Preventing Cancer: How do you protect yourself from 200 diseases? Kathy Redmond, Editor, Cancer World Magazine What are cancers? Cancer types • Common – Lung, prostate, breast and colorectal • Rare – About a quarter of all cancers • Solid tumours • Blood and lymphatic system tumours Breast cancer subtypes based on hormone receptor and HER-2 expression levels and Ki-67 staining.Abbreviations: ER, estrogen receptor; HER-2, human epidermal growth factor receptor 2; PR, progesterone receptor. Hortobagyi G N The Oncologist 2012;17:577-584 ©2012 by AlphaMed Press One third of EU citizens are smokers Tobacco use in the EU 2009 http://ec.europa.eu/health/tobacco/docs/ebs332_en.pdf http://www.dietandcancerreport.org/cancer_resource_center/downloads/Second_Expert_Report_full.pdf About one third of all cancers can be prevented European Code Against Cancer 1) Do not smoke; if you smoke, stop doing so. If you fail to stop, do not smoke in the presence of non-smokers. 2) Avoid Obesity. 3) Undertake some brisk, physical activity every day. 4) Increase your daily intake and variety of vegetables and fruits: eat at least five servings daily. Limit your intake of foods containing fats from animal sources. 5) If you drink alcohol, whether beer, wine or spirits, moderate your consumption to two drinks per day if you are a man or one drink per day if you are a woman. 6) Care must be taken to avoid excessive sun exposure. It is specifically important to protect children and adolescents. For individuals who have a tendency to burn in the sun, active protective measures must be taken throughout life. 7) Apply strictly regulations aimed at preventing any exposure to known cancercausing substances. Follow all health and safety instructions on substances which may cause cancer. Follow advice of national radiation protection offices. http://www.cancercode.eu / European Code Against Cancer There are Public Health programmes which could prevent cancers developing or increase the probability that a cancer may be cured: 1) Women from 25 years of age should participate in cervical screening. This should be within programmes with quality control procedures in compliance with “European Guidelines for Quality Assurance in Cervical Screening”. 2) Women from 50 years of age should participate in breast screening. This should be within programmes with quality control procedures in compliance with “European Guidelines for Quality Assurance in Mammography Screening”. 3) Men and women from 50 years of age should participate in colorectal screening. This should be within programmes with built-in quality assurance procedures. 4) Participate in vaccination programmes against hepatitis B virus infection. http://www.cancercode.eu/ Food, nutrition and physical activity and the prevention of cancer • • • • • Be as lean as possible - maintain body weight within normal range Be physically active every day Limit consumption of energy-dense foods and sugary drinks Eat mostly foods of plant origin Limit consumption of: – Red meat – Processed meats – Alcohol – salt • Avoid mouldy cereals or pulses • Avoid dietary supplements for cancer prevention • Breastfeed children for at least six months http://www.dietandcancerreport.org/cancer_resource_center/downloads/Second_Expert_Report_full.pdf Cancer chemoprevention Challenges faced in preventing cancer Global survey on knowledge and beliefs about cancer • Survey carried out by UICC in 2007 • Findings were aggregated according to three World Bank income categories • The total sample size for the preliminary report was 29,925 – 5,521in low-income countries – 15,746 in middle-income countries – 8,658 in high-income countries http://old.uicc.org/index.php?option=com_content&task=view&id=16481&Itemid=544 Perceived risk of smoking Perceived cancer risk of smoking cigarettes 100 94 90 90 80 69 70 60 50 40 30 20 10 23 8 8 2 4 2 0 Low Middle High World Bank income category Yes, increases cancer risk No risk Can't Say Perceived risk of being overweight Perceived cancer risk of being overweight 100 90 80 70 63 60 50 50 42 44 41 40 31 30 20 14 9 10 6 0 Low Middle High World Bank income category Yes, increases cancer risk No risk Can't Say Perceived risk of drinking alcohol Perceived cancer risk of drinking alcohol 100 90 80 71 70 60 56 51 50 42 40 29 30 20 26 15 10 8 3 0 Low Middle High World Bank income category Yes, increases cancer risk No risk Can't Say Perceived risk of viruses Perceived cancer risk from infection with viruses or bacteria 100 90 80 70 70 57 60 50 40 30 40 39 32 22 23 20 11 7 10 0 Low Middle High World Bank income category Yes, increases cancer risk No risk Can't Say Perceived risk of stress Perceived cancer risk from being stressed 100 90 80 70 59 57 60 50 40 40 44 35 30 30 20 16 11 7 10 0 Low Middle High World Bank income category Yes, increases cancer risk No risk Can't Say Beliefs: causes of cancer Lord et al. (2012) Clinical Oncology. 24, 4-12 Beliefs: causes of cancer by ethnic group Column 1: British White; Column 2: British South Asian Lord et al. (2012) Clinical Oncology. 24, 4-12 Cancer Stigma • Lance Armstrong Foundation conducted a survey on cancer stigma in 2008 – Japan, Mexico, Russia, Argentina, Brazil, China, France, India, Italy, South Africa – About 500 people polled in each country • Survey showed that – Stigma continues to persist across countries, cultures and communities – Caused by misinformation, lack of awareness, deeply engrained cultural myths and fear – Opportunities to capitalise on shifting perceptions – Mass media are key resources for facilitating more positive attitudes http://www.livestrong.org/pdfs/3-0/LSGlobalResearchReport Perceptions about cancer http://www.livestrong.org/pdfs/3-0/LSGlobalResearchReport Journalists have a role to play in raising awareness about modifiable cancer risks and counteracting fatalistic cancer attitudes Effects of newspaper coverage on public knowledge about modifiable cancer risks Health Communication (2008) 23:4, 380-390 Effects of newspaper coverage on public knowledge about modifiable cancer risks Health Communication (2008) 23:4, 380-390 DISCUSSION • Why is cancer prevention not covered well by the media? • What can be done to address this? • How can the mass media help counteract myths and misconceptions about cancer?