The Big C: Cancer, Care, and Aging
What do we talk about when we talk about cancer? The American Cancer Society helps us understand the basics by defining it as, “a group of diseases characterized by the uncontrolled growth and spread of abnormal cells.” Sounds simple enough but there are a wealth of internal and external factors that can interact with one another to cause this misfortune. In a recent article in TIME Magazine, some researchers are finding that as much as two thirds of all cancers are explained as “biological misfortune” a.k.a. “just bad luck”.
A Look at Cancer As We Age
As we age, the topics of conversation tend to include things like the latest treatment or probiotic we’re taking, the powder for this ailment and the potion for that pain. Cancer, while once a word whispered in private, seems to have joined the list of acceptable topics among aging adults, in part because it is so common. 50% of all cancers diagnosed are in people 65 years of age or older. So, why is it that cancer seems to be so prevalent among aging adults? Why do our risks increase as we age?
In short, cancer researchers don’t know. However, Judith Campisi, Ph.D., a professor at the Buck Institute for Research on Aging, has a compelling working hypothesis that the processes that suppress tumors in our youth actually drive our aging and major diseases associated with aging, such as cancer. “Aging isn’t a disease, but it does make us more vulnerable to disease. Aging occurs at all levels; organisms, cells, and molecules all age. Starting at about age 50 our risk factors for all chronic illness start to rise at about the same level. This would include things like diabetes, decreased kidney function, heart disease, hearing loss, osteoporosis, memory loss, etc. These chronic diseases of aging account for about 90% of healthcare expenditures in the developed world. Cancer,” she suggests, “is different from these degenerative diseases of aging.”
According to Campisi’s hypothesis, cancer starts as a healthy cell that has to acquire new abilities and abide by new rules that govern when to grow, when to stop, and when to die. The cancer cell does this through mutations, not that you’re born with, but mutations that you accumulate during your lifetime. Cancer cells have hundreds of mutations, and the body is able to respond with tumor suppression genes that are the caretakers and gatekeepers of the body. Caretakers prevent DNA damage and help them repair and promote longevity. Gatekeepers assess and decide the fate of abnormal cells. We call these activities of gatekeepers apoptosis, the cell killing itself, and senescence, the cell stopping its ability to divide while remaining alive. Mutations alone are not enough to get a malignant tumor, you also need a tissue environment that is degraded. These older cells that have stopped dividing start to accumulate over time and can degrade the tissue influencing both our aging and our risks for cancer. In short, what keeps us cancer free in our youth is also what causes tissue degeneration and higher cancer incidents as we age.
Cancer By the Numbers
According to the Facts and Figures from The American Cancer Society, cancer is the second most common cause of death in the U.S., exceeded only by heart disease, and accounts for nearly 1 in every 4 deaths. Out of the 1,658,370 new cancer cases expected to be diagnosed in 2015, about 589,430 Americans are expected to die of cancer. For much of the human timeline external factors such as infectious diseases or predators ended life at a younger age. Most did not live to the age of 65. In the 21st century, if you reach 65 years of age, it is likely that you will live to 85. Chronic diseases have replaced these external factors as our common causes of death and they are impacting us much later in life.
Types & Tests
According to the National Institute on Aging, getting regular cancer screenings after the age of 50 can be crucial for both men and woman. The screenings coincide with the most common types of cancer:
- Breast Cancer: clinical breast exam/ mammogram
- Cervical Cancer: pap test/ pelvic exam
- Prostate Cancer: digital rectal exam/ prostate specific antigen test (PSA)
Both Men and Women
- Mouth and Throat Cancers: oral exams
- Skin Cancer: skin exams
- Colorectal Cancer: colonoscopy
Sometime we can avoid having regular exams because we are afraid that the doctor will find something. It is good to remember that not all lumps, bumps, and tumors are cancerous, or malignant. It is also key to remember that detection brings about choices and options, not the disease itself. Knowledge is always power and time is in your favor when you screen.
Owning Choices, Mitigating Risks
Many of our lifestyle habits that we control can impact our risks for getting cancer over our lifetime. The most common choices that increase our risks are:
- Using tobacco products
- Not protecting skin and getting sunburns
- Being overweight/ unhealthy diet
- Over consumption of alcohol
- Irregular medical care
Understanding how much power you have in the daily choices you make lays the foundation for building the long life and quality of life you want to enjoy.
Published on January 29, 2015.