The Fellowship for Life

Clinicians, Jan Gerrit Schuurman, Medication, Patient Advocates, Researchers

Posted on Thursday, March 7th, 2013 at 6:01 PM by

By Jan Gerrit Schuurman

This is the third year of our fellowship blog. In 2009 we started a tour, which at the time was called “Three boys in search of Life”. Helped by top scientists and wise men, we embarked on what has become an immense journey.

The partnership of three grew into a fellowship. We started this tour, and were joined by many. Other individuals have become as much involved as we are. A group of patient advocates was formed and is now at the forefront of change. A fellowship for life! We have found out, through the words of wise men and through hard personal experience how complex cancer is. It is so complex because we are immersed in it. It is not just that more than 40% of the people get cancer somewhere in their lifetime. It is not just that we cannot live with and we cannot live without it, because cancer is inherent to the development of life, especially in a long life and a life worth living. The problem with cancer is also that we can do so much about it. It is a problem that can be solved, if not completely but certainly an immense portion of it. There is much we can do to prevent it from occurring. But changing our prospects requires collective action and initiative taken by many individuals in their own privacy. Taking up this responsibility and acting on it, that is our challenge.

In January 2013 the third annual conference of Inspire2Live was planned. Its theme is the reduction of incidence of cancer. The third Inspire2Live Annual Conference is again organised in cooperation with the Dutch Central Bank and Dutch Royal Academy of Arts and Sciences. The main conclusion: we know very well what to do to reduce the number of cancer patients. Tobacco use alone accounts for some 30% of all cancers. There is also much to gain from cutting down alcohol intake, reducing obesity and encouraging exercise and healthier food. Epidemiological and tumor biological research has shown that the reduction of cancer incidence should first and foremost be kick-started through improved prevention. Higher quality education with a specific focus on health at an early age is essential. But there is also an increasingly clear scientific basis for closer attention to prevention geared to citizens’ and patients’ risk profiles.

Prevention reduces cancer incidence by 40%
Prof. Gerd Gigerenzer, keynote speaker at the conference, made this remarkable statement:
The effect of screening on cancer mortality has been shown to be nil for many cancers, and small for a few. The effect of cancer drugs, for most solid cancers, is in the order of a few weeks or months of life prolonged, with heavy loss in quality of life.

An estimated 50% of all cancers are due to behavior, cigarette smoking (20-30% of all cancers), obesity, fast food, sugary drinks, and physical inactivity (10-20%), and alcohol abuse (10% in men, 3% in women). Thus, the best potential for reducing the burden of cancer is prevention, that is, health literacy.

To be successful, prevention programs has to start early in life. To tell a 15-year-old to stop smoking is too late. Eating habits are formed in childhood. The planned Groningen health literacy project starts in first grade, and continues through puberty. It will be taught by the regular teachers, e.g. embedded in sports and biology, and its goal is to make young people risk competent. The goal is not to tell them what not to do, but to help them to make their own, informed decisions.

Prevention: the main recommendations
The attendant experts in fields including cancer, nutrition, behavioral sciences and molecular biology provided the following guidelines that will help to significantly reduce the risk of cancer.

  • General: Prevent overweight and obesity (risk factor) by means of a healthy diet and exercise.
  • Tobacco: Quit smoking (smoking accounts for some 30% of all cancers).
  • Alcohol: Alcohol consumption increases the risk of cancer and does not make for a healthy lifestyle.
  • Nutrition: Eating red meat (beef and pork) poses a risk, but this does not apply to poultry or seafood.
  • Fats and sugars are not carcinogenic in and of themselves but they are more likely to cause overweight.
  • As to many other nutrients, including coffee, artificial sweeteners like aspartame and a wide range of additives that were once considered carcinogenic, there is little (or too little) evidence.
  • Exercising sensibly and more often has a preventive effect on healthy people and (former) cancer patients alike.

There is also insufficient evidence on a number of other foodstuffs that were believed to protect against cancer, including fibers, vegetables, fruit and antioxidants. However, fruit and vegetables and high-fiber food are indeed part of a healthy diet. Alcohol is not, even in small quantities.

Research on prevention in children
Many children from socially underprivileged families miss out on that knowledge and competence. This has prompted Inspire2Live to join forces with several universities at home and abroad to set up a project in Oost-Groningen aimed at familiarizing young children with the importance of healthy choices. The conference speakers and attendants were unanimous in their opinion that many improvements can be initiated top-down, involving parties like Inspire2Live, the Royal Netherlands Academy of Arts and Sciences [KNAW] and the Dutch Cancer Society [KWF], and that the community is supported regionally and locally in the development of a healthy lifestyle.

Patients are at the center
The conference was unique in that it was attended not only by physicians, scientific researchers and fund-raisers but also by a large number of patients. For two days they joined the exchange of ideas and discussions about how to better combat cancer and improve preventive action. In the months ahead, these Inspire2Live “patient advocates” as they are referred to will also be taking the lead in generating increased awareness of and dedication to prevention. All those involved considered the interaction between patients, doctors and researchers highly worthwhile and necessary to promote further action.

Bob Weinberg expressed the importance of cooperation as follows:
‘You Patient Advocates are by far more convincing when it comes to prevention then a scientist can ever be’.

A final note
Prevention is way under supported. But let us not forget treatment. While a large portion of cancers can and should be prevented, let us likewise strive for better care, better treatments, and better prospects for those who have cancer or were diagnosed with it at some point in their life. We have a multiple responsibility: getting cancer under control means we do what we can. That we reduce incidence, and we improve treatments and quality of life.

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