Cancer and the Crab
Have you ever wondered why cancer is represented as a crab? The origins of this connection can be traced back to Hippocrates, known as the Father of Medicine, but it was the Roman physician Celsus who translated the Greek word carcinos to cancer, which means crab in Latin. Interestingly, these ancient doctors seemed to have a prophetic insight, as cancer, once considered a disease of old age, is now affecting more and more young people. Doctors are perplexed by this shift, struggling to determine the causes and identify those at high risk.
A recent story published in the Wall Street Journal tells the story of a 27-year-old law student who was preparing for her bar exams and planning her move to New York City. In June of last year, she began vomiting blood and was later diagnosed with gastric cancer. Six months later, during the holiday season, her stomach was surgically removed, drastically altering her life in terms of her identity, diet, health, and relationships.
What has changed about cancer?
The face of cancer has changed significantly over the years. Previously, it was a disease affecting individuals over the age of 50, but since the 1990s, it has extended its reach like the arms of a crab. Recent studies by Zhao J. Xu L published in BMJ Oncology have shown a staggering global increase of 79% in early onset cancer cases and a 27.7% rise in deaths among individuals under the age of 50 from 1990 to 2019. The highest mortality rates are attributed to early onset cancers of the breast, trachea, bronchus, lung, stomach, colon, and rectum. Those between the ages of 40-49 and belonging to high middle and middle Sociodemographic Index in certain countries are particularly affected. Doctors are left puzzled, with further studies needed to understand why younger people are increasingly falling victim to cancer and to identify those at high risk.
According to the study, dietary risk factors play a significant role in early onset cancers. The risk factors for breast cancer include alcohol consumption, smoking, a high red meat diet, lack of physical activity, and elevated fasting glucose levels. Unsurprisingly, tobacco smoking is the primary risk factor for trachea, bronchus, and lung cancer, along with a low fruit diet and high fasting blood glucose. Colorectal cancer risk factors include dietary risks, alcohol use, tobacco smoking, low physical activity, high body mass index, and elevated fasting blood glucose. When it comes to colorectal cancer, specific dietary risks include low milk consumption, lack of whole grains, and insufficient calcium intake. Early onset stomach cancer is linked to two risk factors: tobacco smoking and a diet high in sodium.
The adoption of a Western diet, characterized by dietary risk factors, has led to high rates of obesity. Additionally, pollution, such as microplastics, and a sedentary lifestyle may have contributed to the rise in early onset cancers, according to studies by Murray et al as published in Lancet in 2020. Another study focusing on cancer trends in young adults in the US revealed that smoking, alcohol consumption, and high-risk pregnancies may have played a role in the incidence of early onset cancer.
What actions are taken by the medical community?
The medical community is desperate to identify those at high risk, as a new generation will be grappling with this disease, according to Dr. Kimmie Ng of Dana Farber Institute. The American Cancer Society has recommended that colorectal cancer screening be started at age 45 instead of age 50. The US has increased the proportion of women 21-65 years old for cervical cancer screening as part of Healthy People 2020 objectives for use of screening tests for cancer.
What is truly unsettling is that cancer can strike seemingly healthy individuals, as observed by Dr. Nancy You, a colorectal cancer surgeon at the University of Texas MD Anderson Cancer Center. She recounts cases such as a 37-year-old triathlon athlete and a 40-year-old mother who visited the emergency room multiple times, only to be diagnosed with rectal cancer that had already spread to her liver.
To gain a better understanding of the disease, Dr. You and her colleagues have studied bacteria found in rectal cancer tissues from patients. They found that diet, use of antibiotics including other factors may trigger inflammation and increase the risks for cancer.
What can we do for ourselves?
The primary factor contributing to the early onset of cancer is believed to be diet. Specifically, a diet that is high in red meat, sugar, and sodium, while being low in fruits, whole grains, milk, and calcium, has been linked to the highest mortality rates for these types of cancers. It is important to note that unhealthy habits such as tobacco smoking, alcohol consumption, and a lack of physical activity are also mentioned as additional risks alongside poor dietary choices. Considering this information, the most logical course of action would be to reduce these risks by adopting a healthy lifestyle.
To start one’s quest for a healthy lifestyle if one hasn’t explored it yet, one can start exploring the Flexetarian Diet, which was developed by Dietitian Dawn Jackson Blatner. This diet promotes the concept of eating in moderation, especially animal products while consuming a whole lot of whole grains, fruits, vegetables, and plant protein found in legumes. It’s a semi-vegetarian diet that puts less emphasis on what is prohibited but rather what to include in one’s diet. A study by Orlich MJ et al published in JAMA Internal Med showed that a vegetarian diet is associated with reduced cancer incidence in general and colorectal cancer in particular.
In addition to improving dietary choices, it is crucial to eliminate unhealthy habits from our lives. This includes quitting smoking, avoiding excessive alcohol consumption, and embracing a more active lifestyle. Engaging in regular exercise, participating in sports, or simply incorporating regular walking into our daily routines can significantly contribute to a healthier lifestyle. One’s primary care physician may be helpful if one needs a support group to quit alcohol for example.
By making these changes and adopting a holistic approach to our overall well-being, we can effectively reduce the risks associated with early onset cancer. It is essential to prioritize our health and make conscious choices that support a healthy lifestyle.
References:
1. Zhao J, Xu L, Sun J, et al; Global Trends in incidence, death, burden and risk factors of early onset cancer from 1990 – 2019; BMJ Oncology; 2023;2:e000049. doi:10.1136/ bmjonc-2023-000049; Received 14 February 2023 Accepted 18 May 2023
2. Understanding What Cancer is: Ancient Times to the Present; American Cancer Society
3. Cancer is Striking More Young People, and Doctors Are Alarmed and Baffled; The Wall Street Journal; January 11, 2024
5. Murray CJL, Aravkin AY, Zheng P. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet 2020; 396:1223–49.
6. Sung H, Siegel RL, Rosenberg PS, et al. Emerging cancer trends among young adults in the USA: analysis of a population-based cancer Registry. Lancet Public Health 2019;4:e137–47.
7. Hall IJ, Tangka FKL, Sabatino SA, et al. Patterns and trends in cancer screening in the United States. Prev Chronic Dis 2018;15:E97
8. Ladabaum U, Mannalithara A, Meester RGS, et al. Cost-effectiveness and national effects of initiating colorectal cancer screening
9. Orlich MJ, Singh PN, Sabaté J, Fan J, Sveen L, Bennett H, Knutsen SF, Beeson WL, Jaceldo-Siegl K, Butler TL, Herring RP, Fraser GE. Vegetarian dietary patterns and the risk of colorectal cancers. JAMA Intern Med. 2015 May;175(5):767-76. doi: 10.1001/jamainternmed.2015.59. PMID: 25751512; PMCID: PMC4420687.
Assessed and Endorsed by the MedReport Medical Review Board