STRATEGIES FOR PREVENTION
| Conference Home Page | Presenter Bios | CMBM Home Page |
Presenters: Carolyn Aldige, Clement Bezold, Ph.D., Devra Lee Davis, Ph.D.
Commentator: James Turner, J.D.
Session: Su3; June 13, 1999I. Abstract
This session explored the concept of prioritizing cancer prevention as a primary goal of health care policy. The first speaker, Carolyn Aldige, spoke about the Cancer Research Foundation of America’s desire to assure quality control in cancer research objectives and publications. Devra Lee Davis, Ph.D., then discussed the importance of continued investigation of environmental risk factors for cancer. Clement Blezold, Ph.D., went on to explore the possibilities for cancer prevention from a futurist perspective. He suggested numerous positive expected advancements for the near future, and he cited equality of distribution and access as one of the most important prospective issues. Finally, James Turner concluded the session with a discussion of the importance of public policy reform in regulating health advances.
II. Carolyn Aldige, Cancer Research Foundation of America
Carolyn Aldige summarized the objectives of the Cancer Research Foundation of America. With the extraordinary wealth of information available concerning cancer research and research findings, it is quite difficult to decipher the good results from the bad. In the interest of clarity and translation, the Cancer Research Foundation strives to elucidate the worthwhile studies, provide funding to those worthwhile studies, and finally assure that the translation of scientific findings is effective and accessible. Ms. Aldige went into a detailed list of the studies that are currently being funded by the foundation. As cancer is such a destructive disease, a tremendous amount of research falls into a number of categories. These types of research include: investigations of dietary preventive possibilities, chemotherapeutical interventions, hormonal interventions, gene abnormalities, possible acceleration of natural human immunity, and increased early detection of disease markers. The Cancer Foundation is currently supporting a number of studies in each of these areas focused on prevention, which are listed in more detail at www.preventcancer.org. These areas of research are similar in their attempt to delineate more sophisticated methods of prevention. Not only does the Cancer Foundation put careful consideration into which projects to support, but it also assures that all projects provide substantial evidence to validate their claims.
After listing the numerous studies currently supported by the foundation, Ms. Aldige then went on to explain the method behind the distribution of funds. The Cancer Research Foundation distributes small grants to groups that may not be able to find money elsewhere. By doing so, a project may get the boost it needs to gain support from sources with larger amounts to give. Furthermore, the foundation attempts to streamline individual funder’s sources with projects in which they may be specifically interested. For example, the foundation can connect a funder with a strong family history of non smoking related lung cancer with a project studying that specific type of disease, so that the supporter will feel personally connected.
Finally, Ms. Aldige discussed the Foundation’s desire to successfully educate the public while preventing the miscommunication of important information. First, it is vital, yet very difficult, for the communication between the scientific world and the public be controlled and successful. Often, a "miracle cure" will become public without scientific support, which can easily create false hopes. The Foundation strives to prevent the spread of information without valid scientific support. Secondly, the Foundation supports various education programs, including elementary school projects, to teach children to make healthy lifestyle decisions at an early age. The Foundation also strives to equally publicize and provide both the education and the treatments to all populations. Once it has identified the worthwhile projects, in terms of both funding and results, it is just as important that the information be successfully spread to all people.
III. Devra Lee Davis, Ph.D., World Resources Institute
Devra Davis, Ph.D., of the World Resources Institute discussed various environmental risk factors of cancer, specifically when conclusive evidence is not available. She pointed out the contradiction posed by the study of risk factors versus drug treatments. In the case of drug treatments, an animal study may provide sufficient evidence for human usage; but in investigating risk factors, an animal study is insufficient. This contradiction does not make sense, considering the severity of possible risk factors that are not eliminated from an environment.
The currently accepted risk factors for breast cancer (factors with an elevated incidence among the population with a disease which are not necessarily causes but are somehow associated) include: radiation, family history, early menses, poor diet, poor exercise, late menopause, sex, and age. In addition, there are two types of environmental factors: vulnerability factors, which alter the timing and rate of exposure to risk factors; and contributing risk factors, which alter the dose of risk factors. Furthermore, there are a number of proposed positive factors, including exercise, soy, fish and olive oil, and high fiber. However, while many risk factors have been suggested, not many have been sufficiently ‘proven’ to merit elimination.
The proposed mechanism of breast cancer is related to the ratio of ‘good’ estrogen to ‘bad’ estrogen. These two types of hormones lead to opposite effects, with good estrogen actually contributing positive effects. Furthermore, bad xenohormones, such as DDE, DDT, atropine, and pesticides increase the bad to good estrogen ratio, while good xenohormones, such as omega-3 fatty acids, increase the good to bad estrogen ratio.
These mechanisms would suggest that strict measures ought to be taken to eliminate any bad xenohormones from the environment, but this has yet to be achieved. For example, Dr. Davis described the possibility of a drop in breast cancer incidence. This could be due to the decreased amount of environmental DDT, but it is difficult to study this effect conclusively because while DDT contributes harmful effects, it does not stay in the blood stream. Therefore, there can be no conclusion that DDT is responsible. Therefore, DDT will not be eliminated. In this manner, risk factors avoid elimination and continue to contribute substantial danger.
With regard to potential risk factors, Dr. Davis suggests that it is "better to be approximately right than precisely wrong." It seems absurd that we continue to expose ourselves to potential risk factors, merely because we lack the "proof" necessary to eliminate them from the environment. Rather, Dr. Davis suggested proactive policies such as the promotion of workplace safety, pollution prevention, subsidization of healthy agriculture, and integrated pest management. Through measures such as these we cannot assure the elimination of cancer, but we can promote a safer environment. Here, we can take positive steps towards encouraging a healthy lifestyle and eventually eliminating the risk of cancer.
IV. Clement Blezold, Ph.D., Institute for Alternative Futures
Dr. Blezold spoke regarding the prospective future for cancer research and cancer treatment in this country. The current rate of discovery and research suggests that amazing advancements in the field of cancer therapy are going to soon be available. Dr. Blezold suggested that soon magical chemical pills will be available, and molecular markers for early stages will be understood and accessible. Before long, genomic markers for cancer will be recognized and treated. Furthermore, he anticipates that the integration of western and eastern therapies will be vital in the coming years. Different therapies have begun to gain credit in all arenas, and he suggests that an integrated treatment specified to a genome will be the means by which we find the mechanism to cure cancer.
However, Dr. Blezold cited a tremendous concern about the disparity of U.S. health care distribution. While we are on the brink of enormous therapeutic discovery, as well as preventive care, our main agenda needs to be the assurance of equality of access to care. The greatest correlation to bad health in the United States is poverty. The elimination of health disparities must become a priority along with the research efforts. Dr. Blezold cited the Healthy People 2010 objectives, which call for a change in lifestyle by the year 2010 that will not only look for longer years of healthy life, but also for the elimination of disparities due to class distinctions.
V. James Turner, J.D., Swankin and Turner
James Turner concluded the session by broaching an important governmental conflict brought on by the prevention debate, that is, social security. As people become more interested in personal responsibility and the ability to extend life through preventive measures, the government faces the issue of social security. With an aging population, we do not have the financial resources to provide social security for so many people. Furthermore, other monetary incentives, such as the lesser investigation of vitamins due to the lesser monetary reward reflect the financially driven nature of society. We cannot let these financial concerns distract us from the ultimate goal of life.
Mr. Turner went on to suggest that we are in the midst of a revolution whereby people are more able to control their own future than ever before. Preventive measures in conjunction with healthy lifestyle choices and the integration of health care options grant people a large degree of personal choice regarding the future. Public policy needs to harness that energy in achieving the goal of longer, healthier life, even in the face of financial constraint. As individuals and as a society, we can utilize our power to make advancements in health, in both policy and lifestyle, and reap the positive rewards of such advancements.
VI. Audience Questions
How can we protect people from toxins in imported products?
The FDA is currently attempting to establish standards, but the bottom line is that you must be careful and try to recognize brand names. The protocols are being developed, but have not been completed yet.
What are the dangers of genetically altered foods?
The exact problems are unknown, and complete investigation has yet to be finished by governmental organizations. WRI is advocating for the labeling of all genetically modified foods, so that awareness can be maintained, although exact effects have yet to be delineated.
While we are getting more technologically advanced, how can we change behaviors? For example, in the AIDS crisis, treatments are becoming more advanced, but the incidence is not decreasing, due to a lack of compliance in lifestyle changes.
This is a very difficult question to answer, we can increase our study: how to motivate people to change behavior, better methods for tailoring messages to individuals, and methods for successful education programs at younger ages.
How can we more successfully publicize this kind of information?
These panel members are all interested in concentrating on successfully getting information out to the public, although it is difficult to obtain a consensus. As more people concentrate on this objective, we will find more successful and pervasive ways to distribute the information.
VII. Resources
The following websites were mentioned: