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Prevention of Cancer PART – 2

(All the articles published in past are available at

Question:  Last time we started a completely new topic – Prevention of Cancer. With increasing awareness, patients and family members routinely ask this question to family doctors. They are reading a lot in social and print media. How can a doctor guide them? This topic is mainly around Lifestyle, Bacteria in our body, Diet, Physical activity, Hygiene, Supplements, Obesity… We decided not to discuss tobacco which has been discussed in great detail earlier, and is clear to all as the number 1 cause of Cancer. around 30% of all cancer cases are due to tobacco. We also discussed that there is no one magic answer to prevent all cancers, since cancers are of over 250 types. And that one solution cannot fit all people. Also, most of the concepts of good health in general apply to cancer as well. And that we need to start cancer prevention efforts from CHILDHOOD, not after age 40 as most people do today.

Que: Can you elaborate this last point, since it is very provocative. About 90% of cancers are seen after age 40, and mainly after age 60. And yet you are saying that we need to start cancer prevention from childhood.

Ans: Yes. It is not a very difficult concept to understand. We do understand this in many other aspects of life. For example, we do know that for making a very good career by age 40-50, one needs to start from childhood with good school etc. We also know now that our Brain Development is largely determined by what happened in first about 5 years of life. Same is true for Health too. Earlier you start the better it is. If you start early, you gain a lot more with little efforts. Kind of like financial investment. However, nature does not close all options after childhood. Hence you can start late and yet gain good health, but the efforts have to be much more.

So what do we know about efforts in childhood and Cancer? This is a very complex and evolving field, but the simplest to understand is Diet and Physical activity. Role of Hygiene, Mental/Emotional health is less studied. We all have now started seeing cancers at much younger age. Not the acute leukemia or lymphomas traditionally also seen in childhood. I am talking about cancers like rectum, head and neck, breast, chronic myeloid leukemia, multiple myeloma and others. We are seeing patients in their 20s and 30s. These cancers were seen only in their 50s and 60s, and rarely 40s. This is terrible. What are the likely causes? It is a complex interplay of genetics, lifestyle, diet, activity, environment etc. However what we do know is that there are huge changes in Diet, and Physical activity of our children. Obesity in children is much more common now. Obesity itself is a risk factor for cancer. What are the possibilities and where can we intervene?

Diet: there is a lot more of so called “junk food” or fast food. A lot more of processed foods like biscuits, cereals, chips, chocolates, cakes, cheese…Eating food not cooked at home is very very common.

Activity: has reduced a lot due to various gadgets like television, mobile..; more prosperity hence maids, vehicles, elevators and other technology to reduce movements and manual work; more focus on career, less on informal outdoor play.

Obesity: a result of above two factors mainly. However, there are studies to suggest additional factors. For example, reduced hours and quality of sleep (yes reduced sleep not too much sleep!!!) adds to risk of obesity. Processed foods, soft drinks etc contain chemicals that alter hormone balance adding to obesity risk. For example, even if you are giving your children so called healthy low calorie snacks, chemicals they may contain could still make their metabolism like an older person. Something similar to someone in their 50s who gains weight easily even with less calorie intake! Information (quality and quantity) we add to our brains through eyes, ears.. also may impact obesity, by altering hormone balance. Sexually explicit material is much more available now to our children, than we did. This has not been studied much, but is a powerful factor that can alter hormone balance. And make children adults earlier in term of their hormones. Hence their risks also become like adults!

We have become a lot more lenient when it comes to disciplining our children. On practically all aspects, except probably focus on education, career. Even we did not know the value of these points as children, but our parents and grandparents ensured that we had reasonably good diet, activity, sleep, hygiene, and lifestyle in general.

This could be the starting point. Take charge of few things as listed below. Whether you are a parent or grandparent or uncle auntie… Start making small but important changes. Don’t try drastic changes. Make 10 percent improvement at one time. Wait for few weeks to months for next level.

Diet: take charge of kitchen. Make more dishes at home. Improve presentation, taste, and insist on eating these more often. At least one fruit a day. A little more of vegetables, salads. A little pickle, chutney etc to improve acceptance. Use little less sugar, cheese, salt, oil.. Reduce serving size of ice cream, processed foods, soft drinks. Reduce availability for all these foods, at home. Add a little bit of dry fruits every day like almonds, walnuts, cashews…And so on.. Give a little explanation, but insist more with love, with firmness. Home is not a Restaurant. Variety and taste can and should differ! Don’t be defensive.

We will see more tips next time, for other important changes as well. “How to eat” is also very important!!!

February 13, 2022 Dr Chirag A. Shah; M.D. Oncology/Hematology (USA), 9998084001. Diplomate American Board of Oncology and Hematology. Ahmedabad.

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