Lifestyle and cancer. Talk to a hundred different people and you may get a hundred different answers on the factors that contribute to a cancer diagnosis. As a patient who has explored all options – including complementary, alternative and holistic treatments – after diagnosis and again after disease progression, being under the gun looking for a way to save your own life will force you to look at every aspect of “how did I get here?” and “what do I do now?”
As an oncologist, patients look to you for these answers, and too often, the wild west of the internet for supporting information. Dip your toe in the sea of Dr. Google and the list of external factors that get blamed for a cancer diagnosis is forever long. Pesticides. Toxins. Heavy metals. Acid water. Sunscreen. Microwaves. Too much processed food. Too much sugar. Too much everything and not enough of anything. In short, it seems – everything can cause cancer, at least according to the internet. Usually, there was a “cure” for every cause and a patient can quickly get sucked into a lifestyle game of whack-a-mole; attempting to address every shortcoming or overindulgence with a countermeasure – ones that are often unproven or very loosely associated with some potential benefit.
Then there is the opposite side – those who think that cancer is primarily or entirely a genetic breakdown and discourage or outright espouse lifestyle changes during a cancer diagnosis. One doctor told me to go on the “Ice Cream diet” – presumptively because I needed to gain wait, but perhaps because he didn’t think I was getting better and it was more humane to enjoy my remaining days with banana splits instead of kale salads. So how does one balance lifestyle and cancer?
In the UK, data from 2015 demonstrates that over 55,000 cases of preventable cancer per year are caused by – you guessed it – smoking. The second leading cause? Obesity, clocking in at nearly 23,000 cases per year. So don’t smoke and watch what you eat – these are real shockers right? Yet, people continue to engage in these behaviors even after a diagnosis; half of lung cancer patients who smoked continued to do so post-diagnosis. These are direct consequences of easily-modifiable behavior. The article continues:
The third biggest cause of cancer is overexposure to UV radiation from the sun and sunbeds, which led to 13,600 cases of melanoma a year (3.8% of all cancer cases). Other preventable causes of cancer include drinking alcohol (3.3%), eating too little fiber (3.3%) and outdoor air pollution (1%).
While cancer is a primary concern of an unhealthy lifestyle, it is by no means the only consequence of poor health. Many chronic conditions have some root in lifestyle choices, so there are plenty of other reasons to keep on the straight and narrow. If a cancer diagnosis is piled on top of a pre-existing condition, treatments become that much more difficult, choices become more limited and recovering one’s health becomes more challenging.
As oncologists, you cannot undo lifestyle decisions that have been made in the past. You can, however, stress the importance of changing those lifestyles while there is still time. This article by Dr. Scott Young details very specific steps physicians can take to intervene in patient personal behavior and offers a number of tools to facilitate a productive and impactful bedside conversation. Being the authority figure in a patient’s health care journey, you are in a position to influence unlike any other person.
With the rise of immunotherapy as a more mainstream treatment option, maintaining overall health becomes even more critical particularly when said immune system that is actually being used as the primary tool to overcome cancer. As my investigational pharmacist told me: “You are using your immune system to beat Stage IV melanoma; I would do everything possible to keep it functioning at its best.”
The final message you can spread is to patients under your care, particularly the ones newly diagnosed or those who have progressing disease and are looking for a Plan B. Those patients are the ones most motivated to make a behavior change – and although they cannot undue what has happened, they certainly can move forward with a better, healthier life. Most of us are willing to make changes that will improve our health, extend our life, or both.
T.J. Sharpe is a Stage IV melanoma patient who shares his journey through cancer in the Patient #1 Blog on www.oncology-central.com, www.philly.com/patient1/, www.SkinCancer.net, and on www.NovartisOncology.com. He was diagnosed in August 2012 with melanoma tumors in multiple organs, only 4 weeks after his second child was born. Since then, he has undergone six surgeries and four immunotherapy treatments over two different clinical trials. The initial failures, and subsequent complete response, have been chronicled in his blog posts since December 2012. In addition to writing, he is a keynote speaker and consultant to the biopharma and clinical research industries, bringing an educated patient voice as a true stakeholder in challenging healthcare’s status and making a difference in patients’ lives via his company, Starfish Harbor LLC. A South Jersey native, T.J. lives in Fort Lauderdale, FL, with his wife Jennifer and two young children, Josie and Tommy.