Why me, doctor?

“Why me, doctor?”

“Well, I’m sorry to tell you, you’re too fat.”

Even the most insensitive oncologist is unlikely to answer the question so bluntly. Your cancer could be hereditary, triggered by a virus or (more likely) caused by a random genetic mutation.

But it really could be because you are overweight.

Cancer Research UK’s ongoing campaign against obesity has been impossible to avoid: http://bit.ly/2FlSixF – as it seeks to ram home the message that being overweight is the second biggest preventable cause of cancer, after smoking of course.

Obesity is a factor in 18,000 cases of cancer a year

As a population, we understand that booze and especially fags cause cancer, but burgers and fries have hitherto escaped their fair share of the blame. In total, 5 per cent of cancers in the UK have a link to obesity.

If 5 per cent does not sound like a big number, think again: that is 18,000 cases a year.

The month-long campaign has involved billboard and print advertising, a social media onslaught and other attention-grabbing tactics.

Volunteers have gone to the high streets of middle England to hand out cigarette packets, asking passers-by what they think is the second biggest preventable cause of cancer.

People in Aylesbury, for example, were astonished to find the packets contained chips, and to learn that 13 different cancers in the UK have a strong link to obesity.

“It is a shocking and surprising message,” comments Emma Shields from Cancer Research. “We have a duty to tell people — and most people, after they have got over their surprise, want to know ‘why haven’t I heard this before.’”

Beyond the headlines, Cancer Research is hoping that the campaign will influence government policy around junk food: the charity wants TV advertising for this kind of food to be banned before the 9pm watershed.

The risk of obesity is especially acute for younger people, so-called millennials whom Cancer Research says are eating much less healthily than their parents, and are going to be fatter as a result.

Four out of ten cases of cancer in the UK are avoidable

The bigger picture is that some 40 per cent of UK cancer is caused by people’s lifestyle, namely smoking, drinking and eating too much of the wrong kind of food.

Yet a comparatively small amount of the healthcare budget for cancer is spent on education and prevention and awareness – most of it goes on the kind of sophisticated and therefore expensive new drugs described in my last post (monoclonal antibodies, immunotherapies and the like.)

New treatments can deliver spectacular results, but only for a relatively small number of people, compared to the numbers who might avoid cancer altogether by changing the way they live.

The need to invest in prevention, education and awareness

“Education and awareness are simply not good enough,” says one oncologist, venting his frustration about public policy priorities. “Especially when we know we can take big steps to prevent the disease by encouraging people to stop smoking, moderate their alcohol consumption and eat a better diet.”

Of course, this is a highly charged subject, as the emotional reaction to Cancer Research’s alleged “fat-shaming” has made only too apparent.

It is fair to say that the connection between being overweight and getting cancer is not straightforward. Not all people who are obese are going to get cancer, just as many perfectly trim people are going to get cancer. And whatever the cause, no one deserves to feel shamed or blamed as a result of the diagnosis.

Yet Cancer Research deserves to be praised for venturing into this controversial territory.

If their warnings encourage just some of us, let alone a whole generation of millennials, to eat a balanced and healthy diet, that has to be a good thing. And if it in any way puts the brakes on the incidence of avoidable cancer, that would be an outstanding outcome.

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