Major Gains Made in Stemming Cancer

Re “An Ounce of Prevention,” Opinion, Aug. 31: While the fight against cancer continues, the portrayal of the current situation by longtime cancer-community critic Samuel Epstein and Quentin Young discounts major gains made thus far. In doing so they ignore a major turnaround in cancer trends. The 1990s saw significant drops in the death rates for the four major cancers (lung, breast, prostate and colon) that together make up half of cancer’s deadly burden.

Epstein claims that the cancer-control community focuses too heavily on screening, diagnosis, treatment and basic research. But that approach has led to a remarkable shift toward finding tumors earlier, when they are more treatable, and to the development of better, less-toxic treatments. The more than 1 million Americans expected to be diagnosed with cancer this year would probably disagree with Epstein’s view that those efforts to find cancer earlier and improve treatment have been misdirected. And while Epstein would focus on cosmetics, pesticides and household products, there is no evidence that these contribute substantially to cancer risk. Avoiding tobacco, making wise nutritional choices and adopting an active lifestyle are critical for reducing our cancer risk.

Michael J. Thun MD, Christy A. Russell MD

American Cancer Society Los Angeles

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I agree with most of what Epstein and Young have to say concerning the need to put more emphasis on the prevention of cancer. (Their hints of a conspiracy involving the American Cancer Society, business and government take the edge off an otherwise good article.)

However, I would like to remind them that death is the only truly zero-sum game. If heart-disease deaths go down, then some other cause will go up. My mother lived with heart disease for over 20 years and died this year (at 90) of cancer. Thirty years ago she wouldn’t have lived long enough to die of cancer, and we are grateful for the extra 20 years we had her.

Chris Daly

Yucaipa