July - August 2018

Written by Steven Burns
From his column To Your Health

“Did you hear? Esther has cancer!” Usually said in hushed tones and with sincere concern, such comments occur every day around the globe. Too often, however, people speak as if “cancer” is a death sentence for Esther or Bob or Margaret. Sometimes it is, but many times it is not. Today, let’s focus on this disease by responding to some of the questions that come with a diagnosis.

So, what are the most common cancers?

For men, the top three are prostate, lung, and colon, in that order. For women, it is breast, lung, and (tied for third) colon and uterine.

What is the likelihood that people will develop cancer in their lives?

One person of every three will get cancer of some type in their life.

Are incidents of cancer increasing or decreasing?

Amazingly, the number of new cancer cases is trending downward. It peaked in about 1992, and has dropped since then. The rate for new cancers is now about 450 per 100,000 people, down from 500 in 100,000 in 1992. And the five-year survival rate has increased dramatically since 1975, in some cases nearly doubling. In other words, people with cancer are living longer.

How many die of cancer each year?

The estimated number of cancer deaths in the USA in 2018 will total 323,630 men, and 286,010 women, per the American Cancer Society. Again, the trend is downward, with significant declines since 1990.

Can I do anything to prevent cancer?

To answer this, we need to look at behaviors that increase one’s chance of getting cancer. The most significant is smoking. The drop in cancer deaths roughly parallels the reduction in smoking over the last 25 years. Second is obesity. Yes, you read correctly. Obesity is second only to tobacco in preventable causes of cancer. Third is alcohol. In the past, some have proposed a protective benefit of drinking alcohol, especially red wine for prostate cancer. More recently, researchers have recognized that alcohol is a cause of cancer, in that there are certain gene mutations that occur when we drink alcohol. Some have said there is no “safe” amount of alcohol. Specifically, alcohol contributes to lung and colon cancer in men, and to breast, lung, and colon cancer in women.

Are there genetic cancers?

There are genes that predispose people to getting cancer. For example, the BRCA1 and BRCA2 gene mutations are associated with greatly increased breast cancer in some families. People with those mutations are at-risk for many other cancers, including ovarian, pancreatic, and colon. One genetic condition known as the Lynch syndrome causes those who have the gene to develop multiple types of cancer. We are just beginning to scratch the surface of the gene determinants of cancer, and so far, most who have cancer have no identified gene mutations.

Obesity is second only to tobacco in preventable causes of cancer.

What treatments are used for cancer?

That depends on the cancer type. The “big three” are surgery, radiation, and chemotherapy. Surgery attempts to eliminate cancer cells by removing the tumor, along with margins of healthy tissue around it.

Radiation therapy is used for certain types of cancer. It precisely targets the tumor, delivering the greatest amount of radiation to the needed spot by moving the source of radiation around the person, with the rays crossing at the tumor site. Surrounding tissues are irradiated, but the hope is to deliver the greatest amount only to the cancer.

Chemotherapy is used in treating many tumors, and consists of medications that typically target cells that are dividing more quickly. Since cancer cells divide more quickly than normal ones, they die at a lower dose than normal cells. With both radiation and chemotherapy, there are side effects based on unavoidable damage to normal cells.

Emerging treatments include biological therapies like “vaccines” that target the problem by making the person immune to the cancer. That sort of cure is in its infancy, but is showing promise in certain types of cancer.

What did Esther do to get cancer?

For all of our research, there is no certain answer to that question. While there are behaviors that contribute to getting cancer, those activities are not in themselves necessary or sufficient to cause cancer. It is common to wonder what a person did to get cancer, but most of the time the answer is, “nothing.” I have seen lung cancer in non-smokers, breast cancer in women who have no family history and get mammograms faithfully every year, and colon cancer in those who have no risk factors. Esther may have just gotten older, and the body becomes less adept at destroying abnormal cells as we age. It is common to more or less blame the victim, but that is not realistic or medically accurate. There are theories that if we do everything right, avoid all the bad habits, exercise, think positively, pray effectively, take the right supplements, and so on, we’ll be healthy. The fact is that people who do all these things still get cancer. The idea that one can “live right” and avoid illness is a kind of pseudo-medical fundamentalism that is just as twisted and inaccurate as religious fundamentalism. Most people who develop cancer have no specific reason for having gotten it.

Where is God in all this?

God is where He has always been. He is present and holds us in His hand through our battle with cancer, just as He holds us in all the other problems of life. I believe He can heal cancer, just as He can heal all other diseases. But many times He does not, and His reasons for this are above my pay grade. I can rest in recognizing that God knows you and me, and that He will be glorified whether we are healed in this life or by receiving a perfect body in the resurrection.

Bottom line, God knows what He is doing. I don’t know His reasons. And just as I could never worship a god who fits inside my head, I don’t need to know the end of the story. I just need to live the life God has given me, for as long as I can, to glorify him. And that’s enough.

Dr. Steven Burns is board-certified in family medicine and has been in practice for more than 30 years.

Note: If you have questions for Dr. Burns, or topics you would like covered in future columns, please email them to This email address is being protected from spambots. You need JavaScript enabled to view it..