Let’s talk about cancer prevention

Because it needs to be done. Over and over again.

3D Structure of a melanoma cell.

We fear cancer because it seems utterly out of our control. The idea of something noxious potentially cooking inside us while we remain unaware is horrible. So we do what we can to stay healthy, cross our fingers, and hope for the best. Yet we’ve all heard stories of the super-fit marathon runner who gets sick while the nicotine-stained boozer doesn’t. How is this fair? Why me, and not him or her, obsess the newly diagnosed. I did everything ‘right’.

To put it super crudely, shite things happen to good people through no fault of their own, while genocidal megalomaniacs get to live in comfort. It makes no sense.

Why I am writing any of this? 

Because, after I posted on Instagram that I’d accepted a role to be an Ambassador for Breast Cancer UK, a charity specifically dedicated to Breast cancer prevention, amid the congratulations and support were a few messages accusing me of blaming, or even shaming, those already diagnosed. As if, by sounding the klaxon for prevention, and stating that “getting cancer isn’t just bad luck, many cases are preventable”, I was simultaneously implying that having cancer must therefore be entirely the fault of the afflicted. 

That’s quite a jump. And clearly not true. While the mechanism of cancer may be described quite simply, its triggers can have multiple origins, from a genetic susceptibility to myriad external factors. 

But those “myriad external factors” can give us cause for optimism! Why? Because understanding them could lead to the prevention of many cancers. Not all. Not every type. Maybe not yours. But maybe, just maybe, some that might otherwise have struck your friends or family. And with regard directly to breast cancer, potentially up to 30% of cases are believed to be preventable. 

Regrettably, the deeply uncomfortable truth is that our environments (from our homes to the wider world) are increasingly toxic. With the role of Endocrine Disrupting chemicals particularly relevant to a potentially increased risk for Breast Cancer. 

Studies show that up to 90% of cancers may be triggered by environmental factors (which might encompass anything from sun for skin cancer to the aforementioned endocrine disruptors). I state this citing rigorously scrutinised studies published in both the scientific journal Nature (this article is part behind a paywall) and in Nature Communications (this one is full free access but a touch harder to read as it’s rife with the language of medicalese!) Nonetheless this sentence from it is quite clear, “We posit that non-intrinsic factors drive most cancer risk, and stress the need for cancer prevention.” 

It is awareness of these non-intrinsic (aka external or extrinsic) risk factors that Breast Cancer UK so brilliantly bangs the drum about (its USP being a focus primarily on prevention ), and this is why I chose to join them rather than any other cancer charity (incidentally, one of my very first posts on this platform was about Hormone Disruptors, way before my association with BCUK!) 

But banging this drum goes hand in hand with firmly quashing the ‘it’s just bad luck’ assumption about cancer. Assuming it’s down to entirely unpredictable fate, implies there’s nothing you can do about it. It denies any room for optimism, and could make many people feel resigned to an inevitability that need not be theirs.

The issue is that many cancer strategies have marginalised prevention to stopping smoking, reducing alcohol consumption and increasing physical exercise. Whereas both of the referenced studies reference what Breast Cancer UK has recognised — that a bigger pool of external factors may also be key risk factors for certain cancers. And awareness of this should form part of any cancer prevention strategy.

Again, it may be too late for some, and make no difference to others, but for those it might help, isn’t this precautionary approach something to stand on a soapbox and shout about? Loudly!

I’m going to quote now from the Nature article I referenced above… 

“Using mathematical modelling, epidemiological data, results from tissue culture studies, and analysis of mutational signatures in cancer cells, researchers at Stony Brook University in New York estimated the contribution of extrinsic and intrinsic factors to cancer. 

“They established that intrinsic factors (those that result in mutations due to random errors in DNA replication) – referred to as bad luck – contribute “only modestly” (between 10 and 30%) to cancer development. They concluded that cancer risk is “heavily influenced” by extrinsic factors. 

“Environmental factors affect mutagenesis rates, such as radiation, environmental contaminants, and lifestyle choices. The research supports the argument that far more could be done to prevent cancer. And that cancer strategies must focus on early diagnosis and treatment and removing as many external triggers as possible.”

I’ve italicised that last line because this is the area that I feel well-researched, well-qualified and experienced enough to be talk about, particularly as it impacts our home environments. In addition, I’m formally training to better understand the role of nutrition and the way it impacts the potential for illness as well. 

I am not a scientist therefore cannot dedicate myself to finding a cure, would that such a thing be possible. Neither am I a surgeon or physician who could investigate less aggressive treatments; nor a doctor, so I would not presume to give medical advice on treatment or care. However, to repeat, because Breast Cancer UK is a charity specifically dedicated to prevention, this is a platform which I feel eminently qualified to join. 

And to add, when the quoted passage says ‘far more could be done to prevent cancer’, this is not a barb aimed at those already diagnosed, it’s a challenge to government, polluters, chemical companies, food processing conglomerates, all of whom should take a damn sight more responsibility for their contribution to some of those environmental triggers we are forced to inadvertently marinate within.

So back to my post…

I heard only fear in the accusations of blame. Fear prompted by the ‘why’ of how has this happened to me. So I wanted to address this head on too, without the constraints of word length or formats — as much as I love Instagram, I’m not sure any Social Media platform is very good for anything involving a degree of interpretation or nuance. 

If you’ve been recently diagnosed with cancer, are undergoing treatment, or even if you have recovered, of course there is fear — of death, pain, recurrence, you name it. It would probably be odd not to feel it. And fear is often followed by anger, if not the self-infliction of guilt. 

From my personal experience though, while it’s entirely natural to want to seek answers or justification, dwelling on the why of anything ‘bad’ that has already happened, seldom fulfils any useful purpose. It’s true that we intuitively search for meaning and order. We want things to make sense. But sometimes they just don’t. Or we can’t get the answers we need. And chasing them, and failing to find them, only ever causes more pain. 

Does it help to think that the benders you went on as a student might have started something untoward way back when? Or the perfume you used to love, or the fruit pastille you ate last week, or the cigarette you smoked yesterday? Or, or, and, and… it’s pointless. The only thing that matters is what you believe, and do, in the here and now.

It reminds me of the Buddhist parable of the second arrow, which goes something like this… It is said that the Buddha once asked a student, ‘If a person is struck by an arrow, is it painful? If the person is struck by a second arrow, is it even more painful?’

He went on to explain, ‘In life, we can’t always control the first arrow. However, the second arrow is our reaction to the first. This second arrow is optional.’

This is not to imply that suffering itself is ‘optional’, rather it is a reflection on the truism that how we react to what has happened to us will have a huge amount of influence over how we then deal with, and ultimately process it. Also, crucially to my mind, whether we can then truly walk away from a painful situation without continually dragging its carcass behind us. Guilt rots. Blame (whether inwards or outwards) is toxic. Reactive anger — or being ‘triggered’ to use current parlance — shows us that we’re still dragging that dead weight around. 

The story too is not about denying our initial natural reactions, or pretending that we are immune from pain. It’s about consciously choosing how next to proceed. Over time, having an awareness of this being a choice, and refraining from flinging endless second arrows at ourselves (or others), can help to liberate us from much unnecessary suffering.

Let me give you a personal example about blame, away from cancer, that I hope might resonate…

When my son was born nine years ago, I started off breast feeding as it’s hammered into most new mums that this is the ‘preferred option’. But my baby seemed to be exceptionally hungry, feeding for upto 2 hours at a time, every four hours. I am a single parent too, so feeding was just me, day and interminable night every freaking 4 hours. I was so exhausted my bones hurt. At about 8 weeks I threw in the breast-feeding towel. He would sleep for longer after a bottle and I was desperate. 

Did I feel guilty about it, hell yes. I’d also had a C-section (following a 36-hour failed induction) so add that to the guilt pot too as I’m told I’ve thus wantonly deprived my child of valuable vaginal microbes certain to affect his gut health for years to come! 

So, when he was hospitalised with viral wheeze at 6 months, or taken to A&E with an allergenic rash, or more recently had the occasional asthma episode, do I automatically think “it must be because…” etc, and consider blaming myself? 100%. Does it help? Not in the slightest. Was his formula milk or my Caesarean section unequivocally the cause? Who cares! Pointless to wonder. What’s done is done. I can’t undo it. The only thing that matters is that today we are both still standing; loving each other very much. And I refuse to beat myself up about something that I cannot change when the healthier option is so clearly to see what I can change for the future. Insight perhaps into one of the reasons I have dived so heavily into the realm of home/health, mind/body/environment, and now nutrition?!

Bottom line, all we ever have is where we are now and what we are prepared to learn. You cannot plan a future in the present based upon fears of the past. 

So while this may feel challenging, I implore you to relinquish guilt. Cease self blame. And catch yourself when you look to project blame. It only extends suffering.

Besides, surely there can be no greater ‘fuck you’ to any illness than to want to do as much as possible to stop anyone else going through what we ourselves may have endured. So if there are any ways at all to prevent a disease like cancer taking hold, I’m 100% here for that, knowing too that all of these things will put you in the best possible place to heal, should you nonetheless succumb due to factors unknown.