The majority of cancers, some 90–95% of cases, are due to genetic mutations from environmental and lifestyle factors. The remaining 5–10% are due to inherited genetics. Environmental, as used by cancer researchers, means any cause that is not inherited genetically, such as lifestyle, economic, and behavioral factors and not merely pollution. Common environmental factors that contribute to cancer death include tobacco (25–30%), diet and obesity (30–35%), infections (15–20%), radiation (both ionizing and non-ionizing, up to 10%), stress, lack of physical activity and pollution.
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Patients who were more willing to bear adversity in the form of an abstract state, decreased quality of life, were more likely to believe, with 100% certainty, that they could be cured. Although conversations regarding prognosis should be conducted with all patients, those who are willing to trade quality of life for survival may especially benefit from conversations that focus on values and emotions.
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