<p>As per GLOBOCAN (Global Cancer Observatory) estimates, every year there are close to 15 lakh new cancer cases in the country. One of the most common myths is that a majority of cancer cases are hereditary. The reality is that less than 15-20 per cent of cancer cases are hereditary/familial in nature and can be associated with genetic mutations, i.e errors in the genetic code/DNA that can be passed on from one generation to another</p>.<p>The etiology of cancer is multifactorial. Most risk factors of cancer are associated with the lifestyle choices one makes. One of the leading risk factor of cancer continues to be tobacco consumption, either in the form of smoking or other means. Smoking is not only a risk factor for lung cancer but cancers such as esophageal cancer, stomach cancer, cancer of the larynx and oral cavity, and intestinal cancers too. Alcohol is another risk factor for development of cancer particularly of the upper aero-digestive tract due to the presence of interactions of cancer causing agents called carcinogens and its impact on metabolism and other pathways. </p>.<p><strong>Obesity a risk factor</strong></p>.<p>Obesity and being over weight is a risk factor for development of almost 13 different types of cancer. Obesity leads to changes in metabolism particularly with insulin related pathways leading to a creation of a chronic inflammatory state leading to an increased risk of cancer. </p>.<p>On the other hand, physical activity reduces the risk of development of cancer. While the optimal level of physical activity is to be defined clearly for reduction of cancer risk, 150-300 minutes of moderate physical activity per week is associated with significant health benefits. Recent guidelines and studies have also shown that a structured exercise programme after surgery for colon cancer reduces the risk of recurrence of cancer.</p>.Indore: Upgrading its palate.<p><strong>Food choices need a close look</strong></p>.<p>The food one consumes and the choices that an individual makes plays a vital role in overall health and reduction of cancer risk. Processed meat has been classified as Group 1 carcinogen by the The International Agency for Research on Cancer (IARC). Increased intake of dietary fat has been associated with a decreased risk of colon cancer. One needs to understand that the food consumed plays a key role in modulating the gut health and the microorganisms present in the human gut (called the microbiome) which play a key role in modulating the inflammation and other pathways in the human body. Avoidance of ultra-processed and refined food, sugary drinks, excessive dietary fat and increasing consumption of a balanced diet with whole grains , fruits and vegetables, legumes would be beneficial for the gut health. </p>.<p>Amidst all this, one should not overlook the importance of good sleep and managing stress. Prolonged night time shift work and disruption of circadian rhythm in the human body can affect repair of DNA and lead to tumour growth. Avoidance of exposure to light form smart gadgets or bright light at least two hours before bed, limiting the number of consecutive night shifts and prioritising healthy sleep patterns along with a healthy diet and exercise would mitigate the risk for cancer.</p>.<p>Certain vaccines such as the HPV vaccine helps protect against infection with the Human Papilloma Virus (HPV) which is associated commonly with the development of cervical cancer. Vaccination against Hepatitis B virus helps reduce the chance of development of liver infection and inflammation which can lead to liver cancers.</p>.<p><strong>Genetic testing</strong></p>.<p>There are specific indications and guidelines as to who needs to get genetic testing for cancer done. Those who carry a risk factor for cancer because they have a hereditary cancer associated gene need to be aware of screening protocols and tests which can be carried out at regular intervals to detect cancer early. They should also consult their oncologist to understand the role of risk reduction surgeries which would prevent the cancer from occurring. A noted example being a famous Hollywood actress who underwent removal of both breasts and ovaries to reduce the risk of breast and ovarian cancer caused in those who carry a BRCA gene mutation.</p>.<p>Prevention and risk reduction begins with everyday choices. Lifestyle change is one of the most powerful cancer risk reduction tools that we have. Changing how one lives can change cancer outcomes. </p>.<p><strong>QUICK TAKES</strong></p>.<p>•India sees nearly 15 lakh new cancer cases annually, according to GLOBOCAN</p>.<p>•Less than 15-20 per cent of cancer cases are hereditary/familial in nature</p>.<p>•Obesity is a risk factor for development of almost 13 different types of cancer</p>.<p><em>(The writer is a consultant medical oncologist & haemato-oncologist at a Bengaluru hospital.)</em></p>
<p>As per GLOBOCAN (Global Cancer Observatory) estimates, every year there are close to 15 lakh new cancer cases in the country. One of the most common myths is that a majority of cancer cases are hereditary. The reality is that less than 15-20 per cent of cancer cases are hereditary/familial in nature and can be associated with genetic mutations, i.e errors in the genetic code/DNA that can be passed on from one generation to another</p>.<p>The etiology of cancer is multifactorial. Most risk factors of cancer are associated with the lifestyle choices one makes. One of the leading risk factor of cancer continues to be tobacco consumption, either in the form of smoking or other means. Smoking is not only a risk factor for lung cancer but cancers such as esophageal cancer, stomach cancer, cancer of the larynx and oral cavity, and intestinal cancers too. Alcohol is another risk factor for development of cancer particularly of the upper aero-digestive tract due to the presence of interactions of cancer causing agents called carcinogens and its impact on metabolism and other pathways. </p>.<p><strong>Obesity a risk factor</strong></p>.<p>Obesity and being over weight is a risk factor for development of almost 13 different types of cancer. Obesity leads to changes in metabolism particularly with insulin related pathways leading to a creation of a chronic inflammatory state leading to an increased risk of cancer. </p>.<p>On the other hand, physical activity reduces the risk of development of cancer. While the optimal level of physical activity is to be defined clearly for reduction of cancer risk, 150-300 minutes of moderate physical activity per week is associated with significant health benefits. Recent guidelines and studies have also shown that a structured exercise programme after surgery for colon cancer reduces the risk of recurrence of cancer.</p>.Indore: Upgrading its palate.<p><strong>Food choices need a close look</strong></p>.<p>The food one consumes and the choices that an individual makes plays a vital role in overall health and reduction of cancer risk. Processed meat has been classified as Group 1 carcinogen by the The International Agency for Research on Cancer (IARC). Increased intake of dietary fat has been associated with a decreased risk of colon cancer. One needs to understand that the food consumed plays a key role in modulating the gut health and the microorganisms present in the human gut (called the microbiome) which play a key role in modulating the inflammation and other pathways in the human body. Avoidance of ultra-processed and refined food, sugary drinks, excessive dietary fat and increasing consumption of a balanced diet with whole grains , fruits and vegetables, legumes would be beneficial for the gut health. </p>.<p>Amidst all this, one should not overlook the importance of good sleep and managing stress. Prolonged night time shift work and disruption of circadian rhythm in the human body can affect repair of DNA and lead to tumour growth. Avoidance of exposure to light form smart gadgets or bright light at least two hours before bed, limiting the number of consecutive night shifts and prioritising healthy sleep patterns along with a healthy diet and exercise would mitigate the risk for cancer.</p>.<p>Certain vaccines such as the HPV vaccine helps protect against infection with the Human Papilloma Virus (HPV) which is associated commonly with the development of cervical cancer. Vaccination against Hepatitis B virus helps reduce the chance of development of liver infection and inflammation which can lead to liver cancers.</p>.<p><strong>Genetic testing</strong></p>.<p>There are specific indications and guidelines as to who needs to get genetic testing for cancer done. Those who carry a risk factor for cancer because they have a hereditary cancer associated gene need to be aware of screening protocols and tests which can be carried out at regular intervals to detect cancer early. They should also consult their oncologist to understand the role of risk reduction surgeries which would prevent the cancer from occurring. A noted example being a famous Hollywood actress who underwent removal of both breasts and ovaries to reduce the risk of breast and ovarian cancer caused in those who carry a BRCA gene mutation.</p>.<p>Prevention and risk reduction begins with everyday choices. Lifestyle change is one of the most powerful cancer risk reduction tools that we have. Changing how one lives can change cancer outcomes. </p>.<p><strong>QUICK TAKES</strong></p>.<p>•India sees nearly 15 lakh new cancer cases annually, according to GLOBOCAN</p>.<p>•Less than 15-20 per cent of cancer cases are hereditary/familial in nature</p>.<p>•Obesity is a risk factor for development of almost 13 different types of cancer</p>.<p><em>(The writer is a consultant medical oncologist & haemato-oncologist at a Bengaluru hospital.)</em></p>