So in cancer control then, what we want to have is a 30% fat diet or less, daily fruits and vegetables, a high fiber grain, low cured, smoked or pickled food and moderate alcohol. Alcoholism as you know is a cocarcinogen with head and neck cancer, esophageal and rectal cancers. So we have to worry about that a little bit also.
This is an area that I was quite surprised at and that is that cholecystectomy raises the incidence of proximal colon cancer by a factor of two, as you can see. Two times greater in females. So we have to watch out for that and try to avoid it and treat conservatively with the things we have available.
Ultraviolet damage is another area we want to look at and as you know the ultraviolet rays will lead to skin problems, lower lip problems and melanomas. In melanomas, as you know, if we take it in 1950, there’s 1:500, in 1980 1:250, in 1985 1:150 and in 2000 1:90 so you can see why melanoma is a real concern because it’s winding up as a tumor that’s occurring at a much more rapid rate than we have seen in the past. Melanoma cases per year constitute 40,300 and 7300 deaths and it’s getting worse, as you know, all the time.
The ultraviolet damage we look for is we want to stop. The necessity of protective clothing. We want to use that to the maximum. Sunscreen. We need to start with the children. I don’t know about you folks but when I was a kid as soon as the period of the year about this time occurred, my family would send us out to get a nice tan so we’d be all protected. As you know, you don’t want to do that at all. But I’m sure that a lot of you have the same problems.
Causes of melanoma are genetic 11%, first degree relatives 1.7 time risk and, of course, sunlight. I don’t know if you’ve had many familial cases of melanoma in your group but I can remember when I was a resident at Minnesota, I was taking care of a lady, she was in her 30s, and there were 12 members of her family, all of them had died from melanoma except her and she was going to die very shortly thereafter. So this is a real problem for us and it’s going to get bigger. As you know, right now, they don’t recommend having studies of your patients. In other words, having breast cancer programs and having a melanoma program. So far most of the groups still don’t feel that that’s necessary. I’m not sure that’s true…

In the United States, there are some 1.25 million new cancer cases expected in 2006 and 550,000 deaths. Six million Americans have, or have had, a cancer. The types are lung, tongue, pharynx, larynx, esophagus, pancreas, bladder and cervix. Passive smoking in our area constitutes 53,000 deaths per year and 4000 lung cancer cases. So this is a real problem, this passive smoking and, as you know, there’s been a little bit of discussion of it in the papers recently. Not only do you have the passive smoking causing problems in terms of cancers but it also affects esophageal and patients who are having problems with shortness of breath as you are well aware.
When we talk about cancer control we want to tell them to stop and that’s very important. You know, most of us say, “Well, what’s the use of talking to them about it? They’re not going to do anything anyhow.” That’s not true. They really do pay attention to you folks and they will modify things. They can try Nicorette gum. Some of them like the patches. Either one of them we’ll find often they’ll tell you, “Well, it works the best if I just quit.” Then we have to educate children as to this. Get them out of cigarettes and all the problems related to that.
As far as most important areas to look at, diet is the most important and education of patients and families into prudent dietary habits is probably the second most cancer preventive activity. When we talk about this, we talk about a high fat diet. As you know that’s bad. That increases breast and colorectal. There are some recent studies that suggested adequate calcium and vitamin D reduce the incidence of cancer of the colon and of the rectum and this occurs throughout life.
Beta-carotene foods decrease the lung cancers and there’s a couple of studies that don’t really believe that, particularly from over in Sweden and those countries – Finland where the data they have suggests that it really doesn’t help much. In fact, it might make it worse.
The beta-carotene foods, of course, are being studied in lung cancer and head and neck cancers but as you know beta-carotene foods are toxic. They cause dryness, cheilosis, liver dysfunction and a rise in our lipids. All the kind of things we don’t want our people to have…