Over the last ten years many of the same screening recommendations remain intact. A few things that have changed:
Is the emergence of obesity as the second most common risk factor for cancer
The increased prevalence of some diseases and thus many will be touched by cancer (1/3 women, 1/2 men)
The emergence of HPV virus as a trigger for oral pharyngeal cancer and it's escalating prevalence.
Still, the leading tumors by incidence in women are breast, lung, and colorectal and those in men are prostate, lung and colorectal. Other developments in the oncology arena include the development of molecules that target receptors for proteins on cancerous cells that may turn off their proliferation. These Targeted Immune Therapies fall into the name of Personalized Oncology as they're typically based on assays that verify the patient has a subset of cells with these targets. Unfortunately, many of these targeted therapies cost more than $10,000 a month, and most cancers have multiple different proliferating subsets that limit significant or complete control of the deadly cellular outbreak. In general, cancer is gradually catching up with cardiovascular disease as the primary cause of death in America.
The above discussion forces me to identify and discuss an etiologic debate and movement that is now occurring in the oncology arena that is worth mentioning and will be relevant to the other topics on this webstie. Most cancer researchers and physicians believed in the Genetic or Somatic Mutation Theory of cancer development implying that faulty genetic control mechanisms ( secondary to aging, carcinogens or viruses) lead to rogue clones of cells that escape surveillance mechanisms and become cancers. A smaller new subset of physicians and scientist, including myself, believe that the root cause is instead energy production failure in the mitochondria of the cell and nucleus that lead to disruption and decay of sound chromosomal division oversight and subsequent multiple mutagenic clones. So there is a small subgroup of caregivers that believe therapies should be directed toward the Metabolic Theory targets while the majority still think the Somatic Mutation Theory and pursue the multiple chemotherapies and immune therapies that target the numerous mutagenic strains. These theories bring up another term that is new in the last ten years called Epigenetic Theory which implies that although we all have a genetic blueprint and a possible propensity to express a specific physical outcome (phenotype), our lifestyle and environmental triggers can either enhance or suppress gene expression and dramatically change the outcome. This new Epigenetic Theory is good news and weakens the old dogma that the genes from your parents determine most of your health outcomes.
Specific cancers and their associated screening for Male and Female:
Prostate Cancer - “ Active” Surveillance for PROSTATE CANCER
Men with high risk of developing prostate cancer or those with a diagnosis of low risk or low risk intermediate are faced with the dilemma of monitoring with PSA and digital rectal exam and hope the “time bomb”called prostate cancer doesn’t explode. Although prostate cancer is considered a favorable cancer by most, still approximate 30,000 men die every year from it and more suffer disease and treatment side effects that impact the quality of life. There are many things one can do to down regulate the expression of prostate cancer or prevent transition from lower risk indolent cancer to higher risk active disease.
First I encourage our patients to develop a daily emotional strategy to manage the autonomic negative thoughts that bombard us through the day when we see commercials about cancer or hear about other people’s cancer stories.I encourage patients to develop a “movie reel” ready to play as their first thought in the morning and last thought before sleep as them “feeling great and looking good in the future doing things they love with people they love in a beautiful place”. They can also play this mental video anytime they have worries or anxieties as they focus on nostril breathing to relax the body.
We also know that regular exercise revs up cellular messengers that down regulates Inflammation and lower many cancer rates especially prostate cancer. It doesn’t take much time to get the job done as one can even get by with a quick 5 to 10 minute high-intensity regimen 3 to 4 days a week before one gets in the shower. A simple stretchy band and gravity exercises can do a lot of good work.
Food is information to the body suppress or express genetic potential for disease and especially cancer. The main food selections to turn off prostate cancer development fall into the category of common anti-inflammatory foods. The main superstars include ginger, turmeric or curcumen, dark cherries or berries, and cruciferous vegetables. Especially beneficial for prostate cancer is pomegranate and using a concentrated source to avoid the sugar is a wonderful idea. Green tea or green tea extract in supplement form has wonderful data in epidemiologic studies. Additionally lycopene from tomatoes but be careful of store/factory added sugar in tomato products.
Supplements have good data as well and initiation of vitamin D in a 5 to 10,000 does range to keep your level optimal above 50 mg/mL is critically important. Just needs to be tested regularly because many of us will find it surprisingly low and once again vitamin D impacts many things beyond bone such as immune function, emotions, recovery, and more. Vitamin C is also important and generally a good baseline dose of 2000 mg a day for men and function and recovery are critical. There is good data with taking baby aspirin or full level aspirin in the prevention of prostate cancer and other cancers but I usually suggest a coated baby 81 mg aspirin. New on the scene from a recent Heidelberg study is the use of vitamin K2 which reduced prostate cancer incidence in a high-risk population. This can be found in a supplement called Menaqinone.
There is a large body of emerging evidence that low carbohydrate/low refined sugar diets which lower insulin levels and inflammatory cytokines also can’t turn off the mutagenic potential.
This is a quick summary and there is much work on all these issues that could be discussed. Remember cancer strikes one in two men and one in three women so prevention is the best treatment,