Cancer is a horrible disease and no wonder people are looking for ways to prevent it. Even though getting the disease is still largely a lottery, knowing the risk factors for cancer gives us at least some chance of delaying it and an opportunity to influence the outcomes.
When one first hears the words “You’ve got cancer”, their world turns upside down. Everything changes, not only for that person but also for their family and close friends. You asks yourself: what did I do wrong? Could I have prevented this? You are facing your mortality and legacy, but also so much more: job security, financial woes, guilt for getting it in the first place. Then the treatments start, and you are overwhelmed, scared, and depressed. You feel as if you are physically and mentally at the end of your rope.
If you’re lucky, you come out victorious on the other side. Sometimes for a short while, sometimes for long, and sometimes all the way to living healthily into old, old age. No matter how your “journey” ends though, no one wishes this disease upon another, and no one wants to hear these dreaded words “You’ve got cancer” ever again.
February is Cancer Prevention Month
Cancer is on the rise, no way denying it. But science also knows more and more about the reasons for the development of cancer and, hence, more about the risk factors that we can try to avoid in order to ward off the disease. Primary prevention measures can decrease the incidence of cancer. Scientists estimate that cancer diagnoses could be halved through primary prevention measures.
First a few sobering statistics from American Cancer Society:
- More than 16.9 million Americans with a history of cancer were alive on January 1, 2019, most of whom were diagnosed many years ago and have no current evidence of cancer.
- More than 1.8 million new cancer cases are expected to be diagnosed in 2020
- About 606,520 Americans are expected to die of cancer in 2020, which translates to about 1,660 deaths per day. Cancer is the second most common cause of death in the US, exceeded only by heart disease.
Even more sobering is the estimate that about one of every three Americans will develop some type of malignancy during his or her lifetime.
According to the World Cancer Research Fund, the top five countries with the highest rates of cancer per capita are Australia (468 per 100,000; New Zealand (438), Ireland (373), Hungary (368), and the US (352).
These are some staggering statistics, and the fact that the prevalence of cancer in the Western world is on the rise (in comparison to other parts of the world) might suggest that there is something in our lifestyle specifically, that makes us more susceptible to this disease.
Is Cancer Preventable?
Yes and no. While some cancers are closely linked to the genetic makeup of a person, the majority of cancer cases are not. These are, if not caused, then at least helped in their developments, by epigenetics – changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself. Such factors include diet, physical activity, exposure to radiation and toxins in our environment, obesity, infection by viruses, stress levels, and more.
While getting cancer is still mostly a lottery, we can at least try to all we can to prevent it, or if we get it, to make our bodies hostile to further development or a reoccurrence. Scientists at the Harvard School of Public Health estimate that up to 75% of American cancer deaths can be prevented. This is impressive, isn’t it?
12 Risk Factors for Cancer
Let’s get to it and discuss the risk factors and strategies that can help us prevent cancer and/or cancer spread.
#1 Avoid Smoking Tobacco
If you smoke, stop. If you don’t, don’t start. Research links many cancers to smoking (not only lung cancer), so avoiding tobacco can be an important step in cancer prevention. Also, try to stay away from second-hand smoking.
“Smoking is the leading cause of premature, preventable death in this country. Cigarette smoking and exposure to tobacco smoke cause about 480,000 premature deaths each year in the United States. Of those premature deaths, about 36% are from cancer, 39% are from heart disease and stroke, and 24% are from lung disease. Mortality rates among smokers are about three times higher than among people who have never smoked.”source
#2 Optimize Your Nutrition
Environmental factors are determinants for cancer, and nutrition influences key cellular and molecular processes that characterize cancer. We are what we eat (or ate in the past). While there is no agreed-upon diet for preventing cancer that would work for everybody, you can certainly use prudent nutritional choices to make your body a fortress that will become impenetrable for cancer.
There are many theories out there about what actually is the optimal anti-cancer diet, and often they seem to contradict one another. It is widely agreed-upon however, that one should consume as many fruits, vegetables, and healthy grains as possible while avoiding or at least limiting the consumption of animal products. I wrote about my own struggle trying to find that “best” diet for the prevention of the spread or recurrence of my cancer.
Cancer protection mainly derives from a systemic metabolic environment that promotes healthy cell replication and tissue integrity. Such a nutritional state reflects avoiding excess adiposity through healthy dietary patterns rich in plant foods (legumes, wholegrains, pulses, vegetables and fruits), with modest meat, fish and dairy, low in alcohol and salt preserved foods, and an active way of life, avoiding sedentary behaviors.Cambridge University
#3 If You Drink Alcohol, Do So in Moderation
Excessive alcohol consumption is unhealthy for a variety of reasons, so it makes perfect sense to stick to a few glasses of wine or beer per week or even less if hard liquor is your poison of choice.
Science is a bit divided on the issue. One study determined a correlation between alcohol intake and prevalence of cancer, while others shed doubts no the issue.
…strong trends in risk were observed for cancers of the oral cavity and pharynx, esophagus and larynx. Less strong direct relations were observed for cancers of the stomach, colon and rectum, liver, breast, and ovary. For all these diseases, significantly increased risks were found also for ethanol intake of 25g per day. No significant nor consistent relation was observed for cancers of the pancreas, lung, prostate, or bladder.British Journal of Cancer
Still, while moderate alcohol consumption might be ok in terms of cancer risk, moderation is the key word here.
#4 Limit Meat Consumption
Related to #2, but more specific: limit or eliminate red meat, and especially processed meats like sausages, cold-cuts, smoked meats. Science is pretty clear on this risk factor, especially when it comes to the cancers of the digestive tract like colorectal or stomach cancer.
Epidemiologic studies have linked consumption of red or processed meat with obesity, type 2 diabetes, cardiovascular diseases, and cancers. Most epidemiological studies suggest that a high intake of meat, especially processed meat, is associated with increased colorectal cancer risk. Potential reasons for the association between high meat intake and colorectal cancer risk include some chemicals naturally contained in meat, or generated by the processing and cooking.Impact of Red and Processed Meat Consumption on Cancer and Other Health Outcomes
#5 Maintain Healthy Weight
Strive to maintain a healthy weight by optimal nutrition and being physically active. Exercise improves outcomes in cancer patients (especially breast and colorectal cancers) According to one study, “physical activity is associated with reduced mortality rates for survivors of colorectal cancer.”
Of course, physical activity has plenty of other benefits as well: de-stressing, community, better sleep. It might seem daunting to start an exercise routine if you don’t have one yet, but it is well worth the initial pain and suffering. If your current level of activity is very low, start slow. Walking, taking the stairs instead of the elevator, parking a bit further away are all good initial steps on the way to fitness. With time, it will become much easier to move to a more strenuous exercise.
According to research, the most positive outcomes come from HIIT activity (High-Intensity Interval Training): in one study from 2019, published in the Journal of Physiology, researchers looked at colorectal cancer in particular — and found that high-intensity interval training (HIIT), even after just one session, may be able to slow the growth of cancer cells.
#6 Be Careful with Sun Exposure
Protect yourself from excessive sun exposure. “Excessive” is the keyword here. Public health authorities in the United States are recommending that men, women, and children reduce their exposure to sunlight, based on concerns that this exposure will promote skin cancer.
On the other hand, though, there is strong evidence that lack of Vitamin D, which our bodies can only produce when exposed to the rays of the sun (without sunscreen and protective clothing), is also a factor that might contribute to the development of cancer. According to research, 32% of Americans suffer from vitamin D insufficiency.
So, what is a girl (or guy) to do? A mix of common-sense protections and common-sense exposure might be just the ticket. Don’t fry yourself for hours on the beach without any sunscreen on. If your skin burns, it cannot be healthy, cancer or otherwise. But also, allow your skin to get a little bit, 20 minutes, of early morning or late afternoon sun to build up your Vitamin D levels.
A 2016 study looked at risks and benefits wide range health benefits from sun/UV exposure. These benefits include among others various types of cancer, cardiovascular disease, Alzheimer disease/dementia, myopia and macular degeneration, diabetes and multiple sclerosis.NIH Study
#7 Limit Your Exposure to Radiation
Screening for cancer is important but if at all possible opt for less radiation. If your doctor deems it ok, try to get MRI and Ultrasound screening over CT and PET scans.
I have to say, I cringe every time I think about how much radiation did my body receive during my cancer journey: 30 treatment sessions directly onto the primary tumor, and then CT scans every three months for two years, then every six months for the next two, now my schedule is one CT scan every 8-9 months. I’ll be graduating to once per year in 2021, and hopefully will get released from this part of screening not too long after.
#8 Avoid Exposure to Environmental Toxins
Avoid exposure to environmental toxins such as asbestos, benzene, aromatic amines, and polychlorinated biphenyls (PCBs), and others. Check out the Environmental Working Group website for a list of toxins that are hiding in our water, foods, packaging, cosmetics, air, and soil, and try to avoid them by choosing organic foods and cosmetics, glass rather than plastic packaging, toxin-free bedding, clothes, and the like.
Some aspects of toxic exposure are beyond our control. If you live close to a chemical-leeching plant or a polluted highway, it might not be easy to just move. We can control some things though:
- Limit canned food and plastic containers. If consuming or buying preserved foods, opt for glass containers whenever possible to avoid the leeching of harmful chemicals such as BPA. If pressed, look for cans with BPA-free lining in them.
- Avoid non-stick pans. Most non-stick cookware uses perfluorooctanoic acid (PFOA) – a toxic chemical linked to cancer and other health issues.
- If you like popcorn, pop your own old-fashioned way. Most microwave popcorn bags have a lining of that same toxic (PFOA)
- Buy organic produce whenever possible and financially feasible. While organic foods might not have any more nutrients than conventionally grown produce, they are grown using only organic fertilizers. Because of this, they do not contain harmful chemicals such as the very toxic pesticide Round-up.
- At the very least, inform yourself about the “dirty dozen” list before you head to the grocery store and make sure to get these twelve from the organic section.
- Filter your drinking water to avoid common contaminants like arsenic and lead. Also avoid buying water in plastic bottles, as they can also leech harmful chemicals (especially when exposed to heat).
- Avoid fake food colorants. Many foods on the market contain food dyes, 90% of which are petroleum derivatives. If it looks like a color made in a lab, don’t buy it, don’t consume it, and make sure your kids don’t impulse purchase the “pretty blue” drink or ice cream or they’ll be ingesting at least traces of harmful chemicals.
- Use clean, green cosmetics only. Why? Read about the hidden dangers here.
#9 Get Some Rest
Make quality sleep your friend. While there is no clear-cut scientific proof linking poor sleep to cancer, insomnia and lack of sleep can lead to obesity, stress, and depression; and all of these are risk factors for cancer.
While sleep might be elusive to many of us – life in contemporary society is not conducive to sleep according to our natural circadian rhythms – it is possible to improve your “sleep hygiene” and to improve your chances of getting some quality sleep.
Here are some steps to better sleep according to Harvard’s Healthy Sleep initiative:
- Avoid caffeine, alcohol and other chemicals that interfere with sleep
- Make your bedroom into a sleep-inducing chamber (dark, cool, and quiet)
- Develop a comforting pre-sleep routine (warm bath, soothing massage, essential oils inhalation, reading, meditating, breathing exercises, etc.)
- Go to sleep at the (approximately) the same time every night, but go only when you’re truly tired
- Nap early—or not at all
- Don’t eat too close to bedtime
- Drink enough fluids to hydrate before sleeping, but not so much that you have to wake up in the middle of the night to use the bathroom
- Exercise early, at least three hours prior to going to bed
Chronic stress can be a silent killer. Limit or learn to deal with stress by adopting mindfulness practices such as meditation, journaling, gratitude, and other self-care ideas. I wrote a complete post about some easy-to-implement techniques to cope with stress. Check them out.
# 11 Avoid Infections that Can Lead to Cancer
In order to avoid infection with one of the cancer-causing viruses, get your vaccines. Hepatitis B can increase the risk of developing liver cancer. HPV can lead to cervical and other genital cancers as well as squamous cell cancers of the head and neck. Consider getting inoculated against these viruses. FDA recently approved the use of vaccine Gardasil 9 for males and females ages 9 to 45.
I know, there is a lot of people out there who oppose any vaccinations. I get it, fear, unwillingness to introduce the microbes into your body. But in the case of these two, I think the choice should be clear. According to the National Cancer Institute, Gardasil and Cervarix vaccines provide nearly 100% protection against persistent cervical infections with HPV and the cervical cell changes that these persistent infections can cause. The combination of HPV vaccination and cervical screening can provide the greatest protection against cervical cancer.
#12 Get Screened
Get screened for breast, cervical, and colorectal cancers regularly and early, when treatment is likely to work best (early onset of colorectal cancer is on the rise, and the disease that used to be “old-people-disease” is now claiming victims in their 30s and 40s).
You can read here about all the available screening options for various types of cancer.
Talk with your doctor about your personal risk of developing cancer. Together you can decide on an appropriate screening schedule based on your age and personal and family medical history.
It is, however, important to remember that cancer screening also has a number of risks, such as:
- Overdiagnosis. Screening tests may find slow-growing cancers that would not have caused any harm during a person’s lifetime. But, when the test finds such small, non-threatening cancers, the patients face fear, stress, potentially unnecessary treatments, and very costly medical interventions.
- False positives. Sometimes a screening test will suggest that a person has cancer when they do not.
- False reassurance. Sometimes a screening test will suggest a person does not have cancer when they actually do.
Finally, watch out for the signs of potential cancer, as developed by Harvard medical professionals, and given the acronym C_A_U_T_I_O_N
- C: Change in bowel or bladder habits (colorectal or urinary tract cancers)
- A: A sore that does not heal (skin cancer)
- U: Unusual bleeding or discharge (gynecological cancers)
- T: Thickening or lump in the breast or elsewhere (breast cancer, head-and-neck cancer)
- I: Indigestion or difficulty in swallowing (esophageal or throat)
- O: Obvious change in a wart or mole (skin cancer)
- N: Nagging cough or hoarseness (lung or throat cancer)
There you have it. While obviously not all cancers will be eradicated by following these sensible steps of prevention (if it were possible, then children and “health-nuts” would never get it, and they do of course). But, following these guidelines, you’ll make your body and mind stronger and less susceptible to illness in general, and you’ll definitely make yourself a less than an optimal host for cancer.
You can read about my own “cancer journey” here, six and half years since diagnosis, five years in remission.