Dr. David Servan-Schreiber: "Had antibiotics existed at the time [of the great Western cholera epidemics] - and if the people in charge at that time had relied on antibiotics to confront the epidemic as we today count on anti-cancer treatments - they undoubtedly would never have succeeded in stamping out cholera." (Artwork: National Institutes of Health Exhibit)
Today, we're confronted with a cancer epidemic. One French person out of four will die of cancer. And quite frequently before the age of 65. I myself have been on the wrong side of the statistics since I was 31, when I discovered I had a brain tumor.
Since 1940, our societies are witness to a rapid and significant increase in the most common cancers (lung, breast, prostate, colon). That is partly explained by the fact that more of us are living longer - long enough to develop cancer - and that we know more about detecting it. But those two factors only partially explain the increase in cancers. For the statistics among children and adolescents are also on the rise: by 1 to 1.5 percent annually since the 1970s. And there's the issue of cancers that we are not tracking down.
For the most common cancers, levels are much higher among us here than in Asian countries. But when Asians emigrate to the West, they catch up to Western cancer rates in one or two generations. Asians living in Asia are consequently protected not by their genes, but by their lifestyle and their environment.
The most recent studies show that: 15 percent at most of all cancers are due to genetic factors - and only partially. Eighty-five percent are not. Nonetheless, cancer strikes families: a notable study published in the New England Journal of Medicine showed that children adopted at birth who were born of parents who died of cancer before age 50 presented the same level of cancer risks as their adoptive - not their biological - parents. What is transmitted from generation to generation are habits and environmental conditions. Not the genes responsible for cancer.
Yet we still continue to devote 97 percent of our research to more effective treatment and earlier detection methods. Only three percent of resources are invested in treating the causes of the epidemic.
I was a founding member of Doctors Without Borders in the United States. I was a volunteer in Iraq, Guatemala, Tadjikistan and Kosovo. I saw epidemics in refugee camps. No cholera epidemic can be arrested either by early detection or by antibiotic treatment - methods that are, moreover, both precious and effective in treating each patient individually. Because the epidemic always spreads faster than our ability to treat each victim.
During the 1800s, Europe and the United States experienced several great cholera epidemics. They were everywhere and in each case able to be stopped without the support of antibiotics. At the time, the concept of infectious microorganisms had not even been discovered. But our leaders were far-seeing and strong-willed enough to act on what seemed the most probable environmental cause: contaminated water sources. And they effectively succeeded in arresting the cholera. Paradoxically, had antibiotics existed at the time - and if the people in charge at that time had relied on antibiotics to confront the epidemic as we today count on anti-cancer treatments - they undoubtedly would never have succeeded in stamping out cholera.
Today, we are in possession of infinitely more data on the probable causes of the modern cancer epidemic than our ancestors had with respect to cholera. The World Cancer Research Fund International concluded in its 2007 report that "most" cancers in Western societies could be avoided by changing our lifestyles:
Forty percent by changes in diet and physical activity (eat more vegetables and fruit, less sugar, less red meat; walk regularly or do 30 minutes of physical exercise six times a week); Thirty percent by stopping tobacco use; And 10 percent by reducing alcohol consumption.
Specific data now also exist showing that some foods, such as broccoli, cabbage, garlic, onions and curcuma, may help directly kill cancer cells and reduce the growth of the new blood vessels they need to develop threatening tumors.
The reduction of carcinogenic chemicals abundantly present in our modern environment (pesticides, estrogens, benzene, PCBs, cleaning products' alkylphenols, parabens in cosmetics and shampoos, phthalates in plastics, etc.) could also contribute to a decline in cancer, as an INSERM commission on "cancer and the environment" has now acknowledged.
By neglecting investment in the preventative research and programs that follow from these scientifically established facts, by refusing even to discuss them, we create a sense of impotence vis-à-vis cancer. Most people continue to see cancer as a sort of genetic Russian roulette, while that's not at all the case. In the face of cancer, we must certainly avoid giving false hope, but we must also fight even more energetically against false despair.
It is time to push our society and every one of us to confront the causes of this modern epidemic today.
David Servan-Schreiber, psychiatrist and professor of psychiatry at the University of Pittsburgh, is the author of "Anticancer" (Robert-Laffont, 2007).
Photo URL: http://history.nih.gov/exhibits/history/docs/index_c.html