We all know the chances of getting cancer increase with age. But healthy lifestyle choices — weight control, minimal alcohol, preventive screening — can help counter the onset of the disease, right?
Results of a recent study by Johns Hopkins University School of Medicine researchers Cristian Tomasetti and Dr. Bert Vogelstein, published last month in the journal Science, found that two-thirds of the mutations that contribute to various kinds of cancers are random. In other words, most cancers may simply be the result of bad luck, although the scientists stress that environmental and genetic factors also contribute to the incidence of the disease.
A Release from Guilt
For some people, the Johns Hopkins findings are good news because they relieve a feeling of guilt that they brought on the cancer themselves or failed to prevent a loved one’s cancer.
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But for millions of others, the randomness of a cancer diagnosis provokes feelings of powerlessness and anxiety. "We are aware that the idea of a major contributing factor to cancer is beyond anyone's control can be jarring," Tomasetti and Vogelstein concede.
Indeed. Why me? Why not me? Why you? Why not the man or woman next door? How are we to cope with the randomness of cancer?
A Difficult Reality
In large part, how an individual views his or her luck or unluckiness in cancer, or any other disease for that matter, is consistent with how they generally see and deal with the world.
Some people have a scientific and practical bent and would never accept the view of their cancer as a manifestation of bad luck. "Luck doesn't play a role in their life," says Dr. Mary Jane Massie, attending psychiatrist at New York's Memorial Sloan Kettering Cancer Center in New York.
For those who have lived a careful, modulated life, a cancer diagnosis may at first seem unbelievable. "Randomness just doesn't fit into their plan,'' Massie continues. “They never ate red meat. They get up every morning at 5 to run for an hour. They don't drink or smoke, and now they have this lethal cancer."
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In her work, Massie’s goal is to help cancer patients find some relief from the stress of feeling that they caused their disease in some way. "I help them understand the facts and limitations of what we know," she says.
What You Can Control
Many cancer experts today agree that the best way to accept a cancer diagnosis is to view it as a challenge that must be met. This message of empowerment — which is the mantra in cancer wellness communities around the country — can transcend a lucky/unlucky scenario.
"It's about perception of circumstances," says Dr. Helen Lavretsky, professor of psychiatry and director of the Late-Life Depression, Stress and Wellness Research Program at UCLA in Los Angeles. "Never be the victim. Try to view a diagnosis as a reason for you to learn something."
This entails taking charge and leading the healthiest lifestyle possible.
"See it (cancer) as a wake-up call to take care of your health," Lavretsky says. "Take a different psychological approach. You never have to be a victim. You're in charge of your life. You always gain something, whether wisdom, some new tools or knowledge."
Don’t Ditch Good Habits
While noting the strong element of chance in a cancer diagnosis, the Johns Hopkins researchers also stress that many cancers are preventable.
“Like car accidents, cancer is caused by a combination of factors — random DNA changes made during stem cell divisions that are not within our control, environmental exposures and inherited gene mutations,” the researchers write. “As a result, there are many opportunities for cancer prevention. The best way to prevent some cancer types is by eliminating environmental factors and by changing lifestyles. This is known as primary prevention. Quitting smoking is one valuable example of primary prevention.
“The best way to prevent deaths from other cancer types is to detect them and treat them early, while they are still curable. This is called secondary prevention,” Tomasetti and Vogelstein continue.
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At almost all ages — even in one's 60s and 70s — people tend to live in denial about the fact that they are going to die, and a diagnosis of cancer fractures that illusion. It means confronting mortality.
For most boomers, the key to coping with the randomness of cancer is to recognize that we have very little control over certain forces of illness that may encroach on our lives. We can do all we can in terms of primary and secondary prevention, and may derive a sense of comfort from leading a healthful life. But the unsteady truth remains that there may be no relationship between intentions and consequences in areas such as cancer.
The takeaway: Do what you can to live healthfully, and don't blame yourself should cancer, in all its randomness, strike you or your loved ones.
Jeanne Dorin is a Los Angeles-based writer who often covers health and wellness.
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