Cancer Science or Cancer Myths. In today’s Internet age, it’s not
unusual to find tidbits about science and health littering your e-mail
inbox—giving advice about a remedy for illness or tips on maintaining wellness.
Sometimes it’s difficult to tell what constitutes good advice based on
high-quality scientific studies, what is a reasonable suggestion based on preliminary
or inconsistent studies, what is biased advice that stretches or distorts the
evidence from research studies, and what is just plain bogus. This introduction
will provide some tips to help you as you navigate all this information and
make informed decisions about your health. Why would anyone provide information
or provide suggestions on how to prevent cancer when they are not sure the
information is completely accurate? Very often, information is based on good
research, but some stories in the media take this information out of context
and therefore are potentially misleading. For example, resveratrol is a substance
found in red grapes, grape juice, and red wine. Moderate intake of wine has
been linked to possible beneficial health effects, such as reduced risk of
cardiovascular disease. However, some studies have found that high resveratrol
doses can reduce cancer risk in some lab animals. Studies of resveratrol in
humans are still quite preliminary. Levels of resveratrol in red wine are too
low for a person drinking wine to absorb enough of this substance to achieve
the doses found beneficial in animal studies. On the other hand, there is
overwhelmingly clear evidence that red wine, white wine, or any other alcoholic
beverage significantly increases the risk of mouth, throat, liver, and breast
cancer. Nonetheless, it’s not hard to find newspaper or mass media Internet
headlines that imply that drinking red wine will reduce your cancer risk. Even
more often, the focus of the story is that a “red wine ingredient” prevents
cancer. The headline takes the information out of context to grab your
attention, and the scientific details may appear only toward the end of the
story, if at all. It is true that a red wine ingredient prevented cancer (in a laboratory
animal study), so the headline is not a lie. Although there are many excellent
medical journalists whose goal is to provide information that helps readers to
make wise health decisions, in some other publications the bar is set lower—and
there is pressure to write something clever or cute that will attract and
entertain readers.
Many people pass along
misinformation because they believe it and are trying to be helpful. This
probably accounts for most of the health tips you receive from friends and
relatives. Unfortunately, many of these tips are based on information or reasoning
that does not follow the scientific approach we have followed in this book.
Later in this introduction I will outline some pitfalls that often lead people
to make dangerous conclusions about their health. And I also will provide some
tips to help you
identify which suggestions are
worth following and which to avoid. Most people recognize that their relatives
or neighbors or coworkers are not medical experts, and they generally apply a healthy
dose of caution before following their advice. Some people tend to be more
gullible when the advice comes from a celebrity. Being a talented (or at least
popular) actor, artist, or athlete does not necessarily mean that someone is an
expert concerning cancer or any other health issue. But many fans tend to
accept the medical advice of celebrities they admire without asking themselves
why. Unless you are confident that the advice is sound (and we will explain how
to make this assessment), you may be risking your health. Sadly, we feel that
it is our responsibility to remind our readers that useless or even harmful
health information and products are sometimes spread and sold for the wrong
reasons—fame and fortune. The quest for fame may play out on a grand scale,
such as celebrities hawking an unproven remedy or their latest diet book. Or
fame may be more local, such as the friend who wants to be recognized as the neighborhood expert in
natural remedies and advises you to use his favorite vitamin instead of your
doctor’s prescription. The same applies to fortune. Unhealthy advice might be
motivated by a neighbor’s participation in a multilevel marketing plan to sell
unproven (or disproven) products for disease prevention or treatment or, at the
other extreme, by large businesses with resources for expensive advertising and
lobbying (to weaken consumer protection laws and regulations). In any industry
or business, there will be a temptation to improve profits by stretching the
truth or even by outright lies, and it should come as no surprise that some
businesses involved in weilness and health are no exception. What may be a
surprise to some is that consumer protection laws and regulations are still rather
weak and that enforcement is difficult, so you still need to some homework if you want to avoid bad health decisions.
After all, it was not until 1938
that Congress passed a law that required drug manufacturers to provide evidence
of the safety of drugs marketed across state lines. That law also banned false
and misleading labels on food, drugs, and medical devices, It was not until
1962 that U.S. law required any drug to be proven safe and effective for its
stated purpose.
Consumers are often surprised by
the lax regulation of food product claims. For example, a recent food industry
program added a smart choices” logo with a green checkmark to some products,
but there were no government standards as to what products they could choose.
At one point the program included sugared breakfast cereals consisting of as
much as 41% sugar by weight. There are some U.S. Food and Drug Administration (FDA)
regulations about health claims in food marketing, but these are complex, and
it is easy to be misled by vague promises that companies are allowed to make
that require little or no scientific evidence.
Complementary and alternative
medicine (CAM) is a diverse and frequently misunderstood category of products
and practices. CAM includes complementary methods that are intended to be used
together with conventional healthcare to improve health and wellness, as well
as alternative methods that are generally promoted to be used instead of
mainstream healthcare for the purposes of treating or preventing diseases such
as cancer.
Although there is some overlap
between the two categories, this distinction is generally useful. Alternative
methods that claim to cure or prevent cancer are in most cases either unproven
or even disproven by scientific evidence but still promoted by some practitioners.
Many are expensive, painful, or toxic and, when promoted for treatment, can
lead patients to forego beneficial conventional treatments while their disease
worsens. Complementary methods recently have been the subject of substantial scientific research,
and there has been important progress toward understanding which methods work
and which don’t. For example, we consider complementary methods such as meditation
and yoga and review some of the growing evidence of benefit. Dietary
supplements are a particularly challenging group of complementary products
because their regulation does not require evidence of effectiveness in support
of marketing claims, which can be misleading. For example, an herbal product
can claim to support the immune system without review of any evidence by the
FDA. Many people reading these claims mistakenly believe that they are
supported by evidence. So, consumers may mistakenly think that these products
improve the immune system in ways that reduce the severity of infections, help
the immune system to prevent or fight cancer, or prevent cancers of immune system
cells (such as lymphoma). We don’t have enough space in this book for a thorough
discussion of dietary supplements and other forms of CAM. For more information,
we recommend the CAM resources at the end of this introduction. In considering
ways to reduce our cancer risk, there is no substitute for scientific evidence,
although you may encounter suggestions to the contrary. Here are some tips for
recognizing unscientific recommendations.
It Doesn’t Rely on
Science
Look for solid scientific
evidence—not anecdotes. Look for results of studies that are published in
respected scientific journals. Articles in these journals are not published
until they have been reviewed by other experts in the field to confirm that the
methods are sound and the conclusions are valid. If the only publications in
support of a recommendation or product is a popular Web site, magazine, or
book, then there is good reason to be suspicious. Personal stories of
successful cancer prevention or treatment often can rely on emotions to
persuade—and emotions can indeed be important as we make decisions. However,
such stones also need to be supported by facts and evidence.
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