how we die: our choices make a difference

On Groundhog Day, msnbc.com published a Reuters story titled "40 percent of cancers could be prevented."  The story is based on a report released by the International Union Against Cancer (UICC), which highlighted nine infections associated with increased cancer risk worldwide.  The UICC hoped that releasing the report would provide international health authorities additional ammunition in the drive to educate people about ways to prevent cancer.

The cancers specifically referenced in the article include cervical cancer, often caused by human papilloma virus (HPV), and liver cancer, often caused by Hepatitis B.  Other cancer-causing infections include HIV and Epstein-Barr, a herpes-type virus transmitted by saliva.   HPV, Hep B, and HIV are all transmitted by body fluids.  There are now vaccines for HPV and Hep B, but no vaccine is in sight for HIV or for Hepatitis C, which is transmitted by blood (now most commonly by sharing needles).  Epstein-Barr, it turns out, is so common (it used to be called mononucleosis) that 95% of adults in the U.S. have been exposed.  Most never suffer any more than a flu-like transitory illness, and where it is associated with cancer, the report's authors conclude, Epstein-Barr is probably not the sole cause of disease.  The point of the report is that the cancers associated with these infections could be largely prevented by a) widespread vaccination and b) lifestyle choices.

After reading the article, I hopped over to the Centers for Disease Control website and did a little browsing.  I found an article there outlining the top ten (meaning ten most common) cancers in men in the U.S.  The top five are: 1) prostate; 2) lung; 3) colorectal; 4) urinary/bladder; and 5) melanoma. 

Now I had to look at the top ten causes of death in men.  They are: 1) heart disease; 2) all cancers; 3) accidents; 4) stroke; and 5) chronic lower respiratory diseases, including bronchitis, COPD, asthma, emphysema, and tuberculosis; then 6) diabetes; 7) flu & pneumonia; 8) suicide; 9) kidney disease (commonly occurring with diabetes and heart disease); and 10) Alzheimer's disease.

It's important to note that the 40% of cancers in the UICC report that are largely preventable based on lifestyle and available vaccines did not include lung cancer, the second most common cancer in men in the U.S.  However, lung cancer is also largely preventable: 90% of lung cancer deaths are in smokers.  The risk of colorectal cancer, urinary/bladder cancer, and melanoma can also be greatly reduced through lifestyle choices (nutrition, exercise, limiting alcohol intake, limiting sun exposure).  Various cancers accounted for 24.3% of all deaths in men in 2004.  Meanwhile, heart disease accounted for 27.2%.

Just for further illumination, the CDC notes that the total death score in 2005 was cancer: 136,418; heart disease, 329,238.  Yes, you did read that right; heart disease killed more than twice as many people as all cancers combined.

The CDC did not have a parallel article on top ten cancers in women.  This did not please me.  I did find a list of the three most common cancers in women, however, and they are breast, lung, and colorectal.  Now, skipping over to top ten causes of death in women in 2005, we find heart disease right up at the top again, followed by "cerebrovascular disease" (stroke) and then lung cancer in third place.  Breast cancer, while the most commonly diagnosed cancer in women, is only number 7 in causes of death, behind 4) chronic lower respiratory diseases; 5) Alzheimer's disease; and 6) accidents.  Number 8) is diabetes; 9) is flu & pneumonia; and 10) is colorectal cancer.

Why did I think this was important enough to write about?  Well ... ISN'T IT?  Let's face it, of the top ten killers of women, the only one that can't really be prevented (except, to some extent, by not smoking) is breast cancer.  All the others have huge lifestyle components.  Choosing to eat good food, be active, be smart about sun exposure, get vaccines, and be careful can, if not guarantee you don't get one of the killer diseases, greatly improve your chances of surviving them.  In the gentlemen's corner, the most common cancer - prostate - isn't even in the top ten killers.  Everything on that list is, arguably, preventable.  Especially number 8.

Now, not all strokes can be prevented.  Not all heart disease can be prevented.  Not all cancer can be prevented.  Type I diabetes can't be prevented.   But smoking is associated with a higher risk for ALL cancers.  It's associated with heart disease, cerebrovascular disease, chronic lower respiratory diseases, and heightened risk of death from flu and pneumonia.  Stop smoking (or don't start) and you cut your risk of dying from four of the top five killers, whatever your gender.

Metabolic syndrome, similarly, is associated with heart disease, cerebrovascular disease, diabetes, kidney disease, some cancers, and Alzheimer's disease.  Metabolic syndrome is the set of disorders including overweight, high blood lipids, and high blood pressure, and commonly associated with Type II diabetes.  Get onto a nutrition and activity plan designed to get you to a healthy weight, healthy blood pressure, and healthy blood lipids profile (all of which can be attained without drugs), and you cut your risk of dying from another three or four of the top ten killers.

We're all going to die from something.  Frankly, I'd rather die from a nice fast heart attack than from any kind of cancer.  And statistically, that's exactly what's likely to happen.  But it's helpful to confirm that my state of health is, to a very great extent, entirely up to me.

All of the above data are from the CDC.  They're not trying to sell you anything.  No pharmaceutical manufacturer is going to profit from you getting active and learning to cook.  Those Big Pharma companies that buy all the ad time may not really want you to get active and learn to cook; they want to sell you the expensive statins and beta-blockers and painkillers and antidepressants and erectile-dysfunction drugs. 

Don't get your medical information from drug ads on TV, from e-mail forwards, or from blog posts (this one included).  Go to the source.  The CDC and the Mayo Clinic and Web MD are there to answer questions.  But what you should really take away is this: your health is in your hands.

Comments

[ask doctor online]

Each of us will die; we just need to be prepared for that when it was near.

[R K Young]

I didn't think avoiding death was the main intent here... more an empowerment by pointing out the choices we have.