8 ms·

Oncologists on simple, doable, everyday things they do to try to prevent cancer

65 points by robaato 2y ago

hsdropout 2y ago
1. Don’t smoke 2. Try to maintain a healthy weight 3. Reduce your meat intake 4. Avoid ultra-processed foods 5. Drink less alcohol 6. If you notice anything you are worried about, see a doctor 7. Keep up to date with screenings 8. Get physical 9. Wear sunscreen 10. Manage stress 11. Look into genetic risk 12. When faced with a diagnosis, knowledge is power 13. Don’t fear treatment 14. Talk about it 15. Live life to the full
- dxbydt 2y ago
  I'm not an oncologist. But I'm married to one. So she tells me these rules on an almost daily basis. Also, many of her cancer patients don't make it - and then she tells me - this person didn't make it because he/she broke this rule #xyz in that list. I mean, ok, I get it. I work in ML in an enterprise. So everyday we have our usual litany of complaints. This item is not ranked correctly. Boosting isn't working on that item. Human overrode the item recommendation and now the faceting is broken. Search is running out of memory. P2 alert!!! program crashed and we are losing $10000 per hour wake up the programmers in the middle of the night... So I can also play this rule game. 1. Don't use computer. 2. If you must use computer, don't program. 3. If you must program, please let it not be in Java. 4. If it is Java, please don't call Python ML code from it. 5. Better yet, don't use ML at all if you have humans overriding recs. 6. Don't cache everything to reduce latency. You'll run out of memory. 7. If you run out of memory don't wake up the fucking programmer in the middle of the night when he's trying to get some action. and so on...I mean, what purpose does it serve ? You can't get programmers in 2024 to stop using hadoop and sprintboot and whatever ancient enterprisecrap. You expect to get Americans to eat less meat, drink less, maintain healthy weight ? With an official obesity rate of 39%, the non-cookedup version hovering in the 70s ? Fat chance.
  - disqard 2y ago
    > Fat chance. I see what you did there.
- amelius 2y ago
  Is this an ordered list?
  - Horffupolde 2y ago
    On some measurement function F.
  - brookst 2y ago
    If so, 15 is a really funny lowest priority.
    - dghughes 2y ago
      And most of the steps above are how to live a full enjoyable life.
    - reginald78 2y ago
      A guy goes to his doctor and when the doctor asks if he has any questions he asks the doctor, "Doc, what do I have to do to live to 100?" "Well," the doctor says "you have to quit smoking." "No problem, I don't smoke" the guys says. "And no drugs." "OK, no problem, what else?" the guys says "You have to exercise five times a week." The guy pauses for a moment and says, "Anything else?" "No processed foods or fast food. And no alcohol. Stay out of the sun and always get a good night's sleep." Looking irritated the guy says, "And if I do all that I'll definitely live to be 100?" "Well, no" says the doc, "But it'll feel like it."
    - jimbokun 2y ago
      In context of the article was clearly put last to be the most important take away and what the reader is most likely to remember.
  - freilanzer 2y ago
    Does not seem to be the case.
  - croisillon 2y ago
    from tangible to abstract maybe
- pharaohgeek 2y ago
  Young-ish cancer survivor here. I would add "9a. Don't ever go to a tanning salon" to this list, per my oncologist. There are genetic factors that caused my cancer, so naturally I was worried about recurrence. Her comments to me? "Do you smoke? No? Good. Don't start. Do you visit tanning salons? No? Good. Don't start." The rest falls into "trying to live a moderately healthy lifestyle". Oh, and definitely #6. If something doesn't seem/look/feel right then have a doctor check it out.
  - Mistletoe 2y ago
    Did you get skin cancer? I’ve often wondered if the higher vitamin D we get from the sun or even tanning beds outweighs the risks from melanoma. Low vitamin D is a big risk factor in the modern world. https://ajcn.nutrition.org/article/S0002-9165(22)03753-4/ https://ajcn.nutrition.org/article/S0002-9165(22)03753-4/ https://ar.iiarjournals.org/content/38/2/1111 https://ar.iiarjournals.org/content/38/2/1111 > Therefore, we rebut these conclusions by addressing the incomplete analysis of the adverse health effects of UV and sunbed exposure (what is ‘safe’?) and the censored representation of beneficial effects, not only but especially from vitamin D production. The stance taken by both agencies is not sufficiently supported by the data and in particular, current scientific knowledge does not support the conclusion sunbed use increases melanoma risk.
    - pharaohgeek 2y ago
      No, my cancer was a sarcoma in my left shoulder.
    - AlexandrB 2y ago
      To get enough vitamin D you need ~10 minutes a day[1] in direct sunlight with 25% skin exposed. > In spring and summer, 25 percent of the body (the hands, face, neck and arms) is exposed to the sun, and in these seasons, about 8 to 10 minutes of sun exposure at noon produces the recommended amount of vitamin D. [1] https://www.uclahealth.org/news/article/ask-the-doctors-round-sun-exposure-vital-to-vitamin-d-production https://www.uclahealth.org/news/article/ask-the-doctors-roun...
- jvanderbot 2y ago
  Arguably, I think exercise should be #1. EDIT: Assuming they are ordered, otherwise ignore me. Cancer is about 20% of your chance of death. Intuitively exercise helps with many things on this list. The other (roughly) 25% is cardiovascular/cerebrovascular events. For that, the best thing you can do is exercise. https://news.ycombinator.com/item?id=18264323 https://news.ycombinator.com/item?id=18264323 Then there's COVID (12), alzheimer + diabetes (6) and a smattering of "other causes" https://www.cdc.gov/nchs/data/databriefs/db492-tables.pdf#4 https://www.cdc.gov/nchs/data/databriefs/db492-tables.pdf#4 For a less trite list with really solid scientific backing, try the book Outlive.
  - soco 2y ago
    I would have thought #8 was exactly that, right?
    - jvanderbot 2y ago
      Yes I suppose - edited to limit to ordered lists only. I'll leave it up for the links.
- _mlbt 2y ago
  Also, several types of preventable cancer are caused by the Human Papilloma Virus (HPV). Get vaccinated for it. Although this virus is primarily associated with cervical cancer, men should be vaccinated for it as well since it can cause penile, oral, anal, and other cancers.
  - bckr 2y ago
    And you can give it to your cervix-owning partners.
- alexpetralia 2y ago
  And something about sleep
valgor 2y ago
I know they are trying to be practical with "reduce meat intake" and "drink less", but meat and alcohol is on par with smoking and they say "don't smoke". I hope we get to a point where we can say "don't eat meat or drink alcohol" just like we say "don't smoke". If the point is to stop cancer from happening, not doing any of those things is huge.
- kvgr 2y ago
  He says that the reporting of nutritional data about cancer can be very confusing, and references the work of the statistician David Spiegelhalter from the University of Cambridge, who has shown that even if everyone ate an extra 50g of bacon every day, that would only increase the incidence of colon cancer from 6% to 7%. “I think it is about having a healthy, balanced diet,” says Sivakumar, “and occasionally having a sweet treat or a steak.” Def not on par with smoking.
  - valgor 2y ago
    Processed red meat is a class one carcinogen and red meat is a class two. Smoking is a class one. What this means is there is a direct, provable correlation to consuming these products to cancer. Sure, a cigarette may not cause the same level of harm as one steak, but they both cause cancer. So, if you goal is to reduce as far and wide as possible your chances of cancer, meat should be off the plate. The "balance" approach is only to be practical, so I find it odd we never say to have a balanced approach with smoking, but we will with red meat.
    - Aperocky 2y ago
      Just because they are both class one doesn't mean they are on the same level quantitatively. Also red meat doesn't cause addiction. I don't feel like I crave red meat if I've just been eating chicken and fish for the whole week.
    - treprinum 2y ago
      Fresh unprocessed red meat is not directly known to cause cancer but it's implicated by the association to smoked/processed red meat that is a strong carcinogen. IARC says that maybe it can increase the risk of certain cancers but there is no direct evidence like with processed red meat.
4ad 2y ago
> If you notice anything you are worried about, see a doctor. Yeah, good luck with that. I've had several relatives who all eventually died of cancer who tried to get their symptoms checked for years only to get bullshit answers like "it's only stress" or false, or incomplete diagnostics. Personally I have a quite severe back pain issue and I have not managed to find a doctor to send me for an MRI for over 12 years now.
- vidarh 2y ago
  In the UK at least, the main difficulty in getting referrals for MRIs is that the evidence for their efficacy at improving outcomes is low enough that unless there are other indicators you're usually referred for physiotherapy first. But at the same time for those willing to go private you can get a same day MRI for down to a few hundred pounds many places.
  - soared 2y ago
    In the US I tore my hamstring very badly. Insurance did not approve an MRI under the reasoning “We know it’s torn, an MRI does not provide actionable information”. Therefore the decision to do surgery or not, and all of my treatment options were barely informed at all.
    - 4ad 2y ago
      In Austria a lot of doctors (most?) don't understand that MRIs do not use ionizing radiation (unlike CT scans) and will refuse to schedule a MRI for you, even if you are willing to pay and go private. If you think this is crazy I will also pont out that homeopathy was invented in Austria and many doctors currently prescribe homeopathic "treatments". You have to specifically state that you don't want homeopathic "medicine" every time you visit a doctor or go to the pharmacy.
      - cloverich 2y ago
        Are the doctors prescribing homeopathic medicine real (M.D. equivalent) doctors? It seems wild to me the equivalent of a board certified physician would prescribe treatments that don't work (in theory or practice); but if they have the equivalent of e.g. our Chiropractors there, would make more sense.
imjonse 2y ago
TIL that 40% of cancers are preventable.
- readthenotes1 2y ago
  Which reduces your risk from roughly .5% down to .3% by age 49. https://www.cancer.gov/about-cancer/causes-prevention/risk/age https://www.cancer.gov/about-cancer/causes-prevention/risk/a...
- patates 2y ago
  Not opposing or anything but how do you even measure that? Really asking to see if anyone knows / has an idea.
  - 3D30497420 2y ago
    I don't know off-hand, but probably a longitudinal survey of cases and pretty rough estimates. It is probably made a bit easier by there being some big chunks which are (likely) more clearly attributable to behavioral choices: smoking-related, sun exposure, and probably some occupational (chemical exposure, etc.).
  - LordKeren 2y ago
    It’s pretty straight forward— you compare the average risk for individuals to the rates for those exposed to carcinogens. For instance, if a population of people develops lung cancer at a rate of 2% by age 70, and a population of smokers has a rate of 10% by age 70– the difference between the base line and the exposed populations becomes the “preventable” count.
    - deleted 2y ago
      [deleted]
deleted 2y ago
[deleted]
Kalanos 2y ago
Why is the advice "Try to maintain a healthy weight?" Just maintain it. Sure, some people are genetically predisposed to obesity, but we should stop coddling the rest. Obesity puts you at 300% risk for cancer and several other lethal diseases. A great place to start is by not spending money on drinks that contain sugar and carbs - drink water. The recipe for healthy weight is 85% diet (less carbs) and 15% exercise (elevated heart rate). Check out the books: Cancer Code, Obesity Code, Diabetes Code
- Ekaros 2y ago
  Also stop being poor. Just earn more and spend less. Then spend the money you earned and saved to improve living conditions so you have less risks. It is very simple and no one should have any trouble with it. /s
  - Kalanos 2y ago
    woah woah woah. can you please phrase that as "try to earn more and try to spend less" we don't want to offend anyone here
- ajross 2y ago
  Your point is what, that behavioral disorders aren't disorders? Do you give the same advice to addiction patients or anxiety or OCD sufferers? Some people have an easier time controlling some behaviors that some other people, and that fact is important where it intersects with health and worthy of consideration as a "medical" condition worthy of treatment, and not knee-jerk judgement on HN. Surely you personally are a skinny guy whose never had trouble with weight. Equally surely there's some behavioral quirk you have that you'd like to change but have struggled with. So... maybe hold off on the "just do it" framing?
  - Kalanos 2y ago
    Notice that everything else is phrased as "Don't smoke." It's tiptoeing around obesity
- infecto 2y ago

65 points by robaato 2y ago

1. Don’t smoke 2. Try to maintain a healthy weight 3. Reduce your meat intake 4. Avoid ultra-processed foods 5. Drink less alcohol 6. If you notice anything you are worried about, see a doctor 7. Keep up to date with screenings 8. Get physical 9. Wear sunscreen 10. Manage stress 11. Look into genetic risk 12. When faced with a diagnosis, knowledge is power 13. Don’t fear treatment 14. Talk about it 15. Live life to the full

dxbydt 2y ago
I'm not an oncologist. But I'm married to one. So she tells me these rules on an almost daily basis. Also, many of her cancer patients don't make it - and then she tells me - this person didn't make it because he/she broke this rule #xyz in that list. I mean, ok, I get it. I work in ML in an enterprise. So everyday we have our usual litany of complaints. This item is not ranked correctly. Boosting isn't working on that item. Human overrode the item recommendation and now the faceting is broken. Search is running out of memory. P2 alert!!! program crashed and we are losing $10000 per hour wake up the programmers in the middle of the night... So I can also play this rule game. 1. Don't use computer. 2. If you must use computer, don't program. 3. If you must program, please let it not be in Java. 4. If it is Java, please don't call Python ML code from it. 5. Better yet, don't use ML at all if you have humans overriding recs. 6. Don't cache everything to reduce latency. You'll run out of memory. 7. If you run out of memory don't wake up the fucking programmer in the middle of the night when he's trying to get some action. and so on...I mean, what purpose does it serve ? You can't get programmers in 2024 to stop using hadoop and sprintboot and whatever ancient enterprisecrap. You expect to get Americans to eat less meat, drink less, maintain healthy weight ? With an official obesity rate of 39%, the non-cookedup version hovering in the 70s ? Fat chance.
- disqard 2y ago
  > Fat chance. I see what you did there.
amelius 2y ago
Is this an ordered list?
- Horffupolde 2y ago
  On some measurement function F.
- brookst 2y ago
  If so, 15 is a really funny lowest priority.
  - dghughes 2y ago
    And most of the steps above are how to live a full enjoyable life.
  - reginald78 2y ago
    A guy goes to his doctor and when the doctor asks if he has any questions he asks the doctor, "Doc, what do I have to do to live to 100?" "Well," the doctor says "you have to quit smoking." "No problem, I don't smoke" the guys says. "And no drugs." "OK, no problem, what else?" the guys says "You have to exercise five times a week." The guy pauses for a moment and says, "Anything else?" "No processed foods or fast food. And no alcohol. Stay out of the sun and always get a good night's sleep." Looking irritated the guy says, "And if I do all that I'll definitely live to be 100?" "Well, no" says the doc, "But it'll feel like it."
  - jimbokun 2y ago
    In context of the article was clearly put last to be the most important take away and what the reader is most likely to remember.
- freilanzer 2y ago
  Does not seem to be the case.
- croisillon 2y ago
  from tangible to abstract maybe
pharaohgeek 2y ago
Young-ish cancer survivor here. I would add "9a. Don't ever go to a tanning salon" to this list, per my oncologist. There are genetic factors that caused my cancer, so naturally I was worried about recurrence. Her comments to me? "Do you smoke? No? Good. Don't start. Do you visit tanning salons? No? Good. Don't start." The rest falls into "trying to live a moderately healthy lifestyle". Oh, and definitely #6. If something doesn't seem/look/feel right then have a doctor check it out.
- Mistletoe 2y ago
  Did you get skin cancer? I’ve often wondered if the higher vitamin D we get from the sun or even tanning beds outweighs the risks from melanoma. Low vitamin D is a big risk factor in the modern world. https://ajcn.nutrition.org/article/S0002-9165(22)03753-4/ https://ajcn.nutrition.org/article/S0002-9165(22)03753-4/ https://ar.iiarjournals.org/content/38/2/1111 https://ar.iiarjournals.org/content/38/2/1111 > Therefore, we rebut these conclusions by addressing the incomplete analysis of the adverse health effects of UV and sunbed exposure (what is ‘safe’?) and the censored representation of beneficial effects, not only but especially from vitamin D production. The stance taken by both agencies is not sufficiently supported by the data and in particular, current scientific knowledge does not support the conclusion sunbed use increases melanoma risk.
  - pharaohgeek 2y ago
    No, my cancer was a sarcoma in my left shoulder.
  - AlexandrB 2y ago
    To get enough vitamin D you need ~10 minutes a day[1] in direct sunlight with 25% skin exposed. > In spring and summer, 25 percent of the body (the hands, face, neck and arms) is exposed to the sun, and in these seasons, about 8 to 10 minutes of sun exposure at noon produces the recommended amount of vitamin D. [1] https://www.uclahealth.org/news/article/ask-the-doctors-round-sun-exposure-vital-to-vitamin-d-production https://www.uclahealth.org/news/article/ask-the-doctors-roun...
jvanderbot 2y ago
Arguably, I think exercise should be #1. EDIT: Assuming they are ordered, otherwise ignore me. Cancer is about 20% of your chance of death. Intuitively exercise helps with many things on this list. The other (roughly) 25% is cardiovascular/cerebrovascular events. For that, the best thing you can do is exercise. https://news.ycombinator.com/item?id=18264323 https://news.ycombinator.com/item?id=18264323 Then there's COVID (12), alzheimer + diabetes (6) and a smattering of "other causes" https://www.cdc.gov/nchs/data/databriefs/db492-tables.pdf#4 https://www.cdc.gov/nchs/data/databriefs/db492-tables.pdf#4 For a less trite list with really solid scientific backing, try the book Outlive.
- soco 2y ago
  I would have thought #8 was exactly that, right?
  - jvanderbot 2y ago
    Yes I suppose - edited to limit to ordered lists only. I'll leave it up for the links.
_mlbt 2y ago
Also, several types of preventable cancer are caused by the Human Papilloma Virus (HPV). Get vaccinated for it. Although this virus is primarily associated with cervical cancer, men should be vaccinated for it as well since it can cause penile, oral, anal, and other cancers.
- bckr 2y ago
  And you can give it to your cervix-owning partners.
alexpetralia 2y ago
And something about sleep

valgor 2y ago

I know they are trying to be practical with "reduce meat intake" and "drink less", but meat and alcohol is on par with smoking and they say "don't smoke". I hope we get to a point where we can say "don't eat meat or drink alcohol" just like we say "don't smoke". If the point is to stop cancer from happening, not doing any of those things is huge.

kvgr 2y ago
He says that the reporting of nutritional data about cancer can be very confusing, and references the work of the statistician David Spiegelhalter from the University of Cambridge, who has shown that even if everyone ate an extra 50g of bacon every day, that would only increase the incidence of colon cancer from 6% to 7%. “I think it is about having a healthy, balanced diet,” says Sivakumar, “and occasionally having a sweet treat or a steak.” Def not on par with smoking.
- valgor 2y ago
  Processed red meat is a class one carcinogen and red meat is a class two. Smoking is a class one. What this means is there is a direct, provable correlation to consuming these products to cancer. Sure, a cigarette may not cause the same level of harm as one steak, but they both cause cancer. So, if you goal is to reduce as far and wide as possible your chances of cancer, meat should be off the plate. The "balance" approach is only to be practical, so I find it odd we never say to have a balanced approach with smoking, but we will with red meat.
  - Aperocky 2y ago
    Just because they are both class one doesn't mean they are on the same level quantitatively. Also red meat doesn't cause addiction. I don't feel like I crave red meat if I've just been eating chicken and fish for the whole week.
  - treprinum 2y ago
    Fresh unprocessed red meat is not directly known to cause cancer but it's implicated by the association to smoked/processed red meat that is a strong carcinogen. IARC says that maybe it can increase the risk of certain cancers but there is no direct evidence like with processed red meat.

4ad 2y ago

> If you notice anything you are worried about, see a doctor. Yeah, good luck with that. I've had several relatives who all eventually died of cancer who tried to get their symptoms checked for years only to get bullshit answers like "it's only stress" or false, or incomplete diagnostics. Personally I have a quite severe back pain issue and I have not managed to find a doctor to send me for an MRI for over 12 years now.

vidarh 2y ago
In the UK at least, the main difficulty in getting referrals for MRIs is that the evidence for their efficacy at improving outcomes is low enough that unless there are other indicators you're usually referred for physiotherapy first. But at the same time for those willing to go private you can get a same day MRI for down to a few hundred pounds many places.
- soared 2y ago
  In the US I tore my hamstring very badly. Insurance did not approve an MRI under the reasoning “We know it’s torn, an MRI does not provide actionable information”. Therefore the decision to do surgery or not, and all of my treatment options were barely informed at all.
  - 4ad 2y ago
    In Austria a lot of doctors (most?) don't understand that MRIs do not use ionizing radiation (unlike CT scans) and will refuse to schedule a MRI for you, even if you are willing to pay and go private. If you think this is crazy I will also pont out that homeopathy was invented in Austria and many doctors currently prescribe homeopathic "treatments". You have to specifically state that you don't want homeopathic "medicine" every time you visit a doctor or go to the pharmacy.
    - cloverich 2y ago
      Are the doctors prescribing homeopathic medicine real (M.D. equivalent) doctors? It seems wild to me the equivalent of a board certified physician would prescribe treatments that don't work (in theory or practice); but if they have the equivalent of e.g. our Chiropractors there, would make more sense.

imjonse 2y ago

TIL that 40% of cancers are preventable.

readthenotes1 2y ago
Which reduces your risk from roughly .5% down to .3% by age 49. https://www.cancer.gov/about-cancer/causes-prevention/risk/age https://www.cancer.gov/about-cancer/causes-prevention/risk/a...
patates 2y ago
Not opposing or anything but how do you even measure that? Really asking to see if anyone knows / has an idea.
- 3D30497420 2y ago
  I don't know off-hand, but probably a longitudinal survey of cases and pretty rough estimates. It is probably made a bit easier by there being some big chunks which are (likely) more clearly attributable to behavioral choices: smoking-related, sun exposure, and probably some occupational (chemical exposure, etc.).
- LordKeren 2y ago
  It’s pretty straight forward— you compare the average risk for individuals to the rates for those exposed to carcinogens. For instance, if a population of people develops lung cancer at a rate of 2% by age 70, and a population of smokers has a rate of 10% by age 70– the difference between the base line and the exposed populations becomes the “preventable” count.
  - deleted 2y ago
    [deleted]

deleted 2y ago

[deleted]

Kalanos 2y ago

Why is the advice "Try to maintain a healthy weight?" Just maintain it. Sure, some people are genetically predisposed to obesity, but we should stop coddling the rest. Obesity puts you at 300% risk for cancer and several other lethal diseases. A great place to start is by not spending money on drinks that contain sugar and carbs - drink water. The recipe for healthy weight is 85% diet (less carbs) and 15% exercise (elevated heart rate). Check out the books: Cancer Code, Obesity Code, Diabetes Code

Ekaros 2y ago
Also stop being poor. Just earn more and spend less. Then spend the money you earned and saved to improve living conditions so you have less risks. It is very simple and no one should have any trouble with it. /s
- Kalanos 2y ago
  woah woah woah. can you please phrase that as "try to earn more and try to spend less" we don't want to offend anyone here
ajross 2y ago
Your point is what, that behavioral disorders aren't disorders? Do you give the same advice to addiction patients or anxiety or OCD sufferers? Some people have an easier time controlling some behaviors that some other people, and that fact is important where it intersects with health and worthy of consideration as a "medical" condition worthy of treatment, and not knee-jerk judgement on HN. Surely you personally are a skinny guy whose never had trouble with weight. Equally surely there's some behavioral quirk you have that you'd like to change but have struggled with. So... maybe hold off on the "just do it" framing?
- Kalanos 2y ago
  Notice that everything else is phrased as "Don't smoke." It's tiptoeing around obesity
infecto 2y ago