Monday, September 22, 2008

We can stop the cancer epidemic

By David Servan-Schreiber

There is an epidemic of cancer today. One in three Americans will be diagnosed with cancer, often before the age of 65. I have been on the wrong side of this statistic since I was 31 years old, when I discovered I had brain cancer.

Since 1940, we have seen in Western societies a marked and rapid increase in common types of cancer. In fact, cancer in children and adolescents has been rising by 1 to 1.5 percent a year since the 1960's. And these are cancers for which there is no screening.

For most common cancers - prostate, breast, colon, lung - rates are much higher in the West than in Asian countries. Yet Asians who emigrate to the United States catch up with the rates of Americans within one or two generations. While in Asia, Asians are protected not by their genes, but by their lifestyle.

Indeed, modern studies show that at most 15 percent of cancers are due - and only in part - to inherited genetic defects. Eighty-five percent are not.

However, cancer does run in families: A landmark New England Journal of Medicine study showed that children adopted at birth by parents who died of cancer before the age of 50 had the cancer risk of their adoptive parents, not of their biological ones. What gets passed on from one generation to the next are cancer-causing habits and environmental exposures, not just cancer-causing genes.

We continue to invest 97 percent of our cancer research funds in better treatments and early detection. Only 3 percent is invested in tackling causes.

I was a founding board member of Doctors Without Borders, USA. I worked as a volunteer physician in Iraq, Guatemala, Tajikistan and Kosovo. I know about epidemics in refugee camps. No cholera epidemic can be stopped by early detection and antibiotic treatment - as effective and important as these are. That is because cases always develop at a rate faster than our ability to treat individual patients.

In the 1800s, Britain and America faced several large cholera epidemics. They were able to stop them without antibiotics. Scientists and physicians at the time had not even discovered the concept of germs, but leaders with enough foresight and concern decided to act on what seemed the most likely environmental cause: contaminated water sources in the neighborhoods with the most cases. Cholera receded.

It is ironic to think that if we had had antibiotics at the time, and had counted on them to deal with the disease as we count today on anticancer treatments, we might never have controlled cholera.

We have much more data about the most likely causes of the modern cancer epidemic than our forbears did about cholera.

The World Cancer Research Fund published a report in 2007 concluding that a majority of cancer cases in Western societies could be avoided with life-style measures: 40 percent from changes in diet and physical activity (more vegetables and fruits, less sugar, less red meat, regular walking or the equivalent activity 30 minutes six times per week), 30 percent from smoking cessation, and about 10 percent from reduced alcohol consumption.

We now even have data about how specific foods such as broccoli and cabbages, garlic and onions, green tea or the spice turmeric directly help kill cancer cells and reduce the growth of new blood vessels they need to develop into tumors.

Reducing exposure to many of the well-characterized chemical carcinogens abundant in our modern environments (pesticides, estrogens, benzene, PCBs, PVCs and bisphenol A from heating liquids in plastic containers, alkylphenols in cleaning products, parabenes and phthalates in cosmetics and shampoos, etc.) would contribute even further to lessen the cancer risk.

By neither discussing nor investing in research and preventive programs based on these established scientific facts, we are promoting a sense of hopelessness with respect to cancer.

Most people continue to view cancer as a form of genetic lottery when it clearly is not. While we should all guard against false hope in addressing cancer, we should guard even more adamantly against this false hopelessness. And we should begin to help our society, and each one of us, address the causes of this modern epidemic.

Dr. David Servan-Schreiber, clinical professor of psychiatry at the University of Pittsburgh and a founding board member of Doctors Without Borders, USA, is the author of "Anticancer - A new way of life."

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Gut Instinct’s Surprising Role in Math


You are shopping in a busy supermarket and you’re ready to pay up and go home. You perform a quick visual sweep of the checkout options and immediately start ramming your cart through traffic toward an appealingly unpeopled line halfway across the store. As you wait in line and start reading nutrition labels, you can’t help but calculate that the 529 calories contained in a single slice of your Key lime cheesecake amounts to one-fourth of your recommended daily caloric allowance and will take you 90 minutes on the elliptical to burn off and you’d better just stick the thing behind this stack of Soap Opera Digests and hope a clerk finds it before it melts.

One shopping spree, two distinct number systems in play. Whenever we choose a shorter grocery line over a longer one, or a bustling restaurant over an unpopular one, we rally our approximate number system, an ancient and intuitive sense that we are born with and that we share with many other animals. Rats, pigeons, monkeys, babies — all can tell more from fewer, abundant from stingy. An approximate number sense is essential to brute survival: how else can a bird find the best patch of berries, or two baboons know better than to pick a fight with a gang of six?

When it comes to genuine computation, however, to seeing a self-important number like 529 and panicking when you divide it into 2,200, or realizing that, hey, it’s the square of 23! well, that calls for a very different number system, one that is specific, symbolic and highly abstract. By all evidence, scientists say, the capacity to do mathematics, to manipulate representations of numbers and explore the quantitative texture of our world is a uniquely human and very recent skill. People have been at it only for the last few millennia, it’s not universal to all cultures, and it takes years of education to master. Math-making seems the opposite of automatic, which is why scientists long thought it had nothing to do with our ancient, pre-verbal size-em-up ways.

Yet a host of new studies suggests that the two number systems, the bestial and celestial, may be profoundly related, an insight with potentially broad implications for math education.

One research team has found that how readily people rally their approximate number sense is linked over time to success in even the most advanced and abstruse mathematics courses. Other scientists have shown that preschool children are remarkably good at approximating the impact of adding to or subtracting from large groups of items but are poor at translating the approximate into the specific. Taken together, the new research suggests that math teachers might do well to emphasize the power of the ballpark figure, to focus less on arithmetic precision and more on general reckoning.

“When mathematicians and physicists are left alone in a room, one of the games they’ll play is called a Fermi problem, in which they try to figure out the approximate answer to an arbitrary problem,” said Rebecca Saxe, a cognitive neuroscientist at the Massachusetts Institute of Technology who is married to a physicist. “They’ll ask, how many piano tuners are there in Chicago, or what contribution to the ocean’s temperature do fish make, and they’ll try to come up with a plausible answer.”

“What this suggests to me,” she added, “is that the people whom we think of as being the most involved in the symbolic part of math intuitively know that they have to practice those other, nonsymbolic, approximating skills.”

This month in the journal Nature, Justin Halberda and Lisa Feigenson of Johns Hopkins University and Michele Mazzocco of the Kennedy Krieger Institute in Baltimore described their study of 64 14-year-olds who were tested at length on the discriminating power of their approximate number sense. The teenagers sat at a computer as a series of slides with varying numbers of yellow and blue dots flashed on a screen for 200 milliseconds each — barely as long as an eye blink. After each slide, the students pressed a button indicating whether they thought there had been more yellow dots or blue. (Take a version of the test.)

Given the antiquity and ubiquity of the nonverbal number sense, the researchers were impressed by how widely it varied in acuity. There were kids with fine powers of discrimination, able to distinguish ratios on the order of 9 blue dots for every 10 yellows, Dr. Feigenson said. “Others performed at a level comparable to a 9-month-old,” barely able to tell if five yellows outgunned three blues. Comparing the acuity scores with other test results that Dr. Mazzocco had collected from the students over the past 10 years, the researchers found a robust correlation between dot-spotting prowess at age 14 and strong performance on a raft of standardized math tests from kindergarten onward. “We can’t draw causal arrows one way or another,” Dr. Feigenson said, “but your evolutionarily endowed sense of approximation is related to how good you are at formal math.”

The researchers caution that they have no idea yet how the two number systems interact. Brain imaging studies have traced the approximate number sense to a specific neural structure called the intraparietal sulcus, which also helps assess features like an object’s magnitude and distance. Symbolic math, by contrast, operates along a more widely distributed circuitry, activating many of the prefrontal regions of the brain that we associate with being human. Somewhere, local and global must be hooked up to a party line.

Other open questions include how malleable our inborn number sense may be, whether it can be improved with training, and whether those improvements would pay off in a greater appetite and aptitude for math. If children start training with the flashing dot game at age 4, will they be supernumerate by middle school?

Dr. Halberda, who happens to be Dr. Feigenson’s spouse, relishes the work’s philosophical implications. “What’s interesting and surprising in our results is that the same system we spend years trying to acquire in school, and that we use to send a man to the moon, and that has inspired the likes of Plato, Einstein and Stephen Hawking, has something in common with what a rat is doing when it’s out hunting for food,” he said. “I find that deeply moving.”

Behind every great leap of our computational mind lies the pitter-patter of rats’ feet, the little squeak of rodent kind.

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Video: Car = Flamethrower

By Noah Shachtman

I will refrain from making any "hot car!" jokes...

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How easily we are fooled: The rotating grid illusion

Filmmaker and animator David O'Reilly (who came up with the concept for iHologram) has noticed an interesting property in this animated GIF:


He writes:

While working in 3D last year, I discovered this optical illusion: A large grid seen rotating at a certain speed will appear to group itself into smaller grids, spinning independently.

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Fear of fairy tales

By Joanna Weiss

Probably because she'd expressed a firm interest in fairy wings and dresses made of tulle, my 3-year-old daughter got a plastic Rapunzel playset last year as a gift. It was a collection of bedroom furniture and three small dolls: a girl with a retractable braid, a smiling prince, and another girl, apparently a playmate. And it came with a small companion book, "Rapunzel's Tower Room," which began, "At the edge of a forest village, there was a tower owned by a kind witch."

(Hulton Archives/Getty Images)

The book went on to spin the tale of a charmed girl named Rapunzel, who spent her days in the tower sewing dresses with a friend. She loved when the witch came to visit and teach songs, including one that made Rapunzel's hair grow longer. But tension arrived: One day, Rapunzel looked out the window and saw a fair in the village nearby. She wanted to go, but the witch was off tending to her garden and couldn't let her out. Fortunately, a prince riding by in his carriage called up to her, "Rapunzel! Why aren't you at the fair?"

This was not the fairy tale I vaguely recalled from my childhood - the one with the mother who gives up her child, the vindictive witch, the powerless girl trapped high above the ground. This new version was sanitary and safe in a way that modern parents will easily recognize. In an age when some families ban the word "killed" or come up with creative euphemisms to mask the death of goldfish, it's not hard to see why a toy company would reduce Rapunzel's story to its prettiest parts. Real life, presumably, packs enough trauma for children to think about later.

Yet something important is lost when a child's introduction to fairy tales comes in such whitewashed form. It's not just Rapunzel: In toys, movies, and books, the old fairy tales are being systematically stripped of their darker complexities. Rapunzel has become a lobotomized girl in a pleasant tower playroom; Cinderella is another pretty lady in a ball gown, like some model on "Project Runway."

"Fairy tale" may be our shorthand for castles and happy endings, but these classic stories have villains, too - nefarious witches, bloodthirsty wolves, stepmothers up to no good. And scholars have come to see the stories' dark elements as the source of their power, not to mention their persistence over the centuries. Rich in allegory, endlessly adaptable, fairy tales emerged as a framework for talking about social issues. When we remove the difficult parts - and effectively do away with the stories themselves - we're losing a surprisingly useful common language.

"There's a very important reason why these tales stick," says Jack Zipes, a German professor and folklorist at the University of Minnesota, who has written such books as "Fairy Tales and the Art of Subversion" and "Happily Ever After: Fairy Tales, Children, and the Culture Industry." "It's because they raise questions that we have not resolved."

Scholars say there are no "pure" versions of fairy tales, which began as oral traditions and were adapted to fit different cultures and times. Even the Grimm brothers, who recorded German versions of these stories in the early 19th century, continually revised their own work. But common story lines have persisted over the centuries, and they address themes that continue to preoccupy people today.

Little Red Riding Hood, in which a wolf lures a young girl out of public view, has been taken as a story about sexual awakening and as an allegory about a girl made responsible for her own rape. Snow White, in which a motherless child is hunted by her jealous stepmother, is rooted in concerns about abusive parenting.

Cinderella, meanwhile, articulates the fears children have about blended families: After a girl's mother dies, her cruel stepmother favors her biological daughters and forces her stepdaughter into servitude.

And then there is Rapunzel, a tale that first emerged in 17th-century Italy. The classic versions begin with a pregnant woman who, consumed with hunger, steals vegetables from the garden of an evil witch. The witch demands the woman's unborn child as payment, then locks the girl in a tower with no stairs or door. When she wants to visit, she calls up to the girl, who hangs her long hair out the window so the witch can climb up.

Many scholars view this story through the lens of fertility, a critical issue for Renaissance-era families that suffered from high child mortality rates. This is an allegory, they say, about a woman preparing for birth, knowing that fate might take her child away. And about another woman, represented by the witch, who may be unable to have children of her own.

As for Rapunzel, Steven Jones, a folklorist at California State University-Los Angeles, places her in what he calls the "Innocent Persecuted Heroine" cycle, which deals with the transition to adulthood. This story, Jones says, is a metaphor for sex. Rapunzel is secluded at the brink of adolescence, kept from any contact with men. Her growing hair reflects her growing sexual awareness and desire. And the prince pierces the tower, sneaking up Rapunzel's hair for secret trysts. In one version of the story, the witch discovers the deceit after Rapunzel winds up pregnant. As most of us know full well, a teenager consumed with desire can find ways around the rules.

Some of these metaphors - fortunately - will fly over the youngest kids' heads. But others, scholars say, carry meaning early on. Zipes reads his own Grimm Brothers translations in Minneapolis-St. Paul elementary schools, and says he has seen young kids latch onto the classic, dark versions of the tales. Some of the most disadvantaged students, he says, "really relate to us, because we're telling tales that they experience in their homes."

And even kids shielded from terrible strife find connections to fairy tale worlds. Of Cinderella, Zipes says, "What are we talking about? We're talking about today. How many families are split today?"

The story of Rapunzel, like most other fairy tales, has inspired modern authors, who have reworked it to address the pressing questions of the day. As the novelist and academic Alison Lurie wrote last May in the New York Review of Books, some modern literary adaptations use the Rapunzel framework to address parental abandonment, adoption, and overprotectiveness. Donna Jo Napoli's 1996 novel "Zel" paints the witch as a possessive mother, unwilling to let her child love anyone but her. Cameron Dokey's 2007 novel "Golden: A Retelling of Rapunzel" treats the witch more kindly: She gives up her long-haired child but adopts another girl who is bald and reunites happily with both in the end.

Filmmakers, too, have long used classic fairy tales as jumping-off points to explore timely issues. "Ever After," the 1998 Drew Barrymore movie, retold Cinderella with a feminist message. The dark and violent 1996 film "Freeway" starred Reese Witherspoon as a modern-day version of Little Red Riding Hood, which exchanged the medieval forest for the dangerous big city.

Even Harry Potter, Zipes says, can be seen as a modern take on Cinderella: a boy who faces cruel treatment at the hands of his adoptive family, before he discovers his true and formidable talents.

But while the Harry Potter books and films contain their share of darkness, Zipes points out that many fairy tales become far more sanitized when they meet the children's literature industry - which is increasingly dependent on sequels and product tie-ins, and calibrated to appeal to the lowest common denominator. He is galled at versions of Little Red Riding Hood in which Granny isn't eaten by the wolf, but is conveniently out of the house when Red Riding Hood pops in.

In truth, I think I've told a version of that one to my little girl, putting my own, gentle spin on the story. And there is reason to protect the smallest kids from the violent parts of fairy tales, says David Bickham, a research scientist at the Center on Media and Child Health at Children's Hospital Boston. Young kids are already exposed to plenty of violence, he says, in news reports and superhero stories. And children process fear differently as they grow older.

I've seen the evolution in my own home: My daughter, now 4, recognizes that some books and films contain mean ladies, from the sea witch in Disney's "The Little Mermaid" to the Michelle Pfeiffer character in "Hairspray." Her understanding of fairy tales will continue to evolve, Bickham says. Preschoolers tend to take stories literally, and may need protection from the scariest parts. By 7 or 8, they can tell the difference between fiction and reality. By 13, they're able to connect allegory to real situations. (For practical viewing and reading suggestions, Bickham recommends psychology professor Joanne Cantor's 1998 book, "Mommy, I'm Scared.")

But it's fair to wonder when some kids will get to the classic fairy tales, if at all. When the stories intersect with commerce these days - whether in children's books or the endless barrage of toys - they can quickly get reduced beyond recognition. It's easier to sell a Rapunzel playset, after all, as something entirely cheery and safe. And if you simplify fairy tales even further, it doesn't take long before you get to the Disney Princesses.

Disney, of course, has long been a fairy tale re-packager par excellence, turning classic folklore into enduring animated films. And like all fairy tale retellings, Disney movies have reflected their times. The 1937 version of "Snow White" celebrated that era's ideals of American beauty. "The Little Mermaid," from 1989, replaced Hans Christian Andersen's helpless heroine with a spunky redhead - and while the movie didn't shy away from darkness, it softened the edges for family viewing. (In Andersen's version, the evil witch cuts off the mermaid's tongue.)

The Disney Princess brand takes the softening much further, recasting fairy tales for a fully consumerist culture. And it's hard not to admire its brilliance as a marketing stroke. The concept dates back to 1999, when the chairman of Disney Consumer Products attended a Disney ice show, says Kathy Franklin, the company's vice president of global franchise development for girls. He saw how many girls showed up in dress-up clothes, and mused about what might happen if Disney's own fairy tale heroines were packaged together.

At first, the idea was controversial even within Disney, James B. Stewart writes in his 2005 book, "Disney War." Roy Disney, Walt's nephew, argued that the Disney Princesses would betray the fairy tales themselves, since these women didn't coexist in their respective stories. But for small girls, pretty ladies seem to tap into a primal dress-up urge. And what began as an experiment in Disney stores - a few toys featuring Snow White, Cinderella, and Sleeping Beauty, striking a sassy group pose - quickly grew into a $4 billion global business, largely aimed at 3- to 7-year-olds.

Today, you can find countless girls in Disney Princess socks and light-up sneakers, and you can't walk through a supermarket without seeing the princesses on diapers and tubes of children's toothpaste. And while Franklin says the characters are based on personalities crafted in the movies - Ariel is independent, Cinderella is a good friend - it's hard to see those differences when you're looking at their pictures on a bedspread. To little girls, these fairy tale heroines are pretty ladies, nothing more. And perhaps to adults, too. Disney has introduced a line of Disney Princess costume wedding gowns, designed, Franklin says, "for women who have always dreamed of their wedding as the day they're a princess."

So there it is: a way to speed straight to the happy ending, without stopping to think about the story along the way. It's a great way to sell just about anything, but it's also precisely the opposite of what makes fairy tales compelling in the first place. The modern, commercial fairy tale contains no conflict, no resolution, no questions unresolved, no larger issues to explore. Once the princess climbs down from the tower, or the ball comes to an end, you're left with nothing to talk about at all.

Joanna Weiss covers television and pop culture for the Globe.

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