Cut Your Cancer Risk
By Alison Palkhivala
Reviewed By Gary Vogin
May 7, 2001 -- Sad to say, but you probably know someone with cancer.
Yes, rates of many cancers are increasing alarmingly in North America and, no, doctors have not identified all the factors that play in a part in getting it. We do know that genes play a significant role -- something you can't do anything about -- but we also know that lifestyle is a major player, and there is a lot you can do about that.
The American Association for Cancer Research (AACR) is dedicated to informing the public about the risks of cancer and providing them with the latest scientific findings. That's why at their annual meeting -- held this past March in New Orleans -- they opened up the conference to the public and addressed many of the issues that concern us all. One of those was preventing cancer.
Here's what the AACR experts had to say about the best ways to minimize your cancer risk. The information here is specifically geared toward women -- although, of course, much of it applies to men, too. (Check out Cancer Risk: It's a Guy Thing, on the Healthy Men channel)
Know Thy Enemy
Cancer is an imbalance between cell growth and cell death, explains Donald S. Coffey, MD, resulting in the accumulation of large numbers of cells.
"When cells pile up, it's called a tumor," he says. "They can pile up like a fist or a tangerine, which can be taken out, and that's benign. Most of what's seen in breast and prostate tumors are benign tumors.
"The other kind looks like your open hand," he says -- although historically this more dangerous, malignant cancer was compared to the spread-out crab-shaped stars in the constellation Cancer.
"The word for the zodiac was here before the disease, and that's why it's called cancer," says Coffey, professor of oncology, pathology, urology, and pharmacology at Johns Hopkins University School of Medicine in Baltimore. Coffey was involved in organizing the AACR public forum and gave a talk on the definition of cancer.
"Don't smoke," says Anna D. Barker, PhD, president and CEO of Bio-Nova Inc., and a member of AACR's board of directors.
Simply by heeding that straightforward bit of advice, you can avoid 35% of all cancers, says Barker, who was a moderator and organizer at the public forum.
There's no good reason to become part of the statistics: If you haven't started smoking, don't -- and if you have, it's time to butt out!
Shun the Sun
The era of bathing beauties is over. Rather than thinking of a deep tan as something that makes you look healthy and vibrant, think of it as a dermatologist does: as your body's reaction to damage, like a scab forming on a cut.
Skin cancer is the most common form of cancer, accounting for half of new cancer diagnoses in Western countries. People with fair skin, hair, and eyes are most susceptible.
Don't want to get skin cancer? Then you need to stay out of the sun, especially when it is strongest, between 10:00 a.m. and 3:00 p.m. If you must be in the sun at any time of day, protect yourself with wide-brimmed hats, large sunglasses, and sunblock with an SPF of at least 15. Report any new, unusual, or changing moles or other marks on your skin to your doctor.
Live an Anticancer Lifestyle
No one who's been conscious the past two decades should be surprised to hear about the strong link between smoking, sun, and cancer. But you might be surprised to learn that all that advice you've been getting about living a heart-healthy lifestyle is also good for preventing cancer.
"There is a direct relationship between obesity and cancer as well as exercise and lack of cancer," says Barker. "There's also no question that diets rich in fruits and vegetables are very effective at preventing cancer. ... Some of these things have been looked at scientifically in enough depth that we're beginning to see some patterns. ...
"You really just have to adopt a [cancer-] prevention lifestyle," Barker continues. "You have to exercise, eat right, and watch your weight. You have to stay out of the sun, and you can't smoke. Even the simple things like drinking eight glasses of water a day ... are very important. In this society we don't like to take the time for things like that."
Talk to Your Doctor If You Know You're at High Risk
Your mother had breast cancer and so did your aunt and two sisters? A family pedigree like that definitely warrants a trip to your doctor to talk about being tested for a genetic trait that places you at very high risk for cancer yourself. If you are found to be a carrier of a gene linked to cancer, you might be given medicine called hormonal therapy to help ward off the disease.
When you have a family history of a specific cancer, you will want to be especially vigilant about getting regular screenings. A good rule of thumb: Begin those screenings 10 years before the age your closest relative was diagnosed. Mom got the bad news at age 45? Start your screenings by age 35.
"I take vitamins," says Barker. "I'm interested in the biology of pro-oxidants and antioxidants, so I understand a little more than some people about how this stuff works. I think people who take vitamins C and E are a bit more protected than people who don't. Vitamin C especially has a very short lifespan, and unless you eat a lot of fruits and vegetables you probably aren't getting enough of it. For vitamin E, you can't really overdose on the stuff, and it's a very good antioxidant. ... I think taking a multivitamin is not a bad idea"
If Prevention Fails, Catch It Early
The next best thing to cancer prevention is early detection.
"We know that small tumors can be treated much more easily," says Barker. "The problem is once they [spread] to other organs."
Catching cancer sooner rather than later is so important that Robert C. Bast Jr., MD, vice president for translational research at the University of Texas M.D. Anderson Cancer Center in Houston, gave a talk on just that topic at the AACR public forum.
"The good news is that if you detect cancer early, more than 90% of patients can be cured," he says. " When it's still localized in the organ [where it originates] and when it hasn't had a chance to spread to other parts of the body, conventional therapy, surgery, radiation, chemotherapy, can cure patients 90% or more of the time."
The best way to catch cancer early is to be sure you're properly screened. Screening tests are available for the following cancers:
- Cervical: PAP smears, where your doctor takes a sample of the cells from your cervix and sends it to a laboratory that examines the cells for abnormalities, are very commonly used as a screening tool in the U.S.
- Breast: Women should ask their doctor to show them how to examine their own breasts for lumps and perform a breast self-exam regularly. You can order a free breast self-exam shower card from the Susan G. Komen Breast Cancer Foundation by clicking here.
A mammography, which is a type of X-ray of the breast, helps detect breast tumors even before you can feel them. Currently in development is a blood test to detect breast cancer.
- Colon: Common tests include the fecal occult blood test, which tests your stool for invisible amounts of blood; sigmoidoscopy, where the lower colon is visualized using a scope; and colonoscopy, where the whole colon is visualized. Many doctors recommend that women over age 50 -- and sooner if they're at high risk -- get a fecal occult blood test annually and a sigmoidoscopy every five years.
- Mouth: Mouth cancers have a very good cure rate when they're caught early -- and very poor when they're allowed to advance. Your dentist should be screening for this -- assuming you're scheduling regular appointments. The most common causes of oral cancer: tobacco and alcohol.
Soon to be available are screening tools for these cancers:
- Lung: Use of low radiation, high resolution CAT scans is under study for use in examining the lungs of smokers, to detect lung cancer at an early stage.
- Ovarian: Transvaginal ultrasound, which visualizes the ovaries to look for tumors, and a blood test called CA125 are used by some doctors now in women known to be at very high risk for this disease, but they are not yet accurate enough to screen the general population. Combining these tests and using other blood tests for screening a larger population of women is currently under investigation.
With all these tests, how do you know which ones are right for you?
That depends on your age and risk factors, say experts. Most cancers, with the exception of brain tumors and some leukemias, usually strike after age 50, so screening strategies should be stepped up as you age. Having a known genetic predisposition for a certain cancer -- or many relatives with a specific cancer -- places you at higher risk of developing that disease, so you need to screen for it more often.
Bast recommends that everyone schedule a doctor's appointment " every three years between ages 20 and 39 and every year thereafter to go over a cancer-specific screening strategy, ... and also to go over [what you] can do to prevent cancer, such as stopping smoking, having multiple servings of fruits and vegetables each day, maintaining an ideal body weight or as close to it as you can get, and having at least some exercise three times a week."
Don't Give In to Fear
According to Barker, never let fear prevent you from being properly screened for cancer.
"If you think something's wrong," she says, "don't wait or give it time to get worse. You can get a lot done about an early cancer and not a lot done about a late cancer."
The AACR has made their public forum available for all to see via webcast. To see it for yourself, go to their web site and select Saturday, March 24.
Alison Palkhivala is a freelance medical writer working in Montreal, Canada. She has been writing about medicine and health care since 1994.
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