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The Truth About Cancer
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Watching: The Truth About Cancer

Chapter 8: The Question of Prevention [7:59]

What role do environmental factors play? Can diet and lifestyle reduce the risks of cancer? Do cancer screenings always help?

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Transcript: Chapter 8 - The Question of Prevention

CORRINNE D'ONOFRIO: Okay.

LARRY D'ONOFRIO: Ready?

CORRINNE D'ONOFRIO: Yeah.

LARRY D'ONOFRIO: Aha!

CORRINNE D'ONOFRIO: Yay!

NARRATOR: Larry built the house that we would share as a couple. While he was still in school, he had taken odd construction jobs where he was exposed to asbestos, a fire-resistant fiber used in building materials, now known to cause mesothelioma.

LARRY D'ONOFRIO: And there will be a bathroom here. This is a landing. Dining room.

NARRATOR: Asbestos use started to be restricted in 1971, but mesothelioma patients have continued to emerge because of the lag time between exposure to a substance that can cause damage to the body's DNA and the development of cancer.

LARRY D'ONOFRIO: You know, this, so what's going to happen is this will become the family room. This won't...

NARRATOR: Indeed, when Larry was sick we befriended a woman at the hospital who had his same disease, and who had been exposed to asbestos as a child simply by shaking out her father's work clothes. She died, too.

*

NARRATOR: Larry used to say that every hammer sees a nail, and the cancer field is no different; every specialist has their own take. Environmentalists point to contamination of the water we drink and the air we breathe as a cause of cancer. And while this is a popularly held perception, careful investigations into community clusters of cancer rarely prove such a link. Epidemiologists think that diet and lifestyle can help prevent cancer, but the results of their studies seem to change from day to day.

NEWS REPORTER 1: ...The chemical that makes tomatoes red - it's called lycopene -- may help protect men against prostate cancer.

NEWS REPORTER 2: But the latest study looked at tens of thousands of men and found the amount of lycopene in their bodies had no effect on their chances of getting prostate cancer.

NARRATOR: If you are an oncologist, you place a premium on new treatments.

FAITH MIDDLETON: So these smart drugs are, are targeted drugs?

DAVID NATHAN: That's right. They hit the very, uh, protein that the abnormal gene in the cancer cell is making and block its function.

NARRATOR: And if you are a primary care doctor, you put your trust in screening--detecting cancers before they have spread.

*

JACQUES CARTER: Hi. Thanks for inviting us out. Good to see you.

Church Congregation: [singing] We lift our hearts in praise, without a doubt we'll know that we have been revived, when we shall leave this place [end singing].

VIOLA BUCHANAN: We praise the Lord, Amen, for providing this day, when Bethel, Amen, continues in its outreach and ministry to the community by lifting up the health of our men, \this awful disease. We feel that the reason for the double mortality rate has to do with the late diagnosis for the most part, and the African American men tend to be diagnosed at a much later stage in their disease, uh, than white men.

JACQUES CARTER: Hi, welcome, welcome. Thank you, come on on. Thank you.

JACQUES CARTER: So we go out to these communities. We invite these men to come in to be, uh, educated, uh, and screened for prostate cancer.

MARK KENNEDY: The blood test is called a PSA. Your doctor is going to tell you that term, so I want you to be familiar with it. PSA stands for Prostate Specific Antigen - antigen's just a fancy word for protein. So the purpose of the test is to measure how much of this protein is in the blood stream, because a normal, healthy prostate only leaks a little bit.

JACQUES CARTER: A significant number of men who have prostate cancer have normal PSAs, probably 20, 25 percent, so when I do the examination on you guys, I'm able to feel that part of the gland and tell you whether it's normal or abnormal. Okay? Totally different than the symptoms of a plain BPA. So it's important to get the blood test and the examination. I would encourage all of you guys to do that today while you're here.

JACQUES CARTER: I believe in screening. I am a screening proponent for prostate cancer. And I'll, I'll screen all of my patients: African Americans at 40, uh, white guys at 50. And I will even offer the white guys in their forties screening opportunities because I've seen guys die of metastatic prostate cancer in their forties who were white.

DAVID NATHAN: I decided to do this book when it occurred to me that I had had a front row seat in the development of cancer treatment.

JULIA HOBART: What happens today when they talk about taking care of yourself, and how do you prevent cancers?

DAVID NATHAN: There's a huge debate about screening for cancer. That does not mean that people should stop doing mammograms, but it does say that maybe very, very high tech screening procedures like yearly CT scans and all that may not produce anything. In fact, there are some who hold that, that cancer screening doesn't change cancer mortality; that little cancers are growing in us all the time and then dying, and that if we pluck one out, we don't know whether we've plucked out one that was going to keep going or one that was going to die. And if you look at screening very, very carefully, you find a very small effect of, on mortality.

MARK KENNEDY: First of all. Get, get back on the van, first of all.

WILLIAM DUPREE: Yeah?

MARK KENNEDY: Get, get, get, get, get. Come on, come on. Come on, take it like a man [laughs].

JACQUES CARTER: I think that's a mistake that we don't screen for prostate cancer. There has been a lot of discussion about the fact that many of these tumors will never amount to anything; and if we left them alone, that 40 years from now, they were still sitting in the prostate. The fact is there are a lot of very aggressive tumors. What we need are better ways to determine which of these tumors that we diagnose will do nothing, and which ones will be very aggressive. Because then we can basically treat the very aggressive guys and leave the other ones alone.

JACQUES CARTER: Too many guys pass on the examinations, alright? You, you listen to me now. Okay? Too many guys pass on examinations, end up with disease that they don't know they've got because they've relying on a blood test that is not a perfect test. So keep that in mind, okay?

CURTIS SINGLETEARY: Alright.

JACQUES CARTER: Alright, and we'll come back next year and look for you.

CURTIS SINGLETEARY: Okay, we can do that, okay [laughs].

JACQUES CARTER: Take care.

CURTIS SINGLETEARY: Alright, take it easy.

JACQUES CARTER: Bye.

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