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Is Cancer a Lifestyle Disease?
Q: Your commentary on Next Medicine (# 301, Lifestyle) says that Dr. Bortz makes a strong case for lifestyle in the prevention of cancer, but you didn’t elaborate. What’s the story on lifestyle and cancer?
A: I focused on heart disease and touched on diabetes, because cancer is more complex. Cancer is an umbrella name for many different diseases—colon cancer, breast cancer, prostate cancer, kidney cancer, skin cancer, etc—with lifestyle playing a different role in each permutation. That said, Dr. Bortz argues forcefully that well over 50 percent—perhaps as high as 90%—of cancers are preventable. He believes the current emphasis on treatment over prevention is misguided. “Playing catch up with surgery, radiation, and toxic drugs once cancer has taken hold reflects an inappropriate obsession with the concept of cure,” he writes. “Some call the present war on cancer futile,” he adds.
The additional factor in cancer prevention is environmental. Citing Walter Willett, head of the Harvard School of Public Health, Bortz asserts that 60% to 80% of cancers have an environmental cause. “Among the many identified environmental factors are smoking, radiation, hormones, viruses, and organic solvent [and] surely others,” he explains.
As in the case of heart disease and type 2 diabetes, diet and physical activity are the other primary factors. “Dr. Michael Marmot, professor of public health at the University of London, suggests that physical exercise, low [saturated] fat and low-sugar diet, and limiting one’s consumption of meat, alcohol, and salt would prevent one third of all cancers,” Bortz writes.
Continuing, Bortz opines: “Individual and collective responsibility calls for avoiding as many of those factors as possible: not smoking, using organic products, eating a diet rich in leafy vegetables, being careful about sun exposure, building lean muscle mass, and taking precautions against toxins at home and at work.”
Two Forms of Fitness
Separately, in another article, we explained how fitness and strength training fight cancer separately. A key finding was that muscular strength and cardiorespiratory fitness were only “moderately correlated.” This suggests that the associations between the two forms of fitness and cancer risk involve “different mechanisms.” Both strength and aerobic fitness appear to have profound and independent effects on cancer risk. A combination of the two forms of fitness, working together, would appear to be most protective—and that’s what one of the studies found. For full details, see Strength and Fitness Fight Cancer Independently http://www.cbass.com/Strengthtrainingandcancer.htm
Too Much Exercise
Finally, there has been some indication that ultra-endurance races, such as the Western States 100-mile, may weaken immunity and possibly heighten cancer risk. Writing in the July 2011 special issue of Runner’s World devoted to “Outrunning Cancer,” Amby Burfoot dismissed this concern. Burfoot quoted David Nieman, DrPH, who studied Western States competitors. “There’s no question that running Western States represents a real physiological insult,” Nieman said. Still, he concluded that “the immune resiliency displayed by [most runners] was the most impressive result.” (The special edition of Runner’s World is filled with runners who have overcome or succumbed to cancer.)
It is well-known that marathon runners often come down with colds or worst in the weeks and sometimes months after the race. This is especially true of ultra-marathoners. In a five year study of 350 athletes in the Western States Endurance Run, perhaps the same study cited by Amby Burfoot, Dr. Nieman found that one out of four runners reported sickness during the 2-week period after the race. (Medicina Sportiva, November 16, 2009)
In another study, Dr. Nieman found that runners who trained for a marathon, but ended up not running the race, had fewer colds than runners who trained for and ran the marathon.
Experts generally agree that moderate physical activity may enhance immune function. Most studies also agreed that high-intensity exercise temporarily impairs immune function.
As you’ll recall, Dr. Bortz, now in his 80s and healthy as a horse, has run a marathon every year for the last 40 years. Clearly, he doesn’t consider long distance running harmful. I would agree, but only if you are well trained—and allow plenty of time for recovery between races. Dr. Bortz fills the bill in both cases.
That’s the story on lifestyle and cancer, as I understand it. As noted earlier, cancer is a many-sided and baffling disease. We can, however, defend against it. A healthy and active lifestyle can substantially reduce the risk of developing the disease. Through lifestyle and a little luck we can prevent cancer. Then we won't need a cure. Cure is good--wonderful if you need it--but prevention is far better.
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