention” can be interpreted as being absolute (“yes” or “no”), and therefore can be discounted, some advocates and organizations have advised use of the phrase “risk reduction” instead.

C-Change is one such organization. C-Change includes leaders from the private, public and non-for-profit sectors working together to eliminate cancer as a public health concern. It includes experts in marketing and advertising who have explored ways to communicate about cancer risk to a broad range of people (for more information, see http://www.c-changeprojects.org/CommunicationsPlan/CancerMessages.asp ).  I recently agreed to co-chair the group at C-Change that is focusing on comprehensive cancer control, and look forward to learning more about these efforts.

I also will be participating in a webcast panel discussion next week in Washington for the Prevent Cancer Foundation. We will be discussing funding for cancer research, including prevention research, in an era of fiscal restraint. It can be seen live at www.preventcancerwebcast.org on February 13 at 2 p.m. CST and will also be available online afterwards.

Whether we say “prevention” or “risk reduction,” encouraging and supporting healthy choices at home and abroad will be vital to reducing the worldwide burden of cancer.

Meanwhile, I need a small notebook to track my weight and exercise routine as I try to reduce my own risk of cancer and remain as physically fit as possible (not so easy this winter). I think I will make a special effort to pick one up at CVS.