What Should Be Done to Prevent Cancer?
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Early Diagnosis
The First Round Can Be Yours With Early Diagnosis…
The best way to defeat an enemy lies in recognizing it and developing the right strategy. Cancer is also an enemy waiting at the door for many people. However, it should be known that it is not such a strong enemy. Thanks to advancing medicine, cancer is now a curable disease if detected early. So, which types of cancer can be diagnosed early?
Everyone now knows the importance of early diagnosis of cancer. Although not all cancers can be screened, cancers that are detected at an early stage with the help of state-of-the-art scans extend the life span of patients. Routine examinations and checkups are vital for some types of cancer. With screening, some types of cancer can be detected early.
Breast Cancer
Self-examination is critical to catch breast cancer at an early stage, which is the most common type of cancer in women around the world. From the age of 20, it is necessary to get to know your breasts by performing a breast examination once a month and to consult your doctor in case of the slightest non-routine change. I also recommend a doctor's examination every 2-3 years between the ages of 20-40. A physician evaluation once a year after age 40 and mammography once a year after age 50 will be lifesaving.
Cervical Cancer
An annual evaluation should be made after an examination and smear test after the first sexual experience. If the results are expected for three consecutive years, the tests can be repeated every 2-3 years. However, if there are diseases that weaken the immune system or the use of drugs (such as AIDS disease or long-term cortisone use), checkups should be made annually.
Intestine Cancer
A colonoscopy performed after age 50 will significantly protect you from advanced disease. It is sufficient to repeat it every ten years. However, it is also essential that the test performed to see if occult blood is present in the stool, which is a more straightforward test, is negative three times. If a positive stool occult blood test develops, I recommend it be evaluated by colonoscopy.
Prostate Cancer
Those with a family history of prostate cancer need to have prostate examination and PSA tests from the age of 45, and those who do not, from the age of 50. It should be noted that prostate cancer is the most common cancer in men after lung cancer.
Work pace and concerns should not interfere with the examination.
Infections detected during the examination can be eliminated with simple treatment methods when caught early. However, the fear of being examined and the intense work schedule delay the diagnosis and treatment possibilities. Progressive infections require more intensive treatments. Therefore, regular checkups are essential for women with ovarian cysts and fibroids, women who smoke, women with a family history of cancer, women who start having sexual intercourse at an early age and have more than one partner, and women with menstrual irregularity.
Genetics
Can we consider cancer among chronic diseases? Can we say that genetic factors are an essential factor in the formation of chronic diseases?
When we say chronic disease, we define the diseases whose treatment we have had limited success with but whose symptoms we can control. In other words, although the disease is established, the application of treatments will maintain the patient's quality of life. That's our goal in cancer. To make cancer patients live for many years without deteriorating their quality of life with drugs like a, diabetes patient or a blood pressure patient. Although we have partially succeeded in this, we still have not succeeded in a severe group of patients. For example, while we have the chance to treat a patient with metastatic breast cancer with only hormonal therapy for many years without deteriorating the quality of life, the disease progresses rapidly in a severe group of patients, and the treatments are unsuccessful.
Genetic factors play a role in cancer, but its rate is only 5-6%. In other words, the leading causes of cancer are mainly smoking, nutrition, infections, and environmental factors. These four substances are responsible for almost 90% of cancer. In other words, when we improve our living standards, we can seriously control cancer. Quitting smoking and eating healthy, which is based on avoiding carbohydrates, prevents cancer to a large extent.
How much do genetic factors increase the risk in cancer?
People with a family history of cancer are not more likely to have cancer. However, genetic transmission is essential in specific cancer types. About 10% of ovarian cancers are genetically transmitted. In addition, people with a family history of breast cancer have a 2-fold increased risk of breast cancer compared to those without. Having cancer in the family at a young age or having similar cancers in 3 generations increases familial risks. In addition, having more than one cancer in the family may not be familial. The important thing at this point is that the scans are done carefully and on time.
Which types of cancer are most affected by genetic factors?
Breast cancer, ovarian cancer, and bowel cancer especially show familial transmission. However, it should be noted that more than 90% of these cancers do not have familial characteristics.
There is a family history of cancer; does this mean that we are in the risk group for life?
Such a judgment is very wrong. First, it is necessary to determine the familial transmission of the existing cancer by performing the required tests. At this point, the most important thing is that individuals with cancer in their families should receive counseling and have their screening meticulously done.
What preventive measures can be taken in this regard?
Even if your genetic risk of cancer is determined, what you will do is essentially standard. Avoiding cigarettes and alcohol, eating healthy, and exercising should be done even if you don't have a genetic risk factor.
However, if there is breast cancer in the family at an early age and if the cancer risk is high after genetic counseling in other individuals, preventive surgery can be planned. However, it is a tough decision. With what percentage of breast cancer risk would you approve of having breasts removed?
Are there any other points you would like to emphasize on this subject?
Although genetic factors are essential, your lifestyle is much more critical in determining diseases. It is a simple irony that someone who smokes and consumes alcohol tries to prevent cancer by talking about genetic risks. When the Far Easterners who immigrated to America were examined, it was shown that their diseases and cancer types were similar to those of the Americans, starting from the 2nd generation. In other words, lifestyle and environment are much more critical.
Nutrition Against Cancer
Cancer is a severe health problem in our country. It seems that the cost of the new drug molecules that have been developed recently in cancer treatment has increased too much, making it difficult for patients to reach treatments. In a well-known classical saying, preventing cancer is more rational than curing it. Studies have shown that 30 percent of cancer is related to dietary habits. The World Cancer Research Fund (WCRF) and the American Cancer Research Institute (AICR) reviewed more than 7000 epidemiological studies examining the relationship between nutrition, physical activity, and cancer until 2007. According to this, to summarize, to prevent cancer...
It is essential to be at the ideal weight.
Being overweight is a significant risk factor for cancer. It is associated with an increased risk of cancers of the intestine, breast (postmenopausal), uterus, esophagus (adenocancer type), pancreas, kidney, and gallbladder. Not only being overweight but also the distribution of body fat is associated with the risk of cancer. For example, abdominal-type adiposity increases the risk of colon cancer. Increased abdominal fat probably increases the risk of cancer formation by changing insulin levels, insulin-like growth factors, and sex hormones circulating in our body. The ideal thing to do is to have a "body mass index" within usual standards, i.e., between 18 and 25, which you can find out by dividing your height by the square of your weight.
Exercise at least 30 minutes a day
Although simple activities such as brisk walking and cycling are sufficient, this period should be 60 minutes for overweight people. Regular exercise reduces the risk of colon cancer, postmenopausal breast cancer, and uterine cancer.
Foods of plant origin reduce risk
Consuming non-starchy vegetables reduces the risk of upper digestive tract cancers, especially mouth, pharynx, larynx, esophagus (squamous cell type), and stomach cancer. Garlic reduces the risk of bowel and rectal cancer. Fruit consumption reduces the risk of mouth, pharynx, larynx, esophagus, lung, and stomach cancers. The protective effect of these starch-free foods is probably due to their low energy content. Recommendations are to consume five meals a day (at least 400 grams) of non-starchy vegetables and fruits and not consume or consume less processed foods containing starch.
Meat consumption should be limited.
Red meat and processed meats significantly increase the risk of colorectal cancer. Red meat can form free radicals during absorption in the intestines. As a second handicap, if enough fiber is not fed, the residence time in the intestines is prolonged, and exposure increases. For this reason, the risk of developing cancer is 18 percent higher in those who consume red meat than those who do not drink. The daily consumption of processed meat should not exceed 50 grams for women and 85 grams for men; limiting red meat consumption to 500 grams per week is recommended.
The amount of ethanol is vital in alcohol.
There is a relationship between these drinks and especially mouth, pharynx, larynx, esophagus, and breast cancer types. In addition, it is reported that alcohol increases the risk of colon cancer and liver cancer. Alcohol consumption is responsible for 10% of cancers in men and 3% of women in Western European countries. The amount of ethanol taken is more important than the type of alcoholic beverage. Alcohol causes cancer development by affecting folate metabolism and impairing DNA synthesis and methylation. When consumed sparingly, it is stated to be protective against coronary heart disease.
Beware of processed, prepared, and preserved foods.
Salt-processed foods significantly increase the risk of stomach cancer. Foods containing alpha toxins, such as cereals, whole grains, and legumes, can cause liver cancer. Less than 6 grams (2.4 grams of sodium) of salty, salt-processed foods and pulses stored in humid environments should be consumed daily and not finished if stored in humid environments.
Other warnings...
Evidence that dietary supplements prevent cancer is inconclusive. Consuming some of them can lead to cancer. Vitamin D deficiency increases the risk of colon cancer. In patients with breast cancer, low vitamin D adversely affects the prognosis.
Advice for special groups...
It is recommended that especially mothers with babies feed their babies with breast milk for at least six months after birth. Breastfeeding reduces the breast cancer risk for the mother and also reduces the risk of cancer for the baby in later life.
What are other foods associated with cancer?
For example, milk protects against colon cancer but increases the risk of prostate cancer. Consuming 1000-2000 mg of calcium supplement daily does not affect colon cancer risk but reduces colon adenoma formation. Unsaturated fish oil may also be protective against cancer. However, more scientific data is required on this subject.
In summary, avoiding one type of diet against cancer is necessary. Excessive consumption, whether with natural or processed foods, always causes harm. Excess calories cause many diseases and cancers. For this reason, vegetables and fruits should be consumed, walking for 25-30 minutes daily should be done, smoking and alcohol should not be consumed, or their consumption should be minimized, and the body mass index should be kept within usual standards, i.e., between 18-25.
Quitting Smoking
Smoking poses a significant threat to the formation of lung cancer!
Lung cancer is the leading cause of cancer-related death in men and women all over the world. Especially in recent years, due to the increase in the use of cigarettes among women, lung cancer is also increasing among women. For this reason, lung cancer ranks first in cancer-related deaths in both men and women.
Surgical treatment is the most effective method in the treatment of lung cancer, which is generally seen over the age of 60 and has started to be seen frequently in the 40 and 50-year-old age groups due to the increase in cigarette consumption in recent years. However, because lung cancer cannot be diagnosed at an early stage, surgical intervention can be performed in 10-15% of patients.
PET-CT, which is used to diagnose lung cancer, determines whether the patient will undergo surgery, if the surgical intervention will be performed, and the criteria required for this. Postoperative chemotherapy and radiotherapy treatments are applied to patients who are not suitable for surgery.
Physical Activity
Eating healthy and exercising is a must.
First of all, we need to organize our lifestyle. Obesity is one of the biggest causes of cancer, and two things lead to obesity: Eating unhealthy and not exercising. If we stay away from harmful substances such as cigarettes and alcohol, we can prevent them by two-thirds. We can prevent half of the remaining one-third with screenings and early diagnosis.
Foods high in fiber, such as vegetables, fruits, and whole grains, are cancer-protective. Vegetables like zucchini, cauliflower, broccoli, soybeans, and beans should be consumed abundantly.
Sun Protection
Protect yourself from the sun consciously.
Cosmetic patients are a group that can be educated and interested in the harmful effects of the sun and the development of protective behaviors. Patients should be told to protect themselves from the sun and that they would be wasting money on cosmetic products and procedures if they do not turn this into a habit. As it is known, the energy provided by the sun's rays of various wavelengths ensures the existence and continuation of life on earth. Half of the rays reaching the earth are infrared, and most of the rest are visible rays and UV rays. UV constitutes about 5 percent of the rays coming from the planet. Most of this amount (90-95 percent) consists of UVA; the rest is UVB (5-10). UVB is the rays that initiate the synthesis of vitamin D in the body. Depending on the dose, it can cause erythema, redness, tanning, skin aging, and skin cancers. UVA rays can reach deeper into the skin. Since they form free radicals and oxygen atoms, they affect DNA, RNA, and other cell proteins. They are effective in premature aging of the skin and the formation of melanoma-type skin cancers.
Six factors affect the amount of UV rays reaching the skin.
- Seventy-five percent of UV rays are taken between 9 AM and 3 PM.
- In summer, the intensity of UVB reaching the earth increases, and seasonal variability loses its importance as it approaches the equator.
- The amount of UV loses its importance as it moves away from the equator.
- Clouds reduce the UV intensity, but the water content in the clouds weakens infrared rays rather than UV, which reduces the heat effect on the skin. The result is a risk of overexposure to UV.
- While 3 percent of UVB radiation is reflected in the grass, this rate can reach 25 percent in the sand. Snow can cause 50 – 95 percent UVB reflections. Water causes 5 percent reflection. Seventy-five percent of UV radiation can get a 2 m depth in water. In long swims, the person may be exposed to significant sunburns due to direct scattering and reflected UV rays.
- Every 300 m increases the sunburn effect of sun rays by 4.8 percent.
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- Assoc. Prof.
- Nilay ŞENGÜL, MD
- Medical Oncology
- Medicana Ataköy
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