Disability, a New History on Radio 4: We can't get enough

We’ve hear diaries of the disabled from all centuries, discarded flyers for freak shows, letters between aristocrats disfigured by smallpox and grappling with wooden limbs, and an account of Samuel Pepys visiting a lady with a beard (“It was a strange sig

Disability: a New History
Radio 4

Invariably, the shorter the programme on Radio 4, the more creative and appealing it is. Tweet of the Day, my current obsession, recording the facts and sounds behind British birdsong, is less than 90 seconds long and more memorable than anything uttered for the following 180 minutes on the Today programme. The recently broadcast A History of Noise was captivatingly brief and loopy, featuring a French anthropologist crouched in a cave summoning, with groans, painted bisons. And now a run of 15-minute programmes – rather sonorously called Disability: a New History (weekdays, 1.45pm) – comes on with a wit and variety that nobody first tuning in could have anticipated in a million pious years.

We’ve heard diaries of the disabled from all centuries, discarded flyers for freak shows, letters between aristocrats disfigured by smallpox and grappling with wooden limbs, and an account of Samuel Pepys visiting a lady with a beard (“It was a strange sight to me, I confess. And pleased me mightily”). In one episode, an essay by the 18th-century politician William Hay, who was born with curvature of the spine, recalled the self-loathing that accompanied feeling obliged to make a joke of his disability before others got in there first – as though the act of first ridiculing oneself provides firm inoculation against any pain caused by others.

It is, of course, a standard impulse, whatever the era. I was born with only half a left hip, and the subsequent operations and scarring and occasional limp can usually be hidden but when they are not (if I’m tired, or on a beach) I do feel a nagging need to make reference to it and never like myself for doing so. The scars seem to be the least of the problem. I don’t think I mind them much at all.

The presenter Peter White – ever confident and eloquent – openly laughs at some of the more appalling facts discussed. “Are you really telling me that this was supposed to be a medically based thing propounded by scientists?” You can feel his interlocutors (historian, psychologist) immediately loosen, feeling the breeze in the room provided by a presenter at the top of his game. This ten-part series could run all summer and still never be enough.

 

The presenter Peter White. Photograph: BBC

Antonia Quirke is an author and journalist. She is a presenter on The Film Programme and Pick of the Week (Radio 4) and Film 2015 and The One Show (BBC 1). She writes a column on radio for the New Statesman.

This article first appeared in the 10 June 2013 issue of the New Statesman, G0

Davide Restivo at Wikimedia Commons
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Scientists have finally said it: alcohol causes cancer

Enough of "linked" and "attributable": a new paper concludes that alcohol directly causes seven types of cancer.

I don't blame you if you switch off completely at the words "causes cancer". If you pay attention to certain publications, everything from sunbeds, to fish, to not getting enough sun, can all cause cancer. But this time, it's worth listening.

The journal Addiction has published a paper that makes a simple, yet startling, claim: 

"Evidence can support the judgement that alcohol causes cancer of the oropharynx [part of the throat], larynx, oesophagus, liver, colon, rectum and [female] breast"

So what's especially significant about this? 

First, scientists, unlike journalists, are very wary of the word "causes". It's hard to ever prove that one action directly led to another, rather than that both happened to occur within the same scenario. And yet Jennie Connor, author of the paper and professor in the Preventive and Social Medicine department at the University of Otago, New Zealand, has taken the leap.

Second, alcohol not only causes cancer of one kind – the evidence supports the claim that it causes cancer at seven different sites in our bodies. There was weaker evidence that it may also cause skin, prostate and pancreatic cancer, while the link between mouth cancers and alcohol consumption was the strongest. 

What did we know about alcohol and cancer before?

Many, many studies have "linked" cancer to alcohol, or argued that some cases may be "attributable" to alcohol consumption. 

This paper loooks back over a decade's worth of research into alcohol and cancer, and Connor concludes that all this evidence, taken together, proves that alcohol "increases the incidence of [cancer] in the population".

However, as Connor notes in her paper, "alcohol’s causal role is perceived to be more complex than tobacco's", partly because we still don't know exactly how alcohol causes cancer at these sites. Yet she argues that the evidence alone is enough to prove the cause, even if we don't know exactly how the "biologial mechanisms" work. 

Does this mean that drinking = cancer, then?

No. A causal link doesn't mean one thing always leads to the other. Also, cancer in these seven sites was shown to have what's called a "dose-response" relationship, which means the more you drink, the more you increase your chances of cancer.

On the bright side, scientists have also found that if you stop drinking altogether, you can reduce your chances back down again.

Are moderate drinkers off the hook?

Nope. Rather devastatingly, Connor notes that moderate drinkers bear a "considerable" portion of the cancer risk, and that targeting only heavy drinkers with alcohol risk reduction campaigns would have "limited" impact. 

What does this mean for public health? 

This is the tricky bit. In the paper, Connor points out that, given what we know about lung cancer and tobacco, the general advice is simply not to smoke. Now, a strong link proven over years of research may suggest the same about drinking, an activity society views as a bit risky but generally harmless.

Yet in 2012, it's estimated that alcohol-attributable cancers killed half a million people, which made up 5.8 per cent of cancer deaths worldwide. As we better understand the links between the two, it's possible that this proportion may turn out to be a lot higher. 

As she was doing the research, Connor commented:

"We've grown up with thinking cancer is very mysterious, we don't know what causes it and it's frightening, so to think that something as ordinary as drinking is associated with cancer I think is quite difficult."

What do we do now?

Drink less. The one semi-silver lining in the study is that the quantity of alcohol you consume has a real bearing on your risk of developing these cancers. 

On a wider scale, it looks like we need to recalibrate society's perspective on drinking. Drug campaigners have long pointed out that alcohol, while legal, is one of the most toxic and harmful drugs available  an argument that this study will bolster.

In January, England's chief medical officer Sally Davies introduced some of the strictest guidelines on alcohol consumption in the world, and later shocked a parliamentary hearing by saying that drinking could cause breast cancer.

"I would like people to take their choice knowing the issues," she told the hearing, "And do as I do when I reach for my glass of wine and think... do I want to raise my risk of breast cancer?"

Now, it's beginning to look like she was ahead of the curve. 

Barbara Speed is a technology and digital culture writer at the New Statesman and a staff writer at CityMetric.