Fighting cancer : right now !

Today cancer kills more than 150,000 people a year in France. But according to Etienne Buisset, director of the medical information sector at the Oscar Lambret center in Lille, hope must prevail. Today, if one cannot cure some cancers, one can singularly delay their onset. And that trend could be strengthened by research in genetics.

“Don’t smoke! Eat fruits and vegetables! Do sport!” Basic indications to prevent the onset of cancers are usually effective. But the multiplication of the number of cancers still worries the population. What can we do to cope with cancers? Can we expect to eradicate cancer? What are the most dangerous types of cancers? Etienne Buisset answers these questions.

According to the Ligue contre le cancer, 278,000 cancers were detected in 2000 as compared to 170,000 in 1980, that is to say a 60% increase in 20 years. How can we account for that rise?

Several explanations can explain the increase. First, one can mention the quality and the precocity of current detections. For instance, today, one can diagnose breast cancers which have not developed yet. 20 to 30% of detected breast cancers are so small that we cannot operate. It is exactly the same with prostate cancers. Before, prostate cancers were detected when the sick person complained of spine pain. Today, a blood test is enough to suspect such a cancer. So, the first criterion is linked to technological progress. Second explanation: ageing. Some patients die of cancer because they get older. As life expectancy increases, the number of cancers does also. And finally, the increase in the number of risk factors can account for that rise. One can quote professional factors for instance: the exposure to asbestos is undoubtedly a triggering factor in the rise of the number of cancers. One can imagine 100.000 deaths or so related to the exposure to asbestos in the following years.

And do you think that factors such as air pollution or stress and anxiety can generate cancers?
Environmental factors elicit the apparition of some peculiar kinds of cancers. Obviously, cigarette smoke increases the probability of getting a lung cancer and liver cancers are often linked to the consumption of huge quantities of alcohol. Another example lies in the cause end effect relation between breathing wood dust and being affected by sinus cancer. In my opinion, one can match environmental and professional factors with cancers. Indeed, among factory workers, there are much more cancers than among businessmen. That is certainly due to working conditions and the quality of life. Now, concerning the second part of the question, one cannot say that there is a relation between cancer and stress. It has never been demonstrated.

The World Health Organization released a report about cancer in the world some years ago. The document affirmed that the more Southern countries imitated the Western way of life, the more affected by cancer they would be. Can we say that cancer is a Western disease?

Surely not. I told you that quality of life is one of the criteria which account for the increase of the number in cancers. But there are two other types of factors at least: genetic ones and ethnic ones. And generally cancers appear on the grounds of the combination of various criteria. Thus, every country in the world is affected by cancer. What changes is the brand of cancer. For instance, while people die of lung or breast cancers in France, the Eskimos are much more affected by mouth or throat cancers. Why? Because their food is based on dry fishes and because they are infected by some viruses which do not exist in our country.

Do you mean that cancer is everywhere in the world and has always existed?

Absolutely! Basically, cancer is part of the evolution of cellular life. It is just the contamination of a specific organ by destructive cells. This contamination is natural (genetic origin, ageing) or can be accelerated chemically (cigarette smoke, alcohol…). You know, human death is part of life. It is the same with cancer. That is why one can assert that cancer is widespread in the world and has always existed.

What are the preventive indications to delay the onset of cancer?
Do not smoke, do not drink too much, eat fresh fruits and vegetables, do sport…Go to a testing center frequently, take care of yourself, pay attention to your genetic inheritance : for example, if a member of your family is affected, go to a testing centre.

President Chirac announced on 14th July 2002 that the struggle against cancer constituted one of his main priorities. Have you felt improvements in the way the state handles the cancer crisis?

Yes but not so much. I would say that the announcement was useful to consider cancer as a big national cause. As a result, one can assert that we are more efficient at delaying the onset of cancers. The national plan against cancer, launched in 2003 by former health minister, Jean-François Mattéi, focuses on most widespread cancers (breast, prostate, rectum, lung …). Its goal is to reduce mortality by cancer by 20% by 2008. That is appropriate! One can also mention the creation of the National Institute against cancer in 2003 which allows research to move forward. Moreover, there were changes in the way of facing the disease nationally. Now, the medical structure (hospitals, testing centers, regional medical centers, specialists…) are more organized. Thus, our common action is more efficient. But at the same time, one must not forget that oncology was also strongly supported before 2002. That is why I am saying that changes were not so numerous. Questions are still at stake: How to develop screening? When will we focus more on genetic research?

Today, one in two patients survives cancer. Can we imagine in the future that one will recover from cancer as one recovers from flu today?
Well, one must be wary of the figure you have just evoked. It is true that 50% from people affected by cancer survive. But, big contrasts exist between the types of cancer. If you are affected by skin cancer, you can be cured quite easily but on the contrary if you are sick from esophagus cancer, your probability of surviving is of the order of 0.5%. In my opinion, it seems difficult to cure all the existing cancers because, as I told you before, cancer is a natural cellular imbalance. But, hope must prevail. If we exhausted all the therapeutic techniques and current methods of treatments in the past few years, we have to focus now on genetic research to prevent the onset of cancers. One could learn much about cancer if we analyzed the genetic inheritance of every one of us. That could be the key to facing cancer in the coming years.

An Interview by Samuel Duhamel

Some interesting figures about cancer:

- Cancer kills about 150,000 people a year in France, that is to say 400 people a day
- One man in three and one woman in four will die of cancer.
- Cancer represents the first cause of mortality for young people before accidents and suicides
- In 2000, lung cancer killed 27,000 people, rectum and colon cancers 16,000, breast cancer 11,000 and prostate cancer 10,000. These are the four most criminal cancers.
- Today, in France, the probability of being sick with cancer is 35% higher than in the 1980s.
- According to the World Health Organization, the frequency of cancers could increase of 50% or so in the world by 2020. About 15 million people would be affected each year, which represents a quarter of the current French population.

Source: French Health ministry

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