Cancer- Should Money Be Spent on Prevention or Therapy?

[M Paquette]

If we look at continental aggregates, then Australia is highest, followed by Western Europe, then North America. Poor countries have the lowest cancer rates which are 1/10 or less of the above numbers.

Skin cancer.

Which is why I suggested way back there that the best preventive measures one can take against that most common of cancers is sunblock, UV blocking clothing, and a hat. One tube of Efudex (skin cancer chemo) costs roughly as much as a decade's worth of sunblock. One Mohs surgery costs as much as a lifetime supply of sunblock. As a bonus for cosmetics users, many moisturizers now include a sunblock, and tests have shown that the UV damage is a big cause of 'skin aging'.

Regarding cancer rates in poor countries:
http://www.inctr.org/about-inctr/cancer-in-developing-countries/

The death rate from infectious disease is higher than that from cancer, but that is changing. The incidence rate is lower, but a higher percentage die.

Regarding cancer prevention, I found the fact that fruit and vegetable consumption not helping ward off cancer disheartening. I am an omnivore and will continue to consume a lot of fruit and vegetable as I love them, and they still help with diabetes, low cholesterol, and high blood pressure, and weight control.

Sounds like an excellent, rational, and reasonable plan to me.

 

[ziggy29]

Yes, I read the article, and a number of the following comments, until they inevitably degenerated into the familiar religious war over "carbs."

We live in an era where we are encouraged to make everything "us versus them". We're no longer allowed to listen to, and actually consider, alternative viewpoints to our own. The result is that just about everything is fair game for full-contact, belligerent "discourse" that used to be reserved to politics and religion.

As for the question in the title, isn't that a false dichotomy? It's not like going "all in" with prevention or going "all in" with treatment are the only options. That said, sure, prevention is better than cure, but even the best "lifestyle choices" are far from a guarantee of a cancer-free future.

 

[marko]

If the rate of obesity is way up but cancer has still dropped by 5 percent, then maybe the War on Cancer has not been completely ineffective.

Doesn't that statistic sort of negate the obesity/cancer connection?

BTW, my Doctor had a chart on his wall that said my 6 foot tall, 210lb frame was 'near obese'. I pointed it out to him and he laughed.

 

[ziggy29]

BTW, my Doctor had a chart on his wall that said my 6 foot tall, 210lb frame was 'near obese'. I pointed it out to him and he laughed.

Former NFL star running back LaDainian Tomlinson was listed at 5'10" and 220. That makes him "obese" according to the charts. Obese people don't run a 4.4 40 or rush for nearly 14,000 yards.

We do have an obesity "problem" in society (I dislike the term "epidemic"), but sometimes it does feel like these BMI charts are being revised in a way that makes people more obese without gaining a single pound.

 

[haha]

As for the question in the title, isn't that a false dichotomy? It's not like going "all in" with prevention or going "all in" with treatment are the only options. That said, sure, prevention is better than cure, but even the best "lifestyle choices" are far from a guarantee of a cancer-free future.

Well, for my part I just made the erroneous assumption that no one was likely to think that the oncology centers of America were likely to be shut down, that pharmacology departments in universities and drug companies were at all likely to close one of their most profitable, and patentable revenue centers. Given this, I would have thought that going "all in" on prevention was easy to recognize as a red herring. Obviously, it would have been better if I had ignored the push of the article (in itself not easy to do) and titled my post, "Perhaps we should debate adding more research into mitigating known risk factors in our war on cancer."

I would also like to point out, that the theme of focusing on weight equals blaming the victim is a rather narrow way of looking at it. These people are doctors, they are used to looking for solutions that can be delivered by doctors or somewhat less, by social interventions. Like pills, or even weight loss surgery. If something is social problem, it may be that social solutions are needed. But my guess is that it might be hard to even consider anything about the topic, if many people will immediately get defensive. How would cigarette smoking ever have been greatly lessened if we hesitated to mention that while some people smoke, some don't, and some former smokers no longer do?

On other threads I have myself stated that the "calories in calories out" idea misses some things. Like for example Katsmeow's statement that once one has been obese, they must forever under eat just to stay in place. Doesn't that kind of challenge calories in-calories out as the complete explanation for overweight? Also, unless I missed something, the association mentioned was not with being plump, but with considerable obesity.

Ha

 

[ziggy29]

Well, for my part I just made the erroneous assumption that no one was likely to think that the oncology centers of America were likely to be shut down, that pharmacology departments in universities and drug companies were at all likely to close one of their most profitable, and patentable revenue centers. Given this, I would have thought that going "all in" on prevention was easy to recognize as a red herring. Obviously, it would have been better if I had ignored the push of the article (in itself not easy to do) and titled my post, "Perhaps we should debate adding more research into mitigating known risk factors in our war on cancer."

I was referring more to the "push of the article", actually, as that was where it seemed to be guiding the reader.

 

[NW-Bound]

Skin cancer.

Which is why I suggested way back there that the best preventive measures one can take against that most common of cancers is sunblock, UV blocking clothing, and a hat. One tube of Efudex (skin cancer chemo) costs roughly as much as a decade's worth of sunblock. One Mohs surgery costs as much as a lifetime supply of sunblock. As a bonus for cosmetics users, many moisturizers now include a sunblock, and tests have shown that the UV damage is a big cause of 'skin aging'.

Yes. Skin cancer accounts for 80% of all newly diagnosed cancer each year in Australia. And 2 in 3 Australians will get skin cancer by the time they are 70.

See: Skin cancer - Cancer Council Australia.

Regarding cancer rates in poor countries:
Cancer in Developing Countries *-*INCTR

Cancer is a disease of the old, and when a country has a life expectancy of 48 as in Sierra Leone, most people do not live long enough to get cancer.

The article says that "approximately 50% of cancer in developing countries occurs in individuals less than 65 years of age", which of course has to be true when most of the population do not make it to 65.

Doesn't that statistic sort of negate the obesity/cancer connection?

Not necessarily. The EPIC study in Europe thinks otherwise.

And in the US, lung cancer rate has been going down dramatically due to fewer smokers. The lung cancer newly diagnosed rate in men peaked at 68/100,000 in 1982, and dropped down to 41/100,000 in 2008. As lung cancer is the most common cancer among men, that drop due to fewer lung cancer might be taken up by other forms of cancer and the total number still dropped.

See: GLOBOCAN Cancer Fact Sheets: Lung Cancer

PS. Another form of cancer that has been going down in the US is stomach cancer. Yet, that cancer is rising in Japan and Korea. In the US, it is thought that people eating less cured meat contributes to the decline, while Japan's consumption of salted fish is the reason they lead the world in stomach cancer.

Come to think of it, could it be that European consumption of cure meats are detrimental to their health too? They have the best jambon and Jamón and prosciutto. They still smoke more than the US, but their lung cancer rate is not higher!

 

[Katsmeow]

On other threads I have myself stated that the "calories in calories out" idea misses some things. Like for example Katsmeow's statement that once one has been obese, they must forever under eat just to stay in place. Doesn't that kind of challenge calories in-calories out as the complete explanation for overweight? Also, unless I missed something, the association mentioned was not with being plump, but with considerable obesity.

The reduced metabolism is seen with people who lost 10% of body weight, so not necessarily obesity. You can be in the overweight category and lose 10% of body weight to get to normal and still get the reduced metabolism.

Also I don't think this does challenge calories in/calories out. What is challenges is that idea that calories out is the same for 2 similar people of similar activity. That is, the one person who weighs 140 pounds and has X amount of activity a day may find that the formulas for total energy expenditure would burn 2000 calories a day. However, if that person had gotten to the 140 pounds by losing 10% of her body weight she might actually instead be burning 1700 calories a day. Now, if she was for eating 2000 calories a day - which would be normal for her weight and activity and would not make her hungry - she would gain 30 pounds in a year.

So calories in/calories out work. However, simplistic notions as to how many calories out each person has does not work.

 

[NW-Bound]

Though I have been on the skinny side all my life, I tend to believe that overweight people do burn fewer calories. Life is not fair and they have to cut down the calorie intake even more.

Over the years, my BP has been creeping up from around 125/82 to 135/87. My doctor recommended that I reduced my weight from 25 BMI. It's tough to do as I love to eat, but once I got down to 23 BMI, I saw that he was right!

I also reduced my sodium intake, and that is tough. Some of my relatives, my wife included, eat the same if not more salty food, and their BP is on the hypotension side! Life is never fair.

 

[haha]

Also I don't think this does challenge calories in/calories out. What is challenges is that idea that calories out is the same for 2 similar people of similar activity. That is, the one person who weighs 140 pounds and has X amount of activity a day may find that the formulas for total energy expenditure would burn 2000 calories a day. However, if that person had gotten to the 140 pounds by losing 10% of her body weight she might actually instead be burning 1700 calories a day. Now, if she was for eating 2000 calories a day - which would be normal for her weight and activity and would not make her hungry - she would gain 30 pounds in a year.

So calories in/calories out work. However, simplistic notions as to how many calories out each person has does not work.

Does this mean that the formerly overweight woman does not need as much fuel to produce a given amount of muscle work, when compared to her never overweight sister? If so, are any mechanisms for this known?

Ha

 

[samclem]

Does this mean that the formerly overweight woman does not need as much fuel to produce a given amount of muscle work, when compared to her never overweight sister? If so, are any mechanisms for this known?

Ha

I don't think it relates to muscle work, it relates to metabolic rate. Just turning the "thermostat" a bit lower can result in a lower daily caloric use even if muscle movement and "work" are identical.

And it takes a lot more calories to maintain muscles than to maintain fat, even if the muscle isn't used. This is one reason we shed muscle so quickly if it isn't used: Starvation has been the big killer of humans across our history, and our bodies do a lot to conserve energy. I can easily believe that genetically identical people subjected to different food intake/weight/exercise histories might develop different metabolic rates, baseline rates of lean muscle, etc. Just an anecdote/observation, no proof supplied here.

 

[donheff]

The reduced metabolism is seen with people who lost 10% of body weight, so not necessarily obesity. You can be in the overweight category and lose 10% of body weight to get to normal and still get the reduced metabolism.

Hummm. I lost about 17% of my weight (195 to 162) but I don't notice any lowering of my metabolism. That doesn't mean that a test might not have shown such a change. Just that subjectively I don't feel a desire for more food than I need. Per my post above, I am on auto pilot as long as I avoid most sugar and refined carbs. If the reduced metabolism/difficulty maintaining loss issue is real it doesn't affect everybody, or it may require more dramatic losses to kick in.

 

[Katsmeow]

Hummm. I lost about 17% of my weight (195 to 162) but I don't notice any lowering of my metabolism. That doesn't mean that a test might not have shown such a change. Just that subjectively I don't feel a desire for more food than I need. Per my post above, I am on auto pilot as long as I avoid most sugar and refined carbs. If the reduced metabolism/difficulty maintaining loss issue is real it doesn't affect everybody, or it may require more dramatic losses to kick in.

How active are you? On the National Weight Control registry I think research studies have shown that the average person (these are people who lost I think at least 30 pounds and kept it off at least a year) exercise at moderate intensity at least 1 hour a day (which is more than that of most people). That is the person who never lost weight might burn 2000 calories a day with less exercise while the person who lost weight might need burn 2000 calories but doing much more exercise than the never overweight person.

All of that said - I am quite sure there are individual variations at play. The studies are looking at groups of people and it would be rare that every person reacts identically or has identical metabolism.


If you look at this article you can see that while there was an overall reduction of energy expenditure in the reduced overweight/obese subjects there were a few that didn't show as significant a reduction.

MMS: Error

This study found the same amount of reduced energy expenditure for those who lost 10% of body weight as those who reduced 20%


I remember years ago going out to work with 2 co-workers. One of them was very obese. At the time I was in the high normal weight category. The third was in the normal range but toward the thin end. The obese co-worker and me ordered with a view toward not eating too many calories. We ordered sugar free drinks. At that time I ate like that all the time. I always watched calories and always drank non-caloric drinks.

I was astonished to see the thin co-worker ordered a chocolate milkshake, a very large cheeseburger and fries. She ate more at that meal than I would eat in a single day. We talked and I learned that she ate like that all the time. She actually had no clue as to how many calories were in any food because she paid no attention to calories. She also didn't exercise. We all 3 had the same sedentary jobs. She was just a person with a naturally high metabolism.

So - maybe you are an outlier and don't show the reduction in metabolism that most people show. In which case, you are fortunate.

 

[donheff]

How active are you? On the National Weight Control registry I think research studies have shown that the average person (these are people who lost I think at least 30 pounds and kept it off at least a year) exercise at moderate intensity at least 1 hour a day (which is more than that of most people).

I ride a bike about 20-30 miles three or four times a week, so I fall in the active category. But I was doing that when I was 195 so nothing has changed in that regard.

I remember years ago going out to work with 2 co-workers...

I was astonished to see the thin co-worker ordered a chocolate milkshake, a very large cheeseburger and fries. She ate more at that meal than I would eat in a single day. We talked and I learned that she ate like that all the time. She actually had no clue as to how many calories were in any food because she paid no attention to calories. She also didn't exercise. We all 3 had the same sedentary jobs. She was just a person with a naturally high metabolism.

That was me through my 20s and I thought I was still doing fine into my 30s but the 1 pound a year creep had slipped in unnoticed. It wasn't until I was about 50 that I realized I was sucking my gut in for pictures Luckily, I am back eating like your skinny friend now only no chocolate shakes. I will still grab a double meat cheese burger with bacon for lunch now and then but I tear off about half the bun and only eat about 1/3 of the fries. I refuse to read any study that doesn't support my bias toward saturated fat.

 

[Lakedog]

Hummm. I lost about 17% of my weight (195 to 162) but I don't notice any lowering of my metabolism. That doesn't mean that a test might not have shown such a change. Just that subjectively I don't feel a desire for more food than I need. Per my post above, I am on auto pilot as long as I avoid most sugar and refined carbs. If the reduced metabolism/difficulty maintaining loss issue is real it doesn't affect everybody, or it may require more dramatic losses to kick in.

Similar story here when I went low carb (210 to 175) with no change in exercise routine -- lift weights 3-4 days a week and run/walk a few miles everyday. At 6'2", I don't think I appeared much overweight to most people at 210 but I feel much better at my current weight. I can eat all I want with no weight gain even when adding a few carbs occasionally (potatoes/chocolate).

 

[Katsmeow]

This is one of those things where anecdotal data is important to the individual person but is not relevant to the larger situation experienced by most people.

As far as anecdotal information, I once lost weight from 167 (which was overweight but not obese) to 119. I was exercising regularly at the time. I found it absolutely impossible to sustain my weight loss. It was very clear that I didn't have the same metabolism after losing weight as a I did before.

But, again, I'm sure there is individual variation. But, for most people there is a reduced metabolism after losing weight.

 

[donheff]

This is one of those things where anecdotal data is important to the individual person but is not relevant to the larger situation experienced by most people.

As far as anecdotal information, I once lost weight from 167 (which was overweight but not obese) to 119. I was exercising regularly at the time. I found it absolutely impossible to sustain my weight loss. It was very clear that I didn't have the same metabolism after losing weight as a I did before.

But, again, I'm sure there is individual variation. But, for most people there is a reduced metabolism after losing weight.

Yes, but how did you achieve that weight loss? Playing to our preconceptions, it would be by controlling your portions while continuing to eat whole grains, bread, etc. In that case, we would argue that you should try again with different macro-nutrients. On the other hand, if you achieved it by going low carb and then stayed low carb but drifted back up, we LCHF types (or at least I) would have to concede that what works for us, doesn't work for you.

 

[Katsmeow]

Yes, but how did you achieve that weight loss? Playing to our preconceptions, it would be by controlling your portions while continuing to eat whole grains, bread, etc. In that case, we would argue that you should try again with different macro-nutrients. On the other hand, if you achieved it by going low carb and then stayed low carb but drifted back up, we LCHF types (or at least I) would have to concede that what works for us, doesn't work for you.

I think there are two different issues. You are addressing one of them while my post was about the other.

One is whether low carb makes it easier for people to lose weight and maintain weight loss. I am not expressing an opinion on that.

The other is about the fact that weight loss itself causes the metabolism of most people to change such that after losing weight they burn fewer calories as compared to the person who has never lost at least 10% of their body weight. It has been suggested by obesity researchers that this is a significant part of the reason (maybe the most significant part) that 95% of people who lose weight gain it back within 5 years. (It might be tempting to urge that the 5% who don't gain back their weight all lost weight on low carb and continue to eat low carb. While that might be tempting it is, however, not a fact. This can be seen by looking at people who have kept weight off at the National Weight Control Registry who have been found to have used a variety of weight loss approaches.)

 

[donheff]

I think there are two different issues. You are addressing one of them while my post was about the other.

One is whether low carb makes it easier for people to lose weight and maintain weight loss. I am not expressing an opinion on that.

The other is about the fact that weight loss itself causes the metabolism of most people to change such that after losing weight they burn fewer calories as compared to the person who has never lost at least 10% of their body weight. It has been suggested by obesity researchers that this is a significant part of the reason (maybe the most significant part) that 95% of people who lose weight gain it back within 5 years. (It might be tempting to urge that the 5% who don't gain back their weight all lost weight on low carb and continue to eat low carb. While that might be tempting it is, however, not a fact. This can be seen by looking at people who have kept weight off at the National Weight Control Registry who have been found to have used a variety of weight loss approaches.)

I was talking about the same thing you are talking about - both issues. My question was simply inquiring whether you, personally, fit the lower metabolism model when you dropped to 116 and then drifted back up. If you lost your weight on LCHF and drifted back up while continuing to eat LCHF, I would agree that you may fit that model and may be SOL (other than thru tormenting yourself with hunger). But, if you lost the weight thru other means (e.g. calorie counting on a LFHC diet) or even lost the weight on a LCHF diet but then switched back to a regular diet and tried to maintain your weight with portion control, I would not agree that you have personally demonstrated a low metabolism issue. You may very well have simply demonstrated that it is hard to achieve weight equilibrium on a standard diet. In the later case, I would argue that you should try staying LCHF during maintenance to find out whether your body would achieve equilibrium by itself without the need to constantly remain hungry. If you haven't given that a try you can't really know it won't work (it does for many others). If you do try it and it doesn't work, then you know for sure.

By the way, I hope my follow-ups don't seem to be bashing you with my theories. I don't actually think LCHF works as well for everyone as it has for me. I am just curious whether you have actually tried it and failed.

 

[rgarling]

When you lose weight using a LCHF diet your muscle mass is preserved for the most part. Increases in muscle mass are possible with proper exercise; however, most merely maintain their existing muscle mass.

When you lose weight using a low-fat diet, the loss of muscle mass is usually significant.

The caloric requirement to maintain fat cells is about 2 calories per day per pound. The caloric requirement to maintain muscle cells is about 6 calories per day per pound. You can compute the approximate change in calorie requirements, if you measure body composition along the way. For LCHF it turns out to be about 2 calories per day per pound of weight loss.

Sometimes the endocrine system will attempt to conserve energy if calorie restriction is prolonged, but this happens infrequently (and rarely with LCHF). Frequent yo-yo dieting using calorie restriction *will* create problems in this regard.

 

[nash031]

Rant alert: I find that much of the attempted correlation in this thread of various individual bodily types or lifestyle characteristics to be based upon a subtext of 'blame the victim' In ancient days, if someone became ill, it was because someone sinned somehow, meaning it was their fault. Now, it is because they did this or didn't do that - still blaming the victim. The truth is life is a risk factor, and no one gets out alive. So enjoy it while you got it!

Eh. I don't know if obesity causes cancer, per se, but it does make it much more difficult to detect in a lot of cases. It is something that is wholly controllable - yes, even diabetics - to some extent. It doesn't mean we shouldn't show compassion, but it does mean that the victim could've done something to help him/herself.

 

[NW-Bound]

It doesn't mean we shouldn't show compassion, but it does mean that the victim could've done something to help him/herself.

... such as Australians putting on some skin lotion for protection, as an example.

 

[Alan]

... such as Australians putting on some skin lotion for protection, as an example.

I had a physical 2 days ago and the doc gave the usual speech about making sure I covered up and/or applied sun screen when outside. I told him that I had a 32 year start on most around here because I grew up in the shadows of the dark satanic mills of northern England, and until I emigrated to Texas I'd spent a total of 3 weeks in a sun strong enough to burn

These days however, with better wages and cheap travel, Scotland has one of the highest rates of skin cancer in Europe as they jet off with their red headed, fair skinned, bodies to the sun every year.

 

[NW-Bound]

Call me a pessimist, but cancer is going to get us one way or the other. All we do is to delay it a bit, but when our own cells go berzerk after copying themselves for the umpteenth time, there's not a whole lot one can do.

In other words, eternal life is not possible. The higher up the evolution ladder a living thing is, the higher the chance of something going wrong eventually. It's the price to pay.

People should read The Cancer Chronicles (2013) by George Johnson.

 

[haha]

People should read The Cancer Chronicles (2013) by George Johnson.

Or not?