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Opinion: Stop cancers before they start

Ethan Dmitrovsky
Dmitrovsky writes: "It’s a harsh truth that half of the men and a third of the women in America will be diagnosed with cancer during their lives."

The war on cancer marks another anniversary this month. It began nearly 50 years ago with President Richard Nixon’s landmark legislation. But as a father and cancer doctor my singular hope on this occasion is that we find ways to stop this battle before it even begins.

It’s a harsh truth that half of the men and a third of the women in America will be diagnosed with cancer during their lives. We must improve these statistics, especially now as our nation is aging and cancer disproportionately strikes older people. As a result, cancer cases will increase unless we find ways to stem this tide.

Prevention is one promising way to control cancer. Years before a cancer is diagnosed, genetic changes arise from exposure to carcinogens (like from tobacco use). They pile up in our bodies. And they cause early changes in our organs that lead to cancer. If these premalignant changes are eliminated, it is thought that cancers will decline or not even occur in the first place.

Intensive research is underway to discover drugs that prevent cancers. But there is an even simpler way to reduce cancer risk: adopt healthy behaviors. These include regular exercise, avoiding an unhealthy weight and diet, and, of course, not smoking.

Almost one-third of all cancers come from use of tobacco products. Every state records its smoking and cancer statistics. Nationally, about 15 percent of adults are current smokers, but these rates fluctuate between states and communities. For example, in Kentucky and some other states, about 25 percent of adults are current smokers.

We must reverse these trends and stay vigilant to prevent and stop smoking and the use of tobacco products, especially among young people.

Education is a proven way to dissuade youths from smoking. Public health announcements and policies also help. These include banning smoking in public places as was done in California, placing higher taxes on tobacco products and raising the age to purchase those products.

One is that even after you stop smoking, it takes years to repair the damage done. Therefore, years must pass before lung cancer risk can substantially fall. The upshot of this is that more lung cancer is now diagnosed collectively in people who have either stopped smoking or never smoked than in current smokers. Therefore, lung cancer will remain a major public health problem for decades to come, even if smoking rates decline.

We should promote healthy behaviors that can save lives and forestall the onset of expensive illnesses. Encouraging our children to choose healthy behaviors, especially not smoking, protects them from lethal cancers and other deadly diseases as adults.

When my daughters were young, I worked at a cancer center that had banned smoking. Because of this, the hospital entry was always crowded by patients puffing on their cigarettes. Unfortunately, some of them could barely stand without the support of their intravenous poles. Even with cancer, many could not kick the tobacco habit.

These sad sentries marked the hospital’s entrance with ironic columns of smoke. Whenever my daughters visited me at work, they saw this unsettling sight.

It was their aversion to this spectacle rather than my constant pestering that kept them from ever smoking. I thank those cancer sufferers for teaching my children this: Smoking prevention is far better than any cancer cure.

Ethan Dmitrovsky is an oncologist and laboratory director at the Frederick National Laboratory for Cancer Research.