All posts by Dr.Chirag Shah

Prevention of Cancer – 10 – Hygiene

                                         Prevention of Cancer PART – 10
(All the articles published in past are available at www.shyamhemoncclinic.com/blog/)
Question: In parts 8, 9 we covered risk factors for Breast Cancer primarily. But most of them apply to other several cancers as well. And several common non cancer diseases. 1. Only 5-10% of cancers are truly hereditary. Others are due to acquired factors. 2. Healthy lifestyle can overcome tendency of a partially bad gene. 3. Avoid whole genome profiles test, in healthy people, to predict risk of cancer or other diseases. These tests are as yet evolving. And likely to be more harmful by creating fear, rather than true guidance for what exact specific health measure to take. Ultimately, they will also advise overall healthy lifestyle.
We then stopped at a very intriguing point. Hygiene and cancer risk. Poor oral hygiene increases risk of not only oral cancer, but also Breast, Lung, Colon, Esophagus, Melanoma, and possibly Stomach as well.
Ans: Yes. Oral cancer is understandable, but how oral hygiene is important for other cancers and heart disease, stroke etc is very intriguing. Various periodontal bacteria, virus, and other microorganisms etc have been found in other organs with diseases. Such as heart, joints etc, apart from being found in cancers. Persistent low grade inflammation is a known risk factor as we know in some areas. For example, a sharp tooth edge brushing repeatedly against tongue can lead to tongue cancer over years.
Que: So, once again reminding our readers “Yes, Clean Mouth Teeth Gums prevent cancer!!!”
Ans: Well, importance of hygiene does not end here. Body is one ecosystem. This may not have been studied yet, but it is very likely that hygiene of other body parts is also important. These include skin as a whole, private parts, nose, ears. If there is any area of body that is not cleaned properly for a long time, just like mouth, it can also lead to collection of pathogenic organisms. These organisms can then create local inflammation and even enter rest of the body by way of blood, lymphatics, perineural spread etc. Many autoimmune disorders are also thought to be related to microorganisms.
Que: Any specific organisms identified related to cancer?
Ans: Yes, several. Many are already well known. For example, HPV – Human Papilloma Virus. We have spoken at length about this virus in our earlier series on cervix cancer, and oral cancer. Briefly, cervical cancer risk is almost wholly related to HPV. Not only that, as you know, a vaccine against HPV even reduces risk of cervical cancer to a significant extent. Same way HPV is linked to a large number of oral cancers in West. And hence they recommend vaccine there for boys too. Chewing tobacco is very uncommon in West. Hence their major known risk factor for oral cancer is HPV.
Que: How does one acquire HPV infection?
Ans: HPV infection is acquired primarily by sexual relationship. By vaginal, oral, or anal sex. Close sexual contact, even without having sex, can also lead to HPV infection. Having multiple sexual partners increases risk. Additionally, it is important to realize that condoms do not protect against HPV (unlike HIV).
Since HPV infection is asymptomatic, it can spread more easily without knowledge of either person involved in the relationship. One big risk factor for oral HPV infection is oral sex.
Que: So, once again HPV infection is a fairly preventable infection. In a way, related to lifestyle change.
Ans: Yes. As we define lifestyle, it is how we live and work, and our beliefs influence this in a big way. As our beliefs towards sexuality is changing, our practices are changing too. This has led to several new questions, infections is only one of them.
Apart from HPV, HIV is another major infection related to this same factor. HIV as you may know is also linked to several cancers. Some of these are well known, such as markedly higher risk of cervical cancer, Kaposi sarcoma, and several types of lymphoma. These are also known as AIDS defining cancers. But what most doctors may not know is that HIV also increases risk of about 20 other types of cancers. These include various skin cancers; cancers of penis, bladder, kidney, prostate; vulva, vagina, ovary; anal, liver, stomach, pancreas, esophagus; lung, head and neck, thyroid, brain.
Que: Really? I also knew only about Kaposi, cervical, lymphomas. But why these other cancers?
Ans: Well, that is a research in progress. But main reason is possibly immunosuppression. As we know, immune surveillance has a big role in prevention of most of the cancers. Once immunity is low, especially T cell mediated immunity, risk of several cancers can increase. Additionally, HIV patients have higher risk of other cancer causing viruses, mainly due to same behavioral risk factors. These viruses such as HPV, Hepatitis B, Hepatitis C, EBV, HHV 8 etc also can cause cancer themselves. HIV itself may have some direct effect in increasing cancer risk.
Que: Oh! So HIV is like a double risk. By itself it can do a lot of damage, but it kind of opens gates for other infections too. But what about role of “immune surveillance” in cancer prevention, that you just mentioned? What is the role of immunity in cancer prevention?
October 16, 2022

Dr Chirag A. Shah; M.D. Oncology/Hematology (USA), 9998084001. Diplomate American Board of Oncology and Hematology. Ahmedabad. drchiragashah@gmail.com www.shyamhemoncclinic.com

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