Friday, February 4, 2011

World Cancer Day 2011: Cancer can be prevented

In case you didn't know it yet: Cancer can be prevented.

As every year on February 4, known since 2005 as World Cancer Day, the Geneva-based Union for International Cancer Control (UICC) is shouting it from the rooftops. "So many of my patients have said to me that they wish they had acted on cancer prevention advice earlier in their lives," says UICC President Dr. Eduardo Cazap. "I would like to ... recommend that you learn about the very simple ways you can reduce your own cancer risk, take action and also spread this advice to those you love."

More than a third of the most common cancers can be prevented by eating a varied and healthy diet, maintaining a healthy body weight, getting regular physical activity and limiting alcohol intake.

Some common cancers are especially influenced by lifestyle: according to data released today by the World Cancer Research Fund (WCRF), in the US alone 70% of endometrial cancers, 69% of esophageal cancers, 47% of stomach cancers, 45% of colorectal cancers, 39% of pancreatic cancers and 38% of breast cancers could be prevented if people ate a healthy diet, exercised and had a healthy body weight. Avoiding tobacco, carefully managing sun exposure and protecting ourselves against cancer-causing infections further lowers our risk.

Alas, the prevention message is struggling to get through. At a talk I gave last night about cancer prevention, one lady said: "I wish I could get my daughter to listen to your advice. But you know what young people are like - they don't worry until it's too late."

One reason why many people don't practice cancer-prevention is that they're confused. A UK survey conducted last summer by the WCRF showed that about half the people polled thought scientists were always changing their minds about what increases and decreases cancer risk. And about a quarter of people thought that because the advice was always changing, the best approach was to ignore it all. (This is despite the fact that cancer prevention advice has not changed substantially over the last 10 years!)

Another reason why people ignore prevention advice is fear. Nearly all of us have seen family members or friends endure the prolonged agony of cancer. Cancer is often referred to as an "enemy," like an insidious alien invader against which we are defenseless and that we need to "fight," "battle," "crush" or "declare war" on.

Indeed, many people find cancer so scary that they dare not pronounce its name; it is often referred to in hushed tones as "The Big C." Some behave as though the mere mention of "the C-word" might increase their risk of "catching" the dreaded disease. Many cancer patients experience that their friends and family struggle to even talk with them about their disease - as though it were all too terrifying to put in words.

I think one reason for this fear is that many people don't understand that many types of cancer can be prevented, nor how. For while most of us now realize that the risk of heart disease or diabetes can be lowered through lifestyle measures, many still see cancer as some kind of act of fate that hits people out of the blue, regardless of whether they are living healthily or not. In which case, they conclude, they might as well eat, drink and be merry!

Don't get me wrong - I'm all for merry-making. But I don't think a "healthy lifestyle" has to mean boring food, tedious exercise routines and an altogether fun-free existence.

Indeed, with regard to healthy eating habits, a diet can only be effective if you truly enjoy it - no sacrifice, no hunger, no suffering. This will motivate you to eat it every day. Even children, adolescents and young adults - easily dismissed as the "junk-food generation" - will eat an anti-cancer diet (without knowingly doing so) if it is presented to them in the form of exciting textures, vibrant colors and stimulating tastes - all of which healthy food can deliver.

Exercise, too, doesn't have to be mind-numbingly boring or expensive. A brisk walk in the park with a two- or four-legged friend, a few flights of stairs bounded up energetically, a half-hour bike ride to work or for errands, an occasional jog around the neighborhood - these cheap, simple activities are not just healthy but can be enjoyable and convivial.

Rest and relaxation are important too, and cost nothing: getting adequate sleep regularly and leaving some ‘empty spaces' in our busy lives for moments of quiet contemplation can have powerful stress-reducing and immune-boosting effects.

Being the hedonist I am, I believe that the most effective way to integrate cancer prevention into our daily lives is to enjoy it, and focusing not on the dreaded fate we wish to avoid, but on the many other immediate rewards a healthier lifestyle brings: more energy, fewer colds, stronger muscles and a slimmer silhouette, clearer skin and brighter thoughts.

Of course, cancer prevention shouldn't just be down to individual effort; policy-makers should do their bit too. Off the top of my mind, I can think of at least eight ways in which government, schools, the media, the food industry, health professionals and employers can help cut cancer incidence, such as
  • making fresh, healthy food accessible to economically disadvantaged citizens,
  • providing nutrition and cookery classes in schools,
  • credibly publicizing the benefits of healthy food and the risks of unhealthy food,
  • serving unprocessed, fresh food in school and workplace cafeterias,
  • building bicycle paths and inexpensive sports facilities,
  • encouraging new mothers to breastfeed their babies,
  • providing clearer information about the risks inherent in convenience food,
  • curbing advertising by junk food manufacturers.
And many, many more. The WCRF's 2009 Policy Report offers an excellent analysis of the need for public cancer-prevention policy with a multitude of realistic recommendations. Public actors would do well to read it.

More pressure on public policy makers is set to come from the UICC. In an effort to move cancer prevention to the top of government agendas, it is collecting signatures that will be presented to the world's leaders at the first UN Summit on Non-Communicable Diseases in September 2011. 

"We want to show them that you care and demand that they use this meeting to set the momentum for effective measures to be implemented in all countries to reduce the global cancer burden," says UICC chief executive Cary Adams. If you want your government to get serious about cancer prevention, sign the UICC's declaration here.