News at NCH
"Tobacco, Obesity, Alcohol, As Cancer Risk Factors" by Allen Weiss, MD, MBA, President & CEO

Tobacco, Obesity, Alcohol, As Cancer Risk Factors

November 15, 2013 - No doubt treatment has never been better for various forms of cancer such as leukemia, lymphoma, Hodgkin’s disease, and testicular cancer. But the best treatment will be prevention by healthy life styles such as avoiding tobacco use, maintaining a good body weight, and moderate use of alcohol.

Sadly, lung cancer kills more than 150,000 people per year and is the most common cancer in our country. A typical chemotherapy regime for non-small cell cancer costs more than $40,000 and helps extend a patient’s life by an average of just two months according to Steven Levitt and Stephen Dubner’s Super Freakonomics.

The age-adjusted mortality rate for cancer is essentially unchanged over the past half-century, at about 200 deaths per 100,000 people. This is a disappointing fact despite President Nixon’s declaration of a “war on cancer’ more than thirty years ago also according to the above authors. For people twenty and younger, mortality has fallen by more than 50% and those 20 to 40 have seen a decline of 20%. However, the incidence of cancer is on the rise which is exactly why current epidemiological studies are being continues by the American Cancer Society so that we can try to avoid cancer in the first place.

Smoking, obesity and alcohol all increase the chance of developing cancer. The association of smoking with lung cancer has been known since 1955 although the tobacco industry tried and failed to undo the scientific evidence.

The American Cancer Society had initial success in 1955 linking smoking to lung cancer. The lead epidemiologist, Dr. Morton L. Levine, was at the Roswell Park Memorial Institute in Buffalo, New York where he was recruited years before to look for an association between viruses and cancer. He designed a hospital in-take questionnaire which was completed by patients with cancer and those without cancer. After a few years, Dr. Levine and his colleagues noted the statistically significant association lung cancer with smoking.

More than a century ago, Louis Pasteur said, “Chance favors only the prepared mind.” By this he meant that sudden flashes of insight don’t just happen— they are the products of preparation. Dr. Levine prepared by designing the questionnaire which included a question on tobacco use. Up to then, everyone from solders to physicians were encouraged to smoke.

The reasons I am sharing this wonderful story of scientific discovery which has helped all of us live longer, happier, and healthier lives is that I had the privilege and pleasure of being a National Science Foundation summer student in high school working for Dr. Levine. His team was still looking for other causes for cancer which we are now know about the risks of obesity and alcohol.

Since this first seminal epidemiological study, other studies have been successfully completed by the American Cancer Society showing the association of obesity with cancer particularly esophagus, pancreas, colon, endometrium, kidney, thyroid, gall bladder, and breast. And also that heavy and/or regular use of alcohol adds calories and the risk developing cancers of the oral cavity, lips, throat, voice box, esophagus, liver, breast, colon, and rectum.

Alcohol and smoking together are far worse than either is alone as causes for cancer. The smoke irritates the lining of the digestive track allowing the alcohol’s irritants to be more toxic than they would be otherwise.

The dreaded sentence, “You have cancer,” will be shared by one in three of us. We can improve our odds substantially by avoiding tobacco, keeping our weight in line, and being prudent with alcohol consumption.


 
Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.