Oral arguments

Like it or not, when it comes to the issue of smoking…for the past 25 years, the push for regulations and legal arguments have dominated the discussion. And this has often left science by the wayside.

And while some have taken my comments in the past as somehow being in support of smoking, that is respectfully, simply not the case. I’m just trying to point out the clear science that gets lost in the shuffle. Science that’s not only important for helping you come to your own, fully-educated conclusions…but also science that indicates the need for further, critical investigation and other directions and efforts for health.

Last week I quoted some statistics that some took the wrong way. I’m afraid my point wasn’t made clear enough. So let me say it another way…

When it comes to research on the causes of lung cancer, the government has poured all of its focus and our money into pinning all the blame on smoking.

So yes, 1 out of 10 smokers get lung cancer. A good reason not to smoke. However, 9 out of 10 don’t get lung cancer. This is a great indication that there’s something important about all those who smoke but never get cancer that may be protecting them. And wouldn’t it be great to know what that is?  

Also consider the people who smoke only cigars or pipes or half-a-pack of cigarettes per day or less. They are in a completely different situation from heavy smokers. Research has shown they are as healthy overall as non-smokers and in fact are better able to maintain healthier body weight. Add to that the fact that 1 out of 100 non-smokers also develop lung cancer. Which begs the question…WHY? What else causes lung cancer besides smoking? And what else can be done to reduce that risk? There are very few answers or help for the many people who have never smoked who get lung cancer anyway. Rather than just pouring more focus and money exclusively into smoking, why not make some further efforts into these scientific facts?

And now, we have yet another example—this one related to oral cancer.

The Memorial Sloan-Kettering Cancer Center has published research illuminating the actual science of the effects of smoking and alcohol consumption on oral cancer. 

Patients are frequently warned about the effects of both smoking and alcohol consumption on the development of oral cancer. And that there may be a synergistic effect of alcohol and smoking together that multiplies the risk.

And it seems like Americans must be heeding that advice. At least according to the results of this new study.  

During the study, researchers analyzed patients with oral cancer generally treated by surgery. They looked at five different successive five-year periods to see if there were any changing patterns over time. 

There were no differences over 25 years in the age, sex, or stage of the disease.  So that allows valid comparisons to be made.

This also tells us, by the way, that unfortunately, any efforts at “early detection” of oral cancer have had virtually no effect over the past quarter-century. If emphasis on early detection was helping, we should have seen a variance in the age and stages of the disease. (I’ve expressed my concerns in the past over the failure of government-researched and recommended methods for early detection of prostate cancer, ovarian cancer, and others as well.)

What is clear over the past 25 years is that the proportion of patients who get oral cancer and use tobacco declined from four-fifths to only three-fifths.  And there was an even greater decline in the amount of tobacco consumed among people who got oral cancer. While over half of oral cancer patients smoked more than one pack per day 25 years ago, today it is less than one-third. 

Similarly dramatic results are observed for alcohol, whereby four-fifths of patients with oral cancer consumed alcohol 25 years ago, today it is less than two-thirds. And the proportion of heavy drinkers among oral cancer patients declined from one-quarter 25 years ago, to less than 10 percent today.

Now it appears that fully two-fifths (40%) of the people who get oral cancer don’t smoke, and many of the smokers who get oral cancer use less than half-a-pack per day. As for alcohol, many non-drinkers get oral cancer and very few who do are heavy drinkers. 

So what we really need to know is what else is involved in causing oral cancer? Something other than the government’s endless focus on smoking and alcohol. And what protects most people who do smoke and drink from ever getting oral cancer (or lung cancer)?

So, if you thought that not smoking or using alcohol is an absolute guarantee against getting oral or lung cancer, think again. Unfortunately, the government has nothing to offer about how to protect yourself if you are not a drinker or smoker. 

“Changing Trends in Smoking and Alcohol Consumption in Patients With Oral Cancer Treated at Memorial Sloan-Kettering Cancer Center From 1985 to 2009,” Arch Otolaryngol Head Neck Surg. 2012;138(9):817-822.