3 Tips on Cancer Prevention from an Oncologist

Dr. Sameer Baig, MD is a triple specialty physician, trained and certified in Hematology, Oncology, and Internal Medicine. Questions / Comments: Hello@SpecializedClinic.com.

TL;DR — Learn about your food and how to cook it, exercise every day, see your Personal Concierge Physician regularly — it’ll save your life, literally, and read the rest of this article for the what, why, and how!

Cancer is perhaps the most feared of all afflictions by both patients and physicians. Consequently, I often get asked what are the best ways to prevent cancers. In Medicine we have a saying, ‘an ounce of prevention is worth a pound of cure’. This couldn’t be more true in Oncology than any other discipline of Medicine. Global data from the World Health Organization shows us that 30-50% of all cancer cases are preventable.

Below are 3 strategies that are the most effective in preventing cancer with scientific data to back it up, which I’ve provided links to. These are the broad strokes that you can implement today, for individualized discussions you should talk to your personal Physician. There are a lot of quacks and snake oil salesmen out there trying to sell you products, supplements, fake ‘genetic’ tests etc— do not be fooled! 

  1. Lifestyle
  2. Energy balance
  3. Doctor-Patient Relationship* — the most interesting data, in my opinion.

Lifestyle

A common question I get is “How does Cancer occur?”. 

Thinking about formulaically: 

Cancer = Hereditary Genetics + Triggers + Chance.

Out of the variables I mentioned above, there’s only one you can realistically control — Triggers. Hereditary genetics are what you inherit from mom and dad, and there’s nothing you can do about that.  By and large most cancers are sporadic, meaning this is just a random accident of cellular division where a cell is now activated in such a way that it divides uncontrollably, and all the systemic brakes on cell growth have been compromised.

That leaves us with ‘Triggers’. Triggers for cancer are what your body gets exposed to e.g. Radon, Radiation, Cigarettes, Alcohol etc. They can be further divided into modifiable risk factors and non-modifiable risk factors. For the sake of this article we won’t delve too much into environmental exposures e.g. benzene, etc because this won’t be generalizable to the average person / population.

  • Tobacco & Nicotine.
  • Alcohol.
  • Inactivity.
  • UV Radiation.

Bottom line: Don’t use any nicotine products. Don’t drink alcohol. Don’t be a couch potato at work or at home. Use sunscreen, don’t go to tanning beds, and cover up when you’re at the beach (i.e. exposed to the sun).

Thank you for not smoking.

Smoking is bad for you - that’s not news. What I do want to change is the mindset of how we view smoking. There is a stigma around smokers and lung cancer patients that ‘they did this to themselves’. That is absolutely false — they are victims of bad government policies and a powerful tobacco industry.  Did you know that Nicotine is more addictive than cocaine and heroin? The latter two get more press because they kill their victims faster. However tobacco / nicotine definitely wins as the drug that causes the most human suffering over a lifetime, and also as the biggest contributor to medical care costs along with the American fast food industry. 

Nicotine addiction, be it cigarettes, cigars, vapes, hookah / shisha, chewing tobacco, or pipe smoking, is a disease like any other and should be treated as such. On average it takes an individual a dozen attempts to quit nicotine — this is normal! Quitting smoking requires a multi-modality approach and regular coordination with your Doctor. There are more options than you think and you should talk to your Doctor about the latest in nicotine cessation strategies.

No booze?!?

The 2020 to 2025 Dietary Guidelines for Americans advise no more than two drinks per day for males and one drink per day for nonpregnant females. However many Doctors feel that this guideline is tainted by bias from the Alcohol industry lobby, and that zero consumption of alcohol is the best policy. The advice of ‘zero alcohol’ is supported by a global study published in the medical journal The Lancet, which found that No Amount Of Alcohol Is Good For Your Health. However, I am a practical Doctor, and realize that alcohol plays an important role culturally. So I advise my patients that zero is best, occasional is reasonable. And I do mean occasional as in important occasions — not every Friday and Saturday night!

Be Active.

The human body was made to move. However in the modern world the reality is that our jobs are often sedentary. Leading a sedentary life independently increases the risk of many cancers as well as your chances of having a serious blood clot (venous thrombosis and pulmonary embolism, which are life threatening).  I recommend taking a walk and stretching in place every 2 hours while at work. What I’m describing is not exercise. These are ADLs (Activities of Daily Living) i.e. just moving around y’all! Exercise is discussed below.

Sun exposure and Tanning.

Tans may look good, but tanning can be deadly. Our bodies evolved in a world of sunlight. In fact the natural circadian rhythm of our bodies is regulated by sunlight exposure. However there are limits to what healthy sun exposure, and of course as humans we tend to over do it.

The working group of the International Agency for Research on Cancer found that tanning bed use in youth was associated with skin cancer and documented a 75% increase in melanoma for those who first used tanning beds in their twenties or teen years. Skin cancer doesn’t get a lot of press because the most common skin cancers — squamous and basal cell are highly curable and often don’t kill. Melanoma on the other hand must never be taken lightly, it does recur, it does metastasize, and most certainly without treatment will kill you. 

The American Academy of Dermatology recommends the use of sunscreen with an SPF of at least 30 during sun exposure. There are seasons and even hours of the day in which UV radiation exposure is higher and I recommend protecting sun-exposed areas of the body during those hours.

Energy Balance

We’re not talking about crystals, auras and chakras here.  What I mean is caloric energy balance = Diet + Exercise. Our bodies burn a fuel called ATP. However we do not store ATP, we generate it. What we do store are calories — as fat! So Energy Balance is simply the calories left over after energy expenditure. 

Bottom line: Learn how to cook your own food, and exercise every day for at least 30 minutes. Poor nutrition leads to weight gain = cancer gain. Walking is not exercise! Exercise is exercise. More exercise = less cancer. No exercise = more cancer.

Diet

Learn to Cook and Understand What You’re Eating.

For some reason they stopped teaching kids how to cook in school (home / economics). Now we have adults who don’t have the slightest idea how to feed themselves, and find “adulting” to be their single greatest challenge in life. This is a huge tragedy. Learning about your food, and how to prepare is a necessary life skill. Without it, you’re left defenseless to the hyenas of the American food industry who are bent on getting you addicted to the worst food.

Think about it, natural foods decay if not used quickly or stored properly. Now they’re saying this food in a box or a can can be stored for a year or longer? There’s a whole industry called Food Science, their job is to make the cheapest low quality food as addictive as possible. That is what you’re putting into your body.

As a rule of thumb, I tell my patients, “If It comes in a box or you can ‘cook’ it in a microwave – do not eat it!”. The implication of coming in a box is that it is highly processed, and likely has less nutrients and excess empty calories. The American Cancer Society agrees with me. The 2020 ACS guideline on diet and physical activity for cancer prevention recommends a healthy diet, which it defined as having a variety of vegetables (dark green, red and orange, fiber-rich legumes and others), fruits, and whole grains, and limiting or not including red and processed meats, sugar-sweetened beverages, or highly processed foods and refined grain products.

Oncologists love data, so here it is: In an analysis that evaluated 117 cohort studies which enrolled 209,597 cancer survivors, it was shown that a high-quality diet and a prudent, healthy dietary pattern was inversely associated with overall mortality among cancer survivors. Conversely, there was an increased association with overall mortality for those patients that ate a typical Western Diet.

Exercise

There is a TON of data demonstrating a direct link between being sedentary and increasing cancer risk, and numerous analyses showing that the more people exercised the less cancer they had. First, we should define what exercise is. I see a lot of patients that tell me that they exercise, and when I probe further, they proudly declare that they take morning walks everyday. While I am happy they’re enjoying their walks and are staying active, that is not exercise. 

There are a lot of medical definitions of exercise e.g. Training Heart Rate (THR) which is based on the linear relationship between heart rate (HR) and oxygen consumption (VO2) and calculated using the Karvonen Method. Or the Metabolic equivalent (MET) system estimates exercise intensity by comparing the VO2 during an activity with VO2 at rest. But the simplest and most practical definition of exercise is: Participating in an activity that elevates your heart rate to 85% of your Max Heart Rate sustained continuously over a minimum of 30 minutes every day.

Max Heart Rate = 220-Your Age.

I’m 34 years old, so 220 – Age 34 = Max Heart Rate of 186. To exercise with vigorous intensity I will need to achieve 85% of that which is 158 beats per minute sustained for at least 30 minutes daily. THAT is exercise.

So how good is exercise for you from a cancer prevention perspective? Well let’s look at the data!

  • In a meta-analysis of 52 studies, there was a 24 percent reduced risk of colon cancer when comparing the most versus the least active individuals.
  • Another meta-analysis evaluating 21 studies, found that there was a dramatic risk reduction in proximal and distal colon cancer. Proximal colon cancer risk was reduced by as much as 27% and distal colon cancer reduction was nearly identical at a 26% risk reduction.
  •  In another meta-analysis, increased physical activity was associated with a 16 percent reduction in the risk of developing adenomatous colon polyps.

The numbers speak for themselves. Exercise clearly provides protection against numerous cancers with the most compelling data being observed in colon and breast cancer risk reduction because these are more common and therefore studied in depth. There are other data showing similar benefits in prevention of bladder, kidney, lung, stomach, esophageal, prostate, endometrial, and pancreatic cancers.

Doctor-Patient Relationship

Maintaining a good relationship with your Doctor is the most important strategy, but often the most neglected one — and there’s data (you guessed it) to back that! Chances are the information above has not been discussed with most patients, or at least not in the way I’ve done it in this article. This is not the patient’s fault, this is not the Doctor’s fault. This is a failing of American Healthcare and the lawyers who (dys)regulate it and treat Doctors and patients like factory workers on an assembly line.

Bottom line: Your Doctor should be explaining cancer prevention, and providing you information on age appropriate cancer screening and anti-cancer vaccines.

Everyone should have a good primary care physician. I actually prefer to use the term personal physician — this is your go-to person for all things healthcare. They should be explaining routine healthcare and maintaining your health, treating acute medical problems and when needed coordinating your care with a sub-specialist like myself. Your personal physician should be advising you on cancer preventative measures such as HPV vaccination, age appropriate cancer screening e.g. , breast, colon, cervical, and lung.

A study published in the Journal of the American Medical Association November 14, 2022 looked at cancer-related outcomes of 245,425 patients in the Veterans Affairs health system. Specifically they were looking at cancer outcomes based on how much the patients saw their Doctor prior to their cancer diagnosis. The patients on the study were organized into three categories:

  1. Those that never saw their Doctor (0 visits)
  2. Those that saw their Doctors occasionally (1-4 visits) and
  3. Those that regularly saw their Doctors, including routine annual visits (5 visits).

The results were eye-opening. They found that patients that had more contact with their primary care physician had significantly better outcomes — decrease in Stage IV metastatic (incurable) disease at diagnosis for 11 out of 12 cancer subtypes, and reduction in cancer-related death for all 12 cancer subtypes studied.

As I said above, your Doctor should be spending time with you to review the information above, ensuring all age-appropriate cancer screening is happening and taking urgent action when needed. If they are not, you need to find a new Doctor who will. If you’re not in St Johns County, Florida, I am happy to help you find a physician, just shoot me an e-mail.

Remember, always demand to see a Medical Doctor (MD or DO after the name), it’s your right!

References:

Our healthcare system is broken

People are struggling to pay for their medical bills and insurance premiums, while pharmaceutical companies and insurance companies are reaping all the benefits. The problem