How we all live — and die — with cancer

You know how people (and especially people who report on health studies) tell you that nearly everything you can think of will give you cancer these days? Or that nearly anything can prevent (or even cure) cancer, if you take enough of it?

You can hardly open a newspaper or an online feed these days without seeing the results of the latest study on cancer mortality. This week, red wine good; next week red wine bad. Or just munch on a truckload of acai berries.

Studying cancer is an industry, and producing conflicting or confusing reports is no deterrent to either its credibility or its ability to raise funds for more research.

But now, in the biggest cancer study bombshell of them all, scientists have produced a mathematical model showing that two-thirds of the cancers that afflict adults are not determined by the things we do, the things we eat (or smoke), or the toxins that we encounter.

The largest cause of all cancers in adults? According to the Johns Hopkins Kimmel Cancer Centre in the U.S., it's plain dumb luck.

In reports shot round the world, Bert Volgelstein, the Clayton professor of oncology at Johns Hopkins University, said: “Cancer-free longevity in people exposed to cancer-causing agents, such as tobacco, is often attributed to their 'good genes', but the truth is that most of them simply had good luck.”

What triggers the cancers this study referred to is the number of times the cells divide in certain organs (your colon, for instance). Despite our evolutionary protections, every time the cells in our body divide, there is a risk some divisions may produce a bad result. Runaway division — a cancer — is one of those results.

Getting an unfortunate cell division is losing the cancer lottery, he says, and it is not likely affected by the number of red-meat dinners you ate. Take that, you paleo nut-crunchers.

In two-thirds of the cancers we get, it now appears pure bad luck is the trigger.

In the rest — obesity, bad lifestyle, smoking, etc. — genetics and environmental factors do play a larger role. So virtue can still be its own reward in many cases.

But on the whole, this is depressing. As one doctor once told me, everyone will get cancer in one form or another, if they live long enough.

And trying to beat the odds by finding a cure is a waste of billions of dollars, says one long-time editor of the esteemed British Medical Journal.

Dr. Richard Smith recently wrote a blog essay suggesting that dying of cancer was a better way to go than dying of other causes, like dementia.

Getting a diagnosis of cancer, he said, allows the patient time to say goodby to loved ones and to wrap up one's affairs, which is denied to others who die either suddenly or slowly of other causes.

Smith was the editor of the journal for 13 years. He's seen umpteen thousand studies on mortality from all causes, in all their contradictory natures.

He wrote in a blog for the journal, that leaving aside suicide, there are four ways to go: sudden death (a traffic collision), the long slow death of dementia, the up and down of organ failure — and cancer, where people “go down usually in weeks.”

Death by cancer, he said, was the best option of the lot. Smith also deplored how many patients die while suffering futile programs of overtreatment of cancer, leading to a “horrible medical death.”

Well, you can imagine the stink this raised in the cancer research community.

Suggesting now that most of the cases of cancer that afflict our society may simply be random, or that influential people are proposing that resistance is futile, is not the best start to the New Year.

But when you think on it, perhaps this frees us from a lot of worry, or from labouring under the myth that we can all completely control our own destinies.

I will not attempt to rank which would be the best way to die.

Instead, I will continue to pursue what I believe would be the best way to live. That makes for a happier, more hopeful New Year.