Preventing Cancer

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Ever since I became a doctor, people have asked me the same questions again and again:

What can I do to prevent cancer?

What tests can I take for early detection?

Should I get full-body scans to look for a possible tumor?

Can I do blood tests to screen for every type of cancer?

Illustration of a human skeletal system highlighting disease-affected areas, with visible redness indicating inflammation or disease in the shoulder region. (Image created through AI)

So let me ask you a different question.

What if I told you there was a vaccine that could prevent cancer?

Would you be first in line to get it?

Would you pay large sums of money to make sure your children received it?Would you fight to ensure pharmaceutical companies produced enough of it for the entire world?

Because why wouldn’t we prevent cancer if we could?

Here’s the truth: we already can. In fact, there are vaccines that prevent cancer.

Today, I want to talk about one of them—the hepatitis B vaccine.

Hepatitis B is a viral infection that attacks the liver and can lead to cirrhosis and liver cancer. Early on, it’s often completely silent. About 70% of children infected don’t know they’re infected until much later in life. The most common mode of transmission is from mother to child, early in life.

Illustration of the liver, highlighting its vital role in maintaining overall health within the human body. (Image created through AI)

Before 1990, roughly 18,000 children in the United States were infected with hepatitis B every year. Then the hepatitis B vaccine was added to the routine childhood immunization schedule, starting with a dose at birth, followed by two additional doses at one month and six months.

The results were extraordinary.

An estimated 500,000 hepatitis B infections were prevented.Ninety thousand childhood deaths were avoided.Infant hepatitis B infections dropped by 95%.

This is what cancer prevention looks like.

A symbolic illustration promoting the power of vaccination, featuring a hand holding a syringe and vial against a backdrop of a stylized virus with a heart at its center. (Image created through AI)

And yet, last month, the Department of Health and Human Services decided to no longer require the hepatitis B birth dose. And just this week, they stopped recommending the full hepatitis B vaccine series for all children in the U.S.

This matters because timing matters.

Only about 20–30% of people infected with hepatitis B after age six develop chronic disease. But among those infected in early childhood, that number jumps to 70–90%. And about one in four untreated infants infected at birth will die prematurely from liver disease or liver cancer.

The rationale given is “free choice” and “shared decision-making” between patients and physicians. And to be clear—shared decision-making is essential. That is how medicine should be practiced.

Doctors and patients engage in collaborative decision-making during a healthcare consultation. (Image created through AI)

But make no mistake: this policy change represents a cultural shift.

Maybe not this month.Maybe not this year.But over time.

Most doctors will continue to follow the science and recommend the hepatitis B vaccine. But as more families are encouraged to “think about it,” fewer vaccines may be given. Pharmaceutical companies, sensing decreased demand, may produce less vaccine. That can lead to shortages and delayed vaccinations. Insurance companies may then decide it no longer makes financial sense to cover the vaccine at all.

Of course, I could be wrong. Maybe none of this will happen.

But how many times have we heard people say that health care today is run like a business?

In business, profits matter. Immediate profits matter most. Preventing a cancer that might have occurred 40 years from now doesn’t generate the kind of short-term returns that corporations are drawn to.

And that’s the uncomfortable truth: the success of prevention is invisible. The cancers that never happen don’t make headlines.

But they matter.

I want to end with a quote I read this week from Sarah Tolzmann: “Americans are not good at building community. We are good at forming teams. Therein is the curse.”

When I read this, I immediately thought back to my earlier blog post about being picked for teams in gym class—and how my childhood relationship with sports, and with my own body, might have been very different if gym class had been about building nurturing communities rather than competitive teams.

But I also think this quote applies far beyond gym class.

I bring it up to remind everyone reading this: you are part of a community. You may not work in health care, but the health of your neighbor affects you. The health of your neighbor’s neighbor affects you. The health of someone across town ultimately affects your own.

And being part of a community means participating in discussion. It means asking questions. It means speaking up when something is factually incorrect. You don’t need to be a medical expert to challenge misinformation about hepatitis B.

Recently, I saw someone argue that babies don’t need the hepatitis B vaccine because “babies aren’t having sex.” This statement reveals a fundamental misunderstanding of the disease. The primary mode of hepatitis B transmission is not sexual activity—it is transmission from mother to infant at birth.

And the timing matters. The earlier a child is infected with hepatitis B, the higher the likelihood that the infection will become chronic—and the higher the risk of cirrhosis and liver cancer later in life.

This isn’t about picking sides or joining teams. It’s about protecting one another.

It’s about recognizing that prevention is a communal act, not an individual one.

When we choose to prevent disease, we aren’t just protecting ourselves or our own children—we’re strengthening the health of the entire community.

And that is something worth standing together for.

A diverse group of children and adults joyfully gather around a table, each proudly displaying their vibrant paintings, showcasing a united community spirit through creativity and collaboration. (Image created through AI)