Transcription:
Cancer: Myths and Misconceptions

Melanie Cole (Host): With so many cancer myths and urban legends out there, it really can be confusing as to what to believe. Here to debunk cancer myths while sharing cancer facts that matter is my guest Dr. May Lin Tao, she’s a board-certified radiation oncologist and a member of the medical staff at Henry Mayo Newhall Hospital. Dr. Tao, what a great topic. So let’s start with, I think one of the most common things is, god forbid, is cancer always a death sentence? Which cancers today in your expertise are seen as more readily treated?

Dr. May Lin Tao (Guest): So cancer is definitely not a death statement, in fact one of the pleasurable things I’m able to do on a regular basis is tell people that my intent is to cure them from their cancer and that the probability of cure is quite high. So the two most common cancers that you see in men separately and in women separately are prostate and breast cancer. If you take all collectively actually lung cancer is more common if take both the male and female population together, but the interesting thing is that for the more serious cancers like lung cancer, the incidence has actually be decreasing over the years. So not only has the incidence been decreasing, the actual cure rate as well has been progressively increasing over the last let’s say 10-15 years, and for the more common ones that I mentioned earlier, prostate and breast, because we tend to detect them at such an early rate for patients who are either early stage, what we call stage 1 disease, the cure rate is incredibly high, approaching greater than 90%, so that’s the kind of good news I’m often able to deliver to patients when they first come to the office.

Host: Wow that’s quite a statistic and also I think Dr. Tao with colonoscopies, low dose CT scans for lung cancer, early detection has really helped in some of those treatment rates as well. So on to some more of these interesting myths is eating sugar and cancer related and I’ve done some shows even on this, and what about some artificial sweeteners? What do you know about this?

Dr. Tao: So there’s a fallacy out there that if we eat a lot of carbohydrates or more simple sugars that that’s going to try cancer or cancer progression if you already have a cancer diagnosis, and the truth is the basic fuel for any cells, which of course is mostly healthy cells in your body is glucose, and that there’s really no evidence that depriving yourself of that primary energy source is actually going to decrease the chances of the cancer progressing, and the challenge is that if one is extreme about their diet, particularly if someone already has a cancer diagnosis and is struggling with maintaining their weight because of some of the treatment side effects, that you end up starving some of the healthier cells. So certainly you want to stay away from excess of refined sugars or processed foods, those are just not good for your general health to begin with, and if you’re thinking about how to maintain a healthy body if you’re already are still healthy, then that should be part of your larger diet anyway. There’s a lot of interesting research that’s being done about how sugar drives insulin levels and how it may effect certain growth factor searches in your body and that’s sort of the hypothesis behind why maybe sugar may drive cancer cell growth, but that’s in not really been born out when we look at actually human studies and look at the outcome for how sugar directly effects cancer progression or even cancer development. Indirectly if you have let’s say a high sugar diet, in particularly a refined sugar or processed sugar diet, you’re going to tend to be more overweight, you also tend to be a little bit less active in sort of a regular physical way and that leads to obesity and obesity is clearly a risk factor for developing cancer, but that’s sort of a progression that has to do more with how you metabolize energy and what a state of being an excessive weight does to your body as opposed to directly sugar driving cancer progression.

Host: It is, it’s sort of like the domino effect. I get what you’re saying, and also I know there’s a lot of research on high fructose corn syrup and it’s relation to cancer, but we don’t have enough time in this episode to get into that completely, so let’s try some of these others now. One that I’m particularly interested in is stress. We know that it has a little bit of a contribution to heart disease, but what about cancer?

Dr. Tao: So stressors like logical stress, physical stress clearly is not a good state to be in, whether it’s chronic or intense and there’s a lot of evidence that it clearly contributes to your general health and many medical issues like digestive problems, urinary problems, your immune system. It effects your ability to fight off infection or even be more likely to get an infection like a viral bacterial infection. It certainly effects your ability to sleep, depression, anxiety, all those things of course are related to your general health, but stress being a direct cause if you will, meaning there’s a causal link between that phenomenon and actual cancer development, there’s actually very, very poor links and certainly no convincing scientific data that that’s a direct contributor to developing cancer. Clearly there are a lot of indirect reasons why that may be related to cancer. So for example, if someone is chronically stressed, it’s been shown to lead to certain behaviors that we know are risky in terms of higher likelihood of developing cancer. For example, people are more likely to overeat, so the obesity issue as I raised earlier. They’re more likely to smoke, they may be more likely to drink alcohol, and all of those are well known to increase cancer risks, but in terms of a direct cause of cancer, that has been not, there’s really essentially no convincing information in large population studies to show that to be the case.

Host: So thank you for that answer, it makes me feel a little bit better. So onto – I have so many questions for you Dr. Tao – can a mammogram or a biopsy cause cancer to spread? There were books written about this, people were concerned. Tell us about that.

Dr. Tao: So I think the concern about, first we’ll just speak about mammogram, as you said causing cancer – so there’s a general really now it’s become kind of a public health announcement, if you’re a healthy person, you want to be judicious about how you expose yourself to x-rays. So there’s a lot of fear about let’s say dental x-rays or x-rays being done for chest x-rays or things like that. Mammograms is also an exposure to x-rays. So if there’s no real medical purpose or screening purpose for an entity that could potential be life threatening and that is relatively common, relatively common in a population, then one shouldn’t willy-nilly exposure themselves to x-ray. There should be some real purpose behind doing that, and so what we’ve learned with large studies, not only in the United States, but in Canada, in Europe, in Sweden, they’ve done a lot of this work, that if you do mammograms then generally the radiation exposure is very low and you’re doing them in an age group of women in which the incidence starts to rise for breast cancer like greater than 50 or 50 and higher and you know that early pickup as we discussed earlier will lead to a much, much curable cancer that in the whole scope of things, that little bit of exposure which of course leads to the fear of inducing a cancer, is going to be far outweighed by the benefit of detecting a relatively common cancer in an early, early stage that’s highly, highly curable. So the principle of yes we want to reduce our exposure of x-rays in general, I like to think about it as we want to reduce our exposure of x-rays when not done for any real purpose or any benefit other than just sort of curiosity or worry or anxiety just to kind of placate us that we don’t see anything on x-ray for a problem or just again willy-nilly exposure, but when you’re applying in a very specific purpose like in this breast cancer surveillance example, the pickup and the ability to detect something very early in a relatively common cancer far outweighs any of that small, small risk of having that exposure.

Host: Now what about cell phones? What do you know about that? Do they cause cancer?

Dr. Tao: So cell phones, of course there’s a lot of concern about that because the amount of cell phone use has increased dramatically in the last decade or last two decades and there is what we call radiofrequency radiation, which – or radio waves more commonly called, but it’s important to understand that those are not ionizing radiations, what we call very, very low frequency radiation. The same applies also when we talk about Bluetooth or any Wi-Fi enabled devices, and the – because cell phones are so ubiquitous and there is this “exposure” of some kind of radio wave, there’s been this concern that maybe we’re actually doing harm to ourselves. Well I think it’s first important to remember that cancer, unless we’re talking about a hereditary situation, is caused by a sporadic genetic mutation and generally speaking when we talk about radiation, whether it’s causing that – we’re talking about ionizing radiation that caused the damage to the gene, so when you’re talking about very low frequency radiation which is nonionizing, the mechanistic process where you even develop the mutation which leads to cancer, isn’t even there as a baseline. Nonetheless, there is this concern in there, but a number of studies now, large population of studies, as well as some animal studies trying to look at what cell phone exposure will lead to in terms of cancer. A lot of the cancers have been focused on of course the head and neck area, which is where we hold our cell phones both for malignant tumors, like brain tumors so called lipomas or even benign tumors of the head and neck areas like meningiomas or benign tumors of the parotid gland, which is the salivary gland that goes around your ear, and basically there’s been no convincing information to say that we can consistently show that there’s a relationship between that. Part of this is to be honest, and the reason why we use hedging words like inconsistent and not convincing, is these things are actually very, very hard to study. How do you study cell phones? You have to rely on data from the telephone company or data from cell service providers or users we’re reporting on that is very, very difficult and then the intensity of the use is very, very difficult, but best we can tell there’s been no convincing information about that, but all large, scientific bodies still say that it’s something that warrants continual study despite the fact that there’s no clear adverse effects. I would like to point out that probably the most dangerous things about cell phones isn’t about the risk for cancer but it’s about the way we use cell phones. So there’s lots of information about cell phones, even in this day and age, is a distracting device and leads to a lot of really preventable accidents, whether they’re car accidents or even pedestrian accidents so that actually far outweighs any damaging effects from cell phones related to cancer risk and that’s something that I think a lot of people frankly accept and put themselves at risk for every day.

Host: Agreed, absolutely, now here’s a big one and we don’t have a lot of time. I’d like to get through a few more, Dr. Tao if we could. There’s a cure, but big pharma’s hiding it. What do you think about that one?

Dr. Tao: Well [laughter] with the level of how knowledge is disseminated now and the availability of information on almost any platform you can imagine, it would be almost unfathomable that big pharma is hiding such an incredible secret, and so I think we all are a little bit of skeptics in the world. I mean I think this society kind of creates that, but there really is no big secret out there. The other challenge with the “cure for cancer” is that cancer isn’t a single diagnosis. The way people develop certain kinds of cancers, even though I said that generally speaking it occurs because of the mutation that sporadically occurs as opposed to inherited, although in a small percentage of patients does occur, the kind of mutation, the way the mutation occurs, how the mutation leaves the cancer, the manifestation of the cancer, how the cancer is responsive to different agents, whether you’re talking about drug therapy like chemotherapy or targeted therapies or even immunotherapy or surgery or radiation, is so specific to that cancer, it’s not possible that there will actually be a single cure for all of the big C or cancer. So it’s a lot, lot more complex than that. There’s no way that anyone could be the holder and hence the denier of the one answer to this whole –

Host: The one answer, the magic pill that we’re all looking for. Last question Dr. Tao, does a positive attitude really help with cancer treatments? You are a radiation oncologist, you see people going through treatments and therapy every day, does it help when they are hopeful or spiritual or have a great support system? Give us your best advice about positive attitude going through these type of treatments.

Dr. Tao: I think what having a positive attitude really leads to is how you experience the whole event as opposed to necessarily, is it going to make you more likely to survive your breast cancer or your prostate cancer, whatever kind of potentially deadly cancer? If you have a more positive attitude, you’re more likely to seek out support, you’re more likely to have social connection. You’re less likely to experience depression and anxiety and that may indirectly lead to you also taking better care of yourself, meaning attending to certain things that are related to you being able to get through some of the side effects of the treatment, potentially leading to you having less delays in your treatment, which we know can directly impact the curability of your cancer. So there may be some indirect things that have to do with you being able to get through the experience or the treatment process in a way that adheres to all the protocols but it in terms of the attitude specifically directly impacting your cancer outcome, there’s less of that but we all know as we’re going through anything, if we experience something in a better way, so essentially our quality of life, that’s as meaningful or as impactful as let’s say a foreshortened or a longer period of life. So that’s what I see, is that people are able to handle the experience or tolerate the treatment consequences much, much better than if they have a poor attitude.

Host: Thank you so much for clearing up some of those myths and busting up some of those misconceptions, people have so many, and we could have gone through about 40 questions here Dr. Tao. There’s just so many, so we’d love to have you on again to clear up some more of them and thank you again for joining us today, and that wraps up another episode of It’s Your Health Radio with Henry Mayo Newhall Hospital. Head on over to our website at henrymayo.com for more information and to get connected with one of our providers. If you found this podcast as cool as I did, with so much great information, share it with your friends, share it on your social media, be sure to check out all the other fascinating podcasts in our library. I’m Melanie Cole.