
Cancer 'Tidal Wave' on Horizon, Warns WHO - ytNumbers
http://www.bbc.co.uk/news/health-26014693
======
tokenadult
The numbers mentioned in this article are numbers of cancer CASES, for the
most part, not numbers of cancer deaths. The chart lower down in the article,
captioned World Cancer Cases 2012, at least shows countries in different
shadings based on cancer RATES (standardized to cases per 100,000 population,
as is typical for international health statistics), but that mostly shows
which countries have higher rates of diagnosis of cancer (or much lower rates
of diseases that kill people when they are young) rather than countries where
cancer is the main cause of death. Rates matter more than the raw number of
cases in a world that still has a growing population.

If we look carefully at charts of death rates by all causes for either the
United States or the developed world, we see that death rates from cancer and
from most causes of death are still steadily falling at all ages. Life
expectancy at age 40, at age 60, and at even higher ages is still rising
throughout the developed countries of the world.

[http://www.pinterest.com/pin/195977021257786739/](http://www.pinterest.com/pin/195977021257786739/)

[http://www.scientificamerican.com/article.cfm?id=longevity-w...](http://www.scientificamerican.com/article.cfm?id=longevity-
why-we-die-global-life-expectancy)

Yes, we still need to do more research on cancer prevention and cancer
treatment. Yes, the article is correct that smoking, infectious diseases
(mostly viral, some of which are already preventable by vaccines), overuse of
alcohol, and obesity all increase cancer risk, but you and I can do something
about our use of tobacco, alcohol, and fattening food-and-activity lifestyle
combinations today--we don't have to wait for more medical research to reduce
our risk of cancer. The article kindly submitted here makes clear that making
people more aware of what increases their cancer risk is one of the best
interventions for reducing cancer rates and cancer mortality. As other
comments have already correctly pointed out, a rise in the number of cancer
cases worldwide first of all indicates that there are more people in the world
than ever, and secondly indicates that fewer people are dying young of
diseases linked to stark poverty. That's good news, on the whole.

~~~
rayiner
I find it particularly frustrating that doctors of all people are so bad with
statistics. I know people in general are bad with statistics, and when
journalists misunderstand them I have some sympathy, because hey they probably
got through college without seeing a number, but I expect more from doctors.

~~~
mildtrepidation
_...but I expect more from doctors._

Is that really reasonable, though? Doctors don't have a use for statistics in
their daily professional lives, and they almost certainly have less free time
in which to immerse themselves in a field of math that isn't going to help
them.

Journalists, on the other hand, often should or need to rely on statistics to
convey useful and pertinent information in a meaningful way. That they often
obviously aren't taught and otherwise usually don't learn statistics, or at
least not effectively, strikes me as a much bigger problem than doctors who
don't have that knowledge.

Now, the people who write reports like these, _they_ should have and use a
thorough working understanding of statistics. I'd say what's really missing is
effective collaboration between the people who do the work and the people who
should be doing and writing the analysis.

~~~
syntaxfree
1\. Some large percentage, possibly more than half, of what a doctor does is
diagnosis and prognosis. This is all pure probability. Failure to understand
the difference between Prob(A|B) and Prob(B|A) has nontrivial consequences.

2\. Frontier areas of medicine -- oncology, psychiatry -- deal increasingly
with uncommon situations that not necessarily happen with enough frequency for
a doctor to develop a doctorly intuition. There are some great resources --
meta-analyses, for example -- out there, but if we keep cutting slack to
practitioners and let them follow the word of "thought leaders", medicine
becomes the prey of ideological waves and conceptual fashions.

------
adamwong246
Dying of cancer is a good thing- it means you didn't die in childbirth or from
malaria or diabetes. Cancer is a really big name for a lot of the tough
diseases we don't yet have a cure for. This "tidal wave" is simply mortal
humans living long enough that they start breaking on a molecular level. That
may someday change but living long enough to die from cancer is, sadly, the
grand prize in life. Not much of a prize but still better than the
alternative.

~~~
kaybe
Ah, but cancer is always the same thing, body cells going amok. The reasons
are manifold and a lot of research is going on there, but the result is,
broadly speaking, the same. (Of course you get different kinds of tumors..)
It's hard to see how it can ever be eradicated for good since it's kind of
part of the system and does not neccessarily have external causes (though in
most cases is does).

And then there are other diseases we have no cure for yet, which are not
cancer, such as Alzheimers and aids. We can eradicate those, I believe.

~~~
adamwong246
I don't really think it can be fixed either. Trying to cure all cancers is
like trying to engineer a car that never, ever breaks for all eternity. Even
if you left this hypothetical perfect sports car in the garage, the belts and
tires and tubes would start to degrade eventually.

Better to try to replace each part as it breaks with an upgrade! That's my
immortality plan- when my hearing breaks, get an implant. When the hip goes
out, in goes a titanium one. You mind starts slipping? We're going to need
some sort of prosthetic neurons, I'm thinking carbon nanotubes you inject into
you spinal fluid and which self-assemble inside the brain. Eventually, enough
meat has been replaced with tech that my mind can make the complete jump to
software and at which point I shed this frail human form and proceed to
explore the universe via self-replicating probes... Well, that's the plan
anyways.

But either way, to beat cancer, you going to need to fundamentally redesign
the human form.

ps (Elon Musk, if you are reading this, please contact me. I'm really don't
want to die and I'm willing to act as a guinea pig towards that end)

~~~
samatman
This is a fundamental misunderstanding of biology.

You think that you have organs, but really, you have cells. When those cells
break in a particular way, cancer results. 99.999% of those cancers are
terminated. The rest can kill.

Preventing cancer is a matter of adding 9s to that statistic until death is
implausible. Then, we run up against other senescence factors: our cells can
only divide so many times, garbage accumulates that can't be purged, etc.

It's plausible to imagine a world where we no longer die of cancer, adding
10-20 years to the average lifespan. People will start to die of obscure
diseases caused by genes no longer being present in their DNA.

So we work on fixing that. It's difficult, of course.

------
mberning
Great video that will give a glimpse into how sugar and dietary carbohydrate
contributes to the development of cancer:
[http://www.youtube.com/watch?v=WUlE1VHGA40](http://www.youtube.com/watch?v=WUlE1VHGA40)

~~~
charlieflowers
That talk is EXCELLENT. Thank you for posting. I've been frustrated over the
lack of accurate, scientifically sound nutritional guidance, and this talk
provides a some.

It is probably the single best talk I've seen this year.

------
mjmahone17
24m by 2035 doesn't actually sound like that much. And the fact that most of
the new cases will be coming from the developed world seems to speak more to
the fact that life expectancy and pollution (due to development) in the
developed world is increasing, meaning people are living longer, in more
hazardous conditions, and are therefore more likely to get cancer.

There really doesn't seem to be anything to be alarmed about. There will be
about 73million deaths in 2035 (looking at current death rates vs. expected
world population). If everyone who gets cancer dies from it in a year, there
will be 24m deaths due to it, although
[http://en.wikipedia.org/wiki/Cancer_survival_rates](http://en.wikipedia.org/wiki/Cancer_survival_rates)
indicates that cancer seems to have a >70% survival rate, in general. In 20
years, it's likely that survival rate will also be reflected in developing
countries. So really, only about 7.2m, or about 10%, of our mortality will
likely be due to cancer. That's still a lot, and it's worthwhile to try to
prevent as many of those deaths as possible. But cancer seems like it's not,
statistically, our biggest threat.

------
MrZongle2
This part struck me as a little ominous: '"The extent to which we modify the
availability of alcohol, the labelling of alcohol, the promotion of alcohol
and the price of alcohol - those things should be on the agenda."

He said there was a similar argument to be had with sugar fuelling obesity,
which in turn affected cancer risk.'

I'm all for educating the public, but why does it seem that education is
_never_ enough for some, and instead the next step needs to be behavior
modification through scarcity?

Haven't we seen this fail in the U.S. with the ridiculous restrictions on some
over-the-counter medications, the War on Drugs, and Prohibition?

~~~
diego_moita
As someone that grew up in Southern Europe I am at times surprised and shocked
by the relation Americans and Canadians have with alcohol.

In Portugal, Spain and Italy alcohol is food. We drink at home, with the
family, a great amount of wine and a little beer. Wine and beer are openly
sold in supermarkets, close to other food. However, the biggest alcoholism
problem we have are American, British and Australian tourists binge drinking
in our beaches.

OTOH, in North America it seems there are only 2 extreme ways of handling
alcohol: the Russian-like approach and the Muslim-like panic. Teenagers and
poor people abuse it and drink heavily, all the others are obsessively scared
of it.

~~~
coldpie
> OTOH, in North America it seems there are only 2 extreme ways of handling
> alcohol: the Russian-like approach and the Muslim-like panic. Teenagers and
> poor people abuse it and drink heavily, all the others are obsessively
> scared of it.

This isn't true at all. You're seeing the extreme cases and generalizing it to
everybody. We may have a higher incidence of alcoholism and alcohol abuse (I
don't know the numbers), but the vast majority of Americans use alcohol
occasionally and responsibly.

------
mbateman
Is the slope on those charts really steeper than population growth?

------
neals
I did not know Alcohol was such a cancer-causer. Maybe I should drink a little
less? :/

~~~
mberning
Alcohol and sugar share some similarities in how they are metabolized in the
body. It's not so surprising that they are both listed as culprits.

~~~
oafitupa
One is a derivative or subcomponent of the other I think. Someone who still
remembers his Chemistry class is welcome to elaborate.

~~~
freehunter
As a brewer, not a true chemist: alcohol is fermented sugars.

------
cliveowen
"Delayed parenthood"

Can someone explain this? I'm guessing it's something referring to cervical
cancer.

~~~
araneae
It's breast cancer.

Those who have a pregnancy before 20 years of age versus those who have a
pregnancy after 35 years of age show a 50% reduction in their risk of breast
cancer.

[http://www.cancer.gov/cancertopics/pdq/prevention/breast/hea...](http://www.cancer.gov/cancertopics/pdq/prevention/breast/healthprofessional#Section_378)

~~~
coldpie
Worth noting, the link clarifies that it's actually 50% less than women who
become pregnant /or never have birth at all/ after age 35.

------
clavalle
What is this about having fewer kids contributes to cancer?

~~~
araneae
Breast cancer is one of the more common cancers in woman.

Having your first pregnancy before 20 versus after 35 lowers your chance of
breast cancer by 50%.

For each birth, breast cancer risk decreases by 7%.

For each year of breast feeding, breast cancer risks decreases by 4%

Source:
[http://www.cancer.gov/cancertopics/pdq/prevention/breast/hea...](http://www.cancer.gov/cancertopics/pdq/prevention/breast/healthprofessional#Section_378)

The mechanism isn't entirely worked out, but the hypothesis is that immature
breast cells are more likely to cause cancer, and that pregnancy and
breastfeeding cause breast cells to mature into cells that are less likely to
become cancerous.

This paper explores the mechanism more: [http://erc.endocrinology-
journals.org/content/14/4/907.full](http://erc.endocrinology-
journals.org/content/14/4/907.full)

~~~
aestra
Yet hormonal contraceptives decrease your risks of ovarian and endometrial
cancer. Wonder if some of the risks can cancel each other out.

[http://www.cancer.gov/cancertopics/factsheet/Risk/oral-
contr...](http://www.cancer.gov/cancertopics/factsheet/Risk/oral-
contraceptives)

------
verisimilitude
I will never say I've "read a book that changed my life" but this one comes
awfully close: "The China Study"
[http://en.wikipedia.org/wiki/The_China_Study](http://en.wikipedia.org/wiki/The_China_Study)

If you get a chance to read it, you'll find the studies of the effects of some
animal proteins, specifically casein, on propensity to develop cancer when
organisms are challenged by mutagens and carcinogens to be rigorous science
and important for our daily lives.

The book encourages eating vegan, which is not hard, just different, and is a
diet whose positive health effects are supported by large scale
epidemiological studies.

------
WasimBhai
Those in Cancer research, how far are we to actually solve the Cancer problem
given recent genetics research surge?

~~~
gus_massa
This is the best simple graphic explanation I found yet:
[http://www.phdcomics.com/comics.php?f=1162](http://www.phdcomics.com/comics.php?f=1162)

~~~
hershel
Can't you say the same thing about infectious diseases, yet we have found a
general tool(vaccine) to fight them off. Isn't it likely that some of the work
done will generate a highly generic tool, that with a few changes could fit to
new types of cancer ?

~~~
gus_massa
Essentially yes, but trying to eradicate cancer is like trying to eradicate
all the infectious diseases. (I don’t even know which problem is more
difficult.)

The infectious diseases can be classified by the pathogen: virus and bacteria
(and prions?). We have vaccines for a few of them, it’s an important subset
because they caused many dead. Vaccines are very specific, each one is against
only one illness, or even only against some strains of the pathogens. (It’s
possible to combine some of them to reduce the number of independent shots.)

We have eradicated smallpox! And I hope we will eradicate polio in my
lifetime. There are many generic antibiotics against a lot of bacteria, and
recently appeared some antiviral drugs. But the eradication or cure of all the
infectious diseases is still a very long term objective.

The treatment for cancer has improved a lot. It’s a more difficult statistic
that simply counting the number of dead, but it’s a hope. Also the tools for
diagnosis have improved a lot, and that reduces the rate of false negatives
and false positives, for example MRI.

Some cancers are clearly linked to virus. The most well known case is the
cervical cancer (and a few similar cancers in other parts of the body). It’s
(mostly) caused by the Human papillomavirus. There is a recent vaccine against
the HPV, and it’s beginning to be applied massively. So I hope that in 50
years the number of cervical cancers will have lowered an almost disappear,
but there will be still cervical cancer dew to radiation, chemical mutations,
and other causes. There are other cancers that probably have a viral origin,
and perhaps it’s possible to create a vaccine and eradicate them.

It’s possible to eliminate or cure some types of cancer, but a complete
solution is almost impossible.

