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Why are so many young people getting cancer? What the data say (nature.com)
60 points by peutetre on March 14, 2024 | hide | past | favorite | 49 comments


I have been investigating nutrition "science" for the past 4 y now, thanks to COVID, and to call it a mess is an understatement. There is still a LOT of unknown, and so many noise in the literature because of bad statistical methodologies, it gets frustrating to form any kind of consensus on big topics. Not to mention how politics have even shaped the modern discourse on everything including diet science (vegan vs vegetarian vs keto vs (un)saturated fat vs lectin vs carbs vs cholesterol). I know these are not necessary directly related, but the amount of conflicting research and the lack of transparency for certain political agendas always make it look shady and hard to trust the literature.


The odd thing is also that a fair number of people with good nutrition are getting cancer. I'm one of them: https://jakeseliger.com/2023/07/22/i-am-dying-of-squamous-ce.... Long-standing interest in nutrition, have never been overweight, experimented with a blood-glucose monitor: https://news.ycombinator.com/item?id=39621339.


My suspicion is that supplements and protein shakes are ultra processed food, full of the same preservatives and emulsifiers that are likely candidates for the increase in cancer.


I read the first paragraph of your post.. Sincerely, the best of luck on your journey.


There is consensus and robust evidence around the basic principles (e.g obesity). The effect size of the remaining details in those debates is negligible anyway.


The problem is hardly limited to nutrition.

Even here in this article, I am looking at the graphs they present as evidence of the thesis. Maybe I'm crazy but looking at the line for male early-onset incidence I don't see anything new or worrying in that graph. If we ignore the puzzling "estimated" section, it wanders up and down. It's not currently the highest it's been in the recent past, and increases in e.g. the 90s were followed by decreases later. The rates in women meanwhile have been roughly the same since 1995 after a small increase in the early 90s. This is presumably why they pick 1990 as their base year, as otherwise they would not be able to report a big percentage change.

So the story here is really being carried by the estimated/modeled future incidence, but it's not a good idea to pay attention to public health modeling. This is epidemiology, a field that we learned during COVID is not robust or honest. These people constantly claim to be able to predict the future incidence of disease, are constantly being proven wrong by miles, always in the direction of over-predicting incidence, and their response is to just ignore that fact, attack their critics and carry on as if everything is fine. Basic methodological errors are everywhere and nobody inside the field cares.

So we look at this prediction and immediately notice a couple of things. Firstly, it's a prediction of the past. Where is the actual cancer data for 2020, 2021, 2022 and 2023? The source they use only runs a survey every two years, and the last was in 2021 but appears to not report cancer in that round for some reason. There certainly are figures for cancer available for many countries but they don't deign to verify their predictions against that data. Replacing data that exists with modeled guesses is completely typical for epidemiology, I've seen that dozens of times.

The second problem is that their estimate isn't a simple extrapolation of whatever was happening previously. Instead it has an immediate sharp upswing at the moment the model begins and then a very steep climb quite unlike anything seen in the past. This is surely an artifact of the rather complicated statistical methodology they picked. When we look at Figure 5 in their source paper we see that the CIs of this prediction are at any rate enormous (and presented confusingly of course).

Is there anything to worry about here? Probably not. In other contexts the steady rates of cancer over the past 30 years are used to debunk claims about mobile phones causing tumors. If there was genuinely a steady and large rise in cancers over a long period of time they would be able to show that clearly using actual collected data, instead of relying on their usual bag of tricks, and the conversation around mobile phones would look very different.


This should be the top comment under the original post.

You’re right the estimated section just looks wrong, and needs a big section explaining why they think the current trends will change.


>The prominence of gastrointestinal cancers and the coincidence with dietary changes in many countries point to the rising rates of obesity and diets rich in processed foods as likely culprits in contributing to rising case rates

Dousing our crops with toxic pesticides for decades, mass-producing the same genetically modified seeds over and over, and sucking every last nutrient out of the soil through overfarming. Nope, nothing to see there! An economy based on maximizing profits at all costs while disregarding environmental impacts will create problems like this.


"likely culprits in contributing to rising case rates"

So what they've said is that dietary changes to diets rich in processed foods are contributors, that doesn't mean it is the only thing and not what you suggest but one contributor.


agreed and the rest of the quote:

“But many think that the answers are still buried in studies that have tracked the lives and health of children born half a century ago. “If it had been a single smoking gun, our studies would have at least pointed to one factor,” says Sonia Kupfer, a gastroenterologist at the University of Chicago in Illinois. “But it doesn’t seem to be that — it seems to be a combination of many different factors.”

They refer to a study of 20k expecting mothers and their children then data from all.

There’s also the (MVP) million veterans program that has a lot of data including dna to be analyzed. There is medical records, location information, etc. Many things to correlate if they choose to put them all together.


You're not wrong, but obesity should not be glossed over so quickly, as it is linked to several varieties of cancer, as well as numerous other serious health conditions.


Obesity should be scrutinized more closely though. The causes of the "obesity epidemic" that has occurred across the world aren't proven and could very well be linked to agricultural chemicals, processing, packaging, or something else entirely. Too many people reflexively write off obesity as something caused by poor diet and lacking exercise, but that hasn't been proven at all.


I often wonder if something is acting as an appetite booster. Any time I let myself indulge in junk food, I find I’m way hungrier over the next week or so. It could also be something more psychologically complex though, like being raised in abundance by parents who weren’t. Food abundance has got to track pretty close to the amount of processing, refined sugars, pesticide use, etc.


Sugar isn't fulfilling, and usually it makes you want more. If you want a snack that fills you up, try something with fat (meat, peanut butter, etc).


Sugar is inserted into most junk foods, even if savory.

The purpose is not to sweeten or adjust the flavor of whatever you're eating. It's to drive the addictive "must have more" response that your body naturally creates, selling more product.

It should be illegal.


> but that hasn't been proven at all.

Do you know of anything that provides a strong rebuttal to the research found in documents like this? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228640/


I imagine everyone in this thread is basically correct.

The only real thing we have done to combat cancer is stop smoking so much while at the same time increasing every other factor imaginable to promote cancer.


We eat garbage, carry a phone all day, stare at millions of micro led lights all day


Three for three that aren't even in the top ten actual causes of cancer.

In Australia, two out of three people will get skin cancer at some point in their lives. That's caused by the Sun, an unshielded nuclear reactor bathing us in dangerous radiation strong enough to hurt.

Your food is probably doing less harm than the plasticisers in the container you put it in, especially if you microwave it.

Your phone and LED lights contribute almost precisely zero to cancer incidence. Your guilt over your Tik Tok habit doesn't mean that you're also getting cancer from it. You're wasting your life, sure, but not dying as a consequence.

As others have pointed out, air pollution from cars is doing real damage to us all, far more than the occasional Happy Meal.


Not to mention untold amounts of non-natural (evolutionary adapted) forced lifestyle choices, like sedentary jobs, staying indoors, tons of sugar and ultra processed foods, constant noise (and "music"), air pollution, constant bullshit information fed to us (from celebrity gossip to the "news").

And especially tons of modern-life induced stress - which is death by some huge-ass cuts and thousands of small cuts (a different experience to fewer big stressors in the past, like a bad farming season, otherwise combined with a quite lax lifestyle).


>> And especially tons of modern-life induced stress

Actually there was an article on HN a few days ago which differentiated work-related distress between stress (induced by too much work) and anxiety (induced by too little work).

It's become a nuisance in the background now after many years but each new task usually brings both these 'joys':

1) When I first get "Do/change/add X into the giant ball of mud of application that noone completely understands", I first get anxiety. Literally I have no idea not just how am I going to implement that but if it's at all possible. The definition of "anxiety caused by too little work" still goes, because I'm not "working" (not anything palpable like lines of code that can be measured and PRs be made). I'm just 'thinking', but that isn't much considered in business. Can't charge the customers for 'thinking', you need to produce.

2) Once I get familiar with the complexity involved and have some idea on how things can be solved, it's already too late in the sprint phase, it should have been done already. Now follows stress of delivering on time the 'commitment'. Not to mention that I usually implement half the task before stumbling into new evidence that changes the equation enough to require a different approach or further 'thinking' all while time is running out and commitments are not met.

Task solved, another one pops up, rinse and repeat #1-#2.


Very relatable. What helps is just starting out a prototype immediately in stage (1), not caring about thinking it through deeply first. Then that "new evidence that changes the equation enough to require a different approach" arrives faster and is easier to incorporate. Plus, you get to be seen as "working" all the time (from the point of view of others, which would otherwise consider your pure thinking stage as 'slacking')!

Essentially you'd be doing the "thinking" by actively coding (at least a minimum solution), instead of thinking about the problem abstractly first. Though I often do it just like you described it, with all the issues you mentioned.


Yep, a solution that you rewrote a thousand times as you understood more, is still better than one perfect solution that occupied your head for several days along with the stress of having not implemented anything yet


Any recommendations for how to deal with this cycle? I find I fall into the same pattern you describe.


You are a smart person I think if you are worrying about this. I suggest finding a different job completely that does not involve technology. From observing many colleagues including ones that have had breakdowns, I think there is no healthy workspace in tech, only people that seem healthy because there are a few exceptional resistant ones.


See my comment to the parent: https://news.ycombinator.com/item?id=39701128


Alcohol! :)

Just kidding. (Well, half-joking only). I really don't know...


>carry a phone all day, stare at millions of micro led lights all day

The link between those and cancer is tenuous at best.


Indirect: screen time = time that your body is not moving.

Health benefits of exercise are well known. And likely to have some effect on the chances of developing particular types of cancer.

Not to mention indoor air vs. outdoor air, that bowl of snacks within reach while sitting, etc. Various factors that shift towards "healthy" while out for a walk, bicycle ride or whatever.


Are you sure? The manufacture of phones and computers and all the technology required for them demands our destructive and polluting infrastructure. To make these devices, mining and pollution is necessary (even if it is exported), so in my mind, eletronic devices is still an indirect cause. Just like a person is still responsible for pulling the trigger even if the bullet kills.


So you're arguing that because phones contain cobalt, and that cobalt mining in africa causes cancer in the local population, that phones are the reason "Why are so many young people getting cancer"? That might be technically true in the sense that some of those miners are young and are getting cancer, but it's a tenuous argument to say the least.


That is not my argument at all: my argument is that phones represent a larger phenomenon of choosing to produce and use unsustainable products that incudes cobalt and many other types of mining, we choose time and again to pollute the earth with our actions that put a sufficient amount of pollution in the air and water to increase the rate of cancers. Phones are the prime example but they are just one of many similar actions by our society to choose short-term gains in exchange for poisoning ourselves.


You don't have to snuff mine tailing dust to use a phone.


We are all breathing a bit of dust, and we all contributed to that mining a little bit by buying phones...


Why do we never mention all that traffic running outside everyones doors all the time?


Or stress. Our lives are much, much busier and inundated with tasks than those of our predecessors simply because technology allows us to do more work in shorter time (which was supposed to result in us doing less work overall, but that sorta backfired hard because yay capitalism and all that)

Our physical health and mental health are both intrinsically linked, and both under attack because it's all very profitable, really.


So they should get higher wages to pay for for better diets?


Diet and lifestyle of course, but mostly diet. I suggest everybody interested listen to this interview of Dr. Thomas Seyfried with an open mind https://youtu.be/qa3j40c8iAo?si=DTeIAaO2_Unn-dpL

In short, chronically elevated insulin + inflammation + mutagens = cells with degraded ability to breathe => switch to fermentation = cancer. This is known as the Otto Wartburg effect and has been known for a century.

Metabolic therapy is tremendously successful in eradicating cancers even in later stages. I have seen so many direct testimonials and stories I wouldn't even know where to begin.


>This is known as the Otto Wartburg effect

No it isn't. Warburg effect is observed in cells as a result of cancer.

>Metabolic therapy is tremendously successful in eradicating cancers even in later stages.

[citation needed]

Every time anything medical gets posted in HN, the amount of disinformation and bad medical advice is insane. It's easy to imagine (because it keeps happening over and over) a newly diagnosed cancer patient reading your comment and declining chemotherapy because apparently "keto diet beats cancer".


Sorry it was a sloppily-written comment in which I mixed up some things but the main point stands.

The video I posted has a detailed explanation by someone vastly more qualified than either of us.

> easy to imagine

People can make up their own minds.

Why the disparaging comment? After my own health concerns, I stumbled upon this information, and I can tell you, again, that I have seen people have success with a metabolically-oriented approach which involves lowering glucose exposure (principally but not solely), that's not saying just saying "do keto", and in fact some of the people that have done this (see https://braintumourresearch.org/blogs/in-hope/andrew-scarbor...) have done much more than that. And often it's because there was NO other option.


>The video I posted has a detailed explanation by someone vastly more qualified than either of us.

I care far less about what "someone vastly more qualified than either of us" has to say than whatever the current scientific/academic consensus is.


Fair enough, but when I watched it appeared convincing to me, so I think it's worth checking out.


https://en.m.wikipedia.org/wiki/Metabolic_typing#Metabolic_t...

''' "Metabolic therapy", including administration of laetrile, was promoted for cancer patients by John Richardson in the San Francisco Bay Area in the 1970s, until his arrest for violating the California Cancer Law and revocation of his license by the California Board of Medical Quality Assurance.[4]

...

"...retrospective reviews of the Gerson, Kelley, and Contreras metabolic therapies show no evidence of efficacy."[5]

'''


Also, you should try following the references you posted. Have you looked at [5]? See what is discussed there, and if it's really relevant to what we're discussing here https://www.mskcc.org/cancer-care/integrative-medicine/herbs.... Note how information and reference-poor that page is.


You're trying to paint it as something cooky. I asked Claude 3 Opus:

> Metabolic therapy for cancer is an approach that aims to exploit the differences in metabolism between cancer cells and normal cells. The idea is to target the unique metabolic vulnerabilities of cancer cells to slow down their growth or cause their death. While there has been some promising preclinical research, the efficacy of metabolic therapies in human cancer patients is still an area of active investigation.

> Some key points about the efficacy of metabolic therapy for cancer:

> Ketogenic diet: High-fat, low-carbohydrate ketogenic diets have been proposed as a way to starve cancer cells of glucose, their primary fuel source. Some animal studies and small human trials have shown potential benefits, but larger, well-controlled clinical trials are needed to establish efficacy. > Insulin potentiation therapy (IPT): IPT involves administering insulin alongside low-dose chemotherapy, with the idea that insulin makes cancer cells more susceptible to the effects of chemotherapy. While some case reports and small studies have suggested benefits, the efficacy of IPT remains unproven. > Targeting metabolic enzymes: Researchers are investigating drugs that inhibit enzymes involved in cancer cell metabolism, such as glutaminase and pyruvate kinase M2. While some of these agents have shown promise in preclinical studies, their efficacy in human patients is still being evaluated in clinical trials. > Combination with other therapies: Metabolic therapies may be most effective when combined with other cancer treatments, such as chemotherapy, radiation, or immunotherapy. More research is needed to identify the most promising combinations and to assess their efficacy and safety.


LLM's are pretty much the oppisite of a reliable source. They _confidently hallucinate_ Honestly very concerning to see someone using them like this on HN of all places


I am very well aware of how LLMs work, this was just to summarize some information that is widely available online. None of what Claude output here is amenable to a hallucination. There ARE animal studies. Insulin potention thepary exists, and so on.

It's funny because you say you are the one concerned, I was pretty much certain I'd get a reply about how silly I am to believe LLM output, in HN of all places.


And yet as conpared to a real source, all thst you've added To your aegument is "this LLM is a summary of real sources (that are trustworthy) I've seen elesewhere, trust me bro". I know people who belive confidently in many different conspiracy theories. If asked they would claim there are supporting studies, docters say so, etc.. Summarizing information online that's not from a verifiable source just isn't very useful.


ok, here's a relevant paper, "Ketogenic diet in the treatment of cancer – Where do we stand? ": https://sci-hub.se/https://doi.org/10.1016/j.molmet.2019.06....

> Major conclusions: The ketogenic diet probably creates an unfavorable metabolic environment for cancer cells and thus can be regarded as a promising adjuvant as a patient-specific multifactorial therapy. The majority of preclinical and several clinical studies argue for the use of the ketogenic diet in combination with standard therapies based on its potential to enhance the antitumor effects of classic chemo- and radiotherapy, its overall good safety and tolerability and increase in quality of life. However, to further elucidate the mechanisms of the ketogenic diet as a therapy and evaluate its application in clinical practice, more molecular studies as well as uniformly controlled clinical trials are needed

I don't understand why people are so rejecting of this information. I'm not a researcher, just someone with interest in health and again, it looks to me as if there is evidence, anecdotal, experimental, and a theoretical basis.

It also seems obvious that a chronically anabolic state such as what modern lifestyles and eating habits encourage, with chronically elevated insulin, prevent the body from entering the catabolic state such as what happens during fasting, in which damaged cells get recycled. In fact, fasting is also potent against cancer, and I've seen many anecdotes of such. You're not going to appreciate any mention of anecdotes though, I presume.




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