Cancer prevention

DEFINITION: Cancer prevention can be defined as reducing cancer mortality by reducing incidences of cancer.

Cancer in the United States: The National Cancer Institute issues an annual Cancer Trends Progress Report describing various statistical aspects of cancer in the United States. As of the March 2024 report, overall death rates from cancer had declined for both sexes and across racial and ethnic groups, and survival rates for cancer patients were rising. The incidence of colorectal, lung, prostate, Hodgkin lymphoma, esophageal squamous cell, larynx, stomach, and ovarian cancers had fallen. However, the prevalence of leukemia, melanoma, myeloma, non-Hodgkin lymphoma, thyroid cancer, and breast, testicular, and oral cancers was increasing. Cancer remained the second leading cause of death in the United States in 2023 after heart disease, according to the Centers for Disease Control and Prevention (CDC). In 2023, nearly 609,820 Americans were estimated to have lost their lives to cancer.

Reducing the number of cancer cases is a multifaceted process. This involves avoiding exposure to known carcinogens, modifying lifestyle habits, and actively enhancing the body's immune system. Although behaviors that help people avoid developing cancer, such as not smoking and lessening consumption of fat and alcohol, are on the rise in the United States, more needs to be done. Prevention generally falls into the categories of lifestyle, chemoprevention (use of vitamins and medicines), preventive surgery, screening, and environment. Prevention of cancer is an active process in which all Americans need to involve themselves to reduce their lifetime chance of cancer.

In 2024, research from the American Association for Cancer Research indicated 40 percent of cancer cases were linked to preventable risk factors. Every day, each person makes choices that could increase or reduce that person's likelihood of developing cancer. No knowledge or program can prevent cancer on its own. People must make responsible choices and integrate them into their patterns of life.

Nutrition: Nutrition is a vital part of cancer prevention. Much has been researched and written about the importance of nutrition. Although the relationship between diet and cancer is complex, numerous studies show that nutrition can make a difference in preventing cancer. The American Cancer Society promotes eating five to seven servings of fruits and vegetables daily as the most important step to prevent cancer. People can achieve this goal by eating vegetables and fruits at each meal and for snacks. Strawberries, raspberries, blueberries, and blackberries have cancer-fighting chemicals, as do citrus fruits such as oranges and grapefruit. Certain phytonutrients in vegetables, such as the indoles found in broccoli and cabbage, can help protect against cancer, especially hormone-related cancers. Generally, the more color the vegetable has, the healthier and more protective it is. The likelihood of developing colon cancer and other gastrointestinal cancers may be decreased by eating dark green and yellow vegetables. Fruits and vegetables in their whole or natural form (fresh, frozen, dried, or canned) are more protective than supplements with dried extracts.

The nutritional aspect of prevention includes other foods besides fruits and vegetables. The use of whole-grain breads and cereals adds fiber to the diet. High-fiber diets increase the motility of food through the colon and are thought to protect against colon cancer. Eating less meat may be accomplished by choosing beans as a protein source; meat consumption has been associated with colon and prostate cancer. Other foods, such as garlic, onions, soybeans, and ginger, are thought to protect against cancer by some experts. Herbal teas such as red clover or green tea have demonstrated promise in studies on cancer prevention.

How food is cooked can affect its nutrients or introduce carcinogens into the body. For example, meat protein cooked at high temperatures or for long periods produces toxic substances. Studies have linked colorectal adenomas to red meat cooked in this manner. Processed meats and bacon contain carcinogens. Boiling vegetables can release nutrients into the water, so steaming is preferred to preserve the vitamins.

Studies have looked at the possibility of food preservatives and additives being carcinogenic, but the studies have not been conclusive. Foods are treated with chemicals to improve taste, increase shelf life, and allow them to be transported long distances in trucks. More than three thousand preservatives and additives are used in the U.S. food supply system. Some experts say that formaldehyde, a suspected carcinogen, is either contained in or released by some food preservatives and constitutes a hazard to humans; however, this has not been proven. Some people have chosen to minimize their exposure to additives and preservatives by eating more food in the raw state and purchasing organic foods and milk.

Exercise: Physical activity and exercise can help protect against developing certain breast, colon, and prostate cancers. The most recent guidelines by the Centers for Disease Control and Prevention (CDC) recommend that adults exercise moderately (for example, walking at a brisk pace) for a minimum of thirty minutes per day, five days per week, or exercise vigorously (for example, racewalking, jogging, or running) for a minimum of twenty minutes per day, three days per week. This recommendation complements the need to decrease the obesity epidemic in the United States. This condition is associated with an increased risk of developing the following cancers: breast (postmenopausal), colorectal, esophageal (adenocarcinoma), gallbladder, liver, kidney, meningioma, multiple myeloma (a blood cancer), ovarian, pancreatic, stomach, thyroid, and uterine.

Alcohol: Alcohol use is associated with an increased risk of mouth, esophagus (throat), larynx (voice box), and liver cancer. The amount of alcohol consumed affects the risk of cancer. Men are advised to have no more than two drinks per day, and women no more than one drink per day. One drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.) Women who drink are at increased risk for breast cancer. When smoking is combined with excessive alcohol consumption, the risk is compounded. Excessive alcohol consumption can result in liver damage that affects the body's ability to excrete toxins and can affect cancer treatment. Wine is associated with an increased risk of upper digestive tract cancers in heavy users. Some studies, however, have shown that moderate consumption of red wine, which contains phytochemicals, may convey some cancer-fighting benefits.

Tobacco: Smoking and use of tobacco products is a choice made by many Americans. Smoking produces known carcinogens that can result in lung cancer as well as cancer of the upper respiratory tract (throat, mouth, and windpipe). Secondhand smoke (smoke in the environment that nonsmokers inhale) can affect people's health. As of 2024, only 28 states and the District of Colombia had comprehensive smoke-free laws that banned smoking in workplaces, bars, and restaurants. No new states have passed such measures since 2013. Though smoking overall is declining, death rates from lung cancer in men have declined more steeply than death rates from lung cancer in women.

Other cancer prevention methods: Chemoprevention is a term that describes using natural or synthetic substances to prevent cancer. Methods include cancer-fighting nutrients such as phytoestrogens in food, herbs, and supplements. Medications such as tamoxifen or raloxifene reduce the incidence of breast cancer, and vaccines such as the human papillomavirus (HPV) vaccine can prevent cervical cancer.

Preventive (prophylactic) surgery is helpful in some cases for patients at high risk for cancer. Preventive procedures include removal of the breast (mastectomy), ovaries, and Fallopian tubes.

Cancer screening, a key part of cancer prevention, is covered by many insurance companies, including Medicare. Coverage may include mammograms for breast cancer, colorectal cancer diagnostic tests such as a colonoscopy, prostate-specific antigen (PSA) tests for prostate cancer, and Pap smears for cervical cancer. Early detection and treatment is one reason that cancer survival rates are rising.

Protective clothing and gear can help reduce cancer risk from environmental hazards. Examples of cancer-causing substances that can be introduced into the workplace include silica from cement, wood dust, lacquers, wood finishes, paints, glues, solvents, asphalt, and pesticides. Wearing an appropriate mask and using proper ventilation can help decrease exposure to these toxins. Using the provided safeguards when taking (or giving) X-rays in a hospital or at a dental office can reduce exposure to harmful radiation that can cause cancer. Those working outdoors exposed to the sun's ultraviolet (UV) rays can minimize their risk of skin cancer by staying out of the sun at midday, using sunscreen, and wearing protective clothing and hats.

In the 2020s, new technologies are being employed in the fight against cancer. These include artificial intelligence, DNA sequencing, precision oncology, and others. While these innovations are certainly welcomed, personal lifestyle choices place a significant amount of control over cancer prevention in the hands of each individual. Healthy choices can help people avoid the often-wrenching financial, physical, and emotional impacts that follow a diagnosis of cancer. Making positive choices has the added benefit of adding to a person's quality of life. Cancer prevention requires vigilance on the part of each individual, businesses, and the government. However, prevention is the best way to "treat" cancer and can save many lives.

Bibliography

American Institute for Cancer Research. Stopping Cancer Before It Starts: The American Institute for Cancer Research’s Program for Cancer Prevention. New York, St. Martin’s Griffin, 2000.

"Cancer Facts & Figures 2023." American Cancer Society, 2023, www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2023/2023-cancer-facts-and-figures.pdf. Accessed 26 Jone 2024.

"Cancer Trends Progress Report." National Cancer Institute, Mar. 2024, progressreport.cancer.gov/about-report. Accessed 26 June 2024. Conley, Edward J. The Breast Cancer Prevention Plan. New York, McGraw-Hill, 2006.

"Leading Causes of Death."Centers for Disease Control and Prevention, 17 Mar. 2017, www.cdc.gov/nchs/fastats/leading-causes-of-death.htm. Accessed 23 Jan. 2018.

Masterson, Victoria. "11 New Breakthroughs in the Fight against Cancer." World Economic Forum, 6 June 2024, www.weforum.org/agenda/2024/06/cancer-treatment-and-diagnosis-breakthroughs. Accessed 26 June 2024.

Pancholi, Neha. "Experts Forecast 2024, Part 1: Advances in Cancer Vaccines." American Association for Cancer Research, 8 Jan. 2024, www.aacr.org/blog/2024/01/08/experts-forecast-cancer-research-and-treatment-advances-in-2024-part-1. Accessed 26 June 2024.

Stiephan, DeeDee. "Can You Prevent Cancer with Lifestyle Changes?" Mayo Clinic, 19 Feb. 2024, newsnetwork.mayoclinic.org/discussion/can-you-prevent-cancer-with-lifestyle-changes. Accessed 26 June 2024.

Tynan, Michael A., et al. "State and Local Comprehensive Smoke-Free Laws for Worksites, Restaurants, and Bars—United States, 2015." Morbidity and Mortality Weekly Report (MMWR), vol. 64, no. 24, 24 June 2016, pp. 623–26, doi: http://dx.doi.org/10.15585/mmwr.mm6524a4. Accessed 23 Jan. 2018.

Verona, Verne. Nature’s Cancer Fighting Foods. New York: Prentice Hall, 2001.