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4/30/2017 Lifestyle and Cancer Prevention 1 LIFESTYLE AND CANCER PREVENTION CANCER SCREENING SEMINAR Prevention & Early Detection Imam Reza Hospital Ali Soroush Department of Sports Medicine and Rehabilitation, KUMS 4/30/2017 Lifestyle and Cancer Prevention 2 CONTENTS Cancer as a Global Health Concern Healthy Lifestyle Unhealthy Lifestyle Lifestyle Risk Factors For Cancer Avoidable Cancer Risk Factors Recommendations 4/30/2017 Lifestyle and Cancer Prevention 3 REMEMBER! “IT IS TRUE THAT WE ALL HAVE TO DIE FROM SOMETHING, BUT THAT SOMETHING CAN BE OLD AGE” THE GOAL IS TO LIVE A LONG, FIRST-CLASS LIFESTYLE, FREE OF DISEASE 4/30/2017 Lifestyle and Cancer Prevention 4 Cancer? Cancer is one of the prevalent non-communicable diseases in developed and under-developed countries Bektas M, Kudubes AA. Developing scales for the assessment of fatigue in Turkish pediatric oncology patients aged 13-18 and their parents. Asian Pac J Cancer Prev. 2014;15(22):9891–8 4/30/2017 Lifestyle and Cancer Prevention 5 Cancer Statistics Cancer is the #1 cause of death among working-age adults in the United States. One-third are caused by tobacco use One-third are related to overweight/obesity, physical inactivity, and nutrition “Two-thirds of cancer deaths can be preventable” --John Seffrin, CEOAmerican Cancer Society 4/30/2017 Lifestyle and Cancer Prevention 6 Is cancer a big killer? Cancer kills more people than AIDS, malaria and TB combined Preventable and curable cancers will continue to kill millions of people worldwide 4/30/2017 Lifestyle and Cancer Prevention 7 WHAT IS CANCER ? A COMPLEX BIOLOGICAL PROCESS THAT MAY TAKE 10-40 YEARS BEFORE IT MANIFEST IT IS INFLUENCED BY YOUR LIFESTYLE STARTS OUT WITH DAMAGE TO A CELL CAN BE CAUSED BY BOTH EXTERNAL AND INTERNAL FACTORS 4/30/2017 Lifestyle and Cancer Prevention 8 STAGES OF CARCINOGENESIS INITIATION – DNA DAMAGED BY CARCINOGEN PROMOTION - CELL REPLICATION PROGRESSION - INCREASED GROWTH METASTASIS - TUMOR SPREAD 4/30/2017 Lifestyle and Cancer Prevention 9 Prevention of cancer! A cost-effective long-term strategy 30-40% of cancers can be prevented One-third of cancers can be cured through early diagnosis and treatment 4/30/2017 Lifestyle and Cancer Prevention 10 PRINCIPLES OF CANCER PREVENTION 1. DECREASE EXPOSURE TO CARCINOGENS 2. CHANGE INTERNAL ENVIRONMENT OF THE BODY SO THAT IT DOES NOT SUPPORT CARCINOGENESIS 4/30/2017 Lifestyle and Cancer Prevention 11 MOST IMPORTANT WEAPON TO PREVENT CANCER Lifestyle! Wright et al. Beliefs about weight and breast cancer: an interview study with high risk women following a 12 month weight loss intervention. Hereditary Cancer in Clinical Practice (2015) 13:1 4/30/2017 Lifestyle and Cancer Prevention 12 WHAT IS LIFESTYLE ? HOW WE LIVE OUR LIVES EVERYDAY 4/30/2017 Lifestyle and Cancer Prevention 13 THE POWER OF LIFESTYLE TO PREVENT CANCER 70% REDUCTION IN CANCER RISK HEALTHY DIET HEALTHY BODY WEIGHT REGULAR PHYSICAL ACTIVITY STOP SMOKING REDUCE STRESS ALCOHOL CONSUMPTION … 4/30/2017 Lifestyle and Cancer Prevention 14 SCIENTIFIC OBSERVATION (1970’s) 23 COUNTRIES WITH HIGH AND LOW CANCER RATES THE MORE ANIMAL PRODUCTS PEOPLE CONSUMED, THE GREATER THEIR RISKS OF COLORECTAL, BREAST, OVARIAN AND PROSTATE CANCER THE MORE FRUITS, VEGETABLES, WHOLE GRAINS AND FISH PEOPLE CONSUMED, THE LOWER THEIR RISKS OF CANCER PEOPLE WHO MIGRATED TOOK ON THE CANCER RISK OF THE COUNTRY TO WHICH THEY MIGRATED DOLL AND ARMSTRONG INT J CANCER, 1975:15, 617 4/30/2017 Lifestyle and Cancer Prevention 15 WORLD CANCER RESEARCH FUND (1997) INTERNATIONAL PANEL OF EXPERTS COMPREHENSIVE REVIEW OF 250 CASE CONTROL AND COHORT STUDIES OVERALL CONCLUSION: “THE GREATER THE CONSUMPTION OF FRUITS AND VEGETABLES THE LOWER THE RISKS OF CANCER OF THE MOUTH, PHARYNX, ESOPHAGUS, STOMACH, COLON, RECTUM AND LUNG” 4/30/2017 Lifestyle and Cancer Prevention 16 Cancer Risk Factors While you can’t change your genetics, there are many things you can do to lower your risk for cancer. 4/30/2017 Lifestyle and Cancer Prevention 17 Preventable risk factors Tobacco Obesity Physical inactivity Alcohol Sun exposure Infections Pollution …… 4/30/2017 Lifestyle and Cancer Prevention 18 ETIOLOGY The etiology of cancer is multifactorial, with genetic, environmental, medical, and lifestyle factors Most cancer is caused by genetic mutations 4/30/2017 Lifestyle and Cancer Prevention 19 RISK FACTORS! Old age Unhealthy lifestyle (Western lifestyle), Poor diet, lack of physical activity, or being overweight Environmental factors, defined broadly to include tobacco use, diet, sunlight and infectious diseases. Occupational carcinogens Radiation Family history of cancer (Genetic susceptibility) Alcohol Chemicals and other substance 4/30/2017 Lifestyle and Cancer Prevention 20 Risk Factor/ Cancer Type Cancer Type Risk Factor Lung Cancer Tobacco smoke Radon Asbestos and other substances Air pollution Breast Radiation Genetic changes (Inherited mutation) Colorectal Cancer polyp Genetic alteration Diet Cigarette smoking Ulcerative colitis or chon's disease Prostate Diet Certain prostate changes Race Africans Americans 4/30/2017 Lifestyle and Cancer Prevention 21 Risk Factor/ Cancer Type Cancer Type Risk Factor Liver Hepatitis viruses (HCV.HBV) Pancreas Smoking Diabetes Being male Chronic pancreatitis Kidney Tobacco smoking High blood pressure Von-Hippel-Lindau syndrome (VHL) Leukemia Radiation Chemotherapy Certain disease (Down syndrome) Human T cell leukemia virus Myelodysplatic syndrome 4/30/2017 Lifestyle and Cancer Prevention 22 Risk Factor/ Cancer Type Cancer Type Risk Factor Bladder Occupation Certain infection Tobacco smoking Race Twice as often as Africans Americans Treatment with cyclophosphamide or arsenic Uterine Endometrial hyperplasia Race Africans Americans Hormonal replacement therapy Obesity Melanoma Dysplastic nevi Fai skin Weakened immune system Sever blistering/Sunburn UV irradiation 4/30/2017 Lifestyle and Cancer Prevention 23 Source:http://ishwaryatechnosolutions.com/cancer.aspx Avoidable Cancer Risk Having a healthy diet, being physically active, and maintaining a healthy weight may help reduce cancer risk. Eat well: A healthy diet includes plenty of foods that are high in fiber, vitamins, and minerals. Also, a healthy diet means limiting foods high in fat Be active and maintain a healthy weight 4/30/2017 Lifestyle and Cancer Prevention 24 LIFESTYLE PA IS RECOMMENDED 4/30/2017 Lifestyle and Cancer Prevention 25 THE CANCERS ASOCIATED WITH DIET AND OVERWEIGHT BREAST (POSTMENOPAUSAL) UTERUS ESOPHAGUS COLORECTAL KIDNEY PROSTATE 4/30/2017 Lifestyle and Cancer Prevention 26 At Present, There Are No Nutritional Risk Factors for Brain Cancer Leukemias Ovarian cancer Source: American Cancer Society, accessed 2005 4/30/2017 Lifestyle and Cancer Prevention 27 Nutrition in the Etiology of Cancer– cont’d Complex relationship Dietary carcinogens: naturally occurring and added in food preparation and preservation Inhibitors of carcinogenesis: antioxidants, phytochemicals Enhancers of carcinogenesis Latency period between initiation and promotion 4/30/2017 Lifestyle and Cancer Prevention 28 Energy Intake, Body Weight, Obesity, and Physical Activity Energy restriction inhibits cancer and extends life span in animals Positive associations between overweight and cancers Overweight increases risk of cancer recurrence and decreases survival Physical activity is inversely associated with cancer 4/30/2017 Lifestyle and Cancer Prevention 29 Nutrition and Cancer Etiology Fat Protein Soy and phytoestrogens Carbohydrates: fiber, sugars, and glycemic index Fruits and vegetables Nonnutritive sweeteners 4/30/2017 Lifestyle and Cancer Prevention 30 Color Code System of Vegetables and Fruits Color Phytochemical Vegetables and Fruits Red Lycopene Red/purple Anthocyanins, polyphenols α-, β-carotene Tomatoes and tomato products, pink grapefruit, watermelon Berries, grapes, red wine, prunes Carrots, mangoes, pumpkin Cantaloupe, peaches, oranges, papaya, nectarines Spinach, avocado, honeydew, collard and turnip greens Cabbage, broccoli, Brussels sprouts, cauliflower Leeks, onion, garlic, chives Orange Orange/yellow β-cryptoxanthin, flavonoids Yellow/green Lutein, zeaxanthin Green Sulforaphanes, indoles White/green Allyl sulphides 4/30/2017 Lifestyle and Cancer Prevention 31 Data from Heber D: Vegetables, fruits and phytoestrogens in the prevention of diseases, F Postgrad Med 50:145, 2004. Guidelines for Cancer Prevention 1. 2. 3. 4. 5. 6. Choose a diet rich in a variety of plant-based foods. Eat plenty of vegetables and fruits. Maintain a healthy weight and be physically active. Drink alcohol only in moderation, if at all. Select foods low in fat and salt. Prepare and store food safely. And always remember . . . Do not use tobacco in any form. From American Institute for Cancer Research: Simple steps to prevent cancer, Washington, DC, 2000, AICR. 4/30/2017 Lifestyle and Cancer Prevention 32 Fat High intake of total and saturated fat is associated with increased risk of breast, colon, lung and prostate cancers High fat diets are associated with obesity, which is linked with cancer of the colon, rectum, esophagus, gall bladder, breast, endometrium, pancreas, and kidney Higher omega-3 vs omega 6 may reduce risk of breast cancer Low fat diet (<20% fat) may reduce risk of recurrence of breast cancer Trabert B, et al, 2015. Metabolic syndrome and risk of endometrial cancer in the united states: a study in the SEER-medicare linked database. Cancer Epidemiol Biomarkers Prev;24(1):261-7 . 4/30/2017 Lifestyle and Cancer Prevention 33 Serum Cholesterol Levels Abnormal serum cholesterol levels have been assigned as a risk factor for cancer But some studies show a discrepant result Mandal CC, et al. 2016. Is cholesterol a mediator of cold-induced cancer? Tumour Biol. 4/30/2017 Lifestyle and Cancer Prevention 34 β-carotene and α-carotene and lower breast cancer risk The data indicate that higher concentrations of plasma β-carotene and α-carotene are associated with lower breast cancer risk of estrogen receptornegative (ER-N) tumors. Bakker MF, et al.2016. Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr. 4/30/2017 Lifestyle and Cancer Prevention 35 Vitamin D Experimental evidence has suggested that vitamin D may be protective against tobacco-related cancers through the inhibition of the formation of tumors induced by tobacco carcinogens Deschasaux M, et al. 2015. Prospective associations between vitamin D status, vitamin Drelated gene polymorphisms, and risk of tobacco-related cancers.Am J ClinNutr. 2015 Nov;102(5):1207-15. 4/30/2017 Lifestyle and Cancer Prevention 36 Vitamin D So ensuring sufficient serum 25hydroxy vitamin D concentrations might play an important role in decreasing the risk of bladder cancer Zhao Y, et al. 2015. Comparative efficacy of vitamin D status in reducing the risk of bladder cancer: A systematic review and network meta-analysis. Nutrition.pii: S0899-9007(15)00475-X. 4/30/2017 Lifestyle and Cancer Prevention 37 Vitamin D Vitamin D deficiency appears to predispose individuals to increased risk of developing a number of cancers The current findings support the application of 1,25D3 in cancer prevention and treatment 4/30/2017 Ma Y, et al. 2016.Mechanistic Insights of Vitamin D Anticancer Effects.Vitam Horm;100:395-431. Lifestyle and Cancer Prevention 38 Energy Intake and Physical Activity Total energy intake is strongly associated with breast cancer in postmenopausal women Physical activity may have a protective effect Women who spent an average 3.8 hours per week in physical activities had lower risk of colon, reproductive cancers 4/30/2017 Lifestyle and Cancer Prevention 39 4/30/2017 40 Lifestyle and Cancer Prevention Chan DS,et al, 2014. Body mass index and survival in women with breast cancer-systematic literature review and metaanalysis of 82 follow-up studies. Ann Oncol;25(10):1901-14. Obesity and Cancer: Mechanisms Adipose tissue is an active endocrine organ Mechanisms by which adipose tissue may influence cancer risk - Production of sex steroid hormones (e.g., estrogen, androgen) - Effects on insulin sensitivity and production of insulinlike growth factors - Actions on other hormones in adipose tissue (e.g., leptin, adiponectin) - Increases in oxidative stress and chronic low-grade inflammation that affect the body’s immune response 4/30/2017 Lifestyle and Cancer Prevention 41 Protein Difficult to isolate effects of protein, since ↑ protein diets are ↑ in fat and ↓ in fiber Low protein diets seem to reduce the risk while the risk is increased by very high protein intakes Increased meat intake is associated with increased risk of colon cancer and advanced prostate cancer 4/30/2017 Lifestyle and Cancer Prevention 42 Fiber Fiber-rich diets are associated with a protective effect in colon cancer Higher intakes of vegetables were inversely associated with colon cancer risk in several studies 4/30/2017 Lifestyle and Cancer Prevention 43 Carbohydrate and Glycemic Index High glycemic-index diet associated with increased risk of cancers including ovarian, endometrial, breast, colorectal, pancreas, and lung Limit processed foods and refined sugars and emphasize whole grains and low GI foods 4/30/2017 Lifestyle and Cancer Prevention 44 Fruits and Vegetables Fruits and vegetables found to be associated with lower risk in 128 of 156 dietary studies Increased consumption of fruits and vegetables is associated with lower risk of cancers of the oral cavity, esophagus, stomach, colon, rectum, and bladder Evidence less strong for hormone-related cancers such as breast and prostate cancer 4/30/2017 Lifestyle and Cancer Prevention 45 Fruits and Vegetables Low in energy, good sources of fiber, vitamins, minerals Good sources of antioxidants (vitamins C, E, selenium) Good sources of phytochemicals such as carotenoids, flavonoids, plant sterols, allium compounds, indoles, phenols, terpenes) 4/30/2017 Lifestyle and Cancer Prevention 46 Calcium and Cancer Risk Several studies suggest that foods high in calcium may reduce the risk for colorectal cancer and that calcium supplements may reduce the formation of colorectal polyps Bottom line: get calcium through food sources 4/30/2017 Lifestyle and Cancer Prevention 47 Lycopene and Cancer Risk Lycopene is a red-orange carotenoid found in tomatoes and tomato-based foods Several studies show that consuming tomato products reduces the risk of some cancers Source: American Cancer Society, accessed 2005 4/30/2017 Lifestyle and Cancer Prevention 48 Preserved Meats and Cancer Risk preserved meat increases risk of colorectal and stomach cancers It could be due to nitrites Nitrites can be converted in the stomach to carcinogenic nitrosamines, which may increase the risk of stomach cancer Vegetables and fruit retard the conversion of nitrites to nitrosamines 4/30/2017 Lifestyle and Cancer Prevention 49 Cooked Meat and Cancer Risk Frying, broiling, and grilling meats at high temperatures creates chemicals that might increase cancer risk Use techniques such as braising, steaming, poaching, stewing and microwaving 4/30/2017 Lifestyle and Cancer Prevention 50 Soy and Cancer Risk Soy contains several phytochemicals (phytoestrogens) which have weak estrogen activity and appear to protect against hormone-dependent cancers in animal studies High doses of soy supplement may increase the risk of estrogen-responsive cancers, such as breast or endometrial cancers Breast cancer survivors should consume only moderate amounts 4/30/2017 Lifestyle and Cancer Prevention 51 Coffee and Tea Coffee has been investigated as a possible risk factor for a variety of cancers Regular drinking of green tea and other sources of polyphenols may reduce the risk of stomach cancer 4/30/2017 Lifestyle and Cancer Prevention 52 Hyperinsulinemia and Cancer Increased BMI may promote hyperinsulinemia and metabolic syndrome Insulin resistance/hyperinsulinemia, higher estrogen levels, and insulin-like growth factor I may act synergistically to promote tumor growth Gen kinger JM, et al. 2015. Central adiposity, obesity during early adulthood, and pancreatic cancer mortality in a pooled analysis of cohort studies. Ann Oncol. 2015 Nov;26(11):2257-66. 4/30/2017 Lifestyle and Cancer Prevention 53 Food Safety and Cancer Naturally occurring carcinogens (aflatoxins in peanuts, safrol in plant oils, tannins in grains and grapes, benzopyrene formed by smoking meat and fish) Naturally found in plant foods like celery, parsley, figs, mustard, pepper, citrus oils 4/30/2017 Lifestyle and Cancer Prevention 54 American Cancer Society Guide to Nutrition and Activity Choose whole grains in preference to processed (refined) grains and sugars. Choose whole grain rice, bread, pasta, and cereals. Limit consumption of refined carbohydrates, including pastries, sweetened cereals, soft drinks, and sugars. Choose fish, poultry, or beans as an alternative to beef, and lamb. 4/30/2017 Lifestyle and Cancer Prevention 55 Say Researchers “Our Chairs Are Killing Us” Physical inactivity is annually responsible for more than 3 million deaths worldwide 4/30/2017 56 Lifestyle and Cancer Prevention Physical Activity for Cancer Prevention A combination of aerobic AND resistance training 4/30/2017 57 Lifestyle and Cancer Prevention The Activity Pyramid Lifestyle activity is at the base of the pyramid because it is something that everyone can do on a regular basis. 4/30/2017 58 Lifestyle and Cancer Prevention PA RECOMMENDATIONS PA recommendations Walking as a PA recommendation 4/30/2017 59 Lifestyle and Cancer Prevention Benefits of Increasing Post-Diagnosis PA Need to encourage cancer survivors to maintain (if active prior to diagnosis) or increase physical activity after diagnosis. Physical activity is associated with numerous benefits – Decreasing adverse side effects of surgery and treatment – Improving quality of life and fatigue – Improving fitness, functional capacity, and body composition – Decreasing serum hormones and growth factors – Improving cancer-specific survival and all cause survival 4/30/2017 Lifestyle and Cancer Prevention 60 Stay physically active • • Adults: Get a least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week, spread throughout the week Children and adolescents: Get 60 minutes/day of moderate to vigorous physical activity each day, with vigorous activity at least 3 days/week 4/30/2017 Lifestyle and Cancer Prevention 61 Physical activity and Cancer: Critical for weight control, growth hormone regulation, stress management, counteract fatigue, support immune system , etc: New Guidelines from the Dept of Health & Human Services Minimum 150 min moderate, or 75 min vigorous to reduce risk of chronic disease Ideally aim for more – and necessary if weight loss and maintenance of loss is the goal – 300 min of moderate or 150 minutes of vigorous. Physical activity linked to lower risk of breast, prostate and colorectal cancer 4/30/2017 Lifestyle and Cancer Prevention 62 PA and Gastric Cancer The study concluded that a regular physical activity may be protective against stomach cancer risk Abioye AI, et al. 2015. Physical activity and risk of gastric cancer: a meta-analysis of observational studies. Br J Sports Med. 2015 Feb;49(4):224-9. 4/30/2017 Lifestyle and Cancer Prevention 63 Physical Activity during Chemotherapy A systematic review indicates that training during chemotherapy may help in preventing the decrease in muscle strength and endurance capacity Van Moll C,et al, 2016. The effect of training during treatment with chemotherapy on muscle strength and endurance capacity: A systematic review. Acta Oncol. 12:1-8.. 4/30/2017 Lifestyle and Cancer Prevention 64 Quality of Life and PA The patients who met public health physical activity recommendations had significantly higher quality of life (QoL) than those not meeting the guidelines. Murnane A, et al. 2015. Adolescents and young adult cancer survivors: exercise habits, quality of life and physical activity preferences. Support Care Cancer.;23(2):501-10. 4/30/2017 Lifestyle and Cancer Prevention 65 Maintain a healthy weight • • • • Know your body mass index (BMI): Below 18.5=underweight 18.5 to 24.9=normal weight 25.0 to 29.9=overweight 30.0 and above=obese 4/30/2017 Lifestyle and Cancer Prevention 66 BMI and Cancer Risk! BMI is statistically significant associated with colon cancer risk in men Overall BMI attained at adulthood was associated with colon cancer risk. Steins Bisschop CN,etv al. 2014. Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study. Am J Clin Nutr;99(1):139-47. 4/30/2017 Lifestyle and Cancer Prevention 67 Obesity Obesity can induce a suitable micro environment for the development of tumors, mainly by enhancing the levels of oxidative stress and the concentrations of hormones such as leptin, insulin and prolactin. all together, these factors increase the probability of cancer development. Herrera-Covarrubias ,et al, Obesity as a risk factor in the development of cancer, Rev Peru Med Exp Salud Publica. 2015 4/30/2017 Lifestyle and Cancer Prevention 68 Tobacco Tobacco kills more than 5 million people a year, an average of one person every six seconds It accounts for one in ten adult deaths worldwide Tobacco use, particularly smoking, is the single biggest cause of cancer in the world Responsible for many type of cancers including lung, mouth, throat, nose and sinuses, liver, pancreas, stomach, cervix, breast, bowel, kidney and bladder. van Osch FH, et al. 2015. Significant Role of Lifetime Cigarette Smoking in Worsening Bladder Cancer and Upper Tract Urothelial Carcinoma Prognosis: A Meta-Analysis. J Urol. 4/30/2017 Lifestyle and Cancer Prevention 69 Smoking and head and neck cancers The data suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers Wyss A,et al. 2013. Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Am J Epidemiol.;178(5):679-90. 4/30/2017 Lifestyle and Cancer Prevention 70 Stopping smoking Numerous studies have shown that stopping tobacco use and creating smoke free environments greatly reduces the risk of cancers and other short and long term health risks Stop smoking, chewing and sniffing tobacco Try to avoid exposure to passive smoke 4/30/2017 Lifestyle and Cancer Prevention 71 Alcohol consumption Alcohol abuse has a major impact on public health It is ranked as the fifth leading risk factor for premature death and disability in the world However, trends indicate an increase in alcohol consumption in recent decades, mostly in developing countries 4/30/2017 Lifestyle and Cancer Prevention 72 Excessive alcohol intake Can lead to: Weakening of heart muscle Hemorrhagic stroke Cirrhosis of the liver Pancreatitis Certain cancers Trauma Suicide Homicide 4/30/2017 Lifestyle and Cancer Prevention 73 Alcohol consumption Alcohol associated with carcinogenesis in cancers of the mouth, pharynx, larynx, esophagus, lung, colon, rectum, liver and breast Appears to act synergistically with tobacco Malnutrition associated with alcoholism may also be implicated Chuang SC,et al, 2015. Alcohol consumption and liver cancer risk: a meta-analysis. Cancer Causes Control.;26(9):1205-31 4/30/2017 Lifestyle and Cancer Prevention 74 Alcohol and cancer recurrence and mortality The data support that heavy alcohol use increases the risk of cancer recurrence and mortality Mayadev J, et al.2015.Alcohol Abuse Decreases Pelvic Control and Survival in Cervical Cancer: An Opportunity of Lifestyle Intervention for Outcome Improvement. American Journal of Clinical Oncology. 4/30/2017 Lifestyle and Cancer Prevention 75 Stop Alcohol Stop or Limit alcohol intake < 1 drink/day for women < 2 drinks/day for men Women who consume 1 drink or more/day have an increased risk of breast cancer (10-40% increased risk) 4/30/2017 Lifestyle and Cancer Prevention 76 Drinking alcohol The more alcohol a person consumes, the higher the risk Adequate folate intake (400mcg/d) may reduce the increased risk of breast cancer associated with alcohol use 4/30/2017 Lifestyle and Cancer Prevention 77 Drinking alcohol and smoking People who drink heavily in combination with smoking are even at higher risk for most of these cancers. 4/30/2017 Lifestyle and Cancer Prevention 78 THE POWER OF LIFESTYLE TO PREVENT CANCER 70% REDUCTION IN CANCER RISK with HEALTHY NUTRITION EXERCISE ONE-HOUR DAILY STOP SMOKING REDUCE STRESS 4/30/2017 Lifestyle and Cancer Prevention 79 PRINCIPLES OF CANCER PREVENTION 1. DECREASE EXPOSURE TO CARCINOGENS 2. CHANGE INTERNAL ENVIRONMENT OF THE BODY SO THAT IT DOES NOT SUPPORT CARCINOGENESIS 4/30/2017 Lifestyle and Cancer Prevention 80 Weight, Diet, PA and Cancer Prevention 4/30/2017 Lifestyle and Cancer Prevention 81 AICR GLOBAL REPORT RECOMMENDATIONS Take home messages Be as lean as possible without becoming underweight Be physically active Avoid sugary drinks Eat more of variety of vegetables, fruits, whole grains and legumes such as beans Stop or limit consumption of red and avoid processed meat 4/30/2017 Lifestyle and Cancer Prevention 82 AICR GLOBAL REPORT RECOMMENDATIONS (Cont) Take home messages If consumed at all, limit alcohol drinks Limit consumption of salty foods Don’t use supplements to protect against cancer Breastfeeding (reducing breast cancer in mom and obesity in child) Stop smoking Get screened for cancer 4/30/2017 Lifestyle and Cancer Prevention 83 Have a healthy lifestyle 4/30/2017 Lifestyle and Cancer Prevention 84