EXPERT VOICES

Timely insight on cancer topics from the experts of the American Cancer Society

American Cancer Society Expert Voices

The American Cancer Society

Less Food Marketing, Healthier Children

January 20, 2015

By Colleen Doyle, MS, RD


Have you seen all those fun and flashy commercials encouraging your kids to eat more fruits and vegetables? No? Neither have I. And there's a reason for that. 

Out of the $1.79 billion that the Federal Trade Commission says major food and beverage companies spent marketing foods and beverages to kids and teens (in 2009 - the most recent data available), less than .05% was spent marketing fruits and vegetables. Unfortunately for those of us who care about children's health - which I hope is all of us - the majority of those dollars was spent on marketing unhealthy foods and beverages. Forty percent was spent to market fast food and other restaurant foods, and another 22% was spent promoting high-sugar sodas and other carbonated beverages.

And consider these additional statistics:

  • Two BILLION advertisements for foods and drinks appeared on websites directed at kids in 2009, mostly for sugary cereals and fast food.
  • Dollars spent to market foods and drinks to kids via online games, mobile apps, social network ads, and other digital media increased by 51% from 2006 to 2009.
  • Companies spent $149 MILLION in 2009 to market sugary drinks and food in schools.
  • Companies spent $113 MILLION in 2009 on packaging with marketing aimed at kids (think SpongeBob, Hello Kitty, and other characters).
  • Fast-food restaurants spent over $700 MILLION in 2009 on marketing to kids, nearly half of which was spent on kids' meal toys and giveaways.
  • Kids saw 12 to 16 TV advertisements per day for unhealthy foods or drinks in 2011.
  • Eighty-four percent of foods and drinks advertised to kids on Spanish-language television are unhealthy.

And according to the Institute of Medicine, such advertising and marketing does indeed influence children's preferences, purchase requests, and diets - and is a contributing factor to the rates of overweight and obesity seen among US youth. Over the past 3 decades, rates of obesity have more than doubled among children ages 2 to 11 and have more than tripled among teens ages 12 to 18. In 2012, 28.5% of Caucasian youth ages 2-19, 32.5% of African American youth, and 38.9% of Latino youth were overweight or obese. If we are going to turn around the youth obesity trends in this country, addressing advertising and marketing of unhealthy foods and beverages to kids is going to have to be part of the equation.

You might wonder why the issue of food advertising and marketing and its impact on youth health is of concern to the American Cancer Society.  It's estimated that 1/3 of all cancers are associated with nutrition and physical activity factors, including extra weight.  And according to Centers for Disease Control, children and adolescents who are obese are likely to be obese as adults - thus putting them at risk for developing obesity-related cancers when they are adults. The cancer death rate has been declining since the early 1990s, and we want to see that trend continue.  Therefore, efforts to help children establish lifelong healthy behaviors - like eating well and being physically active - are important to the mission of the American Cancer Society.

The reality is that some progress has been made in reducing advertising and marketing of high-calorie, high-sugar, and low-nutrient foods and beverages to kids.  But not enough progress has been made. A number of companies participate in the Council of Better Business Bureau's Children's Food and Beverage Advertising Initiative (CFBAI), which has set voluntary standards for advertising and marketing to kids, but even then, there are loopholes. For example, member companies pledging to market only healthier fare to kids still placed 46 million ads for sugar-sweetened beverages on kids' websites in 2013.

Much work to date has focused on establishing standards for the nutritional quality of foods and beverages advertised and marketed to youth, but less attention has been paid to defining what actually constitutes advertising and marketing practices that target youth. Because of that, many children remain vulnerable to current industry marketing practices and tactics.  Existing definitions of marketing to kids do not address the wide range of new digital and interactive media currently used to reach kids; definitions for marketing in schools do not include middle and high schools; child-directed marketing definitions to do not include child- and youth-targeted product packaging, in-store promotions, and toy premiums.

A new report released today, from the Robert Wood Johnson Foundation Healthy Eating Research Program Recommendations for Responsible Food Marketing to Children  can help change that.  The report, which American Cancer Society Cancer Action Network policy experts participated in the development of, provides a comprehensive set of recommendations for food marketing practices directed toward children - all which are designed to help close major loopholes in current voluntary standards that leave our children unprotected from negative advertising and marketing influences.

Key recommendations have been made that can change the way the industry talks to children and influences their eating choices. Our news article explains all of them, and why they'll make a difference. 

It's been suggested that because of unhealthy diets and physically inactive lifestyles - and the resulting impact on overweight and obesity -- this generation of youth will live shorter and less healthy lives than their parents.  The advertising and marketing of unhealthy foods and beverages is contributing to this devastating projection.  As parents, as health professionals, and as concerned citizens, we need to speak up and take action. Food and beverage companies must be encouraged to strengthen their policies on food marketing to children. Companies not participating in the Children's Food and Beverage Advertising Initiative should be urged to join.  Companies should establish more responsible policies for marketing to children that close loopholes and ensure that youth are not regularly exposed to unhealthy food and beverage ads and other forms of marketing. In addition, school districts should update their local school wellness policies to only allow foods and beverages meeting science-based nutrition standards to be sold in K-12 schools.  While the U.S. Department of Agriculture has proposed regulations to this effect, school districts do not need to wait for federal policy to be finalized to update and strengthen their own policy.

Be an advocate for children's health. Demand that companies market their products more responsibly by writing to them and calling them out on social media.

But you can work at home for healthier children, too. Speak up at your kids' schools.  Be aware and mindful as you walk down the aisles at your grocery store.  Turn off the television, and limit screen time. 

It takes a village.  We can make a difference. This generation, and those to come, are counting on us.

 

Doyle is managing director of healthy eating active living environments (HEALE) for the American Cancer Society.

Chemo 101: What you need to know

January 12, 2015

By Agnes Beasley, MSN, RN, OCN

"What should I expect from chemotherapy?" 

I've heard those very words spoken by newly diagnosed cancer patients on many occasions in my extensive oncology nursing career. It's normal for a newly diagnosed patient to try to make sense of what is happening to them. Questions swirl like a tornado in a cancer patient's mind. You may feel that way right now. Some of the questions you may have are:

  • What can I expect on the day of chemotherapy (chemo)?
  • What can I expect when I go home after chemo?
  • What happens in the "chemo room?"
  • How long will it take to get my chemo?
  • Can I have someone with me during chemo to keep me company?
  • What am I allowed to bring with me to keep me busy?
  • Is it okay to sleep?
  • Will there be other people getting treatment around me or can I be in a private room?
  • I'm feeling anxious, overwhelmed, upset, and angry. Is what I'm feeling normal?
  • If I have questions, who do I call for the answers? More...

Filed Under:

Survivorship

The Cancer Atlas Reveals the International Burden of Cancer

December 03, 2014

By Ahmedin Jemal, DVM, PhD

The American Cancer Society has released the second edition of The Cancer Atlas book and, for the first time, a companion website. The Cancer Atlas provides in-depth information on the global burden of cancer, major risk factors, and cancer prevention and control measures.

Changes in developing countries leading to more cancer

 

It is estimated that the global burden of cancer is expected to rise from 14.1 million new cancer diagnoses in 2012 to 19.3 million in 2025 simply due to the aging and growth of the population. This is because the risk of getting cancer is greater as you age. During this period, even more cancers are diagnosed in less economically developed countries, increasing from 59% to 68% of the total cancer cases worldwide. In addition to aging, the burden is likely to increase as countries transition from a farming-based economy to an industry-based economy and as people change their work environments (office instead of farm), modes of transportation (driving instead of walking), and dietary habits (eating out instead of home cooked) - all of which lead to more obesity and physical inactivity, known risk factors for many common cancers.

Also, women are having fewer children and, therefore, also breastfeed for less time over the course of their lives, both of which may increase the risk of breast cancer. In addition, economically developing countries are being increasingly targeted by the tobacco, fast food, and beverage industries in search of new markets, leading to greater obesity, less physical activity, and more smokers. As a result, in many less developed countries more cancers such as lung, colorectal (colon), and breast are being diagnosed, and more people are dying from cancers typically associated with western lifestyles. In more developed countries, including the United States, rates of cancer diagnoses and deaths are decreasing or leveling off for the same cancers.  More...

Filed Under:

Global Cancer

Continuing to smoke after a cancer diagnosis

November 17, 2014

By J. Lee Westmaas, PhD


While the American Cancer Society and other organizations traditionally focus on getting smokers to quit before they develop cancer, there's a group of smokers who are especially susceptible to the negative effects of smoking. They are cancer survivors - some of whom have been diagnosed with a smoking-related cancer. It's easy to say, "If you get cancer, then you should know better and quit, and stay quit," but that's not the whole story.

Getting a cancer diagnosis does motivate some smokers to quit. Using data from the American Cancer Society Cancer Prevention Study-II, we found that about 1 out of 3 smokers quit smoking when they were diagnosed with cancer. That compares with only 1 out of 5 smokers who quit but were not diagnosed with cancer during the same time periods studied.

Even smokers whose cancer was not strongly linked to smoking (like breast cancer) quit at higher rates than undiagnosed smokers. These results were not caused by the smokers being unable to smoke due to their illness; those people were excluded from the study.

Smoking: Risky for patients and survivors

Quitting is particularly important for cancer patients and survivors because smoking can increase the likelihood of a recurrence, delay wound healing, and make cancer treatments less effective. This is true even for cancers that aren't related to smoking. 

Unfortunately, there are some cancer survivors who find it very hard to quit. We looked at data from the Study of Cancer Survivors (SCS-I), a nationwide quality-of-life study conducted by the Behavioral Research Center at the American Cancer Society. The study surveyed 2,938 survivors of 10 different kinds of cancers approximately 9 years after their initial diagnosis.

We found that 9.3% of these survivors were current smokers. Survivors of bladder, lung, and ovarian cancers had the highest smoking rates in this study. Most (83%) current smokers smoked daily, averaging almost 15 cigarettes per day. In fact, 40% percent of daily smokers smoked more than 15 cigarettes per day. More...

Are lung cancer breath tests more than hot air?

November 10, 2014

By Ted Gansler, MD, MBA, MPH

Can breath tests (like those used to check whether drivers have been drinking alcohol) be used for lung cancer screening? Or, is this (pardon the pun) just a lot of "hot air?" Although breath tests for lung cancer are "not ready for prime time," there has been some encouraging research.

There are 3 main ways to fight cancer - prevention, screening, and treatment. Although lung cancer remains the leading cause of death from cancer worldwide and in the United States, researchers are making progress against this disease on all 3 fronts. 

Over nearly a half century, researchers tried several tests for lung cancer screening, none of which were accurate enough for widespread use. Because of research results released in 2010, the American Cancer Society and several other organizations now recommend that people at high risk for lung cancer (certain groups of current and former smokers) ask their doctor about CT scans for lung cancer screening.

On average, people in these high risk groups who have this test every year according to the ACS guidelines can reduce their risk of dying from lung cancer by about 20%. This can save a lot of lives and prevent a lot of suffering, so if you are a current or former smoker, you should read more about our lung cancer screening recommendations.

Research into easier lung cancer screening

One challenge with CT scans is that they find some lung nodules that are neither clearly cancer nor clearly benign (not cancer). This question is usually figured out by follow-up scans, but sometimes biopsies are needed. These biopsies can pose significant risks, which is one reason screening isn't recommended for people whose risk of lung cancer isn't as high as that of heavy smokers. So researchers are looking for ways to make screening easier and more accurate, faster and more affordable. More...

Tips for your first oncologist's appointment

October 13, 2014

By Francisca Alvarado, BSN, RN, OCN


The cancer journey brings about many overwhelming feelings. Many thoughts may go through your mind when you hear, "You have cancer and you need to be seen by an oncologist." You may wonder how this will impact you, your family, and your friends. The possible anxiety caused by wondering what the oncologist will tell you at the appointment and which decisions you will have to make may take over your thinking. You may have trouble listening, understanding, or remembering what anyone is telling you during this time due to the very normal distress, uncertainty, fear, and anger you may be feeling.

Having a better understanding of what to expect, what to take with you, and which questions to ask at your first oncologist's appointment may help you better prepare and lessen the anxiety. 

Get the logistics clear


Before your first appointment, make sure you know the answers to these questions. Although they seem obvious, it can be easy to overlook these details when you're worried about your diagnosis:

  • What is the full name of the oncologist I will be seeing?
  • Does the oncologist take my insurance? What will I be expected to pay on the first visit?
  • How will the oncologist get my medical records? Will the referring physician send them, or do I need a copy to take to the first appointment? If I need a copy, how can I get it?
  • How do I get to the oncology office?
  • Where do I park, and how much will I have to pay for parking?
  • How long will the first appointment take?

More...

Filed Under:

General | Survivorship

Adults Need Vaccines, Too

September 22, 2014

By William Schaffner, MD


As I like to tell my patients, the best approach to everyday health is a proactive one, and that means staying up-to-date on recommended vaccinations in addition to annual checkups.

Many adults don't visit a doctor unless they feel ill, nor do they think about vaccination as part of their routine, preventive healthcare. This leaves them needlessly vulnerable to diseases that can cause severe health complications or even death. 

Vaccines are a safe, effective way to help prevent a number of diseases at any age-from 6 months to 60 years, and beyond. In fact, there are several vaccines recommended specifically for adults because of their risk for certain infections.

It's important for all adults to check with a healthcare professional about which vaccines are recommended for them, as we all need some vaccinations as we age. For example, the chance of having complications from the flu, or getting shingles or pneumococcal disease (see below for more information) increases with age. In other cases, a weakened immune system or the presence of underlying illnesses like cancer, heart disease, or diabetes can make us more susceptible to diseases.

Many adult vaccines are readily available at primary care medical offices and in pharmacies, and the cost of vaccination is usually covered by Medicare and most private insurers. So, there are no excuses for not staying up-to-date!

Vaccines and the immune system


If you have a weakened immune system due to cancer or related treatment, there are vaccines you should receive - and some that you should not receive.

Vaccines come in two forms: inactivated or live. Inactivated vaccines only contain killed viruses or bacteria and can be used for those with compromised immune systems. Live vaccines, such as the flu nasal spray (but not the shot, which has inactivated virus) or shingles, contain weakened but live components. While this does not pose a risk for people with a healthy immune system, live vaccines are not recommended for people whose immune system is weakened by certain cancers, cancer treatment, or other factors. 

Cancers like leukemia, lymphoma, and Hodgkin disease interfere directly with the immune system. In most cases, however, it's not the cancer itself, but the cancer treatment, that changes the immune system. Some cancer treatments, such as radiation, certain chemotherapies, and transplantations, prevent your immune system from responding the way it should to infections. If you aren't sure whether your immune system is being affected, talk to your doctor or other healthcare professional before you or anyone you spend a lot of time with gets any vaccines. More...

Filed Under:

General | Survivorship

After Prostate Cancer Treatment Ends

September 11, 2014

By Rebecca Cowens-Alvarado, MPH


According to the American Cancer Society, there are nearly 3 million prostate cancer survivors in the United States today and this number is expected to increase to almost 4.2 million by 2024.  Most prostate cancers (93%) are diagnosed at the local or regional stage, before the cancer has spread to surrounding organs. Treatment at these early stages is often very successful, and the 5-year relative survival rate approaches 100%.

Treatments for prostate cancer patients vary based on age and stage of diagnosis, but the majority of prostate cancer patients younger than aged 65 are more likely to be treated with radiation, radical prostatectomy, or a combination of both. Some patients may also be treated with androgen deprivation therapy (ADT), while others may simply undergo active surveillance, or "watchful waiting," to see how the prostate cancer progresses before choosing a treatment option. While the survival rate for prostate cancer is high, being diagnosed and treated for prostate cancer may cause a number of physical, psychological, and social side effects that can last (or develop) long after treatment ends.

Common issues faced by prostate cancer survivors who underwent surgery or radiation include: difficulty having an erection and decreased interest in sex, which may impact sexual intimacy; needing to urinate quickly or not being able to control when they urinate; bowel problems such as not being able to control or having diarrhea; and distress or depression. Prostate cancer survivors who are on ADT may also experience lack of interest in sex, hot flushes, weakening of the bones (osteoporosis) and increased risk of heart attack or diabetes. And for those undergoing active surveillance or watchful waiting, the anxiety and distress from waiting for the results of frequent prostate-specific antigen (PSA) tests are very real. More...

Filed Under:

Prostate Cancer | Survivorship

How electronic health records can help on your cancer journey

August 20, 2014

By Simone Myrie

Ed. note: This guest post by Simone Myrie of the Office of Consumer eHealth, Office of the National Coordinator (ONC) for Health Information technology, US Department of Health and Human Services. In it, she explains how electronic health records and Blue Button can help cancer patients, survivors, and caregivers as they navigate their cancer journey.


No two experiences with cancer are alike, but there are certain things that almost all cancer patients and their loved ones share in common. From getting a diagnosis, to coordinating care among doctors and at home, and on to long-term survivorship plans, the cancer experience is one centered around information. Some of the information we seek is mostly objective: What can I expect this disease to do? What are my treatment options? How can I improve my odds of beating cancer?

But some of the most important information you can gather, keep track of and share is information unique to you: Your own health records. The visit summaries, clinical notes, test results, medication lists, treatment histories, and other documents represent a critical picture of your individual cancer experience. This information has implications for your individual choices, your professional care, and the care you receive from loved ones. More...

Filed Under:

General | Survivorship

Can we predict who will become addicted to cigarettes?

July 24, 2014

By Victoria Stevens, PhD

Every day in the United States, nearly 4,000 young people under the age of 18 smoke their first cigarette, according to the Centers for Disease Control's Youth and Tobacco Use Fact Sheet. About 1,000 of these kids will go on to become daily smokers, which is the next step on the pathway to becoming addicted to nicotine. Over the course of a year, that is 365,000 new daily smokers. About 60%, or almost 220,000, will still be regular smokers 7 to 9 years later. 

When they tried that first cigarette, did they expect to become dependent on nicotine and unable to quit smoking whenever they want to? Of course not, because they feel young and invincible. In fact, only 3% of the regular smokers expected to be still smoking 5 years later. 

Is nicotine addiction in our genes?

A paper published in JAMA Psychiatry may give some clues to why so many young people continue smoking after that first try. Please note: the research is preliminary, and much more needs to be done before any conclusions are reached and recommendations made. But it's also intriguing. More...

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