Monday, May 7, 2012

What Will It Take to Prevent Cancer?

“The best cancers are the ones that never happen,” said Wendy Selig, president and CEO of the Melanoma Research Alliance, when introducing the Cancer Prevention panel at the Milken Institute Global Conference. As many as two-thirds of the 1.5 million new cancer diagnoses each year are linked to environment, behavior, or lifestyle factors that can be prevented or managed. So what will it take, she asked panelists, to reach this potential?

Their answers ranged from eliminating tobacco consumption, to making sure people get screened, to providing healthy lifestyle education, to ensuring that every American has access to primary care.

“I’m a lucky one,” said Sherry Lansing, CEO, The Sherry Lansing Foundation and founder, EnCorps Teachers Program. After losing her mother to ovarian cancer more than 20 years ago and receiving treatment for an early cancer of her own, Lansing committed herself to raising money for cancer research and awareness about prevention. “We dreamed big,” she said of her co-founders of Stand Up To Cancer (SU2C). Calling it a Manhattan project for cancer, Lansing noted that SU2C has raised and distributed nearly $200 million for scientific “dream teams.”

Sancy Leachman, director of melanoma and cutaneous oncology at the Huntsman Cancer Institute, noted that “Nothing would have more of an impact on prevention than education on healthy lifestyles.” If you think of successful prevention methods, “it takes research, money, and market forces to push the ball forward.” Behavior science is an important tool to design behavioral approaches to lifestyle change.

“We hear a lot about data, data, data,” said J. Leonard Lichtenfeld of the American Cancer Society, “but we have to remember that at the end of that data is a human being.” He argued that America is stuck in a culture of illness and pointed out that “we could reduce cancer deaths in this country by 50 percent with what we know today about science, exercise, and nutrition . . . if we could convince our country that this is a good thing.”

Stephen Gruber, director, USC Norris Comprehensive Cancer Center, spoke about the benefits of genetic screening in predicting, preventing, and treating cancer. “Screening, medicines, and risk-reducing surgery can have huge impacts on cancer incidence,” he said. For example, oral contraceptives are known to reduce the risk of ovarian cancer by 50 percent, and screening reduces colon cancer risk by more than 50 percent and saves millions of dollars.

“Knowledge is power,” agreed Lansing, “but it can also be destructive.” It’s important, she and Lichtenfeld argued, that sensitivity and specificity be exercised when presenting genetic test results to patients. “We will find out that all of us have a genetic propensity to something; the question is about the penetration of that gene characteristic and how to act upon what we know.”

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