Are men more likely than women to get cancer, and if so, why?
There really isn't anything a person can do to keep from getting cancer, right?
Are genetic tests for cancer risk beneficial?
Are some tobacco products safe to use?
Why does chemotherapy make people sick?

Are men more likely than women to get cancer, and if so, why?

Men and women share most major risk factors for cancer, but they do have a different experience because more than a third of all cancers occur in sex organs (prostate, testes, breast, ovary, uterus, cervix). For women, this means that in addition to lifestyle factors such as smoking, diet, and exercise, hormonal factors relating to their menstrual and childbearing history are also important risk considerations. Women may also have a greater biological vulnerability to certain carcinogens such as those in cigarettes.

          Overall, however, men are more likely than women to have cancer and to die of cancer. For some cancers, the differences are especially significant. For example, men are much more likely than women to die from oral cancer, skin cancer, lung cancer, liver cancer, and urinary cancer. What are some of the factors underlying the higher death rates among men?

• Higher rates of tobacco use: Particularly in the past, men had significantly higher rates of smoking than women, leading to much higher rates of the many cancers linked to smoking. Men also have much higher rates of spit tobacco and cigar use. If one considers cancer death rates since 1930, the statistics clearly show the powerful effects of smoking. Lung cancer rates among men increased dramatically following significantly increased smoking rates beginning in the early 1900s (inexpensive machine-produced cigarettes were developed in the late nineteenth century). The lung cancer rate leveled off and (for men) started to decline after smoking rates began dropping. The smoking-related increase in lung cancer among women occurred about 20-30 years after that seen in men, as smoking among women became more socially acceptable and widespread beginning in the 1930s and 1940s.
• Higher rates of alcohol use and abuse: Alcohol abuse is more common in men and is a risk factor for several cancers, including oral and liver cancers.
• Greater occupational exposure to carcinogens: Men are more likely to work in jobs where they are exposed to chemicals—including asbestos, arsenic, coal tar, pitch, and dyes—or radiation, and such exposure is a risk factor for cancers of the bladder, lung, and skin. Men are also more likely to have outdoor jobs involving frequent sun exposure.
• Less use of preventive measures and less contact with health care providers: Traditional gender roles may make men more likely to minimize symptoms and less likely to seek help or to discuss cancer-related worries with a health care provider. Men may place a low status on preventive care or screenings, such as using sunscreen and hats to protect the skin from the sun or performing self-exams.

          Many of the factors underlying men's greater risk for cancer are controllable. It is important for both men and women to remember that there are many concrete steps they can take to significantly reduce their risk of cancer.

There really isn't anything a person can do to keep from getting cancer, right?

Wrong. Remarkably, even as we are being inundated with information about cancer, studies show that most Americans do not understand basic facts about the disease. Indeed, many still believe myths about cancer that were disproved long ago. Such misperceptions are leading Americans to ignore good advice on cancer prevention and to continue lifestyle habits that increase the risk of cancer. Some of the most commonly accepted myths about cancer include the following:

• Cancer cannot be prevented. As described in your textbook, individuals can do a great deal to prevent cancer. Most preventive measures are simple, commonsense practices such as eating a healthy diet, exercising, controlling weight, and not smoking.
• Supplements prevent cancer. Scientists say there is no evidence that any single vitamin, mineral, or herb can boost the immune system enough to ward off cancer. The best dietary advice, they say, is to eat a wide variety of foods daily, emphasizing whole grains, fruits, and vegetables.
• Surgery causes cancer to spread. For generations, physicians did not have the means to detect cancer until it was advanced. As a result, doctors often performed surgery to remove a tumor from one part of the body without realizing that the cancer had already metastasized. When cancer was found again in another part of the body, many patients assumed that their surgery had "disturbed" the cancer and caused it to spread. This myth prevails even today, although it was disproved long ago. Surgery, in fact, is one of the most effective cancer treatments.
• Stress causes cancer. Stress has been linked to a variety of illnesses, but there is no evidence that it causes cancer. Some very recent surveys, in fact, indicate that stress may actually help prevent certain cancers.
• Cancer cannot be cured. There are more than 10 million cancer survivors in the United States who can dispute this myth. Treatments are more powerful than ever, and although some types of cancer are more lethal than others, there is hope for anyone whose cancer is detected early and who takes steps to get rid of it.

          Surveys show that a significant percentage of Americans still believe these myths (more than 40%, in some cases). Such thinking is both wrongheaded and dangerous. The first step in preventing and treating cancer is finding good sources of reliable information and following a qualified physician's advice.

Are genetic tests for cancer risk beneficial?

Tests for hereditary mutations in genes are now available for some types of cancer, including breast cancer. However, such tests are not always beneficial for the individual. Good news from a genetic test is reassuring, but it doesn't guarantee freedom from cancer because most cancers are not due to inherited genetic mutations. For example, only 5-10% of all cases of breast cancer occur among women who inherit the most common genetic mutation associated with the disease. For people who test positive for a genetic mutation, there aren't many good options beyond increased monitoring. Those who test positive can face problems in addition to an uncertain medical future. Health and life insurers may use results of a genetic test to refuse or cancel coverage; employers may use the information to screen current or prospective employees.

          There is no simple answer to the question of who should undergo genetic testing for disease-related genes. If you think you are at high risk for a genetic abnormality because of your family or ethnic background, consider genetic counseling. A counselor can help you consider all the issues related to testing and can help you make the decision that is right for you.

Are some tobacco products safe to use?

No. Scientists have concluded that "low-tar," "low-nicotine," and "light" cigarettes are no safer than regular cigarettes. In fact, some brands of light cigarettes contain just as much nicotine and just as many additives as regular cigarettes. Further, smokers of light cigarettes tend to smoke more frequently and inhale more deeply than smokers of regular cigarettes—often in the misguided belief that their chosen brand won't hurt them.

          In a 2006 survey, 72% of women and 63% of men said they believed light cigarettes were not as harmful as regular cigarettes. meantime, smoking remains the leading preventable cause of cancer and is responsible for nearly 90% of all lung cancer deaths.

          Similarly, many smokers have switched to smokeless tobacco products (such as chewing tobacco), thinking they pose no health risks. Not so, say the experts. Smokeless tobacco products pack a big nicotine punch and contribute to head, throat, and oral cancers.

Why does chemotherapy make people sick?

Chemotherapy, the use of cell-killing drugs to destroy rapidly growing cancer cells, has been in use as a cancer treatment since the 1940s. Many chemotherapy drugs work by interfering with DNA synthesis and replication in rapidly dividing cells. Normal cells, which usually grow slowly, are not destroyed by these drugs. However, some normal tissues such as intestinal, hair, and blood-forming cells are always growing, and damage to these tissues produces the unpleasant side effects of chemotherapy, including nausea, vomiting, diarrhea, and hair loss.