A recent New York Times article, In Sickness and in Health: a Wedding in the Shadows of Cancer, struck a particularly sensitive chord. It profiled the courageous journey of two of my patients, a husband with advanced pancreatic cancer and his wife with metastatic breast cancer and their preparation for the wedding of their daughter in the face of their battle with cancer. Among the responses of readers, an interesting and common concern stood out, why we continue to have an epidemic of cancer and why have we not dealt with the toxic mix of chemicals in our environment that they assume are a major cause of these cancers.
This perception is widespread. While there is little doubt that there are adverse health effects from these exposures, their role in the origin of the typical “western cancers” (breast, colorectal, prostate, etc.) remains uncertain. Certainly the central role of tobacco in lung cancer and several other cancers is undisputed.
What is most striking is the lack of awareness among the public and health care providers alike about the growing evidence that many non-smoking related cancers may actually be, in part, a direct effect of modern good health. The marked improvement in maternal and early childhood nutrition has played an important role in the health and well being of modern populations.