As reported recently by the BBC, a study by Oxford University has revealed that the cost of cancer exceeds £15bn a year in the UK. This is comprised of £7.6bn in economic costs, £5.6bn in health costs and £2.6bn for unpaid care (care provided by friends and family). For individual cancers, the greatest economic burden was attributed to lung cancer (£2.4bn a year), bowel cancer (£1.6bn), breast cancer (£1.5bn) and prostate cancer (£800m). Data such as this clearly drive home the monumental financial burden of cancer on this country, not just in terms of direct health care costs, but billions in lost earnings for patients and their families. And perhaps more harrowing, is that behind these stark and impersonal figures lies the real life stories of thousands upon thousands of people, whose lives have been blighted by this disease.
But when it comes to cancer prevention, we actually have more control over the odds of succumbing to this disease than you might think. An extensive report recently published concluded that nearly half (43%) of cancer cases in the UK are caused by lifestyle and environmental factors (1). This amounted to 134,000 new cases of cancer in 2010 that were potentially preventable. So, with our eye firmly on prevention, here are 10 things you can do to slash your cancer risk.
1. Don't smoke. Predictably enough, smoking tops the list of preventable lifestyle factors, and remains the single biggest risk factor for both men and women, still responsible for a staggering 20% (or 60,000 new cases in 2010) of cancer in the UK.
2. Maintain a healthy body weight. It's well versed knowledge that being overweight goes hand in hand with the risk of maladies such as heart disease and diabetes, but much less well known is the now strong links with cancer risk. Recent years has seen an increasingly clear picture emerge, which shows that weight gain, overweight and obesity increases the risk of numerous cancers, such as cancers of the oesophagus, pancreas, gallbladder, colon, breast (post-menopausal), endometrium and kidney (2). It offers yet another reason to beat the bulge.
3. Be physically active as part of everyday life. Just like our body weight, we don't immediately associate being physically active with cancer risk. Think again. Not only does physical activity protect against certain cancers (most notably colorectal cancer, but also breast and endometrial cancer), it also protects against weight gain, overweight and obesity (2). In reality this means being moderately physical activity (e.g. brisk walking) for at least 30 minutes daily. With improved fitness, the ultimate aim should be for 60 minutes or more of moderate, or 30 minutes or more of vigorous, physical activity daily.
4. Eat plenty of plant-based foods. Diets packed full of plant foods are associated with cancer protection. We're talking primarily about fruits and vegetables, wholegrains, pulses/legumes, nuts and seeds. Getting five-a-day fruit and veg should be regarded as the bare minimum when it comes to cancer protection. And to really big-up the intake of health-promoting and cancer protective 'phytochemicals', including a rainbow of brightly coloured fruits and vegetables, allium vegetables such as onions, leeks and garlic (rich in sulphur-containing compounds), cooked/processed tomatoes (rich in lycopene), cruciferous vegetables such as kale, broccoli and cabbage (rich in cancer protective compounds called glucosinolates), and green tea (rich in catechins) will all help to maximise the benefits of nature's pharmacy.
5. Limit intake of red meat and avoid processed meat. Red meat, and particularly processed meat are strongly linked with an elevated risk of bowel cancer. Processed meats should be kept to an absolute minimum, whilst intake of red meat should be kept to less than 500g (cooked weight) per week. In The Health Delusion, we describe several ways to make eating red meat safer. Two of those are using lower-temperature cooking methods (e.g. casseroles and stews) rather than high-temperature methods (such as frying, barbecuing and grilling), and marinating meat to reduce generation of harmful chemicals during cooking (for example with virgin olive oil, lemon juice, garlic, herbs and spices).
6. Limit alcoholic drinks. We might hear that a modest amount of alcohol has a protective effect against heart disease risk, but the evidence in relation to cancer tells a different story. In fact, there is no level of consumption below which there is no increase in risk of cancer. The authoritative World Cancer Research Fund/American Institute for Cancer Research diet and cancer report concluded that the evidence on cancer justifies a recommendation not to drink alcoholic drinks, but if they are consumed, to limit consumption to no more than two drinks a day for men and one drink a day for women (2).
7. Limit consumption of salt. Whilst we do need some salt, those with a penchant for processed, pre-prepared, fast foods and junk are almost definitely consuming too much. The consequences are an increased risk of stomach cancer.
8. Minimise highly processed, refined, and fast foods and sugary drinks. No surprises here, junk is bad. These sugary, fatty, highly processed offerings are high in calories yet nutrient depleted, meaning they are major culprits implicated in causing weight gain and obesity (itself a risk for cancer - see above). Not only that, but high intakes of sugary and refined 'beige' carbohydrate are high Glycemic Index (GI) foods, which are suspect when it comes to promoting the risk of some cancers.
9. Vitamin D and the big 'C'. Vitamin D, the 'sunshine vitamin', is in worryingly short supply across great swathes of the UK population, especially during the winter months (3). Evidence continues to mount that insufficient vitamin D is linked to increased risk of common cancers, such as bowel cancer (4). Maintaining a good level of vitamin D all year round should be an integral part of a multi-faceted cancer prevention strategy. As we've discussed in detail in The Health Delusion, whilst you can get your vitamin D through 'safe' sun exposure in the summer months, adults in the UK can achieve and maintain an ideal vitamin D level (20-32ng/ml) during the winter by supplementing 1,100-1,200 IU of vitamin D daily from October through to March.
10. Seek out selenium. The UK (and much of Europe for that matter) is a nation deficient in the important trace mineral, selenium, which impairs the body's in-built defence systems against cancer, amplifying our risk (5). Good dietary sources of selenium include fish, shellfish, meat, kidneys and liver, but even eating a balanced diet in the UK is unlikely to provide enough. Thus, for the typical British adult, a modest selenium supplement (50-60mcg per day for women, and up to 100mcg per day for men) will help to maximise the body's cancer defences.
(1) Parkin DM, Boyd L, Walker LC (2011) The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010 Br J Cancer 105 Suppl 2:S77-81
(2) WCRF/AICR (2007) Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective Washinigton DC: AICR
(3) Hypponen E, Power C. (2007) Hypovitaminosis D in British adults at age 45 y: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr. 85(3):860-8
(4) Gorham ED et al (2007) Optimal vitamin D status for colorectal cancer prevention: a quantitative meta analysis. Am J Prev Med. 2007 Mar;32(3):210-6.
(5) Rayman MP (2005) Selenium in cancer prevention: a review of the evidence and mechanism of action. Proc Nutr Soc 64(4):527-42.