Get cancer[1] and you’ll be inundated with advice about food, most wrong and much contradictory: avoid sugar; processed food kills; meat promotes cancer; ketogenic diets are incompatible with cancer; milk is dangerous; milk is healing; cancer is impeded by vegetables; honey is good; tea is safe; coffee is dangerous; tumors like Adderall. I think people latch onto diet-based advice, like they do prayer, as a mechanism of control, even if the mechanism is faulty, in a situation where any control is highly medical and scientific and thus beyond the typical person’s abilities. Today, the most common form of nutrition advice is to avoid sugar, even though no evidence suggests that a low-sugar diet will eliminate or reduce cancer (“cutting out all sugars doesn’t actually fight existing tumors”)[2]. Sure, it’d be nice if one could follow a particular diet advice in order to eliminate tumors. “It’d be nice” is not the same as “it is true.”

There’s a human tendency to crave control even if craving control isn’t well correlated with true control over a chaotic, uncertain world. One sees this, for example, in people who erroneously think driving is safer than flying—a driver has some control, but, on a per-mile basis, flying is way safer. We imagine that that we’ll evade the drunk driver, the woman distracted by her smartphone, the dude yelling at his kids. In reality, we don’t control the cars and distracted drivers around us. By contrast, no amateurs fly large planes, the pilots are sober experts, and the FAA extensively digs into any crash to figure out how to prevent the same thing from happening again.

We collectively (and bizarrely, in my view) accept 40,000+ car fatalities every year in the U.S. alone. To me this is insane, but I’m the weirdo in that most people don’t think statistically and accept the fact that people they know and sometimes will be seriously hurt or killed in car crashes. In Sweden, however, there’s an effort to understand the factors underlying serious car crashes, and, because of that effort, “Today, Sweden has some of the lowest rates of road traffic fatalities in the world.” In the U.S. and much of the world, we tend to blame individual drivers, instead of systems; systems, however, can (and should) be improved. In Sweden, “officials were no longer allowed to design roads for idealised drivers who never became distracted or exceeded the speed limit. They had to make roads for real people who made mistakes.” Drivers still drive, but the roads are built to limit the ability of people to kill and maim one another. Real control happens at the level of the system.

I’m not saying striving for control is bad; given the frantic, relentless efforts Bess and I have put into keeping me alive, it’d be peculiar and hypocritical if I did. Striving for greater control is good, but grasping at illusions is not, particularly if those illusions are deleterious to the desired outcome, like, for me, staying alive via clinical trials. Individuals influence their cancer risks; not smoking, or not smoking much, is an obvious way. And it is true that high sugar intake is a risk factor for developing cancer. Once someone has cancer, though, eating sugar (or not), or eating meat (or not) isn’t going to affect the cancer’s course. What will is the usual: surgery, chemotherapy, radiation therapy, oncology treatments (like the bispecific antibody I got, or the antibody drug conjugate (ADC) I’m on now). I’ve been on a low-sugar diet for more than a decade, and that didn’t stop a squamous cell carcinoma from growing in my tongue. There’s a correlation between a low-sugar diet and avoiding cancer, but it’s far from r = 1.0.