Fear, frustration fuel the spread of myths about cancer causes

By Kaye Spector

Plain Dealer Health and Medical Writer

 

Stop smoking. If you're overweight, drop some pounds. And exercise several times a week. Those are the things you can do to decrease your risk of developing cancer.

What's not going to do it: avoiding cell phones, underwire bras and hair dye.

Many myths persist about what causes cancer, and in recent years, their circulation has gone into overdrive because of the Internet and e-mail.

Doctors say the myths reflect the fear of cancer and frustration over not knowing its causes, coupled with a desire that the disease come from something controllable.

“A diagnosis of cancer is very scary and we often don't have a good explanation of why it occurred. So it's very natural to look for explanations that seem to make sense,” says Dr. Neal Meropol, hematology and oncology division chief of University Hospitals Case Medical Center.

Dr. Stanton Gerson, director of UH's Ireland Cancer Center, says that many myths, even though erroneous, gain credence because they have some elements of truth.

Take the one that cell phones cause brain cancer. Brain tumors tend to occur more frequently among upper socioeconomic groups and highly educated people.

Those two groups also have high cell-phone use, which may fuel the myth about the phones causing cancer.

But scientific studies have not shown a clear cause-and-effect relationship between the two.

A close examination of research results reveals that cell- phone use “really isn't associated with brain tumors,” Gerson says.

Another common cancer myth with seeds of truth is that heredity plays a large role in whether someone will develop cancer: “My mom had it, so I'm going to get it.” While it's true that some cancers are influenced by heredity, it's a small number – only about 5 percent to 10 percent.

“In most instances, it is environmental factors and behavioral factors that perhaps play the greatest role in cancer development,” Meropol says. “People are able to prevent cancer by following a healthy lifestyle and avoiding exposure to toxic substances such as tobacco.”

Doctors also need to be culturally sensitive and have a greater awareness of people's fears. Folk beliefs are not uncommon, especially among minority populations, the poor and the less-educated, the American Cancer Society says.

Gerson says doctors need to reorient conversations with their patients who ask about myths to talk about behavior that can make a difference. “Often the individual is not taking care of themselves,” he says. “Obesity, lack of exercise, those are the things that the public should be working on.”

The myth that Meropol is most eager to talk about is that cancer is a death sentence.

Cancer rates have actually declined over the past decade, and that reflects better screening as well as better treatment and healthier lifestyles, Meropol says. As researchers learn more and more about the interaction of behavior, exposure and genetic makeup, more effective treatments will be developed and more lives will be saved.

“Cancer survivors are increasing in number,” he says. “There are millions of cancer survivors who have been cured and are living normal lives.”

If you are seeking information about the causes of cancer, be cautious about health-related information you see on the Internet, advises the American Cancer Society.

Play the skeptic by evaluating the source of the information: Check to see who owns the site, make sure the sources are reliable, such as a medical research institution or hospital. Finally, ask your doctor about what you've read.

 

There are far too many myths about cancer causes to address them all. Here are a few popular ones, gleaned from the American Cancer Society, the National Cancer Institute and interviews with local oncologists.

Antiperspirants/deodorants — This myth works on the theory that antiperspirants prevent the body from eliminating dangerous toxins. But no conclusive research links the use of underarm antiperspirants or deodorants with breast cancer, the National Cancer Institute says. Additionally, breast cancer rates haven’t changed significantly since the 1930s, before most people used deodorants and antiperspirants regularly. (Now, more than 90 percent of adults regularly use deodorants.)

Artificial sweeteners — Nonsugar sweeteners got a bad name in 1981, after the U.S. National Toxicology Program’s “Report on Carcinogens” listed saccharin as a substance reasonably believed to be a human carcinogen. Experiments on rats had shown an increased risk of bladder cancer. But saccharin came off the list in 2000 after more research showed the tumors were caused by a mechanism not relevant to humans. Now, there’s no clear evidence that any artificial sweeteners available commercially in the United States are associated with cancer risk in humans, the NCI says. Studies have been conducted on the safety of several, including saccharin, aspartame, acesulfame potassium, sucralose, neotame and cyclamate.

Cell phones — A number of completed and ongoing studies have looked for a link between using a cell phone and brain tumors, says Dr. Neal Meropol, hematology and oncology chief at University Hospitals Case Medical Center. “So far they have failed to identify any increased risk, based on the type of cell phone or frequency of use,” he says. A large international study published this year found that, overall, cell-phone users have no increased risk for two of the most common types of brain tumor — glioma and meningioma. For the small proportion of study participants who reported spending the most total time on cell-phone calls, there was some increased risk of glioma, but the researchers considered this finding inconclusive, the NCI says.

Cancer cells spread when exposed to air — In a study in five urban clinics about 10 years ago, 38 percent of patients believed that cancer spreads when exposed to air during surgery. Of those, 24 percent said they would reject lung cancer surgery based on that belief. Nineteen percent said they would reject surgery even if their doctor told them the belief had no scientific basis. Meropol has encountered patients who believe this. “There really isn’t a basis for this belief,” he says.

Fluoridated water — Fluoride is added, at a rate of one part fluoride per million parts water, to public water-supply systems to prevent tooth decay. Many studies, in humans and animals, have shown no association between fluoridated water and risk for cancer, the NCI says.

Hair dye — Early hair-dye formulations contained chemicals found to cause cancer in animals, and manufacturers changed their products to eliminate some of these chemicals in the mid-to-late 1970s. Some studies have indicated that people who began using hair dyes before 1980 have an increased risk of developing non-Hodgkin’s lymphoma, but the evidence for increased risks of other cancers from hair dye use is limited and inconsistent, according to the NCI.

Mammogram radiation — The amount of radiation used in a mammogram, a low-dose X-ray picture of the breast, is very low, and the risk of any harm is extremely small, the NCI says. Patients should, however, make sure they are imaged at an American College of Radiology-accredited facility using up-to-date equipment.

Somebody else with cancer — Cancer is not a communicable disease, meaning it can’t be transmitted from person to person by close contact, Merepol says. But someone can give you human papillomavirus, a sexually transmitted disease that can cause cervical cancer or oral cancer. Also, hepatitis B and C, viruses transmitted through sexual intercourse or use of infected intravenous needles, can increase the risk of liver cancer.

Underwire bras — This theory was first floated in a 1995 book called “Dressed to Kill.” Authors Sydney Ross Singer and Soma Grismaijer claimed that women who wore tight bras all day, every day, had a much higher risk of developing breast cancer. Their theory was that underwire bras constrict the lymph system, trapping toxins. The magazine Scientific American reported that the authors failed to exclude variables such as known risk factors for breast cancer including age, family history, high-fat diet and obesity.

A weakened immune system — The “strength” of someone’s immune system does not affect the chance of developing cancer, Meropol says. However, a patient with an unusual condition such as HIV or someone who is taking immunosuppression drugs for an organ transplant are predisposed to certain cancers. “But these types of immunodeficiency conditions are very, very unusual,” says Meropol. “For people who frequently get bronchitis or the common cold, this isn’t the type of immunity problem that would lead to cancer.”
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Raw veggies can pack a punch, but cooking can unlock some key benefits

By Kaye Spector

Plain Dealer Health and Medical Writer

 

Congratulations: You've incorporated more fresh fruits and vegetables into your diet. Now the goal is to get the maximum nutritional benefit from them.

Does it matter how you prepare them? And does it make enough difference to change your food-preparation habits?

The answer is yes, preparation does matter.

Raw fruits and vegetables are good choices if you're trying to lose weight, says Nancy Farmer-Dziak, director of clinical nutrition at MetroHealth Medical Center.

In their natural state, these foods are filled with fiber, which can help you feel fuller longer and help you eat less.

“The fiber content is a plus,” says Valerie Myers, a registered dietitian for Kaiser Permanente. “Cooking is going to process the fiber out of there.”

Raw-food advocates believe uncooked food is better for more than losing weight. They say that cooking fruits and vegetables kills the vitamins and minerals and denatures enzymes that aid in digestion. Devotees of the uncooked report more energy, a healthy glow, clearer skin and better endurance.

But a growing body of scientific research supports the view that cooked vegetables are better — depending on the preparation.

Cooked carrots, spinach, mushrooms, asparagus, cabbage, peppers and many other vegetables supply more cancer-fighting antioxidants than they do when raw, according to Rui Hai Liu, an associate professor of food science at Cornell University, in a report last year in Scientific American magazine.

Research also has shown that while some raw food may contain more nutrients, our bodies cannot absorb them.

Cooking releases nutrients locked away inside the food’s cell walls, says Kristin Kirkpatrick, a registered dietitian for the Cleveland Clinic’s Lifestyle 180 program.

“I think there’s been this misconception for a very long time that you have to have vegetables in a raw state,” she says. “But we find that cooking vegetables has a benefit over their raw counterparts.”

Take lycopene, an antioxidant thought to reduce the risk of certain cancers, especially prostate cancer, and guard against heart disease.

Lycopene is found in tomatoes and other red-tinged foods such as red bell pepper. But the nutrient is only released through cooking, which breaks down the cell walls of the plant.

Raw foodies could be missing out on this important nutrient. A British study of a group of strict raw-food eaters showed they had normal levels of vitamin A and relatively high levels of beta carotene, but low levels of lycopene in their blood.

Another example is lutein, an antioxidant found in corn and dark-green leafy vegetables such as spinach and kale. Lutein protects the eyes against age-related macular degeneration, the leading cause of blindness. Cooking helps to release the lutein in corn, Farmer-Dziak says.

Accompanying ingredients also can amp up the nutritional impact. Kirkpatrick recommends sauteing zucchini in a little olive oil — a healthier, “bad”-cholesterol-lowering type of fat — or adding a small amount to cooked tomatoes.

A study at Ohio State University showed that adding a little fat while cooking tomatoes helps the body to absorb lycopene. It also helps the body soak up fat-soluble vitamins, Kirkpatrick says.

Similarly, another OSU study found that when salsa or salad was served with fat-rich avocados or full-fat salad dressing, the diner absorbed as much as four times more lycopene, seven times more lutein and 18 times the beta carotene than those who ate their vegetables plain or with low-fat dressing.

There are tradeoffs. Vitamin C often is lost in cooked produce like tomatoes. Fresh spinach loses 64 percent of its vitamin C when cooked. But vitamin C is available from other sources, such as orange juice. Lutein or lycopene — nutrients released through cooking spinach and tomatoes — is not as readily available elsewhere, so consider cooking those veggies.

Another way to maximize the potential of fruit and vegetables is to buy as freshly picked as possible. Produce loses nutrients from the moment it is harvested.

“I always teach that fresh is best,” Myers says.

Produce that is shipped long distances often is picked before it’s fully ripe. That can lessen the nutrition power, because nutrients develop while the produce matures.

Frozen fruits and vegetables are good alternatives. “If you get the right type, they are picked when they are at their best,” Myers says.

Just make sure your frozen produce has the USDA Fancy shield, which guarantees the best size, shape and color, Myers says. “They tend to have more nutrients than lower grades,” she says.

If you’re making the switch to raw fruits and vegetables from canned or processed, proceed slowly, Myers says. Many people report some digestive problems as their body becomes accustomed to the natural fiber.

If all this is too confusing to remember, an easy rule of thumb is to avoid fried vegetables or recipes that are laden with fats or sugars, Kirkpatrick says. And eat a variety of fruits and vegetables prepared in a variety of ways.

Cleveland Clinic targets added sugar in effort to make its food, drinks healthier

First it was smoking. Then it was trans fat. Now, the Cleveland Clinic is taking aim at sugar-sweetened beverages and food.

 

By Aug. 9, the Clinic and its system affiliates will no longer sell food or drinks that have added sugar or sugar variants whose names end in “-ose.”

 

The Clinic has been slowly removing sugar-sweetened foods and beverages from its facilities. Since 2007, at least 70 percent of food and drinks sold in Clinic vending machines and in its cafeterias had to be no-sugar-added. Retailers such as Au Bon Pain and Starbucks in the main-campus food court even voluntarily modified their bakery menus to comply.

 

That mandate will grow to 100 percent in the coming weeks. The main campus began to eliminate sugar-sweetened beverages about two weeks ago.

 

Drinks with artificial sweeteners still will be available. Clinic leadership is still sorting out whether to ban sugar-added food served to patients.

 

The edict came from Chief Executive Toby Cosgrove, who banned smoking on Clinic property systemwide in 2005 and abolished artery-clogging artificial trans fats systemwide in 2007.

 

More recently, the Clinic directed its food vendor to supply it with antibiotic-free meat and locally sourced produce.

 

Pop and other sweetened beverages, like bottled iced teas, energy drinks and canned lemonade, are the No. 1 source of added sugars in the U.S. diet, the American Heart Association says. Many health experts say the drinks promote diabetes and other diseases and blame them, at least in part, for the soaring U.S. obesity rate.

 

A 12-ounce can of pop, which has no nutritional value, can contain up to 10 teaspoons of sugar and 150 calories.

 

“It’s an important initiative,” said Bill Barum, the Clinic’s senior director of hospitality. “There’s been a longstanding discussion in the health care community around what a poison sugared beverages are.”

 

Barum acknowledged the new policy isn’t going to be popular with some employees, but he said hospital leaders feel strongly about not having a role in providing unhealthy food and drink to its visitors.

 

“It’s a tough thing to tell adults you can’t have any more Coke,” Barum said. “People are going to complain and get upset, but when they realize the type of impact on their health, then it really starts to hit home. We have to put a line in the sand and it’s up to the Clinic to start those kinds of things.”

 

Employees and visitors can, however, still bring their own sugary drinks and food to the Clinic or its regional hospitals.

 

Or, on the main campus, they can stop in at the food court and buy a Coke at McDonald’s.