Live Younger Longer

parts of my body. Treatment would be more grueling — six months of
chemotherapy and surgery to remove any residual cancer.

---

A chest X-ray in 1994 revealed the spread of embryonal carcinoma to my lungs (circled). I
keep this photo by my desk to remind me of how fortunate I am to be here.
Following treatment, I was, for the second time, considered cured. It was at
this point that I had a realization: I had had cancer twice before the age of
40. I had a family history of cancer. I also had a wife and three young
children. Early death was not an option in my mind. I needed to do
everything I could to prevent this from happening again.

---

The thought of recurrence is one that never really leaves a cancer survivor.
And it’s understandable to think that ultimately it may be what kills you.
That was my thinking initially. But as a cardiologist, I saw another stark
reality. As I looked at the growing number of cardiovascular disease-related
deaths worldwide, I realized that, statistically, heart disease was also a foe
— a foe that in many cases was more likely than cancer to kill a cancer
survivor.
My son, Ben, was 2 (left) in 1994 when I received chemotherapy. In 2017 (right), I was
privileged to attend his white coat ceremony when he began medical school.
The big shift
Today, heart disease is the No. 1 cause of death in the world, causing close
to a third of all deaths worldwide. But this wasn’t always the case.
Over a century ago, a person’s greatest health threats came from infectious
diseases. These diseases spread from person to person, often through

---

contaminated water, inadequate hygiene or airborne transmission. The top
causes of U.S. deaths in the early 20th century were influenza, pneumonia,
tuberculosis (sometimes referred to as “consumption”) and gastrointestinal
infections.
Vaccines weren’t available yet, poor hygiene and inadequate sanitation were
rampant, and knowledge of how to prevent or treat these diseases was
limited. It was the perfect storm for the spread of potentially fatal illnesses.
Heart disease also made the top 10 causes of U.S. deaths in 1900. But this
was mostly heart disease stemming from infections or valve problems.
Looking at the chart on the right, you can see the shift in the top causes of
death in the U.S. over the course of the 20th century, even as the population
grew exponentially. Influenza and pneumonia are no longer at the top. Heart
disease — the kind that damages the heart and blood vessels and that’s
primarily due to unhealthy lifestyle factors — now occupies the top spot by
a substantial margin. Chronic noncontagious (noncommunicable) diseases
are much more likely than infectious diseases to kill us now.
Perhaps what’s most troubling is that the majority of these deaths are, to
some degree, preventable. We know that lifestyle measures such as eating a
healthy diet, avoiding tobacco and staying active can help prevent many of
today’s leading causes of death.

---