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The Second Question

When someone is diagnosed with cancer, they have a lot of questions.  The first question, as I mentioned recently, is this:  “Am I going to die?” 

But another common question follows after that.  “How did this happen?”

Cancer patients often feel regret.  What if I had quit smoking?  What if my diet had been healthier?  What if I had gotten my mammogram sooner?  Guilt and regret, while understandable (and, to some extent, unavoidable) are not productive in walking the cancer journey.

“How did this happen?”  The answer is complex.  We know that UV exposure is the causative agent for many melanomas.  We also know many people who tan to the color of well-worn leather never have melanoma.  Just like “Grandpa Earl” who smoked every day until he died in a tractor accident at age 102, these people are able to withstand prolonged and repeated exposure to a known carcinogen and not develop cancer.

A family history of melanoma increases risks.  A history of severe sunburns during childhood increases risk.  Having a lot of moles increases risk.  Yet some people who burned over and over, who have melanoma spread throughout their family tree, and whose skin looks like a crazy game of “connect the dots” never have this cancer.

The fact is, we all have mutations and aberrations that take place in our cells.  Most of the time the cells recognize something has gone wrong and they are able to fix themselves.  If they can’t fix themselves, most of the time the errant cells self-destruct.  If they don’t self-destruct, most of the time our body’s immune system finds those cells and gets rid of them. 

Most of the time.

Getting melanoma is like hitting the lottery in the worst possible way.  An errant melanocyte manages to avoid all of those built-in protection mechanisms and the result is cancer.  Engaging in activities that cause more mutations raises the odds of hitting the cancer lottery.  And, when our immune system is compromised—through sickness or stress, poor nutrition or lack of exercises—it becomes less competent in mopping up mutated cells.

Still, it is all a gamble.  No guarantees that the best, most balanced lifestyle will protect us.  No guarantees that the worst, most reckless lifestyle will result in cancer.

The smart bet is to take reasonable steps to lower the risks.  Avoid carcinogens like UV radiation.  Check your skin for spots that look different, or are changing.  Maintain a healthy lifestyle, with exercise and a mindset that reduces stress.

“How did this happen?”  No-one can say for certain what causes any given individual to have melanoma.  But we have good clues, and by lowering the exposure to risk factors, we can, together, reduce the number of newly diagnosed patients who have to answer that question.