Thursday, August 13, 2009

What Was Good for Grandma Doesn't Work For You - Get Screened for Cancer!

We all have selective memories enhancing good experiences and downplaying bad ones. This phenomenon is particularly common when counseling patients on what preventive screening tests should be done and the need for blood pressure and cholesterol medication to decrease risk of heart attacks and strokes.

The typical office conversation boils down to this -"My grandmother lived to 95 and never saw a doctor in her life and never took medications for anything". This could be in fact true.

Unfortunately, there are key differences with grandma who lived a generation ago and today. This is quite obvious with a recent report in the NY Times which noted that Hispanics that moved to the US had higher cancer rates. In some cases, the risk of cancer increased by 40 percent!

Researchers speculate that one reason for the increase in cancer risk is that immigrants quickly adopt new, less healthy dietary and lifestyle habits, such as increased alcohol consumption, after moving to the United States. It is also possible that some of the increase may be due to more aggressive diagnostic measures in the United States that result in greater cancer detection compared to other countries.
In other words, our lifestyle, what we eat and drink as well as what we do (or not do in terms of physical activity) impacts our likelihood of developing illness. What is particularly disturbing about this article is the speed in which immigrants begin to develop cancers after moving to the United States. In the past, it appeared it took at least a couple generations before immigrant populations began to have illness similar to their adopted countries.

Research has shown that Japanese immigrants to the United States have the same low risk of heart disease as native Japanese inhabitants. By the fourth generation of Japanese Americans, the risk of heart disease is identical to that found among the general American population. It's not just that the type of foods available vary greatly from the native countries, but that it is far more available, less expensive, and individuals work less at acquiring food than generations ago.

This is particularly apparent after I finished reading (actually listening) to the book by Michael Pollan - The Omnivore's Dilemma. The food industry has made the type of foods we eat, more corn based and more meats, because of use of technology, antibiotics, pesticides, and hormones to boost yields of produce and animal products. Consequently the make up of the food is very different than what grandma ate. Is the flesh of a chicken breed purely for breast meat, confined in a tight space with other chickens, fed a diet of corn the same as a chicken roaming on fields and feeding on the variety of food sources found on a typical farm the same type of meat?

He suggests that the food is different and can increase the risk of illness. So not only is the type of food potentially different than what grandma ate, but also far more plentiful and cheaper. As a result, we are eating far more meats routinely than what used to be a periodic indulgence. Grandma probably spent more time gathering and preparing food than we do now. (My grandparents killed chickens on their farms for dinner. The food was amazing).

For better or worse, we've outsourced this responsibility. Vegetables come triple washed and cut. Meats no longer look like pieces of the animals they are from. What's for lunch or dinner? Microwavable meals. Baked products? Simply add water.

What does this mean for you and me? Since we can eat more than ever because food is cheaper than the past and the amount and types of food we eat has changed, the composition of food may be very different than years ago as the food industry uses technology to boost yields, and we spend less time finding and preparing food, our lifestyle is fundamentally different than our grandparents.

As a consequence, we need to treat our health differently and screen for illnesses. An excerpt from my book on recommended guidelines to discuss with your doctor is found here.

So I suppose the commonly quoted phrase is true - you are what you eat!


The Liz Army said...

Dr. Liu: I agree with the we are what we eat statement, but what kind of cancer do you ask your doctor to screen for? Are you just supposed to walk into her office and say, "Hey, can you screen me for cancer?" Where does the doctor begin?

Davis Liu, MD said...

Great question. American Cancer Society has recommendations -

Unfortunately at this time, we are only able to screen for breast, colon, prostate, and cervical cancer, which means that there are many that are unable to be found until they present with symptoms.

The problem is many Americans don't realize that even though they are healthy that they must get the screenings done even if they have no family history or if they otherwise feel well.

When do you go see the doctor? You'll see on review of these guidelines that it is based on the person's age. Women 40 years and older should get a mammogram if they feel well. Women under 40 and without a family history or without symptoms (breast lump for example), therefore don't need to be screened.

This is where doctors begin screening.

Hope that helps.


Related Posts with Thumbnails