David Agus: Why we don’t “get” cancer

With the recent news about Angelina Jolie’s double mastectomy due to a faulty gene, cancer prevention — and the lengths to which it should go — became an even hotter topic in healthcare, grabbing at least 15 minutes of frenzied public attention about genetic testing and breast cancer.

Jay Walker, left, with David Agus at TEDMED 2013. Photo: Jerod Harris/TEDMED
Jay Walker, left, with David Agus at TEDMED 2013. Photo: Jerod Harris/TEDMED

Cancer took center stage at TEDMED 2013, too, as physician and author David Agus joined TEDMED curator Jay Walker to explain, as Agus told us today, why “cancer is not something the body gets, it’s something the body does.”  In other words, most of us are living with cancerous cells at any given time; it’s our body’s environment that decides whether they will multiply and flourish into disease.

“Anglelina Jolie doesn’t have cancer, and the BRCA1 mutation doesn’t cause cancer. It makes your cells more susceptible to getting these mutations that cause cancer,” he said. “What this is telling us is that her body has a systems issue.”

Agus is in favor of widespread genetic testing, particularly in cases of a family history, but in context.

“We’re in favor of getting all the information we can to help make decisions. Not that everyone should go out and have preventive mastectomies; BRCA1 mutations only cause 5 to 10 percent of all breast cancers. This is a small piece of the puzzle of information, but it’s an important piece,” he says.

What testing can do for us, he says, is help influence daily behavior.

“We’re not good at thinking about tomorrow, we’re only good about thinking about today. So if knowing your information changes how you live your life — whether you’re sedentary, whether you smoke or not, what you eat, how much you sleep — it’s still a major win.”

Agus talked more about the issue on CBS Today and yesterday published an op-ed in the New York Times about the cost of a gene test. He spoke at TEDMED 2011 about redefining cancer.