Risk factors

Lots of people get cancer.  It’s the leading cause of death in rich countries for males aged between 35 and 70 years, edging out heart disease for the first time in the latest published statistics.  In cancer, your own body, your own cells turn against you, eating you up from inside.  The reasons are not always clear.

There are risk factors and there are random events like mutations that allow cells to jump checkpoints and start dividing freely.  It’s generally held that the two have to act in unison or that – in the absence of quantifiable risk factors – multiple unlikely random events have to come together to cause cancer.  To answer the admittedly futile question of Why me?, it’s worth having a look at what might have predisposed me to cancer.

Here are two major risk factors for colon cancer:

• Genetic factors – A couple of hereditary colon cancers account for 5% of all cases.  They are called hereditary non-polyposis colorectal cancer (also known as Lynch syndrome) and familial adenomatous polyposis.  The tissue taken from my colon registered negative for markers of these two syndromes.  Then there are families with increased incidence of colon cancer in the absence of a clear genetic link.  Mine is not among them.  This will come as a relief to my children but doesn’t help me rationalize the disease.
• Lifestyle – Excessive alcohol consumption, poor diet, smoking and inactivity increase the risk of colon cancer.  Those exercising regularly have a 25% decreased risk of contracting colon cancer.  I tick all the boxes for a healthy life and get colon cancer at 44.  For Christmas, I want a box of Montecristos, Tequila and Whisky by the barrel, and a big TV.

I wouldn’t have been too surprised to be diagnosed with skin cancer.  I spent too much time out in the flaming sun of Utah, entire afternoons riding my mountain bike with scarcely a thought for solar protection.  Through the seasons, my skin grew darker.  I took this as a sign that my body was taking care of itself.  In Grenoble, the pattern continued when I went out on even longer rides on my road bike.

Whenever I return from Argentina these days after a New Year’s spent in the burning heat, I inspect my skin for new or growing moles.  Some years I get irrationally frightened, but I have never been able to confirm anything, despite many poorly lit bare-chested selfies taken in front of the bathroom mirror.  Now I have colon cancer.

Here are two more risk factors:

• Age – The older the better for the cancer.  In countries where colon cancer screening is covered by health insurance, it’s normally not done before 55.  This would have been a long wait for me.
• Antioxidants – Recent research indicates that supplementing your diet with antioxidants increases your risk of cancer in general, probably by allowing damaged cells withstand the body’s defenses and become cancerous.  I have never used supplements in my life.

None of the risk factors applies.  Might my colon cancer simply be a sign that God hates me?  I find this unlikely.  My disease is not proof that God exists.  This leaves only one risk factor, the one responsible for my cancer.  It’s called sheer dumb luck, and there’s nothing to do about it, and no philosophical questions to ask.  Accepting this, I have a clear mind to focus on treatment and survival.