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Is Cancer Inevitable?

November 13, 2008 By:
Rita Charleston, JE Feature
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Because of advances in medicine and more emphasis on healthy living, people in the United States are living longer. In fact, according to recent statistics, by the year 2050, 79 million people will be older than 65.

That's the good news.

The bad news is that the single, greatest risk factor for developing cancer is aging. According to studies by the National Cancer Institute, the number of new cancer cases is about 10 times greater for people 65 years and older.

The NCI says about 60 percent of all cancers occur in this age group, with cancers of the prostate, breast, colon, pancreas, bladder, stomach, lung and rectum being the most common cancers occurring in people over 65.

The reasons for this may be understandable, but nonetheless disturbing. Abraham "Avi" Lebenthal, M.D., MHA, staff surgeon in the division of surgical oncology, division of thoracic surgery at Fox Chase Cancer Center, describes it this way:

"The longer you live, the greater your chance of having something go wrong over time.

"It's like a car breaking down, the older it gets. That's just the way it is. There are all kinds of genetic reasons and other reasons for this. We don't have all the answers, but we think of it in a very simplistic way. Cells are turning over all the time, from the time we're conceived until the day we die."

As we age, cancer happens when one of these cells starts mutating, Lebenthal explains, something that generally occurs in sequence, where it gets a little bad, then a little worse, then finally goes out of control. We have billions of cells dividing all the time, enough so that a few of them may go astray and that's how cancer develops.

But is it inevitable? "The answer is, unfortunately, yes," says Mitchell Goldstein, M.D., attending physician, division of hematology/oncology at Albert Einstein Medical Center.

Smoking Still a Concern

Echoing Lebenthal, Goldstein says, as we get older, we can acquire genetic mutations that can predispose us to cancer. Then, too, he adds, there are cell mutations that become more prevalent as we age, such as breast, lung, colorectal and prostate cancer. "Those are the four most-common cancers as we grow older. And although we see these cancers developing in people under age 50, the majority occur in older adults," says Goldstein.

One reason, based on a 2004 study published in the Journal of Clinical Oncology, may be that people with cancer over age 65 are significantly underrepresented in cancer clinical trials.

However, sitting back and accepting the inevitability of cancer as we age is not the answer, says Scott Herbert, M.D., chief of radiation oncology at Abington Memorial Hospital. "There are many cancers that we 'earn' from bad behavior," he explains.

So, he notes, we should try to live the right way and do things in moderation. "That doesn't mean you can necessarily escape cancer. We believe the environment, genetics and lifestyle all play a role in developing cancer, although we realize you can't live in a bubble."

Take breast cancer, for instance. Jewish women, particularly of Ashkenazi background, are known to inherit the BRCA I and II gene, where mutations can put these women at a higher risk of breast and ovarian cancer

The answer? The experts agree that we should learn to enjoy our lives without feeling that the sword of Damocles is forever hanging over our heads.

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