Like many busy mums, I loved bacon and ham. Were they linked to my stage-four cancer?

A sharp, irritating and piercing beeping noise wakes me rudely. Is it the doorbell? I’d better get up. Why isn’t the dog barking? What time is it?

I try to move but I feel weighed down. I realise I’m trapped. I look and see I’m being held in place by multiple tubes and wires. I’m sore, groggy, confused. Luminous strip lighting on the ceiling above is making me squint, but I can just see an empty fluid bag hanging above me on a metal trolley. The alarm is going because it needs refilling, but I don’t comprehend that yet, or understand.

I’ve forgotten I’m in intensive care. The sequence of events then starts to slowly re-emerge in my mind. Oh so slowly. I’d been wheeled in late the previous evening for a mammoth 12-hour operation to remove eight metastatic tumours from my liver. Sigh. It’s all coming back to me.

They had to open me up from chest to groin to carry out the “multiple wedge resection”, but thankfully it had been successful, I’d been told by the smiling, yet exhausted, surgeon who spoke to me gently in the recovery room.

“The team had to order pizza just to get through the day,” he said, laughing, trying to cheer me up.

As I begin to take in my surroundings and accept the limits on my current reality, I wish with all my soul I could be at home with my two children. But I’m thankful to be alive, to have made it through my second high-risk liver operation and my fourth surgery in three years.

If cancer is indeed a battle, as it’s so often described, then I felt like I was nursing my wounds in the trenches after a desperate and brutal push forward over the top. I try to turn my head to the right, in the direction of the nurses speaking loudly during the morning staff changeover, where they are obliged to repeat my entire cancer history, stretching back to the early niggles and pain that led to an innocent jaunt to the emergency room, then to months of misdiagnosis, then onwards into the dark abyss of a shock diagnosis in late 2019.

The nurses smile over at me as they keep talking. They are now discussing how I’ve already undergone more than a thousand hours of aggressive chemotherapy. It’s never a quick handover for the lady in bed four.

I attempt a weak smile back, realising my head can’t fully manoeuvre due to the many wires leading to a tube in my neck. And then I see it. On a grey tray perched next to my bed is a ham sandwich. It’s the type of processed-meat sandwich for sale in service stations and shops the world over, packaged up in cardboard and plastic.

The fact that I’m supposed to be on a fluid-only diet for several days at least isn’t what starts to rile me as I stare at the thin, pink, fatty slices of ham poking out from within the flimsy white bread. Despite being on a multitude of hardcore pain medications, and sedatives from the night before to help me sleep, I feel so angry. I can’t help it. I call over one of the nurses. “Whoever is in charge of the catering here, I will need to speak to them,” I say in a slight, weak whisper, in a tone that belies my furious mood.

She looks startled. Intensive-care patients tend to have other things on their mind – mostly surviving, sleeping and, at most, vaguely looking at their phone for a distraction from the difficult and arduous nature of postoperative recovery. Sometimes we only nod. Words are rare.

Why has a ham sandwich caused a patient like her to feel so distressed in intensive care? the nurse must be thinking. This patient is not even supposed to be eating yet. She furrows her brow and puts her hands on her hips. This patient is clearly trouble, her expression says. She’s got that right.

I had found myself – not by choice, it has to be said – to be well-placed and well-qualified to question the status quo regarding that ordinary-looking ham sandwich. It was a sandwich that represented something far bigger than a snack or a light lunch; it represented an entire, greedy, processed-meat industry, presided over by billion-dollar multinational companies and a huge dollop of We Don’t Give a Damn Mustard.

Don’t get me wrong: even I wasn’t fully aware of the dangers of processed meats before my cancer journey. But I had woken up. I had been shaken up by my own pain and suffering, and by detailed research that made my hair stand on end.

Australians consume close to a massive 17 kilograms of processed meat every year on average.

Something was amiss. And it matters enormously. Why? Because Australians consume close to a massive 17 kilograms of processed meat every year on average, with our nation falling in the top 25 countries in the world whose people gorge on various forms of processed pork, beef and other meats. It also matters because, according to the 2022 ranking by World Cancer Research Fund International, Australia is the No. 1 country globally for cancer rates in both men and women. Out of those, 15,000 Australians a year are being diagnosed with bowel cancer. Some of those cases are due to inherited risk factors, but the majority are not.

I started to see how buying mystery-mixed ham and cured meats from the deli means you are shopping amid a backdrop of a long and dark history in which wild guesses, bullied governments and industrial-scale greed are firmly wrapped up with your charcuterie favourites.

Yes, I’m aware these are bold statements to make, and it’s devastating to anyone who loves a cheeky Domino’s BBQ Meatlovers pizza or likes adding chunks of ham hocks to soup. Processed meats are heavily ingrained in our culture and daily lives.

But I began to see that there was a glaring gap in public awareness around the mass consumption of processed meats – in particular sausages, ham, salami, pepperoni, hot dogs and bacon – which are embedded in Australian culture and in many other cultures, especially in Europe and the United States. Actually, there was something more cavernous than just a gap. There was a mass deafness, a culture of ignoring the obvious because it just didn’t suit anyone involved.

But let’s get one thing straight: the major issue with processed meats is their deliciousness. They are not easy to give up. I get it. I smell bacon as it’s sizzling in a pan and I want a slice. Bacon famously turns many of the most determined vegetarians back to meat eating.

As we pulled out of the underground hospital car park in Malvern, in Melbourne’s south-east, my husband and I both fell into a dazed silence. I know the date. I’ll never forget it: November 7, 2019. Everything in my life until that point would now be known as “BBC” – Before Bowel Cancer.

A few minutes earlier, I’d leaned forward and put my head in my hands as a neatly suited bowel cancer surgeon confirmed my worst fears. Following the discovery of a large mass in my colon a few days before, a biopsy had revealed it was indeed cancerous. But there was more devastating news: the results of a subsequent CT scan showed the cancer had spread to my liver.

“You have at least four or five lesions … so … I’m afraid that means it’s officially stage-four bowel cancer, but … um … don’t worry, I’m pretty sure it’s all treatable,” he told us, perhaps in a kind attempt to make the bad news good for the weekend.

All I thought I knew about the words “stage four” was that it meant the cancer was terminal. I would find out later that some stage-four patients do beat the odds and can even be cured, but in that moment I thought I might not have long to live. I headed into an unstable spin. Christmas was just weeks away. Will it be my last? What about the children?

As we walked through the labyrinth of long, grey-walled hospital corridors, I gasped for air and just tried to keep my feet moving. I just needed to do everything I could not to tumble into a terrifying abyss that I feared would be so dark, so deep, that I’d never find my way out.

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The only thought that held still in that moment of internal chaos was that I was desperate to get on to Google. Anyone would be – especially a journalist, I suppose. “What are the causes of bowel cancer?” I typed into my phone as we drove towards our home in Bayside, where we would have to break the news of my diagnosis to our children, then aged just nine and 11, instantly shattering their childhood innocence and sense of security.

There were several main risk factors and causes, it seemed. I went through them one by one. Was I aged over 50? No. Was I obese? A few extra kilos like many mums, yes, but obese? No. Did I smoke? Never. Did I have a close relative with bowel cancer or a genetic risk? No. Did I have a diet low in fibre and high in ultra-processed foods? Not at all; oats, fruit, legumes and vegetables were part of my daily regimen. Was I active? Definitely. Was I a regular drinker? Perhaps one or two glasses of pinot noir on a Friday. I’d had stressful times in my career as a news reporter, but that was it.

Naturally, this brief initial search simply left me confused. Why me? Why now? At 44 years old?

As the weeks went on and I began my intensive treatment, I would have more time to read quietly alone, as my working life as a freelance journalist and author screeched to a halt, as did my ability to be a mother. Lost in my own fast-shrinking world, I dug deeper into other possible links to bowel cancer. To my horror, I discovered that – according to many scientific studies – if you regularly eat red and processed meats, such as frankfurts, bacon and salami, you are risking your health and your life. There is a strong bowel cancer link, and other suspected health impacts, particularly with processed meats.

I’m not really a huge consumer of processed meats, I said to myself, over and over.

You may have read various media headlines over the years and may already know this. But perhaps you are like I was at the time, and not fully aware of the risks, especially being so young and not even considering bowel cancer as a remote possibility.

For quite some time, as I absorbed all this information, I looked back over my life, trying to remember everything I’d ever eaten. I’m not really a huge
consumer of processed meats, I said to myself, over and over. I’d never liked the look of those plastic packets of ham and usually preferred chicken, cheese or salmon. But then I really started to think about it more deeply. I certainly had the time.

I thought about the occasions I’d asked for a side of bacon at brunch, or told the workers at the deli counter to “please slice the prosciutto extra thin, because it’s just so delicate and delicious that way.” I remembered how when I made a big batch of vegetable soup, I’d often fry up a few pieces of chopped bacon to add to it, to inject that complementary meaty, earthy taste.

I thought about how I’d loved carving the little diamond-shaped patterns into the mammoth leg of ham I cooked every Christmas Eve, pushing cloves into the gaps and covering it in demerara sugar, red wine and cinnamon. Sigh.

Gosh, I always loved slices of that ham in the days that followed, just like you might do every year. Cold in salads, or between sourdough with chutney. In truth, over the decades I’d probably eaten quite a few kilos of that salty Yuletide ham.

Then I thought back with a growing sense of dread to all those trips to Bunnings and how I would be occasionally lured in by those tempting, sizzling snags neatly packed into a single, white slice of cheap bread. Oh, the soft, caramelised onions. The mustard. A warming, satisfying late lunch for the whole family, for the price of a few gold coins. Bargain.

In short, I ate processed meats, just like most generally health-conscious modern mums do in our busy family lives. Was it possible, just maybe, that occasionally eating these processed meats in my otherwise healthy diet may have been the cause of my bowel cancer? The thought was horrendous. The idea that I may have brought the pain and suffering on myself, let alone my family, made it even harder. Finding another possible reason outside my own control would have been far easier.

And there I was, trapped in bed on a chemo pump for 48 hours every two weeks as the world went on without me. As my husband and children went out to work and school – because life has to go on. That’s just the reality. I started poring over studies and reports in the following months and years, uncovering facts that I realised the meat industry would much rather you didn’t know.

Why? Because I found out the Australian processed-meat industry, also known as the smallgoods market, is currently worth $4.3 billion a year and employs more than 10,000 people. So there’s a lot at stake in this valuable, salty chain: for major supermarkets, famous fast-food franchises, net profits and share prices.

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I soon realised, with growing clarity, that what the many stakeholders in the processed-food business probably don’t want us to know are the results of an extraordinary analytic study, involving nearly half a million adults, published back in 2013. It concluded that “men and women with a high consumption of processed meat are at increased risk of early death, in particular due to cardiovascular diseases but also to cancer”.

I read this line over and over. It made me gasp as I lay alone on the sofa one day, recovering from a chemotherapy session. The report, from the peer-reviewed journal BMC Medicine, titled Meat Consumption and Mortality, also estimated that “a reduction in processed-meat consumption to less than 20 grams per day per person would prevent more than three per cent of all deaths”.

Finally, the report’s authors advised: “As processed meat consumption is a modifiable risk factor, health promotion activities should include specific advice on lowering processed meat consumption.”

Within just two years, the report’s findings were backed up by another remarkable study. The Global Burden of Disease Study estimated that the number of total deaths (including those from heart disease, diabetes and various cancers) that could be put down to a diet high in processed meat in 2013 was an astonishing 644,000. What the hell?

The damning figure from this study, funded by the Bill & Melinda Gates Foundation, wasn’t just plucked from thin air with vague guesses. It reflected the work of more than 1000 researchers in more than 100 countries. It was a solid, valid study and sparked concern globally. “Apparently, soda isn’t nearly as deadly as bacon, ham and hot dogs,” remarks the respected author Dr Michael Greger in his 2015 bestselling book, How Not to Die. He points out that, worldwide, four times more people die from consuming processed meats than from illicit drug use.

In the same year that the Global Burden of Disease report was published, another explosive report from the World Health Organisation (WHO) made global headlines. The review, by WHO’s International Agency for Research on Cancer (IARC) and released in October 2015, said that eating processed meats like hot dogs, sausages and bacon could cause colorectal cancer in humans, and red meat was also a likely cause of the disease. It also linked the consumption of red meat with pancreatic and prostate cancers. (It’s important to note that, globally, the disease is named colon cancer, bowel cancer or colorectal cancer.)

IARC wasn’t making these bold statements based on flimsy evidence. Far from it. It had, in fact, examined 800 studies during a gathering of 22 top health experts. The meat industry could hardly dispute its rigour.

In its review, the IARC classified processed meat as “carcinogenic to humans” and added it to the Group 1 list of carcinogens. This means there is “sufficient evidence” of cancer links. Group 1 includes at least 120 substances, elements and compounds, with tobacco, asbestos and radiation among them.

According to WHO analysis, a 50-gram portion of processed meat eaten each day increases the risk of colorectal cancer by 18 per cent.

Scientists have estimated that in 2013, 34,000 bowel cancer deaths worldwide were attributable to diets high in processed meat. This may not be on the same scale as tobacco smoking, which is linked to about one million cancer deaths a year, but 34,000 people is 11 times the number of people who were killed in the September 11, 2001 terrorist attacks in New York.

According to WHO analysis, a 50-gram portion of processed meat eaten each day increases the risk of colorectal cancer by 18 per cent. To make it simpler, a 50-gram portion would be just one hot dog or a couple of rashers of bacon. It may sound alarmist, but experts argue the public needs to know. “For an individual, the risk of developing colorectal cancer because of their consumption of processed meat remains small, but this risk increases with the amount of meat consumed,” says Dr Kurt Straif, the then head of the IARC Monographs Program (which identifies agents that can cause cancer). “In view of the large number of people who consume processed meat, the global impact on cancer incidence is of public health importance.”

A possible link between processed meat and stomach cancer was also found in the IARC review. Many other health risks are being established each year. What about red meat? Is that still OK? Well, red meat – including beef, lamb and pork – wasn’t classed in Group 1 with processed meats. Instead, IARC
declared it as “probably carcinogenic” and placed it in the Group 2A list, joining items like glyphosate, the active ingredient in many weedkillers.

It certainly wasn’t the best news for meat lovers. Or for the many authors of paleo diet and keto-diet books for that matter. The outcome of this IARC report? Gasps and tears from all corners. The news outraged agriculture groups, and prompted animal-rights activist People for the Ethical Treatment of Animals (PETA) to offer free vegan-diet starter kits.

It wasn’t surprising, of course, that the meat industry closed ranks and produced all sorts of defensive, deeply strategic sound bites. For example, the Canadian Meat Council, which represents huge meat companies such as Maple Leaf Foods and the Canadian branches of Cargill Ltd and JBS, rejected the findings as “simplistic”. In the meantime, the trade group North American Meat Institute said the IARC report “defies commonsense”. What it defied, of course, was the industry’s concern with profits. So much so, it would also soon fund its favoured scientists to declare in reports that nitro-preservatives (nitrites and nitrates) were safe.

In Australia, the meat and farming industry is a powerful force, representing billions of dollars in investment and taxes, and thousands of jobs. Staying on the defensive, Australian food producers argued that processed meat provides essential protein, vitamins and minerals.

Unsurprisingly, Australia’s then federal agriculture minister, Barnaby Joyce, played down the IARC report. Joyce, at the time, was the deputy leader of the National Party, which traditionally represents graziers, farmers and regional voters. He said that he didn’t think Australians should be concerned.

But with Australians well known for being among the world’s biggest consumers of meat, the minister perhaps could have vowed to at least investigate properly, to find out the facts first and perhaps order an official review. Instead, he decided to brutishly brush off the extensive research by the leading health body in the world and make his own rapid conclusions.

“If you got everything that the WHO said were carcinogenic and took it out of your daily requirements, well, you are kind of heading back to a cave,” he told ABC Radio National. “If you’re going to avoid everything that has any correlation with cancer whatsoever – don’t walk outside, don’t walk down the streets in Sydney. There’s going to be very little in life that you actually do in the end.”

Despite the headlines, the share prices of most meat companies saw little change in the days following the report. Finance experts globally had already weighed in with their view, dismissing the idea that the bad publicity around processed meats would affect market and investor confidence.

Processed meats are winning. They are profitable and popular. Vast swathes of the population love them.

In the end, it was only the cancer charities that tried their best to spread the message. Here in Australia, the Cancer Council website states: “About 2600 cases of bowel cancer diagnosed each year in Australian adults can be attributed to eating red and processed meat.” Yet, their audience, of course, was likely to be made up of those already diagnosed, so reaching millions of other people to encourage them to change their diets was close to impossible.

On its website, Cancer Research UK highlights the studies that have shown eating processed meat increases the risk of bowel cancer. “It is estimated that around 13 out of 100 bowel cancer cases (around 13 per cent) in the UK are linked to eating these meats,” the charity states. “Processed meat is any meat that has been treated to preserve it and/or add flavour.” If this same statistic applies to Australia, this would mean out of the approximately 15,000 new cases a year, around 2000 would be due to processed meats. So that’s five Australians a day.

Australia’s Cancer Council recommends: “Cut out processed meats altogether or keep them to an absolute minimum. Processed meats include bacon, ham, devon, frankfurt, chorizo, cabanossi and kransky.” Despite this recommendation, have you seen any government health campaigns promoting this extremely important dietary advice? Have processed meats been banned in school canteens, or by sporting bodies after youth team games? The answer to both is a firm no.

Still, the studies on the dangers of processed meat continue to flood in. In 2019, the University of Oxford’s Nuffield Department of Population Health warned that even one slice of processed meat per day could increase the risk of colon cancer. The research was conducted by professor of epidemiology Tim Key and his team, and was based on data between 2006 and 2010 from about half a million British participants aged 40 to 69.

According to the team’s findings, people who consumed 76 grams of red and processed meat, such as a large hot dog, a day had a 20 per cent higher chance of getting bowel cancer than people who ate a third of that amount, which was equivalent to one slice of ham. They found this risk then increased by 20 per cent for every further 25 grams – a single rasher of bacon – of processed meat.

The results even alarmed the research team. “A small amount of processed meat appears to have the same carcinogenic effect as a large amount of red meat,” Key stated. It was a damning report, but one which again didn’t seem to infiltrate public awareness or a move to change.

Yes, there have also been occasional media stories that raised the issue. But the problem remains; processed meats are winning. They are profitable and popular. Vast swaths of the population love them, whether they are cured, salted or marinated.

The addition of nitro-preservatives to foods such as ham and bacon is thus central to the cancer risk and marks out those meats that contain these chemicals as significantly more dangerous than other processed meats, such as traditional UK sausages or Italian Parma ham, which do not.

Since the IARC study was published nearly 10 years ago, there has been an unsatisfactory response from those who hold the levers of power – apart from the European Union, which recently set lower nitro-preservative levels in processed meat.

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“Hello?” I said.
“Oh, hello. Is that Lucie Morris-Marr?”
“Yes.”
“Good news. We have a liver for you.”

For a moment, I had no words. I had fought extremely hard to live against the odds for five years with multiple surgeries, chemotherapy and radiation but the cancer kept creeping back in my liver, again and again. I’d waited for this call for six months and had started to wonder whether it would ever come in time. I immediately felt overwhelmed with gratefulness to the donor and their grieving family. You see, historically, metastatic colorectal cancer patients aren’t given transplants in Australia – in very few countries around the world, for that matter. It’s very new. It worries even the surgeons.

But optimistic new French research and a clinical trial in Sydney had proved a tipping point. Thankfully, the planets suddenly aligned and I fitted the bill. I was young and fit enough to become only the third Australian with terminal stage-four bowel cancer to be given the green light. But it had also been made clear to me again and again during the process at Melbourne’s Austin Hospital that a transplant may not be a cure, that the metastatic cancer could return, often in the lungs.

“My alternative is guaranteed death, so I’ll take it,” I said to the surgeon. He told me to stay active and keep my phone on.

And then everything fell silent.

This is an edited extract from Processed: How the Processed Meat Industry Is Killing Us with the Food We Love (Allen & Unwin, $35), by Lucie Morris-Marr, out February 4.

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