Over the past few decades, cancer became one of the leading causes of morbidity and mortality, not only in developed but also developing countries, where 60% of the world’s total new cases are diagnosed.1 Annually on World Cancer Day, many nations around the globe run campaigns to raise awareness about the most dreadful diagnosis for a patient.
Considering the growing fear, rising awareness, rising incidence, with rising cost for the unprecedented successful treatment options, cancer is the nightmare diagnosis around the world. However, very few are aware that 5% to 10% of all cancers are caused by genetic defects, while 90% to 95% are due to modifiable environmental and lifestyle factors.2 On such occasion, it is worth remembering that genes do not dictate our fate; we contribute to our fate by what we decide to endure during our lifetime.
Patients in my clinic frequently ask, especially if cancer was on the news, “Is there anything new?” The answer is always yes. A hopeful "yes," usually referring to new medicines, but with hidden disappointment of the horrendous cost, making it formidable for most patients around the globe. "Yes" never refers to the new information about cancer prevention, but to be fair, that was never the question either. Day after day, we learn more about the impact of the major contributors to cancer, and for that matter to other common morbid diseases (cardiovascular diseases and diabetes) as well; tobacco use, alcohol intake, diet, obesity, infections, lack of exercise, among many more….we know but the actions we take are very little.
It was 1964 when smoking was recognized as the primary cause of lung cancer in the U.S. Surgeon General’s Advisory Commission Report, and since then, the list of cancers caused or enhanced by smoking continues to grow.2 Yet, the prevalence of smoking has been slowly declining in developed countries, while increasing in the developing countries where 85% of the world’s population resides.3 Extensive research has revealed that a diet consisting of fruits, vegetables, spices, and grains has the potential to prevent cancer; so does calorie restriction, and adopting a physically active lifestyle.2,4 Together, those measures will help solve the problem of the 21st century global epidemic of obesity, with its trail of health problems. Avoiding improper sun exposure and using clothing, glasses, and sunscreen will protect the skin from UV radiation known to cause fatal skin cancer.
With 70% of the world’s cancer deaths in developing countries, of which 20% are caused by smoking and another 20% are caused by infections (e.g. HCV/HBV, HPV),5 focusing on prevention seems the rational approach to combat cancer. It only seems logical to avoid the need for what we cannot afford if at all possible. That is possible, if we simply remember those simple modifications mentioned above. Some countries have a national cancer control program, but many more don’t; meanwhile individuals should take responsibility for their health. We need to remember that a lot can be done until a national cancer control program is in place.
Dr. Al Sukhun is President of the Jordanian Oncology Society, and Director of Oncology Practice at Al Hyatt Medical Centre in Jordan.
- World Cancer Report 2014. Available from: http://www.iarc.fr/en/publications/books/wcr/wcr-order.php.
- Anand P, et al. Cancer is a preventable disease that requires major lifestyle changes. Pharm Res. 2008;25:2097-116.
- Tobacco. Available from: http://www.who.int/mediacentre/factsheets/fs339/en/.
- Christiani DC. Combating environmental causes of cancer. N Engl J Med. 2011;364:791-3.
- de Martel C, Franceschi S. Infections and cancer: established associations and new hypotheses. Crit Rev Oncol Hematol. 2009;70:183-94.
Read more posts in ASCO Connection’s blog series on World Cancer Day:
- World Cancer Day: “We Can” and We Will Make a Difference
- The Janitor Is a Member of the Multidisciplinary Team
- Challenging the Myths About Cancer, Causes, and Care
- Medical Students as Agents of Change
- Hello from Lagos, Nigeria
- Creating Healthy Environments in Pursuit of Cancer Prevention
- Work Together for Increased Impact
- We Can Mobilise Our Networks: Approval or Coverage for Oral Cancer Medications in Brazil