10 Harsh Truths About Cancer You Need to Know
Sadly, we now live in a world where ~41% of the people you know will develop cancer at some point in their lives. While the median age for first cancer is 66, that number keeps decreasing over time. In other words, more people are getting cancer younger.
2. Cancer survivorship is not as great as you think it is.
While media headlines boast that cancer mortality rates have dropped 30% since the 1990s the raw numbers are less promising. For example, in 1950 there were 193.4 deaths per 100,000 people due to cancer. Today, that number is 152.5. That means 40 people in 100,000 get to live after 70 years and billions of dollars of research. When it comes to your own life, that stat won’t help you sleep at night. The hard truth is surgery, chemo and radiation are often not enough to cure cancer. Plus, you might survive the treatment and cancer, only to have side effects which increase all-cause mortality such as immunosupression (dying of pneumonia), blot cots, an increased risk of heart disease, a secondary blood cancer caused by treatment, increased risk of Alzheimer's and dementia. The list goes on.
3. You have cancer cells in your body right now.
They’re called circulating tumor cells and for most people they never become anything more than that. Cancer is only a problem when it becomes clinically significant. So what happens in-between? The answer is your immune system. Every day your immune system is finding these CTCs and destroying them. But your immune system is spread thin trying to combat DNA damage all over the place from radiation, pollution, toxins, viruses, pathogens, etc. If you put too much stress on your immune system (i.e. smoking, obesity, alcohol, viruses) it won’t have enough umph to kill the CTCs. Once, CTCs find a home and undergo angiogenesis (i.e. they build blood vessels to start siphoning off nutrients to grow themselves) you’ve got a problem. In other words, keeping up a robust immune system is KEY to preventing and killing cancer.
4. Oncologists get kickbacks for giving out chemo.
It’s crazy to think, but oncologists get back around 6% of the cost of a chemotherapy drug, which not only incentivizes them to prescribe chemo, but it’s a huge conflict of interest (there was famously an oncologist in Michigan who gave chemo to patients who didn’t have cancer in order to take the money). Now, I believe my oncology team ALWAYS had my best interest at heart and I also believe oncologists are in an impossible position. Surgery, chemo, and radiation are still the only real treatments approved by the FDA for cancer (along with new immunotherapies, which are still not effective for enough patients) and they comprise the real standard of care. Oncologists’ hands are often tied because if they don’t use these therapies (or try to offer alternatives) they could lose their license. But the real losers here end up being the patients. Instead of receiving complementary care to these harsh, poisonous treatments cancer patients are told “do this chemo or you’ll die”. Or on the flip side, patients undergo chemo not realizing it’s not curative. One study showed that the extra life added by harsh cancer treatments amounted to 2.1 months. MONTHS. Pharmaceutical companies have too much power in cancer treatment (i.e. they only want a treatment that is patentable) and oncologists, like patients, are often just cogs in the cancer machine.
5. Cancer doesn’t “come back”, it never left.
We used to say cancer was in remission, now we say “no evidence of disease”. Why the change in semantics? It’s because when a cancer patient no longer shows signs of clinically significant cancer it means “as far as we can see with our current diagnostic tools” it does not mean the cancer is gone. So if the cancer “comes back” (i.e. recurrence) the sad truth is, it never left.
Indeed, you can kill all the rapidly dividing daughter cells of cancer (that’s how chemo works), but it won’t kill the stem cell. If that stem cell stays intact, or if some slower dividing cancer cells camp out and wait, they can start dividing or producing new cancer cells as soon as treatment is over (and by that time they’re probably chemoresistant). This is why patients who are fighting cancer should try to do everything in their power to create an unfriendly microenvironment for cancer cells in case they want to hang around. This includes radical lifestyle changes in diet, exercise, smoking, alcohol and exposure to other carcinogens.
6. You might have several types of cancer cells in your “one cancer” — and you have to fight them all differently.
When I was diagnosed with cancer in 2019 I learned I had two different types of cancer — high-grade small cell neuroendocrine (that’s the nasty rare one) and adenocarcinoma (another nasty rare one). Both of my cancer cell types are fast-growing which makes them a good target for chemo, but it’s a double-edged sword because a cancer like high grade neuroendocrine is so rapid it’s often Stage 4 before people catch it (I was stage 3C with only a 2 cm tumor) and the recurrence rate is around 80% to 90%. They still don’t know why NETs are so persistent but it could be because they explode all over the body quite rapidly. An NET cell wants to break off and spread its wings.
Other mixed tumors might be made of two or three cell types, and have different metabolic mechanisms. For example, two could be fast and one could be slow. One could feed more off glucose and the other fatty acids. That means chemo might successfully kill two of the three types, but leave behind the third. Again, a few years later that third type becomes clinically significant again and you’ve got recurrence. This is why cancer needs to be attacked multidimensionally. There is no one cure and it’s unclear if there ever will be.
7. Chemotherapy and radiation destroy your immune system and set you up for failure.
Chemo and radiation are the standard of care for cancer, but in the process of killing your cancer cells they significantly damage your immune system (hence why cancer patients are immunocompromised). As I mentioned above, your immune system IS your defense against cancer. If cancer cells are left behind after treatment and you now have a poorly-functioning immune system it will be quite hard to clean up those circulating tumor cells. We don’t focus enough on rebuilding the immune system with nutrition, supplements and alternative treatments (mistletoe therapy, high dose Vitamin C) during and after cancer. It’s no wonder so many patients have recurrence and suffer long term. We send them to war with no armor and then wonder why they die.
8. Cancer is less about genetics and more about epigenetics.
You might think genetics is responsible for your cancer, but that’s only true in roughly 3% to 10% of cancers. The other 90% of cancers are caused by epigenetics, this means changes in your genome due to environment (i.e. radiation , pollution, toxins, carcinogens, viruses, etc). We are blasted with DNA disruptors everyday (they’re impossible to avoid — heck the sun is one), but our bodies have nifty ways of repairing itself. However, when these repairs break down or are no longer activated (due to epigenetic changes) cancer can occur (it’s usually not just one disruption, many cancers need mutliple genetic disruptions to form). That doesn’t mean you should blame yourself for your cancer, but it does mean you can HELP yourself. You can do everything in your power to be as healthy as possible. This might mean losing weight, exercising more, cutting alcohol, quitting smoking, wearing sunscreen, moving to less polluted areas and the list goes on. Give your body the tools and resources it needs to fight cancer now. (Since my diagnosis I’ve lost 40 pounds and quit drinking. It may not be enough, but it’s something.)
9. Your cancer is unique to YOU.
Cancer is a complicated mess of bio-chemistry. It’s so complicated the top minds in the world can’t figure out how to kill it successfully without practically killing the host (you). Not only that, while your cancer might be “lung cancer” you’ll have a specific histology (ie. small cell vs non small cell) and specific mutations special to your tumor (i.e KRAS). What does all this mean? Your tumor grew in your body and even though you know someone else with the same cancer it doesn’t mean your tumor metabolism is the same. This, again, is why there’s no one cure. Why do survival rates of late stage small-cell neuroendocrine of the lung sit at 5%— why those 5%? What was different about them? Why do some patients respond to immunotherapy and others don’t?
Turns out, cancer is a complicated metabolic disease special to the host. If you block one pathway (like glucose or fatty acid) the cancer finds something else to feed on (Glutamine pathway). In order to kill cancer you have cut off all its resources (and yes, radiation and chemo can be a part of this plan) and build up your own individual defenses.
10. You can start fighting cancer before it starts.
All of this information is not to scare you, it’s to try and emphasize that preventing cancer is a better defense than fighting active cancer. If you haven’t had a cancer scare yet (lucky you) now is the time to boost your defenses and tip the scales in your favor. Eat lots of plant based food (the antioxidants help fight against oxidative stress), supplement with Vitamin C (it’s not super bioavailable and cycles through your system every hour or two, so take a few capsules throughout the day with lots of water), get your weight to a normal range, quit smoking, limit alcohol, make sure you’re exercising (walking is great), cut refined sugar, wear sunscreen, increase fiber intake (colon cancer is often a direct result of the Standard American Diet), limit meat intake, breathe clean air, and — this is important — try not to stress out!
You can take control of your health. Plus everything you do to prevent cancer also helps prevent other diseases like Alzheimer's, Type 2 Diabetes and cardiovascular disease. That’s a win-win.
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