Cancer prevention: 7 tips to reduce your risk

Concerned about cancer prevention? Take charge by making changes such as eating a healthy diet and getting regular screenings.

By Mayo Clinic Staff

You've probably heard conflicting reports about cancer prevention. Sometimes a specific cancer-prevention tip recommended in one study is advised against in another.

Often, what's known about cancer prevention is still evolving. However, it's well-accepted that your chances of developing cancer are affected by the lifestyle choices you make.

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So if you're interested in preventing cancer, take comfort in the fact that simple lifestyle changes can make a difference. Consider these cancer-prevention tips.

 

1. Don't use tobacco

Using any type of tobacco puts you on a collision course with cancer. Smoking has been linked to various types of cancer — including cancer of the lung, mouth, throat, larynx, pancreas, bladder, cervix and kidney. Chewing tobacco has been linked to cancer of the oral cavity and pancreas. Even if you don't use tobacco, exposure to secondhand smoke might increase your risk of lung cancer.

Avoiding tobacco — or deciding to stop using it — is an important part of cancer prevention. If you need help quitting tobacco, ask your doctor about stop-smoking products and other strategies for quitting.

 

2. Eat a healthy diet

Although making healthy selections at the grocery store and at mealtime can't guarantee cancer prevention, it might reduce your risk. Consider these guidelines:

  • Eat plenty of fruits and vegetables.Base your diet on fruits, vegetables and other foods from plant sources — such as whole grains and beans.
  • Avoid obesity. Eat lighter and leaner by choosing fewer high-calorie foods, including refined sugars and fat from animal sources.
  • If you choose to drink alcohol, do so only in moderation The risk of various types of cancer — including cancer of the breast, colon, lung, kidney and liver — increases with the amount of alcohol you drink and the length of time you've been drinking regularly.
  • Limit processed meats. A report from the International Agency for Research on Cancer, the cancer agency of the World Health Organization, concluded that eating large amounts of processed meat can slightly increase the risk of certain types of cancer.

In addition, women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts might have a reduced risk of breast cancer. The Mediterranean diet focuses mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes, and nuts. People who follow the Mediterranean diet choose healthy fats, such as olive oil, over butter and fish instead of red meat.

 

3. Maintain a healthy weight and be physically active

Maintaining a healthy weight might lower the risk of various types of cancer, including cancer of the breast, prostate, lung, colon and kidney.

Physical activity counts, too. In addition to helping you control your weight, physical activity on its own might lower the risk of breast cancer and colon cancer.

Adults who participate in any amount of physical activity gain some health benefits. But for substantial health benefits, strive to get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic activity. You can also do a combination of moderate and vigorous activity. As a general goal, include at least 30 minutes of physical activity in your daily routine — and if you can do more, even better.

 

4. Protect yourself from the sun

Skin cancer is one of the most common kinds of cancer — and one of the most preventable. Try these tips:

  • Avoid midday sun. Stay out of the sun between 10 a.m. and 4 p.m., when the sun's rays are strongest.
  • Stay in the shade. When you're outdoors, stay in the shade as much as possible. Sunglasses and a broad-brimmed hat help, too.
  • Cover exposed areas. Wear tightly woven, loose fitting clothing that covers as much of your skin as possible. Opt for bright or dark colors, which reflect more ultraviolet radiation than do pastels or bleached cotton.
  • Don't skimp on sunscreen. Use a broad-spectrum sunscreen with an SPF of at least 30, even on cloudy days. Apply sunscreen generously, and reapply every two hours — or more often if you're swimming or perspiring.
  • Avoid tanning beds and sunlamps.These are just as damaging as natural sunlight.
 

5. Get vaccinated

Cancer prevention includes protection from certain viral infections. Talk to your doctor about vaccination against:

  • Hepatitis B. Hepatitis B can increase the risk of developing liver cancer. The hepatitis B vaccine is recommended for certain adults at high risk — such as adults who are sexually active but not in a mutually monogamous relationship, people with sexually transmitted infections, people who use intravenous drugs, men who have sex with men, and health care or public safety workers who might be exposed to infected blood or body fluids.
  • Human papillomavirus (HPV). HPV is a sexually transmitted virus that can lead to cervical and other genital cancers as well as squamous cell cancers of the head and neck. The HPV vaccine is recommended for girls and boys ages 11 and 12. The U.S. Food and Drug Administration recently approved the use of vaccine Gardasil 9 for males and females ages 9 to 45.
 

6. Avoid risky behaviors

Another effective cancer prevention tactic is to avoid risky behaviors that can lead to infections that, in turn, might increase the risk of cancer. For example:

  • Practice safe sex. Limit your number of sexual partners and use a condom when you have sex. The more sexual partners you have in your lifetime, the more likely you are to contract a sexually transmitted infection — such as HIV or HPV. People who have HIV or AIDS have a higher risk of cancer of the anus, liver and lung. HPV is most often associated with cervical cancer, but it might also increase the risk of cancer of the anus, penis, throat, vulva and vagina.
  • Don't share needles. Sharing needles with people who use intravenous drugs can lead to HIV, as well as hepatitis B and hepatitis C — which can increase the risk of liver cancer. If you're concerned about drug misuse or addiction, seek professional help.
 

7. Get regular medical care

Regular self-exams and screenings for various types of cancers — such as cancer of the skin, colon, cervix and breast — can increase your chances of discovering cancer early, when treatment is most likely to be successful. Ask your doctor about the best cancer screening schedule for you.

 
Nov. 28, 2018

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By ALEXANDRA SIFFERLIN 
December 7, 2015
TIME Health
For more, visit TIME Health.

Former President Jimmy Carter announced that he is “cancer-free” after undergoing treatment for melanoma, which spread to his liver and his brain.

On Sunday, Carter, 91, told a church group in Georgia that his physicians could not find any cancer in his scans. “My most recent MRI brain scan did not reveal any signs of the original cancer spots nor any new ones,” he said in a statement. Carter says he will continue taking his regular 3-week immunotherapy treatments of the cancer drug pembrolizuma, which has shown promise in the treatment of melanoma.

 

So what exactly does it mean to be “cancer-free”?

Not seeing any cancer on imaging tests is promising, but a physician cannot be 100% certain that means a cancer will not return. Even with potent treatments there’s a chance that cancer cells could survive and grow over time. As the American Cancer Society notes, this is why doctors will rarely say a person is “cured.” Instead, they may say things like, “The cancer can’t be seen on the scan” or “I see no evidence of any cancer.” Usually by two or three months of treatment a doctor can look to see how a person’s cancer is responding.

 

Not all cancers will recur, and if cancer cells do survive treatment it could take years before they develop into identifiable disease.

According to the National Institutes of Health (NIH), if someone remains in complete remission—meaning all signs and symptoms of cancer are gone—for five or more years, some doctors may say a person has been “cured.” Still, cancer cells could remain in the body for many years after treatment.

Carter started his treatment in August, which consisted of a combination of radiation and a newer drug. The drug he was given, pembrolizumab (brand name Keytruda), is part of a rapidly growing class of drugs called immunotherapy, which uses the body’s immune system to fight the cancer. The drug received accelerated approval by the U.S. Food and Drug Administration (FDA) for certain conditions in 2014. In general, immunotherapy works in different ways from chemotherapy. Some treatments work by enhancing the immune system overall and other treatments specifically target cancer cells.

 

Using the immune system as a weapon against cancer makes a lot of sense. The job of the immune system is to identify “foreign” substances in the body and attack them. This is how our body kicks a cold or the flu. However, the immune system has a harder time identifying cancer cells as foreign, sometimes due to the fact that they don’t appear different enough from normal cells or the immune system isn’t powerful enough to take on the cancer. By using different strategies to bolster the immune system, researchers can get the immune system to better recognize cancer cells and launch a stronger attack. Some researchers are also looking into how to harness the knowledge gained from immunotherapy to develop cancer vaccines.

Immunotherapy has proven effective for melanoma, the type of cancer for which Carter received treatment. Reuters reports that about 30% of people treated with pembrolizumab experience significant tumor shrinkage. About 5% go into complete remission.

For now, President Carter will continue part of his treatment as he announced, and his status will likely be regularly monitored.

 
 

Why some cancers come back

 
 
 

This page tells you about how cancer can sometimes come back after treatment. There is information about

Why cancer might come back

Cancer may come back some time after its initial treatment. This idea can be frightening. There are different reasons for why cancer might come back. 

One reason is that the original treatment did not get rid of all the cancer cells and those left behind grew into a new tumour. Another is that some cancer cells have spread to other parts of the body and started growing there to form a tumour.

After surgery

Cancer can come back after surgery because:

  • some cancer cells were left behind during the operation
  • some cancer cells had already broken away from the primary cancer but were too small to see (micrometastases )

Surgeons do their best to remove all of the cancer during surgery. But it is always possible to leave behind a small group of cancer cells. Your surgeon may recommend more treatment if they feel that there is a risk that the cancer could come back.

The extra treatment might be chemotherapy, radiotherapy, hormone therapy or a targeted cancer drug. These treatments aim to try to control or kill any cancer cells left.

You can read about surgery for cancer.  

After cancer drug treatment or radiotherapy

Cancer may sometimes come back after cancer drug treatment or radiotherapy. This can happen because the treatment did not destroy all the cancer cells. 

Chemotherapy drugs kill cancer cells by attacking cells that are in the process of doubling to form 2 new cells. But not all the cells in a cancer divide at the same time. Normal cells go into a long rest period between divisions. Cancer cells do too, although the rest period may be much shorter. 

Giving chemotherapy in a series of treatments helps to catch as many cells dividing as possible. Cells that were resting when you had your first treatment, may be dividing when you have your next and so will be more likely to die.

But it is unlikely that any chemotherapy treatment will kill every single cancer cell in the body. Doctors try to reduce the number of cancer cells as much as possible. The remaining cells will be killed off by the body's own defences (immune system) or may die off naturally.

You might find it helpful to read more about how chemotherapy works

Radiotherapy makes small breaks in the DNA inside the cells. These breaks stop cancer cells from growing and dividing and often make them die. Normal cells close to the cancer can also become damaged by radiation, but most recover and go back to working normally. If radiotherapy doesn't kill all of the cancer cells, they will regrow at some point in the future.

We have more information about radiotherapy treatment

Targeted cancer drugs work by 'targeting' those differences that help a cancer cell to survive and grow. Some treatments may get rid of a cancer completely. Others may shrink the cancer or control it for some months or years. So a cancer may seem to have gone and may not show up on any scans or blood tests. But there may be a small group of cells that remain in the body. They can start to grow again after a while or when the treatment stops.

You can read more about how targeted cancer drugs work

Cancers can become resistant to treatment

Sometimes cancer can become resistant to cancer drug treatment. Cancers develop from normal cells that have changed or mutated to become cancerous. The mutation  happens in the genes of the cell. These gene changes make the cell behave differently to a normal cell. Cancer cells can continue to mutate so that they become more and more abnormal.

Some mutations can make the cells resistant to cancer drugs such as chemotherapy, targeted cancer drugs or hormone therapy. If this happens, you can sometimes have a different type of treatment. But unfortunately, sometimes cancers develop resistance to many drugs at the same time. Doctors call this multi drug resistance. 

Scientists have found a group of genetic mutations that they think can cause drug resistance. These mutations mean that the cancer cell can keep the drugs out. The resistant cells have high levels of a substance called p-glycoprotein. P-glycoprotein is a protein found in cell walls. The protein acts as a pump and removes toxins from cells. Cells with high p-glycoprotein levels are very good at keeping cancer drugs out.

Researchers have been looking at drug resistance for almost as long as they have used cancer drugs. To make cancer drug treatment more effective, we need to find a way of overcoming resistance.

Cure or remission

These days, doctors are able to cure many cancers. But some cancers can come back many years after treatment. So you may find that your doctor is very unwilling to use the word 'cure', even though there is no sign that you have any cancer left. Doctors usually say that your cancer is in remission. This means that there is no sign of cancer in your body. If there are any cancer cells left:

  • there are too few to find
  • there are too few to cause any symptoms
  • they are in an inactive state and are not growing

Doctors can't be sure that the cancer has completely gone after treatment. So they may suggest that you have some type of long term treatment, such as hormone therapy or a targeted cancer drug. Your doctor may call this adjuvant treatment. 

Adjuvant treatment can also be a course of chemotherapy or radiotherapy after surgery. The aim of this treatment is to try to prevent cancer from coming back.

Living with uncertainty

It can be very difficult to live with the fact that your cancer may come back. Even if doctors tell you that they are 95% certain your cancer has gone for good, you may find it very upsetting that no one can say for sure that you're cured.

Some people find that they can't stop thinking about it even after the end of their treatment. You may feel a little frightened of planning anything in the future or you may feel sad or depressed.

For most people who are in this situation, each day lowers the risk of a recurrence. Most cancers that are going to come back will do so in the first 2 years or so after treatment. After 5 years, you are even less likely to get a recurrence. For some types of cancer, after 10 years your doctor may say that you are cured.

Unfortunately, some types of cancer can come back many years after they were first diagnosed. Some people find it very difficult to cope with this idea, but there are some things you can do to help. 

Getting help and support

You may find it helpful to talk to other people in the same situation if you are finding it hard to cope with the fact that you have had cancer. Or you could talk to a trained counsellor. This can help you to find ways of dealing with the fear and worry. 

You can get in touch with a counsellor by contacting one of the counselling organisations.

You can also look at our section about coping emotionally with cancer.

You can share your experiences with other people and find out how they coped by using our online forum, Cancer Chat.

Related information

You may find it helpful to read our information about how cancers grow.

We also have information about how cancer can spread.

You can read about cancer treatments.

6 December 2017
 
 

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CHICAGO (AP) — Most women with the most common form of early-stage breast cancer can safely skip chemotherapy without hurting their chances of beating the disease, doctors are reporting from a landmark study that used genetic testing to gauge each patient's risk.

The study is the largest ever done of breast cancer treatment, and the results are expected to spare up to 70,000 patients a year in the United States and many more elsewhere the ordeal and expense of these drugs.

"The impact is tremendous," said the study leader, Dr. Joseph Sparano of Montefiore Medical Center in New York. Most women in this situation don't need treatment beyond surgery and hormone therapy, he said.

The study was funded by the National Cancer Institute, some foundations and proceeds from the U.S. breast cancer postage stamp. Results were discussed Sunday at an American Society of Clinical Oncology conference in Chicago and published by the New England Journal of Medicine. Some study leaders consult for breast cancer drugmakers or for the company that makes the gene test.

MOVING AWAY FROM CHEMO

Cancer care has been evolving away from chemotherapy — older drugs with harsh side effects — in favor of gene-targeting therapies, hormone blockers and immune system treatments. When chemo is used now, it's sometimes for shorter periods or lower doses than it once was.

For example, another study at the conference found that Merck's immunotherapy drug Keytruda worked better than chemo as initial treatment for most people with the most common type of lung cancer, and with far fewer side effects.

The breast cancer study focused on cases where chemo's value increasingly is in doubt: women with early-stage disease that has not spread to lymph nodes, is hormone-positive (meaning its growth is fueled by estrogen or progesterone) and is not the type that the drug Herceptin targets.

The usual treatment is surgery followed by years of a hormone-blocking drug. But many women also are urged to have chemo to help kill any stray cancer cells. Doctors know that most don't need it, but evidence is thin on who can forgo it.

The study gave 10,273 patients a test called Oncotype DX, which uses a biopsy sample to measure the activity of genes involved in cell growth and response to hormone therapy, to estimate the risk that a cancer will recur.

WHAT THE STUDY FOUND

About 17 percent of women had high-risk scores and were advised to have chemo. The 16 percent with low-risk scores now know they can skip chemo, based on earlier results from this study.

The new results are on the 67 percent of women at intermediate risk. All had surgery and hormone therapy, and half also got chemo.

After nine years, 94 percent of both groups were still alive, and about 84 percent were alive without signs of cancer, so adding chemo made no difference.

Certain women 50 or younger did benefit from chemo; slightly fewer cases of cancer spreading far beyond the breast occurred among some of them given chemo, depending on their risk scores on the gene test.

WILL PEOPLE TRUST THE RESULTS?

All women like those in the study should get gene testing to guide their care, said Dr. Richard Schilsky, chief medical officer of the oncology society. Oncotype DX costs around $4,000, which Medicare and many insurers cover. Similar tests including one called MammaPrint also are widely used.

Testing solved a big problem of figuring out who needs chemo, said Dr. Harold Burstein of the Dana-Farber Cancer Institute in Boston. Many women think "if I don't get chemotherapy I'm going to die, and if I get chemo I'm going to be cured," but the results show there's a sliding scale of benefit and sometimes none, he said.

Dr. Lisa Carey, a breast specialist at the University of North Carolina's Lineberger Comprehensive Cancer Center, said she would be very comfortable advising patients to skip chemo if they were like those in the study who did not benefit from it.

Dr. Jennifer Litton at MD Anderson Cancer Center in Houston, agreed, but said: "Risk to one person is not the same thing as risk to another. There are some people who say, 'I don't care what you say, I'm never going to do chemo,'" and won't even have the gene test, she said. Others want chemo for even the smallest chance of benefit.

Adine Usher, 78, who lives in Hartsdale, New York, joined the study 10 years ago at Montefiore and was randomly assigned to the group given chemo.

"I was a little relieved. I sort of viewed chemo as extra insurance," she said. The treatments "weren't pleasant," she concedes. Her hair fell out, she developed an infection and was hospitalized for a low white blood count, "but it was over fairly quickly and I'm really glad I had it."

If doctors had recommended she skip chemo based on the gene test, "I would have accepted that," she said. "I'm a firm believer in medical research."

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Marilynn Marchione can be followed at @MMarchioneAP .

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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.