Is Cancer Due Mainly to Bad Luck
Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work
MARCH 29, 2017
We know that there are only a few cancers that can be linked to behaviors: some lung cancers are the most obvious example. The culprits then are smoking and asbestos exposure; it is important to remember that many other lung cancers are not related to either thing, and fall into the bad luck category. Some head and neck cancers are associated with (and associated is different than caused by) the combination of heavy smoking and drinking. As hard as we try to identify other carcinogens and pin our cancers on dry cleaner fluids or DDT or diets heavy in animal protein....there is really no hard data. We know about some gene mutations and the increased risk of cancer; the best known are the BRCA mutations and the higher risk of breast and ovarian cancer. That leaves luck, or the lack thereof.
I spend a lot of time trying to convince newly diagnosed people that they are not responsible for the cancer. It is not due to something you did or didn't do, something you ate or didn't eat, the way you did or did not manage stress and life. Not everyone is convinced.
This article from Medscape may help:
Cancer Mutations Mostly Due to 'Bad Luck' -- New Data
Two years ago, the media went into a tailspin over a research article in Science that suggested that many cancer types can be chalked up to random mutations, or simply "bad luck." It led to quite a bit of discussion, as well as many questions regarding the underlying methods and calculations.
The same authors have now published a second study that supports their earlier conclusions. For the new study, also published in Science, the researchers analyzed genome sequencing and epidemiologic data from 32 cancer types and concluded that DNA replication errors (R) are responsible for about two thirds of the mutations in human cancers.
This is a "complete paradigm shift in how we think of cancer," coauthor Cristian Tomasetti, PhD, assistant professor of biostatistics at the Johns Hopkins Kimmel Cancer Center and the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland, said during a press briefing. "The 65% says that the R component is here to stay, and it is a major one." It suggests that 65% of cancer is due to chance, or "bad luck" – which is the same message that caused such an uproar when it was initially suggested by the first study.