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…