By Ian N. Olver, MD, PhD, FRACP. One-third of cancer deaths could be prevented by lifestyle choices alone. If there was a drug that claimed that success, it would be front page news. Changing behavior doesn’t seem dramatic, yet can be very difficult to achieve. The three areas in which the most impact is to be made are tobacco control; reduction of obesity, which encompasses diet, alcohol consumption, exercising and reducing sedentary behavior; and finally sun protection.
Tobacco consumption still represents one-fifth of the cancer burden in higher income countries and sometimes more in the developing world as it contributes to sixteen cancers. The fact that two of every three smokers will die of smoking related disease and reduce their life expectancy by ten years should be motivation enough to quit. It is never too late to quit as after 10 years the lung cancer risk halves and continues to fall.
Obesity has emerged as a major risk factor for cancer, second only to tobacco. Its importance is highlighted by its association with common cancers like bowel and post-menopausal breast cancer in addition to endometrial, esophageal, pancreatic and kidney cancer. The nutritional problem is eating too much energy-dense, nutrition-poor foods high in fats and sugar, rather than a diet with more emphasis on fresh fruit, vegetables, and fiber. Alcohol contributes to cancers such as bowel and breast cancer through weight gain but is also a carcinogen in its own right. The risk increases with increasing consumption, irrespective of the type of alcoholic drink.
Independent of diet as a risk factor, we are not expending enough energy in exercise. Sixty minutes of moderate exercise such as jogging or swimming each day is recommended to prevent cancer or its recurrence.
Skin cancer is a major burden of disease particularly for paler-skinned people in climates where the ultraviolet radiation from the sun is intense. Covering the exposed skin with clothing, a hat and sunglasses and applying sunscreen to exposed skin and seeking shade in the middle of the day, can prevent the skin damage which can later lead to cancer.
In commemoration of World Cancer Day (WCD), this blog is part of a series of posts by ASCO International Affairs Committee members on four areas being highlighted as part of WCD awareness efforts. Additional posts include:
Reducing your cancer risk applies to both home and work, where you may need protection from exposure to additional cancer causing agents. Most lifestyle changes can be achieved individually but it is helpful to have legislative support for tobacco control and living environments where healthy food is available and exercise is facilitated by urban planning.
Ian Olver, MD, PhD, is the Director of the Sansom Institute for Health Research at the University of South Australia, Chaired the Australian Friends of Vellore Board, and helped establish the oncology unit at CMC Vellore, India. He currently is Vice President of the Multinational Association for Supportive Care in Cancer.